The progress test as a structuring initiative for programmatic assessment.

BACKGROUND: The Progress Test is an individual assessment applied to all students at the same time and on a regular basis. The test was structured in the medical undergraduate education of a conglomerate of schools to structure a programmatic assessment integrated into teaching. This paper presents the results of four serial applications of the progress test and the feedback method to students. METHODS: This assessment comprises 120 items offered online by means of a personal password. Items are authored by faculty, peer-reviewed, and approved by a committee of experts. The items are classified by five major areas, by topics used by the National Board of Medical Examiners and by medical specialties related to a national Unified Health System. The correction uses the Item Response Theory with analysis by the "Rasch" model that considers the difficulty of the item. RESULTS: Student participation increased along the four editions of the tests, considering the number of enrollments. The median performances increased in the comparisons among the sequential years in all tests, except for test1 - the first test offered to schools. Between subsequent years of education, 2nd-1st; 4th-3rd and 5th-4th there was an increase in median scores from progress tests 2 through 4. The final year of undergraduate showed a limited increase compared to the 5th year. There is a consistent increase in the median, although with fluctuations between the observed intervals. CONCLUSION: The progress test promoted the establishment of regular feedback among students, teachers and coordinators and paved the road to engagement much needed to construct an institutional programmatic assessment.

Systems approach in planetary health education for medical students: a mixed methods study.

BACKGROUND: Introducing students to the "planetary health lenses" perspective is crucial. Comprehensive strategies for teaching this perspective are lacking, especially in the domains of "interconnection within nature (IWN)" and "systems thinking/complexity." There is also a scarcity of studies assessing medical students' opinions on planetary health and evaluating teaching strategies. OBJECTIVE: To understand Brazilian medical students' perceptions and knowledge of planetary health (PH) and evaluate the application of the educational material "Patient and Clinic through the Lens of Planetary Health," which addresses "IWN" and "complexity" through the sociological lens of Actor-Network Theory, in an integrative course at a medical school in Brazil. METHODS: A mixed-methods, quasi-experimental design involving two medical student classes during 2022/2023. Participants completed a questionnaire on sociodemographic data; pre- and post-intervention closed-ended questions about perceptions related to PH, and an open-ended questionnaire on experience and learning. Each student group presented a portfolio under the planetary health lenses regarding a real patient, developing a network diagram that described the social network involving both human and non-human actors with which this person is interconnected. The cohorts participated in "IWN" activities: a contemplative trail or reflection on belonging to the planet. RESULTS: Ninety-six students and 9 professors participated. The majority of students (66.7%) reported significant or extremely significant learning from the sessions. There was an increase in perception of the need for physicians to incorporate PH into their clinical practice (p = 0.002; r = 0.46) and an intensification of the sense of interconnection with the environment (p = 0.003; r = 0.46). There was a gain in knowledge about how many diseases were related to PH (p < 0.02 for all 13 listed diseases). The majority (83%) found the sessions relevant or highly relevant and commented on their impact, both professionally and personally. CONCLUSIONS: Teaching PH in a medical school allowed students to learn from the patient's perspective, considering psychosocial and environmental determinants, about the intrinsic interdependence between population's health and PH. This strategy made a significant contribution by proposing pioneering didactics and offering valuable insights into the challenges and nuances of teaching PH.

Can AnatomicalTerms.info with its synonyms and succinct open definitions be a solution to address variations in usage of anatomical terminology?

Anatomy, the study of human structure, is foundational to medicine. Its language has a long history, with contributions from authors hailing from diverse cultures and countries, adhering to various scientific traditions, speaking different languages, and practicing medicine across a wide gamut of specialties. The resultant disparity in terms provides challenges both for students in learning and for interdisciplinary communication. We report here on a user-friendly look-up web site, "AnatomicalTerms.info" that links a Terminologica Anatomica term to alternative terms in usage: synonyms, polysemes, eponyms, homonyms, and terms in other languages. Accompanying open-source definitions are generated with the help of "Definition Machine" software, that supports creating the most concise and accessible definitions for anatomical terms, eschewing superfluous description, thus reducing cognitive load of learners of anatomy looking up terms. AnatomicalTerms.info is a readily accessible online source for both the authoritative and alternatively used terms that can accurately cross-reference and/or disambiguate anatomical structures across disciplinary and cultural divides. As such, it can serve as a useful educational and clinical resource that is also flexibly open to additions and expansion as anatomical and clinical needs dictate.

Critical route for development of medical student leadership competencies in 35 Pan American Health Organization member states: A scoping review and thematic analysis.

The Pan American Health Organization has been committed to training physicians in leadership competencies since 2008. However, four reviews on teaching leadership using competency-based education in undergraduate medical education (UME) identified only two of 35 MS: Canada and the USA. Previous reviews did not use a systemic approach or qualitative methodology to explore factors influencing leadership education. Therefore, this review aims to identify facilitating and inhibiting factors in teaching leadership in UME using a scoping review and thematic analysis. Six databases containing grey and indexed literature in English, Spanish, and Portuguese were searched, including a hand search and authors' consultations. Forty-eight documents out of 7849 were selected based on eligibility criteria. Braun and Clarke's thematic analysis guide was used, identifying eight themes: curriculum, intended learning outcomes, teaching methods, assessment, addressing barriers, supporting organisational change, building networks, and developing expertise. Considering these themes, the authors propose a critical route for teaching leadership in UME in the Americas. First, institutional design should consider governance gaps, such as having national and international policies for leadership training in UME with inter-professional, trans-professional, and citizen-focused approaches. There is a pressing need to provide leadership training for physicians and other professionals from government, academia, non-governmental organisations, hospitals, and national and international organisations whose missions are related to health or education. Networking opportunities for stakeholders in leadership education and teacher training is also essential. Second, instructional design reveals knowledge-do gaps in member states (MS) when incorporating leadership into the medical curriculum. This includes using leadership frameworks, defining learning outcomes, and employing assessment and monitoring tools for leadership education. Mechanisms to reduce these gaps in MS include the Equator Network and Evidence-Informed Policy Networks fostering knowledge translation and governance.

