Assessing student perceptions of the clinical teachers' performance during early clinical exposure.

BACKGROUND: The clinical teachers' attributes can be grouped into physician competencies, teacher competencies, and personal characteristics. Global performance is considered the clinical teacher's capacity to facilitate an active and stimulating learning process for medical students and a warm, supportive, and pleasant environment. AIM: To determine which attributes of the clinical teacher influence their global performance from the students' point of view. MATERIAL AND METHODS: The Role Model Apperception Tool questionnaire (RoMAT) was answered by 133 second-year medical students at the University of Chile during 2018. RESULTS: The students assessed 37 clinical teachers. Teaching competencies had the higher influence in global performance. Personal characteristics also had a significant influence. Physician competencies had an indirect influence on teaching competencies. The model obtained 88% of the explained variance of the teacher's global performance. CONCLUSIONS: This study showed that teacher competencies, personal characteristics, and physician competencies are qualities that influence the perception of the global performance of clinical teachers.

Assessing student perceptions of the clinical teachers' performance during early clinical exposure / Evaluación de la percepción de los estudiantes acerca de los atributos de sus tutores en los primeros cursos clínicos

ABSTRACT BACKGROUND: The clinical teachers' attributes can be grouped into physician competencies, teacher competencies, and personal characteristics. Global performance is considered the clinical teacher's capacity to facilitate an active and stimulating learning process for medical students and a warm, supportive, and pleasant environment. AIM: To determine which attributes of the clinical teacher influence their global performance from the students' point of view. MATERIAL AND METHODS: The Role Model Apperception Tool questionnaire (RoMAT) was answered by 133 second-year medical students at the University of Chile during 2018. RESULTS: The students assessed 37 clinical teachers. Teaching competencies had the higher influence in global performance. Personal characteristics also had a significant influence. Physician competencies had an indirect influence on teaching competencies. The model obtained 88% of the explained variance of the teacher's global performance. CONCLUSIONS: This study showed that teacher competencies, personal characteristics, and physician competencies are qualities that influence the perception of the global performance of clinical teachers.

ANTECEDENTES: Los atributos de un tutor clínico pueden agruparse en competencias clínicas, competencias docentes y características personales. En el desempeño global del tutor se considera su capacidad de facilitar un proceso de aprendizaje activo y estimulante y generar un ambiente cálido y de soporte. OBJETIVO: Determinar qué atributos del tutor clínico, evaluados por los estudiantes, influyen sobre su desempeño global. MATERIAL Y MÉTODO: La escala "Role Model Apperception Tool" fue contestada por 133 estudiantes de segundo año de medicina en la Universidad de Chile durante el 2018. RESULTADOS: Los estudiantes evaluaron 37 tutores clínicos. Las competencias docentes tuvieron la mayor influencia sobre el desempeño global. Las características personales también mostraron influencia significativa. Las competencias clínicas influyeron indirectamente a través de las competencias docentes. El modelo logró explicar 88% de la varianza del desempeño global del tutor clínico. CONCLUSIONES: El estudio muestra que las competencias docentes, características personales y competencias clínicas influyen sobre la evaluación de los estudiantes sobre el desempeño global del tutor.

[Experiences of medical students belonging to sexual and gender diversity: a systematic review]. / Las experiencias de los estudiantes de medicina LGBTQ+ durante su formación: Una revisión sistemática.

BACKGROUND: Students belonging to sexual and gender diversity experience chronic stress due to stigmatization and discrimination. AIM: To identify the experiences of lesbian, gay, bisexual, transgender/transsexual, and queer (LGBTQ+) medical students. MATERIAL AND METHODS: Systematic literature review using the PRISMA protocol in PubMed, ERIC, EMBASE, and LILACS databases. Articles published in Spanish or English were considered. Three authors independently reviewed and synthesized information from the selected articles, according to the PRISMA criteria. RESULTS: Fifteen studies met the inclusion criteria. Forty-three experiences were reported, which were finally classified into four categories: i) Relationship between peers in the educational context (23%), ii) Relationship between students and teachers in the educational context (23%), iii) Relationship with the educational institution (34%), and iv) Curriculum and training experience (19%). The relationship with the educational institution was identified as the most relevant category. Students with a strong sense of belonging to their institution were more likely to be persistent and make an effort in learning. The second most relevant experiences, mainly negative, derive from interactions with peers and teachers. CONCLUSIONS: LGBTQ+ medical students still experience more discrimination than inclusion during their training. Therefore, medical schools should render medical education a more inclusive space for the LGBTQ+ population.

