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Introduction: Medical education has been changing, and the evaluation strategies that make it possible to address not only theoretical knowledge but also clinical skills. In Mental Health, these skills play a central role. The Objective Structured Clinical Examination (OSCE) is one of the evaluations that could assess clinical skills. This article describes the implementation and performance for the evaluation of undergraduate students since the OSCE's introduction in 2015., Methods: An explanation of the implementation is made, and a description of the OSCEs carried out to undergraduate medical students in the second semester of mental health, using the databases of the final practical examinations during those years. The perception of mental health teachers is also described., Results: The mental health OSCE implemented in 2015-2, is developed in the Simulated Hospital of the University and has five stations (interview, mental examination, diagnosis, treatment and information to the family and ethics). Between 2016-2 and 2019-2, 486 students performed OSCE with an average score of 3.85 (scale 0-5). It was observed that the grade obtained when evaluating anxiety disorders was below average, that of affective disorders above average, while that of psychotic disorders was within the average. The professors highlight the versatility, the comprehensive objective evaluation of the practical and theoretical aspects, and the possibility of comparison between the different groups., Conclusions: The OSCE is an examination that provides the possibility to evaluate the competences in psychiatry of medical students and allows the identification of the aspects to be improved in the teaching learning process., (Copyright © 2022 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: One of the challenges for teachers in the health area is competency assessment. The OSCE is designed to assess the performance of students in specific clinical situations. The objective of this study was to assess the level of achievement of the competencies proposed in the graduates' profile by applying the OSCE with socioformative rubrics and assessing their relationship with the written final exam and the general average of the degree. Method: A cross-sectional study was carried out with graduates of the career of medicine; in which an OSCE was applied as part of its degree exam. The rubrics were the instrument that was applied to assess competencies. Results: The significant differences between the students who applied the OSCE in the month of January compared to May, were also observed in the results of the written exam, which indicates that the students of the 4th. OSCE developed in better way their skills during their training process. The correlational analysis highlights a significant positive correlation between the average of the OSCE and the average of the written exam of the students, which makes it clear that an adequate performance in the written exam that assesses the theoretical knowledge is related to an adequate performance in the clinical skills demonstrated in the OSCE. Conclusion: The OSCE, is an objective and reliable test, suitable as part of the professional exam of the career of medicine; with the use of the rubric, it is possible to determine the level of achievement with which the student graduates. Resumen: Introducción: uno de los retos para los docentes en el área de la salud es la evaluación de las competencias. La ECOE se diseñó para evaluar el desempeño de los estudiantes en situaciones clínicas específicas. El objetivo de este estudio es evaluar el nivel de logro de las competencias propuestas en el perfil de egreso a través de la aplicación del ECOE con rubricas socioformativas y evaluar su relación con el examen final escrito y el promedio general de la carrera. Método: Se realizó un estudio transversal con egresados de la carrera de medicina. Se aplicó una ECOE como parte de su examen de grado. Las rúbricas socioformativas fueron el instrumento que se aplicó para evaluar las competencias. Resultados: Las diferencias significativas entre los estudiantes que realizaron la ECOE en el mes de enero respecto a mayo, también se observaron en los resultados del examen escrito, lo que indica que los estudiantes del 4to. ECOE desarrollaron mejor sus competencias durante su proceso formativo. El análisis correlacional destaca una correlación positiva significativa entre la media de la ECOE y la media del examen escrito de los estudiantes, lo que deja claro que un desempeño adecuado en el examen escrito que evalúa los conocimientos teóricos se relaciona con un desempeño adecuado en las habilidades clínicas demostradas en la ECOE. Conclusión: La ECOE, es una prueba objetiva y confiable, idónea como parte del examen profesional de la carrera de medicina. Con el uso de la rúbrica socioformativa se puede determinar el nivel de logro con el que egresa el estudiante.

