Aprendizaje o calificaciones: un dilema ético en los alumnos de medicina / Learning or grading: an ethical dilemma in medical students / Aprender ou classificar: um dilema ético em estudantes de medicina

Resumen: Los estudiantes de medicina deben moldear su futuro laboral, antes, durante y después de su vida estudiantil. Es necesidad del médico en general, desde su etapa de estudiante, tener un aprendizaje basado en lo que debe desempeñar para su posterior actividad laboral profesional. Este desarrollo escolar de aprendizaje usualmente se ve influenciado por la forma de los planes de estudio que cada una de las instituciones educativas permiten. En la mayoría de ellas, los privilegios de los alumnos durante su trayectoria están otorgados a través de los promedios de calificaciones que obtienen en cada ciclo escolar. Muy frecuentemente, al alcanzar los privilegios que ofrecen las escuelas, se crean problemas éticos en los alumnos que tienen como alternativa el aprendizaje profesional. El confrontamiento de este dilema puede ocasionar en el estudiante alteraciones en su desarrollo escolar y hasta en su salud física o mental.

Abstract: Medical students must shape their future work, before, during and after their student life. It is a necessity for physicians in general from their student stage to have an apprenticeship based on what they must perform for their later professional work activity. This school development of learning is usually influenced by the form of the curricula that each of the educational institutions allow. In most of them, the privileges that students have during their trajectory are granted through the grade point averages they have in each school cycle. Very often, achieving the privileges offered by schools creates bioethical problems for students who have professional learning as an alternative. The confrontation of this dilemma can cause alterations in the student's school development and even in his physical or mental health.

Resumo: Os estudantes de medicina devem moldar a sua carreira futura, antes, durante e depois da sua vida de estudante. É necessário que os médicos em geral, desde a fase de estudante, tenham uma aprendizagem baseada no que se espera que desempenhem no seu trabalho profissional subsequente. Este desenvolvimento da aprendizagem escolar é geralmente influenciado pela forma dos currículos que as instituições de ensino individuais permitem. Na maioria deles, os privilégios que os estudantes têm durante a sua carreira são concedidos através das médias de notas que têm em cada ciclo escolar. Muito frequentemente, a obtenção dos privilégios oferecidos pelas escolas cria problemas bioéticos para os estudantes que têm a alternativa da aprendizagem profissional. O confronto deste dilema pode causar alterações no desenvolvimento escolar do aluno e mesmo na sua saúde física ou mental.

Learning through the grapevine and the impact of the breadth and depth of social networks.

We study how communication platforms can improve social learning without censoring or fact-checking messages, when they have members who deliberately and/or inadvertently distort information. Message fidelity depends on social network depth (how many times information can be relayed) and breadth (the number of others with whom a typical user shares information). We characterize how the expected number of true minus false messages depends on breadth and depth of the network and the noise structure. Message fidelity can be improved by capping depth or, if that is not possible, limiting breadth, e.g., by capping the number of people to whom someone can forward a given message. Although caps reduce total communication, they increase the fraction of received messages that have traveled shorter distances and have had less opportunity to be altered, thereby increasing the signal-to-noise ratio.

Componentes principales para evaluar la mínima intervención en cariología del plan de estudios de la carrera de Estomatología / Principal components to evaluate the minimum intervention in cariology in the Dentistry curriculum

Introducción: Las evaluaciones al sistema de conocimientos concebido en carreras universitarias precisan de herramientas prácticas para concretar la búsqueda de debilidades en los diferentes procesos. Objetivo: Determinar los componentes principales del instrumento para evaluar las capacidades cognitivo-prácticas necesarias para la enseñanza-aprendizaje de la mínima intervención en el tratamiento de la caries dental en el plan de estudios de la carrera de Estomatología. Material y Métodos: Estudio descriptivo transversal. Los datos de un estudio piloto previo, resultante del proceso de validación del formulario en cuestión fueron empleados para realizar los análisis paramétricos que se describen basados en los criterios de 52 profesores. Se extrajeron los valores de la evaluación realizada ajustándolo a una muestra aceptable para este tipo de estudio. Se realizó el test de Kaiser-Meyer-Olkin y prueba de esfericidad de Bartlett, análisis de comunalidades, análisis de la varianza y la reagrupación de los ítems en las dimensiones propuestas se realizó con la rotación de Varimax. Resultados: el Kaiser-Meyer-Olkin sobrepasó el mínimo aceptable (0,763) y el nivel de significación fue p<0.000 según la prueba de Bartlett, por lo que el análisis factorial fue apropiado. Se observó que todas las variables estuvieron bien explicadas por el modelo con cifras entre 85,8 por ciento y 97,7 por ciento de variabilidad. Los 6 primeros componentes tienen mayor peso para explicar los datos, con cifras respectivas de 29,6 por ciento, 24,0 por ciento, 14,0 por ciento, 10,9 por ciento, 8,4 por ciento y 6,7 por ciento, por lo que explican el 93,6 por ciento de la variabilidad. Conclusiones: Los componentes principales quedaron renombrados de acuerdo con los factores que agrupaban(AU)

