Meaningful and experiential learning in a fascial approach in practice education in the degree of physiotherapy: A pilot study at a Spanish University.

BACKGROUND AND INTRODUCTION: A pilot experience of teaching innovation was developed in the masotherapy practice classes of the University of Seville's degree of physiotherapy using an active learning approach. OBJECTIVE: Significant experiential learning-specific teaching strategies were implemented to address learning style diversity and promote dynamic participation, active listening, and the creation of clinical simulation learning environments. METHODS: The strategies implemented included establishing an affective climate in the classroom that would encourage interaction among participants, facilitating the flow of information and the teaching-learning process, considering students' previous ideas, elaborating upon content maps and key questions to guide the teaching-learning process, establishing discussions favoring student brainstorming, using illustrations and videos ("visual thinking"), implementing experimental demonstrations and simulated clinical scenarios, and collaborative activities mediated by information and communication technology. RESULTS: The evaluation, which was developed using a questionnaire (pretest-posttest) that allowed the development of learning ladders and considered the complexity of the generated knowledge, revealed significant advances in student learning. CONCLUSION: The implementation of significant experiential learning-specific teaching strategies is useful for achieving the learning objectives of this subject. Further research is needed to conclude firmly in this regard.

Meeting the challenge of teaching bioethics: a successful residency curricula utilizing Team-Based Learning.

BACKGROUND: Despite recognition by both the Accreditation Council of Graduate Medical Education (ACGME) and the American Board of Paediatrics (ABP) of the importance of bioethics education, curricular crowding, lack of perceived significance, and insufficient administrative support remain significant barriers to trainees gaining competency in bioethics. Few bioethics curricula at the graduate medical education level are evidence-based or comprehensive. We sought to develop and assess the effectiveness of a Team Based Learning (TBL) curriculum in improving residents' bioethics knowledge and their ability to evaluate ethical dilemmas. METHODS: We integrated L. Dee Fink's curricular design principles of "Significant Learning," Jonsen et. al's "Four-Box Method" of ethical analysis, and ABP bioethics content specifications to create 10 TBL bioethics sessions. Paediatric residents at a major academic centre then completed a 3-year longitudinal, integrated TBL-based bioethics curriculum. Primary outcomes included individual and group readiness assessment tests (iRAT/gRAT), pre-work completion, and satisfaction with sessions. RESULTS: The TBL-based bioethics curriculum contains 10 adaptable modules. Paediatric residents (n = 348 total resident encounters) were highly engaged and satisfied with the curriculum. gRAT scores (mean 89%) demonstrated significant improvement compared to iRAT scores (72%) across all TBLs and all post-graduate years (p < .001). Higher gRAT scores correlated with higher level of training. Although pre-work completion was low (28%), satisfaction was high (4.42/5 on Likert scale). CONCLUSIONS: Our TBL-based bioethics curriculum was effective in improving knowledge, practical and flexible in its implementation, and well-received. We attribute its success to its grounding in ethical theory, relevance to ABP specifications, and a multi-modal, engaging format. This curriculum is easily modified to different specialties, virtual formats, or other specific institutional needs.Key messagesDespite formidable challenges to teaching bioethics in residency education, evidence-based methods such as Team-Based Learning (TBL) can be employed to increase knowledge and satisfaction.This study reports the first successful TBL bioethics curriculum, planned and executed longitudinally over 3 years, with paediatric residents at a large academic children's hospital in the US.TBL can be utilised to teach bioethics at the graduate medical education level and is adaptable to different situational factors, disciplines, and levels of clinical experience.

The application and research of using "creating significant learning experiences" in medical general education curriculum / 中华医学教育探索杂志

To improve the phenomenon of low participation and lack of innovation in education mode in general medical education elective courses, we have applied "creating significant learning experiences" to the design and implementation of medical general education curriculum, starting from six dimensions of learning including basic knowledge, application, synthesis, humanistic dimension, humanistic care, and learning to learn, setting learning goals, developing assessment tools and finally choosing teaching methods, thus forming a closed-loop teaching. And through the curriculum reform, collection of feedback and collation of data, the teaching activities designed according to this method fully meet and serve the teaching purposes, and assessment methods become more diverse and the content is more comprehensive, which reflects the multi-dimensional evaluation of the needs of general education.

