Luz M. Letelier

Análisis crítico de un artículo Las estatinas reducen la morbi-mortalidad en pacientes de alto riesgo cardiovascular: Heart Protection Study Collaborative Group. (HPS). Lancet 2002; 360: 7-22.

: Throughout the usual LDL cholesterol range in Westernpopulations, lower blood concentrations are associated with lower cardiovascular disease risk.In such populations, therefore, reducing LDL cholesterol may reduce the development of vascu-lar disease, largely irrespective of initial cholesterol concentrations.

Health reform in Chile.

The health sector in Chile is a mixture of public and private systems. The Chilean Ministry of Health and the Superintendent of Health are responsible for the regulation and supervision of policies. The National Health Insurance serves 68% of the population including unemployed people and those in extreme poverty. 18 private health-insurance companies provide financial support for 18% of the population. These companies cover people with the highest incomes who receive services through private ambulatory centres and hospitals. Public-health expenditure has increased from 2.2% of gross domestic product (GDP) in 1995 to 2.9% in 2002.1 Health in Chile has changed in the past 30 years because of improved living conditions and public-health policies with a large and widespread effect on the population. Life expectancy at birth has increased from 60·6 years (1965-70) to 76.0 years (2000-05) and maternal mortality has fallen from 4.0 per 10 000 livebirths in 1990 to 1.6 per 10 000 livebirths in 2004. Nowadays the most important causes of death and loss of quality of life are chronic degenerative diseases accidents and mental health. Despite these improvements we still have inequality in access opportunity quality and financial coverage of health care. Various studies have shown that low socioeconomic groups in Chile have a substantially higher mortality and morbidity than other socioeconomic groups. (excerpt)

How to teach evidence-based medicine to teachers: reflections from a workshop experience.

RATIONALE, AIMS AND OBJECTIVES To summarize 20-year experience of conducting a workshop designed for educators who wish to improve their teaching skills of evidence based medicine (EBM). The goal is to provide tips for educators interested in replicating this educational model. METHODS Qualitative description of factors associated with the success of the workshop. RESULTS The factors considered by instructors to be most helpful are: the small group interactive design, role-play and simulation of real world learning environments, a mentorship model and high educator to learner ratio. CONCLUSIONS Although this experience is observational and does not represent high quality evidence, certain attributes in the design of EBM workshops may lead to better dissemination of EBM concepts. Educators may consider empirically applying some of these attributes and testing their efficacy in comparative studies.

Evaluación de docentes clínicos de Postgrado: desarrollo y propiedades psicométricas del instrumento MEDUC-PG14

Experts in medical education, teachers and residents of a medical school participated in interviews and focus groups. With this information, 26 categories (79 items) were proposed and reduced to 14 items (Likert scale 1-5) by an expert’s Delphi panel, generating the MEDUC-PG14 survey, which was answered by 123 residents from different programs of medical specialties. Construct validity was carried out. Factor analysis showed three domains: Teaching and evaluation, respectful behavior towards patients and health care team, and providing feedback. The global score was 4.46 ± 0.94 (89% of the maximum). One teachers’ strength, as evaluated by their residents was “respectful behavior” with 4.85 ± 0.42 (97% of the maximum). “Providing feedback” obtained 4.09 ± 1.0 points (81.8% of the maximum). MEDUC-PG14 survey had a Cronbach’s alpha coefficient of 0.947.