Nippon Medical School's Ethical Review Processes for Studies Involving Human Subjects.

All life science and medical research involving human subjects must be conducted in compliance with the Declaration of Helsinki and the relevant laws and guidelines. Additionally, its scientific and ethical suitability must be reviewed by a committee well versed in the nature and content of the research. Failure to comply with these requirements when conducting research involving human subjects is a serious violation of Japanese laws, guidelines, and local regulations, so several ethics committees and institutional review boards have been established within the Nippon Medical School (NMS) Foundation and its affiliated institutions. It is essential for investigators to keep up to date with the latest developments in the ethical review process and to ensure that any projects they propose to embark on are subjected to an appropriate ethical review before the research is initiated. To help researchers and other staff affiliated with the NMS Foundation keep abreast of these developments, this report outlines NMS's current ethical review processes for research involving human subjects.

Historical trends and current experiences of anatomical body donation in two Zimbabwean medical schools.

BACKGROUND: Body donation is integral to anatomy education, but procurement can be ethically fraught. While voluntary donation is preferred, the use of unclaimed bodies, although considered unethical, is a primary means for body procurement in some countries. This mixed methods study examined historical trends and anatomy technical staff perspectives on body donation in two Zimbabwean medical schools. METHODOLOGY AND MAIN FINDINGS: In Phase 1, 194 cadaver paper records from January 1984 to January 2021 were reviewed. Unclaimed bodies accounted for 67% while 33% (all white Zimbabweans) were voluntarily donated. Most cadavers were black Africans (62.4%) followed by white Zimbabweans (34.0%). Race was not indicated in seven (3.6%) records. In Phase 2, semi-structured interviews were conducted with seven technicians responsible for sourcing cadavers at the two institutions. Data were thematically analysed resulting in the development of eight themes, arranged into three domains. Cadaver procurement themes related to (1) cadaver source, (2) adherence to procurement guidelines, (3) screening for suitability, and (4) cultural and religious beliefs. Cadaver embalmment focused on (5) embalming practices, and (6) hospital mortuary-based embalming. Finally, (7) disposal processes and (8) resource constraints were found to influence cadaver disposal practices. CONCLUSIONS: Contrary to best practice, there is continued reliance on the use of unclaimed bodies to support anatomy education in the two Zimbabwean medical schools. Improving the ethical sourcing of bodies requires increased efforts to educate all Zimbabweans, especially the black majority, about the role and importance of voluntary body donation in medical education. Additionally, well-structured, and well-resourced body donation programs could enhance ethical procurement.

Enseñanza de la bioética en las facultades de medicina; ¿qué se está haciendo mal? / Teaching bioethics in medical schools; what is being done wrong?

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Revolución flexneriana y su influencia en la educación médica / Flexnerian revolution and its influence on medical education

La evolución de la educación médica en América tiene un momento clave en la historia, definido con el estudio de las escuelas de medicina de Estados Unidos y Canadá realizado por Abraham Flexner en 1910, el cual dividió en su momento a la educación médica en una etapa pre-flexneriana y post-flexneriana. Este estudio caracterizó al sistema educativo médico en Estados Unidos como un sistema deficiente, carente de regulación y sin estándares establecidos. La medicina, enseñada y ejercida con pocos principios científicos representaba un importante problema de salud y seguridad poblacional. Ante este panorama, la Asociación Americana de Medicina decide promover una evaluación de la mayoría de las escuelas de medicina con el fin de proponer cambios en el sistema educativo médico. Flexner, un teórico educativo, realiza el análisis curricular, de evaluación y prácticas ejercidas en 155 centros educativos. De su reporte se desprende la propuesta conocida como Revolución Flexneriana la cual hace tambalear el sistema educativo médico en Norteamérica en 1910. Enfatizando falta de estandarización, integración, investigación y deficiencia de la formación de médicos con identidad profesional, Flexner propuso cambios que en su momento llegaron a regir la enseñanza de los médicos en Norteamérica. Se realizó una revisión bibliográfica utilizando búsqueda manual en PubMed y Google Scholar para hacer descripcion de los aspectos históricos de la educación médica en Norteamérica, su influencia en Latinoamérica y la prevalencia actual de la integración curricular en muchas escuelas de medicina...(AU)

