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      El médico residente de urología como educador. Una intervención educativa participativa Translated title: The urology resident physician as an educator. Participatory educational intervention

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          Abstract

          RESUMEN Objetivo Determinar el alcance de una intervención educativa promotora de la participación -implementada por un médico residente de quinto año- con respecto al desarrollo de la aptitud clínica de médicos residentes de urología, en la atención de los cuatro padecimientos urológicos más frecuentes, en un tercer nivel de atención médica. Método Se realizó un estudio de intervención en médicos residentes de segundo (R2 n=7) y tercer año (R3 n=6) de urología en Centro Médico Nacional “La Raza”, en la Ciudad de México, México, periodo: noviembre - diciembre de 2017. Se construyó un instrumento que evaluó la variable: “aptitud clínica” de médicos residentes de segundo y tercer año, en cuatro padecimientos urológicos; la validez conceptual, de contenido y confiabilidad, se valoró por cuatro médicos especialistas en urología, con experiencia en docencia e investigación educativa. La intervención educativa fue implementada por un residente de urología de quinto año. La intervención educativa se desarrolló en forma de seminarios, los cuales se realizaron dos veces por semana (lunes y viernes); duración por sesión: dos horas; duración total de la intervención educativa: 16 sesiones. El instrumento de medición se aplicó al inicio (1ª sesión) y al finalizar la intervención educativa (16ª sesión). Resultados En los R2 y R3 se observaron avances en todos los indicadores de aptitud clínica y en la calificación global, lo cual se expresó con diferencias estadísticamente significativas; los R2, en la calificación global (medición inicial vs. final) mostraron las siguientes medianas: 44 y 110 (p 0.018); los R3, la calificación global mostró: 52.5 y 28 (p 0.027). Conclusiones Una intervención educativa participativa implementada por un médico residente de urología de quinto año, se puede asociar con un avance en el desarrollo de la aptitud clínica de R2 y R3 de la misma especialidad.

          Translated abstract

          Abstract Objective Determining the scope of an educational intervention that promotes participation, implemented by a urology resident physician-fifth year with regard to the development of clinical aptitude of urology resident physicians in the attention of the four most common urological disorders in a tertiary medical care. Methods We performed an interventional study in resident physicians of second (n = 7) and third year (n = 6) of urology at National Medical Center “La Raza”, Mexico City, Mexico, period: November to December 2017. An instrument was designed to evaluate the variable “clinical aptitude” of medical residents of second and third years including four urological conditions, the conceptual validity, content and reliability was assessed by four medical specialists in urology, with experience in teaching and educational research. The educational intervention was implemented by an urology resident of fifth-year. The educational intervention was in the form of seminars, which were performed twice a week (Monday and Friday), duration per session: two hours; total duration of the educational intervention: 16 sessions. The measuring instrument was applied at the beginning (1st session) and at the end of the educational intervention (16th session). Results In the R2 and R3 progress was noted in all indicators of clinical skills and the overall rating, which was expressed with statistically significant differences, the R2, the global score (initial measurement vs final) showed the following median: 44 and110 (p 0018), the R3, the overall rating was: 52.5 and 128 (p 0.027). Conclusions A Participatory educational intervention implemented by an urology resident of the fifth year, it can be associated with the development of clinical aptitude R2 and R3 of the same specialty.

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          El enfoque de competencias en la educación: ¿Una alternativa o un disfraz de cambio?

          Un elemento que caracteriza y distingue a las reformas educativas es el de la "innovación", tema que si bien significa un reto, su ejecución, la mayoría de las veces, va acompañada de una compulsividad que impide su consolidación y revisión conceptual. En este ensayo se parte de un cuestionamiento base: ¿realmente el enfoque de competencias representa una innovación, o sólo una apariencia de cambio? La idea es llegar a una articulación conceptual del término que permita caracterizar los elementos que definen a las competencias en educación y, desde un sentido más pedagógico, ubicar su posible aplicación en el campo curricular.
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            Duty hour recommendations and implications for meeting the ACGME core competencies: views of residency directors.

