Rethinking premedical education.

The world needs more physicians. Increasing their numbers alone won't solve the many problems associated with improving health care. But it doesn't help to have a dearth of doctors, who were generally in short supply before COVID-19 struck. The pandemic has only exacerbated doctor shortages everywhere. This doesn't bode well for a world that must prepare for future pandemics and for populations that are both growing and aging. Better health outcomes require more physicians. So, where are the bottlenecks?

Primeros encuentros clínicos con pacientes: un estudio de la neurofobia y empatía en estudiantes de medicina / First clinical encounters with patients: A study of neurophobia and empathy in medical students

INTRODUCCIÓN: El temor hacia las neurociencias y a la neurología clínica por parte de los estudiantes, mejor conocido como neurofobia, dificulta la relación médico-paciente. La ansiedad creada en los encuentros clínicos obstaculiza el manejo efectivo y la creación de lazos como la empatía. El objetivo de este estudio fue evaluar los niveles de neurofobia y empatía que los estudiantes de medicina demuestran hacia los pacientes en el servicio de neurología. MATERIAL Y MÉTODOS: El diseño de la investigación fue cuantitativo, descriptivo y transeccional, con una muestra de 98 estudiantes del programa de medicina de una universidad privada. Se adaptó un instrumento y se utilizaron 19 ítems con posterioridad al encuentro clínico. RESULTADOS: Se encontró evidencia de neurofobia, siendo esta de mayor grado en mujeres. También se observaron altos niveles de empatía en los alumnos, los hombres presentaron un nivel de empatía significativamente menor. DISCUSIÓN: Los estudiantes presentaron evidente preocupación sobre su capacidad de manejar pacientes con enfermedad neurológica de forma autodirigida. Los resultados sobre empatía fueron más favorables que en otros estudios. Futuros trabajos pudieran adentrarse en el análisis de si estos niveles son sostenibles a largo plazo

INTRODUCTION: Fear of neurosciences and clinical neurology of students, best known as neurophobia, affects the doctor-patient relationship. The anxiety of clinical encounters interferes with effective management and the creation of inter-personal bonding, such as empathy towards patients. The objective of this study was to assess the levels of neurophobia and empathy that medical students show towards patients in the Neurology Department. MATERIAL AND METHODS: A quantitative, descriptive and cross-sectional study was conducted on a sample of 98 students of a private university. A clinical encounter evaluation tool was adapted and 19 items were then used to assess it afterwards. RESULTS: There was evidence of neurophobia, existing in a greater degree in female students. High levels of empathy were observed, although there were significantly lower levels shown by males. DISCUSSION: The students have an obvious concern as regards their ability to manage patients with neurological disease in a self-directed manner. The results regarding empathy were more favourable than previous studies. Future research must analyse these levels further, questioning if these could be preserved in the long-term

Desarrollo de un programa formativo transversal e integral en competencias clínicas, de comunicación e investigación en el 6. o curso del Grado en Medicina / Development of a cross-cutting and comprehensive training program skills clinics, communication and research in the 6th course of the Degree in Medicine

INTRODUCCIÓN: Durante el curso académico 2015-16 se implantó el 6.o curso del Grado de Medicina en la Facultad de Medicina y Ciencias de la Salud de la Universidad de Alcalá. Comprende prácticas clínicas tuteladas y trabajo fin de grado/máster. La Facultad de Medicina y Ciencias de la Salud quería que el programa formativo fuera integral e integrador centrado en la adquisición y potenciación de competencias clínicas, de comunicación e investigación, con una estructura de coordinación que permitiera una evaluación y detección continua de desviaciones, y por supuesto establecer una evaluación de los resultados a medio y largo plazo. El objetivo de este trabajo es presentar el programa formativo desarrollado. MATERIALES Y MÉTODOS: Se formó un equipo de docente y estudiantes para diseñar el curso, con un calendario de reuniones y un programa de acciones a llevar a cabo, siempre intentando que todas las decisiones fueran consensuadas, se tuvieran en cuenta los diferentes escenarios, con herramientas comunes didácticas y de evaluación, flexibles y adaptadas a los diferentes entornos. RESULTADOS: El curso tiene diversidad de entornos y actividades docentes. Las rotaciones integran al estudiante en los servicios y unidades asistenciales. Además, se realizan actividades innovadoras transversales en la Facultad. Se ha diseñado una estructura de coordinación del programa y para su valoración los instrumentos tanto de evaluación del estudiante como del programa son variados y complejos. Se han diseñado numerosas encuestas de opinión que reflejan una satisfacción muy elevada y los resultados académicos son excelentes. CONCLUSIONES: Se ha conseguido desarrollar un programa formativo integral e integrador, con una estructura de coordinación y unos instrumentos de evaluación adecuados. Los indicadores académicos y de opinión son muy positivos e indican que los objetivos de aprendizaje se cumplen con éxito. La coordinación es eficaz y homogeniza la docencia en entornos diferentes, facilitando la detección y subsanación de deficiencias