Las experiencias de los estudiantes de medicina LGBTQ+ durante su formación: Una revisión sistemática / Experiences of medical students belonging to sexual and gender diversity: a systematic review

Background: Students belonging to sexual and gender diversity experience chronic stress due to stigmatization and discrimination. Aim: To identify the experiences of lesbian, gay, bisexual, transgender/transsexual, and queer (LGBTQ+) medical students. Material and Methods: Systematic literature review using the PRISMA protocol in PubMed, ERIC, EMBASE, and LILACS databases. Articles published in Spanish or English were considered. Three authors independently reviewed and synthesized information from the selected articles, according to the PRISMA criteria. Results: Fifteen studies met the inclusion criteria. Forty-three experiences were reported, which were finally classified into four categories: i) Relationship between peers in the educational context (23%), ii) Relationship between students and teachers in the educational context (23%), iii) Relationship with the educational institution (34%), and iv) Curriculum and training experience (19%). The relationship with the educational institution was identified as the most relevant category. Students with a strong sense of belonging to their institution were more likely to be persistent and make an effort in learning. The second most relevant experiences, mainly negative, derive from interactions with peers and teachers. Conclusions: LGBTQ+ medical students still experience more discrimination than inclusion during their training. Therefore, medical schools should render medical education a more inclusive space for the LGBTQ+ population.

Effects of COVID-19 on male sex function and its potential sexual transmission.

INTRODUCTION: Severe Acute Respiratory Syndrome Coronavirus 2, (SARS-CoV-2) was first identified by the Chinese Centers for Disease Control and Prevention on January 8, 2020 and was declared as a global pandemic on March 11, 2020 by WHO. SARS-CoV-2 uses the Angiotensin-converting enzyme 2 (ACE2) receptor as an entry route, associated with the transmembrane serine protease protein (TMPRSS2), which makes the testis and particularly spermatogenesis potentially vulnerable, since this tissue has high expression of ACE2. MATERIAL AND METHODS: We performed a systematic literature review by electronic bibliographic databases in Pubmed, Scopus and ScienceDirect up to August 2020 about the effect of SARS-CoV-2 on male sexual function and its transmission, to assess possible repercussions on sex organs and the existence of a sexual transmission path. RESULTS: Although SARS-CoV-2 presence has not been found in testicle samples, it has been demonstrated that it causes histological changes compatible with orchitis, and sex hormone disturbances. TMPRSS2 is up-regulated in prostate cancer where it supports tumor progression, thus these patients may have a higher risk of SARS-CoV-2 infection. TMPRSS2 inhibitors may be useful for the treatment or prevention of COVID-19. No viral material has been found in blood or semen, however it has been proven to be present in stool and saliva. CONCLUSION: The male reproductive system would be highly vulnerable and susceptible to infection by SARS-CoV-2 given the expression of the ACE2 receptor in somatic and germ cells. The seminal fluid would remain free of viral presence in patients with COVID-19. Regardless, non-genital sex could be an important source of viral transmission. In assisted reproduction techniques all necessary tests must be carried out to ensure the donor is free of the virus at the time of collection and handling of the seminal sample.

Los atributos de un tutor clínico de excelencia: una revisión sistemática

Knowing what characterizes an excellent teacher is relevant to guide training, evaluation, and continuous improvement of the clinical teacher. We performed a systematic review using the PRISMA protocol, aiming to identify the attributes of an excellent clinical teacher. MEDLINE, ERIC, ScienceDirect, and Scopus databases were searched for articles published in English and Spanish, between 2007 and 2019. Two independent reviewers extracted and synthesized data from articles that met the PRISMA pre-established criteria. Twelve studies met the inclusion criteria. Of the 106 attributes reported by the studies, 49 (46,2%) were generic. The most frequently mentioned attribute was respectfulness. Forty-six attributes (43,3%) were pedagogical. Feedback and planning were those most frequently mentioned. Eleven attributes (10,3%) were disciplinary and clinical skills was the most mentioned. We conclude that generic and pedagogical dimensions had a greater representation in the literature, in comparison with the disciplinary dimension. This could be explained, considering that having adequate clinical skills is the minimal necessary requisite to become a clinical teacher, but does not make a difference in how their performance is perceived, contrary to the generic and pedagogical dimensions.

