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Biomedical subjects

L Viniegra Velázquez

Publications and source records attributed to L Viniegra Velázquez.

At least 19 recordsLinked to original sources
PubMedDate not supplied

[Critical reading for medical residents in main specialties].

OBJECTIVE: To explore ability for critical reading of clinical research reports in groups of residents of four specialties: internal medicine, pediatrics, general surgery and gynecology/obstetrics. MATERIAL AND METHODS: A research was carried out in medical residents of 12 hospitals of the Instituto Mexicano del Seguro Social: 143 of internal medicine, 119 of pediatrics, 74 of general surgery and 74 of gynecology/obstetrics. An instrument was built and validated in order to explore the critical reading by three domains: interpretation, judgements and proposals. RESULTS: No significant effect of years of training on the critical reading of clinical research reports was observed. The overall scores were low (maximum: 120): internal medicine = 35, pediatrics = 29, general surgery = 24.5 and gynecology/obstetrics = 25. 116 students (28%) obtained scores below of the level expected by chance. CONCLUSIONS: This study suggest that the training is not very fruitful in the development of the critical reading ability of clinical research reports, a low development of this ability was observed in medical residents.

Educational Measurement↗
PubMedDate not supplied

[Clinical competence of the family doctor in systemic arterial hypertension].

OBJECTIVE: To establish clinical competence of family physicians to diagnose systemic arterial hypertension and to analyze it's associations with some variables related to working conditions and prior training. METHODS: The clinical competence was established in a non probabilistic sample of 165 family physicians working in 12 units of the Instituto Mexicano del Seguro Social (IMSS) in Mexico City. We used questionnaire of 160 items (true/false/don't know) to evaluate clinical competence. Association of the scores were explored for work shift (morning/afternoon), working conditions (very favorable/favorable/little favorable/unfavorable) and having been trained in a familiar medicine residency of the IMSS (yes/no). RESULTS: There were a general low competence to diagnose systemic arterial hypertension (median score of 36 of a possible 160). There were associations of competence with more favorable working conditions (p = 0.005 Kruskal-Wallis test) and with having been trained previously (p = 0.0123 U Mann-Whitney test). CONCLUSIONS: Our results support the need to continue in this area of research to improve measuring instruments and to identify the modifiers of clinical competence to overcome the deficiencies detected in the present study.

Appointments and Schedules↗
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[Comparison of 2 educational interventions in the training of resident physicians].

OBJECTIVE: To compare the results of two educational interventions, habitual versus experimental, in a group of pediatric residents. METHODS: We evaluated 7 residents in the last 4 months of their first year training by incorporating additional hours of an Experimental Intervention (EI) to their Habitual Training (HT). During EI we forced group discussion and debate in the classroom activities in contrast with the HT which was a passive approach of lectures with little or no participation by the trainees. We used a previously developed Differential Scale of a Group Interaction (DSGI) to score groupal activities conducive to better learning during EI and HT at 1, 6 and 11 weeks of starting EI. Simultaneously, the individual participations were scored with an Observation Guide of Discussion and Debate (OGDD) but only during EI as it would score near zero during HT. RESULTS: The DSGI scores were significantly and increasingly higher during EI than during HI at 1, 6 and 11 weeks of EI. All trainees improved their OGDD score after 6 and 11 weeks of EI. CONCLUSIONS: The educational microenvironment created by the Experimental Intervention improved the knowledge and aptitudes for discussion and debate of the trainees. Their increased use of critical exchanges and confrontations of ideas contributed to a better construction of their knowledge as pediatric residents.

Adult↗
PubMedDate not supplied

[Aptitude for critical reading of clinical research reports among medical residents of the Mexican Social Security Institute in Jalisco].

OBJECTIVE: To investigate the aptitude degree of the critical reading in reports of clinical investigation in the residents of the different areas of medical specialties. MATERIAL AND METHODS: It was elaborated and it validated an instrument to explore the critical reading in their abilities of to interpret and to judge. We studied 572 medical residents of eight units of the Mexican Institute of the Social Security: 292 of the medical area, 227 of the surgical area, 30 of the area of auxiliary in diagnosis and treatment, and 23 of the research area. RESULTS: The median of the qualifications obtained, they were low (considering a theoretical qualification maxim of 100), for the residents of the three areas: medicine with 34, surgical with 30 and auxiliary in diagnosis and treatment with 28.5. For the research area, the aptitude was a medium degree with 49. Of the 572 residents 98 (17.1%) it didn't surpass the limit of the accountable qualifications for a random effect. In the medical area we found a positive differential effect of the time of residence in the aptitude for the critical reading, particularly in the specialty of Internal Medicine. CONCLUSIONS: The development of the aptitude for the critical reading of reports of clinical investigation in general is low, the exception, are the residents in investigation and in certain measure those of internal medicine; in this last one it seems product of an intentional, collective, systematic and progressive exercise.

Adult↗
PubMedDate not supplied

[Development and evaluation of an instrument to assess the psychosocial environment].

