Learning to perform research in the degree of medicine: analysis and evaluation of the student ratings of the final degree dissertation.

The Bologna Plan applied to the Medicine Degree in Spain has included a final degree dissertation into the coursework. In this manuscript, we analyzed the validity of a rubric and the grading criteria used to assess the students skills in research and their critical thinking.A total of 62 final degree dissertations were evaluated. Each student was supervised by a clinical or epidemiologist researcher. Each dissertation was rated by three academic assistants using a 10-item rubric. The validity of the scores and the differences in the severity of the examiners were analyzed with a multi-faceted Rasch model, which allowed examining severity within evaluators, ability of the students and difficulty of items. 62 final dissertation were evaluated with a total of 186 rubrics. 58% of the students had higher ability than the severity of the evaluators and the difficulty of the items of the evaluation rubric. No significant differences were observed within the severity of the professors, neither within the final scores. The most difficult item for students was selection of epidemiological design. This study showed that the methodology proposed to evaluate the final degree dissertation is effective to assess the skills of conducting research and critical thinking in medicine students

Aprendizaje de las competencias de investigación en el Grado de Medicina: análisis y evaluación de las calificaciones de los estudiantes en el Trabajo de Final de Grado

The Bologna Plan applied to the Medicine Degree in Spain has included a final degree dissertation into the coursework. In this manuscript, we analyzed the validity of a rubric and the grading criteria used to assess the students skills in research and their critical thinking. A total of 62 final degree dissertations were evaluated. Each student was supervised by a clinical or epidemiologist researcher. Each dissertation was rated by three academic assistants using a 10-item rubric. The validity of the scores and the differences in the severity of the examiners were analyzed with a multi-faceted Rasch model, which allowed examining severity within evaluators, ability of the students and difficulty of items. 62 final dissertation were evaluated with a total of 186 rubrics. 58% of the students had higher ability than the severity of the evaluators and the difficulty of the items of the evaluation rubric. No significant differences were observed within the severity of the professors, neither within the final scores. The most difficult item for students was selection of epidemiological design. This study showed that the methodology proposed to evaluate the final degree dissertation is effective to assess the skills of conducting research and critical thinking in medicine students

Psychometric properties of the Spanish version of the Jefferson Scale of Empathy: making sense of the total score through a second order confirmatory factor analysis

Background: Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model. Methods: The Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach's alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences. Results: The Spanish JSE-S demonstrated acceptable to good sensitivity (individual items - except for item 2 - and JSE-S total score: -2.72 < Sk < 0.35 and -0.77 < Ku < 7.85), convergent validity (AVE: between 0.28 and 0.45) and reliability (Cronbach's alphas: between 0.62 and 0.78; CR: between 0.62 and 0.87). The confirmatory factor analysis supported the three-factor solution and the second order latent factor model. Conclusions: The findings provide support for the sensitivity, construct validity and reliability of the adapted Spanish JSE-S with Spanish medical students. Data confirm the hypothesized second order latent factor model. This version may be useful in future research examining empathy in Spanish medical students, as well as in cross-cultural studies.info:eu-repo/semantics/publishedVersio

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

La relación médico-paciente en el grado en medicina. Una necesidad vista por los protagonistas.

