Development and validation of an endoscopic submucosal dissection video assessment tool.

BACKGROUND: Despite a need for assessment of endoscopic submucosal dissection (ESD) skills in order to track progress and determine competence, there is no structured measure of assessing competency in ESD performance. The present study aims to develop and examine validity evidence for an assessment tool to evaluate the recorded performance of ESD for gastric neoplasms. METHODS: The ESD video assessment tool (EVAT) was systematically developed by ESD experienced endoscopists. The EVAT consists of a 25-item global rating scale and 3-item checklist to assess competencies required to perform ESD. Five unedited videos were each evaluated by 2-blinded experienced ESD endoscopists to assess inter-rater reliability using intraclass correlation coefficients (ICC). Seventeen unedited videos in total were rated by 3 blinded experienced ESD endoscopists. Validity evidence for relationship to other variables was examined by comparing scores of inexperienced (fellows) and experienced endoscopists (attending staff), and by evaluating the relationship between the EVAT scores and ESD case experience. Internal consistency was evaluated using Cronbach's alpha. RESULTS: The inter-rater reliability for the total score was high at 0.87 (95% confidence interval 0.11 to 0.99). The total score [median, interquartile range (IQR)] was significantly different between the inexperienced (71, 63-77) and experienced group (95, 91-97) (P = 0.005). The total scores demonstrated high correlation with the number of ESD cases (Spearman's ρ = 0.79, P < 0.01). The internal consistency was 0.97. CONCLUSIONS: This study provides preliminary validity evidence for the assessment of video-recorded ESD performances for gastric neoplasms using EVAT.

Defining competencies for endoscopic submucosal dissection (ESD) for gastric neoplasms.

BACKGROUND: Current methods for teaching and assessing competencies for endoscopic submucosal dissection (ESD) are highly variable, non-systematic, and are inefficient for the learner to acquire adequate skills. The present study aims to define and establish expert consensus regarding competencies required to perform ESD for gastric neoplasms. METHODS: Fourteen ESD experts from 12 institutions in Japan were invited to complete an online survey to rate potential items for their importance in performing ESD proficiently. By using methodology based on the Delphi principles, the results of each round were analyzed and re-sent to the experts until consensus was established. Items were included if ranked 8 out of a 10-point Likert scale, by ≥ 80% of the respondents. RESULTS: A list of 29 potential items was generated through a review of the literature, textbooks, and experience of the steering group members. Ten new items were added through the survey. Consensus was reached after three rounds. Response rate ranged from 93 to 100%. Thirty-four items achieved consensus as important surrogates of competency in performing ESD. CONCLUSIONS: Essential competencies for performing ESD were identified through expert consensus. These competencies can serve as the foundation for structured training and for development of objective assessment tools to evaluate trainee performance in ESD.

Parents' Understanding of Genetics and Heritability.

Parents have the opportunity to educate their children to facilitate behaviours and lifestyle habits that may prevent or delay genetic disease, or mitigate predispositions within the family. We sought to determine parents' understanding of genetic knowledge and heritability. Using a quantitative survey methodology 108 volunteer participants were surveyed from a convenience sample of all parents/caregivers within the waiting room of a general children's outpatient clinic. Results indicated that average genetic knowledge levels were fairly high, with the majority of participants scoring 70-80 % correct on knowledge-based questions. Further, scores were found to be positively correlated with education, but inversely correlated with self-perceived knowledge. This finding suggests that participants with less experience tended to overestimate their knowledge. We suggest that gaps in knowledge of genetics and heritability could be improved by using educational interventions such as media campaigns, provision of informational brochures, or changes to current high school curriculum which would increase exposure to genetics and heritability for both parents and children.

Development, validation, and application of a Brazilian sleep myths and truths assessment scale (SLEEP-MTAS).

