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Mendive. Revista de Educación
ISSN 1815-7696
30--2023
Original article
Professional skills of Internal Medicine specialists to care for pregnant women with associated pathologies
1Hospital Provincial "Abel Santamaría Cuadrado". Pinar del Río. Cuba
2Universidad de Pinar del Río "Hermanos Saíz Montes de Oca". Cuba
The need to have doctors specialized in Internal Medicine prepared to guarantee the quality of health services according to the always gradual demands of the population, continues to be a priority of the Cuban Health System. This preparation requires a deep mastery of both theoretical knowledge and those professional skills necessary for professional performance during the care of a number of medical problems related to the internal systems of the adult individual, their prevention and treatment from an integral conception of the human being; Among them, attention to pregnant women acquires a great connotation due to the high risk of appearance in the pregnancy stage of certain pathologies. In this sense, the objective of this work was to carry out a characterization of the training and development of professional skills of the Internal Medicine resident for the care of pregnant women with associated pathologies. A mixed approach was assumed on a sequential design for obtaining the information that allowed the performance of a triangulation of data. The main methods used in the empirical order were the interview to different sample groups and the observation of teaching activities; The analytical-synthetic and the inductive-deductive methods were used as theoretical methods. The results of the research allowed us to determine the main characteristics of the training and development of professional skills of Internal Medicine residents for the care of pregnant women with associated pathologies.
Key words: Pregnant women; professional skills; Internal Medicine; associated pathologies; health services
Introduction
Cuban society is increasingly demanding in relation to the guarantee of quality of health services provided by its professionals. In line with this, effective medical care constitutes a dynamic factor of health, representing a source or condition for the achievement of the state of well-being in the patient and their families.
Assuming this previous budget requires that, within the Cuban socioeconomic development strategy, the need to have well-trained specialist doctors be present, who guarantee the quality of health services according to the always gradual demands of the population; budget that is endorsed in the policy of the Cuban State considering that the training and development of the qualified work force is a priority due to the implication it has for the future of the country.
This claim, related to the ongoing training process, must also certify a permanent and comprehensive updating of medical personnel. Thus, from its fundamental functions: medical, administrative, investigative and teaching care (Ledesma et al., 2015), it will be able to solve with relevance the professional situations of their spheres of action (Curbeira, et al. 2019).
This undergraduate training process at the Ministry of Public Health (MINSAP) must take place, on the one hand, in the context of teaching-care-research integration, where the object of the profession and its learning methods are their own pedagogical work. professional. On the other hand, and closely related to the first, the operation of this previous triad would only be possible in a scenario of integration of the University of Medical Sciences with the health care units (Del Huerto et al., 2022).
None of the professional areas that make up the training of specialists in Internal Medicine (IM, also called clinicians or internists) escape this condition or relationship, as a specialized professional of synthesis (generalist nature of the specialty). This branch of medicine studies, prevents, and treats disorders of the internal systems of the adult individual (man or woman), healthy or sick, hospitalized or ambulatory, in the family and community environment, based on collective medical attention to areas and / or groups of individuals at risk. Based on this, the internist guides, treats and solves a large number of medical problems, through actions of health promotion, prevention, cure and rehabilitation that he develops at the levels of primary, secondary and tertiary care (Ledesma et al, 2015).
However, in not all areas or groups of individuals, residents (IM specialists in training) present the same level of development. For researchers such as Hernández, et al. (2021), achieving the teaching-educational function in an integral way is a great problem, which seems to be caused by the deficiencies that exist in the training programs of MI residents, fundamentally in the theory-practice relationship in some areas of medical attention.
In line with the above, a study carried out as part of this research in 2021 reveals that once they graduate, the highest professional incidence of IM specialists (between 35 and 45%) takes place in the health areas. related to polyclinics and family doctor's offices. It was also possible to verify that among the patients (group at risk) that this specialist attends the most in the areas and groups of individuals referred to are pregnant women (pregnant or pregnant) who present certain pathologies associated with the clinical area. However, they draw attention to how in the evaluation carried out by IM residents on the contents of their training for the process of care for pregnant women with associated pathologies, 74% do not feel satisfied with the mastery of professional skills to run with pregnant women during this period.
