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What is the educational challenge? The Medical Education Research Study Quality Instrument (MERSQI) is widely used to evaluate the quality of quantitative research in medical education. It has strong evidence of validity and is endorsed by guidelines. However, the manual appraisal process is time-consuming and resource-intensive, highlighting the need for more efficient methods. What are the proposed solutions? We propose to use ChatGPT to evaluate the quality of medical education research with the MERSQI and compare its scoring with those of human evaluators. What are the potential benefits to a broader global audience? Using ChatGPT to evaluate medical education research with the MERSQI can decrease the resources required for quality appraisal. This allows faster summaries of evidence, reducing the workload of researchers, editors, and educators. Furthermore, ChatGPTs' capability to extract supporting excerpts provides transparency and may have the potential for data extraction and training new medical education researchers. What are the next steps? We plan to continue evaluating medical education research with ChatGPT using the MERSQI and other instruments to determine its feasibility in this realm. Moreover, we plan to investigate which types of studies ChatGPT performs best in.
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The demand for palliative care is increasing globally, yet a notable lack of awareness continues to present a significant obstacle to its widespread adoption. The use of digital tools like Google Trends can help gauging public interest in specific topics. We used Google Trends to conduct a systematic search of terms related to palliative care from January 1, 2010, to May 10, 2023. The results were filtered by location, including worldwide and Latin American countries. We found a global increase in searches for terms related to palliative care, with a peak in December 2022 associated with the death of Brazilian footballer Pelé. Countries like Brazil, Mexico, and Colombia mirrored this trend, while others like Argentina and Peru did not. Interest in palliative care is on the rise in Latin America, albeit with notable regional variations.
Subject(s)
Palliative Care , Latin America , Humans , Palliative Care/trends , Search Engine , InternetABSTRACT
RESUMEN El presente artículo de revisión aborda el concepto, características, pasos para la integración al sistema de salud y epidemiología de los cuidados paliativos. Asimismo, se discuten los avances y las investigaciones realizadas sobre cuidados paliativos en Perú. Los cuidados paliativos pueden definirse como la asistencia activa e integral de personas de todas las edades con sufrimiento severo relacionado con la salud, usualmente debido a una enfermedad grave y especialmente de quienes están cerca del final de la vida. Es importante comprender que los cuidados paliativos no se limitan al manejo de pacientes que cursan con un tratamiento curativo frustro o nulo. En Perú, si bien se han realizado avances importantes, aún no se cuentan con suficientes servicios, programas de capacitación, ni grupos de investigación en cuidados paliativos.
ABSTRACT This review article addresses the concept, characteristics, steps for integration into the health system, and epidemiology of palliative care. Likewise, the advances and research carried out on palliative care in Peru are summarized. Palliative care can be defined as the active and holistic (comprehensive) care of people of all ages with severe health-related suffering due to serious illness and especially of those near the end of life. For this reason, it is important to understand that palliative care is not limited to the management of patients who have failed or no curative treatment. In Peru, although important advances have been made, there are still not enough services, training programs, or research groups in palliative care.
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Objective: To describe the academic and institutional characteristics of students who took the National Medical Internship Exam (ENIM) of the Social Security Health System (EsSalud, abbreviature in Spanish) and explore their association with the score obtained. Materials and Methods: A cross-sectional study of a secondary database of medical students who took the ENIM of EsSalud in Peru on December 27, 2022. We evaluated the factors associated with the ENIM score using linear regression. Results: We evaluated 1228 medical students who took the ENIM. The median ENIM score was 12.2 (range 10.2 to 13.8), 35.9% of students passed the exam, and only 26.5% came from a University with a licensed medicine program. In the adjusted model, the ENIM score was higher in students who belonged to a university with a licensed medicine program (ß 0.5; 95% CI: 0.2 to 0.8) and those with a university-weighted average greater than or equal to 13. And the score was lower in students from the partnership (ß -1.2; -1.6 to -0.8) or associative (ß -2.0; -2.4 to -1.6) universities compared to students from national universities. Conclusion: Medical students from national universities, universities with licensed medicine programs, and a university weighted average of 13 or greater had a better performance in EsSalud's national medical internship exam.
Objetivo: Describir las características académicas e institucionales de estudiantes que rindieron el Examen Nacional de Internado Médico (ENIM) del Seguro Social de Salud (EsSalud) y explorar su asociación con el puntaje obtenido. Materiales y métodos: Estudio transversal analítico de una base de datos secundaria de estudiantes de medicina que rindieron el ENIM del EsSalud en Perú el 27 de diciembre del 2022. Evaluamos los factores asociados al puntaje del ENIM mediante regresión lineal. Resultados: Evaluamos a 1228 estudiantes de medicina que rindieron el ENIM. La mediana de puntaje en el ENIM fue de 12,2 (rango 10,2 a 13,8), el 35,9% de los estudiantes aprobó el examen y solo el 26,5% proviene de una Universidad que cuenta con el programa de medicina ya licenciado. En el modelo ajustado, el puntaje en el ENIM fue mayor en estudiantes que pertenecían a una universidad con el programa de medicina ya licenciado (ß 0,5; IC 95%: 0,2 a 0,8) y aquellos con un promedio ponderado universitario mayor o igual a 13. Y el puntaje fue menor en estudiantes de universidades societarias (ß -1,2; -1,6 a -0,8) o asociativa (ß -2,0; -2,4 a -1,6) con respecto a estudiantes de universidades nacionales. Conclusión: Los estudiantes de medicina provenientes de universidades nacionales, universidades con programa de medicina licenciados y promedio ponderado universitario mayor o igual a 13 tuvieron un mejor desempeño en el examen nacional de internado médico de EsSalud.