Introduction: The evaluations of the knowledge system conceived in the university studies require practical tools to specify the search for weaknesses in the different processes. Objective: To determine the main components of an instrument used to evaluate the cognitive-practical capacities necessary for the teaching-learning of the minimum intervention in the treatment of dental caries in the Dentistry curriculum. Material and Methods: A descriptive cross-sectional study was conducted. A total of 52 teachers participated in the retest previously carried out in a reliability study. The data from the pilot study resulting from the validation process of the form were used to perform the parametric analyzes that will be described. From this, the values ​​of the evaluation carried out in the retest were extracted, adjusting it to an acceptable sample for this type of study. The Kaiser-Meyer-Olkin test and Bartlett's sphericity test, analysis of communalities, analysis of variance and the regrouping of the items in the proposed dimensions were performed with the Varimax rotation. Results: The Kaiser-Meyer-Olkin exceeded the acceptable minimum (0,763) and the level of significance was p <0.000 according to the Bartlett´s test, so the factor analysis was appropriate. It was observed that all the variables were well explained by the model with measures of variability between 85,8 percent and 97,7 percent. The first 6 components have greater weight to explain the data, with respective figures of 29,6 percent, 24,0 percent, 14,0 percent, 10,9 percent, 8,4 percent and 6,7 percent, therefore they explain 93,6 percent of the variability. Conclusions: The main components were renamed according to the factors they grouped(AU)

Diversity Is Not Enough: Advancing a Framework for Antiracism in Medical Education.

Medical students, residents, and faculty have begun to examine and grapple with the legacy and persistence of structural racism in academic medicine in the United States. Until recently, the discourse and solutions have largely focused on augmenting diversity across the medical education continuum through increased numbers of learners from groups underrepresented in medicine (UIM). Despite deliberate measures implemented by medical schools, residency programs, academic institutions, and national organizations, meaningful growth in diversity has not been attained. To the contrary, the UIM representation among medical trainees has declined or remained below the representation in the general population. Inequities continue to be observed in multiple domains of medical education, including grading, admission to honor societies, and extracurricular obligations. These inequities, alongside learners' experiences and calls for action, led the authors to conclude that augmenting diversity is necessary but insufficient to achieve equity in the learning environment. In this article, the authors advance a 4-step framework, built on established principles and practices of antiracism, to dismantle structural racism in medical education. They ground each step of the framework in the concepts and skills familiar to medical educators. By drawing parallels with clinical reasoning, medical error, continuous quality improvement, the growth mindset, and adaptive expertise, the authors show how learners, faculty, and academic leaders can implement the framework's 4 steps-see, name, understand, and act-to shift the paradigm from a goal of diversity to a stance of antiracism in medical education.

Rethinking Goals: Transforming Short-Term Global Health Experiences Into Engagements.

The authors challenge the conventional wisdom guiding what participants in short-term experiences in global health (STEGHs) should be learning. Medical students and residents from the United States have been told to focus on standardized competencies and ethical principles, in addition to the biomedical knowledge, skills, and attitudes highlighted by working internationally. The authors suggest that although these training goals are important, they may divert learners from developing their professional identities in ways that contribute to the health of all persons, especially those who are economically poor and socially marginalized. The authors postulate that such a professional transformation will occur only if STEGH participants attend to 5 key learning goals: develop contextual inquisitiveness, grow in insightful understanding, nurture global humility, cultivate structural awareness, and critically engage in the pursuit of creating equitable and just societies. Further, the authors argue that only by attending to these goals will any genuine change in the root causes of inequities in health outcomes occur. The authors review these goals and encourage their use for professional and pedagogical purposes over the duration of any STEGH-before departure, while in host communities, and upon return home.

