Revistas
Revista:
FAMILY MEDICINE
ISSN:
0742-3225
Año:
2022
Vol.:
54
N°:
8
Págs.:
621 - 628
BACKGROUND AND OBJECTIVES: Empathy is considered a prerequisite for a successful physician-patient relationship. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) is a regularly-used, patient-rated measure of physician empathy. The aim of this study is to translate and analyze the reliability and validity of the JSPPPE Spanish (Spain) version (Sp-JSPPPE) in primary care in order to use it with medical trainees. METHODS: After translation and back translation of the JSPPPE, 369 patients from 21 primary care physicians in Pamplona (Navarre, Spain) completed the Sp-JSPPPE, a sociodemographic questionnaire, the Spanish (Spain) Consultation and Relational Empathy Measure (Sp-CARE), and a question about overall satisfaction. We studied internal reliability (Cronbach's alpha and ordinal alpha), homogeneity (corrected item-total correlations), construct validity (confirmatory factor analysis [CFA]) and concurrent validity (Spearman's correlation) of Sp-JSPPPE. RESULTS: Cronbach's alpha and ordinal alpha were 0.870 and 0.919, respectively, for the Sp-JSPPPE, and all corrected item-total correlations exceeded the accepted cutoff of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The total score for the Sp-JSPPPE was significantly correlated with sp-CARE (Spearman's rho 0.651, P <.001) and with overall patient satisfaction (Spearman's rho 0.504, P <.001). CONCLUSIONS: The results support the reliability and validity of the Sp-JSPPPE in primary care. Sp-JSPPPE could be useful in empathy assessment of medical trainees, both graduate and postgraduate, in the Spanish context.
Revista:
EDUCACION MEDICA
ISSN:
1575-1813
Año:
2021
Vol.:
22
N°:
Suppl. 5
Págs.:
437 - 441
La educación interprofesional (EIP) es clave para garantizar el aprendizaje integrado de los alumnos de diferentes titulaciones, que ejercerán una labor profesional basada en el cuidado centrado en la persona, de manera conjunta. El proyecto de EIP de la Universidad de Navarra pretende dar a los alumnos de medicina, enfermería y farmacia los conocimientos, habilidades y actitudes necesarias para trabajar de manera interprofesional, centrándonos en trabajo en equipo, conocimiento y respeto de roles, resolución de conflictos y comunicación interprofesional.
Para ello, el equipo de docentes implicados en este proyecto ha tenido que trabajar colaborativamente, experimentando las claves de este trabajo interprofesional, centrado en el alumno, constituyendo una experiencia enriquecedora, constructiva, y que ha aportado las claves del trabajo en equipo necesario para llevar a cabo un proyecto docente de EIP.
Revista:
FAMILY PRACTICE
ISSN:
0263-2136
Año:
2021
Vol.:
38
N°:
3
Págs.:
353 - 359
Background: Empathy is an essential competence in the medical field. There are no validated patient-rated empathy measures in Spanish (Spain). The Consultation and Relational Empathy (CARE) measure is a widely used patient-rated measure of physician empathy. Objective: To analyse the reliability and validity of the Spanish (Spain) version of the CARE measure in primary care. Methods: After translation, back translation and pilot testing, a convenient sample of 369 patients recruited through 21 primary care physicians in five primary care centres in Pamplona (Navarre, Spain) completed the Spanish (Spain) CARE (Sp-CARE) measure. The number of 'does not apply' or blank responses was calculated to assess acceptability. We analysed internal reliability by means of Cronbach's alpha and ordinal alpha and homogeneity with corrected item-total correlations.The construct validity was examined by confirmatory factor analysis (CFA) and concurrent validity by Spearman's correlation. Results: We observed high acceptability; only 37 (1%) responses were marked 'does not apply' and only 3 (0.08%) were left blank. Cronbach's alpha and ordinal alpha for the Sp-CARE measure were 0.953 and 0.970, respectively, and all corrected item-total correlations exceeded the accepted cut of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The Sp-CARE measure total score was significantly correlated with overall patient satisfaction (Spearman's rho 0.45, P < 0.001). Conclusion: The results support the reliability and validity of the Sp-CARE measure as a patient-rated empathy measure in the primary care setting.