Evaluando la enseñanza de la bioética: formando «médicos virtuosos» o solamente médicos con habilidades éticas prácticas / Assessing bioethics education: Teaching to be virtuous doctors or just doctors with practical ethical skills

Objetivo: La bioética se ha incorporado en la formación de las Facultades de Medicina las últimas décadas. Diversos estudios analizan el desarrollo ético-moral de los estudiantes y el efecto de la educación ética, midiendo la evolución del razonamiento moral de Kohlberg (médicos virtuosos), y la sensibilidad ética para resolver casos clínicos (médicos con habilidades éticas). El objetivo del estudio es valorar el impacto de la formación en ética en estas dos variables en nuestro ámbito. Diseño: Estudio observacional transversal. Emplazamiento: Facultad de Medicina, Universidad de Lleida. Participantes: Un total de 175 estudiantes de tercer curso de medicina (78 antes de realizar bioética y 97 después de realizar bioética, en diferentes cursos). Intervención: Formación reglada en bioética. Mediciones principales: Se administra un cuestionario sociodemográfico, el Defining Issue Test de Rest como medida del razonamiento moral, y el Problem Identification Test de Hébert como medida de la sensibilidad ética. Resultados: Se halla una relación consistente y significativa entre razonamiento moral y sensibilidad ética. Las mujeres presentan mayor razonamiento posconvencional, es decir, mayor desarrollo moral. No se aprecian cambios en el estadio de razonamiento moral global de Kohlberg con la formación ética. Sí se incrementa de forma significativa y global la sensibilidad ética, medida en forma de Problem Identification Test. Conclusión: No se hallan diferencias en el desarrollo moral de estudiantes de medicina antes y después de la formación reglada en bioética, pero sí con respecto a las habilidades en resolución de casos. Se plantea si esta mejora es suficiente para formar médicos preparados para los nuevos retos

Objective: In the last decades, bioethics has been incorporated into the academic training of the Medical Schools. Some studies analyze the ethical-moral development of medical students and the effect of ethical education in other countries. This evaluation is done by measuring Kohlberg's moral reasoning (virtuous doctors), or ethical sensitivity to resolve clinical cases (physicians with ethical skills). The following study is proposed to assess the impact of bioethics training on these two variables, in Spanish medical students. Design: Observational cross-sectional study. Site: Faculty of Medicine, University of Lleida. Participants: 175 students from third year of medicine (78 before bioethics and 97 after bioethics, in different courses) were conducted. Intervention: Bioethics course. Main measurements: A socio-demographic questionnaire, the Rest Defining Issue test scale, and Problem Identification Test with clinical vignettes were administered. Results: A consistent and significant correlation has been found between moral reasoning and ethical sensitivity. Women presented greater post-conventional reasoning. There were no changes in Kohlberg's stage of global moral reasoning with ethical training. There were changes in ethical sensitivity with bioethical training, with a significantly and globally improvement. Conclusion: In our study, training in bioethics does not improve moral development but rather the ethical problem solving skills. It is asked if this improvement is enough to train doctors prepared for the new challenges

Medicina de familia en la formación del médico del futuro, y del presente / Family medicine in the training of the doctors of the future, and nowadays

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Requerimientos metodológicos generales para la implementación de estrategias encaminadas a la formación en valores de estudiantes de las ciencias médicas / General methodological requirements for the implementation of strategies guided to the values education in medical sciences students

En el presente artículo se destaca la importancia de la estrategia como instrumento contentivo de la proyección anticipada de un sistema de acciones pedagógicas a seguir en condiciones específicas e intencionadas, con vistas a lograr la formación en valores en estudiantes de ciencias médicas, además de precisarse que esta debe tener un modelo teórico para sustentar su implementación y corresponderse con el diagnóstico de la situación actual del valor moral con que se trabaje. También se ofrecen pautas o requerimientos metodológicos para su aplicación lógica por el profesor guía en la carrera de medicina: estructuras funcional y didáctica, así como propuesta de métodos de investigación para valorar la factibilidad del mecanismo instrumentado(AU)