Introduction: Clinical reasoning involves critical thinking and decision-making in clinical situations. It can be evaluated using Objective structured clinical examination (OSCE), which measures clinical skills associated with the development of clinical reasoning. Objective: To describe the implementation of an OSCE to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and to determine their level of satisfaction with this methodology. Materials and methods: Cross-sectional descriptive study conducted in 159 physical therapy students from Universidad Andres Bello, Chile, enrolled in the Reasoning in Physical therapy course (second semester of 2018). The OSCE had 11 stations and a student satisfaction survey was administered. Data normality was determined using the Shapiro-Wilk test. Descriptive statistics (percentages, medians, and interquartile ranges (IQR)) were used for data analysis. Results: The median global score was 142 points (IQR: 132-150) and 61.1% of the students obtained a passing score (≥ 134 points). Stations in which most students had a passing score were S3, S5 and S7 (standardized patient stations): 78.62%, 96.85% and 85.53%, respectively. Regarding the satisfaction survey, 36.48% and 59.12% of the students agreed and strongly agreed with using tools that assess their clinical skills. Conclusions: The OSCE was successfully designed and implemented to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and most of them reported a high level of satisfaction with its use; this confirms OSCE is an excellent methodology to train and evaluate these students.

Introduction: The use of physical agents in physical therapy (PT) requires clinical reasoning, as well as knowledge of their risks and contraindications; however, deficiencies may be observed when used in clinical practice. Objective: To implement the Objective Structured Clinical Evaluation (OSCE) method for the assessment of clinical skills among physical therapy specialty students when using physical agents. Materials and methods: A pilot, non-experimental, cross-sectional study was conducted in 114 physical therapy students enrolled during the first semester of 2019 in a physical agents course offered at the Universidad Andres Bello, Santiago, Chile. The OSCE consisted of 7 peer-validated stations, in which various skills were implemented in simulated clinical scenarios to achieve learning outcomes associated with the use of physical agents, namely: S1: connective tissue flexibility; S2: muscle relaxation; S3: analgesia; S4: drainage; S5: muscle strengthening; S6: parameter interpretation; and S7: equipment installation. Observers at each station assessed students’ clinical skills and decision-making using a checklist. OSCE scores were described using medians and interquartile ranges, representing the data dispersion between the 25th and 75th percentile (P25-P75). Station scores by sex were compared using the Mann-Whitney U test. Results: Median scores were higher than the minimum passing score in stations S1 (66, IQR: 52-70), S2 (55, IQR: 45-60), S3 (60, IQR: 50-69), S4 (65, IQR: 55-73), and S7 (40, IQR: 33-45), but they were below the passing score in stations S5 (54, IQR:46-65) and S6 (10, IQR: 9-13). In addition, 101 (88.59%) students had a global passing score in the OSCE. Conclusion: The OSCE scores obtained by the participants show their attainment of clinical skills when using physical agents since most of them obtained a global passing score; however, reinforcing the clinical skills for parameter interpretation is necessary, considering that the lowest mean score was obtained in said station.

Introducción: para revalidar su título en Chile, los médicos graduados en el exterior (MGEs) deben someterse a un examen compuesto de un módulo teórico y otro práctico. Para realizar este último, la Universidad Mayor utiliza la modalidad OSCE. Este formato garantiza apropiados grados de validez, fiabilidad y objetividad si su diseño y aplicación son meticulosos y detallados. Sus resultados deben ser sometidos sistemáticamente a un control de calidad. Este último, un componente crucial de toda evaluación de alta trascendencia, se menciona escasamente en la literatura biomédica nacional. Nuestro objetivo es describir aquí el diseño, administración y análisis psicométrico de un OSCE destinado a evaluar las competencias quirúrgicas generales de (MGEs). Métodos: el OSCE fue diseñado por un equipo multidisciplinario. Se crearon diez estaciones que estaban en correspondencia con las competencias quirúrgicas generales esperadas en un graduado. El análisis psicométrico de los resultados incluyó el uso del coeficiente alfa de Cronbach y la correlación de Pearson. Resultados: los veinte MGEs aprobaron el examen con puntajes entre 64,8 y 96,0%. El coeficiente de Cronbach global fue 0,67. La correlación entre los puntajes de cada estación con el del OSCE global alcanzó significación estadística en todos los casos. Conclusiones: un OSCE que evalúa la competencia quirúrgica general de un médico graduado es factible. Las propiedades psicométricas del examen fueron satisfactorias; sin embargo es aconsejable perfeccionar aún más el proceso de elaboración del examen así como los casos empleados y otros elementos claves.