Revista:
OTOLARYNGOLOGY-HEAD AND NECK SURGERY
ISSN:
0194-5998
Año:
2021
Vol.:
164
N°:
2
Págs.:
339 - 345
Objective To validate a simulator for upper airway examination, fitted with sensors, for use as an academic tool for learning how to conduct examination of the upper airway and for evaluation of that learning. Study Design Validation study. Setting Undergraduate medical education. Subjects and Methods A group of 18 fifth-year medical students and another of 6 otorhinolaryngology specialists conducted 6 examinations each with the simulator. To investigate concurrent validity, we calculated the correlation between damage scores provided by the simulator and damage assessment by a specialist. To evaluate construct validity, we compared both groups with regard to damage scores, technical procedure, and time spent. To examine content and face validity, we used questionnaires based on a 5-point Likert scale. Results For concurrent validity, the correlation between the simulator's damage scores and the specialist's damage assessment was high: Spearman's rho was 0.828 (P< .001). For construct validity, the group of students differed from the group of specialists in damage scores (P= .027) and in technical procedures (P< .001) but not in time spent. For content validity, all questionnaire statements were scored highly, and both groups had similar average scores. For face validity, the group of specialists considered the simulator to be realistic, and all statements on the questionnaire were rated with at least 4/5. Conclusion Concurrent, construct, content, and face validity have been demonstrated for a sensor-fitted simulator for upper airway examination, which is therefore accurate enough to be used as an academic tool for learning and evaluation of learning.
Revista:
EDUCACION MEDICA
ISSN:
1575-1813
Año:
2020
Vol.:
21
N°:
6
Págs.:
386 - 396
La asistencia sanitaria centrada en el paciente es la clave para una atención humana a la persona y a su familia. La práctica colaborativa en equipos interprofesionales resulta imprescindible para alcanzar una atención sanitaria de calidad. La universidad tiene la responsabilidad de preparar a sus graduados para trabajar en equipos interprofesionales. Una enseñanza/aprendizaje centrada en la persona, fundamentada en las competencias que definen la educación interprofesional, es clave para que nuestros estudiantes reconozcan la necesidad del trabajo colaborativo. Este artículo detalla un proyecto docente de educación interprofesional de la Universidad de Navarra, donde estudiantes de las facultades de medicina, enfermería y farmacia aprenden juntos y de manera gradual, las claves de cómo trabajar en equipo.
Revista:
ACTA OPHTHALMOLOGICA
ISSN:
1755-375X
Año:
2020
Vol.:
98
N°:
3
Págs.:
e397 - e399
Revista:
REVISTA CLINICA ESPAÑOLA
ISSN:
0014-2565
Año:
2017
Vol.:
217
N°:
6
Págs.:
332 - 335
Empathy is a basic skill in the exercise of medicine and increases patient and physician satisfaction and improves clinical results. However, the teaching of empathy is poorly covered in the teaching plans. A number of studies have observed a reduction in empathy during the final training courses. The reasons for this decline include, the students' excessive academic workload, the prioritisation of acquiring medical expertise over humanistic knowledge, the patient load in hospitals and health centres and the physicians' need to distance themselves from their patients. Nevertheless, intervention studies through simulation with standardised patients have shown an increase in empathy in students, which can be evaluated through the Jefferson scales: JSE-S and JSPPPE. The teaching of empathy to medical students is an important commitment in the curricular programs of medical schools. (C) 2017 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.
Revista:
ATENCION PRIMARIA
ISSN:
0212-6567
Año:
2016
Vol.:
48
N°:
7
Págs.:
501 - 502
Revista:
BMC MEDICAL EDUCATION
ISSN:
1472-6920
Año:
2016
Vol.:
16
N°:
1
Págs.:
47
The formal quality of the MIR exam items has improved over the last five years with regard to testwiseness. A more detailed revision of the items submitted, checking systematically for the presence of technical flaws, could improve the validity and discriminatory power of the exam, without increasing its difficulty.
Revista:
ATENCION PRIMARIA
ISSN:
0212-6567
Año:
2015
Vol.:
48
N°:
3
Págs.:
210 - 212
Revista:
REVISTA DE LA FUNDACION EDUCACION MEDICA
ISSN:
2014-9832
Año:
2015
Vol.:
18
N°:
1
Págs.:
35 - 38
Objetivo.
Conocer la valoración de los estudiantes respecto a la simulación como herramienta de formación y la opinión
sobre la figura del alumno instructor.
Sujetos y métodos.
El taller se realizó en el Centro de Simulación y tuvo una duración aproximada de 90 minutos. En cada
sesión estaba el alumno instructor con diez compañeros. Los alumnos instructores fueron formados previamente por un
profesor de cardiología. Al finalizar la sesión, los estudiantes cumplimentaron un cuestionario de satisfacción anónimo
que contenía preguntas relacionadas con el aprendizaje basado en la simulación y sobre la capacidad de sus compañeros
para actuar como formadores.
Resultados.
Se obtuvieron encuestas de 291 estudiantes: 150 de quinto y 141 de sexto curso (82,4% y 71,2% de los matri
-
culados, respectivamente). Los datos obtenidos del cuestionario de satisfacción respecto a la metodología de aprendizaje
obtuvieron puntuaciones entre 3,64 y 4,75 sobre 5. Las preguntas que valoraban la opinión acerca de los alumnos forma
-
dores obtuvieron valores entre 4,88 y 4,93 sobre 5.
