Job preference of preventive medicine students during the COVID-19 pandemic: a discrete choice experiment survey in Shandong Province, China.

BACKGROUND: Public health workers are a crucial part of the health workforce, particularly during the coronavirus disease (COVID-19) pandemic. They play an important role in achieving universal health coverage and sustainable development goals. Human resources in public health in China are in short supply, their distribution is unequal, and their turnover rate is high. A discrete choice experiment (DCE) was applied to investigate preventive medicine students' preferred job choice criteria and trends in trade-offs by calculating the marginal rate of substitution between these criteria. This study identified the properties of jobs primarily selected by preventive medicine students and estimated the monetary value of each attribute. METHODS: Based on discussions and in-depth interviews with preventive medicine students and a literature review, we developed a DCE that assessed how students' stated preferences for a certain choice were influenced by several job attributes, including location, salary, bianzhi, career development opportunities, working environment, and workload. We applied this DCE to preventive medicine students in Shandong Province, China, using a brief, structured questionnaire. Conditional logit models were used to estimate the utility of each job's attributes. Willingness to pay (WTP) was estimated as the ratio of the value of the coefficient of interest to the negative value of the cost attribute. RESULTS: A total of 307 respondents completed the questionnaire, and 261 passed the internal consistency test. All the attributes were statistically significant. Career development opportunities and work locations were the most important factors for the respondents. Preference heterogeneity existed among respondents, e.g., 3-year medical education college students placed a higher value on jobs with bianzhi compared to 5-year medical education college students. Furthermore, rural students' WTP for a job located in the county or city is much lower than that of urban students. CONCLUSIONS: The heterogeneity of attributes indicates the complexity of job preferences. Monetary and nonmonetary job characteristics significantly influenced the job preferences of preventive medicine students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both job incentives and the backgrounds of preventive medicine graduates.

Taking advantage of asynchronous digital feedback: development of an at-home basic suture skills training program for undergraduate medical students that facilitates skills retention.

Purpose: To date, there are no training programs for basic suturing that allow remote deliberate practice. This study seeks to evaluate the effectiveness of a basic suture skills training program and its 6-month skill retention applying unsupervised practice and remote digital feedback. Methods: Fourth-year medical-student trainees reviewed instructional videos from a digital platform and performed unsupervised practice as needed at their homes. When they felt competent, trainees uploaded a video of themselves practicing the skill. In < 72 h, they received expert asynchronous digital feedback. The course had two theoretical stages and five video-based assessments, where trainees performed different suturing exercises. For the assessment, a global (GRS) and specific rating scale (SRS) were used, with a passing score of 20 points (max:25) and 15 (max:20), respectively. Results were compared to previously published work with in-person expert feedback (EF) and video-guided learning without feedback (VGL). A subgroup of trainees underwent a 6-month skills retention assessment. Results: Two-hundred and forty-three trainees underwent the course between March and December 2021. A median GRS of 24 points was achieved in the final assessment, showing significantly higher scores (p < 0.001) than EF and VGL (20.5 and 15.5, respectively). Thirty-seven trainees underwent a 6-month skills retention assessment, improving in GRS (23.38 vs 24.03, p value = 0.06) and SRS (18.59 vs 19, p value = 0.07). Conclusion: It is feasible to teach basic suture skills to undergraduate medical students using an unsupervised training course with remote and asynchronous feedback through a digital platform. This methodology allows continuous training with the repetition of quality practice, personalized feedback, and skills retention at 6 months.

Impacto de la covid-19 en la práctica preprofesional de estudiantes de sexto año de Medicina / Impact of Covid-19 in the pre-professional practice of sixth year medical students i: en

En los últimos meses del curso escolar 2020-2021, debido a la pandemia de la covid-19 fue necesario modificar el proceso formativo de los estudiantes de sexto año de la carrera de Medicina en la Universidad de Ciencias Médicas de Santiago de Cuba, lo cual incluía a los internos en las modalidades rotatoria y vertical de dicha enseñanza. En el presente artículo se comunican brevemente algunos aspectos relacionados con el aporte asistencial de estos universitarios en los centros de aislamientos, ante el llamado de las autoridades gubernamentales de la provincia, donde demostraron sentido de responsabilidad, amor al prójimo y compromiso durante la atención a los pacientes con diagnósticos de sospecha o definitivo de la enfermedad.

In the last months of 2020-2021 academic year, due to the pandemic of covid-19, it was necessary to modify the training process for the sixth year students of Medicine degree at the University of Medical Sciences in Santiago de Cuba, which included interns in rotation and vertical models of said teaching. In this work, some aspects related to their care contribution in the isolation centers, after the call of the governmental authorities in the province, are shortly communicated, where they demonstrated the sense of responsibility, love for their fellow men and commitment during the care to patients with presumptive or positive diagnoses of the disease.

From the West to the East: an evidence-based educational reform for modern medical students in traditional Chinese medicine learning.

