The question of how to quantify insufficient coping behavior under chronic stress is of major clinical relevance. In fact, chronic stress increasingly dominates modern work conditions and can affect nearly every system of the human body, as suggested by physical, cognitive, affective and behavioral symptoms. Since freshmen students experience constantly high levels of stress due to tight schedules and frequent examinations, we carried out a 3-center study of 1,303 students from Italy, Spain and Argentina in order to develop socioculturally independent means for quantifying coping behavior. The data analysis relied on 2 self-report questionnaires: the Coping Strategies Inventory (COPE) for the assessment of coping behavior and the Zurich Health Questionnaire which assesses consumption behavior and general health dimensions. A neural network approach was used to determine the structural properties inherent in the COPE instrument. Our analyses revealed 2 highly stable, socioculturally independent scales that reflected basic coping behavior in terms of the personality traits activity-passivity and defeatism-resilience. This replicated previous results based on Swiss and US-American data. The percentage of students exhibiting insufficient coping behavior was very similar across the study sites (11.5-18.0%). Given their stability and validity, the newly developed scales enable the quantification of basic coping behavior in a cost-efficient and reliable way, thus clearing the way for the early detection of subjects with insufficient coping skills under chronic stress who may be at risk of physical or mental health problems.

RESUMO Numa KEYWORDS:-Education, Medical.-Education, Nursing.-Primary Health Care.-Educational Measurement. ABSTRACT In a multiprofessional, discipline-based curriculum with cumulative and cognitive assessment, anew discipline based on University-Community

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The data indicates that medical schools that employ more active learning methodologies provide more attention and time to ethical themes than schools with traditional discipline-based methodologies. Given the importance of ethical issues in contemporary medical education, these findings are significant for curriculum change and modification plans in the future of Brazilian medical education.

horária, considerada insuficiente. Conclusão: A análise da avaliação evidenciou a necessidade de implementar o desenvolvimento docente, o planejamento conjunto e a continuidade do processo de articulação. A utilização das metodologias interativas contribuiu para a integração da Unidade Curricular de semiologia. Palavras-chave: Semiologia, Educação médica, Estudante, Metodologia. AbstractIntroduction: Curriculum integration is critical to medical education. It represents a constant challenge for teachers since there is no shared concept about what it means, what is to be included, and the dynamics of operationalization. Objectives: To promote and implement the integration of the human semiology curricular unit (medical clinic, pediatrics, diagnostic imaging, psychology and health informatics) through interactive methodologies; and to evaluate the students' perception of the unit. Methods: Action-research was done, involving 76 teachers and 125 third-year medical students. Monthly meetings were held between the coordinators for the implementation and follow-up of the interactive methodologies, which consisted of integration of theory and practice, implementation of a joint discussion of clinical cases, a holistic view of the patient and their problems, collaboration and communication between teachers, joint classes, and integrated evaluation with the process of learning and teaching in small groups. In addition, training workshops were held for the use of a Moodle platform by teachers and to design a page with the activities of the curricular unit. The evaluation of students' perceptions was performed through a voluntary and anonymous questionnaire with open questions (qualitative). All 125 students answered the questionnaire. A five-point Likert scale was used with a midpoint indicating intermediate or nullity, domain of discordance (values 1 and 2) and domain of accordance (4 and 5). The analysis of the data was made comparing their results with those obtained in the tests of the previous year. The Statistical Package for the Social Sciences (version 17.0, SPSS®, Chicago, IL, USA) was used in the statistical analyses. Results: Data analysis showed that there was a positive impact after the integration of the subjects and the introduction of interactive methodologies in the course. There was a significant improvement in performance, theoretical and practical, as measured by the scores obtained by the students, when compared to the students of the previous year (p <0.001). On the other hand, in open questions, students still mentioned heterogeneity among teachers and in the evaluation. They students also commented on the need for a continuous effort to improve and maintain the integration and to adjust their workload. Conclusion: The evaluation analysis supported the need to continue to implement teacher development, joint planning and the continuity of the articulation process. The integration of interactive methodologies was shown to improve student performance compared to the previous class in a Semiology Curric...