In this work stands out the importance of the strategy as an instrument which contains the premature projection of a pedagogic actions system to follow under specific and deliberate conditions, aimed at achieving values education in medical sciences students, besides being necessary that this should have a theoretical model to sustain their implementation and to correspond with the diagnosis of the current situation of the moral value with which one works. Rules or methodological requirements for their logical implementation by the advising professor in the medicine career are also offered: functional and didactic structures, as well as investigation methods proposal to value the feasibility of the implemented mechanism(AU)

A educação em valores e as práticas morais nas disciplinasde bioética de faculdades de medicina no Estado de São Paulo / Education in values and moral practices in bioethics courses in medical colleges in the state of São Paulo

Apresente pesquisa analisou as práticas morais e os valores trabalhados como parte do processo de ensino-aprendizagem nas disciplinas de Bioética. Buscou-se ainda compreender qual a contribuição de tais práticas morais e de valores para auxiliar na formação moral na visão de alunos e professores dos cursos de graduação em Medicina. Para isso, foram investigadas cinco faculdades de Medicina no Estado de São Paulo, e na pesquisa de campo foram aplicados: aos estudantes, um total de 206 questionários fechados, e cinco grupos focais com a participação de 56 alunos; e foi realizado um total de nove entrevistas com os professores responsáveis pelas disciplinas de Bioética das faculdades que participam da pesquisa. Posteriormente, os questionários foram analisados quantitativamente, e as falas dos grupos focais e entrevistas, analisadas qualitativamente, utilizando o método da análise categorial de Bardin, sendo transcritas, analisadas e classificadas de acordo com as categorias encontradas. Através das respostas dos alunos, comprovou-se que as práticas morais podem influenciar para gerar boas discussões em sala de aula e estimular os estudantes: a aprender a respeitar, a ouvir o outro, a expor suas ideias, a dialogar, a tomar decisões e a ser crítico também no seu desenvolvimento moral. E que as práticas morais que mais mobilizaram e possibilitaram esse aprendizado moral foram: as práticas deliberativas, como discussão de filmes e/ou séries de TV, discussões de casos, roleplaying – dramatização, discussões de debate e palestras, e, em uma menor proporção, a prática normativa, neste caso, aula expositiva, porém aula dialógica, em que tenham participação de sujeitos ativos. Verificou-se a importância em se discutir os valores em sala de aula, sendo considerados os mais importantes, segundo os alunos e professores: respeito, tolerância, empatia, liberdade e autonomia. Deste modo, a disciplina de Bioética e as práticas morais, enquanto metodologia para a educação em valores, podem incrementar a maturidade moral dos estudantes de Medicina após um planejamento adequado à sua prática e vivência, através de uso estruturado e o devido conhecimento das finalidades dos métodos de suas técnicas, para que sejam alcançadas e desenvolvidas as capacidades de inteligência moral e a construção da personalidade moral dos alunos. Porém, são necessários mais estudos para o desenvolvimento de métodos de avaliação dessas práticas morais, além de evidenciar a validade de que estas podem mobilizar as capacidades e estruturas do raciocínio moral e formar agentes morais mais competentes.

This research analyzed the teaching-learning process between moral practices and the values used in the disciplines of Bioethics and how they can contribute to the moral education of students of undergraduate courses at Medical schools. For this, five medical schools were investigated in the State of São Paulo, and field research were applied: students, a total of 206 closed questionnaires and five focus groups with the participation of 56 students; and it was performed a total of nine interviews with teachers responsible for the disciplines of Bioethics of the colleges participating in the survey. Subsequently, the questionnaires were analyzed quantitatively, and the speeches of the focus groups and interviews, analyzed qualitatively using the method of categorical analysis of Bardin, being transcribed, analyzed and classified according to the categories found. Through the students’ responses it was proved that moral practices can influence to generate good discussions in the classroom and encourage students to learn to respect, listen to each other, share ideas, discuss, make decisions, and be critical in their moral development. And the moral practices that mobilized more and enabled this moral learning were deliberative practices, such as discussion of movies and/or TV series, case discussions, roleplaying, discussion on debates and lectures, and a smaller proportion was the legislative practice, in this case we can mention the lecture, but the dialogical class that have active participation and subjects. The importance of discussing the values in the classroom, and that the most important was found, according to the students and professors were: respect, tolerance, empathy, freedom and autonomy. Therefore, the discipline of Bioethics and moral practices as a methodology for education in values can increase the moral maturity of Medical students after appropriate practice and experience of planning through structured use and proper knowledge of the purposes of the methods of their techniques, to be achieved and developed the capabilities of moral intelligence and the construction of the moral character of students. However, it is necessary more studies to the development of the methods of assessment of these moral practices and which highlights the validity of these, mobilizing the capacities and structures of moral reasoning and constitute more competent moral agents.

