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BACKGROUND: University teachers prioritize acquiring knowledge about their disciplines over pedagogic training. However, the latter is becoming increasingly important in the present teaching scenario. AIM: To relate pedagogic practices with pedagogic training of teachers from health care careers of public and private universities. MATERIAL AND METHODS: Pedagogic practice and training activities participation questionnaires were answered by 296 teachers of undergraduate students from Chilean public and private universities. RESULTS: There was a direct correlation between discipline training and all pedagogic practice factors. However, pedagogic training correlated with all the factors with the exception of teacher centered learning. Teachers with a master degree had higher scores in factors related to teaching planning and process assessment. Having a doctor degree had no impact on these factors. A multiple regression analysis showed that both discipline and pedagogic training and having a master degree were associated with pedagogic practices of teachers. CONCLUSIONS: Both pedagogic and discipline training influence the quality of teaching provided by undergraduate teachers.

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Background: University teachers prioritize acquiring knowledge about their disciplines over pedagogic training. However, the latter is becoming increasingly important in the present teaching scenario. Aim: To relate pedagogic practices with pedagogic training of teachers from health care careers of public and private universities. Material and Methods: Pedagogic practice and training activities participation questionnaires were answered by 296 teachers of undergraduate students from Chilean public and private universities. Results: There was a direct correlation between discipline training and all pedagogic practice factors. However, pedagogic training correlated with all the factors with the exception of teacher centered learning. Teachers with a master degree had higher scores in factors related to teaching planning and process assessment. Having a doctor degree had no impact on these factors. A multiple regression analysis showed that both discipline and pedagogic training and having a master degree were associated with pedagogic practices of teachers. Conclusions: Both pedagogic and discipline training influence the quality of teaching provided by undergraduate teachers.

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Background: Educational environment has an important effect on the quality of learning and student satisfaction in medicine. Most of previous studies have been conducted using questionnaires that assess the phenomenon considering overall dimensions, without paying attention to the specific manifestations of this topic, especially those aspects that are related to the protagonists of the learning process: teachers and students. Aim: To describe factors that affect the educational environment in the preclinical Medical formation, according to Medical teachers in Concepción, Chile. Material and Methods: Qualitative study, using the Grounded theory method. Semi-structured interviews were performed to 10 medical teachers in Concepcion, Chile. They were selected by theoretical sampling. Data were analyzed using open coding. Results: Four emerging categories about the factors that affect the learning environment were identified: Personal factors of students, academic factors of students, personal factors of teachers and academic factors of teachers. Conclusions: According to interviewed teachers, both personal factors in teachers and students that promote a positive learning environment are related with an attitude oriented towards others and communication skills. Academic factors are related with the responsible exercise of student and teacher roles and with the promotion of participation in the educational process.

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BACKGROUND: Teaching practice is one of the most complex topics of the training process in medicine and other health care careers. The Teaching Practices Questionnaire (TPQ) evaluates teaching skills. AIM: To assess the factor structure and internal consistency of the Spanish version of the TPP among health care teachers. MATERIAL AND METHODS: The TPQ was answered by 315 university teachers from 13 of the 15 administrative Chilean regions, who were selected through a non-probabilistic volunteer sampling. The internal consistency of TPP factors was calculated and the correlation between them was analyzed. RESULTS: Six factors were identified: Student-centered teaching, Teaching planning, Assessment process, Dialogue relationship, Teacher-centered teaching and Use of technological resources. They had Cronbach alphas ranging from 0.60 to 0.85. CONCLUSIONS: The factorial structure of TPQ differentiates the most important functions of teaching. It also shows a theoretical consistency and a practical relevance to perform a diagnosis and continuous evaluation of teaching practices. Additionally, it has an adequate internal consistency. Thus, TPQ is valid and reliable to evaluate pedagogical practices in health care careers.