The problem acquires a high connotation for the Cuban Maternal and Child Program. Li et. to the. (2020) consider the pregnant, parturient or puerperal woman as a subject of very high vulnerability. During pregnancy, various complications can arise that can put the health of the mother and the baby at risk. Consequently, for the Cuban Maternal and Child Program, systematic medical attention is of the utmost importance, not only by obstetricians, but also by all professionals of all medical specialties of the National Health System during the gestation period in order to achieve a good pregnancy monitoring.
In these periodic consultations, possible health problems can be identified early in order to take the necessary measures to protect the health of the mother and the developing fetus. This requires a high preparation of each specialist who starts from the PEA of each specialty.
An analysis of the requirements of the Postgraduate Academic Services in Cuba, in relation to the MI specialty in particular (Vela et al, 2018) shows that the contents provided for the training must guarantee that the future specialist has a solid professional training that will allows to know, assess and transform the state of health of adults, with a scientific approach to the health-disease process and the biopsychosocial nature of patients.
This demands an adequate balance between the theoretical and practical training of specialists. Aspect that implies the appropriation of the professional contents necessary for an adequate medical attention; function that involves attention to a large number of medical problems related to the internal systems of the adult individual, their prevention and treatment from an integral conception of the human being as a biological, psychic and social unit (Ledesma et al, 2015).
For Hernandez, et al. (2021), among the problems that affect the practice of medical education in the training process of residents, is the insufficient organization and projection of the PEA, with emphasis on work with the professional content didactic category. Situation that acts according to them, as the cause of failure in certain tasks or in reaching a previously agreed objective.
The component contained in general in professional training in particular has been addressed by different authors of Cuban pedagogy (Abreu et al., 2015; Rodríguez et al., 2019; Mena et al., 2019; Arboleda ed., 2019; García, et al., 2021; Aguilar et al., 2022; Rodríguez et al., 2023, among others). They all insist on the adequate conception of the theory-practice link in direct contact with the problems that characterize the object of the profession, as an essential relationship in the appropriation by students of professional content. Which in turn implies a harmonious conception between knowledge (theoretical knowledge) and know-how (skills or instrumental knowledge).
As a characteristic, postgraduate specialties weigh practical training over theoretical, while their results contribute to solving problems related to the object of the profession (Serra, 2015).
For the aforementioned author, the postgraduate specialty in health provides the updating, deepening, improvement and expansion of professional skills for professional performance in correspondence with the needs of the economic, political, social and cultural development of the country. In other words, the specialty as a professional training process par excellence requires a close link between knowledge and know-how directly linked to practice, so that the necessary professional skills can be trained and developed during performance.
In correspondence with the aforementioned, the objective of the work was to carry out a characterization of the training and development of the professional skills of the Internal Medicine resident for the care of pregnant women with associated pathologies.
Materials and methods
The investigation followed a mixed approach; A descriptive study of the training of residents of the MI specialty that takes place at the "Abel Santamaría Cuadrado" Provincial Hospital in Pinar del Río province was carried out. The research responded to a sequential execution design-type data collection methodology that linked the qualitative phase, in which the approaches of the subjects involved in the research were explored and contrasted, with the quantitative phase in which the frequency was measured. with which these approaches appeared in order to establish the corresponding generalizations.
This previous sequential design allowed the application of a multiple triangulation of data (Fernández, cited by García, et al., 2021), related to the process of training and development of professional skills in MI residents for work with pregnant women with pathologies. associates.
The process began with a group interview with 27 graduates of the MI specialty in the last five years to find out the main characteristics of their training as specialists, as well as those of their professional performance. With this information, it was then decided to apply an interview to the 17 MI residents who, at the time of diagnosis, were in the last year of the specialty. Based on the data provided by the residents interviewed, an interview was conducted with the 9 specialists who worked as tutors and who therefore assumed the teaching of the specialty, with the aim of knowing their criteria in relation to the object of study and contrasting with it the statements of the residents.
Once the information from the three previous instruments had been processed, it was decided to corroborate in practice the points of coincidence with the application of the observation method to 14 teaching activities (Annex 4), to know the status of the problem studied, in the development of the resident training.
The interpretation of the data obtained from the comprehensive analysis of the results of the applied instruments was possible with the application of analytical-synthetic and inductive-deductive theoretical methods, which facilitated the necessary inferences until arriving at the final regularities.
Results
The results of the study allowed us to corroborate that in more than 50% of the cases the work placement that the students receive is related to the polyclinics and family doctor's offices. Everyone agrees on the effectiveness of the Maternal and Child Program in the province, associated with the increase in care, treatment, and prevention in clinics and polyclinics for a growing number of cases related to the maternal-infant stage.