OBJECTIVE: This study aimed to develop, validate, and apply a scale assessing knowledge of sleep-related myths and truths and associate it with sociodemographic factors. METHODS: A scale with 15 questions was created, containing statements about the characteristics of sleep and related to sleep and dentistry. Each answer ranged from 0 to 4 points, generating a total score from 0 to 60, where higher scores represented greater knowledge. A preliminary study with 200 people assessed its convergent and discriminant construct validity, internal consistency, and temporal stability. The main study included 1965 respondents over 18 years. Additionally, sociodemographic data were collected and a classification of the level of knowledge was performed. Data were analyzed with Student's t-test and one-way ANOVA (p < 0.05). RESULTS: The questionnaire showed convergent (p < 0.001) and discriminant (p = 0.024) construct validity, internal consistency (alpha = 0.7), and temporal stability (ICC = 0.87). In the main study, 90.3% of the participants had moderate and high knowledge, with the score ranging from 24 to 58. Adults over 28 years old (p < 0.001), from the southern region of Brazil (p < 0.001), who lived in capital or metropolitan areas (p < 0.001), with higher education (p < 0.001), without religion (p < 0.001), and involved in dentistry (p < 0.001) had greater knowledge than their peers. CONCLUSIONS: The scale presented good psychometric properties. Most participants had moderate and high knowledge on sleep, with a difference in knowledge related to the age, region and area of residence, education, involvement with dentistry, and religion.

Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students.

STUDY OBJECTIVES: Primary care nurse practitioners (NPs) receive little sleep education in graduate programs but are often first-line providers for patients presenting with sleep-related symptoms. A pre-/postevaluation study was conducted using asynchronous, case-based sleep education modules in a cohort of primary care NP students enrolled in a single academic institution's nursing master's degree program. METHODS: Six virtual, case-based modules addressed adult sleep health and disorders, prioritized based on prevalence and primary care presentation. Kirkpatrick Training Evaluation Model guided outcome selection. Descriptive and paired comparative analyses were conducted. RESULTS: Participants were first-year NP students (n = 149; 88% female; 82% ≤ 35 years of age) in an adult primary care program that included psychiatric/mental health track. Participants reacted positively to course delivery methods and content. Insomnia was endorsed by 87% as most relevant to practice with healthy sleep (88%) and obstructive sleep apnea (50%) also frequently endorsed as practice relevant. Posttest knowledge scores significantly improved for all modules (P < .001). Self-rated confidence for future practice application was high. CONCLUSIONS: This novel asynchronous, virtual curriculum met Kirkpatrick levels 1 and 2 (positive reaction and knowledge transfer) in NP students who predicted an impact on their practice (Kirkpatrick level 3). Studies are needed to assess the benefits of increasing primary care NP knowledge in sleep medicine on quality of care and access to care (Kirkpatrick level 4). Future use of this novel sleep curriculum in other professional curricula, new-to-sleep clinical researchers, and practicing primary care providers may further potentiate care quality and sleep care access. CITATION: Sawyer AM, Saconi B, Lyons MM, et al. Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students. J Clin Sleep Med. 2022;18(10):2367-2376.

[Script Concordance Test: first nationwide experience in pediatrics]. / Prueba de concordancia de script: primera experiencia en pediatría de alcance nacional.

The Script Concordance Test is a suitable test for assessing clinical reasoning in postgraduate medical education. We present the first nationwide, realtime, web-based experience of a Script Concordance Test administered to 3rd year pediatric residents. The test was administered to 268 residents (postgraduate year 3), from 56 different programs, requiring 46.1 ± 27.1 minutes to complete it, and scoring 65.3 ± 7.47 points. A later survey showed limited satisfaction from participants. This experience showed that this kind of test is feasible in this setting.

La prueba de concordancia de script es una herramienta adecuada para evaluar el razonamiento clínico. Se describe la primera experiencia de aplicación de esta prueba a nivel nacional en residentes de Pediatría, utilizando internet, en tiempo real. Participaron 268 residentes de 3.er año correspondientes a 56 sedes. La duración promedio del examen fue 46,1 ± 27,1 minutos, y se obtuvo un puntaje promedio de 65,3 ± 7,47 (sobre 100). Una encuesta posterior mostró una limitada satisfacción de los participantes. Esta experiencia muestra la factibilidad de la propuesta y su aplicabilidad en la formación de posgrado en Pediatría a nivel nacional.

Teachers and students' perceptions about feedback in clinical internships in medical school / Percepções de docentes e discentes sobre feedback em estágios práticos no curso de medicina