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Introduction: Acute respiratory distress syndrome (ARDS) due to Coronavirus Disease 2019 (COVID-19) causes high mortality. The objective of this study is to determine whether the arterial pressure of oxygen/inspiratory fraction of oxygen (PaO2/FiO2) 24 h after invasive mechanical ventilation (IMV) and the difference between PaO2/FiO2 at 24 h after IMV and PaO2/FiO2 before admission to IMV (ΔPaO2/FiO2 24 h) are predictors of survival in patients with ARDS due to COVID-19. Methods: A retrospective cohort study was conducted that included patients with ARDS due to COVID-19 in IMV admitted to the intensive care unit (ICU) of a hospital in southern Peru from April 2020 to April 2021. The ROC curves and the Youden index were used to establish the cut-off point for PaO2/FiO2 at 24 h of IMV and ΔPaO2/FiO2 at 24 h associated with mortality. The association with mortality was determined by Cox regression, calculating the crude (cHR) and adjusted (aHR) risk ratios, with their respective 95% confidence intervals (95% CI). Results: Two hundred patients were analyzed. The average age was 54.29 years, 79% were men, and 25.5% (n = 51) died. The cut-off point calculated for PaO2/FiO2 24 h after IMV and ΔPaO2/FiO2 24 h was 222.5 and 109.5, respectively. Those participants with a value below the cut-off point of ΔPaO2/FiO2 24 h and PaO2/FiO2 24 h after IMV had higher mortality, aHR = 3.32 (CI 95% [1.82-6.07]) and aHR = 2.87 (CI 95% [1.48-5.57]) respectively. Conclusion: PaO2/FiO2 24 h after IMV and ΔPaO2/FiO2 24 h in patients diagnosed with ARDS due to COVID-19 on IMV were associated with higher hospital mortality. These findings are helpful to identify those patients with a higher risk of dying on admission to the ICU.
Subject(s)
COVID-19 , Respiratory Distress Syndrome , Male , Humans , Middle Aged , Female , Respiration, Artificial , COVID-19/complications , Retrospective Studies , Respiratory Distress Syndrome/therapy , OxygenABSTRACT
Background and objectives: Sleep disorders are a common public health problem among college students. The objective of this study was to evaluate sleep quality and its associated factors in medical students during the COVID-19 pandemic. Materials and Methods: Cross-sectional analytical study-we conducted a secondary analysis of the survey "Nomophobia in medical students in Peru" database between 2020 and 2021. Sleep disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI). To evaluate associated factors, crude and adjusted prevalence ratios (aPR) and their 95% confidence intervals (95% CI) were calculated. Results: We analyzed data from 3139 participants from 18 cities in Peru (61.1% were women, median age: 22 years). 43.4% had a quality of sleep that could require medical attention; the PSQI dimension with the highest score was daytime dysfunction. The poor sleep quality was associated with symptoms of anxiety (aPR: 1.48; 95% CI: 1.27-1.72), depression (aPR: 2.03; 1.72-2.39), or nomophobia (aPR: 1.28; 1.09-1.51). Conclusions: Sleep disorders were a common problem among Peruvian medical students and were associated with anxiety, depression, or nomophobia symptoms.
Subject(s)
COVID-19 , Sleep Wake Disorders , Students, Medical , Female , Humans , Young Adult , Adult , Male , Peru/epidemiology , Cross-Sectional Studies , COVID-19/epidemiology , Pandemics , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/diagnosisABSTRACT
Due to close contact with death, medical students may question their own and their patients' dying process, especially with the impact of the COVID-19 pandemic on the increase in deaths. This situation provokes fear and negative attitudes towards dealing with patients and their environment. This study aimed to assess the level of fear of death and associated factors in medical students at a Peruvian university. A cross-sectional analytical study was conducted during March 2021 in human medicine students from the first to the seventh year. A validated survey including the Collet-Lester fear-of-death scale was applied. Factors associated with the fear-of-death score were evaluated by calculating linear regression coefficients (ß). A total of 284 students were included. The median age was 22 years, and 58.1% were female. The mean Collet-Lester scale score was 2.79, and it was higher in the dimensions related to the death of others. Adjusted analysis showed that the score on this scale was lower in students aged 24-40 years compared to 17-21 years (ß: -0.25; 95% CI: -0.46 to -0.04) and those who had no religious beliefs (ß: -0.29; 95% CI: -0.53 to -0.04). In conclusion, fear of death was lower than reported in other investigations despite the COVID-19 situation, being much lower among older students and those without religious beliefs.