Aprendizaje en investigación clínica: experiencia de enseñanza híbrida con estudiantes de medicina / Learning in Clinical Research: Hybrid Teaching Experience with Medical Students

Introducción: la pandemia de COVID-19 indujo un cambio en nuestro sistema de salud y de educación. Los programas formativos también tuvieron que adaptarse y exigieron un cambio rápido. Objetivos: describir una experiencia educativa de enseñanza virtual/híbrida en investigación clínica, entre docentes del Servicio de Clínica de un hospital universitario y estudiantes de Medicina de una institución privada, que participaron del Programa ESIN (EStudiantes en INvestigación). Metodología: los contenidos y las estrategias educativas incluyeron las clases teóricas audiograbadas o videograbadas (asincrónicas y autoadministradas), el aprendizaje basado en proyectos, los talleres prácticos (encuentros sincrónicos virtuales y grupales), mediante la adopción de modelos de aprendizaje como el aula invertida, y la tutoría individual entre docente-estudiante. Los datos se recopilaron mediante la observación en contextos académicos, y basándonos en elementos de encuestas anónimas de satisfacción, previo consentimiento informado de los participantes. Resultados: participaron 14 estudiantes, 6 durante el año 2021 y 8 durante 2022. Todas mujeres y estudiantes de medicina (50% de cuarto año, 35% de sexto año y 15% de quinto año). Las técnicas implementadas favorecieron la participación y promovieron el aprendizaje activo, basado en proyectos. Mencionaron aspectos positivos como el enfoque académico práctico, la disponibilidad del equipo docente para atender cualquier duda, el tiempo y el entusiasmo por enseñar y fomentar la participación. Los videos teóricos resultaron útiles como herramientas de repaso, y los encuentros grupales fueron especialmente valorados, si bien los encuentros individuales fueron destacados como ayuda y apoyo previo a los congresos científicos. En general, manifestaron que fue una experiencia enriquecedora que demostró que se puede lograr lo que se creía imposible. Todas participaron activamente de al menos un congreso científico, y el 50% resultó coautora de una publicación académica. Conclusión: los estudiantes asumieron compromisos y responsabilidades, e incorporaron competencias y habilidades en la implementación y en la difusión de los proyectos. Esta experiencia educativa facilitó que el tiempo de clase pudiera optimizarse para intercambio, discusión y dudas. Los recursos producidos, las actividades desarrolladas y los contenidos abordados quedan disponibles a nivel institución. (AU)

Introduction: the COVID-19 pandemic brought about a change in our health and education system. Training programs also had to adapt and required rapid change. Objectives: to describe an educational experience of virtual/hybrid teaching in clinical research between teachers of the Clinical Service of a university hospital and medical students of a private institution who participated in the ESIN Program (Students in Research). Methodology: the contents and educational strategies included audio or videotaped lectures (asynchronous and self-administered), project-based learning, practical workshops (virtual and group synchronous meetings) by adopting learning models such as the inverted classroom, and individual tutoring between teacher and student. We gathered the data through observation in academic contexts and based on elements of anonymous satisfaction surveys, with prior informed consent of participants. Results: fourteen students participated, six in 2021 and eight in 2022. All were women and medical students (50% fourth year, 35% sixth year, and 15% fifth year). The techniques implemented favored participation and promoted active, project-based learning. They mentioned positive aspects such as the practical academic approach, the availability of the teaching team for any doubts, the time and enthusiasm for teaching, and encouraging participation. The theory videos were a valuable review tool, and team meetings received high praise even if the one-on-one meetings received much attention as help and support before the scientific congresses. In general, they stated that it was an enriching experience that showed that you can achieve what you thought impossible. All of them actively participated in at least one scientific congress, and 50% were co-authors of an academic publication. Conclusion: the students assumed commitments and responsibilities and incorporated competencies and skills in project implementation and dissemination. This educational experience helped to optimize class time for exchange, discussion, and doubts. The resources produced, the activities developed, and the contents addressed are now available at the institutional level. (AU)

Impact of the "Journal Club" activity among medical students' knowledge of scientific methodology / Avaliação de impacto da atividade "journal club" no conhecimento de metodologia científica entre os estudantes de medicina

