Efecto de la implementación de un nuevo plan de estudios en la percepción del ambiente educativo en los estudiantes de la Facultad de Medicina de la Universidad Nacional Autónoma de México / Effect of the implementation of a new curriculum in the perception of the educational environment in students of the Faculty of Medicine of the National Autonomous University of Mexico

Introducción. El Plan de Estudios 2010 de la Facultad de Medicina de la Universidad Nacional Autónoma de México plantea un proceso de evaluación continuo que involucra múltiples factores, como profesores, compañeros o pares, así como las expectativas que los estudiantes tienen de su proceso de aprendizaje. El ambiente educativo es muy importante para el logro de los objetivos educacionales de este plan y por lo mismo repercute en el éxito académico y en la motivación de los estudiantes. Sujetos y métodos. El cuestionario Dundee Ready Education Environment Measure (DREEM) evalúa la percepción del aprendizaje, la percepción de los profesores, la autopercepción académica, la percepción del ambiente y la autopercepción social. Se aplicó a una cohorte inicial de 755 estudiantes y se hizo el seguimiento anual durante los primeros cuatro años de la carrera. Resultados. Se aplicó un total de 2.288 cuestionarios en los cuatro años de la carrera de medicina. Los resultados de primero, tercero y cuarto años se interpretan como un ‘ambiente educacional con aspectos más positivos que negativos’, y el segundo año, con una puntuación total de 74,2, como un ‘ambiente educacional con muchos problemas’. Conclusiones. Conforme a los resultados cualitativos y cuantitativos encontrados en la aplicación de la encuesta DREEM, se ponen en evidencia las áreas de oportunidad y posiblemente algunas fortalezas con las que cuenta el Plan de Estudios 2010. Estos hallazgos invitan a líneas de investigación que den seguimiento a este plan a los seis años de su implementación y ejecución (AU)

Introduction. The Curriculum 2010 of the Medical Faculty of the National Autonomous University of Mexico poses a continuous assessment process involving multiple factors such as teachers, companions or peers, as well as expectations that students have of their learning process. The educational environment is very important for achieving the educational objectives of this plan and therefore affects academic success and motivation of students. Subjects and methods. The questionnaire Dundee Ready Education Environment Measure (DREEM) assesses: perception of learning, perception of teachers, academic self-perception, perception of the environment and social self-perception. It was applied to an initial cohort of 755 students, making the annual monitoring during the first four years of the career. Results. A total of 2288 questionnaires were applied in the four years of medical school. The results demonstrate first, third and fourth years are interpreted as ‘educational environment with more positives than negatives’ and the second year with a total score of 74.2 as an ‘educational environment with many problems’. Conclusions. According to the qualitative and quantitative results in the application of the DREEM survey, highlights the areas of opportunity and possibly some strength that comprise the Curriculum 2010, these findings lead to research to follow up this Curriculum to 6 years of implementation and execution (AU)

Development and implementation of a biomedical informatics course for medical students: challenges of a large-scale blended-learning program.

Biomedical informatics (BMI) competencies are recognized as core requirements for the healthcare professional, but the amount of BMI educational interventions in the curricula of medical schools is limited. UNAM Faculty of Medicine in Mexico is a large public medical school, with more than 7000 undergraduate students. The undergraduate program recently underwent a major curricular revision, which includes BMI education. Two one-semester BMI courses (BMI-1 and BMI-2) were designed, with a blended-learning educational model. A department of BMI was created, with budget, offices and personnel. The first class of 1199 students started the course in 2010, with 32 groups of 40 students each. BMI-1 includes core conceptual notions of informatics applied to medicine (medical databases, electronic health record, telemedicine, among other topics), and BMI-2 embodies medical decision making and clinical reasoning. The program had a positive evaluation by students and teachers. BMI can be successfully incorporated in a large-scale medical school program in a developing country, using a blended-learning model and organizational change strategies.