Acerca de las implicaciones de las facultades de medicina en la medicina de familia / About the implications of medical schools in family medicine

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Respuesta de los autores: Acerca de las implicaciones de las facultades de medicina en la medicina de familia / Reply: About the implications of medical schools in family medicine

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Vinte e dois anos de um Curso Informativo de Cirurgia Plástica / 22 years of an Informational Overview Course on Plastic Surgery

Há 22 anos, um curso informativo de cirurgia plástica para acadêmicos de medicina, promovido pela integração de quatro escolas médicas, três universidades e pela regional da Sociedade Brasileira de Cirurgia Plástica vem sendo ministrado, contribuindo para a educação médica em Curitiba, uma cidade de dois milhões de habitantes, em uma área metropolitana de aproximadamente três milhões de pessoas. Este curso informativo proporciona uma visão abrangente da especialidade, para que acadêmicos de medicina possam avaliar sua vocação pessoal para o exercício da cirurgia plástica, além de fornecer conhecimentos básicos indispensáveis à formação de qualquer médico. Anualmente o curso é ministrado em 47 horas e ofertado para 120 alunos. O programa inclui 70% de "cirurgia reconstrutiva" e 30% de "cirurgia estética", sendo a maioria dos professores membros titulares da Sociedade Brasileira de Cirurgia Plástica. Nos primeiros 19 anos de atividade (1992 a 2010), 4,6% dos alunos que concluíram o curso cursaram residência em cirurgia geral, foram admitidos na residência em cirurgia plástica e hoje fazem parte da Sociedade Brasileira de Cirurgia Plástica. O curso tornou-se um importante instrumento de educação médica, complementando o currículo de quatro escolas médicas e promovendo a cirurgia plástica como especialidade única e indivisível, enfatizando a importância da prova de especialista em cirurgia plástica e a conveniência da escolha e da indicação destes especialistas para a realização de qualquer procedimento no âmbito da cirurgia plástica.

For 22 years, a reproducible introductory overview course on plastic surgery for medical students, cosponsored by four medical schools, three universities and the regional chapter of the Brazilian Society of Plastic Surgery (SBCP), has contributed to medical education in Curitiba, a city of 2 million, and serving a metropolitan population of nearly 3 million people. This course helps medical students determine if plastic surgery is the right choice for them and provides valuable information about the specialty itself that will serve all participants as they go forward into their chosen fields, as plastic surgeons or not. This broad-ranging 47 hour course, limited to 120 students, is fully enrolled every year. Its content is weighted approximately 70% toward reconstructive plastic surgery and 30% toward aesthetic plastic surgery. Most lectures are presented by plastic surgeons who are full members of the SBCP. During its first 19 years of operation, 4.6% of the students completing the course have gone on to a general surgery residency followed by a plastic surgery residency, and are current SBCP members. The course has become a valuable educational and marketing tool for the regional chapter of the SBCP. It promotes the unique scope of the specialty and increases awareness among participants, as well as among their many personal and professional contacts (currently and in the future) about the benefits of becoming fully qualified, board-certified plastic surgeons.

