Scielo RSS <![CDATA[Educación Médica Superior]]> http://scielo.sld.cu/rss.php?pid=0864-214120220002&lang=es vol. 36 num. 2 lang. es <![CDATA[SciELO Logo]]> http://scielo.sld.cu/img/en/fbpelogp.gif http://scielo.sld.cu <![CDATA[Tarea Vida en la Universidad Ciencias Médicas de Sancti Spíritus]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200001&lng=es&nrm=iso&tlng=es <![CDATA[Valor del idioma inglés en el contexto actual de las ciencias médicas]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200002&lng=es&nrm=iso&tlng=es Mr. Editor: Knowledge has acquired a power that bursts into all spheres of life and has demanded the development of capacities for the processing, restructuring and critical recreation of the accelerated dissemination of information. In this context, the English language appears as the most widely used for the dissemination of scientific and technical information. The English language is one of the most important languages when it comes to communication. International relations are more frequent every day and the use of this language is of more preponderance especially in the non-Anglo-Saxon countries of Europe, Asia, Africa, Australia and in all the Spanish-speaking nations from Spain, Central America and South America.1 The primacy currently held by the English language, in the world of international relations, is a reality that few questions. English has become the vehicle of communication par excellence at all levels: politics, economy, commerce, tourism, science and technology. In other words, it has become what we could call a lingua franca, a role that, not many centuries ago, Latin (and to a lesser extent Greek( played in the western world.1 The English language has undergone a huge expansion if we compare its position, for example, in the time of Shakespeare when it was the native language of only a few million inhabitants, with its position today, when it is estimated that approximately 300 million people have it as their mother language and a similar number of inhabitants use it as a second language. It has become a vital medium for the transmission of information and traditional or digital communication, as its use spreads rapidly in the computer network system.1 Over the years, it has been seen that medical science students and specialists themselves have needed the English language during their academic studies, as well as in the professional contexts in which they are developed. Today, the most influential medical journals publish in English, which has also become the language of international conferences. His domain for medical purposes must be a compulsory subject.2 The terms associated with English learned for specific purposes have been analyzed and categorized, in order to differentiate it from English learned for general purposes. While the development of specific-purpose courses has given rise to a large number of acronyms, the general term is: English for Specific Purposes, which is then further subdivided into English for Academic Purposes (EAP) and English for Vocational Purposes (EVP). In relation to the field of Medicine, the predominant term used is English for medical purposes (IFM).3 In higher medical education centers in Cuba, great importance is given to teaching the English language, which is why it represents an essential element in terms of comprehensive preparation for the future performance of health professionals. The study of the English language is included as a discipline, in all medical science careers, from its early years with a gradual derivation of its contents and objectives, starting from the mastery of communicative aspects of language to those related to their profession, from This language preparation allows them to provide medical assistance in countries where English is used as their mother tongue, official language, or lingua franca, and to stay up-to-date on advances in science and technology, through reading, translation, and interpretation of scientific articles in the various existing sources. Furthermore, mastery of this language is an essential requirement for obtaining teaching and research categories, academic and scientific degrees.1 In the field of medicine, it is evident how necessary the English language is for students to achieve their academic purposes and can develop in the research field. The teaching of medical English must be adapted to meet these needs, since the knowledge and command of English is useful for each and every one of the health professionals. There are several articles that reinforce the value of English in the context of medical sciences,3,4,5such is the case of Gutiérrez-Rodillas,4where reference was made to the marked disuse of Spanish in its future as a language of medicine; Furthermore, Roca-Morales,5 refers to English as a means to strengthen the doctor-patient relationship through cordial and authentic communication. It can be concluded that the English language has stood out in the development of the field of medical sciences, where it has been widely used since the second half of the 20th century. An example of undoubted recognition is the increase in the number of publications in English on a daily basis, as well as the fact that most of the journals indexed in prestigious databases publish their results in this language. This