The specialists interviewed agree that among the most common pathologies associated with pregnancy are: iron deficiency anemia, gestational diabetes, depression and anxiety, high blood pressure, infections, bronchial asthma, pneumonia, liver disease, appendicitis, virulence and epilepsy among others. This demonstrates the need for theoretical and practical preparation of specialists for initial clinical care for pregnant women, taking into account their gynecological-obstetric condition.
The empirical study carried out showed as a strength the existence, in the "Abel Santamaría Cuadrado" Provincial Hospital, of a maternal and child block in which more than 90% of pregnant women in Pinar del Río are attended; This element allows the existence of the possibility and the minimum necessary conditions so that MI residents can carry out, during their training, sufficient practical teaching activities related to the different pathologies associated with the gestation stage; aspect that would allow them the training and development of the necessary skills to care for pregnant women who manifest these diseases.
However, both the interviewed graduates of the MI specialty and the residents agreed that not all the potentialities existing in the hospital are taken advantage of during training. In this sense, specialists graduate with deficiencies in the domain of professional skills that facilitate care for pregnant women with associated pathologies. It has practically been during their performance as IM specialists in the referred health areas that they adequately develop these skills.
Both the interviewed specialists who carry out the teaching activities of the PEA of the specialty acting as tutors, as well as the results of the observation of the teaching activities, recognized an insufficient structuring of the contents of the PEA by the teachers; aspect that denotes a lack of integrity and systematicity in the conception, projection, execution and evaluation of the work with the professional contents related to the most frequent pathologies that affect pregnant women, whose first medical care actions must be carried out from the point of view clinical.
The criteria put an end to insufficient teaching performance that allows tutors to guide, demonstrate, follow up, correct errors and evaluate the formation of professional skills under study. Then, the aforementioned deficiencies limit the sufficient link between theory and practice by residents during their training as MI specialists.
Correspondingly, an insufficient role of MI residents was manifested during practical activities that enable them to train and develop the aforementioned professional skills, in direct contact with the problems that characterize the object of the profession. As a result, the process of appropriation of professional content by residents during the development of the PEA is affected, which in turn affects their comprehensive training.
Discussion
Approach to the PEA of the MI specialty. essential categories
Arriving to take sides for a definition of EAP in the MI specialty requires a first analysis of some of the categories that compose it; especially those that have a more marked impact on the object of study, including: teaching, learning, training and development.
Specialists such as Rodríguez et al, (2019) and Rodríguez et al, (2023) consider teaching as an organizational process of the cognitive activity of the students, which implies the appropriation in the activity of the historical-social experience and the representation and understanding ideal of the objects and processes of nature and society, as well as their subjective reproduction. This element regulates all cognitive activity and as an effect it acts on the axiological component, related to the formation of values and attitudes towards what is taught.
For its part, learning is a reciprocal process in which the student, directed by the teacher, participates in a leading way in activities that produce in him the appropriation of the content from the assimilation, reproduction and application of knowledge.
Note how in both cases the activity category is present, understood by these authors as the way in which the student relates to the world; that is, the teaching activity is a process in which the IM resident creatively reproduces and transforms the nature of their professional context, based on objective reality mediated by clinical practice.
As a result, in this dialectical interrelation between teaching and learning, training and development take place, essential categories that, although they do not have their origin in the pedagogical sciences, are indissolubly associated with them.
The term formation, coming from the Latin formatio, means action and effect of forming or forming, which taken to the pedagogical context presupposes the intellectual, professional and axiological preparation of one or several subjects or individuals.
In Cuba, training and development have been explained in various ways, assigning them various meanings. Training is used as a synonym for education and/or as a function of the educational process linked directly to development. It is also assumed as a spiritual guide that the subject who passes the instructive action must necessarily have, among other criteria.
Development, in turn, is a process associated with the systematic gradual change or transformation that occurs in the student as a result of the integration and transfer of knowledge, skills and values in specific activities related to the solution of real or simulated situations of the object that is studied (Mena et al., 2019).
For Rodriguez et. to the. (2019) the categories do not act independently. They are invariably interrelated; They constitute a dialectical unity. Training is explained as a platform for development and also as a consequence of it; expresses the direction of development, points to where it should go. That is, it can be seen as a process and as a result.