Aprender a observar desde el inicio de los estudios médicos es una necesidad formativa / to observe from the beginning of medical studies is a training need

Fundamento: la habilidad observar tiene importancia en la educación y práctica médicas, se aplica ante situaciones que van desde los estudios anatómicos, hasta el trabajo sistemático con distintos métodos y procedimientos propios de la profesión; no obstante los resultados actuales en el ciclo básico biomédico son aún insuficientes. Objetivo: profundizar en las dimensiones conceptuales, microcurriculares y didácticas de la habilidad observar en los estudios básicos biomédicos. Metodología: se realizó revisión documental, observaciones científicas a actividades docentes durante el curso 2012/2013 y se aplicó cuestionario a profesores. Resultados: no se constató claridad conceptual en los profesores con respecto a la habilidad observar en los estudios médicos. En la dimensión microcurricular se comprobó falta de sistematicidad en la inclusión de la habilidad observar en los sistemas de objetivos y habilidades. En las observaciones realizadas se constató un pobre accionar de profesores y estudiantes en la formación y el desarrollo de la habilidad observar; menos aún para evaluar el dominio alcanzado. Conclusiones: el conocimiento conceptual constatado, las condiciones de diseño microcurricular actual y las características del proceso de enseñanza aprendizaje de las ciencias básicas biomédicas, no favorecen una adecuada formación y desarrollo de la habilidad observar en los estudios básicos biomédicos.

Background: the observation ability is important in medical education and practice, it is applied to situations, ranging from anatomical studies to the systematic work with different methods and procedures of the profession; however actual results in the biomedical basic cycle are still insufficient. Objective: to deepen into the conceptual, microcurricular and didactical dimensions of the observation ability in basic biomedical studies. Methodology: a literature review was made as well as scientific observations on teaching activities during the 2012/2013 academic course and a questionnaire to teachers was applied. Results: no conceptual clarity was found in the teachers regarding the observation ability in medical studies. In the microcurricular dimension lack of systematic inclusion of the observation ability in the systems of objectives and skills was found. In the performed observations poor acting by the teachers and students in the training and development of the observation ability was found; still less to assess the achieved mastery. Conclusions: the conceptual knowledge found, the current microcurricular design conditions and the characteristics of the teaching-learning process of the basic biomedical sciences, do not favor the proper training and development of the observation ability in basic biomedical studies.

Las materias preclínicas en el nuevo contexto / Preclinical subjects in the new context

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La construcción de valores y la integralidad estudiantil: un desafío en la educación médica superior / Construction of values and student integrity: a challenge in superior medical education

Se caracterizó la construcción de valores desde cinco tesis que exponen el papel de la integralidad como condición a alcanzar en el egresado, por medio de la labor educativa en los procesos universitarios de la educación médica superior cubana(AU)

It was characterized the construction of values from five theses that expose the role of integrity as a condition to be achieved in graduates, through the educational work in university processes of the superior medical education in Cuba(EU)

Ranking Spain's Medical Schools by their performance in the national residency examination

Antecedentes. En España, los graduados de las Facultades de Medicina deben tomar someterse a nacional uniforme (llamado «MIR») con el fin de ingresar a la formación de posgrado en una especialidad médica. Sus resultados ofrecen una oportunidad única para clasificar las Facultades en términos de calidad. Objetivos. Medir la presencia y la significación de las diferencias en los resultados del MIR entre las facultades de medicina españolas, y evaluar la estabilidad de las clasificaciones basadas en los resultados de la prueba MIR para el período 2003–2011. Resultados. Se observaron diferencias significativas, persistentes y consistentes en los rankings basados en los resultados de la prueba MIR. El graduado promedio de la Facultad con mejores resultados queda clasificado en el percentil 21 en todo el país, mientras que el graduado promedio de la Facultad con peores resultados queda clasificado en el percentil 70. Conclusión. Existen marcadas diferencias en las Facultades de Medicina en España, y estas diferencias son muy consistentes durante los años 2003 a 2011 (AU)

Background. Medical school graduates in Spain must take a uniform national exam (called “examen MIR”) in order to enter postgraduate training in a specialty. Its results offer a unique opportunity to rank medical schools according to this exam. Objectives. We measured differences in the MIR exam results among Spanish medical schools and assessed the stability of the MIR-based rankings for the period 2003–2011. Results. In the year 2011 a total of 6873 residency positions nationwide were offered by the Spanish Ministry of Health, Social Services and Equality. These positions covered 47 specialties distributed over 231 training centers. A total of 11,550 medical graduates (including 1997 foreign graduates) took the MIR examination. Marked differences among medical schools were evident. The median graduate from medical school #1 and #29 occupied the positions 1477 and 5383, respectively. These figures correspond to a standardized ranking of 21 out of 100 for medical school #1 (that is, 1477/6873; half of medical school #1 obtained better [below position 21%] and half worse [over position 21%] results) and a standardized ranking of 70 out of 100 for medical school #29. While 81% of the medical school #1 graduates were amongst the best 3000 MIR exams and only 5% above the 5000 position the corresponding figures for medical school #29 graduates were 21% and 44%, respectively. The ranking position of the 29 medical schools was very stable between the years 2003 and 2011. Conclusion. There are marked differences in medical schools in Spain and these differences are very consistent over the years 2003–2011 (AU)