Abstract: Introduction: In medical education, feedback is considered one of the main types of formative assessment. Feedback can be defined as the transmission of information by observing students in action aiming to provide improvement for the acquisition of medical skills that constitute medical professionalism. Objective: The aim of this study was to assess if there are difficulties in transmitting and receiving feedback by preceptors and students during the practical stages of medical training. Methods: This qualitative / quantitative design study involved all students who completed the internship from March 2018 to August 2019 (n = 50), as well as all preceptors responsible for the internships (n = 9) at Universidade Municipal de São Caetano do Sul. Knowledge about feedback, according to the viewpoint of students and preceptors, was assessed using adapted questionnaires with categorical and open questions. Descriptive analyses were used for the quantitative data and the content technique for the qualitative data. Results: The preceptors report that the objectives of providing feedback are to point out improvement, critical reflection, and opportunity for adjustments. Meanwhile, students report: clarification of doubts, planning for improvements and knowledge of positive points. Half of the preceptors claim to provide very frequent feedback, but students would like to receive feedback more often. Students want feedback to be constructive and private. Half of the preceptors find it difficult to give negative feedback; however, 60% of the students report handling criticism well. Conclusion: The preceptors declare to have knowledge of and know about the objectives of giving feedback; however, they have difficulties communicating it, especially when it involves criticisms for the correction of behaviors and attitudes. The students accept criticism and would like feedback to be conveyed more often in the practical stages. It is necessary to improve the process of providing and receiving feedback.

Resumo: Introdução: No ensino médico, feedback - ou devolutiva - é um dos componentes principais da avaliação formativa. Feedback pode ser definido como transmissão de uma informação quando se observam os estudantes em ação, a fim de propiciar melhorias para aquisição de competências médicas que compõem o profissionalismo médico. Objetivo: Este estudo teve como objetivo avaliar se há dificuldades de transmissão e recepção de feedback pelos preceptores e estudantes durante os estágios práticos do curso de Medicina. Método: Este estudo de delineamento misto qualitativo/ quantitativo envolveu todos os discentes que concluíram os estágios no período de março de 2018 a agosto de 2019 (n = 50), assim como todos os preceptores responsáveis pelos estágios práticos (n = 9) da Universidade Municipal de São Caetano do Sul. O conhecimento sobre feedback, na visão dos discentes e preceptores, foi avaliado por meio de questionários adaptados com perguntas categóricas e abertas. Utilizaram-se análise descritiva nos dados quantitativos e técnica de conteúdo nos dados qualitativos. Resultado: Os preceptores relataram que os objetivos de fornecer feedback são: apontamento de melhoria, reflexão crítica e oportunidade de adequações. Por sua vez, os estudantes relataram: esclarecimento de dúvidas, planejamento de melhorias e conhecimento de pontos positivos. Metade dos preceptores afirmou fornecer feedback, porém os estudantes gostariam de recebê-lo de forma mais contínua. Os estudantes desejam que o feedback seja construtivo e feito em local privado. Metade dos preceptores tem dificuldade em dar feedback negativo, porém 60% dos estudantes relataram lidar bem com críticas. Conclusão: Os preceptores afirmaram ter conhecimento dos objetivos do feedback. Porém, eles têm dificuldades para transmiti-lo, principalmente quando envolve críticas para correções de comportamentos ou atitudes. Os estudantes aceitam críticas e requerem que o feedback seja transmitido com mais frequência nos estágios práticos. Há a necessidade de melhorar o processo de fornecer e receber feedback.

Prueba de concordancia de script: primera experiencia en pediatría de alcance nacional / Script Concordance Test: first nationwide experience in pediatrics

La prueba de concordancia de script es una herramienta adecuada para evaluar el razonamiento clínico. Se describe la primera experiencia de aplicación de esta prueba a nivel nacional en residentes de Pediatría, utilizando internet, en tiempo real. Participaron 268 residentes de 3.er año correspondientes a 56 sedes. La duración promedio del examen fue 46,1 ± 27,1 minutos, y se obtuvo un puntaje promedio de 65,3 ± 7,47 (sobre 100). Una encuesta posterior mostró una limitada satisfacción de los participantes. Esta experiencia muestra la factibilidad de la propuesta y su aplicabilidad en la formación de posgrado en Pediatría a nivel nacional.

The Script Concordance Test is a suitable test for assessing clinical reasoning in postgraduate medical education. We present the first nationwide, realtime, web-based experience of a Script Concordance Test administered to 3rd year pediatric residents. The test was administered to 268 residents (postgraduate year 3), from 56 different programs, requiring 46.1 ± 27.1 minutes to complete it, and scoring 65.3 ± 7.47 points. A later survey showed limited satisfaction from participants. This experience showed that this kind of test is feasible in this setting.

[Comprehensive Assessment of Psychiatric Residents: An Addition to the Program Admission Process]. / Evaluación integral de residentes de psiquiatría: un complemento del proceso de admisión al programa.

