A scientific methodology course for advanced medical students: an eight-year perspective.

Background: Exponential increases in the development of medical knowledge, the expansion of areas where medicine develops its activities, the emergence of new pathologies ( e.g., COVID-19), novel diagnostic methods and therapeutic strategies, together with the appearance of multiple communication and information technologies, determined that the education of future physicians required targeted training in scientific methodology. Methods: The design and execution of a course in scientific methodology in the curriculum of Facultad de Medicina, Universidad de la República, Uruguay, is described. The course is carried out at an advanced stage of the medical studies for all the students, in which they develop a 10-month research project supervised by the medical school faculty. Students undergo all stages of a research endeavor: generation of hypothesis, elaboration of a research protocol, submission to the Research Ethics and Animal Welfare Committees, data recollection, analysis, interpretation and publication of the results. Results: The course is undertaken at the Facultad de Medicina, Universidad de la República, Uruguay, the main university of the country, with high numbers of students enrolled. The course involves the participation of 600 students and up to 300 professors per year, which implies a huge institutional effort Conclusions: The scientific methodology course resulted in one of the most important incorporations of the current 2008 curriculum. Local students, faculty and international evaluators have qualified this activity as an educational breakthrough, being a gratifying and productive experience. The course represented the first exposure of medical students to the research methodology, scientific literature and publication rules, and emphasized the dynamic nature of medical knowledge within modern medical education. Moreover, for some students it constituted the onset of academic research careers. An additional positive outcome was the reactivation of some faculty research projects, in a way that largely exceeded the boundaries of the course.

Percepciones estudiantiles sobre las propiedades del examen clínico objetivo estructurado en Uruguay. Disponiendo un cuestionario válido para analizar la factibilidad del nuevo formato durante la transición curricular / Student perceptions on properties of the objective structured clinical examination in Uruguay. The use of a valid questionnaire to analyse the feasibility of the new format during curriculum transition

INTRODUCCIÓN: Aunque el formato de examen clínico objetivo estructurado (ECOE) se aplica en Uruguay desde 2004 proveyendo medidas confiables de rendimiento, las percepciones sobre sus propiedades y el grado de satisfacción estudiantiles no han sido exploradas. OBJETIVO: La siguiente experiencia estuvo dirigida a evaluar la validez aparente del ECOE como aporte al estudio de su factibilidad local. MATERIAL Y MÉTODOS: Al final del ciclo propedéutico, la subcohorte cursando en el Hospital Universitario contestó un cuestionario de 28 ítems dirigido a explorar las percepciones sobre las propiedades del ECOE en los potenciales factores «diseño» y «validez aparente». Tras analizar su confiabilidad, se depuró el formulario para proveer una herramienta más breve y fiable. RESULTADOS: El cuestionario original mostró una confiabilidad aceptable (alfa de Cronbach = 0,70), dominando las opiniones de «acuerdo/total acuerdo» sobre autenticidad de los estímulos, dinámica, pertinencia y justicia del examen. Los estudiantes percibieron obstáculos organizativos durante la prueba, manifestando desacuerdo en incluir alguna estación dirigida a evaluar solamente habilidades para la comunicación y requiriendo instancias de devolución (feedback) personalizada. La versión depurada del cuestionario original provee medidas consistentes sobre las percepciones estudiantiles y resulta una herramienta útil que podría aplicarse extensamente. Se discuten los aportes de esta experiencia al estudio de la factibilidad del nuevo formato durante la transición curricular. CONCLUSIONES: El ECOE es bien evaluado por los estudiantes al final del ciclo propedéutico, lo que apoya su validez. Deben aprovecharse sus potenciales formativos proveyendo feedback efectivo a estudiantes, tutores clínicos e institución

INTRODUCTION: Although an objective structured clinical examination (OSCE) format has been applied in Uruguay since 2004, and providing reliable performance measures, perceptions of it properties and level of student satisfaction have not been determined. OBJECTIVE: To evaluate the face validity of OSCE format as a contribution to its local feasibility study. MATERIAL AND METHODS: At the end of the introductory clinical course, the sub-cohort enrolled at the University Hospital responded to a 28-item questionnaire aimed at exploring perceptions about the properties of the OSCE about the potential factors 'design' and 'apparent validity'. After analysing the reliability of the original questionnaire, the questionnaire was refined in an attempt to provide a shorter and more reliable tool. RESULTS: The original questionnaire showed good internal consistency (Cronbach Alpha = 0.70), with a dominance of 'agreement/total agreement' opinions on authenticity of the stimuli, dynamic, relevance, and equity of the test. Students perceived organisational obstacles during the test, expressing disagreement to include some stations only aimed at assessing communication skills, and requiring personalised feedback sessions. The refined version of the questionnaire provides consistent measures on student perceptions and is a useful tool that can be widely applied. A discussion is presented on the contributions of this experience to a comprehensive feasibility study of the new format during curriculum transition. CONCLUSIONS: The OSCE is well evaluated by students at the end of the propaedeutic course, supporting its validity. Educational potentials of the new format should be exploited, providing effective feedback to students, clinical teachers, and institutions

Teaching tobacco cessation to large student cohorts through train-the-trainers and problem based learning strategies.

