The accelerated scientific, technological, and social advances in recent years have posed new challenges for professional training institutions, where universities play a leading role. Medical schools have not been oblivious to this process. This is how Pontificia Universidad Católica de Chile implemented in 2015 a curricular reform derived from the joint work of academics, students and graduates. For this purpose, a model consisting of stages was followed, including the identification of the problem, general assessment of needs, definition of purpose and learning objectives. We worked with surveys, focus groups and committees of academics and students to identify and map content within the mesh, review terminal learning objectives while creating and reviewing courses for the vertically and horizontally integrated delivery of content and competencies. The first cohort of the new curriculum entered in 2015, consisting of 126 students. The implementation required constant follow-up and monitoring, establishing changes and adjustments according to educational needs and unforeseen conditions such as the COVID-19 pandemic. The implementation process of the new curriculum has been positive, adjusting to the defined strategic planning and responding to unexpected events.

Background: Simulation is a useful training tool for undergraduate medical students. A valid instrument is needed to assess students’ perception of simulation workshops. Aim: To adapt and validate an instrument to assess the undergraduate medical student’s perception of simulation workshops of clinical procedures. Material and Methods: Delphi Methodology was used to adapt the instrument. Exploratory and confirmatory analyses were performed to determine the construct validity and Cronbach’s Alpha (0 to 1) for internal consistency of the instrument. Results: A Delphi panel of 10 experts adapted a seven-item questionnaire (Likert scale 1-5; ranging from 7 to 35) and four open-questions. After 3-delphi-rounds, the instrument was administered to 210 students in six simulation training programs (Paracentesis, Cardiopulmonary Resuscitation, Airway management, Sutures, Thoracentesis and Nursing Procedures). The instrument was considered unidimensional in the factorial analysis. The overall median (Q1-Q3) score was 34 ranging from 32 to 35 and the Cronbach Alpha coefficient was 0.72, indicating a good reliability. Conclusions: The perception questionnaire is a useful and reliable instrument to assess students’ perceptions of clinical simulations.

Abstract Introduction Medical education is currently going through many changes, and Medical Schools must adapt in order to survive. These have to fulfil multiple roles and tasks, with research, teaching, and clinical care as a bottom line. Furthermore, and in many cases, these also include, management, community work, and continuing education courses. Previous studies show that not all of these roles are valued similarly. Objective The objective of this study was to examine the value of teaching perceived by academics from some Medical schools in Chile. Method Semi-structured interviews were conducted with twelve faculty members, all of whom have an active role in teaching. The sampling was intentional and guided by theory. Based on Grounded theory, the data was analysed using open, axial and selective coding. Finally the information was triangulated with literature ad-hoc. Results Three categories emerged from the analysis. First, the “multiple roles and tasks” performed by the faculties. The second is the “personal value of teaching”, and the third, the “institutional value of teaching”. The problem is that, even though teaching is valued, there are other activities, such as research and patient care, that are valued more,. Conclusions These results are multifactorial and they provide evidence that faculties perceive that teaching is relevant, but other activities, like research and clinical work, are valued more The results are similar to those found in the literature, and encourage us to pursue initiatives to rescue and promote the value of teaching, such as protected time for teaching, mentoring, promotion of innovation and excellence, etc.

Resumen Introducción Los académicos de las escuelas de medicina deben cumplir con múltiples roles, como investigación, docencia y asistencia clínica, además de labores de extensión y gestión. Estudios previos muestran que no todas estas labores son valoradas de similar manera. Objetivo Explorar la valoración de la docencia percibida por académicos de una escuela de medicina chilena, a nivel individual, de los pares y de la institución. Método Estudio cualitativo descriptivo que utilizó para el análisis de datos los procedimientos propuestos por la teoría fundamentada, sobre una muestra de 12 académicos que cumplieron criterio de inclusión. Los datos se obtuvieron a través de entrevistas semiestructuradas. Resultados Emergen 3 categorías de análisis: 1) multiplicidad de roles; 2) valoración personal de la docencia, y 3) valoración institucional de la docencia. Destaca que, si bien la docencia es importante, existen otras actividades más valoradas a nivel personal e institucional, como la investigación y la atención de pacientes. Conclusión Los resultados muestran una multiplicidad de factores que afectan a la valoración de la docencia en medicina. Los académicos percibieron la existencia de tareas de mayor connotación académica que la docencia, asociadas a mayores ingresos económicos o al ascenso en la carrera académica, lo que invita a buscar iniciativas institucionales para generar espacios reales de desarrollo académico con el reconocimiento que merece en instituciones que primariamente tienen como misión la formación de las personas.