Introduction: The Journal Club is an environment for exchanging information within the medical context concerning updated literature and evidence-based medicine. Considering the importance of constantly updating the acquired knowledge and scenarios of social isolation imposed by the COVID-19 pandemic, the Journal Club event was held virtually, aiming to expand the understanding of the scientific methodology among medical students by understanding the differences among each type of evidence pyramid study by reading and discussing scientific articles. Methodology: An analytical, prospective, and cross-sectional study was conducted in October 2021. The Journal Club event took place in nine classes where each type of evidence pyramid study was addressed. The sample included 20 medical students. A questionnaire was used at the beginning and end of the event to assess the participants' knowledge from the classes taught and was divided into two parts: participant identification data and 19 questions regarding the types of studies present on the pyramid of evidence. Results: It was found that after the pre- and post-event analysis of the questionnaire among the 19 questions, correct answers increased in 17, among which 3 obtained a statistically significant value: questions 1 (p = 0.031), 15 (p = 0.039), and 18 (p = 0.016). Discussion: An increase in the number of correct answers was noted between pre- and post-classes, which may indicate an improved understanding of the subject among students. Furthermore, the study demonstrated that the students had little involvement in scientific research (only 25% had ever been involved in a project). Conclu-sion: Based on the analysis of the participants' performance in the pre- and post-event questionnaires, it can be concluded that the medical students were able to expand their knowledge of scientific methodology (AU).

Introdução: O Journal Club é um ambiente para troca de informações dentro do contexto médico, diante de uma literatura atualizada e medicina baseada em evidências. Tendo em vista a importância da atualização constante de conhecimentos adquiridos e o cenário de isolamento social imposto pela pandemia da COVID-19, o evento Journal Club foi realizado virtualmente, com o objetivo de ampliar o entendimento sobre metodologia científica entre estudantes de medicina por meio da compreensão das diferenças de cada tipo de estudo da pirâmide de evidências a partir da leitura e discussão de artigos científicos. Metodologia: Estudo analítico, prospectivo e transversal realizado em outubro de 2021. O evento Journal Club ocorreu em nove aulas onde foram abordados cada tipo de estudo da pirâmide de evidência. A amostra foi composta por 20 estudantes de medicina. Um questionário foi aplicado no início e ao final do evento para avaliar o conhecimento dos participantes a partir das aulas ministradas, e foi dividido em duas partes, a primeira com dados de identificação do participante e a segunda com 19 questões sobre os tipos de estudos presentes na pirâmide de evidência. Resultados: Observou-se que, após a análise do questionário pré e pós-evento, dentre as 19 questões realizadas, houve um aumento de acertos em 17 entre as quais 3 obtiveram um valor estatístico significativo: questões 1 (p= 0,031), 15 (p=0,039) e 18 (p= 0,016). Discussão: Notou-se aumento dos acertos de questões entre o pré e pós-aulas, podendo indicar uma melhora no entendimento por parte dos acadêmicos acerca do assunto. Além disso, o estudo mostrou uma baixa atuação dos acadêmicos em pesquisas científicas (apenas 25% já se envolveram em algum projeto). Conclusão: A partir da análise do desempenho dos participantes nos questionários pré e pós-evento é possível afirmar que os estudantes de medicina conseguiram ampliar seu conhecimento sobre metodologia científica (AU).

Self-perceived competence in managing obstetric emergencies among recently graduated physicians from Lima, Peru.

OBJECTIVE: This study aimed to examine the self-perception of competencies in obstetric emergencies among recently graduated physicians from universities in Lima, Peru; and to identify its associated factors. METHODS: An analytical study was conducted, with the study population comprising newly graduated doctors who attended the "VI SERUMS National Convention" in 2017. We used Poisson regressions to assess the factors associated with the self-perception of competencies in obstetric emergencies, calculating prevalence ratios (PR) and their 95% confidence intervals (95% CI). RESULTS: We analyzed a population of 463 newly graduated physicians (mean age: 25.9 years), of which 33.3% reported feeling competent in obstetric emergencies. In the adjusted analyses, we found that having a previous health career (PR: 1.77, 95% CI: 1.12-2.81), having completed the internship in EsSalud hospitals (PR: 1.48, 95% CI: 1.31-1.68), and completing a university externship (PR: 1.62, 95% CI: 1.34-1.96) were associated with a higher prevalence of self-perceived competence in obstetric emergencies. CONCLUSION: Our findings suggest that certain academic factors, such as completing an externship and internship in specific hospital settings, may enhance the competencies or competence self-perception of recently graduated physicians in obstetric emergencies. Further studies are needed to confirm these results and identify other factors that may impact physicians' competencies in this field.

Evaluation of the Efficacy of an Online Learning Module to Increase Wound Care Theoretical Knowledge Amongst Medical Students.

OBJECTIVE: We developed and evaluated an online learning module for teaching wound care basics to junior medical learners, which was assessed for its ability to increase theoretical knowledge of wound care, and medical learners' perceptions on the use of an online module to teach wound care practices. DESIGN: Between February 2022 to November 2022, participants were enrolled into our unblinded, matched-pair single-arm study. Participants completed a pre- and postquiz prior to and after completing the online module, respectively. Scores on the pre- and postquiz were matched by participant and evaluated for improvement. The online module was composed of free text, animated videos with voiceovers, pictorial examples, and tables, as well as unscored knowledge checks, covering the categories of i) normal wound healing physiology, ii) describing wounds/assessment of wounds, iii) choosing dressings for wounds, and iv) addressing and understanding wound aetiologies, including diabetic, arterial, and venous ulcers. SETTING: Participants were enrolled at the University of Toronto in Toronto, Canada. PARTICIPANTS: Participants were recruited from the undergraduate medicine and physician assistant programs at the University of Toronto. Students were provided with information on how to participate in the study through email and in-person recruitment. Thirty-three participants entered the study, and 23 participants completed the study. RESULTS: Across all participants, the prequiz to postquiz score increase averaged 13.29%, representing a statistically significant increase (p = 0.0000013). Ten of the 20 questions and all question categories had a statistically significant increase in the postquiz scores. All respondents found the module very useful (67%) or extremely useful (33%) for learning wound care, and 67% were very satisfied overall with the quality of the module, with the remainder (33%) of respondents somewhat satisfied. CONCLUSIONS: Online learning modules are effective at increasing wound care knowledge in junior medical learners, with high satisfaction amongst learners.

