Medical Professionalism and Its Association with Dropout Intention in Peruvian Medical Students during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic introduced unprecedented challenges to medical education systems and medical students worldwide, making it necessary to adapt teaching to a remote methodology during the academic year 2020-2021. The aim of this study was to characterize the association between medical professionalism and dropout intention during the pandemic in Peruvian medical schools. METHODS: A cross-sectional online-survey-based study was performed in four Peruvian medical schools (two public) during the academic year 2020-2021. Medical students, attending classes from home, answered three scales measuring clinical empathy, teamwork, and lifelong learning abilities (three elements of medical professionalism) and four scales measuring loneliness, anxiety, depression, and subjective wellbeing. In addition, 15 demographic, epidemiological, and academic variables (including dropout intention) were collected. Variables were assessed using multiple logistic regression analysis. RESULTS: The study sample was composed of 1107 students (390 male). Eight variables were included in an explanatory model (Nagelkerke-R2 = 0.35). Anxiety, depression, intention to work in the private sector, and teamwork abilities showed positive associations with dropout intention while learning abilities, subjective wellbeing, studying in a public medical school, and acquiring a better perception of medicine during the pandemic showed a negative association with dropout intention. No association was observed for empathy. CONCLUSIONS: Each element measured showed a different role, providing new clues on the influence that medical professionalism had on dropout intention during the pandemic. This information can be useful for medical educators to have a better understanding of the influence that professionalism plays in dropout intention.

[Validation of a belief scale regarding adherence to iron supplementation treatment in mothers of children with anemia]. / Validación de una escala de creencias sobre la adherencia al tratamiento con suplementos de hierro en madres de niños con anemia.

Introduction: Introduction: anemia in children can cause cognitive and motor deficits that can lead to difficulties in academic performance, physical endurance, affecting health and well-being Objective: to develop and validate a scale of beliefs about adherence to iron supplementation treatment in mothers of children with anemia (SBAIST) living in a high altitude region of Peru. Methods: a cross-sectional study was conducted in 192 mothers of children with anemia living in a high altitude region of Peru. The Health Belief Model (HBM) was used to develop and validate the SBAIST. Expert judgment analysis (Aiken's V) was used for content validity and exploratory factor analysis for construct validity. Reliability was determined by internal consistency. Results: for content validity, Aiken's V test showed concordant values for relevance (0.60 to 0.90), relevance (0.75 to 0.95), clarity (0.80 to 0.90) and total scale (0.75 to 0.92). Cronbach's alpha values per question ranged from α = 0.70 to 0.81, and for total scale was α = 0.75. The exploratory factor analysis (EFA) reflected Kaiser-Meyer-Olkin (KMO) values of 0.733, Bartlett's test of sphericity indicated a value of 968.680 (p < 0.001). The eigenvalues in the five dimensions reflected values from 1.05 to 4.03. The percentage of variance for factor 1 (barriers = 33.58 %), factor 2 (severity = 12.61 %), factor 3 (action cues = 10.78 %), factor 4 (barriers = 8.07 %), factor 5 (susceptibility = 7.63 %), and for the total scale was 74.12 %. Conclusion: HBM is a useful tool that allowed validation of the scale of beliefs about adherence to iron supplementation treatment in mothers of children with anemia living at high altitude in Peru.

Introducción: Introducción: la anemia en los niños puede provocar deficiencias cognitivas y motoras que pueden conducir a dificultades en el rendimiento académico y la resistencia física, afectando a la salud y el bienestar. Objetivo: desarrollar y validar una escala de creencias sobre la adherencia al tratamiento con suplemento de hierro en madres de niños con anemia (ECATSH) que viven en una región de altitud del Perú. Métodos: se efectuó un estudio transversal en 192 madres de niños con anemia que viven en una región de elevada altitud del Perú. Se utilizó el modelo de creencias de salud (MCS) para desarrollar y validar la ECATSH. Para la validez del contenido se utilizó el análisis de juicio de expertos (V de Aiken) y para la validez del constructo, el análisis factorial exploratorio. La confiabilidad se determinó por consistencia interna. Resultados: en la validez del contenido, la prueba V de Aiken reflejó valores concordantes para la pertinencia (0,60 a 0,90), relevancia (0,75 a 0,95), claridad (0,80 a 0,90) y la escala total (0,75 a 0,92). Los valores de la alfa de Cronbach por pregunta oscilaron desde α = 0,70 hasta 0,81, y para la escala total fue de α = 0,75. El análisis factorial exploratorio (AFE) reflejó valores de Kaiser-Meyer-Olkin (KMO) de 0,733, la prueba de esfericidad de Bartlett indicó un valor de 968,680 (p < 0,001). Los valores propios en las cinco dimensiones reflejaron valores desde 1,05 hasta 4,03. El porcentaje de la varianza para el factor 1 (barreras = 33,58 %), factor 2 (gravedad = 12,61 %), factor 3 (señales de acción = 10,78 %), factor 4 (barreras = 8,07 %), factor 5 (susceptibilidad = 7,63 %) y total de la escala fue de 74,12 %. Conclusión: el MCS es una herramienta útil que permitió validar la escala de creencias sobre la adherencia al tratamiento con suplemento de hierro en madres de niños con anemia que viven a elevada altitud del Perú.