Ansiedad de los estudiantes de una facultad de medicina mexicana, antes de iniciar el internado

ResumenIntroducciónEn el internado médico los alumnos demuestran sus competencias en una institución hospitalaria, lo que puede provocar ansiedad. El objetivo del estudio es cuantificar la ansiedad (de rasgo y estado) antes de iniciar el internado médico en los alumnos de una escuela pública de medicina en México, además determinar si el promedio de calificaciones (GPA: Grade points Average) tiene relación con la ansiedad.MétodoSe realizó un estudio descriptivo, transversal. Se utilizó el instrumento IDARE, que evalúa ansiedad de rasgo (IDARE R) y estado (IDARE E). Se aplicó a alumnos de la Facultad de Medicina de la UNAM, de la generación 2009 que ingresaron al internado rotatorio en 2014, antes de iniciar el internado. El análisis estadístico se realizó con prueba t de Student para muestras independientes e índice de correlación de Pearson.ResultadosEl total de estudiantes en el 2014 fue de 1,023, la población muestreada fue de 479 (46.82%), 332 eran mujeres (32.45%), 147 hombres (14.36%). De la muestra, los estudiantes con ansiedad de rasgo fueron 105 (21.82%), con un promedio de calificaciones de 84.1, con ansiedad de estado 132 (27.55%), promedio de calificaciones 84.0, sin ansiedad de rasgo 374 (78.07%) sin ansiedad de estado 347 (72.44%). La comparación de ansiedad de rasgo, la prueba t de Student reportó p= 0.3 (IC 95% -1,474 a 0.494); el índice de correlación de Pearson fue -0.009, con p= 0.043. La comparación de ansiedad de estado, de la prueba t de Student reportó p= 0.236 (IC 95% -1.46 a 0.360); el índice de correlación de Pearson fue -0.08, con p= 0.047. En cuanto al promedio de calificaciones no hubo diferencias entre los diferentes niveles de ansiedad de rasgo y estado.ConclusionesEl nivel de ansiedad de rasgo y estado es mayor que el que suele reportarse en la población general, no hubo correlación entre la presencia de ansiedad y el promedio de calificaciones.AbstractIntroductionPre-registration medical graduates demonstrate their skills in a hospital as rotation house-officers, which can cause anxiety. The aim of this study is to quantify anxiety (state and trait) in students before starting their pre-registration posts in a public medical school in Mexico, and also to determine if their mean examination grades (GPA) are related to anxiety.MethodA descriptive, cross-sectional study was conducted using the IDARE questionnaire, which assesses Trait anxiety (STAI R) and state (STAI E). It was completed, before starting the pre-registration house officer rotation in 2014, by students of the Faculty of Medicine, UNAM, 2009 course. Statistical analysis was performed using Student t test for independent samples, and Pearson correlation index.ResultsOut of a total number of 1,023 students in 2014, the sampled population was 479 (46.82%), of whom 332 (32.45%) were women and 147 (14.36%) were men. There were 105 (21.82%) students with trait anxiety trait, with a GPA of 84.1, 132 (27.55%) with anxiety state, with a GPA of 84.0. There were 374 (78.07%) with no anxiety trait, and 347 (72.44%) with no state anxiety. On comparing state anxiety, the Student t-test p=.3 (95% CI -1474 to 0.494); the Pearson correlation index was -0.009, p=.043. On comparing anxiety state, the Student t-test p=.236 reported (95% CI -1.46 to 0.360); the Pearson correlation index was -0.08, with a p=.047. As for the GPA, there was no difference between the different levels of state and trait anxiety.ConclusionsThe trait anxiety level and state is often greater than that reported in the general population. There was no correlation between the presence of anxiety and mean examination grades (GPA)

Specific entrustable professional activities for undergraduate medical internships: a method compatible with the academic curriculum

Abstract Background Competency-based education has been considered the most important pedagogical trend in Medicine in the last two decades. In clinical contexts, competencies are implemented through Entrustable Professional Activities (EPAs) which are observable and measurable. The aim of this paper is to describe the methodology used in the design of educational tools to assess students´ competencies in clinical practice during their undergraduate internship (UI). In this paper, we present the construction of specific APROCs (Actividades Profesionales Confiables) in Surgery (S), Gynecology and Obstetrics (GO) and Family Medicine (FM) rotations with three levels of performance. Methods The study considered a mixed method exploratory type design, a qualitative phase followed by a quantitative validation exercise. In the first stage data was obtained from three rotations (FM, GO and S) through focus groups about real and expected activities of medical interns. Triangulation with other sources was made to construct benchmarks. In the second stage, narrative descriptions with the three levels were validated by professors who teach the different subjects using the Delphi technique. Results The results may be described both curricular and methodological wise. From the curricular point of view, APROCs were identified in three UI rotations within clinical contexts in Mexico City, benchmarks were developed by levels and validated by experts’ consensus. In regard to methodological issues, this research contributed to the development of a strategy, following six steps, to build APROCs using mixed methods. Conclusions Developing benchmarks provides a regular and standardized language that helps to evaluate student’s performance and define educational strategies efficiently and accurately. The university academic program was aligned with APROCs in clinical contexts to assure the acquisition of competencies by students