Well-being variations on students of health sciences related to their learning opportunities, resources, and daily activities in an online and on-crisis context: a survey-based study.

BACKGROUND: Universities' training process intensely relies on face-to-face education. The COVID-19 pandemic interrupted it and forced them to reinvent their process online. But this crisis seems not to be the last we will face, and we take it as a lesson to prepare for future crises. These critical contexts are especially challenging because they imply changing teaching strategies, and students may not have the technology access or the living conditions to connect as they need. They also lived through a pandemic where the virus and the life changes added stress to their learning process and threatened their well-being. So, this study aims to analyze how well-being variations reported by Health sciences students relate to their learning opportunities, access conditions, and daily activities. METHOD: We surveyed 910 Health sciences students from six different Chilean universities at the end of the first semester of 2020, the first in pandemic conditions. Respondents answered online questionnaires about 1) Remote teaching activities, 2) Learning resources availability, 3) Daily life activities, and 4) Well-being changes. We performed descriptive analysis and Structural Equation Modelling. RESULTS: Live videoconference classes were the most frequent teaching activity; only a third of the students had quiet spaces to study online, and most had to housekeep daily. More than two third reported some well-being deterioration. The structural equation model showed a good fit. CONCLUSION: Results show an online learning scenario that tries to emulate traditional learning focusing on expositive strategies. Most students reported that their well-being deteriorated during the semester, but tutorials, workplace availability, and social support were protective factors.

[Professionalism and narrative medicine]. / Profesionalismo y medicina narrativa.

This work is a bibliographical review of the challenges of professionalism in medical training. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. By virtue of the changes in the practice of medicine during the last years, professionalism values emerge as qualities that should reshape medicine. Several medical associations are redefining professionalism and insist that this issue should be included in the training curriculum. Thus, several medical education institutions are pursuing strategies to teach and assess professionalism. Modeling is still relevant as a learning strategy, but it must be tutored and directed. Also, timely and formative feedback appears as the most frequently suggested evaluative action. Both processes incorporate a personal reflective practice. Several recent studies suggest that a reflective experience is relevant for the formation of a professional identity. Narrative Medicine methodology emerges as an innovative strategy to address this issue, as it seeks to deliver valuable learning experiences to the students through reflection and the search for a new paradigm for medical practice.

Multidimensional scale of perceived social support: evidence of validity and reliability in a Chilean adaptation for older adults.

BACKGROUND: Given the relevance of social support on the mental health of older adults, having an instrument to evaluate this variable is essential for research in the area. However, mainly, having instruments with suitable evidence of their psychometric properties is critical. For this reason, this study sought to evaluate the factorial and reliability structure of the Multidimensional Scale of Perceived Social Support within autonomous older adults from the Province of Concepción, Chile. METHODS: We surveyed 399 older adults using quote sampling. They answered a Spanish version of the Multidimensional Scale of Perceived Social Support, plus a sociodemographic questionnaire. We performed confirmatory factor analysis using Weighted Least Squares Means and Variances adjusted estimation (WLSMV) to compare the factor models proposes by previous studies. To evaluate reliability, we calculated Cronbach's alpha and McDonald's omega. RESULTS: The Confirmatory factor analysis found that the 3-factors models showed the best fist index between the models with CFI = 0.991, TLI = 0.989, and SRMR = 0.035, even though RMSEA were over the cutoff point. The factors presented reliabilities from α = 0.858 to α = 0.941, and from ω = 0.937 to ω = 0.972. CONCLUSIONS: The results support the existence of three factors for the Multidimensional Scale of Perceived Social Support (MSPSS), differentiating the support perceived from Family, Friends, and significant others. All factors present good or excellent reliability. This solution is theoretically consistent and coherent with the literature, and it presents evidence in favor of the use of MSPSS as a measurement to distinguish the support perceived source.

[Power and gender in relationships between teachers and students in medical schools]. / Poder y género en las relaciones entre docentes y estudiantes de la carrera de medicina.