BACKGROUND: Smoking is a leading cause of preventable deaths worldwide. Graduates of medical schools receive limited training on tobacco cessation and are ill-equipped to treat tobacco dependence. In this paper, we describe and present evidence from an educational intervention based on a train-the-trainers model and problem-based learning strategy aimed to educate a large number of first-year medical students on tobacco-related issues. METHODS: A survey assessing students' knowledge, attitudes and beliefs was conducted before and after educational intervention. Tobacco experts from the faculty staff, who are trained problem-based learning tutors, served as facilitators in the problem-based learning setting with 1000 medical students. RESULTS: Significant changes in knowledge and beliefs were observed. Items such as need for further training in cessation, importance, and effectiveness of brief advice showed significant variations after the educational intervention. DISCUSSION: Educational intervention based on a train-the-trainers and problem-based learning approaches are feasible and effective to educate a large cohort of first-year medical students in tobacco issues. Further research is needed to find out whether this intervention improves overall patient care management.

Medicina basada en evidencia en laformación de grado: experiencia de enseñanza en un laboratorio de habilidades clínicas / Evidence based medicine in the graduates training: teaching experience in a clinical skills laboratory

Introducción: la Facultad de Medicina se encuentra transitando un proceso de reforma en su plan de estudios. En esecontexto se desarrollaron experiencias piloto destinadas a mejorar la formación de los estudiantes e incorporar innova-ciones educativas. Entre estas, el desarrollo de un laboratorio de habilidades clínicas, una de cuyas áreas fue la enseñanza de la medicina basada en evidencias (MBE).Objetivo: describir la experiencia del curso de MBE, sus principales fortalezas y debilidades. Material y método: un total de 230 estudiantes de los cursosclínicos se incorporaron a esta experiencia piloto. De estos, se conformó una cohorte de 80 estudiantes que fueron evaluados sobre el conocimiento y uso de las bases de datos biomédicos, aplicabilidad de los contenidos y nivel de satisfacción con el curso. Asimismo, se evaluó la opinión de los tutores participantes del curso.Resultados: antes del curso la mayoría de los estudiantes encuestados no conocían las principales bases de datos de información biomédica. En relación con la aplicabilidad, fue evaluada como buena o muy buena por 37 estudiantes(46,8%), satisfactoria por 26 (33%) y no aplicable por 16 (20,2%). El cumplimiento de las expectativas fue evaluado como bueno o muy bueno por 28 estudiantes (35,4%), satisfactorio por 39 (49,3%) y no satisfactorio por 11 (15,3%). Todos los tutores consideraron la experiencia como buena o muy buena. Conclusiones: la experiencia fue ampliamente satisfactoria, sugiriendo que la incorporación de la enseñanza de la MBEen los cursos de grado puede resultar favorable para los estudiantes.

Introduction: the School of Medicine is undergoing a reform process of its studies plan. Within this context,pilot experiences were devised geared to improving the training of students and incorporating educational innovations. Among these experiences we find the creation of a clinical skills laboratory which includes the teaching of evidence based medicine. Objective: to describe the weaknesses and strengths of the evidence based medicine course.Method: a total of 230 students of the clinical courses were included in this pilot experience. Out of these, an 80 student cohort group was formed to be evaluated on knowledge and the use of biomedical data, the applicability of contents and the level of satisfaction of the course. Likewise, the opinion of the tutors participating in the course was evaluated. Results: before the course most students in the survey did not know the main biomedical information data bases. In terms of applicability, it was evaluated as good or very good by 37 students (46.8%), satisfactory by 26(33%) and not applicable by 16 (20.2%). Meeting the expectations was seen as good or very good by 28 students (35.4%), satisfactory by 39 (49.3%) and non-satisfactory by 11 (15.3%). All tutors regarded theexperience as good or very good.Conclusions: the experience was highly satisfactory, what suggests the inclusion of evidence based medicine in the graduate courses may be positive forstudents.

Introdução: no contexto da reforma do programa de ensino da Faculdade de Medicina da Universidad de la República, foram realizadas experiências piloto com o objetivo de melhorar a formação dos estudantes e incorporar inovações educativas. Entre estas a criação de umlaboratório de habilidades clínicas no qual uma das áreas desenvolvidas foi a medicina baseada na evidencia (MBE).Objetivo: descrever a experiência do curso de MBE, suas fortalezas e debilidades. Material e método: 230 estudantes dos cursos clínicos foram incorporados a esta experiência piloto. Uma coorte de 80 estudantes foi avaliada sobre o conhecimento e uso das bases de dados biomédicos, aplicabilidade do conteúdo das mesmas e o nível de satisfação com o curso. A opinião dos tutores participantes docurso também foi avaliada.Resultados: antes do inicio do curso a maioria dos estudantes entrevistados não conheciam as principais bases de dados de informação biomédica. A aplicabilidade destas foi avaliada como boa ou muito boa por 37 estudantes (46,8%), satisfatória por 26 (33%) e não aplicável por 16 (20,2%). A satisfação das expectativas foi avaliada como boa ou muito boa por 28 estudantes (35,4%), satisfatória por 39 (49,3%) e não satisfatória por 11 (15,3%). Todos os tutores consideraram a experiência como boa ou muito boa.Conclusões: a experiência foi satisfatória, sugerindo que a incorporação da MBE nos cursos de graduação pode ser favorável para os estudantes.