Referenciais e experiências de ensino em bioética: 3ª reunião do grupo de professores de Bioética em Odontologia da ABENO / Education frameworkand experiences in bioethics: 3rdmeeting of the group of professors of Bioethics in Dentistry of ABENO

A importância daBioética para o aperfeiçoamento ético-humanístico dos cirurgiões-dentistas é amplamente reconhecida. No entanto, para esta disciplina de reflexão teórico-filosófica interdisciplinar, a formação docente limitada à Odontologia implica problemas significativos. Diante deste contexto, criou-seum grupo de professores de Bioética em Odontologia no âmbito da Associação Brasileira de Ensino Odontológico,em 2017. Dois anos após,o grupo se reuniupela terceira vez para compartilhar referenciais e experiências de docência. O objetivo deste artigo é ampliar oalcancedaquele debateaos professores que não puderam estar presentes. Inicialmente apresenta-se o Core Curriculumque está baseado nos princípios da Declaração Universal sobre Bioética e Direitos Humanos. Trata-se de uma proposta pedagógica da United Nations Educational, Scientific and Cultural Organization(UNESCO)para o ensino de Bioética,que pode ser adotado nos cursos de graduação em Odontologiade forma integral ou complementar. Na sequência, apresenta-se aexperiência do ensino de Bioética que vem sendo desenvolvida na Universidade Federal de Santa Catarina,a partir de comparação dos elementos que estruturam os planos de ensino das disciplinas de graduação e pós-graduação.Em comum as propostas defendem:oensino em disciplina própria; a imprescindibilidade da formação docente em Bioética; a consideração da sua natureza interdisciplinar; a ampliaçãodo referencial teórico para muito além do Principialismo, buscando-sereferenciais adequados etemáticas relevantes a cada contexto social e a cada nível educativo; a centralidade do processo ensino-aprendizado no estudante, fomentando sua competência humanística crítico-reflexiva; e o compromisso com a formação ética dos estudantes por parte de todo o corpo docente (AU).

The importance of Bioethics for the ethical-humanistic improvement of dentists is widely recognized. However, professortraining limited to Dentistry implies significant problems for this interdisciplinary theoretical-philosophical reflection course. In this context, a group of professors of Bioethics in Dentistry was created within the scope of the Brazilian Association of Dental Education in 2017. Two years later, the group met for the third time to share education references and experiences. The purpose of this article is to expand the scope of that debate to professorswho were unable to attend. The Core Curriculum is initially presented, based on the principles of the Universal Declaration on Bioethics and Human Rights. It is a pedagogical proposal fromthe United Nations Educational, Scientific,and Cultural Organization (UNESCO) for teaching Bioethics, which can be adopted in undergraduate programsin Dentistry in a comprehensive or complementary manner. Subsequently, the experience of teaching Bioethics that has been developed at the Universidade Federal deSanta Catarinais presented, based on a comparison of the elements that structure the teaching plans of the undergraduate and graduate programs. Likewise,the proposals defend teaching in one'sown course; the indispensability of professortraining in Bioethics; the consideration of its interdisciplinary nature; the expansion of the theoretical framework far beyond Principialism, seeking appropriate frameworks and themes relevant to each social context and each educational level; the centrality of the teaching-learning process forthe student, fostering his/her critical-reflexive humanistic competence; and the commitment to the ethical training of students by the entire faculty (AU).

A 3-step teaching approach for a blended learning of 'understanding and avoiding unintentional plagiarism'.

Plagiarism refers to the behaviour of taking other people's work or idea as one's work or idea. Lack of understanding of plagiarism can lead to unintentional plagiarism. Unintentional plagiarism occurs not only in nursing students' writing but also in other healthcare learners. However, teaching approaches for understanding and avoiding unintentional plagiarism in healthcare education are limited. This is particularly helpful for using blending learning to address the issue of unintentional plagiarism. This editorial will describe the impact of unintentional plagiarism and propose a teaching approach called 'Understanding and Avoiding Unintentional Plagiarism' using blended learning to help avoid unintentional plagiarism. This teaching approach aims to assist healthcare teachers to deliver academic writing development programmes in three important steps: 1) Plan appropriate tasks, 2) Prepare essential resources, and 3) Perform effective delivery.

