Opinión de estudiantes de medicina sobre el uso de un aula virtual asincrónica durante la COVID-19 / Opinion of medical students on the use of an asynchronous virtual classroom during COVID-19

Introducción: Ante la pandemia por COVID-19, las escuelas de medicina debieron transitar de un modelo de enseñanza predominantemente presencial a la modalidad en línea, por lo que se dieron a la tarea de diseñar una serie de herramientas para dar continuidad a la formación de sus estudiantes. Objetivo: Conocer la opinión de los alumnos de medicina sobre el uso de un aula virtual asincrónica como recurso de apoyo durante su proceso de aprendizaje en el contexto de la pandemia. Sujetos y métodos: Participaron 31 alumnos de primer año de medicina en México. Se utilizó un cuestionario de nueve ítems para indagar su opinión sobre la calidad de los contenidos de una asignatura, la idoneidad de la cantidad de actividades utilizadas, así como la claridad de la introducción a cada tema, de sus objetivos y de las instrucciones para cada actividad de aprendizaje. Resultados: Más de la mitad opinó que la introducción, los objetivos y las instrucciones del aula virtual asincrónica para realizar las actividades de aprendizaje de cada tema eran fáciles de entender. Más del 70% consideró que la calidad de los contenidos era muy buena y que el número de actividades de aprendizaje utilizadas era suficiente para cubrir los objetivos. Conclusiones: Los resultados permitieron identificar el material y las actividades del aula virtual asincrónica que resultaron, en opinión de los estudiantes, enriquecedores para su proceso de aprendizaje y qué cambios realizar para mejorar esta plataforma en beneficio de su formación profesional.(AU)

Introduction: Faced with the COVID-19 pandemic, medical schools had to move from a predominantly face-to-face teaching model to the online modality, so they undertook the task of designing a series of tools to continue the training of their students. Aim: To know the opinion of medical students on the use of an asynchronous virtual classroom as a support resource during their learning process in the context of the pandemic. Subjects and methods: Thirty-one first-year medical students in Mexico participated. A nine-item questionnaire was used to find out their opinion about the quality of the contents of a subject, the suitability of the number of activities used, as well as the clarity of the introduction to each topic, its objectives and the instructions for each learning activity. Results: More than half found the introduction, objectives, and instructions of the asynchronous virtual classroom to carry out the learning activities for each topic easy to understand. Over 70% considered that the quality of the contents was very good and that the number of learning activities used was sufficient to cover the objectives. Conclusions: The results made it possible to identify the material and activities of the asynchronous virtual classroom that were, in the opinion of the students, enriching for their learning process and what changes to make to improve this platform for the benefit of their professional training.(AU)

The association between chronotype and perceived academic stress to depression in medical students.

Depression is a multifactorial illness that is highly prevalent among medical students (MS). Chronotypes, which reflect circadian preference in humans, as well as academic stress have been associated with depression in different populations. However, it is not known how chronotype and stress might alone or in combination, associate with depression in MS. Thus, we aimed to evaluate the association between stress, chronotype and depression in MS. In a cross-sectional study, we evaluated a total of 1068 medical students from a public Medical School in Mexico City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depressive symptom severity and the presence of a current depressive episode with a cutoff score of 10 or higher. The Morning-Evening Questionnaire (MEQ) was used to establish chronotype and the Academic Stress Inventory was used to measure perceived academic stress (PAS). We observed that depressive symptom severity was higher in non-morning chronotypes and moderate/severe PAS groups. A factorial ANOVA showed an association between PAS groups and depressive symptom severity. Linear regression showed an association between depressive symptom severity and variables such as PAS scores (p = 0.001), family history of depression (p = 0.001), gender (p = 0.001) and academic year (p = 0.029). Logistic regression analysis showed that evening chronotype (OR: 2.3, 95% CI: 1.2-4.3, p = 0.01) and severe PAS (OR: 4.4, 95% CI: 2.8-7.0, p = 0.0001) were associated with depression. Further, MS with the combination of severe PAS and morning (OR: 5.9, 95% CI: 1.6-22.2, p = 0.01), intermediate (OR: 7.5, 95% CI: 2.3-24.4, p = 0.001) or evening (OR: 10.6, 95% CI: 2.8-40.0, p = 0.001) chronotypes showed a greater association with depression than any PAS or chronotype group alone. Being female, perceiving restricted or limited economic resources, having severe scores of academic stress, and evening chronotype were associated with an increased probability to suffer a current depressive episode. Collectively, these results show that chronotype and PAS are factors associated with depression in MS, and when combined promote this association. Our results might aid in early identification of MS susceptible to depression. Future research could focus on the implementation of simple, low cost preventive strategies, such as chronotype-oriented academic schedules.

Manifestaciones clínicas y tratamiento del trastorno bipolar en niños y adolescentes, una actualización basada en la evidencia / Clinical manifestations and treatment of bipolar disorder (BPD) in children and adolescents, an evidence-based up-to-date approximation

The phenomenology of pediatric bipolar disorder is different from the classical presentation of this disorder in adults as indicated by high rates of psychotic symptoms, episodes and rapid cycling, longer duration of episodes and the presence of subsindromatic symptoms for long periods. The long-term outcome of patients with pediatric onset is worse than those with adult onset. In the last decade, pharmacological research has increased, showing that the response to treatment in children and adolescents is different from that of adults, being better with the combination of psychotropic drugs. Psychosocial interventions involve psychoeducation and skills training can be an alternative treatment for children and adolescents at risk for bipolar disorder.

La fenomenología del trastorno bipolar pediátrico es distinta a la presentación clásica de este trastorno en adultos como lo indican las altas tasas de síntomas psicóticos, episodios de ciclaje rápido, alta duración de los episodios, así como la presencia de síntomas subsindromáticos por períodos largos. El pronóstico de los pacientes que inician la enfermedad durante la infancia y/o adolescencia es peor que para aquellos que la inician en la vida adulta. En la última década se ha incrementado la investigación farmacológica para este trastorno, los ensayos clínicos han mostrado que la respuesta de niños y adolescentes es distinta a la de los adultos, ofreciéndose mejores resultados con la combinación de psicofármacos. Las intervenciones psicosociales involucran a la psicoeducación y el entrenamiento en habilidades, pueden ser una alternativa de tratamiento para los niños y adolescentes con riesgo de desarrollar un trastorno bipolar.