Nivel de Competencia Intercultural en estudiantes de Ciencias de la Salud desarrollada en práctica clínica / Intercultural competences achieved by health sciences students during the clinical practice

BACKGROUND: During their clinical practice, health Sciences students get acquainted with the cultural diversity of patients and learn to deal with this reality in a model of social learning. AIM: To determine the level of Intercultural Competence in Health Sciences students based on the Confrontation, Resistance, and Cultural Openness (CRAC) model, specific for health professionals. MATERIAL AND METHODS: Semi-structured interviews were conducted with 106 Health Sciences students from three universities in Chile. Content analysis was supported by the software ATLAS.ti version 9. RESULTS: The students progressed through the CRAC model and were able to configure a new level called Cultural Understanding, in which the participants innovated care models and offered new therapeutic schemes with cultural relevance. In addition, a fifth level called Cultural Inclusion was proposed. However, a training process with a marked theoretical/scientific emphasis can overshadow the learning process resulting from reflexive practical experience, reducing its real value such as traditional/ancestral medicine. CONCLUSIONS: The students were able to update the Confrontation, Resistance, Openness, Understanding and Intercultural Inclusion Model. The features of those participants who achieve the highest levels of intercultural competences should be explored and used for the training process.

[Intercultural competences achieved by health sciences students during the clinical practice]. / Nivel de Competencia Intercultural en estudiantes de Ciencias de la Salud desarrollada en práctica clínica.

BACKGROUND: During their clinical practice, health Sciences students get acquainted with the cultural diversity of patients and learn to deal with this reality in a model of social learning. AIM: To determine the level of Intercultural Competence in Health Sciences students based on the Confrontation, Resistance, and Cultural Openness (CRAC) model, specific for health professionals. MATERIAL AND METHODS: Semi-structured interviews were conducted with 106 Health Sciences students from three universities in Chile. Content analysis was supported by the software ATLAS.ti version 9. RESULTS: The students progressed through the CRAC model and were able to configure a new level called Cultural Understanding, in which the participants innovated care models and offered new therapeutic schemes with cultural relevance. In addition, a fifth level called Cultural Inclusion was proposed. However, a training process with a marked theoretical/scientific emphasis can overshadow the learning process resulting from reflexive practical experience, reducing its real value such as traditional/ancestral medicine. CONCLUSIONS: The students were able to update the Confrontation, Resistance, Openness, Understanding and Intercultural Inclusion Model. The features of those participants who achieve the highest levels of intercultural competences should be explored and used for the training process.

Competencia intercultural con educación interprofesional en estudiantes de ciencias de la salud, una revisión sistemática / Intercultural competence with interprofessional education in health sciences students, a systematic review

Tanto la formación en Competencia Intercultural como la Educación Interprofesional mejoran los resultados en salud. No se encontraron revisiones sistemáticas, en la literatura especializada, que analicen ambos factores juntos en los últimos diez años. Caracterizar aspectos metodológicos de investigaciones empíricas de Competencia Intercultural con Educación Interprofesional en estudiantes de Ciencias de la Salud, describir aspectos curriculares de la formación en Competencia Intercultural con Educación Interprofesional, y analizar la efectividad de dichas experiencias educativas. Se desarrolló una revisión sistemática de las bases de datos Web of Science, Scopus, SciELO, PubMed y ProQuest desde el 2010 a 2020. Existe un predominio de artículos realizados en Estados Unidos y Australia, con enfoque mixto, no experimentales, tamaño muestral acotado y uso de encuestas de percepción. Los contenidos abordaron el conocimiento intercultural general y la atención de salud, con experiencias de tipo extracurricular, presenciales, de corta duración y para un acotado número de carreras. Destacaron las estrategias de aprendizaje en equipo y Service Learning Experience. La efectividad de las experiencias educativas resultó poco concluyente; no obstante, se sugieren ciertas pautas en base a lo analizado. Resulta imprescindible desarrollar mayor investigación a nivel latinoamericano y que se incluyan las mejoras metodológicas señaladas. La formación debería focalizarse en desarrollar la autoconciencia cultural como base para la comprensión mutua, esto requiere de un equipo docente con competencias pedagógicas y culturales, además de sanitarias. Finalmente, es fundamental investigar sobre los factores que permiten un mayor desarrollo de estas competencias en el estudiantado.