The training of medical specialists is a long and complex process. Its purpose is to guarantee the society that they are the right professionals to meet the health needs of the population. The first step to ensure this objective is the admission process. In psychiatry this process, monitoring resident students and the criteria for each one are different in each country. Admission in Colombia is a heterogeneous process, not standardized, which varies greatly from one university to another, even between private and public universities. At the National University of Colombia, the admissions process is handled by the Admissions Office and includes: a written test for which you must obtain a minimum score, a resume rating and an interview. The Teaching Committee and the Department of Psychiatry considered the admission procedure in general to be good, but in need of refinement. Due to the experience of some teachers and given the current rules, a "comprehensive assessment" for master and doctoral students was required and in 1996 it was decided that this method of assessment for admission to a specialization in Psychiatry would serve to complement the admission process. The article describes the experience of the process and its outcomes, strengths and weaknesses.

Translation and cross-cultural adaptation of the Clinical Competence Questionnaire for use in Brazil / Tradução e adaptação transcultural do Clinical Competence Questionnaire para uso no Brasil / Traducción y adaptación transcultural del Clinical Competence Questionnaire para uso en Brasil

ABSTRACT Objective: translating and transculturally adapting the Clinical Competence Questionnaire to Brazilian senior undergraduate Nursing students, as well as measuring psychometric properties of the questionnaire. Method: a methodological study carried out in six steps: translation of the Clinical Competence Questionnaire instrument, consensus of the translations, back-translation, analysis by an expert committee, pre-testing and then presentation of the cross-cultural adaptation process to the developers. Psychometric properties were measured using Cronbach's alpha, intraclass correlation coefficient and content validity index. Results: the instrument was translated, transculturally adapted and its final version consisted of 48 items. Cronbach's alpha coefficient was 0.90, and the agreement index of the items was 99% for students and 98% for evaluators. Conclusion: the Clinical Competence Questionnaire was translated and adapted to Brazilian students, and the psychometric properties of the Portuguese version of the questionnaire presented satisfactory internal consistency regarding the studied sample.

RESUMO Objetivo: traduzir e adaptar transculturalmente o Clinical Competence Questionnaire aos estudantes brasileiros concluintes da graduação em enfermagem, bem como mensurar as propriedades psicométricas do questionário. Método: estudo metodológico realizado em seis etapas: tradução do instrumento Clinical Competence Questionnaire, consenso das traduções, retrotradução, análise pelo comitê de especialistas, pré-teste e apresentação do processo de adaptação transcultural para os desenvolvedores. As propriedades psicométricas foram mensuradas utilizando-se o alfa de Cronbach, coeficiente de correlação intraclasse e índice de validade de conteúdo. Resultados: o instrumento foi traduzido, adaptado transculturalmente e sua versão final foi constituída de 48 itens. O coeficiente alfa de Cronbach foi de 0,90, e o índice de concordância dos itens foi de 99% para os estudantes e de 98% para os avaliadores. Conclusão: o Clinical Competence Questionnaire foi traduzido e adaptado a estudantes brasileiros, e as propriedades psicométricas da versão em português do questionário apresentaram consistência interna satisfatória quanto à amostra estudada.

RESUMEN Objetivo: traducir y adaptar transculturalmente el Clinical Competence Questionnaire para uso de los estudiantes brasileños que concluyen la graduación en enfermería, así como para medir las propiedades psicométricas del cuestionario. Método: estudio metodológico realizado en seis etapas: traducción del instrumento Clinical Competence Questionnaire, obtención de consenso de las traducciones, retrotraducción, análisis por el comité de especialistas, pretest y presentación del proceso de adaptación transcultural para los desarrolladores. Las propiedades psicométricas fueron medidas utilizando el alfa de Cronbach, coeficiente de correlación intraclase e índice de validez de contenido. Resultados: el instrumento fue traducido, adaptado transculturalmente y su versión final estuvo constituida por 48 ítems. El coeficiente alfa de Cronbach fue de 0,90; el índice de concordancia de los ítems fue de 99% para los estudiantes y de 98% para los evaluadores. Conclusión: el Clinical Competence Questionnaire fue traducido y adaptado para uso de estudiantes brasileños; las propiedades psicométricas, de la versión en portugués del cuestionario, presentaron consistencia interna satisfactoria encontrada en la muestra estudiada.