INTRODUCTION: During 2015-16 academic implanted the 6th course of medicine degree in the Faculty of Medicine and Health Sciences of the Universidad de Alcalá. Includes clinical practices and master's dissertation. The Faculty of Medicine and Health Sciences wanted the training program to be integral and integrator focused on the acquisition and promotion of clinical skills, communication and research, with a coordination structure that would enable an assessment and continuous detection of deviations, and of course establish an assessment of results in the medium and long term. The objective of this work is to present the developed training programme. MATERIALS AND METHODS: A team of teachers and students was formed to design the course, with a calendar of meetings and a program of actions to be carried out, always trying to that all decisions were consensual, the different took into account scenarios, with common teaching tools and assessment, flexible and adapted to the different environments. RESULTS: The course has diversity of environments and teaching activities. Rotations integrated student services and healthcare units. In addition, are cross-cutting innovative activities at the Faculty. A coordination of the program structure is designed and for their evaluation, both of student assessment and program, instruments are varied and complex. Numerous opinion tests that reflect a very high satisfaction and academic results are excellent have been designed. CONCLUSIONS: We have managed to develop a training program comprehensive and inclusive, with a coordination structure and appropriate assessment tools. Academic and opinion indicators are very positive and indicate that the learning objectives are met with success. He has been established very effective coordination to homogenize the teaching in different environments, and facilitates the detection and correction of deficiencies

Introducción al uso de imágenes digitales en formato web en el aprendizaje de la histología humana / Introduction to the use of digital images in a web format in learning human histology

INTRODUCCIÓN: La microscopia virtual se ha convertido en un recurso educativo alternativo para la enseñanza de la organización estructural de células, tejidos y órganos. Su uso mediante el acceso a páginas web de distintas instituciones actúa como refuerzo y sirve como material adicional combinado con el uso de la microscopia óptica convencional en las prácticas de la asignatura de Histología. OBJETIVO: Evaluar el interés de los alumnos de la asignatura Histología de Sistemas del 2.° curso del grado en Medicina por las imágenes virtuales procedentes de páginas web como complemento educativo. MATERIAL Y MÉTODO: El estudio se realizó sobre una muestra de 156 estudiantes del 2.° curso de Medicina mediante un acercamiento cuantitativo para realizar un análisis descriptivo. RESULTADOS: Los conceptos con las valoraciones más altas fueron para utilidad y mejora en comparación con los atlas convencionales. CONCLUSIONES: Los datos presentados en este estudio muestran una preferencia, todavía tímida, de estudio de la Histología mediante aprendizaje electrónico, aunque junto con los recursos tradicionales

INTRODUCTION: Virtual microscopy has become an educational resource alternative for teaching the structural organization of cells, tissues and organs. Its use through access to web pages of different institutions acts as reinforcement and additional material combined with the use of conventional optical microscopy in histology practices. OBJECTIVE: To evaluate the interest of the second-year medical students for virtual images from educational web pages as a complement during histology study. MATERIAL AND METHOD: The study was conducted on 156 second-year medical students through a quantitative approach to perform a descriptive analysis. RESULTS: Usefulness and improvement related to conventional atlas achieved the highest scores. CONCLUSIONS: The data presented in this study demonstrate a preference, still timid, for the study of histology through electronic learning nevertheless along with the traditional educational tools

Evaluación de la estrategia didáctica de dramatización en los estudiantes de la asignatura de sociología de la carrera de medicina de la Universidad de Antofagasta / Evaluation of the didactic strategy of dramatization in the students of the subject of Sociology of the career of Medicine of the University of Antofagasta

Introducción: Los nuevos paradigmas del proceso de enseñanza-aprendizaje y los criterios de aseguramiento de la calidad de la educación superior en Chile exhortan a las universidades y programas de pregrado a la adopción de modelos educativos institucionales que potencien el aprendizaje centrado en el estudiante y a la utilización de estrategias didácticas que aseguren la significación de los aprendizajes. Objetivo: Evaluar la estrategia didáctica de dramatización ejecutada por los estudiantes de segundo año de la carrera de medicina de la Universidad de Antofagasta en la asignatura de sociología. Sujetos y métodos: Estudio cuantitativo transversal de una muestra de 42 estudiantes (de un total de 48) de la asignatura de sociología de la carrera de medicina de la Universidad de Antofagasta, que respondieron el cuestionario de evaluación de la estrategia didáctica de dramatización utilizada para el abordaje de la unidad de aprendizaje IV de la asignatura. Se utilizaron escalas de respuesta mixtas. Resultados: Los resultados se concentran en las categorías de respuesta que refieren acuerdo ('totalmente de acuerdo' y 'de acuerdo'), especialmente cuando se pregunta por la dinámica de trabajo del grupo. Conclusión: La estrategia didáctica de dramatización potencia el aprendizaje centrado en el estudiante. Por otra parte, permite evidenciar aspectos prácticos de la relación médico-paciente, revelando dimensiones del ser y saber hacer

