Browsing by Author "Bitran, Marcela"

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    An instrument in Spanish to evaluate the performance of clinical teachers by students
    (2010) Bitran, Marcela; Mena, Beltran; Riquelmel, Arnoldo; Padilla, Oslando; Sanchez, Ignacio; Moreno, Rodrigo
    Background: The modernization of clinical teaching has called for the creation of faculty development programs, and the design of suitable instruments to evaluate clinical teachers' performance. Aim: To report the development and validation of an instrument in Spanish designed to measure the students' perceptions of their clinical teachers' performance and to provide them with feedback to improve their teaching practices. Material and Methods: In a process that included the active participation of authorities, professors in charge of courses and internships, clinical teachers, students and medical education experts, we developed a 30-item questionnaire called MEDUC30 to evaluate the performance of clinical teachers by their students. The internal validity was assessed by factor analysis of 5,214 evaluations of 265 teachers, gathered from 2004 to 2007. The reliability was measured with the Cronbach's alpha coefficient and the generalizability coefficient (g). Results: MEDUC30 had good content and construct validity Its internal structure was compatible with four factors: patient-centered teaching, teaching skills, assessment skills and learning climate, and it proved to be consistent with the structure anticipated by the theory The scores were highly reliable (Cronbach's alpha: 0.97); five evaluations per teacher were sufficient to reach a reliability coefficient (g) of 0.8. Conclusions: MEDUC30 is a valid, reliable and useful instrument to evaluate the performance of clinical teachers. To our knowledge, this is the first instrument in Spanish for which solid validity and reliability evidences have been reported. We hope that MEDUC30 will be used to improve medical education in Spanish-speaking medical schools, providing teachers a specific feedback upon which to improve their pedagogical practice, and authorities with valuable information for the assessment of their faculty. (Rev Med Chile 2010; 138: 685-693).
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    CEACLIN, an instrument suited to identify medical students' strategies to learn in pre-clerkship years
    (SOC MEDICA SANTIAGO, 2015) Bitran, Marcela; Padilla, Oslando; Zuniga, Denisse; Leiva, Isabel; Calderon, Maribel; Riquelme, Arnoldo
    Background: Upon the beginning of pre-clerkship years, medical students must develop strategies to learn from experience and to improve their relational skills to communicate with patients. Aim: To develop an instrument to identify the strategies used by medical students to learn in clinical contexts. Material and Methods: Using a Delfi technique to reach consensus, a national panel of students and clinical teachers from 15 Chilean medical schools analyzed an 80-item questionnaire built from perceptions of Chilean students and teachers from one medical school. After two Delfi rounds and a pilot application, a 48-item questionnaire was obtained. Its reliability and construct validity were assessed by Cronbach alpha coefficient and factor analysis, respectively, on the base of an application to 336 medical students. Results: The questionnaire developed, named CEACLIN, is highly reliable (alpha = 0.84). Its inner structure is made of eleven factors: Autonomy, Solving doubts and problems, Searching and organizing information, Proactivity, Reaching to others, Paying attention and emotions, Searching for trust, Evading burden, Coping with burden, Motivation and Postponing the personal life. All together, these factors account for 47.4 % of the variance. Conclusions: CEACLIN is a valid, reliable and easy to use instrument suited to identify students' strategies to learn in pre-clerkship years. Many of its items allude to concepts of theories of experiential learning and motivation. We hope that CEACLIN will be of value to medical students and clinical teachers to improve the learning and teaching of clinical reasoning and communication skills.