La vocación médica, ¿nace o se hace? Impacto del Grado de Medicina en la sensibilidad ética del alumno / Is the vocation born or done? The impact of the degree in medicine on the ethical sensitivity of the student

Introducción: La sensibilidad ética como componente de la vocación médica necesita ser evaluada con criterios e indicadores que permitan establecer comparaciones de mejora o deterioro. Sujetos y métodos: Diseño en dos fases: observacional transversal al comienzo del sexto semestre del grado y al finalizar el séptimo semestre, y de intervención, antes y después de la docencia (asignaturas de Comunicación, Ética y Legislación I y II). Instrumento de medida: actividad docente grupal voluntaria (corregida mediante una parrilla de evaluación validada por consenso entre el equipo docente/investigador), consistente en el análisis de un video con guion estructurado donde los participantes debían detectar individualmente y redactar de forma libre las cuestiones éticas que encontraban mientras se reproducía. Ámbito: Facultad de Medicina, Universidad de Zaragoza (216 alumnos, de tercer y cuarto curso). Resultados: 179 estudiantes, 72 en tercero (33%) y 97 en cuarto (45%), realizaron el ejercicio, siendo válidas 169 respuestas, con información apareada (antes-después) de 34 estudiantes (20,11%). Al contrastar las dos muestras transversales no apareadas, los alumnos de cuarto identificaron más cuestiones éticas (30,38%) que los de tercero (20,12%) y cualitativamente más sutiles. La muestra de estudiantes con seguimiento longitudinal confirma el hallazgo: la media en cuarto es del 11,62%, y en tercero, del 9,53%. Conclusiones: Es útil analizar el impacto de las herramientas docentes implementadas en el aula, lo que confirma una mayor sensibilidad (detección de cuestiones éticas) por los alumnos tras la formación en ética

Introduction: The ethical sensitivity as a component of the medical vocation needs to be evaluated with criteria and indicators that allow for comparisons of improvement or deterioration. Subjects and methods: Two phases design: cross-sectional observational at the beginning of the sixth semester of the degree and at the end of the seventh semester, and intervention, before and after teaching (subjects Communication, Ethics and Legislation I and II). Instrument of measurement: voluntary group teaching activity (corrected through an evaluation grid validated by consensus between the teaching/research team) consisting of the analysis of a video with a structured script where the participants had to individually detect and write freely the ethical questions they encountered while it was playing. Scope: Faculty of Medicine, University of Zaragoza (216 students, third and fourth year). Results: 179 students, 72 in third (33%) and 97 in fourth (45%), performed the exercise with 169 responses valid, with paired information (before-after) of 34 students (20.11%). When contrasting the two unpaired cross samples, the fourth graders identified more ethical questions (30.38%) than those of third (20.12%) and qualitatively more subtle. The sample of students with longitudinal follow-up confirms the finding: the average in fourth is 11.62% and in third of 9.53%. Conclusions: It is useful to analyze the impact of the teaching tools implemented in the classroom, confirming a greater sensitivity (detection of ethical issues) by the students after the ethics training

Multi-agent reinforcement learning with approximate model learning for competitive games.

We propose a method for learning multi-agent policies to compete against multiple opponents. The method consists of recurrent neural network-based actor-critic networks and deterministic policy gradients that promote cooperation between agents by communication. The learning process does not require access to opponents' parameters or observations because the agents are trained separately from the opponents. The actor networks enable the agents to communicate using forward and backward paths while the critic network helps to train the actors by delivering them gradient signals based on their contribution to the global reward. Moreover, to address nonstationarity due to the evolving of other agents, we propose approximate model learning using auxiliary prediction networks for modeling the state transitions, reward function, and opponent behavior. In the test phase, we use competitive multi-agent environments to demonstrate by comparison the usefulness and superiority of the proposed method in terms of learning efficiency and goal achievements. The comparison results show that the proposed method outperforms the alternatives.

Thinking through other minds: A variational approach to cognition and culture.