There is a direct impact on health service outcomes when professionals are trained in intercultural competence and interprofessional education. No systematic reviews were found in the specialized literature that examined both factors together over the last ten years. To characterize the methodological aspects of empirical research regarding Intercultural Competence with Interprofessional Education in Health Sciences students, To describe the curricular aspects of training in Intercultural Competence with Interprofessional Education, and To analyze the effectiveness of said educational experiences. A systematic review of the Web of Science, Scopus, SciELO, PubMed, and ProQuest databases was carried out from 2010 to 2020. There is a predominance of articles composed in the United States and Australia, with a mixed approach, not experimental, limited sample size, and use of survey perception. The contents dealt with general intercultural knowledge and health care, with extracurricular, faceto-face, short-term experiences, and for a limited number of majors. Team learning strategies and stood out Service Learning Experience. The effectiveness of the educational experiences was inconclusive; however, certain guidelines are recommended based on what has been analyzed. It is crucial to develop more research at a Latin American level including the methodological improvements. Training should focus on developing cultural self-awareness as a basis for mutual understanding, this requires a teaching team with pedagogical and cultural skills, as well as health knowledge. Finally, it is fundamental to investigate the factors that allow more comprehensive development of these competencies in the student body.

Competencia Cultural de profesionales sanitarios en la atención a inmigrantes a la luz del modelo de Terry Cross / Cultural competence of health professionals in immigrant care, in the light to the Terry Cross model

Objetivo principal: resignificar, a partir de la experiencia de atención a pacientes inmigrantes desarrollada por un grupo de profesionales sanitarios, los niveles de Competencia Cultural del Modelo de Terry Cross a fin de reorientar sus descripciones hacia el ámbito sanitario. Asimismo, se propuso determinar el nivel en que se encuentran dichos profesionales. Metodología: Diseño cualitativo con estudio de caso instrumental. Recogida de datos mediante entrevistas semiestructuradas. Resultados principales: Se establecieron tres niveles de Competencia Cultural que permitieron conforman el Modelo Confrontación, Resistencia y Apertura Cultural (CRAC) específico para profesionales sanitarios. Dichos niveles concuerdan con Incapacidad, Ceguera y Pre-competencia cultural del Modelo de Cross. El nivel alcanzado fue Pre-competencia cultural. Conclusión principal: El nivel en que se encuentran los profesionales sanitarios entrevistados, según el Modelo CRAC, evidencia los desafíos pendientes para proporcionar cuidados en perspectiva cultural. La solución podría comenzar abordando los vacíos formativos en el área. (AU)

Objective: To re-signify the levels of cultural competence of the Terry Cross model based on the experience received by healthcare professionals over the years of service on the care of immigrant patients, with the objective of redirecting the descriptions concerning the health field. Besides, a determination of the level at which these professionals are placed was proposed. Methods: Qualitative design with an instrumental case study. Data collection through semi-structured interviews. Results: Three levels of Cultural Competence were stablished, and constitute the Confrontation, Resistance, and Cultural Openness Model (CRAC) specific for health professionals. These levels coincide with the Incapacity, Blindness, and Cultural Pre-competence of the Cross Model. The level achieved was Pre-cultural competence. Conclusions: The level of the interviewed health professionals, according to the CRAC Model, shows the unresolved challenges to provide care from a cultural perspective. The solution could start by addressing training gaps in the area. (AU)

Cuestionario de percepción de la formación pedagógica: estructura factorial y confiabilidad en académicos de la salud chilenos / Perception about teaching training process questionnaire: factor structure and reliability in chilean health faculties

INTRODUCCIÓN: El presente estudio analiza las propiedades psicométricas de un instrumento para evaluar la percepción de los docentes universitarios sobre las capacitaciones pedagógicas en las que participan. Esta evaluación se realiza considerando las características propias de una capacitación exitosa que facilite la transferencia al aula de lo aprendido. Sujetos y métodos: Estudio cuantitativo, psicométrico, transversal. Respondieron el cuestionario de percepción de la formación pedagógica (CPFP) más un cuestionario sociodemográfico, previo consentimiento informado, 117 docentes de grado del área de la salud, elegidos por muestreo no probabilístico por accesibilidad. Se realizó un juicio de experto del cuestionario antes de la aplicación, y después de ésta se realizó un análisis factorial exploratorio. RESULTADOS: El índice de validez del contenido del cuestionario fue aceptable. Según el análisis factorial exploratorio, los 42 ítems del CPFP se organizaron en cuatro factores: promoción de la reflexión docente, aprendizaje en redes funcionales, aprendizaje adaptado a las necesidades del docente y aprendizaje activo. Sus confiabilidades fluctuaron entre alfa = 0,68 y alfa = 0,951. CONCLUSIONES: El CPFP presenta evidencia a favor de su validez de contenido y de su validez de constructo. Asimismo, tres de sus factores presentan confiabilidades buenas o excelentes, con un factor con confiabilidad cuestionable que requeriría una mayor revisión