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    Dispositional Mindfulness Reduces Burnout and Promotes Flourishing in Medical Students: a Two-Wave Latent Change Score Model
    (2022) Zuniga, Denisse; Torres-Sahli, Manuel; Rigotti, Attilio; Pedrals, Nuria; Echeverria, Guadalupe; Padilla, Oslando; Lagos, Alejandra; McColl, Peter; Trucco, Olivia; Cisternas, Marcela; Gonzalez, Carolina; Bogado, Justo; Moraga, Ana Maria; Altamirano, Patricio; Duran, Esperanza; Mansilla, Marcela; Berrios, Carolina; Epstein, Ronald; Bitran, Marcela
    Objectives Many studies document the high prevalence of burnout among medical students. This syndrome may lead to depression, suicidal ideation, and increased academic dropout. However, there is a scarcity of evidence-based interventions to prevent it. The aim of this longitudinal study was to identify factors that may reduce students' burnout and foster their well-being, and upon which effective interventions can be developed. Methods A total of 1,117 medical students from eight Chilean universities were asked to complete a set of validated scales in 2015 and 2 years later, in 2017. The measures included distress, burnout, positive mental health, academic engagement, and dispositional mindfulness. Using logistic regressions and a two-wave latent change score model, the predictive power of these variables on burnout and flourishing (an optimal state of mental health) was studied, as well as their covariance across time. Results In total, 639 (57.2%) students answered the questionnaires in T1 and T2; 54.4% reported burnout in T1 and 56.2% in T2. Levels of dispositional mindfulness (the ability to pay attention to one's sensations, thoughts, and emotions in everyday life) predicted lower probabilities of burning out at 2 years, whereas having experienced burnout in T1 doubled these odds. Dispositional mindfulness, academic engagement, and flourishing at T1 predicted greater odds of flourishing 2 years later, while depression decreased these odds. Conclusions Dispositional mindfulness was the most powerful predictive factor of students' burnout and flourishing. As dispositional mindfulness can be nurtured through practice, incorporating mindfulness training into undergraduate medical programs may help reduce burnout and promote students' well-being as health professionals.
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    Limitations and opportunities for the appropriation of the Mediterranean diet in Chilean adults with diagnostic elements of metabolic syndrome
    (2024) Calderon, Maribel; Plaza, Gianella; Gomez, Marisol; Samith, Barbara; Pinto, Victoria; Martinez, Ximena; Sara, Daniela; Echeverria, Guadalupe; Calzada, Mariana; Berkowitz, Loni; von Schultzendorf, Andrea; Pedrals, Nuria; Bitran, Marcela; Rigotti, Attilio
    Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lower prevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals for adherence to this food pattern in their daily lives. Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile. Methods: an exploratory qualitative study was applied in 35 to 65 -year -old patients of both sexes who presented at least one diagnostic criterion of metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated with changes and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out under the grounded theory approach using the ATLAS.ti software. Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foods items) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routine adoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but also relational effort as it implies modifications of family and collective practices. Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implement nutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.
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    Reduced burnout and higher mindfulness in medical students after a self-care program during the COVID-19 pandemic
    (2021) Zuniga, Denisse; Torres-Sahli, Manuel; Nitsche, Pia; Echeverria, Guadalupe; Pedrals, Nuria; Grassi, Bruno; Cisternas, Marcela; Rigotti, Attilio; Bitran, Marcela
    Background: Medical students experience high levels of psychological stress during clinical training. However, most medical curricula do not teach self-care skills. The COVID-19 pandemic has disrupted medical education causing increased distress among students. Aim: To report the implementation and impact of an eight-week multifaceted mindfulness-based self-care program on medical students' distress and well-being during the COVID-19 pandemic. Material and Methods: One hundred twenty-three fourth-year medical students attended the program as part of a mandatory course from April to May 2020, during the rising phase of COVID-19 in Chile. They were evaluated using validated tests before and immediately after the program. The measures included burnout, dispositional mindfulness, perceived stress, traumatic stress reactions, general well-being, resilience, and stress coping strategies. Results: Burnout prevalence decreased from 48% to 24%, whereas students with high dispositional mindfulness increased from 25% to 44%. Burnout reduction was mostly due to decreased emotional exhaustion. Additionally, students reported lower levels of stress, self-blaming, and traumatic stress reactions alongside an increased use of active coping strategies and resilience levels after the program. Conclusions: A formal educational intervention, teaching self-awareness and self-regulation skills can help reduce medical students' distress and promote their well-being even amidst a pandemic.