Viviana Rojas’s research while affiliated with Pontifical Catholic University of Chile and other places

Introduction Research activities have a positive impact on the performance of residents. However, information on research conducted by residents from developing countries is scarce. Our study sought to identify the barriers and facilitators for developing research in medical residency programs in a Latin-American faculty of medicine. Methods A mixed methodology study design was carried out. We used a grounded theory approach for the qualitative phase, collecting data through semi-structured interviews and focus groups with faculty and residents. For the quantitative phase, surveys were administered to residents and teachers. We used factor analysis and scree plot (validity), Cronbach's alpha, and Intraclass correlation coefficient (reliability) to evaluate the surveys' psychometric properties. Results Focus groups involving ten faculty members and 15 residents were conducted, and the following domains were identified: a) facilitators for resident participation, b) barriers, c) strategies for introducing research into the curriculum, d) arguments supporting research activities throughout medical residency, and e) profile of research-motivated residents. Both residents and faculty members identified a lack of protected time and adequate mentoring as the major barriers. A gender gap was found related to international publications (34% vs. 66% women/men); women perceived that research activities 'compete with other activities' (OR: 2.04, 95% CI 1.03 to 4.07). Conclusions Research is highly valued by both residents and faculty members at a Latin-American university with a strong academic output. Major barriers to promoting research in this context include lack of protected time and effective mentoring, and gender gaps. Strategies proposed to improve research within medical residency programs include: establishing an interdisciplinary mentoring program between residents and researchers, promoting elective rotations, and rewarding proposals that consider gender equity.

Resumen Antecedentes y objetivos El ambiente educacional (AE) ha cobrado relevancia en las últimas décadas debido al impacto que produce en el proceso de aprendizaje, vida social y futuro laboral de los estudiantes. El objetivo de este proyecto es medir la percepción del AE en estudiantes de pregrado de la carrera de Kinesiología de la Pontificia Universidad Católica de Chile. Métodos Se utilizó metodología mixta. Componente cuantitativo: se aplicó el cuestionario Dundee Ready Education Environment Measure (DREEM) del 1.er al 4.° año. Componente cualitativo: con base en el análisis de preguntas abiertas. Se describen los ítems, dominios y puntaje global del DREEM mediante promedios y desviación estándar. Análisis estadísticos con t de Student para muestras independientes y ANOVA (más de 2 cohortes). Los datos cuantitativos fueron analizados usando el software SPSS y los datos cualitativos (teoría fundada) mediante software Atlas.ti®. Por último, se procedió a la triangulación de la información de ambas fuentes. Resultados Un total de 295 de un universo de estudiantes de 362 contestaron los cuestionarios (81%). El promedio global del cuestionario DREEM fue de 135,74 ± 19,15, lo que revela un AE «más positivo que negativo». La mayor fortaleza fue la percepción de la calidad de los docentes (73%) y el dominio con más baja percepción fue la atmósfera (63%). Los datos cualitativos permitieron complementar y enriquecer los resultados. No se encontraron diferencias significativas en la percepción del AE entre hombres y mujeres. Conclusiones La medición del AE permitió identificar las principales fortalezas y aspectos por mejorar, lo cual servirá de base para un futuro plan de mejoramiento, autoevaluación y proceso de acreditación.

Background: Latin America is a region with huge health inequalities and a tremendous growth in the number of medical schools during the last decades. The role of the medical schools in reducing health inequality has not been systematically explored. Methods: A qualitative framework method was used to explore the meaning, barriers, and facilitators of the concept of the social accountability of medical schools in Latin America. Twenty nine Latin American academic leaders from seven countries participated in an expert panel discussion. The Atlas ti.7 software was used to analyze the information. Results: Social accountability was identified as a core dimension of the mission of medical schools. The panel identified a gradient of three dimensions associated with social accountability. First, a formative dimension related to student selection, curricular structure and community based learning initiatives. Second, a societal dimension associated with institutional mission, community partnerships, and social research projects. Third, a political dimension related with involvement in health policies and primary care engagement. Lack of accreditation standards was identified as a main barrier to improve social accountability. Conclusions: Latin American leaders consider that medical schools should develop specific formative, societal, and political initiatives in order to be socially accountable.

Rationale and objectives: Radiology teachers are well trained in their specialty; however, when working in academic institutions, faculty development and promotion through the education pathway tends to be based on their teaching knowledge and skills. The aim of this study is to assess psychometric properties of the Medicina Universidad Católica-Radiology 32 items (MEDUC-RX32), an instrument designed to evaluate the performance of postgraduate radiology teachers and to identify the best teachers. Materials and methods: Mixed methodology was used, including qualitative and quantitative phases. The psychometric properties of the MEDUC-RX32 survey were performed by factor analysis (validity), Cronbach alpha coefficient, and G coefficient (reliability). The residents assessed their teachers and simultaneously voted for the "best teacher," which was used as a gold standard for the receiver operating characteristic curves construction comparing their votes with the global score. Results: A total of 28 residents answered 164 surveys. The global score was 6.23 ± 0.8 (scale from 1 to 7). The factor analysis showed six domains of the resident's perception: (1) tutorial teaching, feedback, and independent learning; (2) communication and teamwork; (3) learning objectives; (4) respectful behavior; (5) radiological report; and (6) teaching and care support. The tutor's strengths were related with respectful behavior and teamwork. The instrument is highly reliable with a Cronbach alpha of 0.937 and a G coefficient of 0.831 (with a minimum of 8 residents). The MEDUC-RX32 instrument has a sensitivity of 91.7% and specificity of 83.3% to identify tutors as best teachers with at least one vote with an area under the receiver operating characteristic curve of 0.931 with a cutoff of 5.94. Conclusions: The MEDC-RX32 instrument is a multidimensional, valid, and highly reliable method to evaluate radiology teachers, identifying teachers with excellence in tutorial teaching in a postgraduate radiology program.