Educação permanente na atenção secundária: elaboração de protocolo de atendimento de urgência / Permanent education in secondary care: elaboration of an emergency care protocol

Os centros de especialidades, não somente médicas, são apontados como fundamentais na retaguarda à Atenção Primária e desempenham importante papel em Redes Regionalizadas de Saúde, não só no Brasil, sendo representado pela Atenção Secundária. O processo de trabalho no SUS, para ser constituído de forma a permitir a melhor interação interprofissional, requer o exercício cotidiano da Educação Permanente em nossas Unidades de Saúde. Objetivo geral: Elaborar um procedimento operacional padrão para a organização do processo de trabalho comum grupo de funcionários que atua direta e indiretamente no ambulatório de cardiologia da atenção secundária de um município de médio porte da região serrana do estado do Rio de Janeiro. Objetivos especificos: 1.Identificar os entraves encontrados pelos trabalhadores do ambulatório de atenção secundária para o atendimento ao paciente com diminuição do nível de consciência. 2.Descrever as dificuldades no processo de trabalho quanto à necessidade da implementação da Educação Permanente 3.Propor estratégias que poderão ser vivenciadas e experimentadas através da Educação Permanente, para a solução ou enfrentamento desses entraves. Método: Trata-se de uma pesquisa qualitativa,tendo como referencial político-pedagógico a Política Nacional de Educação Permanente. O tipo de pesquisa é a análise intencional de pesquisa-ação de Thiollent (1997), referencial teórico, sendo utilizado como referencial filosófico, o educador Paulo Freire. A técnica e instrumento para coleta e análise de dados mediante grupo focal e/ou Questionário Semiestruturado, sob análise temática em Bardin e Turato (2011). O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade Federal Fluminense sob nº 4.428.883Resultados: Os resultados apontam para melhorias no processo de trabalho cotidiano, calcado em premissas da Educação Permanente como uma prática transformadora. Propõe uma reflexão sobre a prática individual do profissional e, mais do que sua interação multiprofissional no processo de trabalho, apresenta uma experiência positiva originada da atuação em processo de Educação Permanente na Atenção Secundária da região serrana do estado do Rio de Janeiro. Conclusão: Esse estudo trouxe contribuições significativas para a prática, mediante elaboração de um protocolo de atendimento a pacientes com nível de consciência reduzido, em Posto de Saúde da Atenção Secundária, adequado à realidade local, produto da demanda do grupo de trabalho.

Specialty centers, not only medical, are seen as fundamental in the rear of Primary Care, and play an important role in Regionalized Health Networks, not only in Brazil, being represented by Secondary Care. The work process in the SUS, to be constituted in a way that allows the best interprofessional interaction, requires the daily exercise of Continuing Education in our Health Units. General objective: To develop a standard operating procedure for the organization of the work process with a group of employees who work directly and indirectly in the secondary care cardiology outpatient clinic of a medium-sized city in the mountainous region of the state of Rio de Janeiro. Specific Objectives: 1. Identify the obstacles encountered by workers at the secondary care clinic for patient care with a decreased level of consciousness. 2.Describe the difficulties in the work process regarding the need to implement Continuing Education. 3.Propose strategies that can be experienced and tried out, through Continuing Education, for the solution or confrontation of these obstacles. Method: This is a qualitative research, using the National Policy for Continuing Education as a political-pedagogical framework. The type of research is the intentional analysis of action research by Thiollent (1997), theoretical framework, being used as a philosophical framework, the educator Paulo Freire. The technique and instrument for data collection and analysis through focus group and/or Semi-structured Questionnaire, under thematic analysis in Bardin and Turato (2011). The project was approved by the Research Ethics Committee of the Faculty of Medicine of Universidade Federal Fluminense under nº 4.428.883Results: The results point to improvements in the daily work process, based on premises of Continuing Education as a transforming practice. It proposes a reflection on the professional's individual practice, and more than its multidisciplinary interaction in the work process, it presents a positive experience originating from the performance in the Permanent Education process in Secondary Care in the mountainous region of the state of Rio de Janeiro. Conclusion: This study brought significant contributions to the practice, through the elaboration of a care protocol for patients with reduced level of consciousness, in a Secondary Care Health Center, adequate to the local reality, product of the demand of the work group.

Peer teaching, a didactic strategy for learning basic electrocardiography / La enseñanza por pares, una estrategia didáctica para el aprendizaje de la electrocardiografía básica

Abstract Teaching electrocardiography is a very important area in undergraduate student training. A constant concern of professors is for physicians in training to acquire competence in reading and interpreting electrocardiograms (EKGs). This study describes and explores how the didactic strat egy of peer teaching improves learning processes for second-year medical students. Evidence was found that peer teaching fosters significant learning of cardiac physiology and electrocardiograms, in particular, because it allows students to acquire abilities and skills in EKG reading, and improves the understanding and interpretation of this test. In addition, it promotes horizontal peer relationships which facilitate the development of autonomy, self-learning and teamwork. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1971).

Resumen La enseñanza de la electrocardiografía es un área de gran importancia en la formación de los estudiantes de pregrado, para los docentes es una preocupación constante que los médicos en for mación adquieran las competencias para la lectura e interpretación del electrocardiograma (ECG). El presente estudio describe e indaga sobre cómo la estrategia didáctica de la enseñanza por pares mejora los procesos de aprendizaje de los estudiantes de segundo año de formación médica. Se halló evidencia de que la enseñanza por pares favorece el aprendizaje significativo de la fisiología cardiaca y del electrocardiograma, en particular, porque permite la adquisición de habilidades y destrezas a los estudiantes en la lectura del ECG y mejora la comprensión e interpretación de dicho examen; además, propicia relaciones horizontales entre pares que facilitan el desarrollo de la autonomía, el autoaprendizaje y el trabajo en equipo. (Acta Med Colomb 2021; 46. DOI:doi.org/10.36104/amc.2021.1971).