Introduction: The new paradigms of the teaching-learning process and the higher education quality assurance criteria in Chile encourage universities and undergraduate programs to adopt institutional educational models that promote studentcentered learning and the use of strategies didactic that ensure the significance of learning. Aim: To evaluate the didactic strategy of dramatization carried out by the second year students of the Medicine career of the University of Antofagasta in the subject of Sociology. Subjects and methods: Cross-sectional quantitative study, whose sample was 42 students (out of a total of 48) of the subject of Sociology of the Medicine career at the University of Antofagasta, who answered the evaluation questionnaire of the didactic strategy of dramatization used for the approach of the unit of learning IV of the subject. Mixed response scales were used. Results: The results are concentrated in the response categories that refer agreement ('totally agree' and 'agree'), especially when asked about the work dynamics of the group. Conclusion: The didactic strategy of dramatization enhances student-centered learning. On the other hand, it allows to demonstrate practical aspects of the doctor-patient relationship, revealing dimensions of being and knowing how to do

Patient Shadowing: A Useful Research Method, Teaching Tool, and Approach to Student Professional Development for Premedical Undergraduates.

PROBLEM: Questions have been raised about whether undergraduate institutions are effectively preparing premedical students in the sociobehavioral and cognitive reasoning content found on the revised Medical College Admission Test, providing opportunities to understand and apply these sociobehavioral and cognitive reasoning concepts in real-world scenarios, and offering career exploration opportunities. APPROACH: The Research in Physician-Patient Interactions course is a 15-week course designed for premedical students and taught through the collaboration of an emergency medicine physician and an applied medical anthropologist. As of January 2016, the course is offered each spring at the University of South Florida, Tampa, Florida. The course provides opportunities for patient and physician shadowing within the anthropological methodological framework of participant observation. Other qualitative research methods are also taught, and students complete a group patient experience quality improvement project. OUTCOMES: Thematic analysis of students' field notes and reflection essays and follow-up communications with course alumni revealed 3 salient themes regarding the utility of patient shadowing as a research method that provides unique types of qualitative data, as a teaching tool for premedical students to understand the perspectives of patients, and as an approach to developing the professional skills necessary in health care, such as effective communication styles, establishment of rapport, and empathy. NEXT STEPS: Similar courses should be offered at other universities to premedical students. While it appears that patient shadowing experiences have a great impact during premedical education, there may also be value in integrating a similar experience into medical school and residency training.

Diseño de un modelo de evaluación mediante la integración de tecnología inmersiva y a distancia / Design of an assessment model by integrating immersive and remote technology

INTRODUCCIÓN: Uno de los principales retos en educación médica se encuentra en ofrecer una evaluación confiable, precisa, objetiva y auténtica. Particularmente la evaluación de competencias interpersonales, la presencia de múltiples evaluadores favorece la percepción de estos principios por parte del estudiante evaluado. El objetivo de esta investigación fue diseñar un modelo de evaluación innovador, que integre como elementos distintivos el uso de tecnología inmersiva, una estandarización de instrumentos de evaluación, integración de múltiples evaluadores y la posibilidad realizar una valoración remota en tiempo real o diferido. MATERIAL Y MÉTODOS: Se realizó un estudio cuantitativo, descriptivo y transversal con una muestra de 51 estudiantes del segundo año de la carrera de medicina de una universidad mexicana. Participaron en la simulación de un caso clínico con un paciente estandarizado, siendo evaluados de forma presencial y remota por 15 profesores de 3 diferentes universidades. Se utilizó estadística descriptiva para valorar las tendencias por cada elemento incluido. RESULTADOS: Los resultados más favorables se encuentran en el momento del inicio del encuentro con una media de 1,364, siendo más alto particularmente en los elementos de formalidad, con media de 1,636 y modales con media de 1,400. El desempeño menos favorable se encontró durante el encuentro, con media de 0,856, siendo de especial interés el demostrado durante la exploración con media de 0,818. DISCUSIÓN: El uso de tecnologías inmersivas permite hacer una evaluación confiable, precisa, objetiva y auténtica a través de la estandarización de instrumentos de evaluación, con la posibilidad de integrar múltiples evaluadores de forma presencial y a distancia. Esta iniciativa permitió una colaboración interinstitucional para el análisis de los estándares del currículo, a través de distintas regiones geográficas y culturas