O aprendizado melhorado por provas / Test-enhanced learning

Provas não são neutras em termos de aprendizagem. Não têm apenas caráter avaliativo. A utilização de testes repetidamente traz um benefício mnemônico, estudado em psicologia cognitiva no chamado "efeito de ser testado". A utilização de testes repetidos em cenários de educação caracteriza a metodologia do "aprendizado melhorado por provas". Estudos experimentais e aplicados em cursos extracurriculares têm demonstrado melhor desempenho na retenção de conteúdos e em habilidades de alunos submetidos a testes repetidos em comparação aos de grupos controle. Embora caracterize uma metodologia ativa e o incremento de conteúdo factual seja necessário ao desenvolvimento do raciocínio clínico, a crítica que se faz ao método é de ser baseado em memorização e retenção, na era das evidências. Os estudos aplicados não podem, até o momento, estabelecer se há melhor organização dos conteúdos adquiridos para utilização na resolução de problemas e se isto interfere positivamente no cuidado aos pacientes.

Tests are not neutral in terms of learning. They are not only evaluative, but summative too. There is a mnemonic benefit of testing - called the testing effect, in cognitive psychology studies. In educational settings, test-enhanced learning methodology has been associated with improved cognitive skills and performance of students repetitively tested on a specific content. Although it is an active learning method and despite the fact that the development of clinical reasoning depends upon increased factual contents, there has been criticism of memorization and retention in the era of evidence-based medicine. In fact, available studies have been unable to prove the benefits of using this method in problem solving abilities and patient care.

Evaluación integral de residentes de psiquiatría: un complemento del proceso de admisión al programa / Comprehensive Assessment of Psychiatric Residents: An Addition to the Program Admission Process

La formación de especialistas médicos es un proceso largo y complejo, cuyo objetivo primordial es garantizarle a la sociedad que sean profesionales idóneos para atender las necesidades de salud de la población. El primer paso para garantizar este objetivo es el proceso de admisión. En psiquiatría, como en otras especialidades, este proceso, el seguimiento a los residentes y los criterios utilizados para cada uno, son diferentes en cada país. En Colombia la admisión es un proceso heterogéneo, no estandarizado, que varía de manera significativa de una universidad a otra, incluso entre las mismas instituciones pertenecientes al sector público y entre aquellas de carácter privado. En la Universidad Nacional de Colombia el proceso de admisión está centralizado en la Oficina de Admisiones e incluye un examen escrito, en el que se debe obtener la puntuación estipulada como punto de corte o más, la calificación de la hoja de vida y una entrevista. El Comité Docente del Departamento de Psiquiatría consideraba que el procedimiento de admisión en general era bueno, pero, al igual que todo proceso de selección, imperfecto. Con base en esta consideración, la experiencia de algunos docentes y apoyados en la normatividad vigente que exigía una "evaluación integral" para los estudiantes de maestría y doctorado, se decidió, a partir de 1996, establecer esta modalidad de evaluación para los admitidos a la especialización en Psiquiatría, con el objeto de servir como complemento al proceso de admisión. El artículo describe la experiencia del proceso y sus resultados, fortalezas y debilidades.

The training of medical specialists is a long and complex process. Its purpose is to guarantee the society that they are the right professionals to meet the health needs of the population. The first step to ensure this objective is the admission process. In psychiatry this process, monitoring resident students and the criteria for each one are different in each country. Admission in Colombia is a heterogeneous process, not standardized, which varies greatly from one university to another, even between private and public universities. At the National University of Colombia, the admissions process is hand-led by the Admissions Office and includes: a written test for which you must obtain a minimum score, a resume rating and an interview. The Teaching Committee and the Department of Psychiatry considered the admission procedure in general to be good, but in need of refinement. Due to the experience of some teachers and given the current rules, a "comprehensive assessment" for master and doctoral students was required and in 1996 it was decided that this method of assessment for admission to a specialization in Psychiatry would serve to complement the admission process. The article describes the experience of the process and its outcomes, strengths and weaknesses.

Length of internship influences performance on medical residency exam / Duração do internato influencia o desempenho no exame de residência médica

OBJECTIVES: Medical education encompasses globally diverse context and conditions. The Brazilian scenario seemed a natural environment to study the influence of medical education programs and internship duration on the entrance exam for medical residency. This investigation evaluates some methods used during the entrance exam for medical residency as a means to make a distinction between candidates with longer clerkships. METHODS: Candidates selected for a residency program performed a multiple-choice (MC), an open question (OQ) and OSCE-like tests, an interview and a curriculum analysis for participation in scientific meetings, papers published and voluntary activities. Groups were compared for gender, year of graduation, tests and OSCE scores. RESULTS: Participants were distributed into two groups based on clerkship duration: 2 years or less than 2 years. There was no difference for the MCT score among groups or any of the activities from interview and curriculum analysis. The 2 years clerkship group showed significantly higher OQ (p=0.009) and OSCE-like affective (p=0.025) and knowledge (p=0.002) scores. CONCLUSION: The OSCE test identified some aspects related to competence acquisition and assessed basic skills and attitudes essential to the supervised practice of medicine during residency. OSCE discriminated aspects not perceived by the sole use of knowledge tests.