The development, although it does not dismiss the consideration of the socio-educational influence, responds to the internal regularities of the formative process, in which it occurs gradually and increasingly.
Thus, both categories constitute complex processes that occur harmoniously within the PEA. Thus, an interrelation between training and development is caused, in which the first is related to the formation of modes of action and the second strengthens, consolidates and gives perpetuity to those modes, from the systematic training in practical activity, elements which will be addressed later.
For authors such as Abreu et al. (2015), in professional pedagogical processes, the training category largely has the same meaning as the technical education category, due to the complexity of interests and processes that are interconnected in the modeling of a professional for the world of work. Hence, it is usual to find the term or concept of professional training in the technical education literature.
Based on the above criteria, the research followed a formative conception of teaching and learning. So, when assuming a definition in the training of MI specialists, the one proposed by Bermúdez and Pérez (cited by Abreu et al., 2015) for higher education has been taken into account, understood as:
[...] the process of cooperation between the worker and the students through which learning is directed, facilitating the individual and collective construction of the contents of the profession, in the context of the integration university - labor entity - community, to enhance the personal and group growth based on the requirements of the professional model (p. 44)
When assuming this definition, it is necessary to specify two key elements. In the first order, it is analyzed that cooperation implies joint, harmonious and co-responsible participation of students guided by teachers when planning, executing and controlling the training process, essentially linked to practical activity (education at work). Secondly, this cooperation process must take place in scenarios with conditions that facilitate the appropriation of the contents of the specialty.
Both elements typify the PEA of the MI specialty, given the demands of this postgraduate figure related to the close theory-practice interrelation of the content with an emphasis on the training and development of professional skills in a permanent link with real care settings.
The professional contents and their components in the PEA of the MI specialty
Perhaps one of the most debated PEA components in recent years is the content category. From general didactics, most experts associate it with the knowledge accumulated by humanity or part of the culture and social experience that must be acquired by students, just to cite two cases.
If these criteria are assumed, indisputably one falls into the dilemma that implies the impossibility of the PEA for students to learn the copious culture that precedes them; since the significant scientific-technical development and the accelerated socioeconomic transformations multiply the information to be systematized by science until it becomes knowledge.
Therefore, applying these definitions to professional training makes the situation more complex, given the broad cultural baggage that careers and technical and professional specialties contain (Mena et al., 2019). For the student of the postgraduate specialty, the accumulated general culture that makes up the contents to be assimilated during the PEA, also includes the technical and professional culture in constant renewal given the usual change of technological paradigm (Abreu et al., 2015).
Hence, this research starts from the definition given by Bermúdez and Pérez (cited by Abreu et al., 2015), which considers content as that historical and social experience that for the subject "is important, necessary, has significance and personal meaning in his life at the moment he learns it and depending on his future." (p. 12)
In this same order of ideas, Mena et al., (2019) consider that including the technical and professional culture in the content of the PEA in the training of professionals adds the adjective of professional to this didactic category. Therefore, these authors assume the professional content as that "[...] historical, social, cultural, scientific, technical and technological experience that is important, necessary, significant and useful to the student, guaranteeing an integral general and technical-professional preparation, that enables their future successful performance in correspondence with social and labor interests" (p. 9).
This definition is also assumed by the author of this research to explain this didactic category of the PEA of the MI specialty, while the professional content enables the development of the capabilities of the future specialist and contributes to the execution of a variety of work functions. that guarantee their active interrelation with the specialty and the clinical context.
Based on the above, the way in which the PEA of the specialty is organized, developed and evaluated is important, conceiving its systematization from different contexts. Thus, during their training, the MI resident must go through the different levels of knowledge: sensory-perceptual, representative and rational, based on the solution of professional problems contextualized and representative of the object of the profession.
However, this transition must harmoniously include theoretical knowledge and its practical application in solving professional problems in the specialty. So, a brief analysis of the internal structure of the professional content category is necessary. León and Menéndez (quoted by Abreu et al., 2015), assume this composition based on three dimensions that, contextualized in the object studied in this article, characterize the aforementioned category in the training of MI specialists, they are:
- The knowledge seen as the notions, concepts, theories, principles, relationships and laws of the sciences of the general branches of knowledge, of the medical sciences in general and of the clinical area in particular that allow explaining the facts, phenomena and processes of this specialty.