Perfiles de calificaciones obtenidas por estudiantes de medicina en la asignatura Salud Pública durante los cursos académicos desde 2005 hasta 2008 / Profiles of grades obtained by medical students in the subject Public Health during the academic years from 2005 to 2008

Introducción: En el sistema de educación médica superior cubano, la evaluación del aprendizaje implica el control y la valoración de los conocimientos, las habilidades y los hábitos, además de los modos de actuación que los estudiantes van adquiriendo a través del proceso docente-educativo. Objetivo: Comparar los resultados de las evaluaciones finales de la asignatura Salud Pública durante los cursos académicos 2005-2006, 2006-2007 y 2007-2008, con las restantes asignaturas que se impartieron en el quinto año de la carrera de medicina durante esos períodos. Métodos: Se realizó un estudio descriptivo y retrospectivo de los 790 estudiantes que cursaron quinto año en la Facultad de Ciencias Médicas No. 2 de Santiago de Cuba durante los 3 cursos académicos (del 2005 al 2008). Resultados: En la serie se evaluaron las calificaciones de todos los alumnos en las 11 asignaturas del plan de estudios y se obtuvo que en la materia Salud Pública en los 3 cursos de referencia, 8 estudiantes obtuvieron 2 puntos, 57 aprobaron con 3 puntos, 255 tuvieron 4 puntos y 470 calificaron con 5. Solo en la asignatura Urología el porcentaje de estudiantes (34,2) con puntuación de 5 estuvo en un perfil esperado, en tanto Salud Pública estuvo por encima de esa cifra (59,5 por ciento). Respecto a las calificaciones de 4, hubo 32,3 por ciento de educandos en Salud Pública, 55,1 por ciento en Urología y de 20 a 23 por ciento en el resto de las asignaturas comparadas. Igualmente, al analizar la notas de 3 y 2, la asignatura Salud Pública tuvo el mayor índice de alumnos (7,2 por ciento), seguida de Urología (6,8 por ciento) para la primera, contrariamente a la segunda, que mostró primacía en la materia Urología (3,9 por ciento), seguida de Salud Pública (1,0 por ciento); el resto de las asignaturas se mantuvieron con cifras más bajas.Conclusiones: El análisis de la casuística mostró un patrón de excesivas calificaciones de 4 y 5, por lo que es...

Introduction: In the Cuban higher medical education system learning evaluation involves control and assessment of knowledge, skills and habits, as well as the performance that students are acquiring through the educational process. Objective: To compare the results of the final evaluations of the subject Public Health during the academic years 2005-2006, 2006-2007 and 2007-2008 with the other subjects that were taught in the fifth year of the medical career during those periods. Methods: A descriptive and retrospective study was carried out in 790 students who completed the fifth year in the Medical College 2 of Santiago de Cuba for three academic years (2005-2008). Results: In the series grades of all students were evaluated in the 11 subjects of the curriculum and it was found that in the Public Health subject during these 3 reference years, 8 students scored 2, 57 passed with grades 3, 255 with 4 and 470 students with 5. Only in Urology subject the percentage of students (34.2) with grades 5 was in an expected profile, while Public Health was above that rate (59.5 percent). For grades 4 there were 32.3 percent of students in Public Health, 55.1 percent in Urology and 20 to 23 percent in other subjects. Similarly, when analyzing grades of 3 and 2, Public Health subject had the highest rate of students (7.2 percent), followed by Urology (6.8 percent) for the former, unlike the latter, which predominated in the Urology subject (3.9 percent), followed by Public Health (1.0 percent); the remaining subjects were maintained with lower rates. Conclusions: The analysis of cases showed a pattern of excessive grades of 4 and 5, so that it is necessary to deepen the study of factors that influence the evaluation process of these subjects. Also, it was felt that it would be interesting to compare the grade profiles with those of other colleges in the country

