Propuesta para mejorar la formación en profesionalismo y en competencias transversales en los estudios de medicina de las universidades de Cataluña / Proposal to improve training in professionalism and transversal competences in medical studies at the universities of Catalonia

Introducción: En un grupo de trabajo de la Administración de la Generalitat de Cataluña y de los decanos de las facultades con estudios de Medicina de las universidades catalanas se creó una comisión para elaborar una propuesta para fomentar la formación en profesionalismo, en humanidades y en competencias transversales de los graduados en Medicina. Desarrollo: Dicha comisión, compuesta por docentes de todas las facultades, elaboró un documento con tres objetivos específicos: a) mostrar el estado real de dicha formación en los currículos; b) proponer actividades docentes concretas para mejorar dicha formación, considerando las buenas prácticas que se están realizando en las universidades; y c) sugerir criterios y métodos de evaluación de la formación en profesionalismo o de competencias transversales y, también, evaluar competencias específicas que pueden favorecer el desarrollo de las competencias genéricas. Conclusiones: Se espera que las sugerencias presentadas puedan servir para aumentar la formación en valores profesionales, en humanidades y en competencias transversales de los futuros profesionales de la medicina, con el objetivo final de mejorar la salud de la población.(AU)

Introduction: In a working group of the Administration of the regional government of Catalonia and the deans of the faculties with medical studies of the Catalan universities, a commission was created to prepare a document to promote training in professionalism and transversal competences of graduates in Medicine. Development: This commission, made up of teachers from all the faculties, prepared a document with three specific objectives: a) show the real state of said training in the curricula; b) propose specific teaching activities to improve said training, considering those good practices that are being carried out in universities; and c) suggest criteria and methods of evaluation of training in professionalism or of transversal competences and, also, evaluate specific competences that can improve the development of generic competences. Conclusions: It is hoped that the suggestions presented can serve to increase training in professional values, in the humanities and in transversal competences of future medical professionals with the ultimate goal of improving the health of the population.(AU)

Improvement of medical students' performance in simulated patient interviews by pre-clinical communication training.

Objectives: To compare the communication skills shown by medical students during simulated patient interviews between those who received training in communication during the preclinical years and those who did not. Methods: A retrospective study was conducted to analyze the communication skills of several cohorts of fourth-year medical students from Universitat Internacional de Catalunya during simulated patient interviews. Out of a total of 477 students included in the study, 229 (48%) had received training in communication skills through a 60-hour elective course during the preclinical second year, while the remaining 248 (52%) had received none. Communication skills were assessed by an evaluation team using a numerical scale (0 to 10) that included eight categories: "verbal", "non-verbal", "empathy", "concreteness", "warmth", "message content", "assertiveness", and "respect". Scores obtained by trained and non-trained students were compared using the t-test. Results: A trend towards obtaining better results was observed among students who had received communication training (mean score: 6.98/10) versus none (6.83/10, t(1,869)=-1.95, p=0.05). Non-trained male students obtained significantly lower mean scores than non-trained females in the categories of "respect" (7.48/10 vs. 7.83/10, t(968)=-2.89, p<0.01), "verbal communication" (6.87/10 vs. 7.15/10, t(968)=-2.61, p=0.01), "warmth" (6.53/10 vs. 6.95/10, t(968)=-3.40, p<0.01), and "non-verbal communication" (6.49/10 vs. 6.79/10, t(968)=-2.48, p=0.01). Trained female and male students had similar scores. Conclusions: Training in communication skills during the preclinical years may improve fourth-year students' performance in simulated interviews with patients, particularly among males. These results demonstrate the importance of introducing specific training in communication skills early in the undergraduate medical curriculum.

COVID-19: Making the Best out of a Forced Transition to Online Medical Teaching-a Mixed Methods Study.

Introduction: The first wave of the COVID-19 pandemic resulted in a decreed confinement in Spain from March until the end of term in June 2020, forcing an abrupt transition to exclusive distance learning in universities. We aimed to describe and analyze the perceptions and experiences of undergraduate medical students and faculty members as a consequence of this educational shift so as to identify the key elements for successful online medical learning. Methods: A convergent mixed methods design was employed, using both quantitative and qualitative data collected successively through Phase 1: Online teaching follow-up program; Phase 2: Discussion groups (two focus groups and a nominal group with students and faculty, respectively) and a survey of students from first to fifth year; and Phase 3: Triangulation of qualitative and quantitative data. Results: Thirteen strongly interconnected categories were identified. Four of them played an organizational role: course planning, coordination, communication, and pedagogical coherence. The remaining nine categories were learning outcomes, teaching methodology, online resources, evaluation, time management, workload, student motivation, participation, and teacher-student relationship. Among the key aspects of learning were those that promoted rapport between faculty and students, such as synchronous sessions, especially those based on clinical cases. Conclusions: Promoting student motivation and participation at all levels were the main lessons learned for enhancing online learning and teaching experiences in undergraduate medical education. Key elements to reach this goal are, among others, planning, coordination, communication, and pedagogical coherence. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01518-9.

