Abstract:

The integration of knowledge and skills, both in basic medical sciences and clinical fields, is essential to promote the development of solidly grounded clinical reasoning in medical students. To achieve a successful integration of basic and clinical medical sciences, it is necessary to consider four spheres that must be carefully developed and implemented: an integrated curriculum covering knowledge and skills, integration of courses offered during the same semester, as well as previous and subsequent courses, diverse faculty composition, and the evaluation of clinically grounded reasoning in basic medical sciences.

A cross-sectional descriptive study was conducted within the framework of the extraordinary meeting of 2021 of the Mexican Association of Faculties and Schools of Medicine (AMFEM). Directors of medical faculties were invited to complete an electronic questionnaire on Google Forms®, addressing various aspects to assess the level of cognitive integration in different academic spheres.

Inquiries were made regarding the organization and content of courses, faculty composition, the level of integration in courses, and obstacles that teachers identify in teaching. Subsequently, the obtained results were compared with the average score of the National Exam for Medical Residency Applicants (ENARM) of the last 5 years preceding the meeting.

A total of 23 responses were received, distributed among 15 public universities and 8 private universities. 50% of the faculties follow a traditional discipline model in their curriculum. In the initial analysis, no significant relationship was identified between the type of curriculum organization and the average ENARM score. Although a predominance of the discipline model is observed in schools with lower scores, it is noteworthy that 82% of the surveyed schools maintain a problem-based model, reflecting the transformation that has been occurring in recent years.

Regarding the faculty composition, a predominance of experts in basic and clinical medical sciences prevails, a trend observed similarly in public and private universities (40% and 50%, respectively). Finally, teachers identify the lack of medical education training, time constraints, and the absence of guides for teaching sessions as the main obstacles in achieving effective cognitive integration.

Our work provides insight into the situation in Mexico in recent years, revealing a predominance of curricula focused solely on discipline, alongside models that encourage learning based on clinical scenarios. However, there is still a significant journey ahead concerning support for faculty development in our country. A hurdle that we have identified, hindering pedagogical evolution in medical faculties, lies in the lack mentioned above of training for health professionals as educators. This reality prompts us to explore training options, such as asynchronous courses with personalized guidance, medical education workshops alongside annual meetings, and training in the use of resources to teach and evaluate clinical reasoning.

Keywords:

Cognitive Integration, Medical Education, Faculty Development.