Discusión de casos en equipos como estrategia para ejercitar el razonamiento clínico desde el ciclo básico / Case discussion in teams as a strategy for practicing clinical reasoning since the basic cycle

Las estrategias curriculares que persiguen la integración entre las ciencias básicas y las ciencias clínicas se enriquecen con la introducción de las discusiones de casos desde los primeros años de la carrera de medicina. En este sentido, este trabajo tuvo el objetivo de reflexionar sobre el valor educacional de una propuesta de ambiente de aprendizaje mediante el método de discusión colectiva de los casos clínicos para los estudiantes de los primeros años de la carrera. Al soporte teórico del trabajo se adicionó un ejemplo de caso adaptado para estudiantes que cursan el ciclo básico de la carrera de medicina. Los métodos activos de aprendizaje desplazan el protagonismo al educando; el entregar y el recibir han sido sustituidos por crear juntos. Subdividir la clase en pequeños grupos (equipos), facilitados por un docente, estimula la interacción estudiantil. El caso clínico sitúa al paciente en el centro del proceso, y la dirección de la discusión se negocia a través del análisis de las pistas que la situación ofrece, desde las diversas interpretaciones de los participantes, ayudados por el profesor. Esta reflexión no pretende sustituir otros escenarios necesarios para comprender el contenido de las disciplinas individuales, porque ese, al ser el primer nivel de conocimiento, necesita reactivarse y analizarse durante la discusión de los casos. La evocación de tópicos en casos clínicos diversos, y la elaboración en el equipo, se espera faciliten la penetración en su esencia (abstracción) y en consecuencia su aplicación en nuevos pacientes(AU)

The curricular strategies that pursue integration between basic sciences and clinical sciences are enriched with the introduction of case discussions from the first academic years of the medical major. In this respect, this work had the objective of reflecting on the educational value of a proposal of a learning setting, through the method of collective discussion of clinical cases for students in the first academic years of the major. The theoretical foundations of the work were added a case example adapted for students at the basic cycle of Medicine. Active learning methods shift prominence to the learner; giving and receiving have been replaced by creating together. Subdividing the class into small groups (teams), facilitated by a teacher, stimulates student interaction. The clinical case places the patient at the center of the process, while the direction of the discussion is negotiated through the analysis of the clues offered by the situation, from the different interpretations of the participants, helped by the teacher. This reflection is not aimed at substituting other settings necessary to understand the content of individual disciplines, because that one, as long as it is the first level of knowledge, needs to be reactivated and analyzed during the case discussions. The evocation of topics through various clinical cases, and team creation, are expected to facilitate the penetration in its essence (abstraction) and consequently its application in new patients(AU)

Evaluation of an e-book assignment using Fink's Taxonomy of Significant Learning among undergraduate dental hygiene students.

CONTEXT: With significant learning experiences, students undergo positive, substantial, and lasting influences on their personal and professional lives. With grant support from The Ohio State University's Affordable Learning Exchange Program, students created e-book chapters for a Current Concepts in Dental Hygiene as a significant learning experience. OBJECTIVE: The purpose of this study was to evaluate the impact of an e-book chapter creation project on the learning of undergraduate dental hygiene students using Fink's Taxonomy of Significant Learning. DESIGN: Upon IRB exemption, this study involved a mixed-methods, cross-sectional research design involving a survey of attitudinal and reflective questions. The data were analyzed using descriptive statistics and thematic analysis. RESULTS: The data from 100% (n = 41) of the dental hygiene students enrolled in the Current Concepts in Dental Hygiene course were analyzed. Most students recognized the alignment of the 6 scaffolded assignments with the 6 domains of Fink's Taxonomy of Significant Learning. Most students agreed the project focused on foundational knowledge (68.8%, n = 27), promoted active learning (73.2%, n = 30), applied to real life problems (63.4%, n = 26), and provided life lessons (56.1%, n = 23). Thematic analysis revealed students appreciated the teamwork involved and the scaffolding of assignments, recognized the challenges of inconsistent feedback and technical issues with the software, and felt that more faculty guidance and technical support would have improved their experiences. CONCLUSION: Future research should evaluate the impact of using Fink's Taxonomy of Significant Learning with the design of courses or course-long projects on the education of dental and dental hygiene students.