Introduction: Generally, Traditional Chinese Medicine (TCM) courses are now given to modern medicine students without proper course scheduling, resulting in poor teaching results. Methods: To analyze the main factors affecting TCM learning, we surveyed the medical students and TCM teachers from Xiangya School of Medicine of Central South University via online questionnaires. The questionnaire comprised two parts, the students' part included the basic information, the subjective cognition in TCM, the attitude toward TCM course arrangements, and the attitude toward curriculum content and the design of TCM. The teachers' part included the basic information, the attitudes and opinions on TCM course arrangements, and suggestions and views on TCM teaching reform. The related data were collected from 187 medical students divided into two groups, namely, clinical medical students and non-clinical medical students. Results: We found a more positive attitude toward TCM [including "Scientific nature of TCM" (P = 0.03) and "Necessity for modern medicine students to learn TCM" (P = 0.037)] in clinical medical students compared with non-clinical medical students, clinical and non-clinical medical students tended to find TCM courses difficult, and the students prefer clinical training to be better than theoretical teaching, while the teachers believe that lecture-based education should have a more significant proportion. Discussion: Hence, to optimize the current TCM teaching, we conducted education reform, including differentiated teaching, hybrid teaching, and selective teaching.

Estrés académico en estudiantes de Medicina durante la pandemia de covid-19 / Academic stress in Medicine students during covid-19 pandemic i: en

Introducción: Los estudiantes de las ciencias médicas refieren mayores niveles de estrés académico, particularmente los de la carrera de Medicina. Objetivo: Caracterizar a estudiantes de Medicina según nivel de estrés, reacciones psicosomáticas y estrategias de afrontamiento usadas durante la pandemia de covid-19. Métodos: Se realizó un estudio descriptivo y transversal, desde septiembre hasta diciembre del 2020, de 30 estudiantes de primer y segundo años de la carrera de Medicina, pertenecientes a la Facultad No. 2 de la Universidad de Ciencias Médicas de Santiago de Cuba, que refirieron sentirse nerviosos. Como variables analizadas figuraron: sexo, nivel de estrés autopercibido, situaciones generadoras de estrés, reacciones físicas, psicológicas, comportamentales, y estrategias de afrontamiento. Se utilizó el porcentaje para los datos cualitativos, así como la media y la desviación estándar para los cuantitativos. Resultados: El nivel de estrés autopercibido resultó medio en el sexo masculino y alto en el femenino. En el estudio predominaron el tiempo limitado para la realización de trabajos, las evaluaciones de los profesores y la sobrecarga académica como situaciones generadoras de estrés; la somnolencia, la inquietud, el aislamiento y los conflictos o discusiones como principales reacciones; la planificación de sus tareas, la búsqueda de información sobre la situación y la habilidad asertiva como estrategias de afrontamiento. Conclusiones: La muestra estudiada se caracterizó por presentar nivel medio de estrés autopercibido, responder a situaciones generadoras de estrés académico, expresar reacciones físicas, psicológicas y comportamentales ante estas situaciones, así como también por usar estrategias de afrontamiento centradas en el problema.

Introduction: Medical sciences students refer higher levels of academic stress, particularly those of the Medicine career. Objective: To characterize Medicine students according to stress level, psychosomatic reactions and confrontation strategies used during covid-19 pandemic. Methods: A descriptive and cross-sectional study was carried out from September to December, 2020, of 30 first and second year students of the Medicine career, belonging to Faculty No. 2 of the University of Medical Sciences in Santiago de Cuba that referred to feel nervous. The analyzed variables were sex, self-perceived level of stress, situations generating stress, physical, psychological, behavioural reactions and confrontation strategies. The percentage was used for the qualitative data, as well as the mean and the standard deviation for the quantitative ones. Results: The self-perceived level of stress was average in the male sex and high in the female sex. In the study there was a prevalence of the limited time for the realization of works, evaluations of professors and academic overload as situations generating stress; the drowsiness, restlessness, isolation and conflicts or discussions as main reactions; planning of their tasks, search of information on the situation and assertive skill as confrontation strategies. Conclusions: The studied sample was characterized by presenting a medium level of self-perceived stress, responding to situations that generate academic stress, expressing physical, psychological and behavioural reactions when facing these situations, as well as using confrontation strategies focused on the problem.

Estrategia educativa para contribuir al desarrollo de una sexualidad sana y responsable en estudiantes de Medicina

El actual resultado constituye una salida del proyecto de investigación perfeccionamiento de la formación socio-humanista en la educación médica superior, que gestiona el Centro de Desarrollo de las Ciencias Sociales y Humanísticas en Salud, adscrito a la Universidad de Ciencias Médicas de Camagüey. El universo estuvo constituido por los estudiantes de primer año de la carrera de Medicina, de los que se seleccionó el grupo I. La muestra quedó constituida por 55 estudiantes. Predominaron los jóvenes del sexo femenino y el grupo de edad entre los 17 y 19 años. El estudio inicial consistió en la revisión de la bibliografía y la aplicación de la encuesta para medir el nivel de conocimiento que los jóvenes poseían sobre la sexualidad. Los resultados demostraron las insuficiencias que existían al respecto. La estrategia educativa se elaboró con el objetivo de contribuir al logro de una sexualidad sana y responsable en los estudiantes y la misma se llevó a la práctica desde septiembre 2020 a junio del 2021.