The career of Medicine at the Pontificia Universidad Católica de Chile was established from the beginning (1929), with a classical Flexner curriculum design. In seven years, the career is divided in three cycles: basic sciences, clinics and internship. It obtained Chilean accreditation and fulfilled American Association of Medical Colleges accreditation requirements. Changes in the Chilean epidemiological profile and health system, and new teaching methods in medicine, stimulated a process of deep curricular analysis, identifying strengths and weaknesses of the medical career. The curricular strengths were well-developed scientific and clinical components, fully committed students and faculties, well defined learning objectives and excellent clinical campuses. Curricular weaknesses included a poor vertical and horizontal integration, few student centered methodologies and a weak emphasis concerning doctor’s professionalism. Subsequently, the whole community of teachers, students and medical educators worked on the design of a new curriculum, establishing a new graduate profile and designed it oriented by learning objectives, of six years of duration, with an optimized course sequence that melds basic science and clinical concepts, with strong emphasis on humanities and professionalism. It prioritizes an early contact with patients from the first year and expands teaching methods. The main objective of this process was to achieve a new curriculum with an integrative structure. This was implemented in 2015 with an approved protocol to evaluate the outcomes.

Background: Assessment for learning is a paradigm that is taking shape in the field of medical education. This approach aims to embed the assessment process within the educational and learning process. Aim: To evaluate the impact of curricular changes, from a focus of assessment of learning to one of assessment for learning, in the perception of undergraduate students of medicine and their final grades obtained in a theoretical course (TCG). Material and Methods: In the year 2011 lectures were reduced and intermediate assessments followed by a feedback session were introduced. The activities of each program course, surveys about student perceptions of the course and the final grades of students (assessments with multiple choice questions) were compared between the periods prior and after curricular changes (2005-2010 and 2011-2013). Results: As a consequence of curricular changes, time for lectures was reduced by 19.5%, time for summative assessments was increased by 8.5%, and feedback activity, occupying 7.3% of the course time was added. There were significant improvements in student is perceptions in all areas assessed by surveys, emphasizing feedback and assessments. The overall grade assigned to the course dictated after implementing the changes increased from 6.18 to 6.59 (p < 0.001, 1-7 scale). The grades of students also improved from an average of 5.78 to 6.43 (p < 0.001, 1-7 scale). Conclusions: Assessment for learning achieved the desired educational impact without increasing the assigned curricular time. Programmatic assessment is favorably perceived by students.

Objectives. To describe the experience and results of the implementation of a faculty development program for professors of Medicine in the Medical Education Certificate program developed at the School of Medicine, Pontificia Uniersidad Catolica de Chile. Materials and methods. This was a descriptive, cross-sectional, quantitative and qualitative study. The population consisted of all graduates of the program until 2011. A questionnaire with open and closed-ended questions was applied, exploring different levels of impact using the Kirkpatrick evaluation model. Results. Over 97% expressed a high degree of satisfaction (Kirkpatrick level 1). Most respondents reported changes in learning, knowledge and teaching skills (Kirkpatrick Level 2) with statistically significant differences in retrospective pre-post questionnaires 93% reported having improved their teaching performance generally, and 85% in a specific performance (Kirkpatrick Level 3). At level 4 of the Kirkpatrick evaluation model, most perceived an increased interest in teaching and 69% reported being valued more highly at the institutional level. Five categories emerged from the qualitative analysis: value given to teaching and of training in teaching, importance of teaching skills, the contribution of teaching to the professional role, contribution to personal development and strengthening of the academic community. Conclusions. The effects of this faculty development program in medical education have been positive. Professors of Medicine, in addition to improving their teaching performance, perceived changes in personal development, in their role as physicians, in the academic community and in the institution.

