Formando médicos para el siglo XXI: El rol crucial de la educación basada en competencias
Palabras clave:
perfil médico, siglo XXI, competencias profesionales, formación basada en competencias, formación médicaResumen
A lo largo de la historia, el campo de la medicina se ha adaptado a las necesidades cambiantes de la sociedad y del sistema sanitario. Ante esa situación, surge la necesidad de plantear la transformación de la formación médica mediante un enfoque basado en las competencias y así definir el perfil de un médico para el siglo XXI. El presente artículo tiene por objetivo analizar y describir el rol de la formación basada en competencias en la formación médica en la preparación de los estudiantes de medicina. Para tal fin, se ha llevado a cabo una exhaustiva revisión bibliográfica en la que se analizan los conceptos clave de la formación médica basada en competencias. Los resultados destacan la importancia de integrar el desarrollo de habilidades en la formación médica teniendo en cuenta los factores sociales y culturales, así como fomentar la reflexión crítica en la formación médica. Se concluye que la educación médica debe adaptarse a las demandas cambiantes del campo, con la participación de diversas partes interesadas y la evolución de los métodos de enseñanza.
Descargas
Métricas
Citas
Torres CA, Bosio E. Global citizenship education at the crossroads: Globalization, global commons, common good, and critical consciousness. Prospects (Paris) [Internet]. 2020;48(3-4):99-113. Disponible en: http://dx.doi.org/10.1007/s11125-019-09458-w
Binfon TNF. Empowering health care professionals: An interprofessional education model implementation and evaluation using mentorship and TeamSTEPPS methodology [Internet]. Yale University; 2020 [citado 23 de septiembre de 2023]. Disponible en: https://elischolar.library.yale.edu/ysndt/1096/
Mei A, Gao D, Jiang J, Qiao T, Wang F, Li D. The medical education systems in China and Thailand: A comparative study. Health Sci Rep [Internet]. 2022;5(6). Disponible en: http://dx.doi.org/10.1002/hsr2.826
Callahan D, Parens E. The ends of medicine: shaping new goals. Bulletin of the New York Academy of Medicine [Internet]. 1995 [citado 23 de septiembre de 2023];72(1):95. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/7581318
Dissanaike S, Matthews JB. Moral determinants of health: An overview of disparities in healthcare. J Vasc Surg [Internet]. 2021;74(2):2S-5S. Disponible en: https://www.sciencedirect.com/science/article/pii/S0741521421006546
Rami F, Thompson L, Solis-Cortes L. Healthcare disparities: Vulnerable and marginalized populations. En: Covid-19: Health Disparities and Ethical Challenges Across the Globe [Internet]. Cham: Springer International Publishing; 2023. p. 111-45. Disponible en: http://dx.doi.org/10.1007/978-3-031-26200-5_6
Koski E, Scheufele EL, Karunakaram H, Foreman MA, Felix W, Dankwa-Mullan I. Understanding disparities in healthcare: Implications for health systems and AI applications. En: Health Informatics [Internet]. Cham: Springer International Publishing; 2022. p. 375-87. Disponible en: http://dx.doi.org/10.1007/978-3-031-07912-2_25
Abraham P, Williams E, Bishay AE, Farah I, Tamayo-Murillo D, Newton IG. The roots of structural racism in the United States and their manifestations during the COVID-19 pandemic. Acad Radiol [Internet]. 2021;28(7):893-902. Disponible en: https://www.sciencedirect.com/science/article/pii/S1076633221001653
Milán CG, Güemes LA. Intercultural competence in Healthcare Higher Education: Adapting UNESCO Story Circles method in medical education [Internet]. Research Square. 2023 [citado 23 de septiembre de 2023]. Disponible en: https://www.researchsquare.com/article/rs-3196527/latest
Hays RB, Ramani S, Hassell A. Healthcare systems and the sciences of health professional education. Adv Health Sci Educ Theory Pract [Internet]. 2020;25(5):1149-62. Disponible en: http://dx.doi.org/10.1007/s10459-020-10010-1
Khan AMH, Karim MU, Wallace N, Shaukat F, Abbasi MM. Some pertinent solutions to the challenges faced by the Pakistani healthcare systems. Nat J Health Sci [Internet]. 2023 [citado 23 de septiembre de 2023];8(2):47-50. Disponible en: https://ojs.njhsciences.com/index.php/njhs/article/view/395
American Medical Association. Not your grandfather’s med school: Changes trending in med ed [Internet]. American Medical Association. 2017 [citado 23 de septiembre de 2023]. Disponible en: https://www.ama-assn.org/education/accelerating-change-medical-education/not-your-grandfather-s-med-school-changes-trending
Vinagre R, Tanaka P, Tardelli MA. Competency-based anesthesiology teaching: comparison of programs in Brazil, Canada and the United States. Braz J Anesthesiol [Internet]. 2021 [citado 23 de septiembre de 2023];71(2):162-70. Disponible en: https://www.scielo.br/j/bja/a/mqgcTwKnqGQkQmWvwWyGRwH/.