Association of scopophobia with online learning fatigue among medical students in Brazil.

BACKGROUND: Scopophobia can be described in the medical field as the fear of being watched or stared at. Despite the relevance of scopophobia in remote learning scenarios, which have always existed and have been largely expanded during the pandemic in medical education, studies on this topic are exceedingly rare worldwide. Hence, to fill up this gap, a cross-sectional study of medical students was developed to assess the association of scopophobia with the prevalence of online learning fatigue. METHODS: A cross-sectional, quantitative, analytical study was carried out in Medical Schools of Brazil. To assess the risk of scopophobia, questions were developed, based on the literature on the topic. The Zoom Exhaustion & Fatigue Scale (ZEF) was used, and the questions have currently been validated for Brazilian Portuguese. Logistic regression models were also used to assess the relationship of scopophobia risk and ZEF scores. RESULTS: A total of 283 students from Brazil participated in the study. The median age was 23 years, and 64% of the participants were female. In total, 14.5% were considered to be at high risk for scopophobia. It was found that after adjusting for sex, income and number of residents in the household, scopophobia and the total zoom fatigue score remained associated. For the total score, each additional point on the scale increased the chance of scopophobia by 3%, and for the overall domain, 19% (p-values < 0.05). CONCLUSIONS: In conclusion, this study shows a relevant prevalence of students with scopophobia, which requires a differentiated approach on the part of teachers. The causes of scopophobia are often specific and have a psychological origin that goes beyond the usual pedagogical management. Therefore, motivation strategies are necessary in a general, as well as an individualized manner, aiming to favor the improvement of the online teaching and learning process.

Food insecurity in Chilean university students during the COVID-19 pandemic

Background: Food and nutrition were affected by the COVID-19 pandemic, increasing levels of food insecurity. University students were a risk group for food insecurity due to the closure of educational establishments where they received their main meals. Aim: To assess food insecurity among Chilean public university students before and during the COVID-19 pandemic. Material and Methods: The study had a non-probabilistic before-and-after design. Undergraduate students from all colleges at the university were invited to answer an online survey about food insecurity, devised based on FAO Food Insecurity Experience Scale. Results: Nine hundred and one students answered the survey. The prevalence of moderate/severe food insecurity increased from 9.5% to 14.3% before and during the pandemic, respectively. Forty two percent (n = 196) of student households became food insecure during the sanitary crisis. Students commented on the positive and negative aspects of the pandemic in their eating behaviors. Conclusions: Undergraduate students are vulnerable to food insecurity. Mitigation actions should be carried out when educational establishments are closed.

Antecedentes: La alimentación y la nutrición se están viendo afectadas por la pandemia por COVID-19, aumentando los niveles de inseguridad alimentaria. Un grupo susceptible a la inseguridad alimentaria son los estudiantes universitarios debido al cierre de los establecimientos educativos donde ellos pueden recibir sus alimentos principales. Objetivo: Evaluar la inseguridad alimentaria de los estudiantes de una universidad pública de Chile, antes y durante la pandemia por COVID-19. Material y Métodos: El estudio tuvo un diseño de antes y después, no probabilístico. Se invitó a participar a estudiantes universitarios de todas las facultades de la universidad a contestar un cuestionario en línea, desarrollado basado en la escala de experiencia de inseguridad alimentaria de la FAO. Resultados: Novecientos y un estudiantes respondieron la encuesta. En estos estudiantes, la prevalencia de inseguridad alimentaria moderada/grave aumentó de 9,5% a 14,3% antes y durante la pandemia, respectivamente. El 42,3% (n = 196) de los hogares estudiantiles pasó a tener inseguridad alimentaria durante la crisis sanitaria. Los estudiantes comentaron aspectos positivos y negativos de la pandemia en sus conductas alimentarias. Conclusiones: Estos resultados reflejan que estos estudiantes son vulnerables para inseguridad y amerita acciones de mitigación cuando los establecimientos educativos están cerrados.

Gender-Based Discrimination Among Medical Students: A Cross-Sectional Study in Brazil.

