Factor impacto y revista Atención Primaria / Impact factor and Atención Primaria journal

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Dos años de Open Access / No disponible

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Fiabilidad de un cuestionario empleado para la aplicación en el seguimiento longitudinal de la opinión y percepciones de la medicina de familia de los estudiantes de medicina de la Universidad de Zaragoza / Reliability of a questionnaire used in the long-term follow up of the opinion and perceptions of family medicine by medical students of the University of Zaragoza (Spain)

Objetivo: La medicina de familia aborda determinados aspectos y perspectivas que suelen quedar relegados en la formación de otros niveles de atención por lo que cada vez cobra mayor importancia la necesidad de que los estudiantes tomen contacto con la atención primaria. El objetivo de este estudio es el de evaluar la fiabilidad del cuestionario del grupo Unimedifam (FIS PI070975) para conocer la evolución longitudinal de las expectativas y conocimientos sobre medicina de familia de los estudiantes de medicina. Diseño: Estudio de fiabilidad de un cuestionario. Emplazamiento: Alumnos de medicina de la Universidad de Zaragoza. Participantes: Contamos con un total de 371 alumnos de los cursos 1.°, 3.°, 5.° y 6.°. Método: La consistencia interna del cuestionario se determinó con el coeficiente alfa de Cronbach y su estabilidad en una prueba test-retest. Resultados: En la escala A del cuestionario encontramos que 3 ítems de 19 son poco estables; en la escala B 8 de 26 y en la escala C, 3 ítems de 38. El valor de alfa de Cronbach de la escala A es de 0,722, de la escala B de 0,861 y el de la escala C, 0,663.ConclusionesLas 3 escalas están entre los valores adecuados, excepto la escala C que aun así se encuentra muy próxima. Las conclusiones de este proceso de validación pueden servir de referencia y extrapolarse al cuestionario UNIMEDFAM a nivel estatal (AU)

Aim: Family medicine deals with certain aspects and perspectives that are often left behind in the training of other levels of care, thus the need for medical students to make contact with Primary Care is of increasing importance. The aim of this study is to evaluate the reliability of the questionnaire of the UNIMEDIFAM group (FIS PI070975) for the long-term outcome of expectations and knowledge about family medicine. Design: Reliability of a questionnaire. Setting: University of Zaragoza.Participants371 students from the 1st, 3rd, 5th, and 6th years. Method: The internal consistency of the questionnaire was determined using Cronbach's alpha coefficient, and the stability using the test-retest. Results: On scale A of the questionnaire we found that three of 19 items were unstable, in 8 of 26 on scale B, and 3 of 38 items on scale C. The Cronbach's alpha value of scale A was 0.722, 0.861 on scale B, and 0,663 on scale C. Conclusions: The 3 scales are within the appropriate values, except scale C, which is very close. The findings of this validation process can serve as a reference that may be extrapolated to the UNIMEDIFAM national questionnaire(AU)

[Reliability of a questionnaire used in the long-term follow up of the opinion and perceptions of family medicine by medical students of the University of Zaragoza (Spain)]. / Fiabilidad de un cuestionario empleado para la aplicación en el seguimiento longitudinal de la opinión y percepciones de la medicina de familia de los estudiantes de medicina de la Universidad de Zaragoza.

AIM: Family medicine deals with certain aspects and perspectives that are often left behind in the training of other levels of care, thus the need for medical students to make contact with Primary Care is of increasing importance. The aim of this study is to evaluate the reliability of the questionnaire of the UNIMEDIFAM group (FIS PI070975) for the long-term outcome of expectations and knowledge about family medicine. DESIGN: Reliability of a questionnaire. SETTING: University of Zaragoza. PARTICIPANTS: 371 students from the 1st, 3rd, 5th, and 6th years. METHOD: The internal consistency of the questionnaire was determined using Cronbach's alpha coefficient, and the stability using the test-retest. RESULTS: On scale A of the questionnaire we found that three of 19 items were unstable, in 8 of 26 on scale B, and 3 of 38 items on scale C. The Cronbach's alpha value of scale A was 0.722, 0.861 on scale B, and 0,663 on scale C. CONCLUSIONS: The 3 scales are within the appropriate values, except scale C, which is very close. The findings of this validation process can serve as a reference that may be extrapolated to the UNIMEDIFAM national questionnaire.