BACKGROUND: Education is a continuous, critical, holistic process that not only intends to transmit knowledge, abilities, and skills, but also permeates attitudes, values and dispositions, becoming a decisive element to fight inequality in all its nuances. AIM: To characterize the type of power that is established in relation to gender, between teachers and students, from the perspective of students and medical teachers from two Chilean universities. MATERIAL AND METHODS: Qualitative study, according to Grounded Theory. Nine medical teachers were interviewed, and a focus group was conducted with ten medical students. Open coding was performed for the analysis. RESULTS: The presence of five types of power and the gender of the receivers of such expressions was described. Power was expressed also as fair or unfair treatment, pressure, and sexual harassment. CONCLUSIONS: Power exercised by teachers over their students is differentiated according to the gender of students. The ways in which that power is exercised do not go unnoticed when they become arbitrary obstacles or benefits for the students and their learning process. It also affects the way in which they subsequently relate with their environment.

When it is time to decide: factors associated to the choice of a medical specialty.

After finishing their initial education, physicians can enter post-graduate training programs. In Chile, there are multiple medical specialties options. This review synthesizes the factors associated with the choice of specialty, according to international publications. Students coming from rural areas or small towns would tend to choose Family Medicine. Men prefer specialties such as Surgery. Having relatives in the medical profession, specializing in a specific field, also influence the choice. Concerning interests and preferences, these are linked to personal traits and some biological variables. The inclination towards clinical or surgical fields could be predicted. Academically, the curriculum, good learning experiences and teacher models favor choice, while the harassment suffered could contribute to avoidance. Besides, both prestige and economic prospects are influential factors in the choice and specialties such as Surgery are preferred. The choice of specialty must reach a balance between the students' interests and public health needs. Identifying these factors would allow a better understanding of the present shortfall (or surplus) in certain fields and contribute to the definition of policies and decision-making.

[Experiences of medical students dropping out studies. A qualitative approach]. / Experiencias de estudiantes de medicina que interrumpen sus estudios universitarios: un estudio cualitativo.

BACKGROUND: Medical students have a higher prevalence of mental health problems and are more likely to drop out their studies as a result. AIM: To comprehend the academic experiences of medical students who dropped out medical studies in a university that experienced an increase in drop out by medical students and consultations to mental health services. MATERIAL AND METHODS: A qualitative study with a phenomenological design, in which in-depth interviews were conducted with eight medical students who dropped out studies. The analysis was carried out by means of the constant comparison method up to the level of open coding. RESULTS: Two categories were identified, namely experiences prior to interrupting studies, which comprised the subcategories of academic and social experiences, and motives that lead to drop-out, which considered the subcategories related to vocation, mental health and pursuing other projects. CONCLUSIONS: These results identified the challenges faced by students prior to stopping-out, that are related to academic aspects, peer relations and student-teacher relationship. The main motives for drop-out reported by students were mental health problems.

[Relationship between occupational commitment and teaching practices among healthcare teachers]. / ¿Enseña diferente un docente comprometido? Relación entre compromiso docente y prácticas pedagógicas en académicos de carreras de la salud.

BACKGROUND: A central aspect of professional identity is occupational commitment, which has a significant relationship with motivation and positive mental states in healthcare environments. However, it is not clear how occupational commitment is related to teaching practices in universities. AIM: To apply the Occupational Commitment Questionnaire (OCQ) to university teachers and relate its results with the Teaching Practices Questionnaire. MATERIAL AND METHODS: OCQ and Teaching Practices Questionnaire were answered by 319 university teachers from 13 Chilean regions, who were selected through a non-probabilistic volunteer sampling. Data collection was done after informed consent. An exploratory factor analysis was performed for OCQ. The internal consistency of each factor was calculated with Cronbach's Alpha. Spearman correlations were used to explore the relationship between the two questionnaires. RESULTS: Two factors were identified in OCQ, namely Teacher Commitment and Ethical-Professional Commitment. Cronbach's Alpha was 0.85 for both factors. A moderate direct relationship between teacher commitment, ethical-professional commitment, and the Teaching Practices Questionnaire was found. CONCLUSIONS: OCQ showed an adequate internal consistency, and it was directly related with teaching practices. Committed teachers had better teaching practices. This confirms the importance of teachers' values and perceptions on their professional performance.

[Students' perception about mistreatment in undergraduate medical training]. / Maltrato en el pregrado de la carrera de Medicina: percepción de los estudiantes.