Examen Clínico Objetivo Estructurado como instrumento para evaluar la competencia clínica en Pediatría. Estudio piloto / Objective Structured Clinical Examination as an instrument for evaluation of clinical competence in pediatrics. A pilot study

Introducción. La evaluación es un componente esencial del proceso enseñanza-aprendizaje que motiva y dirige al alumno hacia sus objetivos y permite a los docentes conocer si los educandos poseen la destreza y el grado de conocimientos necesarios para una práctica profesional competente. En medicina no existe el método ideal de evaluación, por eso se recomienda el uso de diversos instrumentos como el Examen Clínico Objetivo Estructurado (ECOE) que ha mostrado su utilidad para evaluar las destrezas clínicas. El objetivo de este trabajo fue describir la experiencia de docentes y alumnos en la elaboración y la aplicación de un ECOE en un hospital pediátrico. Métodos. Se preparó un ECOE de 20 estaciones que se aplicó en un estudio piloto a 20 alumnos (2 residentes de primer año, 7 de segundo y 11 de tercero). Para cada estación se definieron los criterios de evaluación y el punto de corte. Con los datos obtenidos se calcularon los promedios por estación y por año de residencia. Resultados. El ECOE se llevó a cabo durante 2 horas con 20 minutos. Las estaciones aprobadas por los alumnos, de manera global, fueron doce. El valor promedio de las 20 estaciones fue 6.53, con una desviación estándar (DE) de 0.62 [R1 = 6.13 (DE 0.43), R2 = 6.26 (DE 0.60) y R3 = 6.76 (DE 0.59)]. Conclusiones. El ECOE es un método válido y confiable que permite evaluar la competencia clínica de manera integral. La experiencia de su uso en programas de posgrado ha sido limitada; sin embargo, el presente estudio muestra que es una herramienta factible que puede resultar de gran valor tanto para los pediatras en formación como para sus profesores.

Background. Assessment is an essential component of the teaching-learning process that stimulates and leads learners towards their goals and allows teachers to ascertain whether the students have acquired the necessary knowledge and clinical skills to be professionally competent. In medicine, the ideal assessment method does not exist; therefore, the use of several assessment instruments is advised; among them, the Objective Structured Clinical Examination (OSCE) has proven its advantage assessing clinical skills. The aim of this work is to describe the experience of teachers and learners developing and applying an OSCE in a children's hospital. Methods. Twenty OSCE stations were designed and applied in a pilot study. The assessment criteria for each station were defined. Individual marks were recorded and means for each station and year of residency were calculated (two first-year residents, seven second-year residents and 11 third-year residents). Results. The OSCE lasted 2 h and 20 min. Overall, 12 stations were accredited. The overall mean was 6.53, standard deviation (SD) 0.62; the mean for first-year residents was 6.13 (SD 0.43), for second-year residents 6.26 (SD 0.60) and 6.76 for third-year residents (SD 0.59). Conclusions. The OSCE isa valid and reliable method that permits an integral evaluation of clinical competence. The experience with this instrument has been limited to assessing postgraduate students. This study, however, shows that it is a useful tool that may be valuable for resident pediatricians and their professors.

The resident-as-teacher educational challenge: a needs assessment survey at the National Autonomous University of Mexico Faculty of Medicine.

BACKGROUND: The role of residents as educators is increasingly recognized, since it impacts residents, interns, medical students and other healthcare professionals. A widespread implementation of resident-as-teacher courses in developed countries' medical schools has occurred, with variable results. There is a dearth of information about this theme in developing countries. The National Autonomous University of Mexico (UNAM) Faculty of Medicine has more than 50% of the residency programs' physician population in Mexico. This report describes a needs assessment survey for a resident as teacher program at our institution. METHODS: A cross-sectional descriptive survey was developed based on a review of the available literature and discussion by an expert multidisciplinary committee. The goal was to identify the residents' attitudes, academic needs and preferred educational strategies regarding resident-as-teacher activities throughout the residency. The survey was piloted and modified accordingly. The paper anonymous survey was sent to 7,685 residents, the total population of medical residents in UNAM programs in the country. RESULTS: There was a 65.7% return rate (5,186 questionnaires), a broad and representative sample of the student population. The residents felt they had knowledge and were competent in medical education, but the majority felt a need to improve their knowledge and skills in this discipline. Most residents (92.5%) felt that their role as educators of medical students, interns and other residents was important/very important. They estimated that 45.5% of their learning came from other residents. Ninety percent stated that it was necessary to be trained in teaching skills. The themes identified to include in the educational intervention were mostly clinically oriented. The educational strategies in order of preference were interactive lectures with a professor, small groups with a moderator, material available in a website for self-learning, printed material for self-study and homework, and small group web-based learning. CONCLUSIONS: There is a large unmet need to implement educational interventions to improve residents' educational skills in postgraduate educational programs in developing countries. Most perceived needs of residents are practical and clinically oriented, and they prefer traditional educational strategies. Resident as teachers educational interventions need to be designed taking into account local needs and resources.