- The abilities seen as the expression of the mastery, the application or the instrumentation in the practice of this knowledge that allow to face and to give solution to the problems that integrate the object of the profession that characterizes the specialty
- The values, feelings, attitudes, qualities, norms and ethics of the profession, etc., which as a result of learning professional knowledge and skills are formed and developed in the residents and regulate and modify their modes of action and their professional performance.
As can be seen, there is a close interrelation between the three components, so the level of appropriation of the professional contents experienced by the residents depends to a great degree on their harmonious integration. This integration is revealed during the performance of residents in education at work when facing and offering solutions to problems related to pathologies associated with the gestation stage.
If it is taken into account that the MI resident is a specialist in training, it must be understood that, despite the fact that he is trained in real clinical conditions, he is not yet a specialist, therefore his performance takes place under conditions of education in the job. Being consistent with this, the resident's performance is assumed to be the first manifestations of future professional performance, which occur in education at work during professional training as a specialist and which takes place in real conditions and characteristics in relation to those of the scenarios. in which he will perform upon graduation. This context must reproduce the characteristics of the future job.
However, regardless of the characteristics of the performance, it is practically essential to be able to verify the current state of what the resident knows (knowledge), what he knows how to do (skills) and how he acts or behaves (attitudes).
Being consistent with the previous criteria on the content category, its components also acquire the status of professionals.
Most common pathologies associated with the care of pregnant women as demands that society establishes to the IM specialist
As part of the professional content that MI residents must appropriate during their training as specialists, there is the area of obstetrics and, fundamentally, pregnant women or pregnant women.
Mastery of professional content enables the development of the capabilities of the future specialist and contributes to the execution of a variety of job functions; Therefore, the way in which it is determined, organized and developed is important, conceiving its systematization from different contexts, based on the specialty (Mena and Mena, 2019).
The specialty program and its professional contents owe their existence to the demands and problems established from the socio-labour field (García, et al., 2021). To be consistent with this, the PEA of the specialty has to respond to the responsibility of preparing a resident in IM who is capable of performing professionally in a competent manner, and for which the improvement of the level of training of its members is an essential issue. Professional skills.
The aforementioned social demands are expressed as situations or problems that, in the case under study, determine the existence of the specialty in particular. In this sense, these problems, therefore, constitute the starting point for the PEA of the specialty.
The problems appear in the socio-labour field outside the PEA of the specialty; which requires designing this training program based on fulfilling the task of preparing the student with the level of training and development of professional skills necessary to solve these problems of the specialty (García, et al., 2021).
Then, being consistent with the object, it is convenient to study its main characteristics, in order to know the problems that integrate it and that will serve as a starting point for the determination of the contents and, from these, the conception to follow in the training. and development of professional skills for the care of pregnant women with associated pathologies.
Pregnancy is the period of greatest metabolic, immunological, and functional changes in all the organs, apparatuses, or systems of the female organism, so the appearance or exacerbation of any clinical pathological entity has a greater impact on maternal and child health. The response to this aggression is different in pregnant women than in non-pregnant women, which is why the participation of all specialists is necessary, mainly clinicians (Li et al., 2020).
Coinciding with the results of the empirical diagnosis made, there may be various pathologies associated with pregnancy that become professional content that is the object of study for the MI resident. A detailed analysis of a group of investigations on the subject, have made it possible to locate as a regularity a group of pathologies associated with (Li et al., 2020) pregnant women that become professional areas or problems that must be mastered by MI residents; among them: emergencies, chronic non-communicable diseases, diseases of the respiratory system, diseases of the cardiovascular system, diseases of the digestive system, diseases of the urinary system, diseases of the hemolymphopoietic system, diseases of the nervous system, musculoskeletal diseases and connective tissue, metabolic endocrine diseases and infectious diseases.
Being consistent with the references previously assumed, conceiving the PEA of the specialty based on these determined socio-medical problems is vital when planning the process in order to achieve the general objectives of the specialty (Ledesma et al, 2015).
On this basis, an IM specialist will have to be able to design and evaluate an empathic doctor-patient relationship that promotes an efficient care and satisfaction process in medical care. Likewise, they must be able to make diagnoses that include the biomedical field, the affectation and suffering with the efficient use of the clinical method, developing as a result a comprehensive solution to the patient's health problem, within the legal, educational and scientific frameworks. established. All this will be possible if he is capable of executing and evaluating the technical procedures established for his specialty, for diagnostic and therapeutic purposes (professional skills).
The study, monitoring and treatment, from the clinical point of view, by MI residents, become professional problems and contents of the specialty for which residents will have to have trained and developed professional skills.