INTRODUCTION: One of the main challenges in medical education is to offer an assessment that is reliable, accurate, objective, and authentic. Particularly in interpersonal skills, and having multiple observers, it benefits the student's perception of these principles. The aim of this project was to design and implement an assessment model that integrates the distinctive elements of the use of immersive technology, standardisation of evaluation tools, multiple observers, and remote assessment. MATERIAL AND METHODS: A quantitative, descriptive and cross-sectional study was conducted with a sample of 51 second year medical students from a Mexican university. They participated in the simulation of a clinical case with a standardised patient, being assessed by 15 teachers from 3 different universities. Descriptive statistics were used to assess trends for each measurement included in the study. RESULTS: The best results were obtained at the beginning of the medical encounter, with a mean of 1.364. The elements that were particularly high were formality with a mean of 1.636, and manners with 0.856. The least favourable results were obtained during the encounter, the one obtained in the physical examination being of particular interest, with a mean of 0.818. DISCUSSION: The use of immersive technologies helps to provide a reliable, accurate, objective, and authentic evaluation through the standardisation of the evaluation tools, with the possibility of the integration of multi-assessors on site, or remotely. This initiative led to an inter-institutional collaboration for the analysis of curriculum standards across different geographic regions and cultures

Diagnosing differences in what Introductory Biology students in a fully online and an in-person biology degree program know and do regarding medical school admission.

Increasingly, institutions of higher education are adopting fully online degree programs to provide students with cost-effective, accessible postsecondary education. A concern these degrees raise is: Will students be prepared for the next step of their career paths after completing their Bachelor's degree online? Biology undergraduates often begin their degrees wanting to become medical doctors, but no studies have explored whether students in a fully online biology degree program are being prepared to be admitted to medical school. In this study, we surveyed Introductory Biology students at one institution who were pursuing Bachelor of Science degrees in Biological Sciences, either in an online or an in-person program. The most prevalent career goal for both in-person students (65.2%) and online students (39.7%) was a medical doctor. Online students were more confident in their intentions to become doctors than their in-person peers. However, online students knew fewer criteria that medical schools consider when admitting students than in-person students [in-person: mean = 3.7 (SD 1.6); online: mean =2.7 (SD 1.7)] and were less likely to plan to become involved in premedical activities, such as undergraduate research. Finally, compared with in-person students, fewer online students were able to name at least one science student (in-person: 76.7%; online: 9.7%), academic advisor (in-person: 21.3%; online: 6.5%), and faculty member (in-person: 33.7%; online: 6.5%) with whom they could talk about pursuing a career in medicine. This work highlights knowledge gaps between students enrolled in a fully online biology degree and an in-person biology degree that are important for developers of online biology degree programs to understand and rectify to better prepare online biology students for admission to medical school.

Comprehensive Medical College Admission Test Preparatory Course as a Strategy to Encourage Premedical Students to Pursue Osteopathic Medicine in Rural Areas.

CONTEXT: Comprehensive Medical College Admission Test (MCAT) preparatory courses could potentially promote interest among premedical students to pursue careers in osteopathic medicine in underserved areas. OBJECTIVE: To determine whether a comprehensive 16-week course centered on MCAT preparation and exposure to an osteopathic medical school setting will promote interest among premedical students to become osteopathic physicians in the rural Southwest. METHODS: At the Burrell College of Osteopathic Medicine in Las Cruces, New Mexico, undergraduate premedical students from the surrounding rural and urban areas completed an all-inclusive 16-week MCAT preparation course. Students were required to have completed medical school prerequisite courses and have a minimum 3.0 grade point average. The program included interactive instructional sessions for teaching material pertinent to the MCAT, an introduction to osteopathic philosophy, workshops for application preparation, a tour of the medical school facilities, full-length practice tests, and mock interviews. After course completion with at least 80% attendance, a survey was conducted to identify effectiveness and outcomes of the course. The survey used a Likert scale that ranged from 1 (strongly disagree) to 5 (strongly agree). RESULTS: Of the 170 student participants, 163 completed the survey. After completing the course, participants felt more knowledgeable about the true nature of medical school and osteopathic medicine (weighted averages, 4.26-4.40) than before the course. Compared with attitudes before taking the course, participants were more inclined to attend an osteopathic medical school and practice rural medicine in the southwestern United States (weighted averages, 4.16-4.45). Participants who completed the course also felt that they were better prepared to take the MCAT (weighted average, 4.37). CONCLUSION: Participant knowledge and attitudes about practicing osteopathic medicine were enhanced after they completed the comprehensive MCAT preparatory course. These results suggest that offering similar courses in osteopathic medical schools throughout the country may improve the outlook of creating a diverse physician workforce that provides health care in rural areas.

Evaluation of critical thinking course for premedical students using literature and film.