RESUMO Objetivo: desenvolver e validar um instrumento de exame clínico objetivo estruturado para o cenário de simulação sobre ressuscitação cardiopulmonar no adulto em suporte básico de vida com o uso do desfibrilador externo automático no ambiente hospitalar. Método: pesquisa aplicada, de produção tecnológica, desenvolvida na Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, no período de janeiro de 2017 a março de 2018 com 16 profissionais experts da área de urgência e emergência para validação do exame clínico objetivo estruturado. O instrumento abordou 40 itens de intervenção relacionados ao elo da cadeia da sobrevivência da American Heart Association (2015) para realizar a avaliação clínica no cenário de simulação em ressuscitação cardiopulmonar. Resultados: dos experts, 62,5% obtiveram pontuação superior ou igual a 10 nos critérios de Fehring e destaca-se que 93,75% possuem prática clínica em urgência e emergência no adulto. O exame clínico objetivo estruturado alcançou concordância de 97,34% em organização; 96,09% em objetividade; 93,75% em clareza, e na categorização da concordância interavaliador proposta por Landis e Kock evidenciou "concordância quase perfeita”, com p

Objectives: The adaptation of the educational programmes of European faculties of medicine to the European Higher Education Area guidelines has focused curricula design on competence acquisition. Competencies are defined as the achievements of a predetermined level of efficacy in real-world scenarios. Our objective was to assess whether performance on a common competence evaluation test, the Objective Structured Clinical Examination (OSCE), resulted in different scores for second-year students after a practical medical training course took place in a primary health centre (PHC) or in a hospital. Design: A descriptive study was conducted during the 2010–2014 academic year of the OSCE test scores obtained by all second-year students. Location: Faculty of Medicine at the University of Lleida (Catalonia, Spain). Main measurements: We performed a correlation analysis between students who completed their practical medical training at the PHC and hospitals utilising Student's t-test for comparison of means. Results: 423 students who completed internships at the PHC and at hospitals obtained OSCE mean scores of 7.32 (SD; IC) (0.82; 7.18–7.47) points and 7.17 (0.83; 6.07–7.26) points, respectively (p = 0.07). Conclusions: Second-year medical students acquired similar competency levels in the two analysed training scenarios. The two areas both serve their teaching purpose.

Background: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education., Aim: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities., Material and Methods: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile = 104, Catholic University = 20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents., Results: The average total OSCE score was 67.3% (range: 84.5%-43.5%). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems., Conclusions: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs.

Background: Objective structured clinical examination has advantages over traditional oral examination of medical student. However, it is not routinely used in Chile., Aim: To describe the objective structured clinical examination system and report the results of its first use with Chilean medical students., Material and Methods: Thirteen interns ware evaluated at the end of their surgical rotation, using the objective structured clinical examination. Thirteen stations were structured for this examination: one for history taking, two for physical examination, four for problem solving and knowledge, one for radiological interpretation, one for instrumental recognition, one for skills and one for text comprehension. There were a total of 88 questions., Results: All students exceeded 60% of requirements. Mean approval score was 73%. The higher score was 80% and the lower 61%. Ten students had a score over 70%. The method was well accepted by teachers and students., Conclusions: This first local experience with the objective structured clinical examination was successful.

Anesthesiology became the first Chilean medical specialty certification board to incorporate an objective structured clinical examination (OSCE) into its certification system. The main reason for the introduction of an OSCE is to include an evaluation that allow candidates to demonstrate what they really "do" in clinical practice domains. Inherent in this justification is that the OSCE detects competences that are not well evaluated in current written and oral exams. This article describes the process of implementing an OSCE in Anesthesiology certification and a description of its application after one year of operation.

Afirma Sigler, que desde una perspectiva multidimensional de la seguridad, el papel de la OSCE en la seguridad europea seguirá siendo importante tras la ampliación de la OTAN. El autor examina los instrumentos y mecanismos con que la OSCE aborda la prevención de crisis y conflictos, especialmente las actividades desarrolladas en Bosnia, Chechenia, el Báltico y el Cáucaso. La OSCE, que intenta reforzar la cooperación en temas de seguridad, es una organización única para abordar los retos actuales y futuros para la seguridad del continente, incluyendo situaciones en algunas zonas de la antiguaUnión Soviética. Su tamaño –54 miembros– su capacidad de innovar y su flexibilidad, y su toma de decisiones consensuada hacen que la OSCE sea efectiva en temas como la temprana prevención de conflictos, Derechos Humanos, asuntos sociales, desarrollo económico, preocupaciones medioambientales y acuerdos de control de armamentos.No obstante, Sigler señala que el papel de la OSCE en temas de seguridad viene limitado por las características de las actividades de mantenimiento de la paz, ya que éstas requieren el acuerdo político previo de las partes implicadas en un conflicto.