Niveles de motivación en el estudiantado de enfermería y estrategias de enseñanza / Levels of motivation in nursing students and learning strategies

Introducción: Para el estudiantado de enfermería el aprendizaje es complejo, y requiere integrar contenidos teóricos, procedimentales y actitudinales durante la etapa formativa, los cuales ejecutará posteriormente en un contexto real. El logro de estos saberes les debe garantizar a los alumnos el desempeño óptimo esperado para su nivel de formación. Objetivo: Identificar los niveles de motivación de los estudiantes de enfermería y su influencia en la concreción de sus logros, a partir de las estrategias de enseñanzas utilizadas en la asignatura Enfermería en salud familiar y comunitaria. Métodos: Se empleó una metodología mixta. La recogida de datos fue cuantitativa: se aplicó al estudiantado el cuestionario de motivación y estrategias de aprendizaje; y cualitativa: se realizó una entrevista semiestructurada a los docentes de la asignatura. Resultados: Se comprobó que un porcentaje importante del estudiantado presentaban una amplia dispersión en la valoración de la motivación intrínseca, lo cual no se observó en la motivación extrínseca. Los datos cualitativos permitieron inferir que el trabajo activo por parte de los estudiantes se encontraba poco desarrollado y las evaluaciones realizadas por los docentes eran principalmente sumativas y dirigidas a los aspectos teóricos. Conclusiones: Los altos niveles de motivación extrínseca del estudiantado de enfermería se vinculan con las estrategias tradicionales de enseñanza del profesorado y la evaluación de competencias en la fase de formación estimula la mejora continua en su desempeño profesional(AU)

Introduction: For nursing students, learning is complex and requires integrating theoretical, procedural and attitudinal contents during the training stage, which they will use further in real settings. Achievement of this knowledge must guarantee students the optimal performance expected from their training level. Objective: To identify the levels of motivation of Nursing students and their influence on such achievements, based on the teaching strategies used in the subject Nursing in Family and Community Health. Methods: A mixed methodology was used. The data collection was quantitative: the motivation and learning strategies questionnaire was applied to the students; and qualitative: a semi-structured interview was conducted with the professors of the subject. Results: A significant percentage of the students were found to have a wide dispersion regarding the assessment of intrinsic motivation, which was not observed for extrinsic motivation. The qualitative data allowed to infer that the active work on the part of the students was poorly developed and that the evaluations carried out by the professors were mainly summative and aimed at theoretical aspects. Conclusions: The high levels of extrinsic motivation among Nursing students are associated with traditional teaching strategies used by the faculty. The evaluation of competences in the training stage stimulates continuous improvement in the students' professional performance(AU)

Fink's integrated course design and taxonomy: The impact of their use in a "Basics of Dental Anatomy" course.

OBJECTIVE: This study aimed to assess whether the adjustment of Fink's Model of Integrated Course Design (ICD) with his Taxonomy of Significant Learning (hereinafter referred to as "ICD/SL") affected the academic performance of students at Universidad El Bosque in the "Basics of Dental Anatomy" course. DESIGN: For this purpose, 3 academic groups were selected: 2018/1 (55 students), 2018/2 (79 students), and 2019/1 (57 students). The control group, 2018/1, was taught without ICD/SL; the 2 treatment groups, 2018/2 and 2019/1, was taught with ICD/SL, which applied revised learning goals based on Fink's Taxonomy and new teaching and evaluation activities. The assessment of academic performance was based on a Likert scale to position student results in each grade score report. Statistical analysis was performed through the Kruskal-Wallis test and P-value through the Mann-Whitney U test and Fisher exact test. RESULTS: The results indicated that the treatment groups evidenced better academic performance in the summative assessment of the partial and final grades. In the treatment groups, 64% to 97% of students were in the High to Excellent segment; in comparison, this percentage in the control group was 44% to 65%. The course's rate of failure dropped from 10.9% in 2018/1 to only 1.7% in 2019/1. All the differences between the treatment and control groups were statistically significant (P < 0.0001). CONCLUSION: The use of ICD/SL improved the academic performance of students.

Impacto de la estrategia análisis de caso en la enseñanza de asignaturas biológicas / Impact of the Case Analysis Strategy in the Teaching of Biological Subjects

Introducción: La técnica de análisis de caso es una estrategia pedagógica que puede utilizarse en la educación superior para el desarrollo de aprendizajes autónomos. Objetivo: Evaluar la contribución de la técnica análisis de casos en la obtención de aprendizajes comprensivos en asignaturas biológicas de alta reprobación. Métodos: Se realizó una intervención mediante la técnica análisis de casos, durante 4 meses, con un diseño preexperimental con evaluación antes-después. La muestra estuvo conformada por 15 estudiantes de la carrera de Kinesiología y 30 estudiantes de Psicología. Para evaluar el impacto de la estrategia se aplicó a los estudiantes el Cuestionario de Procesos de Estudio de Biggs y Kember, y una encuesta de valoración de la experiencia. Resultados: Los resultados evidenciaron cambios en la forma en que los estudiantes procesan la información para lograr una aproximación más centrada en la comprensión. Conclusiones: Se verifican cambios cuantitativos, orientados al uso de estrategias de aprendizaje profundo en el procesamiento de la información(AU)