¿Aprender Medicina a distancia?: percepción de estudiantes confinados por la pandemia COVID-19

Background: The suspension of face-to-face teaching activity due to the COVID-19 pandemic forced an abrupt transition to distance learning in Spanish universities. Aim: To know how medical students value distance learning in the context of COVID-19 pandemic. Material and Methods: Undergraduate medical students from first to fifth year in Barcelona (Spain) were invited to answer an anonymous online survey about their perceptions and level of satisfaction with virtual learning. Results: Of 483 students invited to the survey, 244 (50.5%) answered it. Respondents from the first and second year rated distance learning as acceptable (mean 3.1) on a Likert scale from 1 to 5. Those from third to fifth years rated distance learning as unsatisfactory (mean 2.7). The best evaluated aspects were synchronous lectures (3.9) and lectures based on cases (3.4). The worst evaluated issues were motivation (2.3), interaction with faculty (2.1), and additional workload (0.7). Conclusions: The perceptions expressed by these students reinforce the importance of facilitating communication, motivation and participation of students in distance learning in Medicine.

[Perceptions of students confined by the COVID-19 pandemic on distance learning in medicine]. / ¿Aprender Medicina a distancia?: percepción de estudiantes confinados por la pandemia COVID-19.

BACKGROUND: The suspension of face-to-face teaching activity due to the COVID-19 pandemic forced an abrupt transition to distance learning in Spanish universities. AIM: To know how medical students value distance learning in the context of COVID-19 pandemic. MATERIAL AND METHODS: Undergraduate medical students from first to fifth year in Barcelona (Spain) were invited to answer an anonymous online survey about their perceptions and level of satisfaction with virtual learning. RESULTS: Of 483 students invited to the survey, 244 (50.5%) answered it. Respondents from the first and second year rated distance learning as acceptable (mean 3.1) on a Likert scale from 1 to 5. Those from third to fifth years rated distance learning as unsatisfactory (mean 2.7). The best evaluated aspects were synchronous lectures (3.9) and lectures based on cases (3.4). The worst evaluated issues were motivation (2.3), interaction with faculty (2.1), and additional workload (0.7). CONCLUSIONS: The perceptions expressed by these students reinforce the importance of facilitating communication, motivation and participation of students in distance learning in Medicine.

Evaluación de competencias en comunicación clínica en estudiantes de medicina con paciente simulado / Evaluation of clinical communication skills in medical students with simulated patients

Background: Communication skills are not learnt innately. It is therefore necessary to both train and evaluate medical students in this area. Aim: To evaluate communication skills of fourth-year medical students with the use of a simulated patient (SP). Material and Methods: Four clinical scenarios (CS) for clinical interviews with simulated patients were designed: chronic and acute diseases, difficult and functional patients. Each student performed the four CS, and his communication skills were evaluated using our own questionnaire as agreed with the SP. The questionnaire included items on verbal and nonverbal communication, warmth, respect, specificity, assertiveness and empathy (rated from 0 to 10). The response variable was the arithmetic mean of the scores on each item. All students received a detailed evaluation report. Results: Sixty one students (32 men) performing 244 interviews, were evaluated. The overall mean score was 7.87 (4.62 to 9.03). The highest scores were for respect and specificity (7.57 and 7.15 respectively). The lowest were for empathy and nonverbal communication (6.44 and 6.84 respectively). The CS evaluations were 7.87 (chronic disease), 7.02 (difficult patient), 6.46 (acute disease) and 6.14 (functional pathology). Women had higher overall scores compared to men (7.26 and 6.51 respectively; p < 0.01) and a significantly higher score in all communication variables (p < 0.01). Conclusions: The overall assessment in clinical communication with SP is satisfactory although there is room for improvement, especially in empathy and nonverbal communication. Women had significantly higher scores than men.

Psychometric properties of the Spanish version of the Jefferson Scale of Empathy: making sense of the total score through a second order confirmatory factor analysis.

BACKGROUND: Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model. METHODS: The Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach's alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences. RESULTS: The Spanish JSE-S demonstrated acceptable to good sensitivity (individual items - except for item 2 - and JSE-S total score: -2.72 < Sk < 0.35 and -0.77 < Ku < 7.85), convergent validity (AVE: between 0.28 and 0.45) and reliability (Cronbach's alphas: between 0.62 and 0.78; CR: between 0.62 and 0.87). The confirmatory factor analysis supported the three-factor solution and the second order latent factor model. CONCLUSIONS: The findings provide support for the sensitivity, construct validity and reliability of the adapted Spanish JSE-S with Spanish medical students. Data confirm the hypothesized second order latent factor model. This version may be useful in future research examining empathy in Spanish medical students, as well as in cross-cultural studies.

Educational climate perception by preclinical and clinical medical students in five Spanish medical schools.

OBJECTIVE: The purpose of this study was to investigate student's perceptions of Educational Climate (EC) in Spanish medical schools, comparing various aspects of EC between the 2nd (preclinical) and the 4th (clinical) years to detect strengths and weaknesses in the on-going curricular reform. METHODS: This study utilized a cross-sectional design and employed the Spanish version of the "Dundee Ready Education Environment Measure" (DREEM). The survey involved 894 2nd year students and 619 4th year students from five Spanish medical schools. RESULTS: The global average score of 2nd year students from the five medical schools was found to be significantly higher (116.2±24.9, 58.2% of maximum score) than that observed in 4th year students (104.8±29.5, 52.4% of maximum score). When the results in each medical school were analysed separately, the scores obtained in the 2nd year were almost always significantly higher than in the 4th year for all medical schools, in both the global scales and the different subscales. CONCLUSIONS: The perception of the EC by 2nd and 4th year students from five Spanish medical schools is more positive than negative although it is significantly lower in the 4th year. In both years, although more evident in the 4th year, students point out the existence of several important "problematic educational areas" associated with the persistence of traditional curricula and teaching methodologies. Our findings of this study should lead medical schools to make a serious reflection and drive the implementation of the necessary changes required to improve teaching, especially during the clinical period.