ABTRACT The current result constitutes a departure from the research project for the improvement of socio-humanist training in higher medical education, managed by the Center for the Development of Social and Humanistic Sciences in Health, attached to the University of Medical Sciences of Camagüey. The universe was made up of first-year students of the Medicine career, from which group I was selected. The sample was made up of 55 students. Young females and the age group between 17 and 19 years predominated. The initial study consisted of a review of the bibliography and the application of the survey to measure the level of knowledge that young people had about sexuality. The results demonstrated the insufficiencies that existed in this regard. The educational strategy was developed with the objective of contributing to the achievement of a healthy and responsible sexuality in students and it was put into practice from september 2020 to june 2021.

A Sense of Belonging: Perceptions of the Medical School Learning Environment among URM and Non-URM Students.

Phenomenon: Improving the learning environment (LE), particularly for students underrepresented in medicine (URM), has become an important goal for institutions that provide undergraduate and graduate medical education. Until recently, research and intervention development have been limited by the lack of comprehensive theoretical frameworks. A multi-dimensional conceptual model of the medical school environment, developed by Gruppen and colleagues in 2019, provides a useful framework for guiding research and interventions in this area.Approach: Using Gruppen et al's model, this study investigated experiences of the LE from the perspectives of both URM and non-URM students at a medical school in New York City. In examining experiences of the organizational, social, and physical domains of the LE, we sought to explore the symbolic and experiential links across domains and identify concrete needs for improvement.Findings: Institutional structures and policies, features of the built environment, and social relationships that put learning first and generated a sense of community were highly valued. Although both URM and non-URM students shared many perceptions and experiences, URM students expressed heightened vulnerability to the experiences of devaluation and exclusion.Insights: All participants in the study greatly appreciated aspects of the LE that made them feel like valued members of the community. Medical schools should approach the task of improving the LE for URM students using a comprehensive, multi-dimensional approach.

Family Functioning as an Explanatory Factor of Empathic Behavior in Argentine Medical Students.

Empathy is a relevant competence in the study and practice of medicine whose development could depend on the functioning style of each family. This study aims to compare the distribution of empathy levels, about functionality or dysfunction, and the three styles, which can be derived from family functioning in the families of Argentine medical students. Previously providing evidence of the validity of the family functioning measure. As well as provide evidence of the validity of the measure of family functioning. METHODS: Ex post facto design: 306 Argentine medical students who had already taken the Jefferson Scale of Empathy-Spanish Edition (JSE-S) and the abbreviated Spanish Family Adaptability and Cohesion Evaluation Scale (FACES-20). A gender-weighted linear regression analysis was made, establishing an ANOVA and multiple comparisons via DMS to determine the effect of functional and dysfunctional families' balanced, intermediate and extreme functioning styles concerning empathy. RESULTS: Students who presented dysfunction in familial cohesion and adaptability showed measures of empathy greater than those classified as functional. Differences of cohesion were statistically significant in compassionate care, perspective taking and general empathy. These components were significantly higher in students from families classified as extreme than balanced ones. Students classified within families with either extreme or dysfunctional styles showed greater levels of empathy than more adaptive and functional ones, except in the 'walking in patient's shoes' component where differences were not observed. CONCLUSIONS: Individual resilience as an intervening variable in the presence of empathy is discussed. IMPLICATIONS: The study of empathy, its associated variables, and the conditions of its development remains a central theme in relation to students and professionals of the health sciences. To achieve an effective professional practice, it is necessary to develop human capacities such as empathy and personal resilience.

Modeling the social determinants of resilience in health professions students: impact on psychological adjustment.

Stressors inherent to training and stemming from the learning environment are associated with high rates of burnout, depression, and mental health problems in health professions students (HPS). There is evidence that disadvantaged or stigmatized groups are particularly affected. These problems not only impact students after graduation but may also have detrimental effects on patient outcomes. Resilience, conceptualized as the process of adapting well in the face of adversity, has inspired an increasing number of interventions aimed at addressing those problems in HPS. These interventions have mostly targeted individual students and their psychological traits while ignoring social and structural factors that may enhance or undermine individual resilience. To address this gap in the literature, the authors reviewed the evidence for psychosocial determinants of resilience and proposed a model inspired by the social determinants of health literature and the "upstream-downstream" metaphor. In this theoretical paper, the authors propose that upstream determinants such adverse childhood experiences and socioeconomic and sociodemographic markers of disadvantage have a direct effect on psychological adjustment and an indirect effect mediated by resilience. Additionally, the authors propose that the institutional downstream drivers of learning environment, social support, and sense of belonging moderate the direct and indirect effects of the upstream determinants on psychological adjustment. Future research should test these hypotheses and gather evidence that may guide the development of interventions. The authors present their model as part of a comprehensive response to recent calls to action to address diversity, equity and inclusion in health professions education.

[Frequency of food allergy in students of human medicine of a private university]. / Frecuencia de alergia alimentaria en estudiantes de medicina humana de una universidad privada.

OBJECTIVE: Determine the frequency of total food allergy, and to Peruvian products, in Human Medicine students. METHODS: A study design is observational, descriptive and retrospective was made. Human medicine students, aged 18-25 from a private Peruvian university were included in a type of snowball sampling via electronic messaging. The sample size was calculated using the OpenEpi v3.0 program and the prevalence formula. RESULTS: We registered 355 students, with a mean age of 20.87 years (SD ± 5.01). A frequency of food allergy was also found in 9.3% of the total participants in terms of native products and common in other countries, the highest percentage are seafood 2.24%, spices and condiments 2.24%, allergy to fruits 1.4%, milk 1.4%, red meat 0.84%. CONCLUSIONS: The frequencies of self-reported food allergy produced was 9.3% by native Peruvian products and commonly consumed nationwide.