The processes underwriting the acquisition of culture remain unclear. How are shared habits, norms, and expectations learned and maintained with precision and reliability across large-scale sociocultural ensembles? Is there a unifying account of the mechanisms involved in the acquisition of culture? Notions such as "shared expectations," the "selective patterning of attention and behaviour," "cultural evolution," "cultural inheritance," and "implicit learning" are the main candidates to underpin a unifying account of cognition and the acquisition of culture; however, their interactions require greater specification and clarification. In this article, we integrate these candidates using the variational (free-energy) approach to human cognition and culture in theoretical neuroscience. We describe the construction by humans of social niches that afford epistemic resources called cultural affordances. We argue that human agents learn the shared habits, norms, and expectations of their culture through immersive participation in patterned cultural practices that selectively pattern attention and behaviour. We call this process "thinking through other minds" (TTOM) - in effect, the process of inferring other agents' expectations about the world and how to behave in social context. We argue that for humans, information from and about other people's expectations constitutes the primary domain of statistical regularities that humans leverage to predict and organize behaviour. The integrative model we offer has implications that can advance theories of cognition, enculturation, adaptation, and psychopathology. Crucially, this formal (variational) treatment seeks to resolve key debates in current cognitive science, such as the distinction between internalist and externalist accounts of theory of mind abilities and the more fundamental distinction between dynamical and representational accounts of enactivism.

Faithfulness-boost effect: Loyal teammate selection correlates with skill acquisition improvement in online games.

The problem of skill acquisition is ubiquitous and fundamental to life. Most tasks in modern society involve the cooperation with other subjects. Notwithstanding its fundamental importance, teammate selection is commonly overlooked when studying learning. We exploit the virtually infinite repository of human behavior available in Internet to study a relevant topic in anthropological science: how grouping strategies may affect learning. We analyze the impact of team play strategies in skill acquisition using a turn-based game where players can participate individually or in teams. We unveil a subtle but strong effect in skill acquisition based on the way teams are formed and maintained during time. "Faithfulness-boost effect" provides a skill boost during the first games that would only be acquired after thousands of games. The tendency to play games in teams is associated with a long-run skill improvement while playing loyally with the same teammate significantly accelerates short-run skill acquisition.

Identifying the narrative used by educators in articulating judgement of performance.

INTRODUCTION: Modern assessment in medical education is increasingly reliant on human judgement, as it is clear that quantitative scales have limitations in fully assessing registrars' development of competence and providing them with meaningful feedback to assist learning. For this, possession of an expert vocabulary is essential. AIM: This study aims to explore how medical education experts voice their subjective judgements about learners and to what extent they are using clear, information-rich terminology (high-level semantic qualifiers); and to gain a better understanding of the experts' language used in these subjective judgements. METHODS: Six experienced medical educators from urban and rural environments were purposefully selected. Each educator reviewed a registrar clinical case analysis in a think out loud manner. The transcribed data were analyzed, codes were identified and ordered into themes. Analysis continued until saturation was reached. RESULTS: Five themes with subthemes emerged. The main themes were: (1) Demonstration of expertise; (2) Personal credibility; (3) Professional credibility; (4) Using a predefined structure and (5) Relevance. DISCUSSION: Analogous to what experienced clinicians do in clinical reasoning, experienced medical educators verbalize their judgements using high-level semantic qualifiers. In this study, we were able to unpack these. Although there may be individual variability in the exact words used, clear themes emerged. These findings can be used to develop a helpful shared narrative for educators in observation-based assessment. The provision of a rich, detailed narrative will also assist in providing clarity to registrar feedback with areas of weakness clearly articulated to improve learning and remediation.

Temas de Bioética e de Biossegurança para uso de professores da educação secundária na preparação da autonomia de jovens entre 12 e 17 anos / Bioética y Bioseguridad para uso de profesores de la educación secundaria en la promoción de la autonomía de jóvenes entre 12 y 17 años / Bioethics and biosafety issues for the use of teachers in secondary education in the preparation of the autonomy of young people between 12 and 17 years / Bioètica i bioseguretat per a ús de professors d'educació secundària en la promoció de l'autonomia de joves entre 12 i 17 anys

A educação é crucial para a alocação da liberdade de decisão e autonomia, que possibilita a real dignidade aos indivíduos. A compreensão dos avanços científico-tecnológicos favorece a redução das desigualdades sócio-político-econômicas e culturais na população. Este artigo propõe temas para a abordagem dos professores sobre bioética e biossegurança no ensino secundário. Os professores podem escolher e adaptar temas, de acordo com as indicações institucionais, sua experiência e percepção, considerando o tempo, as idades, as características regionais e a realidade dos alunos

