Pros y contras de las innovaciones en educación médica / Pros and cons of innovations in medical education

Resumen La educación médica ha puesto en práctica diversas estrategias innovadoras con el propósito de alcanzar mejores logros de aprendizaje. Se hace una evaluación de las experiencias relacionadas con el enfoque por competencias, las nuevas tecnologías educativas, las alternativas curriculares, la profesionalización de la evaluación y las técnicas educativas a distancia, para ubicarlas en el lugar que les corresponde.

Abstract Medical education has implemented various innovative strategies with the purpose to attain better learning achievements. An evaluation is made of the experiences in the competencies approach, new learning technologies, curricular alternatives, professional evaluation and distance education technologies in order to locate them in the areas they belong.

[Academic performance in first year medical students: an explanatory multivariate model]. / El rendimiento académico en el primer año de la carrera de médico cirujano: modelo multivariado explicativo.

INTRODUCTION: Current education is focused in intellectual, affective, and ethical aspects, thus acknowledging their significance in students´ metacognition. Nowadays, it is known that an adequate and motivating environment together with a positive attitude towards studies is fundamental to induce learning. Medical students are under multiple stressful, academic, personal, and vocational situations. OBJECTIVE: To identify psychosocial, vocational, and academic variables of 2010-2011 first year medical students at UNAM that may help predict their academic performance. MATERIAL AND METHODS: Academic surveys of psychological and vocational factors were applied; an academic follow-up was carried out to obtain a multivariate model. The data were analyzed considering descriptive, comparative, correlative, and predictive statistics. RESULTS: The main variables that affect students´ academic performance are related to previous knowledge and to psychological variables. CONCLUSIONS: The results show the significance of implementing institutional programs to support students throughout their college adaptation.

[The formative role of the laboratory in teaching the science of physiology]. / El papel formativo del laboratorio en la enseñanza de las ciencias fisiológicas.

Physiology teaching began with Claudius Galenus (c. 126-199 AD), known as Galen, who is considered the initiator of experimental physiology. This discipline was consolidated in the XIX century with the discoveries of Claude Bernard, which influenced the way of teaching this discipline in universities, independently from Anatomy. In Mexico, physiology teaching started in 1580. It was at the beginning of the XIX century when Valentín Gómez Farías created the professorship in Medical Sciences and Daniel Vergara Lope carried out its consolidation when he implemented a lab course. Doctor José Joaquín Izquierdo established that this subject ought to be taught by teachers with experience in research. Undoubtedly, formative physiology teaching carried out in labs must strengthen the application of method and scientific methodology in students. In this symposium, we put forward that the change in physiology teaching must promote multidisciplinary research in students, who will formulate a research question and develop an experimental model that will let them integrate their basic knowledge of physiology, pharmacology, biochemistry, and functional anatomy under the supervision of a research teacher.

Measuring the effectiveness of pharmacology teaching in undergraduate medical students.

OBJECTIVE: Information overload and recent curricular changes are viewed as important contributory factors to insufficient pharmacological education of medical students. This study was designed to assess the effectiveness of pharmacology teaching in our medical school. METHODS: The study subjects were 455 second-year medical students, class of 2010, and 26 pharmacology teachers at the National University of Mexico Medical School. To assess pharmacological knowledge, students were required to take 3 multiple-choice exams (70 questions each) as part of their evaluation in the pharmacology course. A 30-item questionnaire was used to explore the students' opinion on teaching. Pharmacology professors evaluated themselves using a similar questionnaire. Students and teachers rated each statement on a 5-point Likert scale. RESULTS: The groups' exam scores ranged from 54.5% to 90.0% of correct responses, with a mean score of 77.3%. Only 73 (16%) of 455 students obtained an exam score of 90% and higher. Students' evaluations of faculty and professor self-ratings were very high (90% and 96.2%, of the maximal response, respectively). Student and professor ratings were not correlated with exam scores (r = 0.291). CONCLUSIONS: Our study shows that knowledge on pharmacology is incomplete in a large proportion of second-year medical students and indicates that there is an urgent need to review undergraduate training in pharmacology. The lack of relationship between the subjective ratings of teacher effectiveness and objective exam scores suggests the use of more demanding measures to assess the effectiveness of teaching.

[Impact of problem-based learning on the cognitive processes of medical students]. / Impacto del aprendizaje basado en problemas en los procesos cognitivos de los estudiantes de medicina.

The problem based learning (PBL) method was conceived as a teaching strategy to be applied in different areas or disciplines, thus several universities adopted it, among which was the Universidad Nacional Autónoma de México, best known as UNAM. The Faculty of Medicine of UNAM implemented this innovative teaching method of medicine for its learner-centered educational method tendency (patient-centered practice). This method develops also several abilities in the students, such as active and significant learning, seeking and data selection and autoanalysis and synthesis, knowledge integration of, mind's logic for the detection and solution of problems, among others. The aim was to evaluate the PBL impact on pedagogical and cognitive processes through the students' critical thinking and the significance of the experience on students and teachers which were working with PBL; in addition, study strategies and self-regulation in students were considered variables for the study. Our findings indicated that PBL was perceived differently among students and teachers, and it influenced in a positive and significant way the students' perception to solve problems and their motivation to achieve a good academic performance (p < 0.005). These results suggest that PBL is a useful strategy in the teaching and learning process and it is clear that the pedagogical process and other variables can potentially influence the results obtained.

[Teaching performance assessment in Public Health employing three different strategies]. / Evaluación del desempeño docente en Salud Pública mediante tres estrategias.

INTRODUCTION: The educational system depends upon the quality and performance of their faculty and should therefore be process of continuous improvement. OBJECTIVE: To assess the teaching performance of the Public Health professors, at the Faculty of Medicine, UNAM through three strategies. METHODS: Justification study. The evaluation was conducted under a mediational model through three strategies: students' opinion assessment, self-assessment and students' academic achievement. We applied descriptive statistics, Student t test, ANOVA and Pearson correlation. RESULTS: Twenty professors were evaluated from the Public Health department, representing 57% of all them who teach the subject. The professor's performance was highly valued self-assessment compared with assessment of student opinion, was confirmed by statistical analysis the difference was significant. The difference amongst the three evaluation strategies became more evident between self-assessment and the scores obtained by students in their academic achievement. CONCLUSIONS: The integration of these three strategies offers a more complete view of the teacher's performance quality. Academic achievement appears to be a more objective strategy for teaching performance assessment than students' opinion and self-assessment.

[Diagnosis on the unique curriculum of the medical career at the National University of Mexico]. / Diagnóstico del plan único de Estudios de la carrera de médico cirujano de la Universidad Nacional Autónoma de México.

The analysis of the Plan Unico de Estudios of the medical career was the result of five years of collegiate work in which commissions consisting of academic staff of different departments from the faculty of medicine at the Universidad Nacional Autonoma de Mexico (UNAM) participated. The most significant conclusions derived from this analysis are: to adjust the graduate's profile in order to face the emerging health problems of the twenty-first century in our country; to update the academic curricula of the different subjects, including new ones; to create a nuclear curricula; as well as to strengthen the basic-clinic and the clinic-basic. With regard to the teaching/learning process, we acknowledged the need to develop self-cognitive and self-motivational skills in students as well as to consider a different evaluation for students and teachers.