Los estudiantes de medicina españoles y la medicina de familia. Datos de las 2 fases de una encuesta estatal / Spanish medical students and Family Medicine. Data from the two phases of a national questionnaire

Objetivo: Explorar percepciones y expectativas de estudiantes de los cursos 1.°, 3.° y 5.° de las facultades de medicina sobre medicina de familia y comunitaria (MFyC) y atención primaria (AP).Diseño: Estudio observacional con administración de un cuestionario en 2 cortes transversales con un intervalo de 2 años. Emplazamiento: Facultades de medicina españolas. Participantes: Estudiantes de los cursos 1.°, 3.° y 5.° de 22 facultades (1.a fase) y 15 en la segunda. Mediciones principales: Cuestionario autocumplimentado administrado durante el primer trimestre de los cursos 2009-2010 y 2011-2012. Consta de 70 ítems en 3 bloques: percepciones sobre MFyC (19 ítems), formación en MFyC (26 ítems), expectativas y preferencias (25 ítems), más 13 ítems específicos para alumnos de 3.° y 5.°. La mayoría se respondían según una escala Likert (de 1 a 6). Resultados: En la 1.a fase se obtuvieron 5.299 cuestionarios y 3.869 en la segunda. Los estudiantes perciben la MFyC y AP como un ámbito esencial del sistema sanitario y de ejercicio profesional pero con escaso atractivo científico-técnico. El 87% consideran necesaria y obligatoria la formación en MFyC y que debería iniciarse en el 3.er curso. Prefieren las especialidades médicas hospitalarias (88-89%) seguidas de las quirúrgicas y la pediatría. La MFyC es preferida por el 37-39%. Al iniciar la carrera solamente entre el 24 y el 28% de los estudiantes tienen una decisión clara sobre la especialidad que van a escoger. Conclusiones: La MFyC y la AP son ámbitos esenciales y han de formar parte de los currículum pero tienen una baja consideración científica(AU)

Objective: To examine the perceptions and expectations about Family Practice (FP) and Primary Care (PC) in 1st, 3rd and 5th year students in medical schools. Design: An observational study in two cross sections with intervals of two years. Location: Spanish Medical Schools.Participants1st, 3rd and 5th year students of 22 schools (1st phase) and 15 (second phase). Primary measurements: Self-report questionnaires completed during the first quarter of the 2009-2010 and 2011-2012 academic years. It had 70 items in three blocks: perceptions of FP (19 items), training in FP (26 items), expectations and preferences (25 items), plus 13 specific items for 3rd and 5th year students. Most of the items were answered in a 6 point Likert scale. Results: A total of 5299 responses in phase I, and 3869 in phase II were received. Students perceive FP and PC as essential areas of the health system and professional practice, but with little scientific and technical appeal. The large majortiy, 87%, consider training in FP necessary and compulsory, and it should start in third year. They prefer hospital medical specialities (88-89%), followed by surgical and paediatrics. FP is preferred by the 37-39%. Only between 24% and 28% of students have a clear preference for a specialty when they start medical studies. Conclusions: FP and PC are key areas and should be part of the curriculum, but are perceived to be of low scientific appeal(AU)

[Spanish medical students and Family Medicine. Data from the two phases of a national questionnaire]. / Los estudiantes de medicina españoles y la medicina de familia. Datos de las 2 fases de una encuesta estatal.

OBJECTIVE: To examine the perceptions and expectations about Family Practice (FP) and Primary Care (PC) in 1st, 3rd and 5th year students in medical schools. DESIGN: An observational study in two cross sections with intervals of two years. LOCATION: Spanish Medical Schools. PARTICIPANTS: 1st, 3rd and 5th year students of 22 schools (1st phase) and 15 (second phase). PRIMARY MEASUREMENTS: Self-report questionnaires completed during the first quarter of the 2009-2010 and 2011-2012 academic years. It had 70 items in three blocks: perceptions of FP (19 items), training in FP (26 items), expectations and preferences (25 items), plus 13 specific items for 3rd and 5th year students. Most of the items were answered in a 6 point Likert scale. RESULTS: A total of 5299 responses in phase I, and 3869 in phase II were received. Students perceive FP and PC as essential areas of the health system and professional practice, but with little scientific and technical appeal. The large majortiy, 87%, consider training in FP necessary and compulsory, and it should start in third year. They prefer hospital medical specialities (88-89%), followed by surgical and paediatrics. FP is preferred by the 37-39%. Only between 24% and 28% of students have a clear preference for a specialty when they start medical studies. CONCLUSIONS: FP and PC are key areas and should be part of the curriculum, but are perceived to be of low scientific appeal.

