Interés por la Medicina de Familia tras cursar una asignatura de Atención Primaria

Las necesidades de la sociedad actual demandan la figura de un profesional médico con una formación integral en cuidados de salud individual, familiar y comunitaria. El médico de familia es el profesional capacitado para llevar a cabo estas tareas. Las facultades de Medicina deben tener en cuenta estas necesidades a la hora de formar a los profesionales que en un futuro se encargarán de los cuidados de salud de la población. La Medicina de Familia tiene una presencia irregular en el currículo de las facultades de Medicina españolas, en muchos casos, solo de forma indirecta a través de asignaturas de atención primaria, o con rotaciones clínicas en este nivel asistencial que a veces son optativas. Las primeras experiencias docentes datan de mediados de la década de los ochenta. A pesar de los años transcurridos, se observa una distribución irregular y escasa en el número de profesores, en los contenidos docentes y en las actividades desarrolladas. En la Facultad de Medicina de Albacete se imparte una asignatura de Atención Primaria en segundo curso de la licenciatura, desde que se inauguró el 28 de mayo de 1998. Con el objetivo de investigar sobre los conocimientos y las actitudes de los estudiantes hacia la Medicina de Familia, se diseñó un estudio observacional transversal en el que participaron 159 estudiantes de segundo curso para validar un cuestionario que midiese tales conocimientos y actitudes. Con el fin de comparar los conocimientos antes y después de cursar la asignatura de Atención Primaria, se ideó un estudio cuasiexperimental; posteriormente se compararon los resultados con las respuestas de los estudiantes de segundo curso de la Facultad de Medicina de Sevilla (grupo de control). El cuestionario abreviado constituye un instrumento útil para evaluar los conocimientos y actitudes de los estudiantes de Medicina hacia la Medicina de Familia. Ha mostrado una consistencia interna aceptable (alfa de Cronbach 0,72) y las dimensiones identificadas mediante análisis factorial explican un porcentaje importante de la varianza total. Mediante análisis Rasch se ha comprobado que el cuestionario posee un ajuste adecuado de los ítems, pues indica una estrecha relación entre ellos, con lo que corrobora la validez de construcción del instrumento. Los conocimientos y actitudes hacia la Medicina de Familia de los alumnos de segundo curso de la Facultad de Medicina de Albacete son significativamente más favorables después de cursar la asignatura de Atención Primaria. En los estudiantes de la Facultad de Medicina de Albacete se observa una diferencia significativa respecto a los estudiantes de la Facultad de Medicina de Sevilla, en cuanto a la consideración hacia la Medicina de Familia.Needs of today´s society claim the figure of the medical professional with comprehensive training in care of individual, family and community health. The family doctor is the professional trained to carry out these tasks. Medical Schools should consider these needs when they have to train professionals that will be responsible for the healthcare of the population. Family Medicine has an irregular presence in Spanish Faculties of Medicine´s curriculum, in many cases only indirectly through Primary Care subjects or clinical rotations at this care level, which sometimes are optional. The first teaching experiences date from the mid-eighties. Despite the years, irregular and poor distribution is observed, relating to the number of teachers, the teaching contents and the activities developed. In the Faculty of Medicine of Albacete a subject about Primary Care subject is taught in the Second Degree Course, since it opened on 28 May 1998. In order to investigate the knowledges and attitudes of students toward Medicine Family, an observational cross-sectional study was designed, involving 159 students of the second year to validate a questionnaire that would measure such knowledges and attitudes. We used a quasi-experimental study to compare the knowledge before and after studying the subject of Primary Care; then the results were contrasted with the responses of the students of the School of Medicine of Seville (control group). The short questionnaire is a useful instrument to evaluate the knowledges and attitudes of students towards Family Medicine. It has shown an acceptable internal consistency (Cronbach's alpha 0.72) and the dimensions identified by factor analysis explained an important percentage of the total variance. By Rasch analysis, it was found that the questionnaire has a proper adjustment of the items, as it indicates a close relationship between them, which supports the construct validity of the instrument. Knowledge and Attitudes toward Family Medicine of the students of the second year in the School of Medicine of Albacete are significantly more favorable after studying the subject of Primary Care. Significant difference between students of the Faculty of Medicine of Albacete and students of the Faculty of Medicine of Seville is observed, regarding the consideration towards Family Medicine

Validez de predicción de un cuestionario de conocimientos y actitudes hacia la medicina familiar