            To describe the views of residency program directors regarding the effect of the 2010 duty hour recommendations on the 6 core competencies of graduate medical education. US residency program directors in internal medicine, pediatrics, and general surgery were e-mailed a survey from July 8 through July 20, 2010, after the 2010 Accreditation Council for Graduate Medical Education (ACGME) duty hour recommendations were published. Directors were asked to rate the implications of the new recommendations for the 6 ACGME core competencies as well as for continuity of inpatient care and resident fatigue. Of 719 eligible program directors, 464 (65%) responded. Most program directors believe that the new ACGME recommendations will decrease residents' continuity with hospitalized patients (404/464 [87%]) and will not change (303/464 [65%]) or will increase (26/464 [6%]) resident fatigue. Additionally, most program directors (249-363/464 [53%-78%]) believe that the new duty hour restrictions will decrease residents' ability to develop competency in 5 of the 6 core areas. Surgery directors were more likely than internal medicine directors to believe that the ACGME recommendations will decrease residents' competency in patient care (odds ratio [OR], 3.9; 95% confidence interval [CI], 2.5-6.3), medical knowledge (OR, 1.9; 95% CI, 1.2-3.2), practice-based learning and improvement (OR, 2.7; 95% CI, 1.7-4.4), interpersonal and communication skills (OR, 1.9; 95% CI, 1.2-3.0), and professionalism (OR, 2.5; 95% CI, 1.5-4.0). Residency program directors' reactions to ACGME duty hour recommendations demonstrate a marked degree of concern about educating a competent generation of future physicians in the face of increasing duty hour standards and regulation.
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              The resident-as-teacher educational challenge: a needs assessment survey at the National Autonomous University of Mexico Faculty of Medicine

              Background The role of residents as educators is increasingly recognized, since it impacts residents, interns, medical students and other healthcare professionals. A widespread implementation of resident-as-teacher courses in developed countries' medical schools has occurred, with variable results. There is a dearth of information about this theme in developing countries. The National Autonomous University of Mexico (UNAM) Faculty of Medicine has more than 50% of the residency programs' physician population in Mexico. This report describes a needs assessment survey for a resident as teacher program at our institution. Methods A cross-sectional descriptive survey was developed based on a review of the available literature and discussion by an expert multidisciplinary committee. The goal was to identify the residents' attitudes, academic needs and preferred educational strategies regarding resident-as-teacher activities throughout the residency. The survey was piloted and modified accordingly. The paper anonymous survey was sent to 7,685 residents, the total population of medical residents in UNAM programs in the country. Results There was a 65.7% return rate (5,186 questionnaires), a broad and representative sample of the student population. The residents felt they had knowledge and were competent in medical education, but the majority felt a need to improve their knowledge and skills in this discipline. Most residents (92.5%) felt that their role as educators of medical students, interns and other residents was important/very important. They estimated that 45.5% of their learning came from other residents. Ninety percent stated that it was necessary to be trained in teaching skills. The themes identified to include in the educational intervention were mostly clinically oriented. The educational strategies in order of preference were interactive lectures with a professor, small groups with a moderator, material available in a website for self-learning, printed material for self-study and homework, and small group web-based learning. Conclusions There is a large unmet need to implement educational interventions to improve residents' educational skills in postgraduate educational programs in developing countries. Most perceived needs of residents are practical and clinically oriented, and they prefer traditional educational strategies. Resident as teachers educational interventions need to be designed taking into account local needs and resources.
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                Author and article information

                Journal
                iem
                Investigación en educación médica
                Investigación educ. médica
                Universidad Nacional Autónoma de México, Facultad de Medicina (México, Distrito Federal, Mexico )
                2007-5057
                September 2019
                : 8
                : 31
                : 28-37
                Affiliations
                [3] Ciudad de México orgnameUniversidad Nacional Autónoma de México orgdiv1Facultad de Medicina Mexico
                [1] Ciudad de México orgnameUniversidad Nacional Autónoma de México orgdiv1Facultad de Medicina orgdiv2División de Estudios de Posgrado Mexico
                [5] Ciudad de México orgnameUniversidad Nacional Autónoma de México orgdiv1Facultad de Medicina Mexico
                [4] La Habana orgnameUniversidad de La Habana orgdiv1Hospital “Hermanos Ameijeiras” Cuba
                [2] Ciudad de México orgnameInstituto Mexicano del Seguro Social orgdiv1Centro Médico Nacional “La Raza” Mexico
                Article
                S2007-50572019000300028 S2007-5057(19)00803100028
                10.22201/facmed.20075057e.2019.31.18112
                4a8354b5-0e59-45ad-bc30-b5bd430fb733

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 16 March 2018
                : 25 June 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 10
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                SciELO Mexico

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                Aptitud clínica,estrategia educativa,investigación educativa,médicos residentes,Clinical aptitude,educational strategy,educational research,resident physicians

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