Respuesta de los autores: Acerca de las revistas médicas españolas más leídas en atención primaria / Author’s reply: The most read Spanish medical journals in primary care

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Qué revistas médicas españolas leen y cómo se informan los médicos de atención primaria / Which Spanish journals are read and how primary care doctors keep informed

ObjetivoConocer los hábitos de lectura de revistas médicas, preferencias de idioma y formato, y vías de acceso a las mismas de los médicos de atención primaria.DiseñoEntrevista telefónica.Ámbito geográficoTodas las comunidades autónomas de España.Participantes300 médicos de atención primaria seleccionados mediante un muestreo estratificado proporcional por comunidad autónoma y tipo de profesional (médicos de familia y pediatras).MedicionesCuestionario estructurado precodificado de 18 preguntas, administrado telefónicamente mediante técnica asistida por ordenador.Resultados principaleslos encuestados declaran leer preferentemente las revistas de su especialidad y se inclinan por el formato impreso; aunque el electrónico es el preferido por los jóvenes y pediatras. Los médicos de familia están más interesados por los casos clínicos (73%), y los pediatras por las revisiones (74%). El 48% leen de 1 a 4 artículos semanales. Para la búsqueda de los artículos, el 70% utilizan Google y Yahoo, y sólo el 29% bases de datos. El 88% estaría interesado en disponer de un servicio gratuito en línea para consultar revistas españolas de calidad. Al 80% les resulta más útil leer artículos en español que en inglés y el 70% considera que no existen diferencias de calidad entre ellos. El 67% no ha publicado ningún artículo en los pasados 5 años, y la mayoría lo hicieron en español (92%).ConclusionesLas publicaciones que contienen artículos en español son utilizadas como fuente de información preferente por un alto porcentaje de los médicos de atención primaria. Estos profesionales consideran que las bases de datos en español facilitan el acceso a dichas publicaciones y les son útiles y necesarias para su práctica profesional(AU)

ObjectiveTo determine which medical journals are read by Primary Care doctors, their language preferences, publication format and the ways of accessing them.DesignTelephone interview.LocationAll the autonomous communities of Spain.ParticipantsA total of 300 Primary Care physicians selected by proportional stratified sampling by autonomous community and type of professional (general practitioners and paediatricians).MeasuresA structured 18-question survey on reading habits administered by telephone using computer-assisted techniques.ResultsRespondents declared they preferably read specialty journals and are inclined to the printed format, although the online version is the option of younger doctors and paediatricians. The general practitioners prefer to read case studies (73%) and paediatricians opt for the reviews (74%). Overall, 48% read 1 to 4 articles per week. The search tools preferred by 70% of respondents were Google and Yahoo, followed by databases (29%). Eighty eight per cent stated an interest in having a free online service to find quality Spanish journals. As regards language, 80% find it more useful to read articles in Spanish than in English, and 70% believe that there are no quality differences between the publications in both languages.ConclusionsThe publications in Spanish are used as the preferred sources of information by a high percentage of Primary Care physicians. These professionals believe that Spanish-language databases make it easier to access these publications, and are useful and necessary for professional practice(AU)

Effectiveness of a short-course in improving knowledge and skills on evidence-based practice.

BACKGROUND: To assess the effectiveness (change in knowledge and skills measured by the Fresno test) of a short course in Evidence Based Practice (EBP) carried out in a group of family medicine residents METHODS: Before-after study. Participants' were 152 Family Medicine residents in their second year of the training programme. Settings were Primary Care Teaching Units in Catalonia. Intervention was comprised of a four half-day training course designed to develop the knowledge and skills required to practice evidence-based care. The main outcome measure was change in EBP knowledge and skills, measured using the Spanish version of the Fresno test (score range, 0-212) RESULTS: The mean difference between pre-test and post-test was 47.7, a statistically significant result with 95% CI of 42.8-52.5 (p < 0.0001). An important improvement was observed in the questions related to calculations such as sensitivity, specificity, the absolute risk reduction or the number needed to treat. A more modest increase was found in the residents' knowledge and skills in finding the best clinical evidence, and appraising the validity and applicability of an article. Finally, a weak and non-statistically significant improvement was found in formulating a clinical question. CONCLUSIONS: The study provides evidence for responsiveness to changes in knowledge and skills in EBP after an educational intervention.