INTRODUCTION: Gender-based discrimination (GBD) creates a hostile environment during medical school, affecting students' personal life and academic performance. Little is known about how GBD affects the over 204,000 medical students in Brazil. This study aims to explore the patterns of GBD experienced by medical students in Brazil. METHODS: This is a cross-sectional study using an anonymous, Portuguese survey disseminated in June 2021 among Brazilian medical students. The survey was composed of 24 questions to collect data on GBD during medical school, formal methods for reporting GBD, and possible solutions for GBD. RESULTS: Of 953 responses, 748 (78%) were cisgender women, 194 (20%) were cisgender men, and 11 (1%) were from gender minorities. 65% (616/942) of respondents reported experiencing GBD during medical school. Women students experienced GBD more than men (77% versus 22%; P < 0.001). On comparing GBD perpetrator roles, both women (82%, 470/574) and men (64%, 27/42) reported the highest rate of GBD by faculty members. The occurrence of GBD by location differed between women and men. Only 12% (115/953) of respondents reported knowing their institution had a reporting mechanism for GBD. CONCLUSIONS: Most respondents experienced GBD during medical school. Cisgender women experienced GBD more than cisgender men. Perpetrators and location of GBD differed for men and women. Finally, an alarming majority of students did not know how to formally report GBD in their schools. It is imperative to adopt broad policy changes to diminish the rate of GBD and its a consequential burden on medical students.

A comprehensive approach to identify challenges for clinical reasoning development in undergraduate dental students and their potential solutions.

INTRODUCTION: Clinical reasoning is a core competence in health professions that impacts the ability to solve patients' health problems. Due to its relevance, it is necessary to identify difficulties arising from different sources that affect clinical reasoning development in students. The aim of this study was to explore a comprehensive approach to identify challenges for clinical reasoning development in undergraduate dental students and their potential solutions. METHODS: Mixed methods were used in four stages: (1) students and clinical teachers focus groups to identify challenges to clinical reasoning development; (2) literature review to explore potential solutions for these challenges; (3) Delphi technique for teacher consensus on pertinence and feasibility of solutions (1-5 scale); and (4) teachers' self-perception of their ability to implement the solutions. RESULTS: Three categories and seven subcategories of challenges were identified: (I) educational context factors influencing the clinical reasoning process; (II) teacher's role in clinical reasoning development; and (III) student factors influencing the clinical reasoning process. From 134 publications identified, 53 were selected for review, resulting in 10 potential solutions. Through two Delphi rounds, teachers rated the potential solutions very highly in terms of relevance (4.50-4.85) and feasibility (3.50-4.29). Finally, a prioritisation ranking of these solutions was generated using their scores for relevance, feasibility, and teachers' self-perception of their ability to implement them. CONCLUSIONS: The present comprehensive approach identified challenges for clinical reasoning development in dental students and their potential solutions, perceived as relevant and feasible by teachers, requiring further research and follow-up actions to address them.

A nationwide survey of the current status of radiation oncology teaching in Spanish medical schools.

Background: The present study was designed to collect information on the current status of radiation oncology (RO) teaching in undergraduate medical schools in Spain. Materials and methods: A cross-sectional survey was conducted with the support of the Spanish Society of Radiation Oncology (SEOR). An anonymous questionnaire was sent in two waves, one month apart, between January and June 2022, to all Medical Schools and affiliated Institutions having radiotherapy departments throughout the country. Data on load, curricular location of OR, the academic course (or courses) in which the subject of OR was taught, and teachers position were recorded. Results: Responses were obtained from 26 of the 46 available Medical Schools (response rate 56.5%). The average number of theoretical classes was 13 (0-30), seminars: 4.5 (0-12) and hours of practical training 17 (0-60). The scientific content of RO was covered very evenly. Medical physics and radiobiology were taught with different extension in 24 medical schools (92.3%). Information on technological equipment, brachytherapy, indications, and clinical results was provided in all but one medical school. In 13 medical schools (50.0%) the contents of RO were taught in more than one course, but the distribution of RO teaching during the six years of undergraduate training was quite dispersed. The teaching staff included 4 full professors, 8 tenured professors, and 68 clinical associate professors. The average number of associate professors per medical school was 2.2. Also, the average number of full professors and tenured lecturers was 0.42 per medical school, although there were none in 16 centers. Conclusions: The overall teaching content of RO in Spanish medical schools seems appropriate but actions to improve the heterogeneity in the curricular location of RO and the shortage of teachers should be implemented.

Effectiveness of Twitter Threads to Improve Medical Student Electrocardiogram (ECG) Reading-Skills. The TwittUVa-ECG Non-Randomized Pre-Post Study.

Introduction: social media is increasingly used in medical education, but its real educational effectiveness is unclear. In this study we assess the effectiveness of Twitter threads (TTS) in improving electrocardiogram (ECG) basic reading skills (ECGBRS). Materials and Methods: Seven TTS describing ECGBRS were published from October 28, 2021, to November 24, 2021. Tests were used to assess medical students ECGBRS pre and post intervention. All third and sixth-year medical students were invited to participate. Sixty-three students were enrolled (33 third year and 30 sixth year). Nine (14.3%) participants dropped out. Results: Sixth year medical students had higher ECGBRS at baseline. The number of correct items increased after the Twitter intervention; median correct pre-test items were 20 out of 56, (interquartile range (IQR) 14-23), and median post-test were 29 out of 56, (IQR 21-36) (p < 0.001). The improvement in sixth year students was greater than for third year students; 10 more correct items (IQR 4-14) vs. 7 (IQR 1-14) items (p = 0.045). The more TTS followed, the greater the improvement in ECGBRS (p = 0.004). The QRS axis calculation was the ECG reading skill with the lowest scores. Most medical students were definitely (35%) or very probably (46%) interested in repeating another on-line learning experience and found the TTS extremely (39%) or very (46%) interesting. Conclusions: The use of specifically designed TTS was associated with improvement in medical students' interpretation of ECGs. The effectiveness of the threads was higher in the final years of medical school when basic skills had already been acquired. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01885-x.

