La integración de la inteligencia artificial en la educación médica y su impacto en la práctica clínica / The integration of artificial intelligence in medical education and its impact on clinical practice

Introducción: La integración de la inteligencia artificial (IA) en la educación médica redefine paradigmas, optimiza méto-dos y forja una simbiosis tecnológica. Desarrollo: La IA potencia simulaciones clínicas, mejora evaluaciones y desarrolla habilidades blandas, redefiniendo lainteracción médico-paciente. Conclusiones: Aunque persisten desafíos éticos, la colaboración interdisciplinaria y la adaptabilidad son cruciales. La IA marca un hito en la evolución médica al elevar la calidad asistencial y establecer estándares para una colaboración armoniosa entre tecnología y compasión.(AU)

Introduction: The incorporation of artificial intelligence (AI) into medical education redefines paradigms, optimisesmethods and forges a technological symbiosis. Development: AI enhances clinical simulations, improves assessments and develops soft skills, thereby redefining doctor-patient interaction. Conclusions: Although ethical challenges remain, interdisciplinary collaboration and adaptability are crucial. AI marks a milestone in the evolution of medicine by raising the quality of care and setting standards for harmonious collaboration between technology and compassion.(AU)

Percepción de los estudiantes sobre el uso del portafolio digital en prácticas clínicas intermedias de kinesiología / Student’s self-perception on the use of the e-portfolio in intermediate clinical practices of kinesiology

Introducción: El portafolio es un instrumento de aprendizaje y de evaluación que permite a los estudiantes conocer cómo se desarrolla su aprendizaje y autoevaluarse. Objetivo. Describir la percepción de estudiantes de kinesiología respecto al uso de un portafolio digital como instrumento didáctico en el desarrollo de prácticas intermedias. Sujetos y métodos: Estudio observacional, descriptivo, que busca describir la percepción de estudiantes de kinesiología frente al uso de un portafolio digital en el desarrollo y seguimiento de prácticas intermedias de la actividad curricular de geriatría. Resultados: En general, para las dimensiones que evalúan la percepción de los estudiantes en esta metodología docente y evaluativa, un 72% reconoce que los materiales de aprendizaje son muy buenos, seguidos de la dimensión sistema de tutorías, con un 53% de las respuestas de forma satisfactoria, y la de los recursos de la plataforma en línea, con un 42% que la conceptualiza como buena. Conclusiones: La percepción de los estudiantes se describe como positiva en los distintos ítems de evaluación de la estrategia didáctica.(AU)

Introduction: The portfolio is a tool that allows students to account for their learning and assessment processes. Objective: To describe the self-perception of kinesiology students regarding the use of the e-portfolio as a didactic tool for the development of intermediate practices. Subjects and methods. Observational study that aims to describe the self-perception of kinesiology students regarding the use of e-portfolios for the development and monitoring of intermediate practices of the geriatric’s curricular activity. Results: In general, regarding the dimensions that evaluate the self-perception of the students on this learning and assessment tool, a 72% recognize that the learning materials are very good, followed by the tutorial system dimension with a 53% of the responses as satisfactory and the resources of the online platform with a 42% considering the latter as good. Conclusions: The self-perception of the students is described as positive in the different items of evaluation of the didactic strategy.(AU)

Neurosurgery Clerkships in United States Medical Schools: A Survey of Doctor of Medicine-Granting and Doctor of Osteopathic Medicine-Granting Schools.

OBJECTIVE: Exposure to neurosurgery is important for knowledge of neurosurgical conditions that physicians may encounter. The current status of neurosurgery nonsubinternship clerkships in the United States is unknown; this study determined the availability and format of non-subinternship neurosurgery clerkships in DO (Doctor of Osteopathic Medicine)-granting and MD (Doctor of Medicine)-granting U.S. medical schools. METHODS: Association of American Medical Colleges and American Association of Colleges of Osteopathic Medicine websites were used to obtain contact information for all U.S. medical schools. Respondents were asked whether their school offered a non-subinternship neurosurgery clerkship, if it was required, clerkship length, and whether the clerkship was embedded in another clerkship. Nonsubinternship clerkships/electives/selectives were defined as an exploratory neurosurgery rotation. For nonresponding schools, data were collected from school websites. RESULTS: Data were obtained for 180/199 U.S. medical schools; 142 (79%) provided neurosurgery non-subinternships, including 125/150 (83.3%) MD-granting and 17/30 (57%) DO-granting schools. Four MD-granting schools (2.8%) required the clerkship; 87/142 (61%) offered a stand-alone clerkship, 34/142 (24%) an embedded clerkship, and 21/142 (15%) offered both. In total, 200 clerkships were offered across 142 schools. Most were either >1-2 weeks or >3-4 weeks (69/200, 35% and 89/200, 45%, respectively). CONCLUSIONS: Most U.S. medical schools provide elective neurosurgery non-subinternships. Fewer, although still a majority, of DO-granting schools offer a neurosurgery non-subinternship compared with MD-granting schools.