OBJECTIVO: Determinar la frecuencia de alergia alimentaria en general, y de productos de consumo común oriundos del Perú, en estudiantes de medicina humana. MÉTODOS: Estudio observacional, descriptivo y retrospectivo, al que se incluyeron estudiantes de medicina humana de 18-25 años, de una universidad privada del Perú, seleccionados mediante muestreo tipo "bola de nieve" a través de mensajería electrónica. El tamaño de la muestra se calculó con el programa OpenEpi v3.0 y la fórmula de prevalencia. RESULTADOS: Se registraron 355 estudiantes, con edad media de 20.9 años (SD ± 5,01). La frecuencia de alergia alimentaria fue de 9.3% del total de la muestra; y la frecuencia de alergia a productos de consumo común (oriundos del país) reportó: mariscos 2.24%, especias y condimentos 2.24%, frutas 1.4%, leche 1.4% y carnes rojas 0.84%. CONCLUSIONES: Existe una frecuencia de 9.3% de alergia alimentaria autorreportada, producida por productos de consumo común (oriundos del Perú) a nivel nacional.

Prevalence and Factors Associated with Anxiety and Depression in Peruvian Medical Students.

During medical training, students are exposed to stressors that deteriorate mental health. This study determined depression and anxiety prevalence and their associated factors in students from four medical schools in northern Peru. A cross-sectional study was conducted among medical students from Lambayeque, Peru. The Goldberg Anxiety and Zung Depression tests were applied. The dependent variables were depression and anxiety, and their association with covariates (age, sex, type of university, socioeconomic level, experience, family problem, and physical activity) was evaluated. Prevalence ratios were calculated using generalized linear models. Of 482 students, the prevalence of anxiety was 61.8% and depression was 22.0%. A severe level of anxiety was observed in 6.2% in the group between 16 and 20 years old. It was observed that private university students had higher frequencies of having depression (PR = 2.01) and anxiety (PR = 1.35); males had a lower risk of anxiety (PR = 0.82), but higher risk of depression compared to females (PR = 1.45). Performing physical activity decreased the prevalence of depression (PR = 0.53); however, it increased the frequency of anxiety (PR = 1.26). Having family problems increased the prevalence of anxiety (PR = 1.26). Medical students from private universities experienced higher rates of depression and anxiety. Depression and anxiety were associated with gender and physical activity. These findings highlight the importance of mental health promotion due to its link with quality of life and academic performance.

Estudio psicométrico de las pruebas MIR de 2020 y 2021 / Psychometric study of the MIR tests of 2020 and 2021

Introducción: En España, el ejercicio de cualquier especialidad médica exige disponer del título de especialista. El acceso a la formación como especialista se realiza a través de la prueba MIR. Esta prueba es obligatoria para poder optar a una plaza de formación en cualquier especialidad médica. El presente artículo realiza un estudio psicométrico tanto a través de la teoría clásica de los test como de la teoría de la respuesta al ítem de las pruebas MIR de 2020 y 2021 (de 175 y 200 preguntas, respectivamente).Material y métodos.La base de datos utilizada en el presente trabajo contiene las respuestas de un total de 4.810 opositores que se examinaron en 2020 y 3.888 que lo hicieron en 2021. La información disponible se analizó haciendo uso de indicadores como el alfa de Cronbach, la fórmula número 21 de Kuder y Richardson, el índice de dificultad, el índice de dificultad con corrección de los efectos del azar, el índice de discriminación, el índice de correlación biserial puntual, así como los índices de dificultad y discriminación según la teoría de respuesta al ítem.Resultados.Las pruebas MIR de 2020 y 2021 presentan una alta fiabilidad, con variaciones pequeñas de un año a otro en el comportamiento de las distintas asignaturas y bloques de preguntas en lo relativo a los índices utilizados en el presente estudio.Conclusiones.Los resultados obtenidos en el presente estudio permiten afirmar que el examen MIR es un examen objetivo, de dificultad y discriminación adecuadas, así como estable de una convocatoria a otra. (AU)

Introduction: In Spain, in order to practise any medical speciality, it is necessary to have qualified as a specialist. Access to training as a specialist is gained through the MIR test. This test is mandatory to qualify for a training position in any medical specialty. This article carries out a psychometric study of the 2020 and 2021 MIR tests (with 175 and 200 questions, respectively) through both the classical test theory and the item response theory.Material and methods.The database used in this study contains the responses from a total of 4,810 individuals who took the exam in 2020 and 3,888 who did so in 2021. The information available was analysed using indicators such as Cronbach's alpha, the formula number 21 of Kuder and Richardson, the difficulty index, the difficulty index corrected for random effects, the discrimination index and the point biserial correlation index. The difficulty and discrimination indices were also used, according to item response theory.Results.The MIR tests of 2020 and 2021 present high reliability, with only slight variations from one year to another in the behaviour of the different subjects and question blocks in terms of the indices used in the present study.Conclusions.The results obtained in the present study allow us to affirm that the MIR exam is objective, of appropriate difficulty and discrimination, as well as stable from one year to another. (AU)

