Editorial

Relevance of continuing education and the development of professional competences in medical sciences

Dayimit Nancy Casamayor Rubio^{1  *} 
http://orcid.org/0000-0001-7214-4853

Gloria Patricia Gálvez Jaramillo² 
http://orcid.org/0000-0002-0107-7929

Mariolys Hernández Rodríguez¹ 
http://orcid.org/0000-0002-3357-6300

¹Universidad de Ciencias Médicas de Sancti Spíritus, Cuba.

²Institución Educativa Juan María Céspedes, Municipio de Tuluá, Departamento del Valle del Cauca, Colombia.

Training is an inherent process to human development, conceptually complex and from different meanings and interpretations according to the discipline, science and technology to be analyzed as a study object. Some authors refer that training in the first place, as a conceptual reality, is not identified or diluted within other concepts and quote as examples: Education, teaching, training. They add that it incorporates a personal dimension of global human development related to training capacity and will, that is, it is the individual himself, who is ultimately responsible for the activation and development of the training processes. ¹

Starting from the idea that "preparing for life is not just about professionalizing", nor is education to prepare only for exams. It is about thinking and seeing one's life as training, ² from this view it is corroborated that training is not memorizing knowledge, it is to understand what has been learned, innovating and transforming about one's own practical action where the individual, in turn, transforms himself in the different orders of life.

For its part, the process of continuous teacher training constitutes, in general, the central nucleus of development in education professionals for the achievement of professional competences. Currently, the development obtained in the knowledge society in the different areas of knowledge has generated, globally, a complex change in the political, economic and socio-cultural reality; that is why the educational systems, as governing bodies of the training of their teachers, are called to face the constant and varied demands that the current XXI century demands. From this perspective, the continuous training of teachers is crucial for improving the quality of education.

Several authors review that teacher training constitutes an indispensable aspect for the improvement of teaching and learning, as well as for research. They address the development of the state of the art in the performance of the discipline that is exercised, as an aspect of great importance since it favors the continuous training of the professional, referring to the systematic study of the knowledge accumulated around a specific study area, “that is its more advanced development state”. ³ It is essential, then, that teachers maintain a motivating spirit of constant and developer work towards research.

Recognized international organizations emphasize the importance of having trained professionals who search for practical solutions to problems in their social environment, as well as to provide cooperation services at a global level. Among them, the United Nations Organization for Education, Science and Culture (Unesco), recognizes that "Higher Education extends the training of teachers with plans and programs of study that give teachers the ability to prepare their students with the knowledge and skills they need in the XXI century", ⁴ thus contributing to social development. Most of these organizations focus their objectives and strategies on the renewal and improvement of educational processes, including the teacher training for integral professionals, with the capacity to innovate and adapt to new realities, and become those forces for changing.

In the medical sciences, as in many other professions, updated knowledge in the graduate is undoubtedly indispensable, as well as the strengthening and acquisition of new skills on a continuous way. Adapting to the changes and challenges of the profession, with a broad capacity for innovation, makes it easier to provide excellent services to the population, providing an efficient solution to the main health problems.

For this reason the World Health Organization (WHO) 2015 emphasizes the need to guarantee quality training for health personnel, taking into account that the human factor is essential to strengthen health systems, it refers to: "Countries must transform the health workforce based on aptitude, better supporting and respecting all employees to provide the best possible care.", ⁵ from this perspective, the endowment of Human Resources in Health was identified by WHO as an indispensable factor for the strengthening of health systems in the world, calling the decade from 2005 to 2015 the “Decade of Human Resources in Health”.

Previously, the Declaration of Helsinki, proclaimed by the World Medical Association (WMA), in its General Principle 12 held that "Medical research in human beings should be carried out only by people with education, training and scientific and ethical qualifications appropriate”. ⁶

Taking into account the principles of the referred organizations, the National Health System in Cuba (SNS) has sufficient human resources in constant improvement, as well as the political will of the State and the legal instruments established to increase the demand in the different levels of training according to the world development trends. Consequently, the training and professional development of medical sciences in our country are considered as a continuum of specialization and permanent education activities. However, recent studies in Cuba in the context of health show some difficulties regarding postgraduate improvement actions due to a high teaching-assistance burden on teachers, which implies new challenges to maintain the quality of the faculty and aspire to higher stages. The doctoral studies in science have not achieved the progress required by the SNS because the number of trained doctors is insufficient. ⁷ Consequently, the low scientific production of the tutors due to the assistance pressure, some do not find the time or are not motivated to research. The conditions for publishing are not the best and the number of sites available decreases. They are not properly planned to overcome and fulfill the requirements towards higher teaching categories. ⁸ So, It is necessary to reflect on better organizational forms of the postgraduate course in health institutions.