En los últimos años, el consentimiento informado del paciente ha asumido un papel tan importante en la relación médico-paciente, que ha cambiado el sistema de responsabilidad penal del médico en caso de intervención sin consentimiento, incluso en casos con resultados exitosos. También ha habido propuestas legislativas para introducir el delito de intervención médica arbitraria, pareciendo muy difícil encontrar una solución a este conflicto. En la actualidad, el Parlamento italiano examina una propuesta de ley sobre voluntades anticipadas, centradas en el consentimiento del paciente, que pueden no prestarse, o revocarse después de haberse dado, también para tratamientos como la nutrición y la hidratación artificial, eximiendo de toda responsabilidad civil y penal al médico. Es evidente que tal énfasis en el consentimiento informado, que involucra con tal fuerza al paciente en su tratamiento, está tomando un camino peligroso que puede vaciar por completo la alianza terapéutica médico-paciente que se juega en el campo de la atención médica

In recent years, informed consent of the patient has assumed such an important role in the physician-patient relationship that it has changed the system of criminal liability of the physician in case of intervention without consent, even in cases with successful results. There have also been legislative proposals to introduce the crime of arbitrary medical intervention, making it difficult to find a solution to this conflict. At present, the Italian Parliament is examining a draft bill on advanced directives, focusing on patient consent, which may not be given, or may be revoked after they have been given, also for treatments such as artificial nutrition and hydration, exempting the doctor from all civil and criminal liability. It is evident that such an emphasis on informed consent, which involves the patient in his treatment, is taking a dangerous path that can completely empty the doctor-patient therapeutic alliance played out in the field of medical care

L'educació és fonamental per a la llibertat i l'autonomia, que donen dignitat a les persones. La comprensió dels avanços científics i tecnològics afavoreix la reducció de les desigualtats socioculturals i políticoeconòmiques entre els ciutadans d'una població. En aquest article es proposen exemples de temes de bioètica i de bioseguretat per a ús de docents a l'escola. Els mestres poden adaptar els temes transversalment segons les exigències institucionals, la seva experiència i percepció, considerant les edats, temps, característiques regionals i realitats dels seus alumnes

Democratización de la comunicación, aprendizaje mutuo y acción política colectiva: reflexiones desde Guatemala / Democratization of communication, mutual learning and collective action: Thoughts from Guatemala / Democratització de la comunicació, aprenentatge mutu i acció política col·lectiva: reflexions des de Guatemala

Cuidar del planeta es una responsabilidad común, para ello, el diálogo intercultural es ahora más necesario que nunca. Este artículo pretende analizar herramientas desarrolladas en Guatemala que promueven la democratización de la comunicación, el aprendizaje mutuo y la acción política colectiva para garantizar los derechos de los Pueblos Indígenas. Este análisis tiene el fin de brindar una oportunidad de aprender de voces ausentes en nuestros medios de comunicación, fomentar la cooperación y promover la crítica a las políticas de nuestros países que fomentan un sistema desigual e injusto a escala local y global

Caring for the planet is a shared responsibility. Thus, intercultural dialogue is now more necessary than ever. This article aims to analyse some tools developed in Guatemala that promote democratization of communication, mutual learning and collective action in order to guarantee the rights of Indigenous Peoples. These examples are presented here with the goal to encourage us to learn from absent voices in our media and to be more critical with respect to unequal and unfair policies in our countries, whether in a global or a local context

Cuidar del planeta és una responsabilitat comuna, per això, el diàleg intercultural és ara més necessari que mai. Aquest article pretén analitzar eines desenvolupades a Guatemala que promouen la democratització de la comunicació, l'aprenentatge mutu i l'acció política col·lectiva per a garantir els drets dels Pobles Indígenes. Aquest anàlisi vol brindar l'oportunitat d'aprendre de veus absents als nostres mitjans de comunicació, fomentar la cooperació i promoure la crítica a les polítiques dels nostres països que fomenten un sistema desigual i injust a escala local i global

Informed consent learning: Needs and preferences in medical clerkship environments.