Huang X, Li Z, Wang J, Cao E, Zhuang G, Xiao F, et al. A KSA system for competency-based assessment of clinicians’ professional development in China and quality gap analysis. Med Educ Online [Internet]. 2022;27(1). Disponible en: http://dx.doi.org/10.1080/10872981.2022.2037401
ZacharyR JD, TimothyE JD. Physician professionalism: Ethical and moral duties young physicians encounter in the new business model of medicine. 2019;34(5):316-20. Disponible en: https://www.proquest.com/docview/2504870436
The Lancet. Tomorrow’s Doctors: an improvement if evaluated. Lancet [Internet]. 2009;374(9693):851. Disponible en: http://dx.doi.org/10.1016/s0140-6736(09)61604-4
Ryan MS, Holmboe ES, Chandra S. Competency-based medical education: Considering its past, present, and a post–COVID-19 era. Acad Med [Internet]. 2022;97(3S):S90-7. Disponible en: http://dx.doi.org/10.1097/acm.0000000000004535
Keijser WA, Handgraaf HJM, Isfordink LM, Janmaat VT, Vergroesen P-PA, Verkade JMJS, et al. Development of a national medical leadership competency framework: the Dutch approach. BMC Med Educ [Internet]. 2019;19(1). Disponible en: http://dx.doi.org/10.1186/s12909-019-1800-y
Matsas B, Goralnick E, Bass M, Barnett E, Nagle B, Sullivan EE. Leadership development in U.s. undergraduate medical education: A scoping review of curricular content and competency frameworks. Acad Med [Internet]. 2022;97(6):899-908. Disponible en: https://www.ingentaconnect.com/content/wk/acm/2022/00000097/00000006/art00053
Stovel RG, Gabarin N, Cavalcanti RB, Abrams H. Curricular needs for training telemedicine physicians: A scoping review. Med Teach [Internet]. 2020;42(11):1234-42. Disponible en: http://dx.doi.org/10.1080/0142159x.2020.1799959
Misko J, Circelli M. Adding value to competency-based training. En: National Centre for Vocational Education Research (NCVER). National Centre for Vocational Education Research Ltd. P.O. Box 8288, Stational Arcade, Adelaide, SA 5000, Australia. Tel: +61-8-230-8400; Fax: +61-8-212-3436; e-mail: ncver@ncver.edu.au; Web site: http://www.ncver.edu.au; 2022.
Poláková M, Suleimanová JH, Madzík P, Copuš L, Molnárová I, Polednová J. Soft skills and their importance in the labour market under the conditions of Industry 5.0. Heliyon [Internet]. 2023;9(8):e18670. Disponible en: https://www.sciencedirect.com/science/article/pii/S2405844023058784
Sydorenko V. Soft skills as an educational trend and a necessary development component for a vocational lifelong education teacher. Fundamental and applied researches in practice of leading scientific schools [Internet]. 2020 [citado 23 de septiembre de 2023];38(2):127-34. Disponible en: https://lib.iitta.gov.ua/722987/
Karimian Z, Farrokhi MR, Moghadami M, Zarifsanaiey N, Mehrabi M, Khojasteh L, et al. Medical education and COVID-19 pandemic: a crisis management model towards an evolutionary pathway. Educ Inf Technol [Internet]. 2022;27(3):3299-320. Disponible en: http://dx.doi.org/10.1007/s10639-021-10697-8
Reinhart A, Malzkorn B, Döing C, Beyer I, Jünger J, Bosse HM. Undergraduate medical education amid COVID-19: a qualitative analysis of enablers and barriers to acquiring competencies in distant learning using focus groups. Med Educ Online [Internet]. 2021;26(1). Disponible en: http://dx.doi.org/10.1080/10872981.2021.1940765
Afshar L, Yazdani S, Shahr HSA. Professional identity of medical students: Proposing a Meta Static Structural Model. Journal of Advances in Medical Education & Professionalism [Internet]. 2021 [citado 23 de septiembre de 2023];9(4):211. Disponible en: http://dx.doi.org/10.30476/JAMP.2021.89121.1364
Jung SD, Aragon K, Anderson YK. What are health disparities? En: Best Practices for Acknowledging and Addressing Racial and Ethnic Health Disparities in Medical Education [Internet]. Cham: Springer International Publishing; 2023. p. 13-30. Disponible en: http://dx.doi.org/10.1007/978-3-031-31743-9_2