INTRODUCTION: The present study analyzes the psychometric properties of an instrument to assess university teachers' perceptions about pedagogical training in which they participate. This evaluation is carried out considering the successful training process' characteristics that facilitate learning transference to their classroom activities. Subjects and methods: Quantitative, psychometric, cross-sectional study was performed. 117 undergraduate teachers from health area degrees, chosen by non-probabilistic convenience sampling, answered Pedagogical Training Perception Questionnaire (CPFP) plus a sociodemographic questionnaire, with prior informed consent. The expert judgment of this questionnaire was performed before the survey. An Exploratory Factor Analysis (AFE) was performed after it. RESULTS: The questionnaire's Content Validity Index was acceptable. According to the AFE, their 42 items were organized into four factors: Promotion of teacher reflection, Learning in functional networks, Learning adapted to the needs of the teacher and Active learning. Their reliabilities fluctuated between α=0.680 and α=0.951. CONCLUSIONS: The CPFP presents evidence in favor of its content validity and its construct validity. Likewise, three of its factors present good or excellent reliability, with a factor with questionable reliability that would require further revision

Espiritualidad en el contexto de cuidados paliativos oncológicos dirigidos a personas mayores / Spirituality in palliative care aimed at the elderly / Espiritualidade no contexto de cuidados paliativos oncológicos a idosos

Resumen La última década ha estudiado la faceta "espiritualidad" en el contexto de cuidados paliativos oncológicos en personas mayores desde perspectivas cuantitativas, cualitativas y mixtas. El estudio busca develar -en este contexto- el significado de espiritualidad. Se revisa literatura indexada en buscador PubMed vía Medline entre los años 2009 y 2019, con acceso on line, a texto completo, en forma anónima, en idiomas inglés-español y, análogamente, con búsqueda manual en la Revista Medicina Paliativa. Los resultados arrojan 50 artículos de pertinencia temática y cuatro categorías. Se concluye que existen desafíos relacionados con el significado de espiritualidad y calidad de vida, formación y perspectivas de investigación.

Abstract In the last decade, spirituality has been studied in oncological palliative care for the elderly from quantitative, qualitative, and mixed perspectives. The study seeks to reveal the meaning of spirituality in this context. It reviews indexed literature from the MEDLINE database through PubMed between 2009 and 2019, which was accessed online, in full text, anonymously, and in English and Spanish. Revista Medicina Paliativa was manually searched. The results include 50 subject-relevant articles and four categories. It is concluded that there are challenges related to the meaning of spirituality and quality of life, education, and research perspectives.

Resumo Na última década, a faceta "espiritualidade" tem sido estudada no contexto de cuidados paliativos oncológicos a idosos sob perspectivas quantitativa, qualitativa e mista. O estudo pretende revelar o significado de espiritualidade nesse âmbito. A literatura indexada no buscador PubMed via Medline entre 2009 e 2019 é revisada, por meio do acesso on-line dos textos completos, de forma anônima, em inglês e espanhol, além da busca manual na Revista Medicina Paliativa. Os resultados demonstram 50 artigos de pertinência temática e quatro categorias. Conclui-se que existem desafios relacionados com o significado de espiritualidade e qualidade de vida, formação e perspectivas de pesquisa.

Prácticas reflexivas del proceso de enseñanza en docentes universitarios de las ciencias de la salud / Reflective practices of the teaching process in university health science professors

Introducción: para transformar los procesos de formación de los docentes universitarios es relevante generar espacios reflexivos, ya que estos influyen en el cambio y la innovación docente. Objetivo: comprender cómo se desarrollan las prácticas reflexivas en el proceso de enseñanza-aprendizaje de docentes universitarios del área de la salud de la Universidad de Concepción. Métodos: cualitativo, enfoque de estudio de casos. Participaron 8 docentes universitarios del área de la salud, previo consentimiento informado, se realizó un análisis de contenido. Resultados: los escenarios educativos y las concepciones de enseñanza influyen en los procesos reflexivos de los docentes. Conclusión: las prácticas reflexivas deben ser estimuladas, ya que favorecen una mayor conciencia de la formación y mejoramiento educativo(AU)

Introduction: for the purpose of transforming the process of university professor formation, it is relevant to generate spaces for reflection since these may influence the educational change and innovation. Objective: to understand the development of reflective practices of the teaching-learning process of university health science professors in Universidad de Concepción. Method: qualitative method, case study approach. Eight university professors of health careers participated in this study after giving their informed consent. A contents analysis was made. Results: educational scenarios and teaching conceptions influence reflective practice of professors. Conclusions: reflective practices must be encouraged since they facilitate greater awareness about formation and educational improvement (AU)