Semblance of a physician: medical students' experiences during Type 2 Diabetes Mellitus clinic simulation / Com o semblante de médico: experiências de estudantes de medicina durante a simulação clínica em Diabetes tipo 2 / Con el semblante de médico: experiencias de estudiantes de medicina durante la simulación clínica en Diabetes tipo 2

This qualitative research aimed to understand the experiences of a fourth-year medical class during two clinical simulation scenarios of type 2 diabetes management in Primary Care. Ten simulated students were interviewed. The results describe the symbolic conception of diabetes and its treatment as anguish, damage, condemnation and an unpleasant sentence that affects the appropriation and performance of the medical role by students. Considering Medical Psychology, we suggest that such subjective factors should be addressed in teaching-learning in addition to commonly cognitive aspects mentioned in the medical education literature in order for students to develop the work profile to cope with diabetes in Primary Care. Clinical simulation facilitates the subjective approach through its group support component to promote reflection, insights and self-awareness.(AU)

Esta pesquisa qualitativa objetivou compreender as experiências de estudantes de um quarto ano médico durante dois cenários de simulação clínica do manejo do diabetes tipo 2 na Atenção Primária. Dez estudantes simulados foram entrevistados. Os resultados descrevem a concepção simbólica do diabetes e seu tratamento como angústia, dano, condenação e uma sentença desagradável que afeta a apropriação e o desempenho do papel médico pelos estudantes. Considerando a Psicologia Médica, sugerimos que os fatores subjetivos apontados devem ser abordados no ensino-aprendizado além de aspectos cognitivos mais comuns na literatura de educação médica para que os estudantes desenvolvam o perfil de trabalho ao enfrentamento do diabetes na Atenção Primária. A simulação clínica permite esta abordagem subjetiva por seu componente de suporte grupal promovendo reflexão, insights e autoconsciência.(AU)

Esta encuesta cualitativa tuvo el objetivo de comprender las experiencias de estudiantes del cuarto año de medicina durante dos escenarios de simulación clínica del manejo de la diabetes tipo 2 en la Atención Primaria. Fueron entrevistados 10 estudiantes simulados. Los resultados describen la concepción simbólica de la diabetes y su tratamiento, tales como angustia, daño, condenación y una sentencia desagradable que afecta la apropiación y el desempeño del papel médico por parte de los estudiantes. Considerando la Psicología Médica, sugerimos que los factores subjetivos señalados deben abordarse en la enseñanza-aprendizaje, más allá de aspectos cognitivos más comunes en la literatura de educación médica para que los estudiantes desarrollen el perfil de trabajo para el enfrentamiento de la diabetes en la Atención Primaria. La simulación clínica permite este abordaje subjetivo por su componente de soporte grupal promoviendo reflexión, insights y autoconciencia.(AU)

Percepción de docentes sobre habilidades comunicativas de sus estudiantes para una adecuada relación médico-paciente / Perception of teachers about communication skills of their students for an adequate doctor-patient relationship

Fundamento: la existencia de insatisfacciones en la relación médico-paciente constituye una preocupación por la dirección del Estado y del sector de salud cubanos. Objetivo: valorar el desarrollo de las habilidades comunicativas de los educandos, según la percepción docente sobre el cumplimiento de las funciones de la comunicación para una adecuada relación médico-paciente. Métodos: se realizó una investigación cualitativa en la Facultad de Medicina de la Universidad de Ciencias Médicas de Villa Clara, Cuba, entre mayo-junio 2021. Se aplicaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; y empíricos: análisis documental y encuesta de opinión estructurada a los docentes sobre la base de las funciones comunicativas. Los resultados se expresaron en porcientos según los indicadores para la valoración, y se ilustraron en figuras. Resultados: la malla curricular de la carrera de Medicina ofrece posibilidades de desarrollo de habilidades comunicativas como basamento para una adecuada relación médico-paciente, constituyen fortalezas las asignaturas y disciplinas propias de la formación en pregrado y la educación en el trabajo. La función informativa de la comunicación resultó ser la más favorecida en los criterios expresados por lo docentes; obtuvieron más bajos porcientos la reguladora y la afectiva. Conclusiones: la percepción docente mostró insuficiencias en la relación médico-paciente en todas las funciones, por lo que se precisa elaborar estrategias para el desarrollo de las habilidades comunicativas, imprescindibles en la formación médica humanitaria que caracteriza la asistencia médica cubana.

Background: the existence of dissatisfies in the doctor-patient relationship constitutes a concern for the direction of the State and the Cuban health branch. Objective: to assess the development of students' communication skills, according to the teacher's perception of compliance with communication functions for an adequate doctor-patient relationship. Methods: a qualitative research was carried out at the Faculty of Medicine of Villa Clara University of Medical Sciences, Cuba, from May to June 2021. Theoretical methods were applied: analysis-synthesis, induction-deduction and historical-logical; and empirical ones: documentary analysis and structured opinion survey of teachers based on communicative functions. The results were expressed in percentages according to the indicators for the assessment and were illustrated in figures. Results: the curriculum of the Medicine career offers possibilities for the development of communication skills as a basis for an adequate doctor-patient relationship, the subjects and disciplines of undergraduate training and the in-service training are strengths. The informative function of communication turned out to be the most favored in the criteria expressed by the teachers; the regulatory and affective obtained lower percentages. Conclusions: the teacher's perception showed insufficiencies in the doctor-patient relationship in all functions, which is why it is necessary to develop strategies for the development of communication skills, essential in humanitarian medical training that characterizes Cuban medical assistance.

