Medical students’ perceptions towards learning communication skills: a qualitative study following the 2-year training programme.

Objective: This study aimed to gain an understanding of the perceptions of 4th-year medical students about a training course in communication skills with 'experiential learning' characteristics, completed over the past two years.Methods: Twenty 4th-year medical students were invited to participate in a qualitative study with focus groups. These students were selected randomly, stratifying by gender, from all 4th-year medical students (106) at the Francisco de Vitoria University (Madrid). The students had just completed their communication skills training taught in small groups, with simulated patient interviews and feedback. The focusgroup facilitator used an open-ended discussion guide to explore the students' perceptions. Thematic analysis was used to identify salient themes from these discussions. Results: Sixteen students participated in two focus groups. The discussions revealed two contrasting perceptions: while this learning is considered useful, it nevertheless brings about a great deal of stress, especially regarding student exposure to peers in small-group sessions when interviewing standardised patients, and summative assessment. This generates a range of negative feelings in students that could affect perspective and attitude towards the importance of doctor-patient relationships. Conclusions: Experiential learning is effective in improving students' communication skills. However, these results suggest that use of such strategies requires a strong focus on "student-centred" teaching approaches, in order to minimise some sensitive topics that may arise during the learning. Further research is needed to refine these strategies depending on the teaching situation and to identify different ways of implementing these experiential methods.post-print206 K

Uso de las redes sociales en la promoción turística

Introduction. It is relevant to discuss that tourism promotion can be carried out both in the physical and virtual environment, where it is possible to reach a larger audience by transcending physical barriers such as distance. Due to confinement and the change in learning modality from face-to-face to virtual, the virtual technological tool Instagram was used to publicize the tourist sites of Ecuador. Target. This research aims to describe how the use of social networks allows the tourist promotion of destinations. The content published on this network was developed by students as a voluntary supplement where students could share tourist information. Methodology. To analyze the impact of the tourist content generated on the platform, the PRGS model proposed by IAB Spain Research was applied, which is based on the 4 variables presence, response, generation and suggestion, the last three united in a single variable called engagement. Results. There are 289 tourist publications. 77% are national tourists and 23% international. The scope is 3702 users. Conclusion. Consequently, it was possible to understand that social networks have the potential to be a space for complementary practice for the student and, in turn, as a space for tourism promotion.Introducción. Es relevante discutir que la promoción turística se puede realizar tanto en el entorno físico como virtual, donde es posible llegar a mayor audiencia trascendiendo barreras físicas como la distancia. Debido al confinamiento y el cambio de modalidad de aprendizaje de los presencial a lo virtual se utilizó la herramienta tecnológica virtual Instagram para dar a conocer los sitios turísticos del Ecuador. Objetivo. La presente investigación pretende describir cómo el uso de las redes sociales permite la promoción turística de los destinos. El contenido publicado en esta red fue desarrollado por los estudiantes como suplemento voluntario donde los alumnos podían compartir información turística. Metodología. Para analizar el impacto del contenido turístico generado en la plataforma se aplicó el modelo PRGS propuesto por IAB Spain Research que se fundamenta en las 4 variables presencia, respuesta, generación y sugerencia, las tres últimas unidas en una sola variable denominada engagement. Resultados. Existen 289 publicaciones turística. El 77% son turistas nacionales y el 23% internacionales. El alcance es 3702 usuarios. Conclusión. En consecuencia, se pudo entender que las redes sociales tienen el potencial de ser un espacio de práctica complementaria para el estudiante y a su vez como un espacio de promoción turística

Measures to evaluate quality of care in head and neck cancer: Results of a Delphi study.

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Medical students’ attitudes toward communication skills learning: comparison between two groups with and without training.

Objective: The value students give to communication skills (CS), acquiring them, or other related matters can influence the effectiveness of educational programs. In this study, we explored first and fourth year medical students’ attitudes toward CS and their learning, assessing the possible influence they have on programmed experiential training in a medical school. Subjects and methods: Two hundred and twenty first and fourth year medical students completed the Communication Skills Attitudes Scale, analyzing the positive and negative, and affective and cognitive attitude subscales toward learning. Results: Fourth year students trained in CS showed less positive attitudes toward CS than first year untrained students. Cognitive and affective attitudes displayed different patterns in both groups; while affective attitudes decreased in fourth year students, cognitive attitudes did not vary significantly between groups. Accumulated learning experiences seem to be more influential than sex. Conclusion: The findings suggest that students’ attitudes toward CS could decline as a result of CS training. Nevertheless, students’ attitudes at the cognitive and fundamental level stay fairly unchanged. Learning CS with experiential methods seems to be challenging for students at a personal level; so, educators should personalize these methods as much as possible. However, further studies using longitudinal research designs should be performed for exploring students’ attitudes changes over time.post-print182 K

Health state perception of people close to retirement age: Relationship with lifestyle habits and subjects' characteristics