Uso de fuentes de información en estudiantes de Medicina de una universidad de Tacna, Perú

El uso de fuentes de información es importante en la formación del estudiante de medicina; sin embargo, en Latinoamérica se ha reportado una disminución en su empleo y se han identificado problemas en su conocimiento. El objetivo del estudio consistió en determinar los factores asociados al uso de las fuentes de información en estudiantes de Medicina de una universidad de Tacna, Perú. Se realizó un estudio observacional, analítico y transversal en estudiantes de una universidad privada, mediante un muestreo aleatorio estratificado. Se utilizó un instrumento autoaplicado de forma virtual, que indagó en las características socioeducativas, la frecuencia de uso/capacitación de las fuentes de información y las características de la investigación científica. El resultado del estudio indicó un mayor uso de las fuentes de información, asociado con las variables independientes, mediante los modelos de regresión múltiple. De 274 estudiantes, el 32,1 % utilizó frecuentemente las fuentes de información. Las de mayor uso fueron: Google Académico (36,5 %) y SciELO (25,2 %); en contraste, la mayoría de los estudiantes desconocen las fuentes: HINARI (56,2 %) y EMBASE (55,5 %). Desempeñarse en un año académico superior y tener más percepción de las habilidades en la búsqueda de información científica, constituyen los factores asociados a un mayor uso de las fuentes de información.

The use of information sources is important in the training of the medical student; however, in Latin America a decrease in its use has been reported and problems have been identified in its knowledge. The objective of the study was to determine the factors associated with the use of information sources in medical students at a university in Tacna, Peru. An observational, analytical and cross-sectional study was carried out in students of a private university, using a stratified random sampling. A virtual self-applied instrument was used, which inquired into the socio-educational characteristics, the frequency of use/training of the information sources and the characteristics of scientific research. The result of the study indicated greater use of information sources, associated with the independent variables, through multiple regression models. Out of 274 students, 32.1% frequently used information sources. The most used were: Google Scholar (36.5%) and SciELO (25.2%); in contrast, most students are unaware of the sources: HINARI (56.2%) and EMBASE (55.5%). In conclusion, performing in a higher academic year and having more perception of the skills in the search for scientific information are the factors associated with greater use of information sources.

Os cuidados paliativos na visão de internos de um curso de medicina: estudo transversal / Palliative care from the perspective of internal medicine students: a cross-cross study / Cuidados paliativos desde la perspectiva de estudiantes de medicina: un estudio transversal

Este estudo teve por objetivo verificar o conhecimento de estudantes de medicina sobre cuidados paliativos em saúde durante a sua formação. Método: Estudo transversal com 58 participantes dentre um universo de 200 internos de medicina dos quatro últimos períodos da graduação (internato médico) de uma instituição de ensino superior brasileira privada sem fins lucrativos, que tem um currículo integrado com o uso intensivo de metodologias ativas de ensino-aprendizagem. Foi utilizado um questionário, enviado por meio eletrônico e que foi baseado no instrumento americano "Physician's End-of-Life Care Attitude Scale". A coleta de dados ocorreu no terceiro trimestre de 2020 e os dados foram analisados por meio da estatística descritiva simples. Resultados: Participaram 58 estudantes, entre 20 e 34 anos, sendo 72% mulheres. Apenas 15,5% se consideraram competentes em dar notícias ruins. Quanto ao manejo clínico, 65,5% necessitaram maior supervisão ou instrução básica na dispneia terminal. Na decisão de retirada do suporte ventilatório de um paciente incapaz de decidir por si, 74,1% se preocuparam com questões legais e profissionais e 77,6% com questões éticas. Em relação ao pensamento sobre a morte do paciente, 67,2% se manifestaram ansiosos ou desconfortáveis. 80% dos estudantes classificaram como importante ou muito importante abordar a temática dos cuidados paliativos durante o internato. Conclusão: Os estudantes expressaram graus variados de conhecimento acerca do tema. Manifestaram maior segurança no manejo dos principais sintomas clínicos. Observou-se que o tema morte provoca certo grau de angústia e desconforto nos estudantes, que consideram necessário o conhecimento sobre cuidados paliativos.

This study aimed to verify the knowledge of medical students about palliative health care during their training. Method: Cross-sectional study with 200 medical students from the last four periods of graduation (medical internship) at a private, non-profit Brazilian higher education institution, which has an integrated curriculum with the intensive use of active teaching-learning methodologies. A questionnaire was used, sent electronically and based on the American instrument "Physician's End-of-Life Care Attitude Scale". Data collection took place in the third quarter of 2020 and the data were analyzed using simple descriptive statistics. Results: 58 students, aged between 20 and 34 years old, 72% of whom were women. in terminal dyspnea. In the decision to withdraw ventilatory support from a patient unable to decide for himself, 74.1% were concerned with legal and professional issues and 77.6% with ethical issues. Regarding the thought about the patient's death, 67.2% expressed anxiety or discomfort. 80% of the students classified it as important or very important to address the topic of palliative care during the internship. Conclusion: The students expressed varying degrees of knowledge about the topic. They showed greater confidence in the management of the main clinical symptoms. It was observed that the theme of death causes a certain degree of anguish and discomfort in students.