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Background: Medical Education, according to the constructivist education paradigm, puts students as the protagonists of the teaching and learning process. It demands changes in the practice of teaching. However, it is unclear whether this new model is coherent with the teachers’ ways to cope with learning. Aim: To analyze the relationship between teaching practices and learning strategies among teachers of health careers in Chilean universities. Material and Methods: The Teaching Practices Questionnaire and Learning Strategies Inventory of Schmeck were applied to 200 teachers aged 24 to 72 years (64% females). Results: Teachers use different types of teaching practices. They commonly use deep and elaborative learning strategies. A multiple regression analysis showed that learning strategies had a 13% predictive value to identify student-centered teaching, but they failed to predict teacher-centered teaching. Conclusions: Teaching practices and learning strategies of teachers are related. Teachers frequently select constructivist model strategies, using different teaching practices in their work.

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BACKGROUND: Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. AIM: To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. MATERIAL AND METHODS: A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. RESULTS: From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. CONCLUSIONS: Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

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Introducción: Los factores de riesgo asociados a la depresión han sido estudiados ampliamente, pero no se dispone de estudios prospectivos sobre factores que predigan la incidencia de depresión en personas sanas. Tampoco se dispone de una ecuación predictiva que incorpore factores genéticos. Método: Estudio de cohorte, prospectivo con evaluaciones en línea base y a los doce meses, sobre una muestra aleatoria de consultantes en centros de atención primaria de la Provincia de Concepción, Chile (n = 1.596). Se midieron 8 factores psicosociales y se realizó genotificación de los polimorfismos para la monoaminooxidasa A, la uMAO, y para la región transportadora del gen del transportador de serotonina, el 5-HTTLPR, gen SLC6A4 del cromosoma 17, como factores genéticos y la variable de resultado fue la presencia/ausencia de depresión a los 12 meses de seguimiento. Se empleó regresión logística binaria. Resultados: Las dos variables genéticas no muestran relación estadísticamente significativa con la variable depresión a los 12 meses de seguimiento. Las variables sexo, nivel educacional, satisfacción con las condiciones de vida, antecedente personal de depresión, autopercepción de la salud física y de la salud mental y satisfacción con las relación de pareja se relacionan con la aparición de depresión en el seguimiento. Conclusiones: Los resultados permitirán identificar personas vulnerables entre los consultantes de atención primaria que podrían participar de programas preventivos. El estudio de otros genes será necesario para mejorar la capacidad predictiva del modelo.

Introduction: Riskfactors associated to depression have been extensively studied, though there is a lack ofprospective studies on factors thatpredict the incidence of depression in healthy people. There is not a predictive equation that incorporates genetic factors is not available. Method: A cohort study, prospective, with baseline assessments at 12 months was carried out on a random sample of attendees in primary care centers form the Concepción Province, Chile (n = 1,596). Eight psychosocial factors were measured and the genotyping of the uMAO and 5-HTTLPR in SLC6A4 as genetic factors polymorphisms was also carried out. The outcome variable was the presence/absence of depression at 12 months follow-up. A predictive model for depression was obtained by means of analyses of binary logistic regression. Results: Genetic variables have no statistically significant relation with the variable depression at 12 months follow up. Variables such as gender, educational level, satisfaction with living conditions, personal background ofdepression, selfperception ofboth physical and mental health and satisfaction with relationship are related to the onset ofdepression in the follow up. Conclusions: Outcomes will allow identifying vulnerable people among the primary care attendees, who could participate in prevention programs. The study offurther genes will be necessary in order to improve the predictive capacity of the model.

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Background: Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. Aim: To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. Material and Methods: A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. Results: From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. Conclusions: Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

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BACKGROUND: Medical Education, according to the constructivist education paradigm, puts students as the protagonists of the teaching and learning process. It demands changes in the practice of teaching. However, it is unclear whether this new model is coherent with the teachers’ ways to cope with learning. AIM: To analyze the relationship between teaching practices and learning strategies among teachers of health careers in Chilean universities. MATERIAL AND METHODS: The Teaching Practices Questionnaire and Learning Strategies Inventory of Schmeck were applied to 200 teachers aged 24 to 72 years (64% females). RESULTS: Teachers use different types of teaching practices. They commonly use deep and elaborative learning strategies. A multiple regression analysis showed that learning strategies had a 13% predictive value to identify student-centered teaching, but they failed to predict teacher-centered teaching. CONCLUSIONS: Teaching practices and learning strategies of teachers are related. Teachers frequently select constructivist model strategies, using different teaching practices in their work.