Conclusiones.
La simulación es una herramienta docente complementaria muy valiosa. La participación de alumnos ins
-
tructores podría ser una ayuda adicional en los talleres de simulación de exploración cardiológica.
Revista:
SIMULATION IN HEALTHCARE
ISSN:
1559-2332
Año:
2015
Vol.:
10
N°:
5
Págs.:
277 - 282
Introduction: Simulation enables medical students to practice clinical skills in a safe environment. Graduates in medicine must be able to correctly perform an examination on a pregnant woman using Leopold maneuvers. Learning curves-cumulative summation (LC-CUSUM) may help determine when the student has achieved a specific skill. Our objective was to perform the LC-CUSUM test regarding the ability of students to correctly carry out Leopold maneuvers; a pregnancy simulator was used, transferring the results to a clinical setting. Methods: Five medical students were trained to carry out Leopold maneuvers using the simulator. Each student performed maneuvers for 50 cases of different fetus positions; a LC-CUSUM was plotted for each student. Afterward, the students performed the Leopold maneuvers on 5 pregnant women. Results: Of the 5 students, 3 achieved a level of proficiency; the attempts needed for reaching this level were 13, 13, and 37, respectively. The other 2 students did not reach proficiency level. Of the students who became successfully proficient with the simulator, one of them attained a 100% success rate in pregnant patients, whereas the other two had success rates of 80%. The students who did not achieve a level of competency with the simulator had only a 60% success rate with patients. Conclusions: Because of the differences observed between students in the number of attempts needed for achieving proficiency in Leopold maneuvers, we believe that each student should build his/her own learning curve. Achieving competency in carrying out Leopold maneuvers using the simulator could be transferable to patients. Copyright © 2015 by the Society for Simulation in Healthcare.
Revista:
ACTAS UROLOGICAS ESPAÑOLAS
ISSN:
0210-4806
Año:
2014
Vol.:
38
N°:
6
Págs.:
367 - 372
Objective: To know the level of confidence of fifth year medical students in order to perform maneuvers in bladder catheterization and rectal examination before and after training with simulators. To be able to assess student satisfaction regarding the use of the simulation as a learning method.
Material and Methods: The study was conducted in the Simulation Center of the Faculty of Medicine. A total of 173 students who completed a practical workshop on the subject of Urology participated. The students were asked to answer anonymous questionnaires on their level of confidence in performing a bladder catheterization and rectal examination before and after the workshop as well as their satisfaction in using the simulation as a training tool. The workshops were organized using groups of 10 students. A teacher or a resident in that area of expertise supervised each student individually, resolving their doubts and teaching them the proper technique.
Results: All the evaluations made on the different abilities were significantly higher after training (P<.001). Significant differences were found in the confidence level between men and women before the training regarding male urethral catheterization maneuvers and recognition of normal or pathological prostate, The confidence level was lower in women (P<.05). These differences disappeared after training. The level of overall satisfaction with the workshop was high, going from 4.47 ± 0.9 to a maximum score of 5.
Conclusions: Simulation is a training method that helps improve the confidence of the medical student in performing a bladder catheterization and digital rectal examination.
Revista:
SIMULATION IN HEALTHCARE
ISSN:
1559-2332
Año:
2013
Vol.:
8
N°:
4
Págs.:
234 - 241
Introduction: Current European Resuscitation Guidelines 2010 recommend the use of prompt/feedback devices when training for cardiopulmonary resuscitation (CPR). We aimed to assess the quality of CPR training among second-year medical students with a voice advisory mannequin (VAM) compared to guidance provided by an instructor.
Methods: Forty-three students received a theoretical reminder about CPR followed by a 2-minute pretest on CPR (compressions/ventilations cycle) with Resusci Anne SkillReporter (Laerdal Medical). They were then randomized into a control group (n = 22), trained by an instructor for 4 minutes per student, and an intervention group (n = 21) trained individually with VAM CPR mannequin for 4 minutes. After training, the students performed a 2-minute posttest, with the same method as the pretest.
Results: Participants in the intervention group (VAM) performed more correct hand position (73% vs. 37%; P = 0.014) and tended to display better compression rate (124 min-1 vs. 135 min-1; P = 0.089). In a stratified analyses by sex we found that only among women trained with VAM was there a significant improvement in compression depth before and after training (36 mm vs. 46 mm, P = 0.018) and in the percentage of insufficient compressions before and after training (56% vs. 15%; P = 0.021).
Conclusions: In comparison to the traditional training method involving an instructor, training medical students in CPR with VAM improves the quality of chest compressions in hand position and in compression rate applied to mannequins. Only among women was VAM shown to be superior in compression depth training. This technology reduces costs in 14% in our setup and might potentially release instructors' time for other activities.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2013
Vol.:
36
N°:
2
Págs.:
275-280
To determine the degree of confidence of students regarding obstetric examination before and after training with simulators, and assess their satisfaction with the use of simulation as a tool for acquiring skills.
