ABSTRACT
INTRODUCTION: In Latin America there is almost no published information about knowledge retention and formative assessment of competencies in medical students, during medical school training and curricular changes. OBJECTIVE: To assess knowledge level and clinical competencies in medical students at the end of the second year in a new curriculum. METHODS: Observational, cross-sectional study in UNAM Faculty of Medicine students. A diagnostic evaluation was performed in the first class of the "Plan of Studies 2010" curriculum, as part of an integral program evaluation strategy. The assessment had two components: theoretical and practical. RESULTS: 456 (87%) of the 524 students that successfully completed the second year of Plan 2010 were assessed. The written test had 211 items, a mean score of 60 ± 14.5, mean difficulty index of 0.60, reliability with Cronbach's alpha of 0.85. The OSCE mean global score was 58 ± 9, Cronbach's alpha of 0.36, and G-coefficient of 0.48, and results were provided for each station. Results by area of knowledge, course, and station were reported. CONCLUSIONS: The results in general are acceptable, compared with previous written evaluations at the end of the second year, suggesting that the new program is achieving its educational goals. Competencies were formally assessed for the first time in our Institution, establishing a starting point for follow-up. The study provided useful information to the institution, teachers and students.
Subject(s)
Clinical Competence , Curriculum , Education, Medical , Cross-Sectional Studies , Education, Medical/standards , Mexico , Students, MedicalABSTRACT
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.
Subject(s)
Cognition , Education, Medical/methods , Problem-Based Learning , Students, Medical/psychology , HumansABSTRACT
Hematotoxicology has been studied with less interest than other fields associated with atmospheric pollution. There is limited knowledge about on the effects that certain atmospheric pollutants may provoke in the blood and bone marrow. Suspended particle pollution has become an area of scientific inquiry due to the contaminants adhering to its surface. We have identified the association of inhaled vanadium and variations in megakaryopoyesis and thrombopoyesis. Platelets are the smallest elements in the blood, but they play a strategic role in hemostasis. They are derived from the largest cell of the bone marrow, the megakaryocite. This cell size is about 150 microm, with apolyploid nucleus and unknown origin until few years ago. When TPO was cloned in 1994 the knowledge about megakaryocyte began to growth exponentially, elucidating the mechanisms of proliferation, differentiation and release of platelets. More information is still needed in order to translate knowledge into clinical application for diseases such as thrombocytopenia or thrombocytosis. A review of the current concepts of megakaryopoiesis and its regulation, with emphasis on signaling pathways are presented in this paper; a classification in TPO-dependent and TPO-independent is also detailed. In addition, we review some diseases associated with changes in the signaling pathway of megakaryopoyesis, as well as possible perspectives in this field, including toxicology.
Subject(s)
Megakaryocytes/physiology , Signal Transduction , Animals , Chemokines/physiology , Cytokines/physiology , Humans , Thrombopoiesis/physiologyABSTRACT
La hematotoxicología es un área poco estudiada en nuestro país y es limitado el conocimiento sobre el efecto que ciertos contaminantes atmosféricos inducen en la sangre y en la médula ósea. La contaminación por partículas suspendidas ha cobrado más interés, por los contaminantes que se adhieren a su superficie. Un ejemplo es el benceno, relacionado con aplasia medular y leucemia. Algunos metales que también están en las partículas inhaladas son hematotóxicos. Uno de ellos es el vanadio, que nuestro grupo ha identificado como un agente inductor de alteraciones en la megacariopoyesis, lo que motivó esta revisión. Las plaquetas desempeñan un papel muy importante en la hemostasia y derivan de la célula más grande de la médula ósea: el megacariocito. Hasta hace algunos años desconocíamos casi todo del megacariocito, pero con la clonación de la trombopoyetina, en 1994, la principal hormona reguladora de la producción plaquetaria, ha existido un desarrollo acelerado en el conocimiento de la megacariopoyesis. Este artículo hace una revisión de la megacariopoyesis y su regulación, con énfasis en las vías de señalización implicadas. Además, se mencionan algunas enfermedades relacionadas y se discuten las perspectivas de investigación de este proceso, con énfasis en la toxicología.
Hematotoxicology has been studied with less interest than other fields associated with atmospheric pollution. There is limited knowledge about on the effects that certain atmospheric pollutants may provoke in the blood and bone marrow. Suspended particle pollution has become an area of scientific inquiry due to the contaminants adhering to its surface. We have identified the association of inhaled vanadium and variations in megakaryopoyesis and thrombopoyesis. Platelets are the smallest elements in the blood, but they play a strategic role in hemostasis. They are derived from the largest cell of the bone marrow, the megakaryocite. This cell size is about 150 microm, with apolyploid nucleus and unknown origin until few years ago. When TPO was cloned in 1994 the knowledge about megakaryocyte began to growth exponentially, elucidating the mechanisms of proliferation, differentiation and release of platelets. More information is still needed in order to translate knowledge into clinical application for diseases such as thrombocytopenia or thrombocytosis. A review of the current concepts of megakaryopoiesis and its regulation, with emphasis on signaling pathways are presented in this paper; a classification in TPO-dependent and TPO-independent is also detailed. In addition, we review some diseases associated with changes in the signaling pathway of megakaryopoyesis, as well as possible perspectives in this field, including toxicology.