Background: Feedback is one of the most important tools to improve teaching in medical education. Aim: To develop an instrument to assess the performance of clinical postgraduate teachers in medical specialties. Material and methods: A qualitative methodology consisting in interviews and focus-groups followed by a quantitative methodology to generate consensus, was employed. After generating the instrument, psychometric tests were performed to assess the construct validity (factor analysis) and reliability (Cronbach’s alpha). Results: Experts in medical education, teachers and residents of a medical school participated in interviews and focus groups. With this information, 26 categories (79 items) were proposed and reduced to 14 items (Likert scale 1-5) by an expert’s Delphi panel, generating the MEDUC-PG14 survey, which was answered by 123 residents from different programs of medical specialties. Construct validity was carried out. Factor analysis showed three domains: Teaching and evaluation, respectful behavior towards patients and health care team, and providing feedback. The global score was 4.46 ± 0.94 (89% of the maximum). One teachers’ strength, as evaluated by their residents was “respectful behavior” with 4.85 ± 0.42 (97% of the maximum). “Providing feedback” obtained 4.09 ± 1.0 points (81.8% of the maximum). MEDUC-PG14 survey had a Cronbach’s alpha coefficient of 0.947. Conclusions: MEDUC-PG14 survey is a useful and reliable guide for teacher evaluation in medical specialty programs. Also provides feedback to improve educational skills of postgraduate clinical teachers.

Background: Feedback is one of the most important tools to improve teaching in medical education. Aim: To develop an instrument to assess the performance of clinical postgraduate teachers in medical specialties. Material and Methods: A qualitative methodology consisting in interviews and focus-groups followed by a quantitative methodology to generate consensus, was employed. After generating the instrument, psychometric tests were performed to assess the construct validity (factor analysis) and reliability (Cronbach's alpha). Results: Experts in medical education, teachers and residents of a medical school participated in interviews and focus groups. With this information, 26 categories (79 items) were proposed and reduced to 14 items (Likert scale 1-5) by an expert's Delphi panel, generating the MEDUC-PG14 survey, which was answered by 123 residents from different programs of medical specialties. Construct validity was carried out. Factor analysis showed three domains: Teaching and evaluation, respectful behavior towards patients and health care team, and providing feedback. The global score was 4.46 +/- 0.94 (89% of the maximum). One teachers' strength, as evaluated by their residents was "respectful behavior" with 4.85 +/- 0.42 (97% of the maximum). "Providing feedback" obtained 4.09 +/- 1.0 points (81.8% of the maximum). MEDUC-PG14 survey had a Cronbach's alpha coefficient of 0.947. Conclusions: MEDUC-PG14 survey is a useful and reliable guide for teacher evaluation in medical specialty programs. Also provides feedback to improve educational skills of postgraduate clinical teachers.

Training of postgraduate medical specialty program managers (PMSPM) is essential for the proper development of their programs. Aim: To identify the main training needs of PMSPM at a medical school. Material and Methods: A mixed-methodology approach was implemented including focus group/interviews and the administration of the Program Managers Training Needs Assessment Questionnaire (PROMANAQ) developed by an expert panel with 59 items (with two sections: relevance/performance-self-perception). Higher priority was assigned to items with high relevance and low performance. Results: Forty five PMSPM completed the PROMANAQ (81.8% response rate). Both sections of PROMANAQ were highly reliable (Cronbach alpha of 0.95/0.97 for relevance/performance-self-perception, respectively). The items with higher priority value were evaluation of clinical educators, evaluation of teaching programs and accreditation of programs. Ten PMSPM were included in the focus group (18.2% of the universe). The findings of the qualitative component were concordant with the areas explored in the questionnaire. Conclusions: The PROMANAQ is valid and reliable to identify the training needs of PMSPM. The views of PMSPM must be taken into account for faculty development planning.

Background: Training of postgraduate medical specialty program managers (PMSPM) is essential for the proper development of their programs. Aim: To identify the main training needs of PMSPM at a medical school. Material and Methods: A mixed-methodology approach was implemented including focus group/interviews and the administration of the Program Managers Training Needs Assessment Questionnaire (PROMANAQ) developed by an expert panel with 59 items (with two sections: relevance/performance-self-perception). Higher priority was assigned to items with high relevance and low performance. Results: Forty five PMSPM completed the PROMANAQ (81.8% response rate). Both sections of PROMANAQ were highly reliable (Cronbach alpha of 0.95/0.97 for relevance/performance-self-perception, respectively). The items with higher priority value were evaluation of clinical educators, evaluation of teaching programs and accreditation of programs. Ten PMSPM were included in the focus group (18.2% of the universe). The findings of the qualitative component were concordant with the areas explored in the questionnaire. Conclusions: The PROMANAQ is valid and reliable to identify the training needs of PMSPM. The views of PMSPM must be taken into account for faculty development planning. (Rev Med Chile 2013; 141: 1126-1135).