Introduction: The case analysis technique is a pedagogical strategy that can be used in higher education for the development of autonomous learning. Objective: To assess the contribution of the case analysis technique to obtaining comprehensive learning in biological subjects of high failure. Methods: An intervention was carried out using the case analysis technique, during four months, with a pre-experimental design with a before-after evaluation. The sample consisted of 15 students from the Kinesiology major and 30 Psychology students. To assess the impact of the strategy, the Biggs' and Kember's Study Processes Questionnaire and an experience assessment survey were applied to the students. Results: The results showed changes in the way students process information to achieve a more focused approach to understanding. Conclusions: Quantitative changes are verified, oriented to the use of deep learning strategies in the information processing(AU)

Análisis de caso clínico mediante foro virtual por Facebook para favorecer la transferencia de aprendizajes / Clinical Casa Analysis through a Facebook Virtual Forum for Strengthening Learning Transfer

Introducción: Las carreras del área de la salud se caracterizan por tener una rigurosa base científica, que les aporta los fundamentos indispensables para que los futuros profesionales desarrollen investigaciones, especializaciones o profundizaciones en algún área determinada. El presente trabajo incorpora un foro virtual de participación libre y voluntaria para los estudiantes de la asignatura Diagnóstico Integrado de la carrera de Odontología, mediante un grupo cerrado de Facebook. Objetivo: Evaluar el progreso de la transferencia de aprendizajes y las estrategias cognitivas y metacognitivas en los estudiantes de Odontología de la Universidad de Concepción, con la aplicación de la metodología de análisis de caso clínico mediante foro virtual. Métodos: Se trabajó con la metodología análisis de caso clínico para mejorar la transferencia del aprendizaje y se empleó una metodología mixta: cualitativa con análisis de contenido mediante grupos focales, y cuantitativa con método cuasi experimental de pre- y postest del Cuestionario para la Evaluación de Estrategias de Aprendizaje de los Estudiantes Universitarios. Participaron 68 estudiantes que cursaron la asignatura Diagnóstico Integrado en 2017 y que manifestaron su decisión de participar voluntariamente de manera escrita. Resultados: Mejoró la transferencia de aprendizajes en todos los estudiantes. Aquellos que participaron más en el foro obtuvieron mejor rendimiento en la asignatura. Todos reconocieron que resultó un aprendizaje significativo para su futuro desempeño profesional. El conocimiento declarativo y la consciencia aumentaron su media y porcentaje para las opciones positivas. En cambio, el conocimiento procedimental, el control y la autopoiesis disminuyeron su media, y aumentó el porcentaje para las opciones negativas y la indecisión. Conclusiones: La metodología desarrollada constituyó un acierto porque aumentó la transferencia de aprendizajes(AU)

Introduction: Health majors are characterized by having a rigorous scientific base, which provides them with the essential foundations for future professionals to develop research, specializations or deepening in a given area. The present work incorporates a virtual forum of free and voluntary participation for the students of the subject Integrated Diagnosis of the dental medicine major, through a closed Facebook group. Objective: To assess the progress of learning transfer of the cognitive and metacognitive strategies in the students of dental medicine from University of Concepción, with the application of the clinical case analysis methodology in a virtual forum. Method: The clinical case analysis methodology was used to improve learning transfer. A mixed methodology was used: qualitative with content analysis through focus groups and quantitative with quasi-experimental method of pre- and post-test with the Questionnaire for the Evaluation of Learning Strategies of University Students. Sixty-eight students participated who took the Integrated Diagnosis course in 2017 and who expressed their decision to participate voluntarily through writing. Results: Learning transfer improved in all students. Those who participated more in the forum obtained better performance in the subject. All of them recognized that it was significant learning for their future professional performance. Declarative knowledge and awareness increased their mean and percentage values for positive options. In contrast, procedural knowledge, control and autopoiesis decreased their mean values, while the percentage values increased for negative options and indecision. Conclusions: The methodology developed was a success because it increased learning transfer(AU)

Aiming Beyond Competent: The Application of the Taxonomy of Significant Learning to Medical Education.