Autorregulación del aprendizaje: análisis de su apreciación por estudiantes de primer año de Medicina / Self-regulation of learning: analysis of its appreciation by first￾year medical students

Fundamento: la autorregulación del aprendizaje es un parámetro importante para tomar decisiones docente-metodológicas, promotoras de la autogestión del conocimiento. Objetivo: analizar la apreciación sobre su autorregulación del aprendizaje, por estudiantes de primer año de Medicina del curso 2021-2022, en la Facultad de Ciencias Médicas "Salvador Allende". Métodos: se realizó una investigación exploratoria, descriptiva, transversal y no experimental, con un enfoque mixto. Se utilizaron métodos teóricos: análisis-síntesis, inductivo-deductivo y enfoque sistémico; empíricos: el instrumento de medición utilizado consistió en un cuestionario conformado a partir de una adaptación de la Escala de Autorregulación del Aprendizaje, con las dimensiones: actitud hacia el estudio, enfoque estratégico en el aprendizaje y regulación metacognitiva; y matemático-estadísticos para el procesamiento de los datos. Resultados: se determinó que la autorregulación del aprendizaje fue insatisfactoria, al presentarse deficiencias en dos de sus dimensiones: Enfoque estratégico en el aprendizaje y Regulación metacognitiva. La dimensión Actitud ante el estudio obtuvo una valoración satisfactoria; se apreció que el ítem correspondiente a la dedicación al trabajo con las tareas orientadas, tuvo una débil relación directa con el interés personal, las calificaciones obtenidas y el reconocimiento personal. De todos los ítems considerados en la encuesta, solamente hubo una relación débil e indirecta del sexo (p ˂ 0,01) con la solicitud de ayuda y el aprovechamiento de las explicaciones de los compañeros. Conclusiones: la percepción de la autorregulación del aprendizaje por la población objeto de estudio mostró dificultades en rasgos significativos de dicha conducta, lo que limita la disposición para el aprendizaje autónomo.

Background: self-regulation of learning is an important parameter for making teaching-methodological decisions, promoting self-management of knowledge. Objective: to analyze the appreciation of their self-regulation of learning, by first-year Medicine students of the 2021-2022 academic year, at the "Salvador Allende" Faculty of Medical Sciences. Methods: an exploratory, descriptive, cross-sectional and non-experimental investigation was carried out, with a mixed approach. Theoretical methods were used: analysis-synthesis, inductive-deductive and systemic approach; Empirical ones: the measurement instrument used consisted of a questionnaire made from an adaptation of the Self-regulation of Learning Scale, with the dimensions: attitude towards study, strategic approach to learning and metacognitive regulation; and mathematical-statisticalfor data processing. Results: it was determined that the self-regulation of learning was unsatisfactory, as there were deficiencies in two of its dimensions: strategic focus on learning and metacognitive regulation. The Attitude dimension towards the study obtained a satisfactory assessment, it was observed that the item corresponding to dedication to work with oriented tasks, had a weak direct relationship with personal interest, qualifications obtained and personal recognition. Of all the items considered in the survey, there was only a weak and indirect relationship between sex (p ˂ 0.01) with the request for help and taking advantage of the explanations of the classmates. Conclusions: the perception of self-regulation of learning by the study population showed difficulties in meaningful features of such behavior, which limits the willingness for autonomous learning.

Estrategia curricular de Medicina Natural y Tradicional desde la disciplina inglés en la educación médica / Curricular strategy of Herbal and folk Medicine from the English discipline in medical education

La formación de profesionales demanda que el proceso enseñanza aprendizaje tenga una visión integradora para alcanzar los objetivos generales con los niveles de profundidad y dominio requeridos. A partir de ello, es que se introduce una novedosa forma de abordar la interdisciplinariedad, aplicando estrategias curriculares. La aplicación de la Medicina Natural y Tradicional en la formación de los médicos generales no ha sido sistemática ni de forma coordinada por el colectivo de profesores de inglés en la Universidad de Ciencias Médicas de Villa Clara. Es objetivo de los autores describir una tesis de maestría que contiene: metodología y acciones para implementarla desde la disciplina y asignaturas de inglés, un curso de posgrado para profesores de este idioma y ofertas de bibliografías actualizadas impresas y digitales como materiales de consulta para el estudio independiente, cuyos contenidos se aplican de forma satisfactoria para solucionar las carencias mencionadas.

The training of professionals demands that the teaching-learning process have an integrating vision to achieve the general objectives with the required levels of depth and mastery. From this, a new way of approaching interdisciplinarity is introduced, applying curricular strategies. The application of herbal and folk Medicine in the training of general practitioners has not been systematic or coordinated by the group of English teachers at the Villa Clara University of Medical Sciences. The authors' objective is to describe a master's thesis that contains: methodology and actions to implement it from the discipline and subjects of English, a postgraduate course for teachers of this language and offers of updated printed and electronic bibliographies as reference materials for the independent study whose contents are satisfactorily applied to solve the aforementioned deficiencies.