PURPOSE: Limited information exists regarding students' routine educational needs in support of ethics and professionalism practices faced in real clinical practice. As such the authors aimed to explore medical students learning needs and preferences for informed consent and relevant ethical issues in the clerkship environments. MATERIALS AND METHODS: A cross-sectional study using a self-administered, printed survey distributed to final year clinical clerks. RESULTS: 84% completed the survey. Students indicated the need for more attention to all topics related to informed consent (mean = 7.1 on a scale of 0 to 9; ±1.2). Most additional instructional attention was requested for topics raised in discussions with patients concerning the risks, benefits and alternatives to recommended treatments (7.3 ±1.4). The cohort expressed the need for education in the care of vulnerable patients (7.2 ±1.2) with a maximum score for the care of abused children. Women perceived greater need for education concerning informed consent than male respondents (p>0.05). There were significant differences between students who scored high or low on the item "being treated in professional manner" and "endorsement of educational needs for care of adolescents" (p = 0.05). CONCLUSION: There was heightened perception among final year medical students of the need for greater attention to be paid to informed consent education.

Los medios de enseñanza en la didáctica especial de la disciplina Anatomía Humana / Teaching aids in the special didactics of the matter Human Anatomy

RESUMEN La anatomía humana, ciencia independiente desde la Edad Antigua, ha evolucionado históricamente en correspondencia con cambios políticos, económicos, sociales y el desarrollo científico-técnico. Sin embargo, existen indefiniciones acerca de su didáctica especial, con diferentes criterios sobre cómo ejecutar el proceso de enseñanza aprendizaje, en particular al referirse a los métodos y los medios de enseñanza a emplear y aunque de modo general se asume el uso del cadáver como medio de enseñanza idóneo, existen diferentes tendencias al respecto. Los autores, mediante análisis de diversas fuentes bibliográficas, realizaron una sistematización acerca del uso de los medios de enseñanza en la didáctica especial de la anatomía humana en la actualidad. La sistematización efectuada mostró que el cadáver o piezas anatómicas preparadas continúan siendo el medio de enseñanza idóneo, pero también resulta importante el uso de otros medios y proponen que, en el tratamiento didáctico referido al uso de los medios de enseñanza en la disciplina, se consideren exigencias didácticas o regularidades como la interacción con diversos medios que semejando la realidad anatómica lo acerquen a la misma, proceso en el que deben ser guiados para establecer los nexos y relaciones entre los órganos, homogeneidad y diferencia referente a su estructura y sistemas que integran, así como la interdependencia forma-función, para lo cual es importante estudiar los contenidos teóricos interactuando con la observación anatómica, esto permite comprender y asimilar de modo significativo el contenido que se estudia (AU).

ABSTRACT Human Anatomy, an independent science form the Old Age, has historically evolved in correspondence with the politic, economic and social changes and the technical scientific development. However, there are still unclear definitions on its special didactics, with different criteria on how to develop the teaching learning process, particularly referring to teaching methods and aids to use; although it is assumed in general the dead body use as a suitable teaching aid, there are different tendencies about it. The authors, through the analysis of several bibliographic sources, made a systematization on the use of teaching aids in the special didactics of Human Anatomy nowadays. It showed that the dead body or prepared anatomic pieces are still the appropriate teaching aid, but it is also important the use of other aids, proposing the consideration of didactic exigencies or regularities like the interaction with several aids that, resembling the anatomical reality, approach to it, process in which they should be guided to establish the connections and relations between organs, the homogeneity and difference according to their structure and systems they take part of, and also the interdependency form-function; for all of that it is important to study the theoretical content interacting with the anatomic observation; it allows to understand and significantly integrate the studied content (AU).

Los medios de enseñanza en la didáctica especial de la disciplina Anatomía Humana / Teaching aids in the special didactics of the matter Human Anatomy

