Slide presentation Latin American Study Group Teaching in undergraduate students of Medicine American College of Rheumatology

1. Educaciónen Reumatología en AméricaLatina
Education in Rheumatology in Latin America
Carlo V Caballero-UribeMD-PhD (c)
Internist-Rheumatologist
AssociatedProfesor of Medicine
Universidad del Norte
Barranquilla-Colombia

2. Nothing to Disclose
Thanks to Drs. Loreto Massardo, Claudio Galarza, Carlos Pineda and PANLAR.

3. Education in Rheumatology . Trends to consider 4
1. Burdenof disease
2. Worldwideshortageof Rheumatologists
3. Inadequaciesof RheumatologyTeaching
4. New learningmethods
5. Needsof workforcein Rheumatology

4. Undergraduate Teaching of Rheumatology in Latin America . Outline 6
Education for undergraduate students:
A survey to Latin American Rheumatologistsabout pre grad medical education on Rheumatology
Seven points survey to Presidents of National Societies (N°10)
Individual Survey to members of National Societies sent from Panlar: N°320

5. Survey to the Presidents of National Societies

6. Millions
Hab.
(aprox.)
MD
per 1 millionh.
Rheumatologists
Per 1 millionh.
N º of medicalschools
N º teachingpregraduaterheumatology(%)
Argentina
40
500
13
29
7 (24%)
Chile
17
170
9
21
9 (43%)
Colombia
48
160
3
57
NA
CostaRica
4
260
6
6
3 (50%)
Ecuador
14
170
4
16
7 (44%)
ElSalvador
5
254
33
4
1 (25%)
DominicanRep.
10
300
2
9
NA
Mexico
112
180
6
85
35 (41%)
Uruguay
3
470
33
2
2 (100%)
Venezuela
30
200
6
8
5 (62%)
TOTAL
283
266.4
11.5 *
237
69 (29.1%)
Rheumatologyteachingin pregradmedschool
Surveytopresidentsof nationalsocieties
*Ideal # 80 -100 /million h

7. Survey QuestionsSurvey using Survey Monkey via e- mail sent to Rheumatologists through their National Societies38 questions320 answers to the survey

8. Whoare theteachers?
Feature
Mostfrequentanswer
Percentage
Speciality
Rheumatologist
96%
Universityaffiliation
YES
71%
Academicposition
Professor(Anylevel)
64%
Teachingin undergraduatestudents
YES
56%
Paymentas aprofessor
YES
55%
Teachingsemiology
Semiologyin rheumatology
51%
Yearof medical degreeprogram(Teaching).
3-4 year
50 %
PANLAR. Individual survey 2014

9. Relevant Survey Questions

10. En general ¿quétan de acuerdoestácon la siguienteafirmación? La mayoríade los médicosen AméricaLatina tieneun déficiten suformación/ pobreconocimientode la historiaclínicay examenarticular o exploraciónen reumatología.
Answered: 316 Skipped: 4
In general, to what extent do you agree with the following statements? Themajority of doctors in Latin America lack training or have a poor knowledge of the clinical history/background and articular tests or exploration in Rheumatology.
72. % Totally agree or agree with a lack of training o poor Knowledge

11. En general ¿quétan de acuerdoestácon la siguientesafirmación? La mayoríade los médicosegresadosde mi universidad/ escuelade medicinaen AméricaLatina tieneun déficiten suformación/ pobreconocimientode la historiaclínicay examenarticular o exploraciónen reumatología.
Answered: 320 Skipped: 0
In general, to what extent do you agree with the following statements? A majority of doctors that studied atmy university/Institution lack training or have a poor knowledge of the clinical history/background and articular tests or exploration in Rheumatology.
67.5% agree with lack of training by their own institution

12. ¿Reumatologíase enseñaen etapas? (esdecirse reparteen distintosnivelesen distintoscursoso añosdurantela formacioncomomédico)
Answered: 281 Skipped: 39
¿Rheumatologyisteachedbysteps? (Severalcoursesacrosstheyearsof pre-medical school)
61.57% Onecourseof rheumatologyin thelifetime

13. ¿Hay un Perfilde egresadode suinstituciónqueincluyaelementosde la reumatología?
Answered: 282 Skipped: 38
Does your institution have a Graduate Profile that includes elements of Rheumatology?
Not a clear profile that includes rheumatology elements (67%)

14. ¿Do you participate choosing the rheumatology topics ?
Answered: 283 Skipped: 37
48% Do not participate choosing the topics
¿Participa Ud. en las decisiones del temario que se enseña en reumatología?