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BACKGROUND: Educational environment has an important effect on the quality of learning and student satisfaction in medicine. Most of previous studies have been conducted using questionnaires that assess the phenomenon considering overall dimensions, without paying attention to the specific manifestations of this topic, especially those aspects that are related to the protagonists of the learning process: teachers and students. AIM: To describe factors that affect the educational environment in the preclinical Medical formation, according to Medical teachers in Concepción, Chile. MATERIAL AND METHODS: Qualitative study, using the Grounded theory method. Semi-structured interviews were performed to 10 medical teachers in Concepcion, Chile. They were selected by theoretical sampling. Data were analyzed using open coding. RESULTS: Four emerging categories about the factors that affect the learning environment were identified: Personal factors of students, academic factors of students, personal factors of teachers and academic factors of teachers. CONCLUSIONS: According to interviewed teachers, both personal factors in teachers and students that promote a positive learning environment are related with an attitude oriented towards others and communication skills. Academic factors are related with the responsible exercise of student and teacher roles and with the promotion of participation in the educational process.

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In Chile the only requirement to study medicine is to obtain an academic achievement score over a certain cutoff value. However, the literature states that this type of selection is insufficient, since the medical profession requires cognitive and non-cognitive skills. These abilities are associated with better adaptation and academic success, as well as less dropping out. Therefore, those skills should be considered in the selection process to assure that the education goals are met. The aim of this study was to review the existing literature regarding the selection and evaluation criteria for students who are applying to medical schools. It was evident that Chilean medical schools need to establish appropriate criteria to ensure a more inclusive and fair admission. They need to design a system of admission with solid evidence of validity and reliability, complementary to the current form of student selection. This system should be considered common to all schools of medicine and, in turn, consider the sensibilities of the particular mission of each school, since academic, cognitive, inter- and intrapersonal aspects may vary among them.

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In Chile the only requirement to study medicine is to obtain an academic achievement score over a certain cutoff value. However, the literature states that this type of selection is insufficient, since the medical profession requires cognitive and non-cognitive skills. These abilities are associated with better adaptation and academic success, as well as less dropping out. Therefore, those skills should be considered in the selection process to assure that the education goals are met. The aim of this study was to review the existing literature regarding the selection and evaluation criteria for students who are applying to medical schools. It was evident that Chilean medical schools need to establish appropriate criteria to ensure a more inclusive and fair admission. They need to design a system of admission with solid evidence of validity and reliability, complementary to the current form of student selection. This system should be considered common to all schools of medicine and, in turn, consider the sensibilities of the particular mission of each school, since academic, cognitive, inter- and intrapersonal aspects may vary among them.

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BACKGROUND: Stress may affect the sense of wellbeing and academic achievement of university students. AIM: To assess the relationship of academic engagement and burnout with academic achievement among first year medical students. MATERIAL AND METHODS: The Utrecht Work Engagement Scale-Student and Maslach Burnout Inventory Student Survey (MBI-SS) were applied to 277 first year medical students of four universities. Their results were correlated with the grades obtained in the different courses. RESULTS: Moderately high engagement and low burnout levels were detected. There was a high level of satisfaction with studies and a moderate exhaustion level. Academic achievement was associated with the degree of engagement with studies but not with burnout. Conglomerate analysis detected a group of students with high levels of wellbeing, characterized by high levels of academic engagement and low burnout. Other group had moderate levels of engagement and lack of personal fulfilment. Other group, identified as extenuated, had high levels of personal exhaustion and depersonalization. Finally the disassociated group had a low academic engagement, low emotional exhaustion, high levels of depersonalization and lack of personal fulfillment. CONCLUSIONS: Academic achievement is associated with the level of engagement with studies but not with burnout.

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BACKGROUND: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. AIM: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. MATERIAL AND METHODS: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. RESULTS: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). CONCLUSIONS: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.