Jegan R, Dierickx K. Ethics without borders: an analysis of national and international guidelines on ethics in basic medical education. Adv Health Sci Educ Theory Pract [Internet]. 2023; Disponible en: http://dx.doi.org/10.1007/s10459-022-10186-8
Shevzov-Zebrun N, Barchi E, Grogan K. “the spirit thickened”: Making the case for dance in the medical humanities. J Med Humanit [Internet]. 2020;41(4):543-60. Disponible en: http://dx.doi.org/10.1007/s10912-020-09646-2
Sullivan BT, DeFoor MT, Hwang B, Flowers WJ, Strong W. A novel peer-directed curriculum to enhance medical ethics training for medical students: A single-institution experience. J Med Educ Curric Dev [Internet]. 2020;7:238212051989914. Disponible en: http://dx.doi.org/10.1177/2382120519899148
Burgess A, Matar E, Roberts C, Haq I, Wynter L, Singer J, et al. Scaffolding medical student knowledge and skills: team-based learning (TBL) and case-based learning (CBL). BMC Med Educ [Internet]. 2021;21(1). Disponible en: http://dx.doi.org/10.1186/s12909-021-02638-3
Meyer MW, Norman D. Changing design education for the 21st century. She Ji J Des Econ Innov [Internet]. 2020;6(1):13-49. Disponible en: https://www.sciencedirect.com/science/article/pii/S2405872620300046
Karami M, Hashemi N, van Merrienboer J. Medical educators’ beliefs about learning goals, teaching, and assessment in the context of curriculum changes: a qualitative study conducted at an Iranian medical school. BMC Med Educ [Internet]. 2021;21(1). Disponible en: http://dx.doi.org/10.1186/s12909-021-02878-3
Ottenhoff- de Jonge MW, van der Hoeven I, Neil Gesundheit, van der Rijst RM, Kramer AWM. Medical educators’ beliefs about teaching, learning, and knowledge: development of a new framework. BMC Med Educ [Internet]. 2021;21(1). Disponible en: http://dx.doi.org/10.1186/s12909-021-02587-x
Abd-alrazaq A, AlSaad R, Alhuwail D, Ahmed A, Healy PM, Latifi S, et al. Large language models in medical education: Opportunities, challenges, and future directions. JMIR Med Educ [Internet]. 2023 [citado 23 de septiembre de 2023];9(1):e48291. Disponible en: https://mededu.jmir.org/2023/1/e48291/
Dickinson BL, Gibson K, VanDerKolk K, Greene J, Rosu CA, Navedo DD, et al. “It is this very knowledge that makes us doctors”: an applied thematic analysis of how medical students perceive the relevance of biomedical science knowledge to clinical medicine. BMC Med Educ [Internet]. 2020;20(1). Disponible en: http://dx.doi.org/10.1186/s12909-020-02251-w
Husain M, Khan S, Badyal D. Integration in medical education. Indian Pediatr [Internet]. 2020;57(9):842-7. Disponible en: http://dx.doi.org/10.1007/s13312-020-1964-x
Wijnen-Meijer M, van den Broek S, Koens F, ten Cate O. Vertical integration in medical education: the broader perspective. BMC Med Educ [Internet]. 2020;20(1). Disponible en: http://dx.doi.org/10.1186/s12909-020-02433-6
Ramanathan R, Shanmugam J, Gopalakrishna SM, Palanisami K, Narayanan S. Exploring the learners’ perspectives on competency-based medical education. Journal of Education and Health Promotion [Internet]. 2021 [citado 23 de septiembre de 2023];10. Disponible en: http://dx.doi.org/10.4103/jehp.jehp_866_20
Borowczyk M, Stalmach-Przygoda A, Doroszewska A, Libura M, Chojnacka-Kuraś M, Małecki Ł, et al. Developing an effective and comprehensive communication curriculum for undergraduate medical education in Poland – the review and recommendations. BMC Med Educ [Internet]. 2023;23(1). Disponible en: http://dx.doi.org/10.1186/s12909-023-04533-5
Barman L, Weurlander M, Lindqvist H, Lönn A, Thornberg R, Hult H, et al. Hardness or resignation: How emotional challenges during work-based education influence the professional becoming of medical students and student teachers. Vocat Learn [Internet]. 2023; Disponible en: http://dx.doi.org/10.1007/s12186-023-09323-0