Este estudio tuvo como objetivo verificar el conocimiento de los estudiantes de medicina sobre los cuidados paliativos en salud durante su formación. Método: Estudio transversal con 200 estudiantes de medicina de los últimos cuatro períodos de graduación (internado médico) en una institución de educación superior brasileña privada, sin fines de lucro, que tiene un plan de estudios integrado con el uso intensivo de metodologías activas de enseñanza-aprendizaje. Se utilizó un cuestionario, enviado electrónicamente y basado en el instrumento estadounidense "Physician's End-of-Life Care Attitude Scale". La recolección de datos se realizó en el tercer trimestre de 2020 y los datos se analizaron mediante estadística descriptiva simple. Resultados: 58 estudiantes, con edades entre 20 y 34 años, de los cuales el 72% eran mujeres. En la decisión de retirar el soporte ventilatorio a un paciente incapaz de decidir por sí mismo, el 74,1% se preocupó por cuestiones legales y profesionales y El 77,6% con problemas éticos. En cuanto al pensamiento sobre la muerte del paciente, el 67,2% manifestó ansiedad o malestar. El 80% de los estudiantes calificaron como importante o muy importante abordar el tema de cuidados paliativos durante la pasantía. Conclusión: Los estudiantes expresaron diversos grados de conocimiento sobre el tema. Mostraron mayor confianza en el manejo de los principales síntomas clínicos. Se observó que el tema de la muerte provoca cierto grado de angustia y malestar en los estudiantes.

Comportamiento del tabaquismo en estudiantes de primer año de medicina de la Universidad de Ciencias Médicas de Cienfuegos

Fundamento: el hábito de fumar se ha convertido en uno de los mayores problemas de Salud Pública a escala internacional. La Organización Mundial de la Salud reporta al tabaquismo como la principal causa prevenible de enfermedad, discapacidad y muerte prematura. Cuando este consumo se inicia en la adolescencia temprana, favorece la consolidación del hábito de fumar, el cual se extiende hasta la vida adulta. Objetivo: caracterizar el comportamiento del tabaquismo en estudiantes de primer año de medicina de la Universidad de Ciencias Médicas de Cienfuegos. Métodos: se realizó un estudio descriptivo, de corte transversal en estudiantes de primer año de medicina de la Universidad de Ciencias Médicas de Cienfuegos en el período comprendido desde el 5 de septiembre de 2018 al 20 de julio de 2019. El universo estuvo constituido por 199 estudiantes y la muestra quedó conformada por 61 de ellos. Se estudiaron las variables: edad, sexo, color de la piel, inicio del consumo, causas que motivaron al hábito de fumar y lugar de consumo. Fueron empleados como métodos estadísticos, las frecuencias absolutas y los porcentajes. Los resultados se presentaron en cuadros estadísticos. Resultados: el 30,5 % de los adolescentes son fumadores y predominó el sexo femenino con un 85,24 %. Predominó el grupo de 18 años, con un 67,21 %. El 77,04 % comenzó a fumar después de los 16 años y el 100 % fuma en lugares públicos. Conclusiones: se evidenció un incremento del hábito de fumar en adolescentes a expensas del sexo femenino cuyo comienzo del hábito fue en edades tempranas.

Background: smoking has become one of the biggest problems of international Public Health. The World Health Organization reports smoking as the leading preventable cause of disease, disability, and premature death. When said consumption begins in early adolescence, it favors the consolidation of the smoking habit, which extends into adulthood. Objective: to characterize the behavior of smoking in first-year medical students at the University of Medical Sciences of Cienfuegos. Methods: a descriptive, cross-sectional study was carried out in first-year medical students at the University of Medical Sciences of Cienfuegos in the period from September 5, 2018 to July 20, 2019. The universe consisted of 199 students and the sample was made up of 61 of them. The variables: age, sex, skin color, start of consumption, causes that motivated smoking and place of consumption were studied. Absolute frequencies and percentages were used as statistical methods. The results were presented in statistical tables. Results: 30.5 % of adolescents are smokers and 85.24 % are female. The 18-year-old group predominated, with 67.21 %. 77.0 4 % started smoking after the age of 16 and 100 % smoke in public places. Conclusions: there was evidence of an increase in the smoking habit in adolescents at the expense of the female sex, whose habit began at an early age.

Compassion and Self-Compassion: Counterfactors of Burnout in Medical Students and Physicians.

OBJECTIVE: To examine the relationship between self-compassion, compassion for others and Burnout in medical students and physicians. METHODS: A cross-sectional study was conducted. Medicine students and general physicians from two Colombian cities participated (n = 359). The Compassion Scales and the Maslach Inventory were administered. An Exploratory Structural Equation approach was used for validating new measures and testing for relationships between latent variables. RESULTS: Most participants were students (85.9%), mean age was 22 years (SD = 7), 55.2% were female, 62,6% dedicated more than 48 weekly hours to study or practice, while physicians had worked a mean of 10.34 years (SD = 8.67). Self-compassion and Compassion for others action subscales were validated, but engagement subscales of were not. Participant´s compassion actions for others and self-compassion actions are negatively related to depersonalization and emotional exhaustion, respectively. Additionally, compassion dimensions were positively associated with professional accomplishment. CONCLUSION: Our findings indicate that compassion and self-compassion actions inversely relate to different components of Burnout and could constitute protective factors against the stress of healthcare. Compassion and self-compassion training programs for medical students and physicians might be an alternative to avoid Burnout, diminishing physicians' depersonalization and emotional exhaustion while enhancing their professional accomplishment.