It is an instrument to explore the psico-social environment that carries out a thorough inventory of the elements in such environment, it groups them in general categories that, from the process of stress (taken as the point of the departure), are the following: stressing situations, psicosocial support and facing conducts. And they are expressed in four levels or spheres of action: society, family, occupation and individual. It was intended to satisfy the need to count on relatively simple material, self-managable, widely applicable, standardized and that describes in an integral way the environment. The validity of contents and concepts was estimated through the Delphos technique. Though the concurrent validity is established by its application with another similar instrument, when this late was not available, some scales that could work as standards were use. The t Student test was used to evaluate the discrimination capacity among subgroups. In this, statistical differences were noticed for the same items with a significant value of 0.01. It was observed that the older they were there was an increasing set of stressing situations in the society and occupation spheres (correlation quotient of 0.80). According to sex, there were more stressing family situations in women. According to income, it was found that the bigger number of stressing situations and fewer psicosocial supports pertained to a higher income (correlation quotient of 0.91). It is deduced that the instrument, though it has some limitations, can be widely used. The only requirement is that it should be applied to individuals over 18 years old, of any sex and socio-economical class, and they should be literate.

Humans↗
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[Method for calculating the distribution of randomly expected scores in a false-true-do not know-type of test].

Multiple choice tests have been used widely in the evaluation of knowledge. The lowest passing limit is generally chosen arbitrarily. Better and more objective criteria may arise from analyzing the distribution of correct and incorrect answers as expected by chance. In order to calculate the distribution of correct answers and the difference between correct and incorrect answers (core) we propose the use of a method based on a gaussian distribution. The distribution of scores expected by chance is approximated by a gaussian distribution with a mean of zero and a standard deviation SD = square root of n(pA + pE), and the distribution of the total number of correct answers has a mean of npA and SD = square root of npApE, where n is the total number of questions, and pA and pE are the probabilities of having a correct and an incorrect answer, respectively. The formulae are applicable to questions type false/true/do not know and to the more common type of one correct in five options. Once the chance distribution is known, it can be compared with the distribution of scores or correct answers obtained, which can then be used to separate people in two groups: those that answer the test as expected or worse than expected by chance, and those that answer the test better than expected by chance. The first group should not be passed. The passing of individuals in the second group can be decided by additional criteria.

Educational Measurement↗
PubMedDate not supplied

[Effect of an educational strategy on critical reading among medical students].

We developed an educational intervention aimed at promoting the participation of the undergraduate medical students in the classroom in order to improve critical reading, specifically in the skills of comprehension and interpretation. The study is a quasi-experimental one with basal evaluation, educational intervention, and posintervention evaluation. We included two groups of top medical students with a high school individual grade of 9 or higher (in a scale 0 to 10) designated as A groups (experimental [N = 29] and control [N = 23]), and two groups of students with low grades (7 or less) designated as B groups (experimental [n = 20] and control [n = 16]). The experimental educational intervention consisted of the use of guided housework for text interpretation (individual work) and groupal work in the classroom. The groupal work included a debate and confrontation of viewpoints of the individual work. Comprehension was initially superior to interpretation in all groups; comprehension and interpretation were lower in the B groups compared with the A groups. After the intervention, 97% of the students from the A experimental group showed an improvement in comprehension and 79% improved their interpretation (p < 0.001). Of the students in the B experimental group, 75% showed improvement in comprehension and 90% in interpretation (p < 0.01). There were no significant changes in the students of the control groups. We find that with the use of an appropriate educational intervention, students with low scores have the opportunity to improve their critical reading by gaining skills in comprehension and interpretation.

Education, Medical↗
PubMedDate not supplied

[The path of criticism and education].

In this paper critical reading is considered as the key method for the construction of knowledge. Its characteristics are analyzed in detail and some implications in medical education are emphasized. The outstanding characteristics of critical reading is the ability of the reader to selectively assimilate the information in the text. Criticism is contrary to the reductionist approaches in which the real world is atomized in disjointed compartments. We emphasize the main components of critical reading: a) a passion for knowledge; b) an autocritical attitude; c) a transdisciplinary vision; d) the development of a personal point of view; e) an aperture towards new knowledge; and f) an adequate social environment.

Education, Medical↗
PubMedDate not supplied

[Theory and practice in medical specialization. I. An instrument for measuring learning strategies].

We present the development and validation of a measurement instrument intended to estimate the degree of vinculation between the theoretical and practical learning activities of medical residents in their usual working conditions in hospitals. The main reason for residents to read medical literature is to find support to their decisions when treating patients. Based on this perspective we designed a self-applied questionnaire that explores diverse circumstances in which the vinculation between theory and practice may be expressed. This instrument was validated through rounds of experts in terms of its construction and content. Its external validity was explored with two groups of internal medicine residents with a different degree of vinculation between theory and practice: one high and the other with a low vinculation. In addition, we designed a guide for the direct observation of the theoretical and practical clinical learning activities in order to estimate its concordance with the results of the questionnaire. The questionnaire was able to discriminate the group differences and showed a satisfactory concordance with the information provided by direct observation. A copy of the questionnaire is available by request to the authors. We conclude that in its present stage of development, the instrument has shown internal and external validity and may be used to explore the process training of medical residents.

Education, Medical↗