METHODS:Training groups involved 10 students per lecturer. Students learned how to perform Leopold's manoeuvres and measure uterine height with a simulator. The instructor supervised each physical exam. Surveys by those students who had previously done an internship at the Department of Obstetric & Gynecology were not taken into account.
RESULTS:Students' confidence in performing the procedures improved significantly (p¿0.001) after the intervention.
Revista:
DIABETOLOGIA
ISSN:
0012-186X
Año:
2013
Vol.:
56
N°:
12
Págs.:
2743-2752
MMP-10 is involved in the development of microvascular complications in type 1 diabetes and emerges as a potential therapeutic target for slowing down the evolution of diabetic nephropathy and retinopathy.
Revista:
EDUCACION MEDICA
ISSN:
1575-1813
Año:
2012
Vol.:
15
N°:
1
Págs.:
47 - 52
Objetivos. La utilización de la simulación es habitual en medicina para mejorar el conocimiento y habilidades de competencias. Se pueden utilizar pacientes virtuales, simuladores y pacientes simulados. Nosotros planteamos que alumnos de quinto y sexto curso actúen como pacientes simulados para que sus compañeros de primero aprendan la anamnesis de la historia clínica.
Sujetos y métodos. Un total de 207 alumnos de primer curso de grado aprendieron a realizar la historia clínica en una sala de urgencias del centro de simulación entrevistando a pacientes simulados, que eran sus compañeros de quinto y sexto curso. Se evaluaron las historias clínicas realizadas, y para conocer el grado de satisfacción de los estudiantes se pidió que cumplimentasen un cuestionario anónimo tanto a los alumnos de primer curso como a los de cursos superiores.
Resultados. La valoración de la calidad de las historias clínicas fue de 8,2 sobre 10. Esta metodología ha sido muy bien valorada. A la pregunta "¿el entrenamiento con pacientes simulados ayuda al aprendizaje para la realización de la historia clínica?", los alumnos de primero puntuaron 9, y los de quinto y sexto, 9,2. Al ítem "¿trabajar con pacientes simulados mejora sus habilidades de comunicación?", ambos grupos puntuaron 8,6. Y para "¿es adecuado el aprendizaje de la historia clínica mediante pacientes simulados previo a su aprendizaje con pacientes reales?", ambos grupos puntuaron 9,3. La valoración de la experiencia como paciente simulado fue de 9,3.
Conclusión. El aprendizaje de la historia clínica en primer curso del grado de Medicina mediante pacientes simulados resulta beneficioso para los alumnos. Un contacto temprano con la clínica a partir del aprendizaje basado en la simulación podría mejorar la formación de los estudiantes.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2012
Vol.:
35
N°:
3
Págs.:
425 - 432
Background. Type 1 diabetes is associated with vascular morbidity. The aim of this study was to evaluate the role of polymorphisms rs1410996 CFH and rs10490924 ARMS2 with proliferative diabetic retinopathy and coronary disease in type 1 diabetes patients. Material and methods. We present a retrospective study that analyses the clinical characteristics and the polymorphisms rs1410996 CFH and rs10490924 ARMS2 of 147 type 1 diabetes patients. Results. The patients who developed proliferative diabetic retinopathy in the first 20 years carried the rs1410996 CFH polymorphism. The overall risk-allele frequency was significantly higher among patients with coronary artery disease than in those without it (75 vs. 53%, p<0.001). Conclusions. rs1410996 CFH polymorphism could be associated with both proliferative diabetic retinopathy and coronary artery disease in type 1 diabetes patients. However, rs10490924 ARMS2 does not seem to be associated either with retinopathy or coronary artery disease.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2012
Vol.:
35
N°:
3
Págs.:
425 - 432
BACKGROUND:
Type 1 diabetes is associated with vascular morbidity. The aim of this study was to evaluate the role of polymorphisms rs1410996 CFH and rs10490924 ARMS2 with proliferative diabetic retinopathy and coronary disease in type 1 diabetes patients.
MATERIAL AND METHODS:
We present a retrospective study that analyses the clinical characteristics and the polymorphisms rs1410996 CFH and rs10490924 ARMS2 of 147 type 1 diabetes patients.
RESULTS:
The patients who developed proliferative diabetic retinopathy in the first 20 years carried the rs1410996 CFH polymorphism. The overall risk-allele frequency was significantly higher among patients with coronary artery disease than in those without it (75 vs. 53%, p<0.001).
CONCLUSIONS:
rs1410996 CFH polymorphism could be associated with both proliferative diabetic retinopathy and coronary artery disease in type 1 diabetes patients. However, rs10490924 ARMS2 does not seem to be associated either with retinopathy or coronary artery disease.