PURPOSE: Premedical education is one stage in which various educational approaches are used to promote critical thinking. Given that critical thinking ability could be regarded as one of the intended outcomes of social science and humanities education, this study explored the effectiveness of a course to promote critical thinking in a premedical curriculum using both literature and film. METHODS: Fifty-one 2nd year premedical students enrolled in a 'Critical Thinking for Premeds' course. Students were required to read or watch a selected material, submit group discussion agendas, attend five group discussion sessions, and write critical essays. Five tutors facilitated the group discussions, observed and assessed the students' performance and critical essay. Students' critical thinking disposition and opinion on assigned reading materials were examined before and after the course. A program evaluation survey was conducted to investigate the students' reaction after the course. RESULTS: On average, students appreciated 78.6% of the total assigned materials. The students indicated that group discussions and the narrative comments of facilitators contributed the most to develop critical thinking. After the course, the students' tendency preferring cheaper price books, as well as medicine-related books decreased significantly. Students who had critical essay scores greater than or equal to the median demonstrated a significant improvement in critical thinking disposition scores. CONCLUSION: The course was well-accepted by premedical students and had several positive outcomes. A more effective use of the course could be anticipated with a clearer explanation of the purpose, the consideration of previous reading experience, and use of complementary learning activities.

Intermittent exotropia evaluation using the propedeutics proposed by Kushner: a 25-year study / Avaliação de exotropia intermitente usando propedêutica proposta por Kushner: estudo de 25 anos

ABSTRACT Purpose: To evaluate the clinical and surgical impacts of phenomena that could occur in intermittent exotropia. Methods: The medical records of intermittent exotropia cases from 1991 to 2014 were retrospectively reviewed. All patients underwent a series of measures, including a protocol to assess monocular occlusion based on the propedeutics proposed by Kushner. Results: Outdoor sensitivity was observed in 31% of patients with an undercorrection rate of 44% vs. 18% of cases with no outdoor sensitivity. After 1 h of monocular occlusion, 41% of all patients achieved an increase in deviation with an undercorrection rate of 40%, whereas 25% did not. Conclusion: The results show the importance of complete propedeutics, since there is a higher rate of late undercorrection in cases with outdoor sensitivity and increased deviation after occlusion.

RESUMO Objetivo: Avaliar os impactos clínico e cirúrgico dos fenômenos que podem ocorrer na exotropia intermitente. Métodos: Os prontuários de casos de exotropia intermitente de 1991 a 2014 foram revisados retrospectivamente. Todos os pacientes foram submetidos a uma serie de medidas incluindo o protocolo com oclusão monocular com base na propedêutica proposta por Kushner. Resultados: Outdoor sensitivity foi observada em 31% dos pacientes com taxa de subcorreção de 44% vs. 18% dos casos sem outdoor sensitivity. Após 1 hora de oclusão monocular, 41% de todos os pacientes apresentaram um aumento no desvio com uma taxa de subcorreção 40%, enquanto 25% não. Conclusão: Os resultados demonstram a importância da propedêutica completa, uma vez que há maior taxa de subcorreção tardia nos casos de outdoor sensitivity e maior desvio após a oclusão.

Análisis del programa Propedéutica Clínica y Semiología Médica. Una metodología estructurada por pasos / Analysis of the Syllabus of Semiology and Clinical Propedeutics. Steps-structured methodology

Introducción: Los diseños establecidos en planes y programas de estudios deben ir al unísono de los cambios que la sociedad genera; esto implica su análisis con el propósito de perfeccionarlos de manera permanente. Objetivo: Determinar el alcance y limitaciones que puede tener el plan de estudio de la asignatura Propedéutica Clínica y Semiología Médica. Material y métodos: Se realizó un estudio cualitativo de corte pedagógico entre el 1 de abril y el 31 de junio de 2017, que asume el método dialéctico-materialista con enfoque de sistema como rector del proceso de investigación, para efectuar el análisis crítico a un programa de estudio; la metodología utilizada para ello consta de cinco pasos fundamentales que incluye, entre otros elementos, la pertinencia y la revisión de los componentes del proceso enseñanza-aprendizaje. Resultados y Discusión: Se realizó el análisis crítico del programa, se identifican puntos de mejora y una contradicción didáctica relacionada con el desarrollo del razonamiento clínico en los estudiantes de la carrera de Medicina, al reconocerse una discordancia entre el contenido de la asignatura y la forma ideal de impartirlo, por lo que los autores consideran que es un problema metodológico. Conclusiones: El programa de estudio satisface la idea integradora del comandante Fidel en relación con el proceso docente-educativo en la formación de médicos en Cuba, al orientar integralidad, presencia de la educación en el trabajo, aumento del protagonismo del alumno, con la garantía de su calidad humana, científica y técnica, comprometida con el pueblo. El uso de esta metodología puede generalizarse(AU)