OBJETIVOS: A educação médica mostra contextos e condições globalmente diversas. O cenário no Brasil pode ser considerado um ambiente natural para se estudar a influência da diversidade dos programas de educação médica bem como a duração do internato no exame de entrada para residência médica. Esta investigação avalia alguns métodos usados no exame de entrada para residência médica como métodos para diferenciar os candidatos com internatos mais longos. MÉTODOS: Candidatos selecionados para um programa de residência executaram um teste múltiplas-escolhas (MCT), teste com perguntas abertas (OQ) e o OSCE, além de uma entrevista e uma análise de currículo para avaliar participações em reuniões científicas, artigos publicados e atividades voluntárias. Foram comparados grupos pelo gênero, ano de graduação, resultados dos testes e do OSCE. RESULTADOS: Os participantes foram distribuídos em dois grupos baseados na duração do internato: 2-anos ou menos de 2 anos. Não houve nenhuma diferença para a pontuação no MCT entre os grupos ou por quaisquer das atividades de entrevista e análise de currículo. O grupo de internato de 2-anos mostrou OQ mais alto (p =0.009) bem como os resultados do OSCE afetivo (p =0.025) e de conhecimento (p =0.002). CONCLUSÃO: O exame OSCE diferenciou alguns aspectos relacionados a aquisição de competências e pode avaliar habilidades básicas e atitudes que seriam essenciais à prática supervisionada de medicina durante residência médica. OSCE separou aspectos não notados pelo uso de testes de conhecimento ou múltiplas escolhas.

Efectividad del protagonismo estudiantil / Effectiveness of Students' Leadership

El protagonismo de los jóvenes tiene raíces en nuestra historia. Fueron precisamente jóvenes los que se alzaron contra el colonialismo español y figuras como Carlos Manuel de Céspedes, Ignacio Agramonte y José Martí iluminaron y enseñaron a la generación del centenario encabezada por Fidel Castro a luchar por las ideas de independencia y soberanía, esta misma batalla es la que hoy libran nuestros jóvenes, precisamente por la importancia del protagonismo estudiantil, se realizó un estudio transversal prospectivo en el Instituto Politécnico de Enfermería “Lidia Doce Sánchez” durante el curso 2001 - 2002, nos auxiliamos de la observación de las actividades curriculares y extracurriculares, además de la entrevista a dirigentes estudiantiles, tomamos como universo los 70 estudiantes que fueron matricula del centro y una muestra de 60 estudiantes, conformada con los tres años que cursan estudios, 23 de primero, 25 de segundo y 12 de tercero. Los datos obtenidos se procesaron y se resumieron en tablas estadísticas. Se utilizaron variables como la asistencia y participación a las diferentes actividades, matutinos, vespertinos, información política, programas audiovisuales y otras. Se alcanzaron índices mayores de participación y mayor nivel de calidad y se destacaron con por cientos más significativos los programas audiovisuales, las asambleas integrales y otras actividades, no sólo en el incremento de la asistencia sino también en la calidad de la participación.

The leadership of young people has deep roots in our history. They were precisely the ones that rebelled against Spanish colonialism, and personalities such as Carlos Manuel de Cespedes, Ignacio Agramonte and José Martí illuminated and taught the “Centennial Generation” headed by Fidel Castro to fight for the ideas of independence and sovereignty. This same battle is the one that our youth faces nowadays, but in order to achieve students' protagonism. A prospective transversal study in “Lidia Doce Sánchez” Polytechnic Institute of Nursing was carried out during the course 2001-2002. The authors of this work made use of observations to the students' curricular and extracurricular activities. Besides, interviews to the students' leaders were also helpful. The research group included the 70 students registered in the school, and from this a sample of 60 students of the three years was selected, 23 coursing the first year, 25 the second year and 12 the third. The data obtained was processed with a calculator CEDAR CD-337 and summarized in statistical charts. Variables as school attendance and participation in the different activities, such as school meetings, political information, audiovisual programs and others were used. Higher levels of participation and quality were achieved mainly in activities related to the audiovisual programs, integral assemblies and other activities.