Objetivos. Describir la experiencia y resultados de la implementación de un programa de formación en docencia para profesores de Medicina del Diplomado en Educación Médica, desarrollado en la Escuela de Medicina de la Pontificia Universidad Católica de Chile. Materiales y métodos. Estudio descriptivo, transversal, de carácter cuantitativo y cualitativo. La población estuvo compuesta por todos los graduados del programa hasta el 2011. Se aplicó un cuestionario con preguntas abiertas y cerradas explorando diferentes niveles de impacto, utilizando el modelo de evaluación de Kirkpatrick. Resultados. Sobre el 97% expresó un alto grado de satisfacción (nivel 1 Kirkpatrick). La mayoría reportó cambios en el aprendizaje de conocimientos y competencias docentes (nivel 2 Kirkpatrick) con diferencias pre y posretrospectivas estadísticamente significativas. El 93% refirió haber mejorado globalmente su desempeño docente y sobre el 85% en desempeños específicos (nivel 3 Kirkpatrick). En el nivel 4 de Kirkpatrick, la mayoría percibió un incremento del interés por la docencia y 69% reconoció una mayor valoración a nivel institucional. Del análisis cualitativo emergieron cinco categorías: valoración de la docencia y de la formación en docencia, relevancia de las habilidades docentes, aporte de la docencia al rol profesional, contribución al desarrollo personal y fortalecimiento de la comunidad académica. Conclusiones. Los efectos de este programa de formación en educación médica han sido positivos. Los profesores de Medicina, además de perfeccionar sus desempeños docentes, perciben cambios en el desarrollo personal, en su rol de médico, en la comunidad académica y en la institución.

Background: In medical education there has been increasing emphasis on faculty development programs aimed at the professionalization of teaching and increasing students' learning. However, these programs have been shown to have an impact beyond improvement in teaching skills. The medical school of the Pontificia Universidad Católica de Chile (EMUC) has been running a faculty development program (DEM) since 2000. Aim: To explore the perception of graduates on the effects of having participated in DEM on their development as teachers and clinicians. Material and Methods: Using an exploratory, descriptive and qualitative design, the 79 teachers who graduated from DEM from 2004-2008 were sent a questionnaire containing three open questions. Their answers were analyzed using the Constant Comparative Method of Qualitative Analysis of Glaser and Strauss by four researchers. Results: Faculty development, becoming a better clinician, personal development, appreciation of the value of teaching and strengthening of the academic community were the five categories that emerged from the answers. Graduates felt that, besides learning new educational skills, they changed their attitude towards teaching. DEM was perceived as facilitating self-awareness and refection about the graduates' role as doctors and teachers. The graduates also valued meeting other faculty. Conclusions: Faculty development programs can have an impact far beyond the learning objectives. The planning and design of programs contributes to their wider impact. This should be taken into consideration in the design, planning, and evaluation of faculty development programs. Care should be taken to protect time for participation, refection and for interaction with other academics.

Background: Since 2000, the medical school of the Catholic University of Chile (EMUC) has offered courses for its faculty as part of a Diploma in Medical Education (DEM). However by 2009, 41% of faculty had never taken any courses. Aim: To explore the reasons why faculty choose not to participate in these courses. Material and Methods: Semi-structured interviews to seven faculty members, all of whom have an active role in teaching but who had not taken any DEM courses. The sampling was intentional and guided by theory. Based on Grounded theory, the data was analyzed using open, axial and selective coding. Results: Three categories emerged from the analysis. First, the characteristics of a "good teacher" and what it means to be a good teacher. Second, the current status of teaching. Third, the barriers to participate in courses of DEM. Non-attendance is multifactorial; teaching is seen as a natural skill that is difficult to be trained, teaching has a lower priority than other activities, and there are many barriers perceived for attendance. Conclusions: With these results we developed a model to explain the reasons why faculty choose not to participate in these courses. The lower value of teaching and the multiple roles that teachers have, are highlighted.