ResumenObjetivoconocer la validez de predicción de un cuestionario que evalúa los conocimientos y las actitudes de los estudiantes de medicina hacia la medicina familiar (mf).Material y métodoestudio de cohorte; los sujetos de estudio fueron estudiantes matriculados en una asignatura de Atención Primaria (ap) entre 2005 y 2006, que se graduaron en 2010 y eligieron especialidad en 2011. Se diseñó un cuestionario con 34 preguntas cerradas. A los estudiantes se les invitó a contestar antes y después de cursar ap, así como a los matriculados en el sexto curso (2009-2010). Se registró la especialidad que eligieron; para calcular la validez predictiva del cuestionario se estimó su sensibilidad y especificidad, analizando las curvas cor (características operativas del receptor).Resultadosrespondieron el cuestionario 44 estudiantes antes de cursar la asignatura y 79 después. Al final del sexto curso contestaron 76. El área bajo la curva cor fue, respectivamente, 0.299 (ic 95%: 0.094-0.504), 0.482 (ic 95%: 0.280-0.684) y 0.688 (ic 95%: 0.282-1.093). Solamente en el último caso la curva cor estaba por encima de la diagonal. El mejor punto de corte en este caso fue 31, con sensibilidad=0.75 y especificidad=0.714.Conclusionesel cuestionario tiene una deficiente validez de predicción en relación con la elección de la mf. Sólo mejora en el último curso de la licenciatura.SummaryObjectiveto learn about the validity of prediction of a questionnaire that assesses knowledge and attitudes of students of medicine towards Family Medicine (fm).Material and methodscohort study; the studied individuals were students enrolled in a Primary Care course (pc) between 2005 and 2006, who graduated in 2010 and chose a specialty in 2011. It was designed a questionnaire with 34 closed questions. Students were invited to answer before and after taking the pc course, as well as those students enrolled in the sixth course (2009-2010). The specialty chosen was registered; to calculate the predictive validity of the questionnaire, their sensitivity and specificity was estimated, analyzing the roc (receiver operating characteristic) curves.Resultsthe questionnaire was answered by 44 students before studying the course and 79 after studying it. At the end of the sixth course, 76 students answered the questionnaire. The area under the roc curve was, respectively, 0.299 (ic 95%: 0.094-0.504), 0.482 (ic 95%: 0.280-0.684) and 0.688 (ic 95%: 0.282-1.093). Only in the latter case the curve roc was above the diagonal. The best cut-off point was 31, with sensitivity=0.75 and specifcity=0.714.Conclusionsthe questionnaire has a poor validity of prediction concerning the choice of fm. It only improves during the last year of the degree

Internet use by adolescents for medicine related topics

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At what stage in the undergraduate curriculum is it best to train in family medicine? A study from two medical schools in Spain.

A course in family medicine (FM) could dispel the possibility of negative stereotyping about this speciality, and instil in students a greater interest. However, when is it preferable: at the beginning or at the end of undergraduate training? To determine changes in knowledge and attitudes towards FM by medical students completing a course in primary care at the beginning or the end of the undergraduate training and whether those changes anticipate the choice of speciality. Students from Albacete and Seville medical schools (primary care course in second and sixth years, respectively) were asked to respond to the 'valuation of attitudes towards and knowledge of family medicine questionnaire' (CAMF). Students from Albacete answered before and after the course, and in Seville second-year students answered at the end of the first trimester. All students were invited to respond again at the end of their undergraduate training. Afterwards, we investigated the score on the speciality exam (order for the election from highest to lowest score) and their choice of speciality. The outcome measures were the MIR exam score, the number in the ranking, the chosen speciality and the result of the CAMF. In Albacete 88 and 64 and in Seville 50 and 98 students responded in their second and sixth years, respectively. In Albacete, mean CAMF scores were 15.4, 22.7 before and after the course, and 21.8 at the end while in Seville, 13.9 in the second year, and 23.5 in the sixth year. Logistic regression analysis showed an association of the choice of FM only with the score on the speciality exam (OR: 0.667; 95%CI: 0.553-0.806). There were no significant differences between CAMF scores at the end of undergraduate training. Only the score on the speciality exam predicts FM choice: the higher the score, the lower the probability of choosing FM

Validez predictiva del Cuestionario de Conocimientos y Actitudes hacia la Medicina de Familia abreviado

Señor editor: No abundan en la bibliografía instrumentos de valoración de conocimientos y actitudes hacia la medicina de familia (MF), y los pocos que existen proceden principalmente de ámbitos anglosajones

Predictors for choosing the specialty of Family Medicine from undergraduate knowledge and attitudes

ABSTRACT: CONTEXT AND OBJECTIVE: A cold climate towards primary care (PC) within medical academia could form a barrier against choosing family medicine (FM) as a career option. This study was designed to determine whether medical students' knowledge of and attitudes towards FM predicted their career choice. DESIGN AND SETTING: Cohort study conducted at two different medical schools. METHODS: After completing a PC course at the Albacete Medical School in 2005-2006, 81 second-year students were asked to give responses to a questionnaire. In their sixth year (2009-2010), 79 students in Albacete and 42 in Seville (taken as an unexposed cohort) were asked to give responses too. Their choice of specialty was investigated in 2011. RESULTS: In Albacete, the questionnaire was answered by 79 second-year and 76 sixth-year students; in Seville, it was answered by 26 sixth-year students. After completing the PC course, 69.3% said they would like to become a family doctor. This percentage decreased to 40.3% at the end of the undergraduate course (P < 0.0001). In the sixth year, the attitudes towards FM worsened, yet these were significantly more favorable than those in Seville. Only 12 students chose FM; they obtained significantly worse scores in their specialty selection examination than their peers (P < 0.0001). CONCLUSION: In the Albacete Medical School, the students' opinion about FM worsened over the undergraduate course, although it was still better than the Seville students' stance. In any case, FM was seen to be a minority option