Issue: Competency-Based Medical Education (CBME) focuses on demonstrable outcomes, as well as upholding medical education's accountability to society. Despite calls for a robust, multifaceted approach to competency-based assessment (CBA), lingering critiques exist. These critiques include reductionism, reinforcement of an external locus of control within learners, an loss of focus on learner development. Both CBME and CBA may be strengthened if viewed through the lens of a complementary curriculum design framework that broadens the focus on the learner. Evidence: Researchers and physician organizations have articulated the need for medical practitioners trained to provide optimal care in the rapidly changing care environment. In the drive to ensure accountability to patients and society, CBME may overlook the duty of educators to foster the necessary intrinsic development of learners as holistic professionals. The focus of CBA on outcomes may reward memorization and rote performance but may fail to ensure the underlying comprehension or critical thinking necessary to adapt to the variability of real-life patient care. Learners focus on tasks chosen for assessment; thus, areas less easily assessed may be overlooked or deemed unimportant. Reinforcement for learner motivation becomes externalized in CBA, as opposed to being driven by the desire for self-improvement and self-actualization. A recently proposed framework that views learner development as a process-based improvement cycle, the "Master Adaptive Learner," may help remedy this issue. L. Dee Fink's Taxonomy of Significant Learning aims to create meaningful learning experiences in higher education. This taxonomy consists of six interwoven domains: (a) Learning How to Learn, (b) Foundational Knowledge, (c) Application, (d) Integration, (e) Human Dimension, and (f) Caring. Each domain encompasses a unique perspective on the learning process, and when collectively applied to curriculum design, significant learning occurs. This taxonomy has not been widely applied to medical education but may offer an important counterbalance to the outcomes-based focus of CBME. Implications: The outcomes-based focus of CBME is well suited for skill-based tasks, such as procedures, that are observable and measurable. However, other essential physician skills-such as critical thinking, reflection, empathy, and self-directed learning-are not easily assessed, and thus may receive little focus in an outcomes-based model. A holistic approach, such as the Taxonomy of Significant Learning, can counter the deficits of CBME and provide a balanced approach to education program design and assessment.

Transferencia de aprendizajes en estudiantes de Odontología de la Universidad de Concepción, Chile / Transfer of Learning Types in Dental Students of Universidad de Concepción in Chile

Introducción: Un obstáculo al cual se enfrenta el estudiante de Odontología es la dificultad para interrelacionar los conocimientos que han aprendido de manera parcelada durante los dos primeros años de estudio, dificultando la transferencia de aprendizajes para reconocer la multicausalidad de factores presentes al momento de tratar al paciente de manera integral. La evidencia científica señala que una forma de lograrlo es que el estudiante posea estrategias cognitivas y metacognitivas que le permitan un aprendizaje significativo. Objetivo: Determinar el nivel de estrategias cognitivas y metacognitivas presentes en los alumnos de Odontología de la Universidad de Concepción. Método: Metodología mixta; de tipo descriptivo y transversal. Un enfoque cualitativo mediante entrevistas semiestructuradas y cuantitativo mediante la aplicación del Cuestionario para la Evaluación de Estrategias de Aprendizaje de los Estudiantes universitarios (CEVEAPEU). Participaron 117 estudiantes que cursaron el tercer año entre el 2016 y 2017. Resultados : En lo cualitativo, los estudiantes destacaron varios aspectos positivos en la asignatura. No obstante, señalan la necesidad de incorporar herramientas que incentiven su participación y curiosidad, además de aumentar las oportunidades para integrar lo aprendido. Refirieron que utilizan una amplia variedad de estrategias de aprendizaje. Ello evidenció un aprendizaje significativo receptivo que no fomenta la transferencia de aprendizajes. En lo cuantitativo, existió una alta dispersión en las respuestas, tanto para estrategias cognitivas como metacognitivas, asimismo se evidenció una moda de 4 (de acuerdo) para la mayoría de las preguntas. Se demostró que los estudiantes no aseguran un alto nivel de adherencia a las aseveraciones planteadas. Conclusiones: Los estudiantes refirieron que utilizan una amplia variedad de estrategias de aprendizaje, sin embargo, no las adaptan cuando la situación de aprendizaje es más compleja. Los estudiantes no evidenciaron un alto nivel de adherencia a las aseveraciones planteadas en el CEVEAPEU. Por tanto, se logra un aprendizaje significativo receptivo que no fomenta la transferencia de aprendizajes(AU)

Introduction: One obstacle faced by the student of Dental Medicine is the difficulty to interrelate the knowledge they have learned separately during the first two years of study, making it difficult to transfer learning to recognize the multi-causality of factors present at the time of providing comprehensive treatment to the patient. Scientific evidence show that one way to achieve this is for the student to possess cognitive and metacognitive strategies that allow significant learning. Objective: To determine the level of cognitive and metacognitive strategies present in the dental students of Universidad de Concepción. Methods: Mixed methodology, of descriptive and cross-sectional type. A qualitative approach through semi-structured interviews, and quantitative approach through the application of the Questionnaire for the Evaluation of Learning Strategies of University Students (CEVEAPEU). 117 students participated who attended the third academic year between 2016 and 2017. Results: Qualitatively speaking, the students highlighted several positive aspects in the subject; however, they point out the need to incorporate tools that encourage their participation and curiosity, as well as increasing opportunities to integrate what they have learned. They reported that they use a wide variety of learning strategies. This showed a significant receptive learning that does not encourage the transfer of learning types. Quantitatively speaking, there was a high dispersion in the answers, both for cognitive and metacognitive strategies, as well as a trend of 4 (agreed) for most questions. The students were shown not to ensure a high level of adherence to their stated assertions. Conclusions: the students reported that they use a wide variety of learning strategies, but they do not adapt them when the learning situation is more complex. It was shown that students do not ensure a high level of adherence to the assertions made in the CEVEAPEU. Therefore, receptive significant learning is achieved that (AU)

Developing an instrument to measure emotional behaviour abilities of meaningful learning through the Delphi technique.