Introduction: The designs established in the different syllabuses should be in complete agreement with the demands of society. Therefore, an analysis should be carried out in order to improve them permanently. Objective: To determine the scope and limitations of the syllabus of the subject Semiology and Clinical Propedeutics. Material and Methods: A qualitative study from a pedagogical perspective was conducted from April 1st to June 31st, 2017, which assumes the materialistic dialectic method with an approach on the system as the main action of the research process in order to carry out a critical syllabus analysis. The methodology used for this consists of five main steps which include, among other elements, the appropriateness and the review of the components of the teaching-learning process. Results and discussion: A critical syllabus analysis was carried out, and aspects for the improvement and a didactic unit of contradiction related to the clinical discussion in the medical students were identified at recognizing a disagreement between the subject contents and the ideal way to teach them, thus considering it a methodological problem. Conclusions: The curriculum satisfies the integrative idea of Commander Fidel in relation to the teaching-learning process for the formation of doctors in Cuba at advising a comprehensive formation, implementing the in-service training, and increasing the students´ leading role that guarantees a human, scientific, and technical quality, directed to give a better care to the people. The use of this methodology can be generalized(AU)

Intermittent exotropia evaluation using the propedeutics proposed by Kushner: a 25-year study.

PURPOSE: To evaluate the clinical and surgical impacts of phenomena that could occur in intermittent exotropia. METHODS: The medical records of intermittent exotropia cases from 1991 to 2014 were retrospectively reviewed. All patients underwent a series of measures, including a protocol to assess monocular occlusion based on the propedeutics proposed by Kushner. RESULTS: Outdoor sensitivity was observed in 31% of patients with an undercorrection rate of 44% vs. 18% of cases with no outdoor sensitivity. After 1 h of monocular occlusion, 41% of all patients achieved an increase in deviation with an undercorrection rate of 40%, whereas 25% did not. CONCLUSION: The results show the importance of complete propedeutics, since there is a higher rate of late undercorrection in cases with outdoor sensitivity and increased deviation after occlusion.

Influencing Mindsets and Motivation in Procedural Skills Learning: Two Randomized Studies.

OBJECTIVES: An incremental (growth) theory of intelligence (mindset), compared with an entity (fixed) mindset, has been associated with improved motivation and performance. Interventions to induce incremental beliefs have improved performance on non-surgical motor tasks. We sought to evaluate the impact of 2 brief interventions to induce incremental beliefs in the context of learning a surgical task. DESIGN: Two randomized experiments. PARTICIPANTS AND SETTING: Secondary school students participating in medical simulation-based training activities at an academic medical center. INTERVENTIONS: We created 4 instructional messages intended to influence mindsets (two 60-second videos in Study 1, 2 fabricated "journal articles" in Study 2). In each study, one message emphasized that ability improves with practice (incremental); the other emphasized that ability is fixed (entity). After reviewing their randomly-assigned message, participants completed a laparoscopic cutting task as many times as they desired. Measurements included performance (product quality, self-reported task, and completion time), task persistence (repetitions), and entity beliefs. RESULTS: Two hundred and three students completed Study 1. Postevent entity beliefs (1 = lowest, 6 = highest) were similar between groups (incremental, 2.0vs entity, 2.0; p = 0.78). Contrary to hypothesis, the incremental video group demonstrated slower time (276vs 191 seconds; p < 0.0001), lower product quality (7.2vs 3.8mm deviation; p < 0.0001), and fewer task repetitions (1.4vs 1.8; p = 0.02). In Study 2, 113 participants provided outcomes related to mindset beliefs, but only 14 provided usable performance outcomes. Postevent entity beliefs were lower in the incremental article group (1.7vs 2.4; p < 0.0001). Task time (507vs 585 seconds; p = 0.40) and quality (7.1vs 7.5mm deviation; p = 0.85) were similar between groups. CONCLUSIONS: Brief motivational interventions can influence procedural performance and motivation. We need to better understand motivation and other affective influences on procedural skills learning. Mindset theory shows promise in this regard.

Aproximación a la investigación en el Grado en Medicina de la Universidad de Oviedo / Approach to research in the Degree of Medicine of the University of Oviedo

Objetivo: Presentar iniciativas de fomento de la investigación científica realizadas en el primer curso del Grado en Medicina. Sujetos y métodos: Participaron 150 estudiantes de primer curso que recibieron lecciones teóricas (12 horas, en grupos de 75) y cuatro sesiones (6 horas y 45 minutos) de seminarios sobre descubrimientos científicos, análisis de publicaciones y diseño experimental, en grupos de 4-5. Las tareas de los seminarios estuvieron disponibles con 7-15 días de antelación y, sobre ellas, debían elaborar una presentación para las sesiones y un documento escrito. Ambas actividades fueron objeto de calificación. La evaluación de la satisfacción de los estudiantes se realizó mediante una encuesta. Resultados: Las tareas relacionadas con descubrimientos científicos se refirieron a aspectos relevantes de la fisiología, la patología, la terapéutica y los desarrollos tecnológicos aplicados a la medicina. También, han analizado y discutido publicaciones científicas y han elaborado propuestas de diseños de investigación a partir de textos breves facilitados por el profesor. Las calificaciones globales obtenidas, sobre cuatro puntos, han sido: 3,71 ± 0,07 y 3,9 ± 0,3 en las tareas sobre descubrimientos y comentarios de artículos científicos, respectivamente, y 3,6 ± 0,2 en el diseño experimental. El 84% de los matriculados cumplimentaron la encuesta que reflejó una opinión favorable (sobre cinco puntos) de los contenidos teóricos (4,01 ± 0,07), seminarios sobre descubrimientos (3,97 ± 0,1) y diseño experimental (3,87 ± 0,1). Conclusiones: Los estudiantes tienen una opinión favorable de las actividades realizadas y consideran que pueden contribuir a la formación de los médicos en investigación