Ensino da anatomia: dissecção em associação com a tecnologia no curso de Medicina / Teaching anatomy: dissection in association with technology in the Medical course

Resumo: Introdução: Um estudo de 2010 apontou as necessidades futuras da educação médica, com conteúdos e práticas integrados, fomentada pela tecnologia educacional virtual e pela prioridade na competência, não no tempo. A anatomia, indistinta de outros fundamentos da medicina, enfrenta restrições à dissecção de cadáveres. Objetivo: Ensaio sobre o ensino da anatomia em contextos clínicos e com emprego de tecnologias. Método: Utilizaram-se a plataforma PubMed da National Library of Medicine e os descritores ((anatomy [MeSH Terms]) AND (method, teaching [MeSH Terms])) AND (surgery [MeSH Terms]). Resultado: Há indicação de 316 artigos no período 2000-2022 (junho de 2022). A principal pergunta sobre o ensino de anatomia refere-se à substituição da técnica de dissecção e, por consequência, do uso do cadáver. Estudos sugerem a manutenção do uso da dissecção, da prossecção e de maior uso de meios digitais e modelares. Conclusão: O material cadavérico deve ser garantido com maior uso da prossecção, com a dissecção sendo dirigida ou eletiva. Realidade virtual e material de prossecção devem ser assimilados como instrumentais e supervisionados por anatomistas qualificados e enriquecidos pela interpretação e aplicabilidade clínica.

Abstract: Introduction: A 2010 study pointed out the future needs of medical education, with integrated contents and practices, fostered by virtual educational technology and by prioritizing competence, not time. Anatomy, indistinguishable from other fundamentals of medicine, faces restrictions on cadaver dissection. Objective: Essay on the teaching of anatomy in clinical contexts and the use of technologies Method: The "pubmed" platform of the National Library of Medicine and descriptors ((anatomy[MeSH Terms]) AND (method, teaching[MeSH Terms])) AND (surgery[MeSH Terms]) were used. Result: There are indications of 316 articles in the period 2000-2022 (June 2022). The main question about the teaching of Anatomy is the replacement of the dissection technique and, consequently, the use of the cadaver. Studies suggest maintaining the use of dissection, prosection and greater use of digital and model means. Conclusion: Cadaveric material should be secured with greater use of prosection and dissection being directed or elective. Virtual reality and permanent material must be assimilated as instrumental and supervised by qualified anatomists and enriched by interpretation and clinical applicability.

Experiencias investigativas basadas en cursos, análisis de sus fundamentos y resultados en la Educación Médica

Introducción: las experiencias investigativas durante el pregrado son diversas y tienen como objetivo la formación de competencias en ese mismo ámbito de investigación. Objetivo: recopilar la información relacionada a las experiencias investigativas basadas en cursos (EIBC) que se han implementado en el contexto de la educación médica. Métodos: se realizó una revisión de la literatura narrativa donde se indagaron las bases de datos ERIC, SciELO, Redalyc, Scopus y PubMed a través de los términos: "ciencia", "basados en cursos", "investigación", "en el aula", "experiencia(s)", "pasantía(s)", "pregrado", "licenciatura", "formación". De las 780 fuentes iniciales, se analizaron 35. La información fue descrita según las categorías de: resultados de las mediciones, fundamentos teóricos, beneficios de la experiencia, limitaciones/ desventajas. Resultados: las EIBC se consideran como experiencias positivas y atractivas para los estudiantes, pues permiten exponerlos al proceso investigativo, desarrollar habilidades y oportunidades para futuros proyectos de investigación, permitir establecer redes y trabajo en equipo, brindar la oportunidad para trabajar en equipos de investigación y laboratorios de experimentación, y comprometer a los estudiantes y docentes a difundir los hallazgos a través de publicaciones científicas. Sus fundamentos se encuentran en el aprendizaje situado, las comunidades de práctica, el aprendizaje basado en problemas y el aprendizaje constructivista. El objetivo en común es el de involucrar a los estudiantes de pregrado en la investigación científica y que logren formar sus competencias a través del mismo acto investigativo. Conclusión: las EIBC permiten mejorar el aprendizaje estudiantil, la formación de competencias investigativas, otorgan ganancias en su identidad científica, autoconfianza, y persistencia en su carrera de estudios.

Summary Background: Investigative experiences during undergraduate education are diverse and their objective is the formation of investigative competences. Objective: to compile information related to coursebased research experiences (CBRE) that have been implemented in the context of undergraduate medical education. Methods: A review of the narrative literature was carried out where the ERIC, SciELO, Redalyc, Scopus and PubMed databases were investigated through the terms: "science", "course-based", "research", "in the classroom", "experience(s)", "internship(s)", "undergraduate", "bachelor", "training". Of the 780 sources initially searched, 35 references were analyzed. The information was analyzed according to the categories of: measurement results, theoretical foundations, benefits of the experience, limitations / disadvantages. Results: The CBRE are considered positive and attractive experiences for students, as they allow the student to be exposed to the research process, developing skills and opportunities for future research projects, allows networking and teamwork to be established, provides the opportunity to work in research teams and research laboratories, experimentation, and commits students and teachers to disseminate the findings through scientific publications. Its foundations are in situated learning, communities of practice, problembased learning and constructivist learning. The common objective is to involve undergraduate students in scientific research and that they manage to form their competencies through same investigative act. Conclusion: CBRE allow improving student learning, the formation of investigative competences, and gains in their scientific identity, self-confidence, and persistence in their study career.