Estrés académico asociado a proteína C-reactiva y síndrome metabólico en estudiantes de medicina / Academic stress associated with C - reactive protein and metabolic syndrome in medical students

Introducción: El estrés académico resulta de la confrontación de un individuo con las demandas del medio universitario, lo cual puede producir cambios a nivel neuro-endocrino-inmunológico y generar un estado de inflamación crónica en donde los niveles de proteína C-reactiva aumentan. Objetivo: Determinar los niveles de estrés académico y proteína C-reactiva en estudiantes de medicina y su posible asociación con síndrome metabólico. Métodos: Se realizó un estudio observacional descriptivo de corte longitudinal que determinó el estrés académico en 68 estudiantes de medicina (41 mujeres y 27 hombres). Se obtuvo información sociodemográfica y clínica de cada estudiante. Se aplicó un cuestionario para la evaluación del estrés académico y se obtuvieron dos muestras de sangre para realizar dos pruebas de proteína C-reactiva de alta sensibilidad en dos tiempos diferentes. Resultados: Pese a que se observaron niveles altos de estrés académico y proteína C-reactiva, no hubo una asociación directa; sin embargo, se encontraron relaciones significativas entre proteína C-reactiva y las variables clínicas, además de un riesgo alto de desarrollar síndrome metabólico. Conclusiones: Se observaron altos niveles de estrés académico asociado a las demandas y exigencias de un programa de medicina con acreditación de alta calidad. Los altos niveles de proteína C-reactiva fueron asociados a los altos niveles de obesidad abdominal, lo que hace que un número significativo de estudiantes se encuentre en riesgo de desarrollar enfermedades cardiovasculares y diabetes mellitus tipo 2, sobre todo aquellos en los que se detectó prehipertensión. No se encontró una relación significativa entre el estrés académico y los niveles de proteína C-reactiva(AU)

Introduction: Academic stress results from the confrontation of an individual with the demands of the university environment, which can produce changes at the neuro-endocrine-immunological level and generate a state of chronic inflammation where the levels of C-reactive protein increase. Objective: To determine the levels of academic stress and C-reactive protein in medical students and their possible association with metabolic syndrome. Methods: A longitudinal descriptive observational study was conducted to determine academic stress in 68 medical students (41 women and 27 men). Sociodemographic and clinical information was obtained from each student. A questionnaire was applied to assess academic stress and two blood samples were obtained to perform two high-sensitivity C-reactive protein tests at two different times. Results: Although high levels of academic stress and C-reactive protein were observed, there was no direct association; however, significant relationships were found between C-reactive protein and clinical variables, in addition to a high risk of developing metabolic syndrome. Conclusions: High levels of academic stress associated with the demands and requirements of a medicine program with high quality accreditation were observed. High levels of C-reactive protein were associated with high levels of abdominal obesity, which means that a significant number of students are at risk of developing cardiovascular diseases and type 2 diabetes mellitus, especially those in whom prehypertension was detected. No significant relationship was found between academic stress and C-reactive protein levels(AU)

Utilidad atribuida por los estudiantes a los recursos para el aprendizaje de la Medicina Interna / Usefulness of learning resources for internal medicine recognized by students

Introducción: En la educación médica superior, las opiniones de los estudiantes constituyen valiosas herramientas para justipreciar la calidad del proceso docente educativo. En la asignatura Medicina Interna es importante determinar los recursos de aprendizaje más provechosos y atractivos para los estudiantes, con el propósito de mejorar la calidad del proceso docente educativo. Objetivos: Identificar la utilidad que los estudiantes le atribuyen a los recursos didácticos para el aprendizaje de los contenidos teóricos de la asignatura Medicina Interna. Métodos: Se realizó un estudio observacional descriptivo y transversal en el Hospital Docente Clínico Quirúrgico Joaquín Albarrán Domínguez. La muestra incluyó 483 estudiantes de la asignatura Medicina Interna de los cursos 2016-2017 y 2017-2018, a los que se les aplicó una encuesta para identificar sus opiniones sobre la utilidad que le atribuyen a los recursos para el aprendizaje de los contenidos teóricos de la asignatura Medicina Interna. Resultados: El 67,5 por ciento de los estudiantes prefiere disponer de materiales digitales confeccionados por los profesores con preguntas para su autoevaluación, el 67,3 por ciento considera que puede aprender los contenidos teóricos de la asignatura solo mediante el estudio independiente, el 32,1 por ciento encuentra útil asistir a las conferencias y el 84,1 por ciento prefiere consultar al profesor para aclarar sus dudas. Conclusiones: Para alcanzar mayor eficiencia en el aprendizaje de los contenidos teóricos de la asignatura Medicina Interna, debe potenciarse el desarrollo de modalidades de clases taller que tengan en cuenta las expectativas de los estudiantes y promuevan el empleo de recursos didácticos para el aprendizaje activo(AU)

