Browsing by Author "Rivera, Solange"

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    Curriculum reform at the Pontificia Universidad Catolica de Chile School of Medicine
    (SOC MEDICA SANTIAGO, 2016) Cisternas, Marcela; Rivera, Solange; Sirhan, Marisol; Thone, Natalie; Valdesa, Claudia; Pertuze, Julio; Puschel, Klaus
    The career of Medicine at the Pontificia Universidad Catolica de Chile was established from the beginning (1929), with a classical Flexner curriculum design. In seven years, the career is divided in three cycles: basic sciences, clinics and internship. It obtained Chilean accreditation and fulfilled American Association of Medical Colleges accreditation requirements. Changes in the Chilean epidemiological profile and health system, and new teaching methods in medicine, stimulated a process of deep curricular analysis, identifying strengths and weaknesses of the medical career. The curricular strengths were well-developed scientific and clinical components, fully committed students and faculties, well defined learning objectives and excellent clinical campuses. Curricular weaknesses included a poor vertical and horizontal integration, few student centered methodologies and a weak emphasis concerning doctor's professionalism. Subsequently, the whole community of teachers, students and medical educators worked on the design of a new curriculum, establishing a new graduate profile and designed it oriented by learning objectives, of six years of duration, with an optimized course sequence that melds basic science and clinical concepts, with strong emphasis on humanities and professionalism. It prioritizes an early contact with patients from the first year and expands teaching methods. The main objective of this process was to achieve a new curriculum with an integrative structure. This was implemented in 2015 with an approved protocol to evaluate the outcomes.
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    Diseño e implementación de talleres con aprendizaje basado en casos en un curso de salud pública de odontología
    (2022) Cantarutti, Cynthia; Véliz Paiva, Claudia; Mellado, Beatriz; García-Huidobro, Rosario; Ortuño, Duniel; Rivera, Solange
    Introducción: la enseñanza de la salud pública en pregrado de odontología ha presentado dificultades para que los alumnos apliquen y valoren su utilidad en la práctica clínica. Los odontólogos recién titulados señalan no sentirse preparados para resolver necesidades de atención relacionadas con la gestión de los recursos disponibles. El objetivo de este artículo es describir el diseño e implementación de un dispositivo educativo en el módulo Planes y programas de atención de la salud bucal en el curso Salud Pública en el pregrado de Odontología UC. Metodología: estudio de caso del diseño e implementación de talleres en un módulo del curso Salud Pública en el pregrado de Odontología UC. El diseño del dispositivo educativo se planificó en cuatro fases basadas en el modelo de diseño curricular de Kern: búsqueda de evidencia sobre metodologías de enseñanza aprendizaje utilizadas en cursos de salud pública; diseño del dispositivo educativo; implementación y evaluación del proceso. Resultados: se seleccionó la metodología aprendizaje basado en casos según factibilidad de implementación y las necesidades del curso y se diseñaron cinco talleres. Se realizó la evaluación del proceso mediante un registro on the run, lo que permitió implementar mejoras. Conclusiones: aprendizaje basado en casos permite integrar contenidos teóricos con la práctica clínica, sin necesidad de salidas a terreno o incorporar más sesiones. Al diseñar un dispositivo educativo con esta metodología es necesario considerar aspectos relacionados con los alumnos, los profesores y el diseño e implementación.
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    Effectiveness of a brief intervention based on the '5A' model for smoking cessation at the primary care level in Santiago, Chile
    (OXFORD UNIV PRESS, 2008) Puschel, Klaus; Thompson, Beti; Coronado, Gloria; Huang, Ying; Gonzalez, Loreto; Rivera, Solange
    Chilean women have the highest smoking rates in Latin America. Prevalence in this population is about 40%. There are no national programs for smoking cessation at the primary care level. This study explores the feasibility and effectiveness of a brief counseling intervention targeted to women smokers of childbearing age who seek primary care in Santiago, Chile. A quasi-experimental design was used to compare the effect of an intervention based on the '5A' model developed by the National Cancer Institute in the United States and the standard care provided in two control clinics. Women smokers seeking care at the three primary care clinics were contacted during a 2 months period and offer to participate in the study. Sampling was stratified according to the age groups to ensure comparability between cohorts. Quotas were calculated for each age group. Participants were asked about their willingness to quit, self-efficacy, smoking behavior, addiction level as well as support received for smoking cessation. After 18 months of intervention all women were re-evaluated. A total of 773 women were recruited for the study; 76% of them completed the trial. Women smokers are characterized by a large percentage of light smokers with a low self-efficacy for quitting and with very low information on where and how to get assistance to quit. At study end, 15.2% of women reported quitting smoking at least for 1 month in the intervention clinic versus 7.8% in one of the control clinics (p < 0.05) and 14.6% in the second control clinic (p = NS). Over 70% of women in the intervention clinic were asked, assessed and received advice for quitting in comparison with < 15% in the control clinics (p < 0.01). To conclude, a primary care intervention based on the '5A' model for smoking cessation is feasible and can have a significant effect in reducing smoking prevalence in this population.
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    Subgroup analysis: Do they help or mislead when interpreting study results?
    (SOC MEDICA SANTIAGO, 2012) Candia B, Roberto; Rivera, Solange; Neumann, Ignacio
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    System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation (Preprint)
    (2020) García-Huidobro Munita, Diego Nicolás; Rivera, Solange; Valderrama Chang, Sebastián; Bravo, Paula; Capurro, Daniel
    Background: As the COVID-19 pandemic disrupted medical practice, telemedicine emerged as an alternative to outpatient visits. However, it is unknown how patients and physicians respond to an accelerated implementation of this model of medical care. Objective: To report the system-wide accelerated implementation of telemedicine, compare patient satisfaction between telemedicine and in-person visits, and report provider perceptions. Methods: A convergent parallel mixed-methods study design consisting of simultaneous use of both qualitative and quantitative methods. This study was conducted at the UC-Christus Health Network, a large private academic health network in Santiago, Chile. Satisfaction of patients receiving telemedicine care between March and April, 2020, was compared to those receiving in-person care during the same period (concurrent control group) and during March and April, 2019 (retrospective control group). Patient satisfaction with in-person care was measured using the Net Promoter Score (NPS) survey. Satisfaction with telemedicine was assessed by patients using an online survey assessing similar domains. Providers rated their satisfaction and responded to open-ended questions assessing challenges, strategies to address them, the diagnostic process, treatment, and the patient-provider relationship. Results: A total of 3,962 patients receiving telemedicine, 1,187 patients from the concurrent control group, and 1,848 from the retrospective control group completed the surveys. Satisfaction was very high with both telemedicine and in-person services. Overall, 263 physicians from over 41 specialties responded the survey. During telemedicine visits, most providers felt their clinical skills were challenged (61.8%). Female providers felt more challenged than male providers (70.7% vs 50.9%, P = .002). Surgeons, obstetricians and gynecologists felt their clinical skills were challenged the least, compared to providers from non-surgical specialties (P < .001). Challenges related to the delivery modality, diagnostic process, and patient-provider relationship differed according to the provider’s specialty (P = .046, P < .001, and P = .022, respectively). Conclusions: Telemedicine implemented in response to the COVID-19 pandemic produced high patient and provider satisfaction. Specialty groups perceive the impact of this new mode of clinical practice differently.