Training and development of professional skills by MI residents to work with pregnant women with associated pathologies
There are various definitions of the concept of ability, however, according to the interests of this research, the criteria of Rodríguez et al. (2019) who assume it as certain forms of assimilation of the activity from the domain of operations (psychic and practical) that allow a rational ordering of the activity, as a result of the systematization of actions subordinated to a conscious purpose.
Fuentes (Cited by Curbeira et al. 2019), when studying higher level professional training processes, professional skill stands out as a type of skill to be systematized in the training process until applying the knowledge by acting and transforming the object of work until solving professional problems with precision, speed, transfer, stability and flexibility.
For these authors, the construction of the skill requires the ordering of certain operations that constitute its structure, and from there the levels of depth with which each of the operations must be mastered are determined.
However, it should not be overlooked that these operations are part of the content of a system of essential actions in the object of profession that the specialist has to assimilate and master and for this it will be necessary to systematize them conveniently from an initial realization succeeded by repetition, reinforcement and improvement of professional activity.
Thus, getting to train and develop professional skills in IM residents for the care of pregnant women affected by any of the previously mentioned pathologies, is a complex and dynamic process within the framework of work and professional practice activity with these patients, which requires taking into account a process made up of two inextricably linked stages: training and development.
In this regard, Aguilar et al. (2022) assume the training stage as the conscious acquisition of ways of acting during education at work, when under the direction of the tutor, the student receives adequate guidance on how to proceed.
On the other hand, he speaks of the development of professional ability when, once the modes of action have been acquired, the process of exercising the newly formed ability begins in the necessary quantity and with an adequate frequency, so that it becomes increasingly easier. to reproduce and eliminate errors.
That is to say, although in the formation stage a qualitative nature prevails (simple character of reproduction) the primary or starting character, during the development process the quantitative (quantity, frequency) is weighted, according to the conception with which it is repeated. the action.
However, both stages (training and development) work as a system, so it is impossible to separate them when structuring the activity. Therefore, the training and development of professional skills is presented as an integration of actions and operations that are not found separately, are mutually conditioned and have an internal correspondence in themselves (Rodríguez et al., 2019; Aguilar et al., 2022)
In view of the above and from the context of the training of MI specialists, it is considered that the complexity and dynamism that characterizes this process requires the following premises to be taken into account:
- The training and development of professional skills occurs from the socialization of an IM resident who has all the potential to develop as such (basic professional training) and can only be achieved by integrating with the object of the specialty (care to pregnant women).
- The professional skills under study are formed, developed and manifested in the activity and the tutor-resident communication as a result of the continuous interaction between the resident's theoretical knowledge and its application in confronting and solving real professional problems.
Achieving these demands requires meeting a group of requirements such as:
- Plan and organize the process (teaching activities of a practical nature) that allows the systematization and consolidation (repetition, reinforcement and improvement in the activity) of the actions and operations corresponding to the professional skills to be trained and developed
- Determine and organize the system of actions with their corresponding operations (internal structure of the activity) that enables the training and development of the necessary skills in the care of each pathology associated with pregnant women.
- Guarantee the active and conscious nature of learning, starting from a correct guiding base of the actions that allow the IM resident a clear understanding of the proposed objectives.
- Execute the process in an increasing, progressive, uniform and programmed way until the development of each skill and all of them as a whole.
By way of conclusion and without intending to exhaust the study of the object, it is considered that the training and development of professional skills in MI residents for the care of pregnant women with associated pathologies constitute a requirement or requirement that contributes to the integrality of the PEA of the specialty. As a result, the resident's competence gradually increases, directly affecting the effectiveness and quality of their performance during the pedagogical process. In this sense, the conception of the PEA of the specialty will reach a greater degree of rigor and significance when its projection is specified based on real criteria (object of the profession) that specify the significance of a competent professional performance from the socio-labour point of view.
Thus, the training and development of the professional skills of MI residents for the care of pregnant women with associated pathologies is appreciated as a pedagogical process of configuration of essential clinical practical actions in the object of work of this specialist, related to care. of pregnant women based on an empathic doctor-patient relationship, promoting efficient diagnostic and therapeutic follow-up that, with the efficient use of the clinical method, enables the creation, improvement and mastery of modes of action that guarantee better performance with this group of patients. risk.