Aim: To present initiatives for the promotion of scientific research in the Degree of Medicine. Subjects and methods: The participants included 150 first-year students who received theoretical lessons (12 hours, in groups of 75) and, in groups of 4-5, four sessions (6 hours and 45 minutes) of seminars on scientific discoveries, publication analysis and experimental design. The topics of seminars were available 7-15 days in advance on which students had to prepare a presentation, and a written document. Both activities were scored. The evaluation of student satisfaction was carried out through a survey. Results: The tasks were related to scientific discoveries and referred to relevant aspects of physiology, pathology, therapeutics and technological developments applied to medicine. Students also analyzed and discussed scientific publications and prepared research design proposals based on short texts provided by the lecturer. The marks obtained, out of four points, were 3.71 ± 0.07 and 3.9 ± 0.3 on the tasks of discoveries and comments of scientific articles, respectively, and 3.6 ± 0.2 in the experimental design. 84% of those enrolled completed the survey that indicated a favorable opinion (out of five points) on the theoretical contents (4.01 ± 0.07) and seminars on discoveries (3.97 ± 0.1) and experimental design (3.87 ± 0.1). Conclusions: The students had a favorable opinion on the activities and considered that they could contribute to the training of research doctors

Aprendizaje y puesta en práctica del protocolo FAST de exploración ecográfica en cursos preclínicos del Grado en Medicina de la Universidad de Murcia / Eco-FAST. Pilot learning by second year medical students, University of Murcia

Objetivo: Integrar los conocimientos impartidos en la asignatura de esplacnología a través del uso práctico del ecógrafo, concretamente mediante el protocolo FAST. Sujetos y métodos: A propuesta del profesor de esplacnología, se diseñó un taller teórico-práctico para un total de 72 alumnos de segundo curso de medicina, el cual se repitió en el año académico sucesivo. Al final del taller, se pasó una encuesta con diferentes ítems a valorar relacionados con el conocimiento adquirido y la organización del taller. Resultados: La valoración de la experiencia fue muy positiva, tanto desde el punto de vista global como de identificación de objetivos anatómicos concretos. Además, el interés por la ecografía y la confianza de los participantes en la práctica de esta técnica se vieron incrementados. Conclusiones: Se ha demostrado que una actividad como la descrita, con un carácter más práctico y real que otros seminarios en cursos preclínicos, puede abordarse con sencillez y, al mismo tiempo, lograr un afianzamiento bastante fiable de los conocimientos impartidos hasta el momento en las asignaturas de anatomía

Aim: To assimilate the knowledge taught in the Splachnology subject by using the sonographical FAST protocol. Subjects and methods: Our teacher proposed us designing a theoretical-practical course for a number of 72 second year Medicine students, which was developed again the next academic year. At the end of the course they received an online survey with different items to evaluate the knowledge acquired and the course preparation. Results: The overall experience and pursue of concrete anatomical objectives was successful. Furthermore, the interest on sonography and self-confidence of the participants improved. Conclusions: It is demonstrated that an activity as such, with a way more practical approach than other courses taught in preclinical studies, can be undertaken with ease and at the same time achieve a further consolidation of the knowledge taught in Anatomy subjects until now

Habilidad de "Describir" para el aprendizaje de las malformaciones congénitas / Ability to "Describe" for the learning of congenital malformations

Introducción: El programa de la disciplina Embriología que se imparte en la República de Angola, como parte del currículo de la carrera de Medicina fue elaborado y desarrollado en Cuba. El medio donde se desarrolló el proceso docente y las características del sistema de salud no son las mismas para lo cual fue concebido. Es importante desarrollar en los estudiantes, no solo las habilidades de promoción y prevención de los defectos, presentes en los objetivos de la disciplina, también, habilidades de identificación y descripción morfológica de los defectos congénitos, para la confección adecuada de la historia clínica en las disciplinas clínicas. Objetivo: Determinar el nivel de desarrollo que alcanzan los estudiantes cuando aplican la habilidad de Describir al utilizar un algoritmo para el aprendizaje de las malformaciones congénitas. Material y Método: Se elaboró un algoritmo basado en el método embriológico; se aplicó en las preguntas iníciales de los seminarios a los estudiantes de segundo año de Medicina en el curso académico 2012, en la Facultad de Medicina de Cabinda en la República de Angola. Conclusiones: Las acciones elaboradas para el desarrollo de la habilidad "Describir" en el estudio de las malformaciones congénitas, permitió al estudiante apropiarse de un conocimiento teórico-morfológico de las características de estos defectos, en la medida que el estudiante aplicó las acciones del algoritmo de esta habilidad adquirió mayor nivel de desarrollo en la habilidad(AU)

