La entrevista se define como “una conversación que se propone con un fin determinado distinto al simple hecho de conversar”. Es un instrumento técnico de gran utilidad en la investigación cualitativa, para recabar datos. El presente artículo tiene como propósito definir la entrevista, revisar su clasificación haciendo énfasis en la semiestructurada por ser flexible, dinámica y no directiva. Asimismo, se puntualiza la manera de elaborar preguntas, se esboza la manera de interpretarla y sus ventajas. Finalmente, por su importancia en la práctica médica y en la educación médica, se mencionan ejemplos de su uso.
BackgroundCompetency-based education has been considered the most important pedagogical trend in Medicine in the last two decades. In clinical contexts, competencies are implemented through Entrustable Professional Activities (EPAs) which are observable and measurable. The aim of this paper is to describe the methodology used in the design of educational tools to assess students´ competencies in clinical practice during their undergraduate internship (UI). In this paper, we present the construction of specific APROCs (Actividades Profesionales Confiables) in Surgery (S), Gynecology and Obstetrics (GO) and Family Medicine (FM) rotations with three levels of performance.MethodsThe study considered a mixed method exploratory type design, a qualitative phase followed by a quantitative validation exercise. In the first stage data was obtained from three rotations (FM, GO and S) through focus groups about real and expected activities of medical interns. Triangulation with other sources was made to construct benchmarks. In the second stage, narrative descriptions with the three levels were validated by professors who teach the different subjects using the Delphi technique.ResultsThe results may be described both curricular and methodological wise. From the curricular point of view, APROCs were identified in three UI rotations within clinical contexts in Mexico City, benchmarks were developed by levels and validated by experts’ consensus. In regard to methodological issues, this research contributed to the development of a strategy, following six steps, to build APROCs using mixed methods ConclusionsDeveloping benchmarks provides a regular and standardized language that helps to evaluate student’s performance and define educational strategies efficiently and accurately. The university academic program was aligned with APROCs in clinical contexts to assure the acquisition of competencies by students.
BackgroundA time-honored strategy for keeping up to date in medicine and improving critical appraisal skills is the Journal Club (JC). There are several reports of its use in medicine and allied health sciences but almost no reports of JC focused on medical education. The purpose of the study is to describe and evaluate an eight years’ experience with a medical education Journal Club (MEJC).MethodsWe started a monthly medical education JC in 2006 at UNAM Faculty of Medicine in Mexico City. Its goal is to provide faculty with continuing professional development in medical education. A discussion guide and a published paper were sent 2 weeks before sessions. We reviewed the themes and publication types of the papers used in the sessions, and in June-July 2014 administered a retrospective post-then-pre evaluation questionnaire to current participants that had been regular attendees to the JC for more than 2 years. The retrospective post-then-pre comparisons were analyzed with Wilcoxon signed-rank test. Effect sizes were calculated for the pre-post comparisons with Cohen’s r.ResultsThere have been 94 MEJC sessions until July 2014. Average attendance is 20 persons, a mix of clinicians, educators, psychologists and a sociologist. The articles were published in 32 different journals, and covered several medical education themes (curriculum, faculty development, educational research methodology, learning methods, assessment, residency education). 22 Attendees answered the evaluation instrument. The MEJC had a positive evaluation from good to excellent, and there was an improvement in self-reported competencies in medical education literature critical appraisal and behaviors related to the use of evidence in educational practice, with a median effect size higher than 0.5. The evaluation instrument had a Cronbach’s alpha of 0.96.ConclusionsA periodic Medical Education Journal Club can improve critical appraisal of the literature, and be maintained long-term using evidence-based strategies. This activity is a useful adjunct to the scholarship of teaching.
Introducción: El proceso asistencial y educativo en las instituciones de salud implica diversos actores, uno de los cuales es el médico residente. Este grupo desarrolla simultáneamente dos roles diferentes, como alumnos de programas de especialización de las universidades y como profesionales de la salud empleados por las instituciones hospitalarias. Es necesario reflexionar sobre los avances y obstáculos que tiene el papel docente del médico residente, en el escenario actual de la educación y práctica médica. Objetivo: Proveer una actualización y reflexión crítica sobre el concepto del “médico residente como educador” (MRE). Método: Revisión narrativa de la literatura y ensayo crítico sobre el tema. Discusión: El concepto de MRE ha evolucionado y se ha incorporado en varios programas educativos a nivel internacional, aunque su penetración ha sido menor en nuestro medio. En este documento revisamos el papel del MRE en los escenarios educativos actuales, describimos esfuerzos relevantes para formalizarlo en el currículo de las especialidades médicas, analizamos estrategias para implementar actividades educativas sobre el tema en el entorno de atención de la salud y reflexionamos sobre sus perspectivas para el futuro. Conclusiones: El MRE es un elemento fundamental en el proceso asistencial-educativo de las instituciones de salud y universitarias. Es necesario promover el desarrollo profesional de esta faceta del médico residente, elaborar intervenciones educativas sobre el tema y diseñar instrumentos para evaluar su impacto.
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