Background: Few medical teaching institutions provide faculty development in curriculum development to program directors of medical specialties (PD), despite the increased demand for renewal of residency programs and the evaluation of outcomes. Aim: To describe and evaluate a training program in curriculum development for PD developed in 2008 and 2009. Material and Methods: Thirty PD attended an on campus course of fifteen hours. Evaluation was done using Kirkpatrick model through an end-of-course questionnaire, a retrospective pre/post self-assessment test of skills, the assessment of learning and the final projects developed by PD. Results: All PD finished the course and answered the questionnaire. In level 1 (Reaction), 100% reported high satisfaction and would recommend it highly to others, with perceived mean achievement of course objectives of 81%. In level 2 (Learning), all the differences between the retrospective pre and posttest were statistically significant (p < 0.01), and achievement of learning was in average 82.9%. In level 3 (Behavior), 100% felt they would apply what was learnt and 17 PD (57%) sent projects. Conclusions: This model of faculty development was highly accepted by PD and had a positive evaluation based in high satisfaction, the improvement in pre/posttest assessment, the achievement of learning objectives and the development of projects.

Background: The medical school of the Pontificia Universidad Católica de Chile offers a Diploma on Medical Education (DME) for its faculty since 2000. However its impact had never been evaluated. Aim: To determine the perception of the graduates of the impact of DME, using the Kirkpatrick model for evaluation of educational outcomes. Material and Methods: A questionnaire containing closed and pre-post retrospective questions that represented Kirkpatrick's four levels of evaluation, was sent to all the graduates in 2009. Results: Eighty two of 91 graduates returned the questionnaire. Ninety one percent had a high level of satisfaction at Kirkpatrick Level 1 (Reaction), and perceived an average of 81.8% completed objectives. Most respondents reported modification of attitudes and perceptions about teaching, at Kirkpatrick Level 2 (Learning). All the differences between the pre and posttest retrospective questionnaire were statistically significant. More than 98% of responded stated that they improved their role as teacher using the skills learned during DME, according to Kirkpatrick Level 3 (Behavior). According to Kirkpatrick Level 4 (Outcomes), 66% stated that the DME contributed to appreciate the value of teaching at an institutional level. Conclusions: According to the perception of the respondents, the DME has had a positive impact at all the levels described in the Kirkpatrick model.

Background: Portfolio is an innovative instrument that promotes reflection, creativity and professionalism among students. Aitn: To describe the development and validation process of a questionnaire to evalúate the use of portfolio in undergraduate medical students. Material andMethods: Focus groups with students and teachers were employed to identify aspects related with portfolio in undergraduate teaching. The Delphi technique was used to prioritize relevant aspects and construct the questionnaire. The validated questionnaire, consistingin 43 Ítems and 6factors, was appliedto 97students (response rote of99.9%) in2007and 100students (99.2%) in 2008. Each question had to be answered using a Likert scale,from 0 (completely disagree) to 4 (completely agree) The validity and reliability of the questionnaire was evaluated. Results: The questionnaire showed a high reliability (Cronbach alpha = 0.9). The mean total scores obtained in 2007 and 2008 were 106.2 ± 21.2 (61.7% ofthe maximal obtainable score) and 104.6 ± 34.0 (60.8% ofthe maximal obtainable score), respectively No significant differences were seen in the analysis by factors. Changes in portfolio during 2008 showed differences in Ítems related with organization, evaluation and regulation. Conclusions: The questionnaire is a valid and highly reliable instrument, measuringperceptions about the portfolio by undergraduate medical students. The students perceived an improvement in their creativity and professionalism as one ofthe strengths of portfolio. The weaknesses identified during the implementation process helped us to focus changes in organization and evaluation to improve the portfolio as a dynamic process.

Effective clinical teaching is an imperative of medical education. Clinical teachers and faculty development initiatives as well as Medical Schools, need to focus their efforts to pursue common outcomes: effective learning in students, future competent physicians and healthy patients. Excellence in quality of teaching needs scholars in education. To achieve this objective, institutions must recruit a core of medical faculty according to its mission, define the attributes and teaching competences, implement faculty development programs, and finally, support academic vitality. This article describes the three main issues of medical teaching: faculty, faculty development and its organization.