Effect of a medical formation curriculum on the development of clinical competencies to identify and manage chronic kidney disease

  • Carlos Enrique Cabrera-Pivaral Universidad Guadalajara LAMAR, Campus Vallarta, Guadalajara, Mexico
  • Diego Ramos-Peña Universidad Guadalajara LAMAR, Campus Vallarta, Guadalajara, Mexico
  • Guillermo Gaona-Bojorquez Universidad Guadalajara LAMAR, Campus Vallarta, Guadalajara, Mexico
  • Jennifer Aylin Espinoza-González Universidad Guadalajara LAMAR, Campus Vallarta, Guadalajara, Mexico
  • Santiago Alejandro Herrera-Ornelas Universidad Guadalajara LAMAR, Campus Vallarta, Guadalajara, Mexico
  • Ana Méndez-Magaña Universidad Guadalajara LAMAR, Campus Vallarta, Guadalajara, Mexico
  • Adrián Enrique Hernández-Muñoz Universidad Guadalajara LAMAR, Campus Vallarta, Guadalajara, Mexico
Keywords: clinical competence, chronic kidney disease, curriculum, medical education

Abstract

Introduction:Chronic kidney disease is a worldwide epidemic and represents one of the most important challenges for the health personal; because of this, the importance of generating competent human resources is crucial to the correct treatment and prevention of this disease. Objective: To measure the effect of a medical formation curriculum on the development of clinical competencies to identify and manage chronic kidney disease. Methods: A quasi-experimental study was carried out at the Guadalajara LAMAR University Campus Vallarta in the first scholar semester of 2019 (2019A cycle). With a sample of 133 medical students, which 18 were from second semester (G1), 31 from fourth semester (G2), and 84 medical interns (G3); additionally, we included 22 college students with no medical formation to form the fixed group (G0). The Instrument used was a Spanish-language scale that evaluated the knowledge on chronic kidney disease, whose total sum allows the identification of the clinical competencies. The analysis was made by means of non-parametric inferential statistics (p-Value of ≤0.05). Results: The clinical competency was higher in those who were exposed to the medical formation program: G1 attained 38.8% of competence, G2 achieved 35.5%, and G3 had 61.91% of competence expectations. Meanwhile, G0 achieved only 18.1% of competence. Conclusion: The evaluation of the curriculum, during the 2019A cycle, showed a gradual growth of professional competences in chronological form, which gets higher when the theoretical knowledge is combined with the clinical practice.

References

Morales-Buenrostro LE, Ramos-Gordillo JM. Etapas tempranas de la ERC: detección y manejo. En: La enfermedad renal crónica en México. México: Editores Intersistemas, 2016, pp. 27-38.

Pérez-Oliva Díaz JF, Almaguer López M, Herrera Valdés R, Martínez Machín M, Martínez Morales M. Comportamiento de la enfermedad renal crónica en la atención primaria de salud. Cuba, 2017. Rev Haban Cienc Méd. 2018;17(6):1009-21.

Torres-Toledano M, Granados-García V, López-Ocaña LR. Global burden of disease of chronic kidney disease in Mexico. Rev Med Inst Mex Seguro Soc. 2017;55(Suppl. 2):118-23.

Ahlawat R, Tiwari P, D'Cruz S. Prevalence of depression and its associated factors among patients of chronic kidney disease in a public tertiary care hospital in India: A cross-sectional study. Saudi J Kidney Dis Transpl. 2018;29(5):1165-73. doi: 10.4103/1319-2442.243972.

Harris DC, Davies SJ, Finkelstein FO, Jha V, Donner J-A, Abraham G, et al. Increasing access to integrated ESKD care as part of universal health coverage. Kidney Int. 2019;95(4):S1-S33. doi: 10.1016/j.kint.2018.12.005.

Barrientos-Jiménez M, Durán-Pérez VD, León-Cardona AG, García-Tellez SE. La práctica deliberada en la educación médica. Rev Fac Med. (Méx.) 2015;58(6):48-55.

Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638-45. doi: 10.3109/0142159X.2010.501190.

Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies and accreditation in graduate medical education. Health Aff (Millwood). 2002;21(5):103-11. doi: 10.1377/hlthaff.21.5.103.

Carraccio CL, Benson BJ, Nixon LJ, Derstine PL. From the educational bench to the clinical bedside: translating the Dreyfus developmental model to the learning of clinical skills. Acad Med. 2008;83(8):761-7. doi: 10.1097/ACM.0b013e31817eb632.

Garvey TM, McCarron NM. A nursing perspective of caring for patients with end-stage renal disease in hospitals. Saudi J Kidney Dis Transpl. 2018;29(4):755-65. doi: 10.4103/1319-2442.239644.

