RESUMO
Medical education has implemented various innovative strategies with the purpose to attain better learning achievements. An evaluation is made of the experiences in the competencies approach, new learning technologies, curricular alternatives, professional evaluation and distance education technologies in order to locate them in the areas they belong.
La educación médica ha puesto en práctica diversas estrategias innovadoras con el propósito de alcanzar mejores logros de aprendizaje. Se hace una evaluación de las experiencias relacionadas con el enfoque por competencias, las nuevas tecnologías educativas, las alternativas curriculares, la profesionalización de la evaluación y las técnicas educativas a distancia, para ubicarlas en el lugar que les corresponde.
Assuntos
Educação a Distância , Educação Médica , Currículo , Humanos , AprendizagemRESUMO
Resumen La educación médica ha puesto en práctica diversas estrategias innovadoras con el propósito de alcanzar mejores logros de aprendizaje. Se hace una evaluación de las experiencias relacionadas con el enfoque por competencias, las nuevas tecnologías educativas, las alternativas curriculares, la profesionalización de la evaluación y las técnicas educativas a distancia, para ubicarlas en el lugar que les corresponde.
Abstract Medical education has implemented various innovative strategies with the purpose to attain better learning achievements. An evaluation is made of the experiences in the competencies approach, new learning technologies, curricular alternatives, professional evaluation and distance education technologies in order to locate them in the areas they belong.
Assuntos
Humanos , Educação a Distância , Educação Médica , Currículo , AprendizagemRESUMO
Background: Educational curricula require constant improvement to respond to the needs of students, institutions and society. Objective: To evaluate the Plan de Estudios 2010 of the Facultad de Medicina de la Universidad Nacional Autónoma de México. Methods: Documentary and qualitative study of three phases. First, revision of trends of general medicine in special databases and comparison of curricula between universities. Second, focus groups with clinical teachers and basic sciences to investigate experiences and opinions in relation to trends in general medicine. Third, a "Generalists Committee" was convened to whom the results were presented (phase one and two) and the recommendations were adapted to adapt the results to the general practitioner's context. The participants were informed about the research objective and their participation was voluntary, the anonymity of theirs comments was protected. Results: The trend towards specialization in clinical practice defines the future of general medicine, and the administrative uses have an impact on the practices of the general practitioner and on the patient's medical relationship. Conclusion: Various aspects mainly educational and assistance hindered the quality of the practice of general medicine.
Introducción: los currículos educativos requieren estar en constante perfeccionamiento para responder a las necesidades de estudiantes, instituciones y de la sociedad. Objetivo: evaluar el Plan de Estudios 2010 de la carrera de medicina de la Facultad de Medicina de la Universidad Nacional Autónoma de México. Métodos: estudio documental y cualitativo, de tres fases. En la primera se revisaron las tendencias de la medicina general en bases de datos especializadas y se compararon los planes de estudios entre universidades. En la segunda, se realizaron grupos focales con docentes clínicos y de ciencias básicas para indagar experiencias y opiniones en relación con las tendencias de la medicina general. En la tercera, se convocó a un "Comité de Generalistas" a quienes se les presentaron los resultados de las fases anteriores, y se realizaron las recomendaciones pertinentes para adecuar los resultados al contexto del médico general. La participación de los entrevistados fue voluntaria, fueron informados sobre el objetivo de investigación y se resguardó el anonimato de sus testimonios. Resultados: la tendencia hacia la especialidad en la práctica clínica define el futuro de la medicina general; asimismo, los intereses administrativos repercuten en las prácticas del médico general y en la relación médico-paciente. Conclusión: diversos aspectos, principalmente educativos y asistenciales, obstaculizan la calidad de la práctica de la medicina general.
Assuntos
Medicina Geral/educação , Clínicos Gerais/educação , Comitês Consultivos/organização & administração , Currículo , Grupos Focais , Medicina Geral/normas , Medicina Geral/tendências , Humanos , México , Faculdades de MedicinaRESUMO
BACKGROUND: There is no systematic evaluation of teaching performance in the clinical area at UNAM Faculty of Medicine. The study purpose is to assess the teaching competence level in the Undergraduate Medical Internship (UMI). METHODS: The paper describes the process of psychometric validity for the instrument designed to evaluate teaching competence in the UMI. This instrument was constructed from two previously developed instruments. The final version with 54 items in a Likert scale was studied with exploratory factorial analysis. Four dimensions were obtained: Solution of clinical problems, Psychopedagogy, Mentoring, and Evaluation. The instrument had a reliability of 0.994, with an explained variance of 77.75%. RESULTS: To evaluate the teaching competence level, we administered 844 questionnaires to a sample of students with a response rate of 89%. We obtained an overall global score of 89.4 ± 9.6 (mean ± SD). The dimension Solution of clinical problems was the one with a greater value, in contrast with the dimension of Evaluation, which had a lower score. CONCLUSION: The teachers of the UMI are considered educators with high level of teaching competence, according to the perceptions of the undergraduate internal doctors. The evaluation of teaching competence level is very important for institutions that look for the continuous professional development of its faculty.