Aim: Societal ageing increases the need for correct and healthy ageing to ensure the well-being of older adults. Practical strategies are needed to acquire healthy habits for the ageing process. This study aims to analyse the lifestyle habits of subjects who are retired or close to retirement and identify factors that could influence their perceived health and that could be related to these habits. Methods: A Spanish observational, descriptive, cross-sectional study of subjects close to retirement-age. Socio-demographic, family, work, leisure, social, and clinical-psychological indicators were evaluated. Results: 1,700 participants (581 employed; 714 retirees; 405 other-status) were included, average age 63 years, 52% women. Most reported a satisfactory social life (90%), were in live-in relationships (74%), non-smoking (80%), followed a Mediterranean diet (73%), and took medicines daily (70%). Perceived health (EQ-VAS) was 75.9/100, with low disability (12-WHODAS) (7.4/100) and moderate/severe depression. Women reported higher disability (p < 0.001) and depression (p < 0.001), a better social life, and healthier lifestyle, but lower physical/work activity. Retirees reported less depression, better social life, healthier lifestyle, higher physical/work activity, and better sleeping habits. The multivariate model showed a significant association of health-status with disability level, number of chronic diseases, sleep habits, exercise, diet, and alcohol consumption. When depression level was introduced, age and being a woman were also related. Conclusions: Retirement does not mean worse health but rather an opportunity to reinforce favourable health activities and improve lifestyle factors. Incorporating the differences related to gender and employment status in health-perception will facilitate the design of healthy ageing strategies.S

Searching for the erosion of empathy in medical undergraduate students: a longitudinal study.

Objective To analyse the trajectory of empathy throughout the degree programme of medicine in a Spanish school of medicine. Design Longitudinal, prospective 5-year study, between October 2014 and June 2019. Setting Students from a Spanish university of medicine. Participants Two voluntary cohorts of undergraduate medical students from two different school years were invited to participate (n=135 (cohort 1, C1) and 106 (cohort 2, C2) per school year). Finally, a total number of 174 students (102 (C1, 71.6% women) and 72 (C2, 70.8% women) students, respectively) were monitored for 5 years. Each cohort was divided in two subcohorts of paired and unpaired students that were analysed to check possible social desirability bias. Primary outcome measure The Jefferson Scale of Empathy (JSE). Results The cohort of 102 students (C1) monitored between their first and fifth years of study (71.6% women) showed an improvement among paired women of 2.15 points in total JSE score (p=0.01) and 2.39 points in cognitive empathy (p=0.01); in the unpaired female cohort the increase was of 2.32 points (cognitive empathy) (p=0.02). The cohort of 72 students (C2) monitored between their second and sixth years of study (70.8% women) displayed a cognitive empathy increase of 2.32 points (p=0.04) in the paired group of women. There were no significant differences between paired and unpaired results for either cohort. Empathy scores among men did not decrease. Conclusions The empathy of medical students at our school did not decline along grade years. In fact, it improved slightly, particularly cognitive empathy, among women. This paper contributes to enlarge data from Europe, where longitudinal studies are scarce. It supports the idea that there may be global geo-sociocultural differences; however, more studies comparing different school settings are needed.post-print362 K

Barriers to teaching communication skills in Spanish medical schools: a qualitative study with academic leaders.

Background: In recent years, Spanish medical schools (MSs) have incorporated training in communication skills (CS), but how this training is being carried out has not yet been evaluated. Objective: To identify the barriers to the introduction and development of CS teaching in Spanish MSs. Methods: In a previous study, 34 MSs (83% of all MSs in Spain) were invited to participate in a study that explored the factual aspects of teaching CS in these schools. The person responsible for teaching CS at each school was contacted again for this study and asked to respond to a single open-ended question. Two researchers independently conducted a thematic analysis of the responses. Results: We received responses from 30 MSs (85.7% of those contacted and 73% of all MSs in Spain). Five main thematic areas were identified, each with different sub-areas: negative attitudes of teachers and academic leaders; organisation, structure and presence of CS training in the curriculum; negative attitudes of students; a lack of trained teachers; and problems linked to teaching methods and necessary educational logistics. Conclusions: The identified barriers and problems indicate that there are areas for improvement in teaching CS in most Spanish MSs. There seems to be a vicious circle based on the dynamic relationship and interdependence of all these problems that should be faced with different strategies and that requires a significant cultural shift as well as decisive institutional support at the local and national levels. The incorporation of CS training into MS curricula represents a major challenge that must be addressed for students to learn CS more effectively and avoid negative attitudes towards learning CS.post-print853 K

Ibero-American consensus on learning outcomes for the acquisition of competencies by medical students through clinical simulation.

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Results of donor after cardiac death circulation activation: recuperation of spontaneous circulation analysis.

The activation procedure of a potential donor after cardiac death begins after recognition of a situation of unrecovered PCR patient meets the criteria donor after cardiac death. Still have to meet a number of medical conditions and logistical both for the potential donor becomes effective donor. The aim of this study is to describe this procedure and know the number of potential donors who finally become effective donors. Method: Collection of all activations procedure after cardiac death donor HU 12 de Octubre for 5 years (2009-2013). Data collection is performed on a web platform created for this purpose.post-print255 K

Teaching medical students to express empathy by exploring patient emotions and experiences in standardized medical encounters.

OBJECTIVES: To increase medical students’ ability to detect contextual and emotional cues and to respond empathetically to patients. METHODS: a training course in communication skills and patient-centered care with different teaching activities (didactic, reflective and interactive: workshops and encounters with simulated patients) was delivered to third-year medical students just before their clerckships. The program was evaluated by an external observer (OE) and simulated patients (SP) in 2 or 3 videotaped encounters. RESULTS: Students improved significantly from baseline to 3rd interview in all communicative skills and domains explored both in OE (32.4%) and SP (38.3%) measurement. At the end of the course students detected significantly more clues and made more empathetic expressions. CONCLUSIONS: The course seems to improve the ability of students to explore the illness experience, showing more empathy in a more genuine way. This was carried out in consultations lasting 10 minutes. PRACTICAL IMPLICATIONS: The program is effective and feasible to be applied as a regular formative activity. Further research is needed to assess whether this training program is applicable to students in more advanced educational levels and if it has any additional outcomes.pre-print432 K