letter is intended to promote the knowledge and development of English by medical science students, in order to guarantee adequate training for health professionals in Cuba. <![CDATA[El proceso de superación del profesional de enfermería en cuidados intensivos obstétricos]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200003&lng=es&nrm=iso&tlng=es RESUMEN Introducción: La sociedad cubana actual requiere de un profesional de enfermería mejor preparado, desde el punto de vista técnico y humano, para desarrollar con éxito su labor de acuerdo con las exigencias del desarrollo científico tecnológico y las demandas sociales. Objetivo: Exponer el proceso de superación profesional de enfermería para la solución de los problemas profesionales en su desempeño en cuidados intensivos obstétricos. Métodos: El estudio histórico-lógico posibilitó determinar las diferentes etapas histórico-contextuales del proceso de superación de los profesionales de enfermería desde la educación de posgrado, así como el análisis documental y la sistematización realizada a investigaciones nacionales e internacionales. Conclusiones: La superación profesional de enfermería debe corresponderse con el contexto real en que se presentan los problemas profesionales para darles solución; así como promover el desarrollo de nuevos conocimientos y habilidades con pertinencia social, científica y humanística, que posibiliten el fortalecimiento de la práctica del cuidado y eleven la calidad del desempeño.<hr/>ABSTRACT Introduction: The present Cuban society requires better prepared nursing professionals, from the technical and human point of view, who can develop their work successfully in accordance with the demands of scientific-technological development and the society. Objective: To present the process of nursing professional improvement for the solution of professional problems as part of nurses’ performance in obstetric intensive care. Methods: The historical-logical study permitted to determine the different historical-contextual stages of the process of nursing professional improvement from postgraduate education, as well as the documental analysis and the systematization of national and international research. Conclusions: Nursing professional improvement should correspond to the real context where professional problems appear, in order to solve them; as well as to promote the development of new knowledge and skills with social, scientific and humanistic relevance, ensuring the care practice be strengthened and quality of performance be raised. <![CDATA[Dificultad y discriminación del examen de Ontogenia Humana y SOMA en la carrera de medicina]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200004&lng=es&nrm=iso&tlng=es RESUMEN Introducción: La evaluación es la categoría reguladora del proceso de enseñanza-aprendizaje. Los instrumentos evaluativos utilizados para tal propósito deben reunir los criterios mínimos de calidad. Objetivo: Evaluar la dificultad y discriminación del examen de la asignatura Ontogenia Humana y SOMA de la carrera de medicina en la Facultad de Ciencias Médicas de Matanzas en tres cursos académicos. Métodos: Se realizó un estudio de investigación descriptivo transversal en el marco de la educación médica, para describir la estructura del examen de la asignatura Ontogenia Humana y SOMA, en la Facultad de Ciencias Médicas de Matanzas, en los cursos 2016-2017, 2017-2018 y 2018-2019; y determinar la frecuencia de errores, y el nivel de dificultad y el poder de discriminación de estos. Resultados: En el examen aplicado en los tres cursos predominaron las preguntas tipo ensayo. La frecuencia de errores fue media, baja y alta, respectivamente. Los exámenes presentaron dificultad media y excelente poder de discriminación. Conclusiones: Los indicadores de calidad estudiados alcanzaron valores satisfactorios para el examen de la asignatura Ontogenia Humana y SOMA en la Facultad de Ciencias Médicas de Matanzas en los cursos académicos estudiados.<hr/>ABSTRACT Introduction: Evaluation is the regulatory category of the teaching-learning process. The evaluative instruments must meet the minimum quality criteria. Objective: To assess the difficulty and discrimination of the exam of the Human Ontogeny and Osteomioarticular System subject of the medical major in the School of Medical Sciences of Matanzas during three academic years. Methods: A descriptive and cross-sectional research was carried out in the framework of medical education, in order to describe the structure of the exam of the Human Ontogeny and Osteomioarticular System subject, in the School of Medical Sciences of Matanzas, in the academic years 2016-2017, 2017-2018 and 2018-2019; as well as to determine the frequency of errors, together with their level of difficulty and power of discrimination. Results: In the exam applied during the three academic years, essay-type questions predominated. The frequency of errors per year was medium, low and high, respectively. The exams presented medium difficulty and excellent power of discrimination. Conclusions: The studied quality indicators obtained satisfactory values for the exam of the Human Ontogeny and Osteomioarticular System subject in the School of Medical Sciences of Matanzas during the studied academic courses. <![CDATA[Posicionamiento conceptual