Oral 'Board Style' Examination for Surgery Clerkship.

Evaluating medical students during surgical clerkships relies on multifactorial methods of evaluation. Clinical evaluations, combined with standardized multiple-choice exams, are often the foundation of evaluation highlighting the challenge of combining subjective and objective measurements. Oral board exams are standard amongst medical certification and employ an additional element to evaluate students more holistically. Course evaluations from years that incorporated an oral board exam were compared to a year that omitted the exam. We found course satisfaction was higher in the years that included the oral exam (3.25 /5) than years without the oral board exam (3/ 5). The oral exam adds a novel element to the evaluation of a medical student that allows for a comprehensive understanding of a student's fund of knowledge and helps prepare them for future board certifications. Because students have an opportunity to demonstrate knowledge in a standard, more comprehensive format, they have higher satisfaction with the course.

Notas sobre o pesquisar em cena(s) / Notes on researching in scenes / Notas sobre la investigación en escena(s)

O presente artigo tem como objetivo apresentar a construção metodológica desenvolvida em uma pesquisa de mestrado, na qual sustentamos a escrita de cenas como método de pesquisa da escuta clínica. As cenas do trabalho em questão foram recolhidas ao longo do tempo, no contorno da experiência de um projeto de extensão universitária de atenção à infância e adolescência em situação de vulnerabilidade social, situado em uma comunidade periférica. Apresentamos, neste texto, as interrogações que se elaboraram em torno da escolha pelo trabalho com cenas, e compartilhamos o resgate histórico dessas como um método de escrever a clínica, bem como a retomada de sua análise a partir da tradição psicanalítica. Amparadas nesta teoria e em leituras e contribuições do filósofo francês Jacques Derrida, embasamos a noção de que a cena se constitui como um lugar de produção, ao engendrar a configuração particular de elementos significantes nos processos de subjetivação e de construção social. A cena não é, então, compreendida aqui como uma representação do que acontece na clínica, mas como um modo de produzir a escuta e os seus processos de investigação.(AU)

This article aims to present the methodological construction developed in a master's research, in which the writing of scenes as a method of clinical listening research was endorsed. The scenes from the study in question were collected over time, from the experience gained in a project conducted within a university extension program on care in childhood and adolescence in social vulnerability, in a peripheral community. In this study, we present some questions that were elaborated surrounding the choices of working with scenes; and we share the historical rescue of this work as a method of writing on clinic practices and resuming their analysis from the psychoanalytic tradition. Based on the psychoanalytic theory and on the readings and contributions of the French philosopher Jacques Derrida, we corroborate the notion that the scene is constituted as a place of production, engendering the particular configuration of significant elements in the processes of subjectivation and social construction. Here, the scene is not a representation of clinical practice but one mode of producing listening and its research processes.(AU)

Este artículo tiene como objetivo presentar la construcción metodológica desarrollada en una investigación de maestría, en la que sostenemos la escritura de escenas como método de investigación de la escucha clínica. Las escenas del trabajo en cuestión se recogieron a lo largo del tiempo desde la experiencia en un proyecto de extensión universitario de atención a la niñez y adolescencia en situación de vulnerabilidad social aplicado en una comunidad periférica. En este texto, presentamos los interrogantes que se elaboraron en torno a la elección por el trabajo con escenas y compartimos el rescate histórico de las mismas como un método de escribir la clínica y la reanudación del análisis a partir de la tradición psicoanalítica. Amparadas en el psicoanálisis y en lecturas y contribuciones del filósofo francés Jacques Derrida, nos basaremos en la noción de que la escena se constituye como un lugar de producción, engendrando la configuración particular de elementos significantes en los procesos de subjetivación y de construcción social. La escena no es aquí una representación de lo que pasa en la clínica, sino un modo de producir escucha y sus procesos de investigación.(AU)

Evaluating Teaching Effectiveness of Medical Humanities in an Integrated Clerkship Program by a Novel Prospective Propensity Score Matching Framework.

