Self-Perceived Mental Health and Perceived Discrimination in Family Physicians and Residents: A Comparative Study Between Men and Women.

INTRODUCTION: The present study aims to examine sex differences in demographic variables, professional activities and adversities, self-reported mental health problems, and perceived discrimination in a sample of family doctors and family medicine residents in Mexico. METHODS: From a larger sample of medical specialists, an analytic, cross-sectional study was conducted with 566 participants, including 317 (56%) family medicine residents and 249 (44%) family doctors in Mexico through an online survey. Demographic features, professional activities and adversities, mental health, and perceived discrimination were examined. Descriptive and comparative analyses were performed. Cramer's V for chi-square tests and Hedge's g for t test were conducted to determine effect sizes. RESULTS: Both sexes displayed similar percentages of professional adversities (such as attending patients with suicidal behavior or who died not by suicide under their care), and a higher number of women reported seeking specialized support to cope with these deaths (Fisher = 0.04). Men perceived greater discrimination (P = .01), worked more hours per day (P < .001) and were more verbally assaulted (P = .04), whereas women reported mental health problems more frequently (P < .001) particularly depression, anxiety, burnout and sleeping problems. Women also reported worse health status (P < .001) when compared with men. CONCLUSION: Family medicine specialists constitute a vulnerable group for mental health problems and perceived discrimination. Particular attention should be paid to how men and women cope with professional adversities to determine whether additional support is required. Interventions should encourage self-care and promote the well-being of health personnel.

[Game-based learning: proposal of teaching technique in medical fellows]. / Aprendizaje basado en juegos: propuesta de técnica-enseñanza en médicos becarios.

Background: Games are a learning technique of high educational value that contributes to the development of cognitive, emotional and psychological systems. The Traffic Light is an instrument that evaluates the perception of learning and the student's level of fun. Objective: To propose a game-based learning teaching technique in fellow medical personnel. Material and methods: Quasi experimental, consecutive non-probabilistic sample, in 42 medical interns (residents from Family Medicine, social work interns, and undergraduate fellow students). A board was made to identify images of dermatological pathologies. Informed consent was given, teams of 2 people were formed. Each one was given a board, they began to ask each other about the dermopathology described by these signs and through discrimination they reached the diagnosis. This board is based on the board game Guess Who. The Traffic Light instrument was applied. For the statistical analysis it was used measures of central tendency, standard deviations, ranges, and chi-squared. Results: 47 male medical interns (female 61.7%). 40.4% were 31 to 40 years. 74.5% were medical residents, 14.9% social work interns, and 10.6% undergraduate fellow students. In the Traffic Light instrument in both questions (How much do you think you have learned in class? and How much fun did you have in class?), the answer was a lot in 76.6%. There was significant chi-squared for age and sex. Conclusions: The game is a very viable option to be applied to the teaching-learning process.

Introducción: los juegos son una técnica de aprendizaje de alto valor educativo que contribuye al desarrollo del sistema cognitivo, emocional y psicológico. El Semáforo es un instrumento que evalúa la percepción del aprendizaje y el nivel de diversión del alumno. Objetivo: proponer una técnica de enseñanza-aprendizaje basada en juegos en personal médico becario. Material y métodos: estudio cuasi experimental, muestra no probabilística consecutiva, en 42 médicos becarios (residentes de Medicina Familiar, pasantes de servicio social y en internado de pregrado). Se hizo un tablero de identificación de imágenes de patologías dermatológicas. Se otorgó consentimiento informado y se formaron equipos de dos integrantes. A cada uno se le dio un tablero y se hicieron preguntas entre ellos, referentes a la patología dermatológica que tenía esos signos y por medio de discriminación llegaron al diagnóstico. El tablero se basó en el juego ¿Adivina Quién? Se aplicó el instrumento Semáforo. Para la estadística, se usaron medidas de tendencia central, desviaciones estándar, rangos y chi cuadrada. Resultados: fueron 47 médicos becarios (61.7% mujeres); la mayoría (40.4%) tuvo de 31 a 40 años. Fueron residentes 74.5%, pasantes 14.9% e internos 10.6%. En el instrumento Semáforo en ambas preguntas (¿Cuánto crees que has aprendido en clase?, ¿Cuánto te has divertido en clase?) la respuesta fue mucho en 76.6%. Hubo chi cuadrada significativa para la edad y el sexo. Conclusiones: el juego es una opcion muy viable para ser aplicada al proceso enseñanza-aprendizaje.

Aprendizaje basado en juegos: propuesta de técnica-enseñanza en médicos becarios / Game-based learning: proposal of teaching technique in medical fellows