Este estudio recoge la perspectiva de pacientes y estudiantes de medicina sobre la comunicación médico-paciente, con la intención de mejorar la formación en comunicación «centrada en el paciente- persona» en el grado en medicina. Metodología: Se aborda de forma iterativa la visión de los pacientes mediante metodología cualitativa fenomenológica, recogiendo las característica comunicativas de los médico que son más o menos valoradas y la visión de los estudiantes de medicina mediante el análisis de las respuestas propuestas en un cuestionario. La aportación de ambas visiones contrastada con la de los referentes de la formación en comunicación en el grado en medicina, da respuesta a “qué”, “cuándo” y “cómo” se debe formar en comunicación para tener una auténtica “comunicación centrada en el paciente-persona”. Resultados: Se identifican 17 características comunicativas a potenciar y 13 a evitar. Esta valoración varía en función de la gravedad y vulnerabilidad de cada caso. El paciente quiere sentirse partícipe y que se considere a la familia y su entorno social como elementos claves de su atención. Estudiantes y pacientes valoran ser formados en comunicación aunque difieren en lo que debe priorizarse. Los estudiantes hablan de aspectos genéricos mientras que los pacientes se centran en detalles específicos. Se proponen métodos formativos efectivos que perduren en el tiempo, adecuándose a la madurez y situación de los estudiantes en cada curso. Conclusiones: Los pacientes identifican características concretas de la comunicación que esperan encontrar en los médicos recién graduados. Se identifican específicamente: competencias, objetivos educativos, resultados de aprendizaje y habilidades para mejorar la comunicación, susceptibles de incorporarse en todos los cursos del grado, con los métodos formativos adecuados a cada nivel, teniendo en cuenta también las preferencias de los estudiantes.Aquest estudi recull la perspectiva de pacients i estudiants de medicina sobre la comunicació metge-pacient, amb la intenció de millorar la formació en comunicació «centrada en el pacient-persona» en el grau en medicina. Metodologia: S’estudia de forma iterativa la visió dels pacients mitjançant metodologia qualitativa fenomenològica, recollint les característiques comunicatives dels metge que són més o menys valorades pels pacients i la visió dels estudiants de medicina mitjançant l'anàlisi de les respostes proposades en un qüestionari. L'aportació de les dues visions contrastada amb la dels referents de la formació en comunicació en el grau en medicina, dóna resposta a "què", "quan" i "com" s'ha de formar en comunicació per tenir una autèntica "comunicació centrada en el pacient-persona ". Resultats: S'identifiquen 17 característiques comunicatives a potenciar i 13 a evitar. Aquesta valoració varia en funció de la gravetat i vulnerabilitat de cada cas. El pacient vol sentir-se partícip i que es consideri a la família i el seu entorn social com a elements claus de la seva atenció. Estudiants i pacients valoren ser formats en comunicació encara que difereixen en el que s'ha de prioritzar. Els estudiants parlen d'aspectes genèrics mentre que els pacients se centren en detalls específics. Es proposen mètodes formatius efectius que perdurin en el temps, adequant-se a la maduresa i situació dels estudiants en cada curs. Conclusions: Els pacients identifiquen característiques concretes de la comunicació que esperen trobar en els metges acabats de graduar. S'identifiquen específicament: competències, objectius educatius, resultats d'aprenentatge i habilitats per a millorar la comunicació, susceptibles d'incorporar en tots els cursos del grau, amb els mètodes formatius adequats a cada nivell, tenint en compte també les preferències dels estudiants

Aprendizaje basado en proyectos aplicados al entorno del laboratorio de inmunología

En la aplicación de metodologías participativas en el entorno de laboratorio, son muchos los recursos educativos que han mostrado su utilidad para la adquisición de competencias, tanto genéricas (trabajo colaborativo, autoaprendizaje) como específicas (razonamiento clínico, reconocimiento de mecanismos relacionados con fundamentos científicos). En este contexto, en la asignatura “Estructura y función de la sangre y del sistema inmunitario” de segundo curso del Grado en Medicina de la UIC se ha introducido una estrategia de aprendizaje basada en proyectos (ABP), que ha permitido dar sentido a la adquisición de conocimientos y habilidades con el fin específico de solucionar un caso clínico. Para ello, los estudiantes, en grupos de tres, se enfrentan al caso debiendo analizar, orientar y seleccionar una prueba de laboratorio que permita confirmar un diagnóstico. El alumno dispone de conexión a internet para la obtención de la base teórica del caso planteado y el apoyo de un tutor para orientar su investigación. Una vez decidida la prueba a realizar dispone de la muestra biológica del paciente, de los kits diagnósticos apropiados y de los protocolos necesarios para llevarlos a cabo. El alumno, con ayuda del tutor, realiza el test diagnóstico que ha seleccionado, obtiene los resultados, los interpreta y con la información obtenida emite un diagnóstico del caso clínico propuesto. Posteriormente los grupos de alumnos exponen cada caso clínico al resto de sus compañeros. En la presente comunicación se muestra con más detalle la realización de este tipo de “Aprendizaje Basado en Proyecto”, y se discute la aceptación que ha tenido por parte de los alumnos, los resultados académicos obtenidos y el grado de adquisición de las competencias trabajadas

Psychometric properties of the Spanish version of the Jefferson Scale of Empathy: making sense of the total score through a second order confirmatory factor analysis

Background: Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model. Methods: The Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach's alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences. Results: The Spanish JSE-S demonstrated acceptable to good sensitivity (individual items - except for item 2 - and JSE-S total score: −2.72 < Sk < 0.35 and −0.77 < Ku < 7.85), convergent validity (AVE: between 0.28 and 0.45) and reliability (Cronbach's alphas: between 0.62 and 0.78; CR: between 0.62 and 0.87). The confirmatory factor analysis supported the three-factor solution and the second order latent factor model. Conclusions: The findings provide support for the sensitivity, construct validity and reliability of the adapted Spanish JSE-S with Spanish medical students. Data confirm the hypothesized second order latent factor model. This version may be useful in future research examining empathy in Spanish medical students, as well as in cross- cultural studies