Introduction: The syllabus for the Embryology discipline, which is taught in the Republic of Angola as part of the curriculum of the Medical Education was drawn up and developed in Cuba. The environment in which the teaching process developed and the characteristics of the health care system are not the same for which it was conceived. It is not only important to develop students´ skills for the promotion and prevention of defects that are present in the objectives of the discipline, but also identification skills and morphological description of congenital defects for an adequate drawing up of the clinical history in the clinical disciplines. Objective: To determine the level of development reached by the students when they apply the skill of describing using an algorithm for the learning of congenital malformations. Material and Method: An algorithm based on the embryological method was developed; and the initial questions asked in the seminars given to Second Year Medical Students were used in the Medical School of the University of Cabinda in the Republic of Angola during the 2012 Academic Year. Conclusions: The actions developed for the ability to Describe in the study of congenital malformations allowed the student to get a theoretical morphological knowledge of the characteristics of the defects; on the extent to which the student applied the actions of the algorithm, he acquired a higher level of skill development(AU)

Addressing Health Disparities with School-Based Outreach: the Health Career Academy Program.

Pipeline programs address health disparities by promoting academic achievement and entry of low-income ethnic and racial minority youth into healthcare fields. The Health Career Academy (HCA) is a 3-year pipeline program for high school students from low-income, ethnic, and racial minority communities. Health professional students serve as program mentors. The HCA has been implemented in nine US sites, with partnerships between 17 health professional schools and 17 high schools. A total of 386 10th grade students and 95 11th grade students enrolled as participants in the 2015-2016 HCA program. In post-participation surveys, 10th grade students reported that the HCA helped them learn about different healthcare career options, plan for how to reach career goals, and understand how healthcare workers care for patients. Eleventh grade participants noted the program made them aware of the importance of public health and taught them about medical conditions, self-care, and safety. Eighty-six percent of 10th graders and 71% of 11th graders reported that they are considering healthcare careers. Students' favorite aspects of the HCA included the following: time with mentors, learning about science and health, team collaboration and hands-on experiences, field trips, and team presentations. Teachers noted the following as most important in the program: interaction with mentors and healthcare professionals, learning broadly applicable skills, stimulation of interest in health-related careers, presentation skills, and creating optimism about furthering education. The HCA is well received by participants and can be replicated successfully at multiple sites nationally. By providing mentorship, increasing exposure to health professionals and health careers, offering high-level science and health curriculum, and fostering collaboration and presentation skills, the HCA has potential to increase interest in health professions among racial and ethnic minority youth from low-income communities.

A Pipeline Program to Address the South African Crisis in Human Resources for Health.

BACKGROUND: The WHO Africa Region faces a shortage of health workers due to inadequate production of health workers and emigration of physicians and nurses to wealthier countries. South Africa and the United States share a history of discriminatory policies and practices resulting in groups that are under-represented amongst health professionals. One US response is the Area Health Education Centers Program (AHEC), a pipeline program to recruit members of under-represented groups into the health professions. OBJECTIVES: (1) Compare and contrast the United States' AHEC model with that developed in South Africa by Stellenbosch University Faculty of Medicine and Health Sciences SA AHEC in partnership with Morehouse School of Medicine in the United States. (2) Describe a formative evaluation of the Stellenbosch AHEC Program. Methods: Four hundred students (grades 7-12) and 150 teachers participated in SA AHEC with the goal of preparing the students to better compete for university admission. Students received after-school tutoring, holiday schools, and counselling on study skills, health careers, and university entry. Educators received continuing professional education, classroom observation, and feedback. The program was evaluated through a series of interviews and focus groups involving AHEC staff, educators, and parents and caregivers. RESULTS: Program strengths included educator training, collaboration, and increased student maturity, motivation, and academic success. Challenges included limited time with students, the location of some sites, and the educators' need for more engagement with AHEC staff and schools. Quarterly workshops were conducted to address challenges. Over 50% of program alumni are currently enrolled in institutions of higher education. Students will be tracked to determine whether they are able to complete their health professions studies and return to the communities where they grew up, or to similar communities. CONCLUSIONS: With appropriate adaptation and attention to context, it might be possible to implement similar programmes in other African countries. The comparison of the United States and South African models suggested that more parent and teacher participation in an advisory capacity might help to avoid some challenges.