medigraphic.com
ISSN 0016-3813 (Print)

2016, Number 5

<< Back Next >>

Gac Med Mex 2016; 152 (5)

Grado de competencia clínica de siete generaciones de estudiantes al término del internado médico de pregrado

Martínez-González A, Sánchez-Mendiola M, Méndez-Ramírez I, Trejo-Mejía JA

Language: Spanish
References: 22
Page: 679-687
PDF size: 198.17 Kb.


ABSTRACT

Introduction: Objective structured clinical examination is the instrument with more validated evidence to assess the degree of clinical competence of medical students. Objectives: To assess the degree of clinical competence of medical students at the end of their internship; to assess the reliability of the instruments with G theory. Methods: This was an observational, longitudinal, and comparative study. The target population was composed of 5,399 interns of seven generations that finished their internship at the Faculty of Medicine of UNAM, between 2009 and 2015. The instrument used was 18 OSCE stations, three in each subject of the internship. Results: The undergraduate medical interns show a sufficient degree of clinical competence to be general practitioners. The laboratory interpretation and physical examination had the highest scores. The interpretation of imaging studies was the component with the lowest score. The Family Medicine disciplinal area had the highest average score in the OSCE; in contrast, Pediatrics obtained the lowest score on average. The reliability was measured with Generalizability Theory and ranged between 0.81 and 0.93. Conclusions: The clinical competence of undergraduate medical interns is considered sufficient. The results also show the subjects that require educational interventions to improve clinical competence of students.


REFERENCES

  1. Paredes Sierra R, Rivero Serrano O. El papel de la medicina general en el Sistema Nacional de Salud. Seminario El ejercicio actual de la medicina. 2001.

  2. Estadísticas: Salud en Números: DGIS. 2015.

  3. Eva KW, Neville AJ, Norman GR. Exploring the etiology of content specificity: factors influencing analogic transfer and problem solving. Acad Med. 1998;73(10 Suppl):S1-5.

  4. Collins JP, Harden RM. AMEE Medical Education Guide No. 13: real patients, simulated patients and simulators in clinical examinations. Medical Teacher. 1998;20(6):508-21.

  5. Reznick R, Smee S, Rothman A, et al. An objective structured clinical examination for the licentiate: report of the pilot project of the Medical Council of Canada. Acad Med. 1992;67(8):487-94.

  6. Sloan DA, Donnelly MB, Schwartz RW, Strodel WE. The Objective Structured Clinical Examination. The new gold standard for evaluating postgraduate clinical performance. Ann Surg. 1995;222(6):735-42.

  7. Neufeld V, Norman G. Historical Perspectives on clinical competence. En: Company SP, ed. Assessing Clinical Competence. Nueva York: 1985. p. 3-14.

  8. Hodges B, Hanson M, McNaughton N, Regehr G. Creating, monitoring, and improving a psychiatry OSCE: A guide for faculty. Acad Psychiatry. 2002;26(3):134-61.

  9. Guttormsen S, Beyeler C, Bonvin R, et al. The new licencing examination for human medicine: from concept to implementation. Swiss Med Wkly. 2013;143:w13897.

  10. Short MW, Jorgensen JE, Edwards JA, Blankenship RB, Roth BJ. Assessing intern core competencies with an objective structured clinical examination. J Grad Med Educ. 2009;1(1):30-6.

  11. Facultad de Medicina U (SECISS). Manual Departamental de Medicina General I. Programa académico teórico-práctico. Departamento de Tercer Año. 2012.

  12. Facultad de Medicina U (SECISS). Manual Departamental de Medicina General II. Programa académico teórico-práctico. Departamento de Cuarto Año. 2012.

  13. Trejo J, Larios H, Cortés M, Martínez M, García O. Competencia clínica en el área de medicina familiar. Arch Med Fam. 2000;2(3):65-74.

  14. Frenk-Mora J, Robledo-Vera C, Nigenda-López G, Ramírez-Cuadra C, Galván-Martínez O, Ramírez-Avila J. [Policies for training and employment of physicians in Mexico 1917-1988]. Salud Publica Mex. 1990;32(4):440-8.

  15. Narro J, Robles M. Panorama del posgrado médico en México. En: Graue E, Sánchez M, Durante I, Rivero O, eds. Educación en las residencias médicas. México: Textos Mexicanos; 2010. p. 9-14.

  16. Trejo Mejía JA, Martínez González A, Méndez Ramírez I, Morales López S, Ruiz Pérez LC, Sánchez Mendiola M. [Clinical competence evaluation using the Objective Structured Clinical Examination (OSCE) in medical internship at UNAM]. Gac Med Mex. 2014;150(1):8-17.

  17. Larios Mendoza H, Trejo Mejia JA, Mendez I. Examen profesional con el examen clínico objetivo estructurado. Revista de la Educación Superior. 2005;34(4[136]):7-17.

  18. Ruesseler M, Weinlich M, Byhahn C, et al. Increased authenticity in practical assessment using emergency case OSCE stations. Adv Health Sci Educ Theory Prac. 2010;15(1):81-95.

  19. Streiner DL, Norman GR. Health Measurement Scales: A practical guide to their development and use. En: Norman GR, Streiner DL, eds. 4.a ed. Oxford University Press; 2008. p. 452.

  20. Van Der Vleuten CP. The assessment of professional competence: Developments, research and practical implications. Adv Health Sci Educ Theory Prac. 1996;1(1):41-67.

  21. Mavis BE, Henry RC. Between a rock and a hard place: finding a place for the OSCE in medical education. Med Educ. 2002;36(5):408-9.

  22. Hill DA, Guinea AI, McCarthy WH. Formative assessment: a student perspective. Med Educ. 1994;28(5):394-9.




2020     |     www.medigraphic.com