Introducción: en la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM) no hay una evaluación sistemática del desempeño docente del área clínica. El propósito de este estudio fue evaluar el nivel de competencia docente en el Internado Médico de Pregrado (IMP). Método: se describe el proceso de la validación psicométrica de un instrumento diseñado para evaluar la competencia docente en el IMP. El instrumento se construyó a partir de dos instrumentos previamente desarrollados y con base en el análisis factorial exploratorio de un instrumento con 54 reactivos y una escala tipo Likert, se obtuvieron cuatro dimensiones. El instrumento tuvo una confiabilidad de 0.994, con una varianza explicada de 77.75%. Resultados: para evaluar en nivel de competencia docente, se utilizaron 844 cuestionarios, lo que constituye la muestra de estudiantes, con una tasa de respuesta del 89%. Se obtuvo una media global de 89.4 ± 9.6 de desviación estándar. La Solución de problemas clínicos fue la que obtuvo mayor valoración, en contraste con la dimensión de Evaluación, que observó menor valoración. Conclusiones: los docentes del IMP son considerados educadores con alto nivel de competencia docente, según las percepciones de los médicos internos de pregrado. Se advierte cómo la evaluación de la competencia docente es indispensable en cualquier institución que busque el desarrollo profesional continuo de sus profesores.
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Educação de Graduação em Medicina/normas , Docentes de Medicina/normas , Competência Profissional/normas , Ensino/normas , Humanos , México , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Research on diagnostic and formative assessment competencies during undergraduate medical training is scarce in Latin America. OBJECTIVE: To assess the level of clinical competence of students at the beginning of their medical internship in a new curriculum. METHODS: This was an observational cross-sectional study in UNAM Faculty of Medicine students in Mexico City: a formative assessment of the second class of Curriculum 2010 students as part of the integral evaluation of the program. The assessment had two components: theoretical and practical. RESULTS: We assessed 577 students (65.5%) of the 880 total population that finished the 9th semester of Curriculum 2010. The written exam consisted of 232 items, with a mean of 61.0 ± 19.6, a difficulty index of 0.61, and Cronbach's alpha of 0.89. The mean of the objective structured clinical examination (OSCE) was 62.2 ± 16.8, with a mean Cronbach's alpha of 0.51. Results were analyzed by knowledge area and exam stations. CONCLUSIONS: The overall results provide evidence that students achieve sufficiently the competencies established in the curriculum at the beginning of the internship, that they have the necessary foundation for learning new and more complex information, and integrate it with existing knowledge to achieve significant learning and continue their training.
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Competência Clínica , Educação de Graduação em Medicina , Internato e Residência , Estudos Transversais , DiagnósticoRESUMO
In Mexico, the primary aim of "Healthcare Supplies Catalog" (CBCISS) is guide the optimization of public resources to the attention of the health problems of the country, through the use of medicines, treatments, procedures and devices which have proven safety, efficacy and efficiency. Since May 2003, the Commission of CBCISS established as a requirement for updating submits a Health Economic Evaluation (EE) of the product. Therefore, in 2008, was a prepared and published methodological guideline for the conduct of studies of economic value (GCEEE). In 2011 was developed some strategies as updated the Internal Regulations and developed the Evaluation Guide Health Products (GEIS); both complement the GCEEE and oriented between other things, to increased the availability of technologies in different public institutions, decreased likelihood to commit injustices and inequities in access to supplies and standardize a transparent process. With the epidemiological transition, the cares of patients with chronic or terminal phase are contributing to the escalating costs of health care. The escalating costs are driven by the use of therapies that unfortunately have only marginal benefits, increasing the health and social costs, and upholding financial sustainability of healthcare systems. Therefore the stakeholders must decide the order of preference and establish an allocation methodology.
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OBJECTIVE: To identify ethics committees in medical practice in Mexico and possible implications stemming from their composition and functions. METHODS: A cross-sectional descriptive study was conducted from January-December 2005. A survey was sent by e-mail to the hospitals and family medicine centers with at 10 practices within the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social) (n=437) and the Institute for Security and Social Services for State Employees (Seguridad y Servicios Sociales de los Trabajadores del Estado) (n=167) and to the Mexican Ministry of Health's most important health care centers (n=15). The following items were analyzed: name of the committee, date of formation, current status, composition, functions, and level of authority. RESULTS: In all, 116 committees were identified, with various names. Of these, 101 (87.1%) were active. The committees were formed from 1985-2006, with a spike occurring in 2004-2005. Of the active committees, 59 (58.4%) were charged with ethical problems/dilemmas related to clinical practice as well as those related to research projects. Of the committee members, 357 (59.0%) held managing positions in the establishment to which the committee pertained; most were medical professionals (71.5%), followed by nursing staff (11.9%). Among the members of the active committees, 77.9% had not received training in ethics. CONCLUSIONS: Legal conflicts can be expected, mainly within the organizations whose committees have the authority to determine a course of action. An integrated plan is needed that will set standards for the composition and proceedings of Mexico's ethics committees and the improved training of committee members.