AIM: To identify items for a new instrument that measures emotional behaviour abilities of meaningful learning, according to Fink's Taxonomy. BACKGROUND: Meaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge and produces a long-term change of knowledge and skills. To measure meaningful learning capability, it is very important in the education of health professionals to identify problems or special learning needs. For this reason, it is necessary to create valid instruments. DESIGN: A Delphi Study technique was implemented in four phases by means of e-mail. METHODS: The study was conducted from April-September 2015. An expert panel consisting of ten researchers with experience in Fink's Taxonomy was established to identify the items of the instrument. Data were analysed for conceptual description and item characteristics and attributes were rated. Expert consensus was sought in each of these phases. An 87·5% consensus cut-off was established. RESULTS: After four rounds, consensus was obtained for validation of the content of the instrument 'Assessment of Meaningful learning Behavioural and Emotional Abilities'. This instrument consists of 56 items evaluated on a 6-point Likert-type scale. Foundational Knowledge, Application, Integration, Human Dimension, Caring and Learning How to Learn were the six major categories explored. CONCLUSIONS: This content validated tool can help educators (teachers, trainers and tutors) to identify and improve the strategies to support students' learning capability, which could increase their awareness of and/or responsibility in the learning process.

The significance of personal learning environments (PLEs) in nursing education: Extending current conceptualizations.

BACKGROUND: Personal learning environments (PLEs) have been shown to be a critical part of how students negotiate and manage their own learning. Understandings of PLEs appear to be constrained by narrow definitions that focus primarily on technological engagement with a range of web tools and associated applications. This paper addresses a gap in the literature around PLEs for students currently enrolled in undergraduate nursing degrees. PURPOSE: To provide in-depth insights into how undergraduate students of nursing manage and experience their learning. METHODS: This was an international multi-site qualitative study, utilizing focus groups. A schedule of 10 questions and nominal group techniques were used. FINDINGS: Whilst the focus groups took place in very different geographical locations, there were strong similarities in student understandings of effective PLEs. These went well beyond current technological definitions. Findings were organized into three major themes; technologies, learning modalities and influencing factors. DISCUSSION: We propose a broader understanding of PLEs that acknowledges individual personal and cultural contexts which we call the personally significant learning environment (PSLE). There is a need for greater investigation of how students understand and systematize their PSLE. CONCLUSIONS: This paper and our findings will be of interest to educators, researchers and institutions for developing appropriate frameworks that may maximize learning outcomes, encourage cultural sensitivities and facilitate greater understandings of how to support students to create appropriate PSLEs.

Instruments for measuring meaningful learning in healthcare students: a systematic psychometric review.

AIM: To identify, evaluate and describe the psychometric properties of instruments that measure learning outcomes in healthcare students. BACKGROUND: Meaningful learning is an active process that enables a wider and deeper understanding of concepts. It is the result of an interaction between new and prior knowledge and produces a long-standing change in knowledge and skills. In the field of education, validated and reliable instruments for assessing meaningful learning are needed. DESIGN: A psychometric systematic review. DATA SOURCES: MEDLINE CINAHL, SCOPUS, ERIC, Cochrane Library, Psychology & Behavioural Sciences Collection Database from 1990-December 2013. REVIEW METHOD: Using pre-determined inclusion criteria, three reviewers independently identified studies for full-text review. Then they extracted data for quality appraisal and graded instrument validity using the Consensus-based Standards for the selection of the health status Measurement INstruments checklist and the Psychometric Grading Framework. RESULTS: Of the 57 studies identified for full-text review, 16 met the inclusion criteria and 13 different instruments were assessed. Following quality assessment, only one instrument was considered of good quality but it measured meaningful learning only in part; the others were either fair or poor. The Psychometric Grading Framework indicated that one instrument was weak, while the others were very weak. No instrument displayed adequate validity. CONCLUSIONS: The systematic review produced a synthesis of the psychometric properties of tools that measure learning outcomes in students of healthcare disciplines. Measuring learning outcomes is very important when educating health professionals. The identified tools may constitute a starting point for the development of other assessment tools.