Medicina de Familia y universidad en España: reflexiones iniciales a partir de un proyecto de investigación estatal / Family medicine and university in Spain: initial reflections from a national research project

En el año 2006 se inició en España el diseño de un proyecto de investigación deámbito estatal con el objetivo básico de analizar el grado de información sobre Atención Primariade que disponen los estudiantes de medicina, su percepción del papel de la Medicina deFamilia en el sistema sanitario, sus expectativas y preferencias de ejercicio profesional así comola opinión expresada sobre la utilidad y necesidad del aprendizaje específico sobre AtenciónPrimaria y Medicina de Familia durante los estudios de grado.Para conocer datos cuantitativos y cualitativos sobre la situación actual de la docencia enAtención Primaria y Medicina de Familia en las facultades españolas elaboramos un cuestionariopara cada una de ellas. En este artículo describimos resumidamente las característicasdel proyecto de investigación, los datos principales obtenidos con este primer cuestionario y,fundamentalmente, las primeras reflexiones sobre la situación académica de la Medicina deFamilia en España(AU)

In 2006, a national research project was initially designed in Spain, with the basicaim of analysing the level of information on Primary Care that is available to medical students,their perception of the role of family medicine in the health system, and professional practicepreferences, as well as the opinion expressed on the usefulness and need of specific teachingon primary care and family medicine during undergraduate studies. A questionnaire was prepared for each of the Spanish Faculties of Medicine to gather quantitativeand qualitative data on the current situation on the teaching of primary care and familymedicine. In this article, we give a short description of the characteristics of the project, theprinciple data obtained with this first questionnaire and, importantly, the first reflections onthe academic situation of Family Medicine in Spain(AU)

Psychometric properties of a test in evidence based practice: the Spanish version of the Fresno test.

BACKGROUND: Validated instruments are needed to evaluate the programmatic impact of Evidence Based Practice (EBP) training and to document the competence of individual trainees. This study aimed to translate the Fresno test into Spanish and subsequently validate it, in order to ensure the equivalence of the Spanish version against the original English version. METHODS: Before and after study performed between October 2007 and June 2008. Three groups of participants: (a) Mentors of family medicine residents (expert group) (n = 56); (b) Family medicine physicians (intermediate experience group) (n = 17); (c) Family medicine residents (novice group) (n = 202); Medical residents attended an EBP course, and two sets of the test were administered before and after the course. The Fresno test is a performance based measure for use in medical education that assesses EBP skills. The outcome measures were: inter-rater and intra-rater reliability, internal consistency, item analyses, construct validity, feasibility of administration, and responsiveness. RESULTS: Inter-rater correlations were 0.95 and 0.85 in the pre-test and the post-test respectively. The overall intra-rater reliability was 0.71 and 0.81 in the pre-test and post-test questionnaire, respectively. Cronbach's alpha was 0.88 and 0.77, respectively. 152 residents (75.2%) returned both sets of the questionnaire. The observed effect size for the residents was 1.77 (CI 95%: 1.57-1.95), the standardised response mean was 1.65 (CI 95%:1.47-1.82). CONCLUSIONS: The Spanish version of the Fresno test is a useful tool in assessing the knowledge and skills of EBP in Spanish-speaking residents of Family Medicine.

Study protocol of psychometric properties of the Spanish translation of a competence test in evidence based practice: the Fresno test.

BACKGROUND: There are few high-quality instruments for evaluating the effectiveness of Evidence-Based Practice (EBP) curricula with objective outcomes measures. The Fresno test is an instrument that evaluates most of EBP steps with a high reliability and validity in the English original version. The present study has the aims to translate the Fresno questionnaire into Spanish and its subsequent validation to ensure the equivalence of the Spanish version against the English original. METHODS AND DESIGN: The questionnaire will be translated with the back translation technique and tested in Primary Care Teaching Units in Catalonia (PCTU). Participants will be: (a) tutors of Family Medicine residents (expert group); (b) Family Medicine residents in their second year of the Family Medicine training program (novice group), and (c) Family Medicine physicians (intermediate group). The questionnaire will be administered before and after an educational intervention. The educational intervention will be an interactive four half-day sessions designed to develop the knowledge and skills required to EBP. Responsiveness statistics used in the analysis will be the effect size, the standardised response mean and Guyatt's method. For internal consistency reliability, two measures will be used: corrected item-total correlations and Cronbach's alpha. Inter-rater reliability will be tested using Kappa coefficient for qualitative items and intra-class correlation coefficient for quantitative items and the overall score. Construct validity, item difficulty, item discrimination and feasibility will be determined. DISCUSSION: The validation of the Fresno questionnaire into different languages will enable the expansion of the questionnaire, as well as allowing comparison between countries and the evaluation of different teaching models.