Autopercepción de los residentes de la relación con su tutor de medicina familiar durante el proceso de tutoría en investigación / Residents' selfperception of their relationship with their family medicine tutor during the research mentoring process

Introducción: Durante el proceso de tutoría en investigación se presenta una relación personal entre el residente y su tutor que tiene gran importancia para el desarrollo del trabajo de tesis. En este trabajo se presenta la autopercepción que el residente experimentó sobre los aspectos positivos y negativos durante el proceso del trabajo de tesis de su especialidad. Objetivo: Identificar las características generales de la auto-percepción de los residentes en la relación con su tutor de medicina familiar durante el proceso de tutoría en investigación. Material y métodos: Estudio descriptivo, transversal y observacional. Participaron 77 residentes del Curso de Especialización en Medicina Familiar. Se diseñó un cuestionario para evaluar la autopercepción de la relación de los residentes con su tutor durante el proceso de tutoría de sus tesis. El cuestionario formó parte de un instrumento de 45 preguntas, 15 de ellas para evaluar las características de la autopercepción de los residentes de la relación con su tutor de medicina familiar durante el proceso de tutoría en investigación. Las preguntas fueron diseñadas en escala ordinal tipo diferencial semántico de seis opciones de respuesta con valores entre 1 y 6. El análisis estadístico se realizó mediante estadística descriptiva e inferencial (prueba binomial y x²). La confiabilidad fue determinada mediante el coeficiente alfa de Cronbach. Resultados: El promedio de evaluación de la autopercepción de los residentes en la escala positiva (8 items) fue de 42.81 ± 5.09, el coeficiente de confiabilidad alfa de Cronbach = 0.833. El promedio en la escala negativa (7 ítems) fue de 16.70 ± 6.523, el coeficiente de confiabilidad alfa de Cronbach = 0.645. Conclusiones: Los residentes se autoperciben con puntuaciones altas en los aspectos de interés, puntualidad, honestidad, compromiso, satisfacción, cumplimiento, motivación y capacidad; manifestaron puntuaciones bajas en actitud negativa e intolerancia durante el proceso de tutoría. Sin embargo no mostraron una tendencia clara (puntuaciones medias) en su autopercepción en los aspectos de irresponsabilidad, fastidio, frustración y preferencia por no realizar el trabajo de tesis y usar el tiempo en otras actividades. Los resultados conducen a analizar la validez de constructo de los elementos que integraron el contenido teórico del cuestionario utilizado.

Introduction: During research mentoring process, a relationship between resident and tutor is developed which is of great importance for thesis development. This paper presents the self-perception on positive and negative aspects that residents experienced during their thesis development. Objective: To identify the general characteristics of residents' self-perception in their relationship with family medicine tutor during the research mentoring process. Material and methods: A descriptive, cross sectional, and observational study was performed. Seventy seven residents from Specialization Course in Family Medicine participated in this study. A questionnaire to assess self-perception of the relationship of residents with their tutor during the thesis tutoring process was designed. The questionnaire was part of a 45 item instrument, 15 to evaluate the characteristics of self-perception of their relationship with the Family Medicine tutor during the research mentoring process. The questions were designed on an ordinal scale of six semantic differential-type response choices with values between 1 and 6. Statistical analysis was performed using descriptive and inferential statistics (binomial test and x2). Reliability was determined using Cronbach's alpha coefficient. Results: The average of residents'self-perception assessment in the positive scale (8 items) was 42.81 ± 5.09, Cronbach's alpha reliability coefficient = 0.833. Average in the negative scale (7 items) was 16.70 ± 6523, Cronbach's alpha reliability coefficient = 0.645. Conclusions: Residents perceive themselves with high scores on: interest, punctuality, honesty, commitment, satisfaction, compliance, motivation and ability, they showed low scores on negative attitudes and intolerance during the mentoring process. No clear trend (mean scores) in their self-perception in aspects such as irresponsibility, boredom, frustration and preference for not doing the thesis work and using the time in other activities however was showed. Results lead to analyze construct validity of the elements that formed the theoretical content of the questionnaire used.

[Appropriate use of diagnostic esophagogastroduodenoscopy and its relation with positive results]. / Uso appropriado de las esofagogastroduodenoscopia diagnóstica y su relación con hallazgos positivos.

INTRODUCTION: Upper gastrointestinal endoscopy is a sensitive and safe procedure, but expensive and with certain risks. The range of inappropriate use of upper gastrointestinal endoscopy in open access system is between 5.6 to 61.7%. In our department we use restricted access system. OBJECTIVE: To determine the accuracy of Gastrointestinal Endoscopy American Society guidelines in the diagnosis through the upper gastrointestinal endoscopies performed in a reference hospital setting with restricted access. METHODS: We review requests for diagnostic upper gastrointestinal endoscopies and their reports between March 1st 2003 and February 29th 2004. It was defined as an appropriate diagnostic esophagogastroduodenoscopy which followed the American Gastrointestinal Endoscopy society guidelines. It was done statistical descriptive analysis. RESULTS: A total of 3033 requests and reports of upper gastrointestinal endoscopies were reviewed. The proportion of clinical diagnoses that followed the guidelines was 74.3%. We found a 56.3% of abnormal positive endoscopy findings, concordance between clinical diagnosis and abnormal positive endoscopy findings was 46.8%. CONCLUSION: The proportion of upper gastrointestinal endoscopies that follow the American Gastrointestinal Endoscopy Society guidelines in our restricted access system is low.

[Association between symptomatic gastroesophageal reflux and Barrett's esophagus]. / Asociación entre reflujo gastroesofágico sintomático y esófago de Barrett.

BACKGROUND DATA: Barrett esophagus is a proximal displacement of the squamocolumnar junction relative to the gastroesophageal junction with intestinal metaplasia, it has been linked to gastroesophageal reflux disease. However, it has been observed in individuals without gastroesophageal reflux symptoms, with prevalence up to 25% in 50 years older men. OBJECTIVE: Assess the association between symptomatic gastroesophageal reflux and Barrett's esophagus. METHODS: Consecutive patients undergoing endoscopy at our center were studied. Before endoscopy, through a direct interview all subjects were asked to complete the Carlsson-Dent questionnaire for determining 2 groups (patients with and without gastroesophageal reflux symptoms). Those subjects with suggestive image of Barrett's esophagus, biopsy specimens were obtained from the distal esophageal mucosa with the intention of find intestinal metaplasia. We compared prevalence of Barrett's esophagus between groups. RESULTS: One hundred and nine patients were studied. Prevalence of symptomatic gastroesophageal reflux disease was 37.6%. Barrett's esophagus was found in 9.7% of symptomatic gastroesophageal reflux disease patients and in 9.6% of subjects without symptoms of gastroesophageal reflux disease (p = 0.87). Gender and age were similar between groups. Prevalence of hernia hiatal was bigger in patients with Barrett's esophagus (90 vs. 42%) (p = 0.004). CONCLUSION: Our study didn't show association between symptomatic gastroesophageal reflux detected by a questionnaire and Barrett's esophagus.