BACKGROUND: This study aims to rigorously compare the effectiveness of the educational programs of a new integrated clinical clerkship in medicine (3 months) and surgery (3 months) at a cancer center with the conventional subspecialty-based rotations at a tertiary teaching hospital, by this prospective, pre-post comparative method. METHODS: Between 2013-2016, we compared 69 students who had selected the integrated clerkship that emphasized clinical competency and medical humanities training with 138 matched peers who had completed conventional clerkships during the same period. Outcome measures for medical humanities included empathy, patient-centeredness, and other values and skills related to holistic health care professionalism by introducing prospective propensity score matching (PSM). RESULTS: At baseline, no significant between-group differences existed. At the completion of the core clerkships, students receiving the integrative clerkship had significantly higher scores on the Patient-Practitioner Orientation Scale (PPOS) and the Professionalism Climate in Clinical Teaching Environment (PCI), and similar Jefferson Scale of Physician Empathy Student Version (JSPE) scores, as compared with the comparison group. We also found that the students in this program did not perform worse than those in the traditional internship group in the comprehensive and formative OSCE medical clinical skills test. CONCLUSIONS: Our study develops an empirical basis for rigorous evaluation to design medical education to improve the medical humanities values and skills of interns. Features of the new integrated clerkship program that we developed include substantial participation by the students in patient-centered in-hospital culture, as well as reflection, discussion, and feedback on actual clinical cases.

"A vida como ela é" e o desenvolvimento de competências e autonomia na integração ensino-serviço-comunidade / "Life as it is" and the development of skills and autonomy in the teaching-service-community integration

A formação em Odontologia alinhada às demandas atuais de saúde tem sido uma agenda importante. O objetivo desta pesquisa foi compreender os aprendizados a partir dos estágios supervisionados na perspectiva do desenvolvimento de competências e autonomia, a partir da voz de estudantes de Odontologia. Utilizou-se pesquisa qualitativa, com dois gruposfocais, com 13 estudantes, de ambos os sexos,de um curso de Odontologia, de uma instituição federal de ensino noNordeste do Brasil. Procedeu-se à análise temática de conteúdo. Os Estágios Supervisionados da Saúde Coletiva atuam como oportunidades de ensino-aprendizagemavaliação, permitindo vivência nos serviços públicos de saúdelocais e territórios, sensibilizando o estudante para o cuidado integral e para a compreensão ampliada do processo saúde-doença. As vivências partemsempre da premissa de que o aprendizado está vinculado aos serviços de saúde e a um percurso construído coletivamente por todos. Portanto, a compreensão dos estudantes sobre a integração entre o ensino, o serviço e a comunidade, permitiram a articulação entre a teoria e a prática da Saúde Coletiva e o desenvolvimento de competências "socio-lógicas" implicadas aos contextos do trabalho em saúde. Com esse entendimento, os participantes reconheceram o princípio da educação pelo/com o trabalho e a importância de todos para troca e produção de conhecimentos e de saberes em saúde (AU).

Dentistry education aligned with current health demands has been an important topic on the agenda. The objective of this research was to understand the acquired knowledge in supervised internships in terms of the development of skills and autonomy, from the point of view of dentistry students. Qualitative research was used, with two focus groups, with 13 students of both genders, from a dentistry course, from a Federal Educational Institution in Northeastern Brazil. A thematic content analysis was performed. The Collective Health Supervised Internships act as teaching-learning evaluation opportunities, allowing experience in local public health services and territories, creating student awareness of comprehensive care and a broader understanding of the health-disease process. The experiences are always based on the premise that learning is linked to health services and to a path built collectively by everyone. Therefore, the students' understanding of the integration between teaching, service and community allowed the articulation between theory and practice of Collective Health and the development of "socio-logical" competencies involved in the contexts of work in healthcare. With this understanding, the participants recognized the principle of education through/with work and the importance of everyone to exchange and produce knowledge and health education (AU).