Morphological changes of the cellularity in the prostatic gland from patients with confirmed cancer: Gleason level and presence of eosinophils and mast cells: cellular bioindicators / Cambios morfológicos de la celularidad en la glándula prostática de pacientes con cáncer confirmado: nivel de gleason y presencia de eosinófilos y mastocitos: bioindicadores celulares

The different pathologies of the prostate, involve the presence of a new microenvironment where inflammatory cells are actively recruited. This research explores the presence of mast cells and eosinophils associated with age and the evaluation of prostate cancer progress (Gleason Index). Forty two biopsies of anonymized patients, with confirmed prostate cancer, were used for histological analysis for eosinophils and mast cells and subsequent determination of Gleason index according to age. The results of the histological analyzes show the presence of eosinophils and mast cells in prostate biopsies with confirmed cancer. In the multiple correlation studies, a high correlation was observed between the presence of lymphocytes and the age of the patient diagnosed with prostate cancer, same correlation was observed between the patient's age and higher Gleason Index (Pearson and Spearman p< 0.05). It is concluded that in prostate biopsies from Chilean patients with confirmed cancer, eosinophilia and tissue mastocytosis were observed. Correlation analyzes show a direct correlation between older patients, higher Gleason index and presence of mast cell. Regarding eosinophilia, only a correlation between age and Gleason index was observed Further studies are suggested to determine that the presence of eosinophils and mast cells can be used as early bioindicators of prostate cancer.

Las diferentes patologías de próstata, involucran la presencia de un nuevo microambiente donde las células inflamatorias son activamente reclutadas. La presente investigación explora la presencia de mastocitos y eosinófilos asociadas a la edad y la evaluación del progreso del cáncer de próstata según índice de Gleason. Cuarenta y dos biopsias de pacientes anonimizados, con cáncer prostático confirmados, fueron utilizadas para su análisis histológico para eosinófilos y mastocitos y posterior determinación del índice de Gleason según edad. Los resultados de los análisis histológicos, muestran la presencia de eosinófilos y mastocitos en biopsias de próstata con cáncer confirmado. En los estudios de correlación múltiple, se observó una alta correlación entre la presencia de linfocitos, mastocitos y la edad del paciente diagnosticado con cáncer prostático, igual correlación se observó entre la edad del paciente y mayor índice de Gleason (Pearson y Spearman p<0,05). Se concluyó que en las biopsias de próstata de pacientes chilenos con cáncer confirmado, se observó eosinofilia y mastocitosis tisular. Los análisis de correlación muestran una correlación directa entre pacientes de mayor edad, índice de Gleason más alto y la presencia de mastocitos. Con respecto a la eosinofilia, solo se observó una correlación entre la edad y el índice de Gleason. Se sugieren estudios adicionales para determinar que la presencia de eosinófilos y mastocitos puede usarse como bioindicadores tempranos del cáncer de próstata.

[A systematic review about the most important attributes of clinical teachers]. / Los atributos de un tutor clínico de excelencia: una revisión sistemática.

Knowing what characterizes an excellent teacher is relevant to guide training, evaluation, and continuous improvement of the clinical teacher. We performed a systematic review using the PRISMA protocol, aiming to identify the attributes of an excellent clinical teacher. MEDLINE, ERIC, ScienceDirect, and Scopus databases were searched for articles published in English and Spanish, between 2007 and 2019. Two independent reviewers extracted and synthesized data from articles that met the PRISMA pre-established criteria. Twelve studies met the inclusion criteria. Of the 106 attributes reported by the studies, 49 (46,2%) were generic. The most frequently mentioned attribute was respectfulness. Forty-six attributes (43,3%) were pedagogical. Feedback and planning were those most frequently mentioned. Eleven attributes (10,3%) were disciplinary and clinical skills was the most mentioned. We conclude that generic and pedagogical dimensions had a greater representation in the literature, in comparison with the disciplinary dimension. This could be explained, considering that having adequate clinical skills is the minimal necessary requisite to become a clinical teacher, but does not make a difference in how their performance is perceived, contrary to the generic and pedagogical dimensions.