metodológico para el examen estatal en anatomía humana]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200005&lng=es&nrm=iso&tlng=es RESUMEN Introducción: El examen estatal en las especialidades médicas cubanas es un garante de calidad en las competencias y el desempeño profesional. Su calidad técnica y metodológica debe ser objeto de perfeccionamiento permanente como acción responsable hacia la excelencia académica. Objetivo: Promover un posicionamiento conceptual metodológico para el perfeccionamiento del examen teórico práctico de la especialidad anatomía humana. Métodos: Se emplearon el analítico sintético, la observación participativa y la revisión documental. Resultados: Se obtuvo una propuesta valorativa en el contexto de la especialización en anatomía humana, con acciones específicas para el perfeccionamiento del examen práctico y teórico de esta especialidad. Conclusiones: Los fundamentos teóricos y prácticos presentados son pertinentes para superar debilidades en los exámenes estatales anteriores, y favorecer en el residente de anatomía humana el desarrollo de un pensamiento holístico durante su proceso de formación, con beneficio de mayores competencias y mejor desempeño docente e investigativo.<hr/>ABSTRACT Introduction: The state examination in Cuban medical specialties ensure quality in competences and professional performance. Its technical and methodological quality should be subjected to permanent improvement as a responsible action towards academic excellence. Objective: To promote a conceptual-methodological stance for the improvement of the practical-theoretical examination of the Human Anatomy specialty. Methods: The methods of analysis-synthesis, participative observation and documental review were used. Results: An assessment proposal was obtained in the context of the specialization in Human Anatomy, with specific actions for the improvement of the practical and theoretical examination of this specialty. Conclusions: The theoretical and practical foundations presented are pertinent to overcome weaknesses of previous state examinations, as well as to favor, in the Human Anatomy resident, the development of a holistic thinking during her or his training process, with the benefit of greater competences and better teaching and research performance. <![CDATA[Competencias específicas del especialista de medicina general integral para enfrentar la conducta violenta]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200006&lng=es&nrm=iso&tlng=es RESUMEN Introducción: Las competencias específicas, igualmente llamadas “técnicas” o “especializadas”, tienen que ver con lo propio de determinadas ocupaciones. Designan aquellas relativas al campo disciplinario, de formación y de experiencia del participante. Son la base particular del ejercicio profesional y están vinculadas a condiciones específicas de ejecución. Objetivo: Determinar las competencias específicas del especialista de medicina general integral para enfrentar la conducta violenta. Métodos: Se realizó un estudio descriptivo y de corte transversal durante el primer semestre de 2020. Se desarrolló un trabajo de grupo con informantes clave que ofrecían atención especializada a las víctimas de situaciones violentas en el Centro Comunitario de Salud Mental del municipio Playa. Se aplicaron diferentes técnicas grupales, entre las que se destacaron: la tormenta y la escritura de ideas, las cuales, unidas a la experiencia y el conocimiento de cada participante, propiciaron el logro del objetivo propuesto. Resultados: Como principal aporte teórico se determinó un conjunto de competencias que permitieron al especialista de medicina general integral enfrentar las conductas violentas, orientadas esencialmente a la prevención y la detección temprana de esta compleja problemática de salud. Conclusiones: Resultó pertinente determinar un sistema de competencias, en términos de conocimientos, habilidades y actitudes, que permitieran al especialista de medicina general integral enfrentar el comportamiento violento, al considerar que la asistencia a las víctimas dependería de la capacidad de estos profesionales para reconocer, comprender y responder a situaciones violentas.<hr/>ABSTRACT Introduction: Specific competences, also called technical or specialized, have to do with what is specific to certain occupations. They refer to those related to the disciplinary, training and expertise area of the participant. They are the particular basis of professional practice and are linked to specific performance conditions. Objective: To determine the specific competences of the family and community medicine specialist to deal with violent behavior. Methods: A descriptive and cross-sectional study was carried out during the first semester of 2020. A group work was developed with key informants who provided specialized care to victims of violent situations in the Community Center for Mental Health of Playa Municipality, Havana, Cuba. Different group techniques were applied, with a special interest in brainstorming and writing of ideas, which, together with the experience and knowledge of each participant, favored the achievement of the proposed objective. Results: As the main theoretical contribution, a set of competences was determined that allowed the specialist in family and community medicine to