Formação em Odontologia para além dos muros da Universidade: relato de experiência do estágio na Estratégia Saúde da Família / Dentistry training beyond the walls of the University: experience report of the internship in Family Health Strategy

A exigência de profissionais de Odontologia aptos a trabalharno Sistema Único de Saúde (SUS) traz a necessidade de uma formação direcionada ao desenvolvimento de competências e habilidades. A inserção do aluno na Atenção Primária à Saúde (APS) por meio dos estágios vem sendo preconizada, por ser um nível de atençãoimportante para construção da integralidade do cuidado. Assim, o objetivo deste artigo é descrever e analisar a experiência vivenciada por graduandos de Odontologia junto a uma equipe da Estratégia Saúde da Família (ESF) no componente curricular Estágio Supervisionado na ESF, em uma Unidade Básica de Saúde (UBS) de um município do interior, em um bairro com grande vulnerabilidade social. Trata-se de um relato de experiência de abordagem descritiva, caráter qualitativo e cunho crítico-reflexivo. Osdados foram alcançados pelapercepção dos alunos durante as atividades do estágio, utilizando como base o portfólio crítico reflexivo (PCR) construído durante dez encontros na UBS. Previamente, um semestre foi destinado à aquisição de conhecimento teóricoe planejamentodas atividades a serem desenvolvidas durante o estágio. Na UBS, os estudantes tiveram a possibilidade de vivenciar o funcionamento e interação da equipe de saúde, realizar atividades voltadas à prática interprofissional, visualizar as demandas da comunidade e desenvolver atividades com metodologias participativas. Em seguida, foi construído o PCR e partilhada a vivência por meio de apresentação aberta ao público. Dessa forma, o estágio permitiu desenvolver um olhar mais humanizado e integral aos estudantes de Odontologia, com competências importantes para o profissional apto a trabalhar no SUS (AU).

The requirement for Dentistry professionals able to work in the Brazilian Unified Health System (SUS, as per its Portuguese acronym) brings the need for training aimed at developing skills and abilities. The insertion of the student in Primary Health Care (PHC) through internships has been advocated, since this is an important level of care for the construction of comprehensive care. Accordingly, the objective of this article is to describe and analyze the experience lived by undergraduate Dentistry students with a team of the Family Health Strategy (FHS) in the curricular component Supervised Internship in FHS, in a Primary Health Care Unit (PHCU), located in a city in the countryside, in a neighborhood with great social vulnerability. It is an experience report with a descriptive approach, qualitative character and critical-reflective nature. The data were obtained from the perception of students during the internship activities, using as a basis the reflective critical portfolio (RCP) constructed during ten meetings in the PHCU. Previously, a semester was destined to the acquisition of theoretical knowledge and planning of activities to be developed during the internship. In the PHCU, students were able to experience the functioning and interaction of the health team, perform activities aimed at interprofessional practice, visualize the demands of the community and develop activities with participatory methodologies. Subsequently, the RCP was constructed and the experience shared through an open presentationto the public. Thus, the internship allowed the Dentistry students to develop a more humanized and comprehensive look, with important skills for the professional who is able to work in the SUS (AU).

Formação em Odontologia sob o olhar da integração ensino, serviço e comunidade: um relato de experiência / Training in Dentistry under the view of integration teaching, service and community: an experience report

Este estudo se refere a um relato sobre a experiência vivenciada nos Estágios que ocorrem de forma articulada entre universidade, serviço de saúde e comunidade do curso de Odontologia da Universidade Estadual de Feira de Santana (Bahia, Brasil), após dez anos de implantação do novo currículo obedecendo às Diretrizes Curriculares Nacionais. Quanto aos resultados, observou-se um maior comprometimento social e criticidade dos discentes em relação à aplicação do conteúdo teórico-prático, adquirido ao longo da graduação, bem como a aproximação destes com os outros profissionais da Equipe de Saúde da Família e a busca em atender às necessidades de transformação e melhorias da sociedade. Para que os objetivos pedagógicos sejam plenamente alcançados, destaca- se a relevância, não só da capacitação docente e da existência de uma matriz curricular do curso estruturada a partir do conceito de integralidade, como também da sensibilização dos estudantes, da interlocução com os preceptores e da participação ativa de todos os protagonistas nos estágios, colaborando e retroalimentando a integração ensino-serviço-comunidade (AU).

This study refers to a report on the experience in the Internships that occur in an articulated way between the university, the health service, and the community of the Dentistry course at the State University of Feira de Santana (Bahia, Brazil), after ten years of implementation of the new curriculum obeying the National Curriculum Guidelines. As the result, there was a significant social commitment and criticality of the students about the application of theoretical and practical content, acquired during graduation, as well as the approximation of these with other professionals of the Family Health Team and the search for meet society's needs for transformation and improvement. For the pedagogical objectives to be fully achieved, the relevance is highlighted, not only of teacher training and the existence of a curricular matrix of the course structured on the concept of comprehensiveness but also of student awareness, dialogue with preceptors, and the active participation of all the protagonists in the internships, collaborating and providing feedback to the teaching-service-community integration (AU).