BACKGROUND: Alarms about mistreatment in medical education have been raised for almost 30 years. AIM: To describe the frequency of abuse reports among medical students at a university in Chile, investigating their association with age, sex, and educational level. MATERIAL AND METHODS: The Mistreatment by Teachers Questionnaire was applied to 264 first to seventh year medical students (54% males). An exploratory factorial analysis of the instrument was performed, a descriptive analysis was made and its relationship with age, sex and level of training were evaluated. RESULTS: Ninety eight percent of respondents reported having been mistreated at least once. Mistreatment was grouped into three factors with a confidence ranging between α = 0.79 and 0.93, namely demoralization, deregulated demands and physical aggression. The first two were associated with age and level of education. There were no differences by sex. CONCLUSIONS: Mistreatment is common in undergraduate medical education, as it has been found in other universities around the world.

Utrecht work engagement scale: Construct validity and reliability in Chilean health science students.

OBJECTIVE: The Utrecht Work Engagement Scale-Student (UWES-S) has been extensively applied in different countries to assess engagement in students, but there are discrepancies about its factor structure outcomes. To analyse the factor structure of Utrecht Work Engagement Scale-Student as construct validity evidence and reliability in medical students. METHODS: The non-experimental cross-sectional study was conducted at the public-sector University of Concepción in the Bio-Bio region in central Chile at the end of the first academic semester, between July and August 2017, and comprised students of health science undergraduate degree programmes in Medicine, Kinesiology, Pharmacy, and Speech and Language Therapy. Data was collected using a sociodemographic proforma and the Utrecht Work Engagement Scale-Student. The subjects were randomly divided into groups A and B. With group A, exploratory factor analysis was performed using the method of extraction of the main axis analysis. With group B, confirmatory factor analysis was performed using the maximum likelihood method. Data was analysed using STATA 11 SE. RESULTS: Of the 898 students, 538(59.91%) were females and 360(40.09%) were males. The overall mean age was 21.29±2.51 years (range: 17-34 years). Two factors, 'involvement with studies' and 'enthusiasm for the career', with eigenvalues 7.59 and 1.18 were identified with the potential to explain majority of the total variance of items. Comparative fit index, Tucker-Lewis index and the root mean square error of approximation showed the solution having the best fit. CONCLUSIONS: Involvement with studies and enthusiasm for career were found to be critical factors, but did not show adequate adjustment even though confirmatory factor analysis found this to be the solution with the best fit.

[Variables associated with a good response to steroids in chronic inflammatory demyelinating polyradiculoneuropathy]. / Factores asociados a respuesta favorable de tratamiento corticoidal en pacientes con polirradiculoneuropatía desmielinizante inflamatoria crónica.

BACKGROUND: The treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is based on corticosteroids, immunoglobulin and plasmapheresis. In our Health System, corticosteroids are commonly used as first line therapy for economic reasons and accessibility. However, the factors associated with a good response are not well known. AIM: To assess the association of demographic, clinical and laboratory variables with a favorable response to corticosteroid therapy in patients with CIDP. MATERIAL AND METHODS: Observational, descriptive, longitudinal and retrospective study of 33 patients with a diagnosis of typical, definitive or probable CIDP, treated with corticosteroids for at least six months. RESULTS: Twenty-three patients had a good clinical response to corticosteroid treatment and 10 were non-responders. The variables significantly associated with a good response to steroids were a disease lasting less than 1 year prior to the start of treatment, the absence of axonal damage in electromyography a relapsing-recurrent course and a favorable response within two months of treatment. CONCLUSIONS: Most of these patients with CIDP had good response to corticosteroid therapy.

[Academic self-efficacy among health care undergraduate students in a Chilean university]. / Autoeficacia académica en estudiantes de carreras de la salud de una universidad tradicional chilena.