Robaina J, Fayad A, Forlano C, Leguizamón L, De Rosa M, Vavich R, et al. Detección de factores de riesgo e indicadores tempranos de enfermedad renal crónica en población adulta en una campaña de salud renal. Rev Nefrol Dial Traspl. 2013;33(4):196-214.

Campbell DT, Stanley JC. Diseños cuasiexperimentales. En: Diseños experimentales y cuasiexperimentales en la investigación social. Buenos Aires: Amorrortu, 1995, pp. 70-122.

Hernández-Sampieri R, Fernández-Collado C, Baptista-Lucio P. Concepción o elección del diseño de investigación. En: Metodología de la investigación. México, D.F.: McGraw-Hill, 2010. p. 136.

México. Reglamento de la ley general de salud en materia de investigación para la salud [Internet]. México, D.F.: Diario Oficial de la Federación de los Estados Unidos Mexicanos, 1982. Disponible en: http://www.salud.gob.mx/unidades/cdi/nom/compi/rlgsmis.html (consulta: 19/12/2019).

Universidad Guadalajara LAMAR. Licenciatura en Medicina: plan de estudios [Internet]. Guadalajara: Universidad Guadalajara LAMAR, 2018. Disponible en: https://lamar.mx/licenciaturas/ciencias-de-la-salud/medico-cirujano-y-partero (consulta: 10/02/2020).

Cabrera-Pivaral CE, Chávez SA, González-Reyes HF, Cortés-Sanabria L. Valoración global de la aptitud clínica de médicos familiares en el manejo de la diabetes mellitus con nefropatía inicial. Rev Invest Clín. 2005;57(5):685-90.

Cortés-Sanabria L, Cabrera-Pivaral CE, Cueto-Manzano AM, Rojas-Campos E, Barragán G, Hernández-Anaya M, et al. Improving care of patients with diabetes and CKD: a pilot study for a cluster-randomized trial. Am J Kidney Dis. 2008;51(5):777-88. doi: 10.1053/j.ajkd.2007.12.039.

Dreyfus SE, Dreyfus HL. A five-stage model of the mental activities involved in directed skill acquisition. Berkeley: University of California, Operations Research Center, 1980. 21 p.

Cueto-Manzano AM, Martínez-Ramírez HR, Cortés-Sanabria L. Comparison of primary health-care models in the management of chronic kidney disease. Kidney Int Suppl. 2013;3(2):210-4. doi: 10.1038/kisup.2013.16.

Saad CY, Fogel J, Rubinstein S. Awareness and knowledge among internal medicine resident trainees for dose adjustment of analgesics and neuropsychotropic medications in CKD. South Med J. 2018;111(3):155-62. doi: 10.14423/SMJ.0000000000000781.

Cabrera-Pivaral CE, Crócker-Sagástume RC, Carmona-Ruvalcaba J, López-de-la-Mora DA, Sánchez-Toscano YG, Zavala-González MA. Efecto de un plan de estudios de Medicina sobre las competencias para la promoción de la salud y la participación social. Educ Méd. 2019;20(Supl. 2):129-35. doi: 10.1016/j.edumed.2018.06.002.

Moreno-Segura A, Frías Navarro VO, Casas Patiño D, Rodríguez Torres A. Aptitud clínica del médico familiar en los principales motivos de consulta y temas prioritarios de la atención primaria. Arch Inv Mat Inf. 2016;8(3):77-84.

Surana S, Kumar N, Vasudeva A, Shaikh G, Jhaveri KD, Shah H, et al. Awareness and knowledge among internal medicine house-staff for dose adjustment of commonly used medications in patients with CKD. BMC Nephrol. 2017;18:26. doi: 10.1186/s12882-017-0443-7.

Casas D, Rodríguez A, Tapia E, Camacho E, Rodríguez R. Aptitud clínica en médicos familiares apegados a guías de práctica clínica. Rev Med Investig. 2014;2(2):100-6. doi: 10.1016/S2214-3106(15)30005-4.

Viniegra VL. El concepto de postura: más allá de la medición de actitudes. En: La investigación en la educación. Papel de la teoría y de la observación. México, D.F.: Instituto Mexicano del Seguro Social, 2004, pp. 201-26.

Published
2020-12-15
How to Cite
1.
Cabrera-Pivaral CE, Ramos-Peña D, Gaona-Bojorquez G, Espinoza-González JA, Herrera-Ornelas SA, Méndez-Magaña A, Hernández-Muñoz AE. Effect of a medical formation curriculum on the development of clinical competencies to identify and manage chronic kidney disease. Rev Nefrol Dial Traspl. [Internet]. 2020Dec.15 [cited 2024Dec.27];40(4):311-9. Available from: http://vps-1689312-x.dattaweb.com/index.php/rndt/article/view/573
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Original Article