Estágio Comunitário Interprofissional na formação do estudante de Odontologia: relato de experiência da Universidade Federal de Goiás / Interprofessional Community Internship in Dental Student Education: experience report of the Federal University of Goiás

O Sistema Único de Saúde configura-se como um potente cenário de atuação e campo de formação interprofissional, principalmente,no que se refere aos estágios supervisionados. Esse relato de experiência (RE) tem como objetivo descrever o processo de construção do Estágio Comunitário Interprofissional (ECI) da Universidade Federal de Goiás na perspectiva da formação do cirurgião-dentista. A construção parte das experiências vivenciadas e refletidas pelas autoras/sujeitos do RE: as professoras do estágio em cada curso (enfermagem, nutrição, medicinae odontologia) e a coordenadora da integração ensino-serviço-comunidade do campus do município onde ocorre o estágio. Foram ainda consultados os planos de ensino e projetos pedagógicos dos cursos envolvidos, as memórias das oficinas avaliativas realizadas ao longo do estágioe o Manual do Estágio Comunitário. O contexto do ECI, o processo ensino-aprendizagem na formação interprofissional do estudante de odontologia, a busca da sustentabilidade do estágio e a potencialidade da aprendizagem informal são apresentados e discutidos. Considera-se os avanços históricos alcançados no percurso do ECI e os dispositivos que favorecem tais mudanças na perspectiva da educação e prática interprofissional, além dos potenciais pontos de evolução do estágio para garantir a formação integral do cirurgião-dentista, no que tange às competências colaborativas (AU).

The Unified Health System (SUS) in Brazil is a powerful scenario for action and a field of interprofessional education, particularly with regard to supervised internships. This experiencereport (ER) describes the structure of the interprofessional community internship (ICI) at the Federal Universityof Goiás from the perspective of dental education. The articleis based on the experiences and reflectionsofthe authorsand subjectsof the ER: the faculty of each study program (Dentistry, Medicine, Nursing, and Nutrition) and the coordinator for the integration of teaching, service, and community on the campus where the internshiptakes place. The pedagogical projects and teaching plans of the participating programs, the evaluation workshops during the internship, and the community internship manualwere also consulted.The ICI context, the learning process in interprofessional dental student education, the sustainability of the internship, and the potential of informal learning are presented and discussed. The historical advances made during the ICIand the means by which such changes in the perspective of education and interprofessional practice are fostered, as well as the potential points of development of the internshipto ensure the holistic education of dental studentsin terms of collaborativeskills, are considered (AU).

From the "what" to the "how": Teaching integrative medicine-related skills to medical students during COVID-19.

OBJECTIVE: To examine the impact of an integrative medicine (IM) course on self-perceived IM-related communication and research skills. METHODS: A 3-day mandatory "hybrid" (online and in-person) IM course was held within COVID-19 restrictions for 161 pre-clerkship medical students, with workshops facilitated by mentor healthcare professionals (IM and non-IM) and student-directed tasks. Self-perceived levels of 6 IM-related skills were scored (from 1 to 5) for history-taking; communicating with patients with "alternative" health-beliefs; referral to IM consultations; assessing risks/benefits; and working with non-medical IM practitioners. RESULTS: 137 students (85.1%) completed pre-/post-course questionnaires, with overall scores improving from pre-course (1.98 ± 0.92) to post-course (3.31 ± 0.63; p < 0.0001), for the entire group and student subgroups (with vs. without prior IM experience). Multivariate analysis found no association between age, gender, primary language or prior experience with IM and improvement in skill scores. CONCLUSIONS: The IM course increased self-perceived skill levels, reflecting the course curriculum and workshops. Further research needs to explore the application of these skills during clinical training. PRACTICE IMPLICATIONS: Teaching medical students about IM in a course comprising communication and research skills was shown to be feasible and effective. The application of IM-related skills needs to be evaluated during the clinical clerkship.

