[A comparative study between two academic working environments in residents of family medicine]. / Satisfacción de los residentes de medicina familiar con el ambiente académico laboral.

OBJECTIVE: To compare the satisfaction level in the academic working environments (AWE) between the residents of two training primary care units. METHODS: Observational, transversal and comparative study. A previously constructed and validated instrument was applied, it included 30 items that evaluated the AWE with the following indicators: support, satisfaction, participation and respect; the reliability index's instrument was high (Cronbach's alpha is 0.88). The statistical analysis was made with the Mann-Whitney U test, and χ2 test for proportions. RESULTS: Regarding the AWE, 4.28% of the residents obtained a really inappropriate environment; 8.57% very appropriate and 14% inappropriate environment. However the 72% was between intermediate environments. No statistical significant difference was found between the three measurements. CONCLUSIONS: Our results are consistent with other national studies results where the "respect" indicator was the one with higher rank. The environment along with "participation," and "support," creates a favorable relationship among residents, teachers and the staff. However, the "imposition" and "rigidity" produces a decrease in the collective participation.

[An educational position development in medicine teachers]. / Desarrollo en profesores, de una postura ante la educación.

BACKGROUND: From a participative educational position view, enhancement of the teaching is subjected to the fact that mentors had though about conditions and circumstances that determine their performance and to get a solid position that guides them into overcoming their day-to-day trouble burden. Our objective was to measure effects of a participative educational strategy that motivates critical evaluation in the development of a position on education; seven groups of teachers were compared. METHODS: Through a longitudinal comparative intervention design, 71 students (mentors) coming from seven educational interventions, were studied, during a period from 2002 to 2005. RESULTS: Differences between previous and posterior to educational process measuring were statistically significant in favor of the development of a position in all the groups (Wilcoxon p < 0.01); 68 out of 71 mentors developed a position on education. CONCLUSIONS: A participative educational strategy consolidated a personal position, resulting from the reflexive activity of the mentor.

[Further than learning contents, developing skills]. / Desarrollo de aptitudes, más allá del aprendizaje de contenidos.

OBJECTIVE: To evaluate the scope of an educational strategy for developing an aptitude for critical reading of educational research information (CRERI) and for clinical research information (CRCRI). METHODS: A longitudinal, intervening, comparative study was performed on seven groups with educational interventions that promote development skills rather than learning contents. This was evaluated through two instruments that measure skills for critical reading information from educational and clinical investigation reports. RESULTS: Significant differences were encountered favorable to CRCRI, among the initial and final evaluation of students in a whole manner (p < 0.001). Group analysis showed differences until the end of educational interventions in three of them (p < 0.01). CONCLUSIONS: The educational strategy had two favorable effects on the CRCRI; nevertheless the educational interventions were solely aimed at promoting CRERI. The extension from one to another aptitude was shown to be independent of contents. This strategy can be an alternative for encouraging students to self-learning, which leads to a better usage of available information sources.

[Is epistemological meditation a feature of scientific activity?]. / La reflexión epistemológica es una característica de la actividad científica?

INTRODUCTION: In research activities, critical thinking about mechanisms that control the selection of certain knowledge forms and correlative practices are unusual. OBJECTIVE: To compare the levels of epistemological meditation in professional groups with different grades of expertise in research field. METHODS: Prolective, comparative, cross-sectional study by means of validated questionnaire that measure posture (consistence in points of view about diverse scientific conceptions and activities), main indicator of epistemological meditation level. Three groups were included: 25 professional biomedical researchers (group "A"), 22 postgraduate professors of health sciences (group "B") and 16 postgraduate students of social sciences (group "C"). RESULTS: Most participants showed low scores in posture with not significant differences between groups (p > 0.05). However, group "B" after an educational intervention, showed significant increase in consistence points of view (p < 0.01). DISCUSSION: Epistemological meditation about scientific work is not a feature of research activities in studied groups. The grades of expertise in research field do not have influence in posture development.

Valoración global de la aptitud clínica de médicos familiares en el manejo de la diabetes mellitus con nefropatía inicial / Clinical aptitude of the family doctors front of sick patients with diabetes type two with initial nephropathy

The diabetic nephropathy in initial phase requires an opportune identification by family physicians. Indeed, they should be qualified to interpret the data that suggesting that a patient be going through that phase of the illness, in order to orientate the management and processing of the same one, from an integrative perspective. The purpose of this work was to measure the aptitude of the family doctors to interpret, to judge and to propose in front of sick patients with diabetes type two with initial nephropathy. We made this with a representative sample of family physicians in five Family Medicine Units of the Instituto Mexicano del Seguro Social in the city of Guadalajara, Jalisco, Mexico. The main variable of the study was the clinical aptitude of the doctors: interpretation, judgment and proposals carried out in the practice of their profession; and through an ordinal scale, levels of aptitude were defined, which related to the remainder of variables using the medium, Kruskal Wallis stadiometer and x2.

La nefropatía diabética en etapa inicial requiere de una oportuna identificación por parte de los médicos familiares. De hecho, ellos deberían estar capacitados para interpretar los datos que sugieren que el paciente está cursando esa etapa de la enfermedad, con el objetivo de orientar el manejo y tratamiento de la misma desde una perspectiva integradora. El propósito del presente trabajo fue medir la capacidad de aptitud clínica del médico, frente al caso clínico de un enfermo con diabetes tipo 2 con nefropatía inicial. Con este fin se utilizó un instrumento estructurado y validado, en una muestra representativa de 101 de 450 médicos familiares en cinco de veintitrés Unidades de Medicina Familiar del Instituto Mexicano del Seguro Social en la Ciudad de Guadalajara, Jalisco, elegidos por conglomerados en dos etapas. La principal variable de estudio fue la aptitud clínica de los médicos definida como la capacidad de interpretación, evaluación y propuestas que éstos realizan en la práctica de su profesión (indicadores de factores de riesgo, integración diagnóstica, uso de paraclínicos y recursos terapéuticos). Los niveles de aptitud se definieron a través de una escala ordinal y se relacionaron con el resto de variables utilizando la mediana, el estadígrafo de Kruskal Wallis, y la x2. La mediana de la aptitud clínica fue de 73 con rango de 18 a 113, al relacionar entre las unidades de atención médica. Con el resto de variables de estudio no se demostró diferencia estadísticamente significativa. Se concluye que 8% de los médicos familiares reúne la aptitud para el manejo de la nefropatía inicial del diabético 2.

[Clinical aptitude of family doctors in the management of patients with diabetes type two with initial nephropathy]. / Valoración global de la aptitud clínica de médicos familiares en el manejo de la diabetes mellitus con nefropatía inicial.

The diabetic nephropathy in initial phase requires an opportune identification by family physicians. Indeed, they should be qualified to interpret the data that suggesting that a patient be going through that phase of the illness, in order to orientate the management and processing of the same one, from an integrative perspective. The purpose of this work was to measure the aptitude of the family doctors to interpret, to judge and to propose in front of sick patients with diabetes type two with initial nephropathy. We made this with a representative sample of family physicians in five Family Medicine Units of the Instituto Mexicano del Seguro Social in the city of Guadalajara, Jalisco, Mexico. The main variable of the study was the clinical aptitude of the doctors: interpretation, judgment and proposals carried out in the practice of their profession; and through an ordinal scale, levels of aptitude' were defined, which related to the remainder of variables using the medium, Kruskal Wallis stadiometer and chi2.