In an indissoluble link with training, the development of professional skills is decisive for the practical and comprehensive application, in different contexts, of the knowledge acquired, allowing the solution of typical problems of the environment. The training processes of professionals, based on competences, emerge to respond in a pertinent way to social demands, where "being and knowing how" acquires a meaning about "knowing and doing what". ⁹ This means that the professional must first know how to act and interact, carry out his profession with ethics and respect and with the appropriate technique, being efficient and creative at the same time. Therefore, teacher training is also necessary, not only aimed at enriching the knowledge society, but also at developing professional skills on a continuous way.

Competence, according to Tobón, ¹⁰ is the ability to integrate what is done with what is known and what is; being competent is to know how to do and to know how to act as a human being, with conviction of what is done, assuming with ethics and commitment the implications of own actions in a given context. This author also highlights as main keys of the competences the solution of problems in a specific context where knowledge, disciplines and areas are integrated, evaluating in a pertinent way, based on evidence, their own performance in order to achieve continuous improvement.

Other concepts suggest that competence is an emergent and self-organized process of updating potentials and mobilizing-articulating the necessary resources, aimed at responding to a contextual demand for a social and historically constructed practice that is expressed in an individual and/or collective-self-regulated performance and socially valued for their suitability. ¹¹ While some scholars on the subject in the last three years denote that the competences refer to the intentional mobilization of personal resources in relation to specific demands of the external environment, associated with their professional relationship but at the same time emerge in the relationship with such external demands. ¹²

By integrating the previous concepts, it is deduced that competences in the professional are achieved through an interrelated process of knowledge, generalized abilities, both of professional and social values, where the interdisciplinary is manifested in the academic, investigative and labor aspects. Competence is, therefore, the man's ability, as a biopsychosocial being, to give a pertinent response to everyday situations through his abilities, attitudes, values and knowledge, conceptualized in each professional environment, where he transforms reality progressively.

In teachers, competences go beyond a mere transmission of knowledge; they must generate flexible and dynamic training environments, focused on solving real-world problems, in order to obtain comprehensive training. ¹³ Thus, educational processes should guarantee the development of competences that respond to the needs of the knowledge society through the employment, in addition to information and communication technologies, in a pertinent way.

That is why the teaching competences in the medical science professionals cannot be separated from ethical, responsible and social commitment training. More than any other educational approach, professional competences in teachers determine how to guide the teaching-learning processes with quality, its implementation offers principles, indicators and essential tools for the good performance of the profession.

It should also be noted that in order to achieve professional competences in these teachers through continuous training, it is necessary to stimulate and enhance the development of scientific research as a way to constantly explore and update knowledge and an essential requirement for the improvement of education from the obtained experiences and, consequently, raise the scientific level of the professionals, which will have a positive impact on the entire society.

When it comes to training human talent, it is necessary to think of a professional development plan that links the area of disciplinary knowledge with the development of investigative skills. ¹⁴ Then, in the current context, it is urgently required to carry out such researches focused on improving the population life quality, since the accelerated scientific and technological development achieved by man requires professionals global health to develop an individual and social investigative attitude in their daily work, as an unbeatable way to increase the efficiency of their professional performance, where Cuba is not exempt from changes.

The importance of continuous training and the development of professional competences must be reflected day by day as a necessity in the contemporary world to face the constant changes and challenges of the present century. The factors that block their normal development influence negatively in different contexts. In the teaching-learning process, the teacher, as a social agent and transmitter of knowledge, would feel limited by not possessing sufficient and updated knowledge or the necessary tools to continuously develop skills, attitudes and values that allow being increasingly competent in the exercise of the profession and in the practical solution of problems in the social environment. Not only teachers must have an active participation in the improvement of the referred process, but also those guiding, organizing, controlling and evaluating it, especially in the medical sciences, where professionals trained for medical cooperation in different countries are also required. In general, knowledge and good management of technological advances, which facilitate access to the enormous wealth of existing sources of information for research, are not enough, but also, keep updated to act effectively facing any process in a reflexive, critical and creative way that favors the constant transformation of reality.

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Received: May 28, 2020; Accepted: June 15, 2020