[Level of teaching competence at the Undergraduate Medical Internship of UNAM's Faculty of Medicine]. / Nivel de competencia docente en el Internado Médico de Pregrado de la Facultad de Medicina de la UNAM.

BACKGROUND: There is no systematic evaluation of teaching performance in the clinical area at UNAM Faculty of Medicine. The study purpose is to assess the teaching competence level in the Undergraduate Medical Internship (UMI). METHODS: The paper describes the process of psychometric validity for the instrument designed to evaluate teaching competence in the UMI. This instrument was constructed from two previously developed instruments. The final version with 54 items in a Likert scale was studied with exploratory factorial analysis. Four dimensions were obtained: Solution of clinical problems, Psychopedagogy, Mentoring, and Evaluation. The instrument had a reliability of 0.994, with an explained variance of 77.75%. RESULTS: To evaluate the teaching competence level, we administered 844 questionnaires to a sample of students with a response rate of 89%. We obtained an overall global score of 89.4 ± 9.6 (mean ± SD). The dimension Solution of clinical problems was the one with a greater value, in contrast with the dimension of Evaluation, which had a lower score. CONCLUSION: The teachers of the UMI are considered educators with high level of teaching competence, according to the perceptions of the undergraduate internal doctors. The evaluation of teaching competence level is very important for institutions that look for the continuous professional development of its faculty.

Introducción: en la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM) no hay una evaluación sistemática del desempeño docente del área clínica. El propósito de este estudio fue evaluar el nivel de competencia docente en el Internado Médico de Pregrado (IMP). Método: se describe el proceso de la validación psicométrica de un instrumento diseñado para evaluar la competencia docente en el IMP. El instrumento se construyó a partir de dos instrumentos previamente desarrollados y con base en el análisis factorial exploratorio de un instrumento con 54 reactivos y una escala tipo Likert, se obtuvieron cuatro dimensiones. El instrumento tuvo una confiabilidad de 0.994, con una varianza explicada de 77.75%. Resultados: para evaluar en nivel de competencia docente, se utilizaron 844 cuestionarios, lo que constituye la muestra de estudiantes, con una tasa de respuesta del 89%. Se obtuvo una media global de 89.4 ± 9.6 de desviación estándar. La Solución de problemas clínicos fue la que obtuvo mayor valoración, en contraste con la dimensión de Evaluación, que observó menor valoración. Conclusiones: los docentes del IMP son considerados educadores con alto nivel de competencia docente, según las percepciones de los médicos internos de pregrado. Se advierte cómo la evaluación de la competencia docente es indispensable en cualquier institución que busque el desarrollo profesional continuo de sus profesores.

Specific entrustable professional activities for undergraduate medical internships: a method compatible with the academic curriculum.

BACKGROUND: Competency-based education has been considered the most important pedagogical trend in Medicine in the last two decades. In clinical contexts, competencies are implemented through Entrustable Professional Activities (EPAs) which are observable and measurable. The aim of this paper is to describe the methodology used in the design of educational tools to assess students´ competencies in clinical practice during their undergraduate internship (UI). In this paper, we present the construction of specific APROCs (Actividades Profesionales Confiables) in Surgery (S), Gynecology and Obstetrics (GO) and Family Medicine (FM) rotations with three levels of performance. METHODS: The study considered a mixed method exploratory type design, a qualitative phase followed by a quantitative validation exercise. In the first stage data was obtained from three rotations (FM, GO and S) through focus groups about real and expected activities of medical interns. Triangulation with other sources was made to construct benchmarks. In the second stage, narrative descriptions with the three levels were validated by professors who teach the different subjects using the Delphi technique. RESULTS: The results may be described both curricular and methodological wise. From the curricular point of view, APROCs were identified in three UI rotations within clinical contexts in Mexico City, benchmarks were developed by levels and validated by experts' consensus. In regard to methodological issues, this research contributed to the development of a strategy, following six steps, to build APROCs using mixed methods. CONCLUSIONS: Developing benchmarks provides a regular and standardized language that helps to evaluate student's performance and define educational strategies efficiently and accurately. The university academic program was aligned with APROCs in clinical contexts to assure the acquisition of competencies by students.

Nueva variante del síndrome de Bart: comunicación de un caso / New form of Bart's syndrome: report of a case

El síndrome de Bart se describe por primera vez en 1966 como un padecimiento con las siguientes características: ausencia congénita de piel, selectivamente en miembros inferiores; lesiones ampollosas en regiones de apoyo o fricción; afectación de anexos tegumentosos con implicaciones de distrofia ungueal y lesiones de mucosa bucal y anal. En la literatura médica general revisada, hay información de 21 casos con síndrome de Bart; sim embargo, la bibliografía nacional examinada sólo da a conocer la enfermedad en un lactante masculino de 72 días de edad