Structured clinical examinations with simulated patients during internal medicine clerkship Background: Practice is essential in clinical training and can be carried out with simulations. The medical school of the University of Chile performs Objective Structured Clinical Examinations (OSCE) using standardized simulated patients for interns. Aim: To report the experience with OSCE in an environment with a high number of students. Material and Methods: Four hundred sixty-two students, participated in three OSCEs during 2016 and 2017, during their internal medicine clerkship. Each OSCE consisted of five scenarios of ambulatory care patients with prevalent medical conditions. Every student had to perform history taking, physical examination and deliver a diagnostic hypothesis, and a plan for management and counseling. Simulated patients provided feedback. To assess validity and reliability, in an argument-based model, planning and activity development were declared. The results were evaluated according to students' and organization variables, internal consistency, interobserver and theoretical concordance tests. Results: No significant bias was found by demographic features or evaluation moment. Internal consistency was good (Cronbach 0.8). Simulated patient evaluators had a high correlation with medical evaluators (r = 0.7). There was a low correlation between OSCE results and theoretical tests. Conclusions: OSCE´s continuously assess competences during internal medicine clerkship in an environment with a high number of students.
Objetivos: describir la percepción estudiantil en las carreras de Fonoaudiología, Obstetricia y Terapia Ocupacional respecto a la formación bioética en pregrado y su aplicabilidad al inicio de su experiencia práctica profesional.
Método: estudio descriptivo transversal; se diseñó y aplicó una encuesta a 147 estudiantes, correspondiendo un 29,9% a la Escuela de Fonoaudiología, 42,2% a la Escuela de Obstetricia y 18,4% a la Escuela de Terapia Ocupacional. Las aseveraciones fueron dirigidas a indagar sobre: conocimientos, actitudes y aplicabilidad de los conocimientos en el ámbito clínico asistencial. Se realizó análisis estadístico simple de frecuencia.
Resultados: 99,3% de los estudiantes encuestados refiere que está muy de acuerdo y de acuerdo con la relevancia de esta formación bioética, 85% reconoce estar muy de acuerdo y de acuerdo en utilizar regularmente sus conocimientos de bioética en la práctica clínica.
Conclusiones: los estudiantes de las tres carreras, perciben muy relevante la formación en bioética durante el pregrado y de alta aplicabilidad en el contexto clínico. En el actual proceso de innovación curricular se sugiere que la enseñanza bioética de futuros profesionales de la salud, tenga un enfoque más práctico orientado a lo clínico.
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