Rajeh N, Grant J, Farsi J, Tekian A. Contextual analysis of stakeholder opinion on management and leadership competencies for undergraduate medical education: Informing course design. J Med Educ Curric Dev [Internet]. 2020;7:238212052094886. Disponible en: http://dx.doi.org/10.1177/2382120520948866
Senok A, John-Baptiste A-M, Al Heialy S, Naidoo N, Otaki F, Davis D. Leveraging the added value of experiential co-curricular programs to humanize medical education. J Exp Educ [Internet]. 2022;45(2):172-90. Disponible en: http://dx.doi.org/10.1177/10538259211021444
Ndawo G. The development of self skills in an authentic learning environment: A qualitative study. Curationis [Internet]. 2022;45(1). Disponible en: http://dx.doi.org/10.4102/curationis.v45i1.2198
Ijioma NN, Don C, Arora V, Edgar L, Hawkins B, Monteleone P, et al. ACGME Interventional Cardiology Milestones 2.0–an overview: Endorsed by the Accreditation Council for Graduate Medical Education. Catheter Cardiovasc Interv [Internet]. 2022;99(3):777-85. Disponible en: http://dx.doi.org/10.1002/ccd.29975
Kozato A, Shikino K, Matsuyama Y, Hayashi M, Kondo S, Uchida S, et al. A qualitative study examining the critical differences in the experience of and response to formative feedback by undergraduate medical students in Japan and the UK. BMC Med Educ [Internet]. 2023;23(1). Disponible en: http://dx.doi.org/10.1186/s12909-023-04257-6
Ganguly B, D’Souza R, Nunes R. Challenges in the teaching–learning process of the newly implemented module on bioethics in the undergraduate medical curriculum in India. Asian Bioeth Rev [Internet]. 2023;15(2):155-68. Disponible en: http://dx.doi.org/10.1007/s41649-022-00225-2
Shrivastava SR, Shrivastava PS. Qualitative study to identify the perception and challenges faced by the faculty of community medicine in the implementation of competency-based medical education for postgraduate students. Fam Med Community Health [Internet]. 2019 [citado 24 de septiembre de 2023];7(1):e000043. Disponible en: http://dx.doi.org/10.1136/fmch-2018-000043
Vasquez JA, Marcotte K, Gruppen LD. The parallel evolution of competency‐based education in medical and higher education. J Competency-based Educ [Internet]. 2021;6(2). Disponible en: http://dx.doi.org/10.1002/cbe2.1234
Ghosh A, Bir A. Role of written examination in the assessment of attitude ethics and communication in medical students: Perceptions of medical faculties. J Educ Health Promot [Internet]. 2021 [citado 24 de septiembre de 2023];10(1):23. Disponible en: http://dx.doi.org/10.4103/jehp.jehp_424_20
McMahon CJ, Tretter JT, Redington AN, Bu’Lock F, Zühlke L, Heying R, et al. Medical education and training within congenital cardiology: current global status and future directions in a post COVID-19 world. Cardiol Young [Internet]. 2022;32(2):185-97. Disponible en: http://dx.doi.org/10.1017/s1047951121001645
Otaki F, Gholami M, Fawad I, Akbar A, Banerjee Y. Students’ perception of Formative Assessment as an Instructional Tool in competency-based medical education: Proposal for a proof-of-concept study. JMIR Res Protoc [Internet]. 2023 [citado 24 de septiembre de 2023];12(1):e41626. Disponible en: https://www.researchprotocols.org/2023/1/e41626
Pinilla S, Lenouvel E, Cantisani A, Klöppel S, Strik W, Huwendiek S, et al. Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review. BMC Med Educ [Internet]. 2021;21(1). Disponible en: http://dx.doi.org/10.1186/s12909-021-02608-9
Duggan N, Curran VR, Fairbridge NA, Diana Deacon D, Coombs H, Stringer K, et al. Using mobile technology in assessment of entrustable professional activities in undergraduate medical education. Perspect Med Educ [Internet]. 2020;10(6):373-7. Disponible en: http://dx.doi.org/10.1007/s40037-020-00618-9