Actitudes hacia la asignatura de Estadística en estudiantes de la Facultad de Ciencias Médicas General Calixto García / Attitudes towards the subject of Statistics in students of the Medical Science Faculty General Calixto García

Introducción: la formación estadística del profesional de Medicina en nuestro país, ha estado encaminada a desarrollar una capacidad transformadora capaz de dar respuestas a las necesidades o demandas de la población en general y el sector de la salud en particular, siendo una de sus expresiones, el desarrollo de un pensamiento científico. El propósito de este trabajo es proporcionar información sobre las actitudes hacia la Estadística de estudiantes de la Facultad de Ciencias Médicas Calixto García. Objetivo: determinar la fiabilidad de un instrumento que explora las actitudes hacia la asignatura de Estadística en estudiantes de Medicina e identificar los ítems que mayor contribución tienen al desempeño de dicho instrumento. Material y Métodos: se realizó una investigación de carácter descriptivo, se midieron las actitudes hacia la Estadística a partir de las respuestas a la escala de LIKER, del instrumento SATS (Survey of Attitudes Toward Statistics). Resultados: se valora la actitud global de los estudiantes, que resultó positiva en su mayoría, por lo que se propone considerar este resultado como punto de partida para un aprendizaje significativo de la Estadística orientado a las competencias profesionales en los diferentes perfiles de la carrera de Medicina. Conclusiones: la mayor puntuación correspondió a la componente del Conocimiento acerca de relacionar la estadística con situaciones de la realidad; muy próximas a este componente se encuentra la Dificultad, la Afectiva y la Valoración(AU)

Introduction: the statistical formation of the professional of Medicine in our country has been conducting to develop a transforming capacity able to give answers at the needs or demands of the population in general and to the sector of the health in particular, being one of its expressions, the development of a scientific thought. The intention of this work is to provide information about the attitudes towards the students' Statistics of the faculty of Medical sciences Calixto García. Objectives: to determine the reliability of an instrument that explores the attitudes towards the Statistics subject in Medicine students and to identify the items that have major contribution to the performance of the above mentioned instrument. Material and Methods: an investigation of descriptive character was realized, the attitudes measured themselves towards the Statistics from the answers to the scale of LIKER, of the instrument SATS (Survey of Attitudes Toward Statistics). Results: there is valued the global attitude of the students, which turned out to be positive mostly, for what he proposes to consider the above mentioned result to be a starting point for significant learning of the Statistics faced to the professional competitions in the different profiles of the career of Medicine. Conclusions: the highest scores corresponded to the component of the Knowledge about relating the statistics to situations of the reality, very next to this component there is the Difficulty, the Affective one and the Assessment(AU)

Innovaciones educativas en la enseñanza de la Fitoterapia / Educational innovations in Phitotherapy teaching

Introducción: la innovación educativa es transformar el proceso de enseñanza tradicional en uno en el cual el estudiante sea el sujeto activo de su propio aprendizaje y la enseñanza de las Ciencias Médicas esté a tono con esta realidad, especialmente en temas como la Fitoterapia, donde se aportan las bases científicas para que el futuro profesional de la salud realice una terapéutica racional de las plantas medicinales y las utilice como una alternativa viable de tratamiento. Objetivo: describir algunas innovaciones educativas que puedan contribuir a perfeccionar la enseñanza del tema Fitoterapia. Material y Métodos: se realizó una revisión de la literatura nacional e internacional publicada sobre el tema. Las fuentes consultadas y seleccionadas recogen los mejores aportes que brindan las investigaciones en innovación educativa, a través de la revisión de revistas médicas cubanas, las Bases de Datos EBSCO y otras a través del Portal de la Salud (Infomed), así como en Internet, la Base de Datos de Dialnet. Para la búsqueda general se utilizó el motor de búsqueda Google. Desarrollo: se describen algunas innovaciones educativas para la enseñanza del tema Fitoterapia, donde se utilizó la elaboración escrita, la resolución de problemas y la vinculación de la Farmacología con las humanidades que, según las opiniones de los estudiantes, es más ameno, aprenden más y retienen más los conocimientos. Conclusiones: las innovaciones propuestas modifican el proceso enseñanza-aprendizaje a través del cumplimiento de la estrategia curricular y la innovación para la generación de propuestas de modalidades educativas que permitan al estudiante aprender aprendiendo y aprender investigando(AU)

Introduction: the educational innovation, is change the traditional teaching-learning process in one where the student is the active subject of own learning and Medical Sciences teaching most be today with this reality, especially in them as Phitotherapy, contributing the scientific bases to future health professional doing the rational use of medicinal plants and its use like a therapeutic alternative. Objective: describe some educational innovation to contribute to improve Phitotherapy teaching. Material and Methods: realize a national and international literature review published about them. The consult and selected sources collect the better contribution to bring educational investigation, through the revision of Cuban Medical Reviews, the Data Bases EBSCO, INFOMED and Data Base Dialnet in INTERNET. To general search was used Google. Development: describe some educational innovations to teaching Phitotherapy, use write elaboration, problems solutions and the linking Pharmacology and humanities. In students opinion this innovations are interested and improve learning. Conclusions: the proposal innovations modify teaching-learning process throw the compliment of curricular strategy and innovation to generate educational proposal to learn learning and to learn researching(AU)