Clinical Competence and Perception of Medical Students after Early Clinical Exposure through Pre-clerckship Education at an Ethiopian Medical School: A Cross-sectional Study

BACKGROUND: Conventional medical curriculum is the mainstay in the long history of modern medical education. Innovative integrated medical curriculum attracted significant attention in improving conventional curriculum. In the integrated curriculum, basic sciences are incorporated horizontally with each other, and students are exposed early to clinical settings. This is expected to improve students' knowledge and skills in clinical medicine by the time they start their clerkship rotation. METHOD: the study aims to make a baseline assessment on the overall knowledge and skills of medical students towards clinical medicine. An institution-based cross-sectional study was conducted from March to April of 2020 using 91 third year medical students (convenience sampling). A threesection selfadministered survey instrument, short written MCQ exam, and practical (OSCE) students' examination were used for this survey. RESULT: participants tend to exhibit better knowledge on basics of history taking and physical examination with an average score of 79%. Comparatively, the score for average physical examination skill was low (56.3%). Students' perception on ECE showed, over 50% of participants believe ECE increases burden on their overall workload. Even then, the majority (92.3%) still think that ECE has positive impact on their clerkship education. Taken together, it appears more hands-on interventions is needed to further improve skills of medical students in physical examination with particular emphasis on the clinical examination of breast, thyroid, musculoskeletal, and neurologic systems

Estágio Supervisionado em Odontologia no Sistema Único de Saúde: revisão integrativa / Supervised internship in dentistry in the unique health system: an integrative review

Este estudo visa analisar a relevância dosEstágios Supervisionados em Odontologia no Sistema único de Saúde para o ensino, serviço e comunidade. Trata-se deuma revisão de literatura integrativacombusca nas bases de dadosBVS/LILACS, SciELO e Google Acadêmico. Os estudos para análise foram escolhidos após o estabelecimento de critérios de inclusão(artigos publicados nos últimos 5 anosque tratem das percepções dos envolvidos nessa vivência de integração,autores clássicos, teses, relatos de experiência, artigos em português, inglês e espanhol)e exclusão(artigos semDOIoutratando deestágiosem outras áreasesistemas de saúde). Assim, após a busca inicial, foram selecionados 113 estudosno total sendo 25, 8e 100,respectivamente,da BVS/LILACS, SciELO e Google Acadêmico. No entanto, após a leitura dos artigos na íntegra somente 17publicaçõesforam selecionadas. Dessa forma, das competênciasgerais apresentadas pelas Diretrizes Curriculares Nacionais em Odontologia, os estudos indicam que trabalho em equipe, atenção integral à saúde do usuário e comunicação adequada com usuários e membros da equipe são as características mais estimuladasna formação dos estudantes. Ademais, destaca-se a atenção primária como principal cenário de atuação do estagiário, compouco enfoque nos demais níveis de atenção. Analisou-se que perante as fragilidades desse processo, o estudante, sob orientação da preceptoria, deve adaptar-se àrealidade vivenciada para exercer a sua função com sucesso. Logo, o estágio insere o estudante na realidade profissional,além de trabalhar as suas insegurançase a capacidade de adaptação (AU).

This study aims to analyze the relevance of Supervised Internships in Dentistry at SUS for teaching, serviceand community. This is an integrative literature review, which was elaborated through a search in the databases: BVS/LILACS, SCIELO and GOOGLE ACADEMIC. The studies for analysis were chosen after the establishment of inclusion criteria: articles publishedin the last 5 years dealing with the perceptions of those involved in this integration experience, classical authors, theses, experience reports, articles in Portuguese, English and Spanish; and exclusion: articles without DOI and dealing with internshipsin other areas and health systems. Thus, after reading the titles, 113 studies were selected in total, 25, 8 and 100 respectively from the BVS/LILACS, SCIELO and Google academic. However, after reading the articles in full, only 17 publications were selected. Thus, from the general characteristics presented by the National Curriculum Guidelines in dentistry, studies indicate that teamwork, comprehensive care to the user's health and adequate communication with users and team members are the characteristicsmost encouraged by academics. Furthermore, primary care is highlighted as the main scenario in which the intern works, with little focus on other levels of care. It was analyzed that, in view of the weaknesses of this process, the student, under the guidance of the preceptorship, must adapt to the reality experienced in order to successfully perform his role. Therefore, the internship inserts the student into the professional reality, in addition to working on their insecurities and adaptability (AU).

Using peer role-playing to improve students' clinical skills for musculoskeletal physical examinations.