15. En general ¿quétan de acuerdoestáUd. con el temariode enseñanzade la reumatologíaen pregradoen suinstitución?
Answered: 273 Skipped: 47
In general; to what extent do you agree with the subjects that are taught in Rheumatology for undergraduates at your institution?
71.4%. Agree with the subjects or topics

16. ¿Are the topics focus in the reality of your country or institution?
Answered: 270 Skipped: 50
63.3% agree withfocus on the topics
¿El temario se encuentra enfocado a la realidad de los problemas de atención de reumatología de su región o país?

17. Are immunology and rheumatology teaching integrated in the curriculum?
Answered: 276 Skipped: 44
Separate courses in 42.75%
La enseñanza de la inmunología en relación con la reumatología en su programa se encuentra integrada?

18. In your country. The education program its regulated by a national institution or organization regarding depth and extension of the courses?
Answered: 280 Skipped: 40
In 50% there is a national organization
En su país ¿Existe una entidad nacional que regule los temas a enseñar en cuanto a profundidad y extensión entre la distintas instituciones educativas?

19. ¿Cuálesla metodologíaqueutilizade preferenciasuescuelade medicinay en particular reumatología? (puedemarcarvariasrespuestas)
Answered: 275 Skipped: 45
What is the methodology of choice with regard to Rheumatology at your institution? (You may choose more than one answer)
73.8% use a traditional teaching methodology

20. ¿Does you med school has interactive methods to teach rheumatology?
Answered: 274 Skipped: 46
62% Does not have interactive methods to teach rheum
¿Cuenta su escuela de medicina con métodos interactivos para la enseñanza de reumatología?

21. How many teaching hours does your Rheumatology course have annually?
Answered: 261 Skipped: 59
38% have 24 or more hours dedicated to rheumatology
¿Cuántas horas lectivas tiene el curso de Reumatologiaanualmente?

22. ¿Los alumnostienenaccesoen forma sistematizadaa la atenciónde pacientesambulatorios?
Answered: 261 Skipped: 59
Do students have access to attend Rheumatology out-patient clinics in a systematic way?
59 % teach in settings with real patients

23. ¿QuébarrerasidentificaUd. paraobtenerunaenseñanzaefectivade pregradoen reumatología? (puedemarcarvariasrespuestas)
Answered: 243 Skipped: 77
In your opinion, what are the main barriers to effective undergraduate teaching in Rheumatology? (You may choose more than one answer)
60% mention lack of motivation as a barrier to effective teaching

24. ¿IdentificaUd. algunade lassiguientesbarrerasparala enseñanzay aprendizajedel examendel sistemamúsculo-esqueléticoen suinstitución? (puedemarcarmásde unarespuesta)
Answered: 239 Skipped: 81
Could you identified any of the barriers in relation to the teaching of MSK examination skills at your institution ? (You may choose more than one answer)
57.32% lackof standarizedapproachto MSK examinationskills

25. Acercadel sistemade exploracióno examendel aparatolocomotor"GALS" (Gait, Arms, Legs, Spine)
Answered: 272 Skipped: 48
Are you familiar with "GALS" (Gait, Arms, Legs, Spine) examination?
31.62% Doesn’tknowabouttheGALS

26. Conclusions
•Very few rheumatologists per habitants and fewschoolsteachingrheumatology
•Lack of training o poor Knowledge with more than a half with pre grad teaching by Non Rheumatologists.
•The curriculum It’s not standarizedto teach reumathology.
•Only 1/3 knows, practice and teach the GALS.

27. Conclusions. Whatneedsto be done
•Set of recommendations for core content of a musculoskeletal course through a task force on pregraduateeducation (i.ePANLAR Education Committee?
•Teach the GALS? . Students who had formal instruction in the GALS were proficient in examining the locomotorsystem
•A PANLAR basicalcourse oriented to pregraduateusing different methods to reach those students lacking of rheumatology education (i.eonline text or course)