face violent behaviors, oriented essentially to the prevention and early identification of this complex health concern. Conclusions: It was pertinent to determine a system of competences, in terms of knowledge, skills and attitudes, that would allow the specialist in family and community medicine to face violent behavior; upon considering that assistance to victims would depend on the professionals’ ability to recognize, understand and respond to violent situations. <![CDATA[Sobre la naturaleza del conocimiento médico y su enseñanza (Parte II)]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200007&lng=es&nrm=iso&tlng=es RESUMEN Introducción: La atención clínica de pacientes individuales representa la actividad más característica de la profesión médica, mientras que el proceso de diagnóstico constituye la piedra angular del razonamiento clínico. La autoexplicación, la reflexión estructurada y las oportunidades de actividad clínica constituyen los fundamentos de una eficiente educación médica. Objetivo: Identificar los recursos disponibles para llevar a cabo la evaluación del proceso de diagnóstico como centro del razonamiento clínico, así como los errores que puedan producirse en dicho proceso y su corrección. Posicionamiento del autor: Los saberes de carácter metacognitivo en relación con la naturaleza del conocimiento médico y su enseñanza deben formar parte, tanto del conocimiento de los profesores de medicina como de los propios estudiantes. Una adecuada ponderación de este y el desarrollo del conocimiento médico plantea retos en cuanto a las modalidades evaluativas que puedan resultar más adecuadas para justipreciar las capacidades alcanzadas por los educandos y orientar las acciones correctoras que posibiliten enmendar las dificultades detectadas. Conclusiones: Una adecuada evaluación del razonamiento clínico de los aprendices requiere atender no solamente el resultado del proceso, sino a sus diferentes etapas y la justificación de estas, lo cual requiere que el estudiante despliegue y exponga los procesos mentales que desarrolla en los casos que atiende. La ocurrencia de errores en el proceso de diagnóstico, sus causas y las medidas adecuadas para su corrección deben tenerse presentes en el proceso de formación con el fin de contribuir a minimizarlos.<hr/>ABSTRACT Introduction: The clinical care of individual patients represents the most characteristic activity of the medical profession, while the diagnostic process is the cornerstone of clinical reasoning. Self-explanation, structured reflection and opportunities for clinical activity are the foundations of efficient medical education. Objective: To identify the resources available to carry out the assessment of the diagnostic process as the center of clinical reasoning, as well as the errors that may occur in this process and their correction. Author's stance: Knowledge of a metacognitive nature in relation to the characteristics of medical knowledge and its teaching should be part of knowledge possessed by both medical professors and students themselves. Its adequate consideration and the development of medical knowledge poses challenges in terms of the evaluation modalities that may be more appropriate to assess accurately the capabilities achieved by learners and guide the corrective actions that allowed to amend the difficulties detected. Conclusions: An adequate assessment of the trainees' clinical reasoning requires considering not only to the process outcomes, but also its different stages and their justification, which requires from the student to deploy and expose the mental processes that she or he develops in the cases treated. The occurrence of errors in the diagnostic process, their causes and the appropriate measures for their correction must be taken into account in the training process, in order to contribute to minimize them. <![CDATA[Aportes a la biomedicina y la enseñanza a noventa años del desarrollo de la microscopía electrónica]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200008&lng=es&nrm=iso&tlng=es RESUMEN Introducción: La atención clínica de pacientes individuales representa la actividad más característica de la profesión médica, mientras que el proceso de diagnóstico constituye la piedra angular del razonamiento clínico. La autoexplicación, la reflexión estructurada y las oportunidades de actividad clínica constituyen los fundamentos de una eficiente educación médica. Objetivo: Identificar los recursos disponibles para llevar a cabo la evaluación del proceso de diagnóstico como centro del razonamiento clínico, así como los errores que puedan producirse en dicho proceso y su corrección. Posicionamiento del autor: Los saberes de carácter metacognitivo en relación con la naturaleza del conocimiento médico y su enseñanza deben formar parte, tanto del conocimiento de los profesores de medicina como de los propios estudiantes. Una adecuada ponderación de este y el desarrollo del conocimiento médico plantea retos en cuanto a las modalidades evaluativas que puedan resultar más adecuadas para justipreciar las capacidades alcanzadas por los educandos y orientar las acciones correctoras que posibiliten enmendar las dificultades detectadas. Conclusiones: Una adecuada evaluación del razonamiento clínico de los aprendices requiere atender no solamente el resultado del proceso, sino a sus diferentes etapas y la justificación de estas, lo cual requiere que el estudiante despliegue y exponga los procesos mentales que desarrolla en los casos que atiende. La ocurrencia de errores en el proceso de diagnóstico, sus causas y las medidas adecuadas para su corrección deben tenerse presentes en el proceso de formación con el fin de contribuir a minimizarlos.