RESUMEN La anatomía humana, ciencia independiente desde la Edad Antigua, ha evolucionado históricamente en correspondencia con cambios políticos, económicos, sociales y el desarrollo científico-técnico. Sin embargo, existen indefiniciones acerca de su didáctica especial, con diferentes criterios sobre cómo ejecutar el proceso de enseñanza aprendizaje, en particular al referirse a los métodos y los medios de enseñanza a emplear y aunque de modo general se asume el uso del cadáver como medio de enseñanza idóneo, existen diferentes tendencias al respecto. Los autores, mediante análisis de diversas fuentes bibliográficas, realizaron una sistematización acerca del uso de los medios de enseñanza en la didáctica especial de la anatomía humana en la actualidad. La sistematización efectuada mostró que el cadáver o piezas anatómicas preparadas continúan siendo el medio de enseñanza idóneo, pero también resulta importante el uso de otros medios y proponen que, en el tratamiento didáctico referido al uso de los medios de enseñanza en la disciplina, se consideren exigencias didácticas o regularidades como la interacción con diversos medios que semejando la realidad anatómica lo acerquen a la misma, proceso en el que deben ser guiados para establecer los nexos y relaciones entre los órganos, homogeneidad y diferencia referente a su estructura y sistemas que integran, así como la interdependencia forma-función, para lo cual es importante estudiar los contenidos teóricos interactuando con la observación anatómica, esto permite comprender y asimilar de modo significativo el contenido que se estudia (AU).

ABSTRACT Human Anatomy, an independent science form the Old Age, has historically evolved in correspondence with the politic, economic and social changes and the technical scientific development. However, there are still unclear definitions on its special didactics, with different criteria on how to develop the teaching learning process, particularly referring to teaching methods and aids to use; although it is assumed in general the dead body use as a suitable teaching aid, there are different tendencies about it. The authors, through the analysis of several bibliographic sources, made a systematization on the use of teaching aids in the special didactics of Human Anatomy nowadays. It showed that the dead body or prepared anatomic pieces are still the appropriate teaching aid, but it is also important the use of other aids, proposing the consideration of didactic exigencies or regularities like the interaction with several aids that, resembling the anatomical reality, approach to it, process in which they should be guided to establish the connections and relations between organs, the homogeneity and difference according to their structure and systems they take part of, and also the interdependency form-function; for all of that it is important to study the theoretical content interacting with the anatomic observation; it allows to understand and significantly integrate the studied content (AU).

A tool for the consensual analysis of decision-making scenarios.

The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals (4-12) to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework's five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. The design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students.

Consideraciones sobre la enseñanza de las falsas cognadas en la disciplina Inglés en Ciencias Médicas / Consideration about the teaching of the false cognate words in the English Discipline in Medical Sciences

Introducción: Una de las particularidades que ha distinguido el lenguaje médico en el siglo XXI es el predominio del idioma inglés como lengua internacional de la Medicina. La Medicina es un campo del saber amplio y multidisciplinar, por lo que hay que tener en cuenta el significado exacto de las palabras en el contexto de que se trate, de aquí que la traducción correcta de las falsas cognadas del inglés al español es fundamental para la comprensión. Objetivo: Exponer algunas consideraciones sobre la enseñanza de las falsas cognadas en la disciplina Inglés en la Universidad de Ciencias Médicas. Material y Método: La información se obtuvo mediante métodos teóricos de análisis y síntesis de revisiones documentales y bibliográficas sobre el tema. Desarrollo: La traducción inadecuada de las falsas cognadas conduce a un proceso de erosión y empobrecimiento progresivo de nuestra lengua materna, y en no pocas ocasiones transmite un sentido erróneo de lo que se comunica. Conclusiones: El uso correcto de las falsas cognadas es un aspecto esencial para una comunicación eficiente. Esto sugiere que la enseñaza de las falsas cognadas tiene que ser integrada con otros aspectos lingüísticos para que el estudiante aprenda a reconocer y a utilizar estas palabras, ya que el uso preciso de la terminología influye decisivamente en el ejercicio profesional(AU)

Introduction: One of the peculiarities that have characterized the medical area in the 21st century is the predominance of English as an international language. Medicine is an ample and multidisciplinary field of study, so it is necessary to take into account the precise meaning of words according to the context. In this regard, the accurate translation of false cognates from English to Spanish is indispensable for a correct comprehension. Objective: To take into consideration the teaching of false cognate words in the English Discipline in the University of Medical Sciences. Material and Methods: The information was obtained by means of theoretical methods of analysis and synthesis of bibliographic review on the topic. Development: The incorrect translation of false cognate words leads to a process of gradual erosion of our mother tongue, and in many cases, it conveys a wrong meaning. Conclusions: The correct use of false cognate words is essential for an effective communication. In this sense, the teaching of false cognates has to be incorporated to the syllabus, along with other linguistic aspects, for the students to learn how to recognize and use these words, as the precise use of terminology is crucial for a good professional performance(AU)