Person: Álvarez Montero, Santiago
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Santiago
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Álvarez Montero
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Medicina
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Item Estudio preliminar para la creación de una Unidad de Educación Médica: exploración de la coherencia interna de una facultad de Medicina y las necesidades educativas de sus profesores.(Educación Médica, 2022) Ruiz Moral, Roger; Monge Martín, Diana; ; Cervera Barba, Emilio; García de Leonardo Mena, Cristina; Caballero Martínez, Fernando; Álvarez Montero, SantiagoIntroducción una Unidad de Educación Médica (UEM) debe ofrecer distintos servicios educativos y de investigación relacionados a su personal docente y a la Dirección Académica. Con esta finalidad se priorizó un proceso de detección de aspectos educativos que repercuten en el aprendizaje de los estudiantes de Medicina y se exploró la visión de los docentes sobre el papel de una UEM, valorando sus necesidades educativas. Material y Métodos mediante 2 escalas validadas se identificó el nivel de coherencia interna de la escuela (Escala de Coherencia Interna [ECI], 58 items) presencialmente respondida por 30 profesores. Se exploraron las opiniones y necesidades de sus profesores (escala NESEM, 12 preguntas) respondidas online por 75 de ellos. Para la ECI se catalogaron 3 niveles de puntuaciones: alto (> 4,60), medio (entre 4,20 y 4,59) y bajo (< 4,19). Análisis cuantitativo descriptivo y cualitativo para las preguntas abiertas (NESEM) analizadas independientemente por 2 investigadores agrupando las respuestas en códigos homogéneos y discutiendo discordancias. Resultados veinticinco profesores contestaron la ECI (83,3%) y 56 la NESEM (74,7%). La ECI muestra niveles altos en casi todos los factores a excepción del grado de implicación y participación en las decisiones de la escuela y aspectos del desarrollo profesional. La percepción de la UEM es positiva y las necesidades educativas de los profesores concuerdan con sus funciones habituales. Conclusión esta aproximación a la coherencia interna y las necesidades percibidas por los profesores de una facultad de Medicina ofrece una fotografía de gran valor para orientar las tareas más inmediatas de la UEM.Item La interfaz comunicación clínica-ética clínica: implicaciones para la educación médica.(Educación médica, 2017) Ruiz Moral, Roger; Álvarez Montero, SantiagoEste estudio trata inicialmente de clarificar los aspectos y componentes de una Comunicación Médico-Paciente “centrada en la persona-paciente” y definir los valores éticos de esta práctica. A partir de ahí aborda, la inextricable interfaz existente entre comunicación (relación) y ética, y resalta cómo esta unión comunicación-ética se manifiesta en la práctica clínica habitual del médico, en sus acciones, a través de las actitudes y los hábitos del profesional (el carácter). Lo anterior revelará la necesidad ineludible de educar a nuestros estudiantes de medicina en valores y en habilidades para poder realizar una auténtica y eficaz “atención centrada en la persona-paciente”. Esto a su vez mostrará cómo este tipo de educación repercute en la persona-médico moldeando su carácter.Item Searching for the erosion of empathy in medical undergraduate students: a longitudinal study.(BMJ Open, 2020) Blanco Canseco, José Manuel; Caballero Martínez, Fernando; Álvarez Montero, Santiago; Plans, Mercedes; Monge Martín, DianaObjective To analyse the trajectory of empathy throughout the degree programme of medicine in a Spanish school of medicine. Design Longitudinal, prospective 5-year study, between October 2014 and June 2019. Setting Students from a Spanish university of medicine. Participants Two voluntary cohorts of undergraduate medical students from two different school years were invited to participate (n=135 (cohort 1, C1) and 106 (cohort 2, C2) per school year). Finally, a total number of 174 students (102 (C1, 71.6% women) and 72 (C2, 70.8% women) students, respectively) were monitored for 5 years. Each cohort was divided in two subcohorts of paired and unpaired students that were analysed to check possible social desirability bias. Primary outcome measure The Jefferson Scale of Empathy (JSE). Results The cohort of 102 students (C1) monitored between their first and fifth years of study (71.6% women) showed an improvement among paired women of 2.15 points in total JSE score (p=0.01) and 2.39 points in cognitive empathy (p=0.01); in the unpaired female cohort the increase was of 2.32 points (cognitive empathy) (p=0.02). The cohort of 72 students (C2) monitored between their second and sixth years of study (70.8% women) displayed a cognitive empathy increase of 2.32 points (p=0.04) in the paired group of women. There were no significant differences between paired and unpaired results for either cohort. Empathy scores among men did not decrease. Conclusions The empathy of medical students at our school did not decline along grade years. In fact, it improved slightly, particularly cognitive empathy, among women. This paper contributes to enlarge data from Europe, where longitudinal studies are scarce. It supports the idea that there may be global geo-sociocultural differences; however, more studies comparing different school settings are needed.Item Medical resilience and morality: a survey study on the opinions and actions of exemplary family physicians.(BMC Family Practice, 2021) Ruiz Moral, Roger; Monge Martín, Diana; García de Leonardo Mena, Cristina; ; Caballero Martínez, Fernando; Álvarez Montero, SantiagoBackground: Studies conducted to understand how family doctors develop resilience and deal with the challenges posed by work-related stress, usually have focused on identifying the elements that generate resilience from psychological perspectives and their impact on coping strategies. Few have explored the role that personal qualities and values that traditionally motivate family physicians can play as drivers of well-being and resilience. Objectives: To explore attributes that exemplary family physicians (EFP) consider important for their work and the elements that, for them, are source of gratification and resources in the face of the adversities they encounter in their practice. Methods: This is an exploratory study carried out by online survey. Eighty six doctors regarded as exemplary by their colleagues answered 7 close and 4 open-ended questions that explored their job satisfaction, the elements of their work that reward them, the difficulties and problems they usually encounter, the resources they use to cope with those problems, and the personal qualities they consider central to their work. Four researchers conducted a thematic (deductive and inductive) analysis of the free text responses received. Based on the results obtained, and through an iterative discussion process, the researchers proposed an integrated set of qualities at the core of their professionalism. Results: 88.4% (76) of the doctors said they were satisfied with their work. However, they face problems (202 comments), including demanding patients, insensitive managers with unshared interests/care goals, excessive paperwork, work overload, or time pressures. Sources of gratification point to personal identity; clinical, relational, and collaborative efficiency; a holistic and comprehensive practice (centred on individuals); and a continuous search for excellence (149) and the root of their resources (135). These elements, in turn, corresponded to the attributes considered essential for the practice of family medicine (131). Conclusions: For EFPs, certain professional values give meaning to their clinical practice and are a source of wellbeing and resources. This central focus on professional values and qualities can help for better understand the burnout nature and expand the type of action that promotes resilience. Further studies using a less structured qualitative research will be needed to confirm/expand these results.