Perfiles de calificaciones obtenidas por estudiantes de medicina en la asignatura Salud Pública durante los cursos académicos desde 2005 hasta 2008 / Profiles of grades obtained by medical students in the subject Public Health during the academic years from 2005 to 2008

Introducción: En el sistema de educación médica superior cubano, la evaluación del aprendizaje implica el control y la valoración de los conocimientos, las habilidades y los hábitos, además de los modos de actuación que los estudiantes van adquiriendo a través del proceso docente-educativo. Objetivo: Comparar los resultados de las evaluaciones finales de la asignatura Salud Pública durante los cursos académicos 2005-2006, 2006-2007 y 2007-2008, con las restantes asignaturas que se impartieron en el quinto año de la carrera de medicina durante esos períodos. Métodos: Se realizó un estudio descriptivo y retrospectivo de los 790 estudiantes que cursaron quinto año en la Facultad de Ciencias Médicas No. 2 de Santiago de Cuba durante los 3 cursos académicos (del 2005 al 2008). Resultados: En la serie se evaluaron las calificaciones de todos los alumnos en las 11 asignaturas del plan de estudios y se obtuvo que en la materia Salud Pública en los 3 cursos de referencia, 8 estudiantes obtuvieron 2 puntos, 57 aprobaron con 3 puntos, 255 tuvieron 4 puntos y 470 calificaron con 5. Solo en la asignatura Urología el porcentaje de estudiantes (34,2) con puntuación de 5 estuvo en un perfil esperado, en tanto Salud Pública estuvo por encima de esa cifra (59,5 por ciento). Respecto a las calificaciones de 4, hubo 32,3 por ciento de educandos en Salud Pública, 55,1 por ciento en Urología y de 20 a 23 por ciento en el resto de las asignaturas comparadas. Igualmente, al analizar la notas de 3 y 2, la asignatura Salud Pública tuvo el mayor índice de alumnos (7,2 por ciento), seguida de Urología (6,8 por ciento) para la primera, contrariamente a la segunda, que mostró primacía en la materia Urología (3,9 por ciento), seguida de Salud Pública (1,0 por ciento); el resto de las asignaturas se mantuvieron con cifras más bajas.Conclusiones: El análisis de la casuística mostró un patrón de excesivas calificaciones de 4 y 5, por lo que es... (AU)

Introduction: In the Cuban higher medical education system learning evaluation involves control and assessment of knowledge, skills and habits, as well as the performance that students are acquiring through the educational process. Objective: To compare the results of the final evaluations of the subject Public Health during the academic years 2005-2006, 2006-2007 and 2007-2008 with the other subjects that were taught in the fifth year of the medical career during those periods. Methods: A descriptive and retrospective study was carried out in 790 students who completed the fifth year in the Medical College 2 of Santiago de Cuba for three academic years (2005-2008). Results: In the series grades of all students were evaluated in the 11 subjects of the curriculum and it was found that in the Public Health subject during these 3 reference years, 8 students scored 2, 57 passed with grades 3, 255 with 4 and 470 students with 5. Only in Urology subject the percentage of students (34.2) with grades 5 was in an expected profile, while Public Health was above that rate (59.5 percent). For grades 4 there were 32.3 percent of students in Public Health, 55.1 percent in Urology and 20 to 23 percent in other subjects. Similarly, when analyzing grades of 3 and 2, Public Health subject had the highest rate of students (7.2 percent), followed by Urology (6.8 percent) for the former, unlike the latter, which predominated in the Urology subject (3.9 percent), followed by Public Health (1.0 percent); the remaining subjects were maintained with lower rates. Conclusions: The analysis of cases showed a pattern of excessive grades of 4 and 5, so that it is necessary to deepen the study of factors that influence the evaluation process of these subjects. Also, it was felt that it would be interesting to compare the grade profiles with those of other colleges in the country(AU)