<hr/>ABSTRACT Introduction: The clinical care of individual patients represents the most characteristic activity of the medical profession, while the diagnostic process is the cornerstone of clinical reasoning. Self-explanation, structured reflection and opportunities for clinical activity are the foundations of efficient medical education. Objective: To identify the resources available to carry out the assessment of the diagnostic process as the center of clinical reasoning, as well as the errors that may occur in this process and their correction. Author's stance: Knowledge of a metacognitive nature in relation to the characteristics of medical knowledge and its teaching should be part of knowledge possessed by both medical professors and students themselves. Its adequate consideration and the development of medical knowledge poses challenges in terms of the evaluation modalities that may be more appropriate to assess accurately the capabilities achieved by learners and guide the corrective actions that allowed to amend the difficulties detected. Conclusions: An adequate assessment of the trainees' clinical reasoning requires considering not only to the process outcomes, but also its different stages and their justification, which requires from the student to deploy and expose the mental processes that she or he develops in the cases treated. The occurrence of errors in the diagnostic process, their causes and the appropriate measures for their correction must be taken into account in the training process, in order to contribute to minimize them. <![CDATA[Salud y transformación digital]]> http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412022000200009&lng=es&nrm=iso&tlng=es RESUMEN Introducción: La atención clínica de pacientes individuales representa la actividad más característica de la profesión médica, mientras que el proceso de diagnóstico constituye la piedra angular del razonamiento clínico. La autoexplicación, la reflexión estructurada y las oportunidades de actividad clínica constituyen los fundamentos de una eficiente educación médica. Objetivo: Identificar los recursos disponibles para llevar a cabo la evaluación del proceso de diagnóstico como centro del razonamiento clínico, así como los errores que puedan producirse en dicho proceso y su corrección. Posicionamiento del autor: Los saberes de carácter metacognitivo en relación con la naturaleza del conocimiento médico y su enseñanza deben formar parte, tanto del conocimiento de los profesores de medicina como de los propios estudiantes. Una adecuada ponderación de este y el desarrollo del conocimiento médico plantea retos en cuanto a las modalidades evaluativas que puedan resultar más adecuadas para justipreciar las capacidades alcanzadas por los educandos y orientar las acciones correctoras que posibiliten enmendar las dificultades detectadas. Conclusiones: Una adecuada evaluación del razonamiento clínico de los aprendices requiere atender no solamente el resultado del proceso, sino a sus diferentes etapas y la justificación de estas, lo cual requiere que el estudiante despliegue y exponga los procesos mentales que desarrolla en los casos que atiende. La ocurrencia de errores en el proceso de diagnóstico, sus causas y las medidas adecuadas para su corrección deben tenerse presentes en el proceso de formación con el fin de contribuir a minimizarlos.<hr/>ABSTRACT Introduction: The clinical care of individual patients represents the most characteristic activity of the medical profession, while the diagnostic process is the cornerstone of clinical reasoning. Self-explanation, structured reflection and opportunities for clinical activity are the foundations of efficient medical education. Objective: To identify the resources available to carry out the assessment of the diagnostic process as the center of clinical reasoning, as well as the errors that may occur in this process and their correction. Author's stance: Knowledge of a metacognitive nature in relation to the characteristics of medical knowledge and its teaching should be part of knowledge possessed by both medical professors and students themselves. Its adequate consideration and the development of medical knowledge poses challenges in terms of the evaluation modalities that may be more appropriate to assess accurately the capabilities achieved by learners and guide the corrective actions that allowed to amend the difficulties detected. Conclusions: An adequate assessment of the trainees' clinical reasoning requires considering not only to the process outcomes, but also its different stages and their justification, which requires from the student to deploy and expose the mental processes that she or he develops in the cases treated. The occurrence of errors in the diagnostic process, their causes and the appropriate measures for their correction must be taken into account in the training process, in order to contribute to minimize them.