BACKGROUND: The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. Therefore, an effective programme is required to help medical students and residents improve their clinical skills in MSK. This paper aims to assess the clinical skills of medical students who have participated in a peer role-playing simulation programme using a mini clinical evaluation exercise (mini-CEX). METHODS: Participants were 90 female medical students who were completing their first orthopaedic clinical clerkship. They were divided into two groups. The simulation group participated in a role-play focussed on MSK cases as low-fidelity simulation, a structured debriefing with the course supervisor, and a self-reflection on Day 1 (n = 64). The control group did not participate in the role-play due to randomised clerkship schedules (n = 26). On Day 2 of the intervention, we observed and assessed all participants' performances during MSK outpatient encounters using the mini-CEX. We compared the mini-CEX score between the simulation group and the control group; the Wilcoxon rank-sum test was used for statistical analysis. RESULTS: The mini-CEX scores for physical examination, clinical reasoning and diagnosis, and overall clinical competency were significantly higher in the simulation group than in the control group (p < .05, physical examination: p = .014, clinical reasoning: p = .042, overall: p = .016). These findings suggest that medical students who partake in a peer role-playing simulation programme could experience improved clinical skills for physical examination, clinical reasoning and diagnosis, and overall clinical competency in real-life MSK outpatient encounters. CONCLUSIONS: Through a mini-CEX assessment, our findings indicate that medical students who participated in our peer role-playing simulation programme have improved clinical skills. Peer role-playing as a low-fidelity simulation and practical educational opportunity will enable educators to polish the competency of medical students in musculoskeletal physical examinations and clinical reasoning and diagnosis in a clinical setting.

Psychotropic Medication Informed Consent: A Cross-Specialty Role-Playing Skill Builder.

Introduction: Obtaining informed consent (IC) is an essential medical practice. Utilization of IC role-playing training with medication study cards and self-peer-supervisor review should improve student fund of knowledge and strengthen IC skills for clerkship-level medical students. Methods: Between 2017 and 2020, approximately 555 clerkship medical students used our formative role-playing exercise tools. Students independently prepared psychotropic medication study cards and role-played IC during group didactics. Peer and supervisor reviews were not recorded but were discussed as a group. Students completed routine anonymous postclerkship surveys regarding the IC exercise. An enhanced IC curriculum was deployed in 2020, adding a training video and peer/supervisor feedback form. Student feedback and specialty shelf exam scores were reviewed to assess the exercise's effectiveness. Results: Surveys indicated satisfaction with the exercise and increased confidence in obtaining IC. Interestingly, the student group that received enhanced IC training had fewer shelf exam failures than those without, perhaps indicating improved fund of psychotropic medication knowledge. Discussion: Peer role-playing IC training is well accepted by students, allows practice of essential elements of IC and shared decision-making, and provides an engaging way to improve medication fund of knowledge. Our clerkship has initiated development of an IC objective structured clinical examination station and is adapting the exercise across specialties for longitudinal learning in response to the positive feedback and ease of use. Structured review of psychotropics and peer IC role-playing can be tailored for other specialties, medications, and procedures and further developed for use in pre- and postclerkship education.

Transforming a clerkship with telemedicine.

The coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on both clinical practices and learning environments. On March 17th, 2020, the American Association of Colleges of Osteopathic Medicine and Commission on Osteopathic College Accreditation issued a statement recommending a "pause" in medical student participation in-person at clinical sites. In response, the Family Medicine Department at the Rowan University School of Osteopathic Medicine recognized the need to evolve the traditional curriculum and quickly transitioned to an online format, incorporating telemedicine into the clerkship. This new model enabled 44 third-year medical students to obtain high-quality, offsite, virtual education and learn new skills.

The effect of the education model on the levels of state/continuous anxiety and self-efficacy of midwifery students.

BACKGROUND: In midwifery practice, the education model used for skill acquisition is extremely important for the management of students' stress, anxiety and self-efficacy. Innovative practices aim to improve the students' cognitive, emotional and psychomotor skills, and new research needs to be performed to evaluate the results of such practices. AIMS: The present study aimed to evaluate the effects of the education model and clinical practice features, such as practice time, laboratory practice and exam evaluation, on the students' state and continuous anxiety and self-efficacy status. METHODS: This was a semi-experimental non-randomised study, including three steps. Research was conducted in two institutions. Sample selection was not made in the research. The sample consisted of two groups. Group 1 included students (n = 39), who get educated in 1st institution. Group 2 included students (n = 40), who get educated in 2nd institution. In the collection of research data; Introductory Information Form, Self- Efficacy Scale, Spielberger's State/Continuous Anxiety Inventory was used. Data were analysed by Shapiro Wilk Tests, numbers, percentages, Chi-square test, analysis of single factor variance in repeated measurements, repeated measures analysis of variance, t test in indepentdent samples. RESULTS: A significant difference was found between the three data collection steps, regarding self-efficacy as well as state and continuous anxiety scores (P < 0.001). A significant correlation was found between the mean self-efficacy scores of each group (P < 0.001). CONCLUSIONS: The results indicate that students have a high level of self-efficacy using the daily life activities model, engaging in 8 hours of clinical practice, performing clinical practice under the supervision of a midwife or a nurse.