Introduction: In higher medical education, students´ s opinions are valuable tools to assess the quality of the educational teaching process. In the Internal Medicine subject, it is important to determine the most profitable and attractive learning resources for students, with the purpose of improving the quality of the educational teaching process. Objectives: To identify the usefulness that students attribute to the didactic resources for learning the theoretical contents of Internal Medicine. Methods: A descriptive and cross-sectional observational study was carried out at Joaquín Albarrán Domínguez Clinical-Surgical Teaching Hospital. The sample included 483 students of the Internal Medicine of 2016-2017 and 2017-2018 school years, to whom a survey was applied to identify their opinions on the usefulness they attribute to the resources for learning theoretical contents of Internal Medicine. Results: 67.5 percent of students prefer to have digital materials made by teachers with questions for self-assessment, 67.3 percent consider that they can learn theoretical content of the subject only through independent study, 32.1 percent find it useful to attend the lectures and 84.1 percent prefer to consult the professor to clarify their questions. Conclusions: In order to achieve better efficiency in learning theoretical contents of Internal Medicine, workshop- class modalities should be promoted to take into account the expectations of the students and promote the use of didactic resources for active learning(AU)

Calidad de la evaluación en estomatología en el período 2014-2021 / Quality of the evaluation in the dental medicine major in the period 2014-2021

Introducción: La ampliación de la matrícula en la carrera de estomatología y la apertura de nuevos escenarios docentes descentralizados han constituido un reto en la formación de los educandos. Con el ejercicio del examen estatal se certifica la competencia de los egresados. Objetivo: Comparar los resultados de la evaluación final de la asignatura Atención integral a la población con los del examen ordinario estatal de la carrera de estomatología en los escenarios docentes descentralizados de Plaza de la Revolución. Métodos: Se realizó una investigación descriptiva y transversal de los resultados del examen ordinario estatal de la carrera de estomatología en el período 2014-2021, en los escenarios docentes descentralizados de Plaza de La Revolución. Los resultados finales se compararon con la nota final de la asignatura Atención integral a la población. Se trabajó con el universo de los estudiantes (161). Se utilizaron los números enteros y el porcentaje. Resultados: Los resultados de la asignatura Atención integral a la población fueron ligeramente superiores a los obtenidos en la prueba estatal. En ambos predominaron las calificaciones de alto rendimiento, para un 69,5 por ciento y un 57,1 por ciento respectivamente. Conclusiones: La calidad satisfactoria de los resultados docentes de los exámenes finales de Atención integral a la población y el estatal se mantuvieron con una tendencia a la mejoraría de las calificaciones de los últimos tres cursos(AU)

Introduction: An increase in the enrollment acceptance for the dental medicine major and the creation of new decentralized teaching settings have become challenges with respect to the training of students. The state examination certifies the competence of graduates. Objective: To compare the results of the final evaluation corresponding to the subject of Comprehensive Population Care with the results of the first call for the state examination corresponding to the dental medicine major in the context of decentralized teaching settings of Plaza de la Revolución Municipality, Havana, Cuba. Methods: A descriptive and cross-sectional research was carried out with the results of the first call for the state examination corresponding to the dental medicine major in the period 2014-2021, in the context of decentralized teaching settings of Plaza de La Revolución Municipality. The final results were compared with the final scores corresponding to the subject of Comprehensive Population Care. The universe of students (161) were included. Integer numbers and percentages were used. Results: The results corresponding to the subject of Comprehensive Population Care were slightly higher than the results obtained in the state examination. Both were characterized by predominantly high performance scores, accounting for 69.5 percent and 57.1 percent, respectively. Conclusions: The satisfactory quality of the teaching results corresponding to the final exams for the subject of Comprehensive Population Care and the state examination maintained a tendency of improving scores in the last three academic years(AU)

Use of Actors or Peers as Simulated Clients in Veterinary Communication Training.

Using simulated clients is an effective teaching method for training and assessing communication skills in veterinary education. The aim of this study is to evaluate the use of actors and peers in communication skills training in veterinary medicine. For this purpose, the subjective perception of the use of actors was assessed in a first study using a paper-based self-evaluation survey. In a second study, different groups of veterinary students who trained their communication skills with actors or peers were compared in an electronic Objective Structured Clinical Examination (eOSCE) assessment with regard to their outcomes of communication proficiency. All participants reported the actors to be helpful and supportive in learning communication skills. Above all, participants highly rated the achieved authenticity when using actors as well as feedback sessions. Regarding the comparison of actors and peers as teaching methods, no significant difference in the performance of veterinary students in an eOSCE was identified. Despite the lack of objective evidence, both methods may be considered valuable and accepted teaching tools. Training with peers gives students an opportunity to learn how to conduct structured history interviews and to understand pet owners' motives at an early stage of undergraduate veterinary training. Change of perspective is considered a positive training element. However, when portraying authentic and standardized emotions and reactions and giving formative feedback based on the pet owners' internal perspectives, actors are beneficial for training advanced veterinary students and graduates in difficult conversation topics.