Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: The theoretical phase of the high-stakes examination (EP-FT) evaluated the acquisition of five competencies established in the graduate profile described in the 2010 Curriculum (PE-2010) of the Faculty of Medicine (FM) UNAM, used the Medical Professional Competencies Integral Assessment Method (MIDECOMP). Objective: Describe the method used for the design, elaboration, delivery, and analysis of the EP-FT of January of 2024 of the Medical Degree of FM. Method: This assessment tool was designed based on a strategy that integrated the sequential analysis of the competencies, their attributes, the learning outcomes, and the taxonomic level, in a generalist medicine based practice environment. The design, development, and crossover review of the cases and the items was performed by inter and multidisciplinary committees. Therefore, for this task and the assembly of the test, we used the Automated System for Medicine Item Bank (SABERMED). For the delivery of the test we utilized the Integral System For Test Delivery (SIAEX), both of these systems were developed by the FM. The psychometric analysis established the parameters that showed the evidence of the quality of the tool and allowed us to make inferences of the results. Results: The MIDECOMP was used to construct the EP-FT. We were able to design an assessment tool composed of 300 clinical cases with multiple-choice questions with three different options, based on the national epidemiological outlook. We integrated sequentially conceptual and logistics elements, informatic solutions, and psychometric analyses that let us achieve the quality standards to assess 1,312 candidates. We obtained an internal consistency (Cronbach’s Alpha) of 0.90, difficulty (P mean) of 0.63, and a discrimination index (Rpbis) of 0.17; these values represented adequate values. Conclusions: The implementation of the MIDECOMP permitted the design, elaboration, delivery, and analysis of the 2024 EP-FT in a massive and efficient manner, with high quality standards, aligned with the PE-2010 of the FM, UNAM.

Introduction: The accurate interpretation of electrocardiograms (ECGs) is crucial for medical trainees, as it directly impacts patient outcomes. Errors in interpretation can lead to severe consequences, such as undiagnosed heart attacks. Learning to interpret ECGs remains an educational challenge due to the lack of a standardized approach. Integrating information and communication technologies, such as social media, could enhance its teaching. In this context, a phenomenological study could shed light on how medical interns experience ECG learning through these platforms. Objective: To analyze the learning experiences of undergraduate medical interns at the Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca” while participating in an electrocardiographic interpretation course on a social media. Method: A phenomenological study based on Heidegger’s hermeneutic philosophy was conducted. Ten medical interns were interviewed, and the data were analyzed using Van Manen’s four lifeworld existentials. The interviews were transcribed and thoroughly reviewed to identify themes representing the essence of the lived experience. The rigor of the study was ensured through data triangulation and participant review. Results: The data interpretation revealed four themes: “accessible, didactic, and practical”, “flexible, but requires commitment”, “convenient but incomplete” and “complex and emotionally charged”. Conclusions: The ECG learning experience through a social media was described as accessible, with purpose-driven freedom. Engagement was influenced by the context of being a medical intern, often involving an emotional response that affected not only existential time and space but also the dimensions of the body and relationships with peers.

This text explores the similarities between theatrical representation and medical practice. Both fields require a meticulous study of the “characters” to be portrayed or attended to. It also mentions simulation scenarios and standardized patients as examples of the intersection between theater and medicine. The text highlights Konstantin Stanislavski and his acting method, which emphasizes the integral creation of characters, not just reciting lines. This approach is compared to the work of the physician, who must reconstruct the life story of their patients to understand their current situation. Thus, the physician is seen as a Stanislavskian interpreter of the patient’s character. The word “drama” is analyzed in its two senses: a literary work intended to be performed and a play with tense actions and conflicting passions. Both apply to the medical act. The analogy between the doctor-patient interaction and theatrical representation suggests that the art of medical acting could be taught using stage techniques. The art of acting involves credibly portraying a role, which is similar to the work of the physician in convincing the patient to achieve communication, therapeutic adherence, and trust. Emotional intelligence is essential in both fields. According to Cherry, the emotional intelligence of physicians affects outcomes and can be observed in communication. The text concludes that the theory of acting can be effectively applied to medical education, using techniques such as role-playing and psychodrama. It also highlights the importance of social cognition in medical practice. In summary, the physician, like the actor, must interpret their own role and consider the impression they wish to make on the patient.

We trace the evolution of resident work hours in Mexico, a training model introduced in the mid-twentieth century based on total clinical immersion. For decades, shifts exceeding 100 hours per week and 36-hour on-call duties were standard, defended as necessary for clinical exposure but ultimately raising serious concerns about occupational health, patient safety, and educational quality. Regulatory ambiguity generated wide institutional variability until the 2012 standard NOM-001-SSA3, which addressed graduate medical education but set no explicit hourly limits. Responding to mounting evidence on fatigue and institutional pressure, NOM-001-SSA-2023 now caps duty hours at 80 per week, limits residents to two calls a week, and introduces the ABCD rotating model, assigning one duty every four days to curb cumulative fatigue. The chapter reviews physiological and cognitive consequences of chronic sleep deprivation —cardiovascular risk, metabolic disorders, memory impairment— and its association with increased medical errors. International benchmarks are analyzed: the 80-hour ACGME rule in the United States; Europe’s 48-hour Working Time Directive; Quebec’s 72-hour limit; and Japan’s recent reforms aimed at preventing karōshi (death from overwork). Alternative shift structures such as 12×12 and 24×24 are discussed, highlighting benefits and operational challenges. The text underscores the ambiguous legal status of Mexican residents, straddling student and worker categories, which complicates full labor protection. It calls for tighter university oversight, adequate financing, and a cultural shift that prioritizes resident well-being, faculty supervision, and proper rest facilities. The chapter concludes that dignified training environments are not merely a welfare issue; they are fundamental to patient safety and to the future quality of healthcare delivery.

Introduction: Scientific literacy involves skills that enable students to identify, interpret, and use primary sources of scientific information. There is little evidence on whether scientific literacy predisposes college students to better academic performance. Objective: To evaluate the predictive role of scientific literacy on the weighted average mark of the first academic semester in first-year human medicine students. Method: Analysis with data routinely collected during the implementation of the course “Methodology of Scientific Research I”. This subject is taken by medical students at a Peruvian university between March and July 2023.Scientific literacy was assessed using the Test of Scientific Literacy Skills (TOSLS) validated in Spanish, the weighted average mark was measured on a vigesimal scale. We performed a nonparametric quantile regression to model the weighted average based on the TOSLS score and other covariates. Results: We analyzed data from 115 students, formulated three models. In all, the TOSLS score was a significant independent predictor of the weighted average at the end of the first semester. The magnitude of the effect of the TOSLS score was larger in the lower quantiles. In the full model, at the 25th quantile, the β coefficient was 0.25 (95% CI: 0.12 to 0.39), while at the 75th quantile, the β coefficient was 0.18 (95% CI: 0.08 to 0.27). Conclusions: In first-year medical students, scientific literacy was able to predict academic performance at the end of the first semester, the incremental effect was greatest among those with the lowest weighted average mark.

The aim of this text is to analyze the role of theory in qualitative research in medical education, highlighting its relevance within the interpretative paradigm framework. It addresses how theory influences research by guiding the understanding of reality and knowledge, and how these aspects vary depending on the paradigmatic approach. In particular, the integration of theory in qualitative studies is explored, emphasizing the importance of having a solid theoretical foundation to enrich the analysis of educational phenomena, such as the teaching-learning process in clinical contexts. Additionally, the different levels of theory scope are discussed, ranging from broad abstract theories to macro-theories and more specific micro-theories, and how these guide the design, data collection, and analysis in qualitative research.