Referencias bibliográficas
Abreu Regueiro, R. L., & Soler Calderius, J. L. (2015). Didáctica de la Educación Técnica y Profesional. Pueblo y Educación. [ Links ]
Aguilar Blanco, Y. E., & Mena Lorenzo, J. A. (2022). La clase de enseñanza práctica en el contexto laboral en la Educación Técnica y Profesional. Roca: Revista Científico - Educacional de la provincia de Granma, 18(2), 277-301. [ Links ]
Arboleda Aparicio, J. C. (ed.). (2019). Educación y Pedagogía. New York - Cali: Editorial REDIPE (95857440), https://redipe.org/wp-content/uploads/2019/08/Libro-educacion-y-pedagogia-cuba-2019-parte-iii.pdf [ Links ]
García, J.; & Varens, S. (2021). La formación de las habilidades profesionales específicas en los profesores en la Licenciatura en Cultura Física. Revista Científica Cultura, Comunicación y Desarrollo, 6(2), 41-44. https://rccd.ucf.edu.cu/index.php/aes/article/view/291 [ Links ]
Hernández, M.; Carvajal, A. Rísquez, A.; Guzmán M.; Cabrera, C. y Drummond, T. (2021). Consenso de la COVID-19 en el embarazo. Bol Venez Infectol 32(1), 7-26. https://docs.bvsalud.org/biblioref/2021/07/1255046/01-hernandez-m-7-26.pdf [ Links ]
Ledesma Villavicencio, L. C., & Madinaveitia Turcott, J. (2015). Opinión de médicos internos respecto al residente como educador. Investigación en Educación Médica, 45. https://doi.org/10.1016/S2007-5057(15)30002-8 [ Links ]
Li J, Wang Y, Zeng Y, Song T, Pan X, Jia M, et al. (2020). Critically ill pregnant patient with COVID-19 and neonatal death within two hours of birth. Int J Gynaecol Obstet, 150(1),126-128. [ Links ]
Mena-Lorenzo, J. L., & Mena-Lorenzo, J. A. (2019). La integración curricular de contenidos científicos en la formación profesional de estudiantes cubanos de Ingeniería Agrónoma. Indagatio Didactica, 11(1). https://doi.org/10.34624/id.v11i1.5647 [ Links ]
Curbeira, D.; Bravo, M.L. & Morales, Y.C. (2019). La formación de habilidades profesionales en la educación superior. Revista Cubana Medicina Militar, 48(1), 426-440. [ Links ]
Del Huerto, M. E.; Romero, Y.; Velazco, Y.; Triana, L. A.; Cañete, R. & Semper, A. I. (2022). El concepto cultura de la profesión en la educación médica superior cubana: una reflexión necesaria. Revista Cubana De Educación Superior, 41(3). https://revistas.uh.cu/rces/article/view/273 [ Links ]
Rodríguez Rodríguez, A., Ponce Zavala, C. V., Pibaque Pionce, M. S., Solorzano, S. E., Macías Parrales, T. M., Vélez Mejía, R. M., & Cañarte Ávila, J. W. (2019). Relaciones de las categorías pedagógicas en función del aprendizaje óptimo. Editorial Área de Innovación y Desarrollo, S. L. https://www.3ciencias.com/wp-content/uploads/2019/12 /RELACIONES-DE-LAS-CATEGOR%C3%8DAS-PEDAG%C3%93GICAS-EN-FUNCI%C3%93N -DEL-APRENDIZAJE-%C3%93PTIMO.pdf [ Links ]
Rodríguez Chaud, Ángela, Oliva Jaume, E. P., Torres Rodríguez, E., & Benítez Reyes, D. (2023). Experiencia sobre el desarrollo de habilidades prácticas en la asignatura de Química Básica y Orgánica, en la carrera de Medicina Veterinaria y Zootecnia. Revista Cubana De Educación Superior , 36(3). [ Links ]
Serra Valdés, A. M. (2015). La formación de especialistas en la Educación Médica Superior. Importancia del Tutor de la Especialidad. Revista Cubana de Reumatología, 17(1), 92-99. [ Links ]
Vela-Valdés J., Salas-Perea, R. S., Quintana-Galende, M. L., Pujals-Victoria N, González Pérez, J., Díaz Hernández, L. (2018). Formación del capital humano para la salud en Cuba. Rev Panam Salud Publica, 42(2). [ Links ]
Received: January 09, 2023; Accepted: May 25, 2023