Introducción: los juegos son una técnica de aprendizaje de alto valor educativo que contribuye al desarrollo del sistema cognitivo, emocional y psicológico. El Semáforo es un instrumento que evalúa la percepción del aprendizaje y el nivel de diversión del alumno. Objetivo: proponer una técnica de enseñanza-aprendizaje basada en juegos en personal médico becario. Material y métodos: estudio cuasi experimental, muestra no probabilística consecutiva, en 42 médicos becarios (residentes de Medicina Familiar, pasantes de servicio social y en internado de pregrado). Se hizo un tablero de identificación de imágenes de patologías dermatológicas. Se otorgó consentimiento informado y se formaron equipos de dos integrantes. A cada uno se le dio un tablero y se hicieron preguntas entre ellos, referentes a la patología dermatológica que tenía esos signos y por medio de discriminación llegaron al diagnóstico. El tablero se basó en el juego ¿Adivina Quién? Se aplicó el instrumento Semáforo. Para la estadística, se usaron medidas de tendencia central, desviaciones estándar, rangos y chi cuadrada. Resultados: fueron 47 médicos becarios (61.7% mujeres); la mayoría (40.4%) tuvo de 31 a 40 años. Fueron residentes 74.5%, pasantes 14.9% e internos 10.6%. En el instrumento Semáforo en ambas preguntas (¿Cuánto crees que has aprendido en clase?, ¿Cuánto te has divertido en clase?) la respuesta fue mucho en 76.6%. Hubo chi cuadrada significativa para la edad y el sexo. Conclusiones: el juego es una opción muy viable para ser aplicada al proceso enseñanza-aprendizaje

Background: Games are a learning technique of high educational value that contributes to the development of cognitive, emotional and psychological systems. The Traffic Light is an instrument that evaluates the perception of learning and the student's level of fun. Objective: To propose a game-based learning teaching technique in fellow medical personnel. Material and methods: Quasi experimental, consecutive non-probabilistic sample, in 42 medical interns (residents from Family Medicine, social work interns, and undergraduate fellow students). A board was made to identify images of dermatological pathologies. Informed consent was given, teams of 2 people were formed. Each one was given a board, they began to ask each other about the dermopathology described by these signs and through discrimination they reached the diagnosis. This board is based on the board game Guess Who. The Traffic Light instrument was applied. For the statistical analysis it was used measures of central tendency, standard deviations, ranges, and chi-squared. Results: 47 male medical interns (female 61.7%). 40.4% were 31 to 40 years. 74.5% were medical residents, 14.9% social work interns, and 10.6% undergraduate fellow students. In the Traffic Light instrument in both questions (How much do you think you have learned in class? and How much fun did you have in class?), the answer was a lot in 76.6%. There was significant chi-squared for age and sex. Conclusions: The game is a very viable option to be applied to the teaching-learning process

Adolescent medical care: A priority in family medicine / La atención médica del adolescente: una prioridad en Medicina Familiar

Today's adolescents are, undoubtedly, very different from those attended by the family doctor in the past. Currently, we are facing young people full of ideas, with a lot of personality, who show novel interactions with the world. It is a fact that the care of adolescent patient by family physicians it is performed more frequently and will be further increased by the recent incorporation of the care of adolescent patient to the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security: IMSS). Among the most frequent medical problems of adolescents, the most important are: early pregnancy, depression, violence, use and abuse of alcohol and drugs, and nutrition and eating disorders. It is required an approach to this very complex population. For this reason, family doctors should be open to facilitate dialogue, without making judgments, and with too much empathy. To that end, it is necessary to be updated in all issues that are emerging day by day concerning adolescents.

Los adolescentes de ahora son, sin duda, muy diferentes de aquellos que atendía el médico familiar en épocas pasadas. Actualmente, nos encontramos ante jóvenes llenos de ideas, de personalidad, que presentan nuevos vínculos e interacciones con el mundo. Es un hecho que la atención del paciente adolescente por los médicos familiares se realiza cada vez con mayor frecuencia y se verá incrementada aún más por la reciente incorporación de la atención del adolescente al IMSS. Entre los problemas médicos más frecuentes del adolescente destacan aquellos referentes a embarazos, depresión, violencia, consumo de alcohol y drogas, así como los trastornos de la conducta alimenticia. Se requiere de un acercamiento a esta población, la cual es muy compleja. Por ello, los médicos familiares deben estar abiertos a facilitar el diálogo, sin juzgar y con la máxima empatía posible. Para ello, es necesario estar actualizados en todos los temas que van surgiendo día a día con respecto a los adolescentes.

Diagnostic accuracy in Family Medicine residents using a clinical decision support system (DXplain): a randomized-controlled trial.

BACKGROUND: Clinical reasoning is an essential skill in physicians, required to address the challenges of accurate patient diagnoses. The goal of the study was to compare the diagnostic accuracy in Family Medicine residents, with and without the use of a clinical decision support tool (DXplain http://www.mghlcs.org/projects/dxplain). METHODS: A total of 87 first-year Family Medicine residents, training at the National Autonomous University of Mexico (UNAM) Postgraduate Studies Division in Mexico City, participated voluntarily in the study. They were randomized to a control group and an intervention group that used DXplain. Both groups solved 30 clinical diagnosis cases (internal medicine, pediatrics, gynecology and emergency medicine) in a multiple-choice question test that had validity evidence. RESULTS: The percent-correct score in the Diagnosis Test in the control group (44 residents) was 74.1±9.4 (mean±standard deviation) whereas the DXplain intervention group (43 residents) had a score of 82.4±8.5 (p<0.001). There were significant differences in the four knowledge content areas of the test. CONCLUSIONS: Family Medicine residents have appropriate diagnostic accuracy that can improve with the use of DXplain. This could help decrease diagnostic errors, improve patient safety and the quality of medical practice. The use of clinical decision support systems could be useful in educational interventions and medical practice.