Mindful medical practice: An innovative core course to prepare medical students for clerkship.

BACKGROUND: Medical students show a decline in empathy and ethical reasoning during medical school that is most marked during clerkship. We believe that part of the problem is that students do not have the skills and ways of being and relating necessary to deal effectively with the overwhelming clinical experience of clerkship. APPROACH: At McGill University in Montreal, starting in January 2015, we have taught a course on mindful medical practice that combines a clinical focus on the combination of mindfulness and congruent relating that is aimed at giving students the skills and ways of being to function effectively in clerkship. The course is taught to all medical students in groups of 20, weekly for 7 weeks, in the 6 months immediately prior to clerkship, a time when students are very open to learning the skills they need to take effective care of patients. EVALUATION: The course has been well accepted by students as evidenced by their engagement, their evaluations, and their comments in the essays that they write at the end of the course. In a follow-up session at the simulation centre one year later students remember clearly and enact what they were taught in the course. REFLECTION: The next steps will be to conduct a formal evaluation of the effect of our teaching that will involve a combination of qualitative methods to clarify the nature of the impact on our students and a quantitative assessment of the difference the course makes to students' experience and performance in clerkship.

Conocimiento y prácticas sobre desnutrición crónica en madres beneficiarias de un programa social peruano / Knowledge and practices on chronic malnutrition in mothers benefiting from a Peruvian social program

La desnutrición crónica representa un problema de salud pública principalmente en países subdesarrollados, por lo que se requieren estrategias gubernamentales que promuevan la alimentación saludable. Estudio de tipo cuantitativo, descriptivo y correlacional que tuvo como finalidad determinar la relación entre el nivel de conocimiento y las prácticas sobre desnutrición crónica en madres beneficiarias de un programa social del estado peruano. La muestra fue obtenida de forma no probabilística tipo sujeto voluntario que incluyó a 72 madres que tenían niños menores de 3 años de edad al momento del estudio de conformidad a las políticas del beneficiario del programa social. Se utilizó un cuestionario y una lista de cotejo para medir el nivel de conocimientos y prácticas de prevención sobre desnutrición crónica respectivamente, que fueron sometidos previamente a un análisis psicométrico para la determinación de la validez y confiabilidad. El 45,8% de madres tenían alto conocimiento y el 65,3% realizaban prácticas adecuadas. Analizado mediante el coeficiente de correlación de Spearman se encontró un valor de 0,268. Se concluyó que existió correlación positiva y significativa entre el nivel de conocimiento y las prácticas sobre prevención de desnutrición crónica en madres beneficiarias, lo que indicaría la idoneidad de la implementación de estos programas sociales en la disminución de la morbimortalidad de niños menores de 3 años, y a partir de los resultados encontrados se establezcan políticas gubernamentales que permitan la sostenibilidad en el tiempo

Chronic malnutrition represents a public health problem mainly in underdeveloped countries, which is why governmental strategies that promote healthy eating are required. The purpose of this quantitative, descriptive and correlational study was to determine the relationship between the level of knowledge and practices on chronic malnutrition in mothers who benefit from a social program of the Peruvian state. The sample was obtained using a non-probabilistic system with voluntary subject type that included 72 mothers who had children under 3 years of age at the time of the study in accordance with the policies of the beneficiary of the social program. A questionnaire and a checklist were used to measure the level of knowledge and prevention practices on chronic malnutrition respectively, which were previously subjected to a psychometric analysis to determine the validity and reliability. The 45,8% of mothers had high knowledge and 65,3% performed appropriate practices. After analyzing using the Spearman correlation coefficient, a value of 0,268 was found. It is concluded that there was a positive and significant correlation between the level of knowledge and the practices on prevention of chronic malnutrition in beneficiary mothers, which would indicate the suitability of the implementation of these social programs in the reduction of the morbidity and mortality of children under 3 years of age, and based on the results found, government policies that allow sustainability over time are established