BACKGROUND: Self-efficacy refers to people's expectations about personal resources available for goal achievement. Higher self-efficacy expectations are correlated with higher academic performance. AIM: To analyze the psychometric properties of the Academic Behavior Self-Efficacy Scale (ABSES) and to describe Self-efficacy expectations of students from health-related careers. MATERIAL AND METHODS: A non-probabilistic sample of 479 first- and second-year students from Nursing, Physiotherapy, Medicine, Nutrition and Medical Technology in a public university in Chile, answered the ABSES. Results were analyzed by Exploratory Factor Analysis and its reliability was evaluated using Cronbach's alpha. Also a descriptive analysis and a non-parametric relational analysis were performed. RESULTS: Two factors were identified: Attention and Participation. Attention obtained significantly higher scores than Participation (p < 0.001). Compared to their second-year counterparts, first year students had higher scores in Attention (p < 0.001) and Participation (p < 0.01). Medicine students had higher scores in Participation than students from other careers. CONCLUSIONS: A two factor solution was identified for ABSES. Surveyed students had a predominantly passive Self-efficacy, focused in attention. Also, a reduction in self efficacy was noted among second year students.

Factor structure and reliability of the Multidimensional Body-Self Relations Questionnaire in Chilean youth.

The aim of this study was to ascertain the psychometric properties of the Multidimensional Body-Self Relations Questionnaire (MBSRQ) for a sample of youth in Chile. Cross-sectional survey was conducted with 451 participants. A non-clinical sample of adolescents and young adults between 15 and 25 years responded the MBSRQ and a sociodemographic questionnaire. Factorial analysis identified seven factors and provided empirical evidence that supports the use of these factors to evaluate body perception in Chilean youth. Scores exhibited good reliability in three factors (over 0.80) and acceptable reliability in the other four (over 0.70). Findings suggest that the Spanish MBSRQ was psychometrically sound, with 7 factors which are largely consistent with those identified in the original version and validation study of this scale. These factors possess sufficient internal consistency to make it plausible for use in research and screening with Chilean youth, and potentially useful as an adjunctive measure in the context of clinical decision making.

[Psychometric properties of a newly developed occupational identity questionnaire for university teachers]. / Identidad ocupacional en docentes de carreras de la salud y su relación con las prácticas pedagógicas.

BACKGROUND: Occupational identity is defined as the perception of occupational interests, abilities, goals, and values, and the structure of the meanings that link these self-perceptions to career role. We developed an occupational identity questionnaire suitable to be used with university teachers. AIM: To evaluate the psychometric properties of the Occupational Identity Questionnaire (OIQ) and relate its results with those of the Teaching Practices questionnaire. MATERIAL AND METHODS: The OIQ and Teaching Practices Questionnaire were answered by 311 university teachers along Chile, who were selected through a non-probabilistic volunteer sampling. An exploratory factor analysis was performed and the internal consistency of each factor was calculated with Cronbach's Alpha. Spearman correlations were used to explore the relationship between the two questionnaires. RESULTS: Two factors were identified in OIQ: Teaching Vocation and Sense of Competence. Cronbach's Alpha was 0.75 for teaching vocation and 0.82 for the sense of competence. There was a moderate direct relationship between teaching vocation, sense of competence and the results of the Teaching Practices Questionnaire. CONCLUSIONS: OIS has an adequate internal consistency, its factorial structure showed two different types of identities and it is directly related to the results of the Teaching Practices Questionnaire.

[Self-directed learning and academic background of 2010 to 2014 cohorts of medical students]. / ¿Cómo han cambiado los estudiantes que ingresan a medicina? Aprendizaje autodirigido y antecedentes académicos de las cohortes 2010 a 2014 de una universidad tradicional.

BACKGROUND: The widespread growth of higher education is increasing the heterogeneity of university students in terms of socioeconomic characteristics, academic story and cultural background. Medical schools are not an exception of this phenomenon. AIM: To compare the academic background and self-directed learning behavior of students who entered to a public medial school between 2010 and 2014. MATERIAL AND METHODS: A non-probabilistic sample of 527 medical students aged between 17 and 29 years (60% men), was studied. Their academic information was collected from the University data base; they answered the Self-directed learning readiness scale of Fisher. RESULTS: Students from the 2014 cohort had higher high school grades than their counterparts. The scores in mathematics of the Scholarship Aptitude Test (SAT) were higher in the cohorts of 2010 and 2011. Those of the sciences test were superior in the 2013 cohort. The 2014 cohort had the lower general score of self-directed learning behaviors. CONCLUSIONS: The lower SAT and self-directed learning scores of the students entering medical school in 2014, indicate the progressive increase in the heterogeneity of Medical students.

