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BACKGROUND: Trauma Evaluation and Management course was designed to develop trauma cognitive skills in senior medical students. Its effectiveness has been demonstrated in many regions, except in Latin America, where it has been poorly studied. The objective was to determine the Trauma Evaluation and Management course effectiveness, and whether greater effectiveness is achieved in basic- or clinic-cycle students, as well as student perception. MATERIAL Y METHODS: Descriptive, observational, longitudinal and prospective study. Two tests were performed, pre- and post-course; the manual was read by the students prior to both tests. Students were divided into 2 groups: group A (consisting of 71 basic-cycle medical students) and group B (consisting of 44 clinical-cycle medical students). RESULTS: Group A achieved a 2.45 increase (p<0.01) in the post-course evaluation compared with pre-course test. Group B increased the mean score by 2.25 (p>0.05) from pre- to post-course tests. There was a significant difference between groups in both evaluations (pre-course test p<0.01 and post-course test p>0.05), with no difference in improvement (p>0.05). Using a questionnaire, 92.17% of the students totally agreed that the course improved their trauma knowledge, 76.52% that it increased their trauma clinical skills, with 94.78% being totally satisfied with the course, and 86.09% totally agreed that Trauma Evaluation and Management course should be in Medicine curriculum. CONCLUSIONS: Trauma Evaluation and Management course improves trauma cognitive skills, and undergraduate medical students in Mexico broadly accept it.

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Objetivo: Proporcionar material didáctico útil al estudiante y al médico general para conocer la técnica de venodisección en un modelo biológico no vivo. Sede: Departamento de Cirugía, Facultad de Medicina, UNAM. Diseño: Modelo de enseñanza. Material y método: Se proporcionan indicaciones, contraindicaciones, características anatómicas y técnica a considerar. Empleamos pata de cerdo como modelo didáctico por ser accesible en costos, disponibilidad y un modelo fácilmente reproducible por los alumnos. Por su semejanza con los eventos clínicos que suceden en los pacientes a nivel hospitalario, consideramos que representa un buen método de enseñanza de habilidades quirúrgicas en el pregrado. Conclusión: El actual modelo biológico es una opción viable y representativa de la venodisección; el alumno aprende a identificar al paciente que requiere de este procedimiento; una vez identificado, podrá realizar el procedimiento de manera adecuada evitando, en la medida de lo posible, cualquier tipo de complicación.

Objective: To provide teaching material useful for the medical student and the general physician to learn the venous cutdown technique in a non-live biological model. Setting: Department of Surgery, School of Medicine, UNAM. Design: Teaching model. Material and method: Indications, contraindication, anatomical characteristics and technique to be considered will be provided. We use a pig foot as didactic model because it is accessible in terms of costs, availability, and can be reproduced easily by students. Due to its similarity with clinical events occurring in patients at the hospital level, we consider that it represents a good teaching method of surgical skills at the undergraduate level. Conclusion: The current biological model is a viable option and representative of venous cutdown. The student learns to identify the patient that requires this procedure, once identified he will be able to perform the procedure adequately avoiding, as much as possible, any type of complication.

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Introducción. Los alumnos generalmente profundizan en el conocimiento de acuerdo al tipo de preguntas con que son evaluados: si evalúan memoria se favorece un aprendizaje mecánico y repetitivo que permanece poco tiempo en la memoria; si son de comprensión o aplicación favorecerán aprendizajes significativos. Materiales y métodos. Estudio analítico, observacional transversal. Por jueces se seleccionaron preguntas obtenidas de exámenes de anatomía, psicología, fisiología y cirugía de los tres niveles de conocimiento. El mismo examen se aplicó al azar a 13 grupos de segundo año y a 13 grupos de cuarto. La calificación y el análisis se realizaron de manera electrónica. Se aplicó la U de Mann-Whitney para identificar diferencias y percentiles con rango intercuartílico para la dispersión. Resultados. Se contestaron 310 exámenes de segundo año y 247 de cuarto. La fiabilidad del examen fue de 0,9009 y 0,9102, respectivamente. Se identificaron diferencias significativas (p = 0,000) en el examen global y en las respuestas de cirugía y psicología, considerando aciertos y nivel de conocimiento (memoria y comprensión). No se encontraron diferencias en anatomía (p = 0,527) y fisiología (p = 0,203). La mediana de aciertos fue de 39 y 43, respectivamente. La dispersión de reactivos en el análisis global y por asignatura mantuvo un rango intercuartílico de 3-4. Conclusiones. Al ser evaluado, el alumno con conocimientos memorísticos pierde interés al no encontrar la aplicación y la integración del conocimiento básicos en la clínica (AU)

Introduction. Students generally go deep into the knowledge according to the type of questions they are evaluated with, if they only will support mechanical and repetitive learning that remains just a short time in the memory, if they understand and apply their learning then these supports significant learning. Materials and methods. Analytical observational study by the method of judges there were selected 88 questions of the three levels of knowledge from tests of Anatomy, Psychology, Physiology and Surgery. The same test was randomized and applied to 13 groups of second and fourth grade. The evaluation and the analysis were performed with an electronic system. The U of Mann-Whitney was applied to identify differences and percentiles with inter-quartiles rank for the dispersion. Results. 310 students of second grade and 247 of fourth grade were answered and analyses. The reliability of the test was of 0.9009 and 0.9102, respectively. Significant differences were identified (p = 0.000) in the global examination and the answers of Surgery and Psychology, considering right answers and level of knowledge and Psychology. Considering right answers and level of knowledge (memory and understanding). There were no differences in Anatomy (p = 0.527) and Physiology (p = 0.203). There median of right answers was 39 and 43, respectively. The dispersion of items in the global analysis and by subject maintained an inter-quartiles rank between 3 and 4. Conclusions. It is important to include as many items of high cognitive levels in assessments to facilitate meaningful learning (AU)

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BACKGROUND: "Surgical scrub" of the hands and arms is a fundamental procedure for reducing infection risk. We undertook this study in order to compare different antiseptics and their microbicidal effects, costs and times of the procedures. METHODS: Thirty students followed the surgical scrub procedure using benzalkonium chloride. Seven days later the students used povidone-iodine and, 7 days after that, they used chlorhexidine/alcohol. After the surgical scrub, cultures were obtained from the palms of their hands and from their nail beds. The students wore sterile gloves, which were removed 30 min later to obtain new cultures from the same sites. The cost of the products was calculated in Mexican pesos and the time of each procedure was measured in minutes. RESULTS: There was a statistically significant difference in the number of colony-forming units (CFUs). The number of CFUs was lower in the groups of students who used chlorhexidine/alcohol and povidone-iodine as compared to the benzalkonium chloride group. There was no difference between chlorhexidine/alcohol and povidone-iodine. Costs were higher for povidone-iodine and benzalkonium chloride compared to chlorhexidine/alcohol. Procedure times were similar with povidone-iodine and benzalkonium chloride but the time was reduced approximately five times when using chlorhexidine/alcohol. CONCLUSIONS: It is a proven fact that the lack of surgical scrub favors wound infections, longer hospital stays and increased costs. Therefore, further studies are needed to determine the best antiseptic according to cost/benefit. Chlorhexidine/alcohol proved to be the superior antiseptic in terms of cost/benefit compared to povidone-iodine and benzalkonium chloride.

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