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Background: Stress may affect the sense of wellbeing and academic achievement of university students. Aim: To assess the relationship of academic engagement and burnout with academic achievement among first year medical students. Material and Methods: The Utrecht Work Engagement Scale-Student and Maslach Burnout Inventory Student Survey (MBI-SS) were applied to 277 first year medical students of four universities. Their results were correlated with the grades obtained in the different courses. Results: Moderately high engagement and low burnout levels were detected. There was a high level of satisfaction with studies and a moderate exhaustion level. Academic achievement was associated with the degree of engagement with studies but not with burnout. Conglomerate analysis detected a group of students with high levels of wellbeing, characterized by high levels of academic engagement and low burnout. Other group had moderate levels of engagement and lack of personal fulfilment. Other group, identified as extenuated, had high levels of personal exhaustion and depersonalization. Finally the disassociated group had a low academic engagement, low emotional exhaustion, high levels of depersonalization and lack of personal fulfillment. Conclusions: Academic achievement is associated with the level of engagement with studies but not with burnout.

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BACKGROUND: Self-directed learning is a skill that must be taught and evaluated in future physicians. AIM: To analyze the association between self-directed learning, self-esteem, self-efficacy, time management and academic commitment among medical students. MATERIAL AND METHODS: The self-directed learning, Rosemberg self-esteem, general self- efficacy, time management and Utrecht work engagement scales were applied to 297 first year medical students. RESULTS: A multiple regression analysis showed a significant association between self-efficacy, time management and academic commitment with self-directed learning. Self-esteem and satisfaction with studies did not enter in the model. CONCLUSIONS: self-esteem, academic commitment and a good time management were associated with self-directed learning in these students.

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Background: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. Aim: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. Material and Methods: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. Results: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). Conclusions: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.

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Background: Self-directed learning is a skill that must be taught and evaluated in future physicians. Aim: To analyze the association between self-directed learning, self-esteem, self-efficacy, time management and academic commitment among medical students. Material and methods: The self-directed learning, Rosemberg self-esteem, general self- efficacy, time management and Utrecht work engagement scales were applied to 297 first year medical students. Results: A multiple regression analysis showed a significant association between self-efficacy, time management and academic commitment with self-directed learning. Self-esteem and satisfaction with studies did not enter in the model. Conclusions: self-esteem, academic commitment and a good time management were associated with self-directed learning in these students.

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BACKGROUND: Academic Involvement Questionnaire, Expectations version (CIA-A), assesses the expectations of involvement in studies. It is a relevant predictor of student success. However, the evidence of its validity and reliability in Chile is low, and in the case of Medical students, there is no evidence at all. AIM: To evaluate the factorial structure and internal consistency of the CIA-A in Chilean Medical school freshmen. MATERIAL AND METHODS: The survey was applied to 340 Medicine freshmen, chosen by non-probability quota sampling. They answered a back-translated version of CIA-A from Portuguese to Spanish, plus a sociodemographic questionnaire. For psychometric analysis of the CIA-A, an exploratory factor analysis was carried on, the reliability of the factors was calculated, a descriptive analysis was conducted and their correlation was assessed. RESULTS: Five factors were identified: vocational, institutional and social involvement, use of resources and student participation. Their reliabilities ranged between Cronbach's alpha values of 0.71 to 0.87. Factors also showed statistically significant correlations between each other. CONCLUSIONS: Identified factor structure is theoretically consistent with the structure of original version. It just disagrees in one factor. In addition, the factors' internal consistency were adequate for using them in research. This supports the construct validity and reliability of the CIA-A to assess involvement expectations in medical school freshmen.

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BACKGROUND: Understanding how autonomous students are capable of regulating their own learning process is essential to develop self-directed teaching methods. AIM: To understand how self-directed medical students approach learning in medical schools at University of Concepción, Chile. MATERIAL AND METHODS: A qualitative and descriptive study, performed according to Grounded Theory guidelines, following Strauss & Corbin was performed. Twenty medical students were selected by the maximum variation sampling method. The data collection technique was carried out by a semi-structured thematic interview. Students were interviewed by researchers after an informed consent procedure. Data were analyzed by the open coding method using Atlas-ti 7.5.2 software. RESULTS: Self-directed learners were characterized by being good planners and managing their time correctly. Students performed a diligent selection of contents to study based on reliable literature sources, theoretical relevance and type of evaluation. They also emphasized the discussion of clinical cases, where theoretical contents can be applied. This modality allows them to gain a global view of theoretical contents, to verbalize knowledge and to obtain a learning feedback. CONCLUSIONS: The learning process of autonomous students is intentional and planned.

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