Identifying the Needs of Older Adults Associated with Daily Activities: A Qualitative Study.

INTRODUCTION: By 2050, older adults will constitute 16% of the world population; hence, there is an urgent demand and challenge to design solutions (products and services) that meet the needs of this age group. This study sought to analyse the needs that impact the well-being of Chilean older adults and present possible solutions through the design of products. METHODOLOGY: A qualitative study was used, where focus groups were held with older adults, industrial designers, health professionals, and entrepreneurs on the needs and design of solutions for older adults. RESULTS: A general map was obtained that linked the categories and subcategories related to the relevant needs and solutions, which were then classified in a framework. CONCLUSIONS: The resulting proposal places the needs in different fields of expertise; and thus, enables positioning, broadening, and expanding upon the map to share knowledge, between the user and key experts, to co-create solutions.

Inclusion in the university: Who assumes responsibility? A qualitative study.

Society challenges higher education institutions and their members to generate inclusive communities to enable the full development of all members. This study aims to analyze who is responsible for generating inclusion according to community members from a traditional Chilean University. We carried out qualitative research based on the Grounded Theory. We collected data through focus group and semi-structured Interviews, involving 14 undergraduate students, two post-graduate students, 17 faculty members, five non-teaching staff members, and nine executives officers. All of thembelonging to the three campuses of the University. We analyzed data using ATLAS.ti 7.5.7, using the constant comparison method and reaching an axial codification level. From the data analysis, 25 subcategories emerged, grouped into six categories. Later we organized them under the codification paradigm. Results highlighted the perception of the interaction and influence of the social, institutional, and personal fields in the inclusion phenomenon. Also, that inclusive practices must be a responsibility shared among different educational community members.

The training of a new social-responsible generation of health professionals with a patient-centered vision.

The challenges that Latin America faces in health are deeply related to others, such as access to clean water, the right to education, and housing. Health professionals that work in an environment where the population faces constant barriers to accessing care in the public health system or has limited resources to pay for it in a private sector will face an ethical dilemma, the question of how to honor the call to care for patients when there is not enough support system or infrastructure to do so. Within the schools of medicine and health sciences, the question is how to train students to face or resolve these conflicts. The social responsibility approach is a proposal that allows the alignment of education for health professionals and health systems to contribute to the creation of an effective, equitable, and sustainable system. The present article aims to discuss this problem from the importance of training health professionals, ethical and committed to their communities, that have the skills and attitudes to implement a patient-centered vision. The involvement of universities and training institutions of the next generation of health professionals cannot be postponed.

Inclusion at universities: Psychometric properties of an inclusive management scale as perceived by students.

INTRODUCTION: During the last century, the inclusion of all kinds of diversity became a social imperative in all social spaces but above all in some institutions such as the educational ones. Among these, inclusion has been least studied in the tertiary education organizations. This communication proposes and evaluates the psychometric properties of a new instrument, named Inclusive Management in Tertiary Institutions Scale (IMTIS), to assess inclusive management in universities. METHOD: The researchers used a quantitative research model through survey. We based on the Index for Inclusion to design the IMTIS. We first submitted it to the assessment of experts. Then we applied the resulting version in an online survey including a sample of 1557 students from two universities and 121 different undergraduate careers. A panel of experts judged the content validity of the instrument. Participants answered the IMTIS after informed consent. We used confirmatory factor analysis to assess the construct validity of the instrument. We also evaluated the reliability of the measurements. RESULTS: From a kit of 33 originally proposed items, we obtained a version of 22 items with CVR between 0.60 and 1.00, and a IVC = 0.78. The confirmatory factor analysis showed that the six-factor solution had a better adjustment than the one and three factors solutions (RMSEA = 0.059; CFI = 0.947; TLI = 0.937). The McDonald ω coefficients were between 0.864 and 0.922. CONCLUSION: The results deliver evidence that supports the validity and reliability of the IMTIS measurements to carry out research and diagnosis of inclusive management in higher education institutions.