Background: The COVID-19 pandemic forced medical programs to rapidly switch to remote teaching from scratch, impacting hands-on skills training. This study compared the efficacy of a hybrid online format to a regular in-person session for a mandatory surgical skills class. Methods: Third-year undergraduate medical students attending the surgical skills class in the winter semester of 2020/21 at the Medical University of Graz were randomly assigned to either the hybrid or in-person class, depending on their course schedule and government regulations. The hybrid class involved online videos, one-on-one peer tutoring, and an Objective Structured Clinical Examination (OSCE). Pre- and post-class self-assessments were conducted to evaluate their theoretical and practical knowledge of a single interrupted suture. Results: The study included 85 students in the regular in-person class and 50 in the hybrid class. A pre-class assessment revealed higher self-assessments in the hybrid class for theoretical and practical knowledge, but a post-class assessment showed no significant difference. The advantages and disadvantages of both modalities were identified, providing valuable insights for future curriculum development. Conclusions: Both teaching modes were effective for undergraduate surgical skills training. This study recommends implementing positive aspects of both the hybrid and in-person formats while recognizing their respective limitations.

Introduction: The Objective Structured Clinical Examination (OSCE) is a widely used measurement tool to assess clinical competence in the health sciences. There is little published evidence of its use in Mexican medical schools., Objective: To assess clinical competence in medical students with an OSCE, before and after the Medical Internship., Methods: Prospective cohort study, pre- post-test research design. The assessed population was medical students at UNAM Faculty of Medicine in Mexico in their Internship year. The instrument was an 18-stations OSCE, three stations per academic area of the Internship curriculum., Results: We assessed the clinical competence of 278 students in a pretest OSCE when starting the Internship year, and tested them 10 months later with an equivalent post-test OSCE. The sample of students was 30.4% of the total Internship population. Test reliability with Cronbach's alpha was 0.62 in the pre-test and 0.64 in the post-test. The global mean score in the pretest OSCE was 55.6 ± 6.6 and in the post-test 63.2 ± 5.7 (p < 0.001), with a Cohen's d of 1.2., Conclusions: The clinical competence of medical students measured with an OSCE is higher after the medical internship year. This difference suggests that the internship can influence the development of clinical competence in medical students.

Background: To evaluate professional competences is the main goal of every training program; the Objective Structured Clinical Examination (OSCE) is a useful tool for this task., Objective: We describe OSCE administration across three different levels of pediatric training (postgraduate, internship and graduate medical education)., Methods: Regarding the most common pediatric scenarios, knowledge, clinical judgment and communicational skills were evaluated., Results: In the postgraduate setting OSCE was used for the last 8 years, testing 330 students, and passing 60%-82% of them. In the internship setting OSCE was used for the last 2 years, testing 12 students, and passing 84% of them. In the medical school setting OSCE was used just once, testing 15 students, and passing 93.4% of them., Conclusion: Despite logistic issues, OSCE could be administered across three different levels of pediatric training.

Background: Outcomes-based education is a trend in medical education and its assessment is one of the main challenges. The Objective Structured Clinical Examination (OSCE) is one of the tools used to assess clinical competencies. Although Chilean medical schools have used OSCEs for 18 years, there is a vast variability in the way these examinations are administered., Aim: To design and implement an integrated OSCE to assess clinical competencies at the end of the medical program in Chilean medical schools, aiming to reduce variability between these schools., Material and Methods: Seven medical schools, supported by experts from the National Board of Medical Examiners, designed a 12 station OSCE to measure clinical outcomes at the end of the seventh year of medical training. Unlike traditional OSCEs, this new examination incorporated the assessment of clinical reasoning and communication skills, evaluated from patients' perspective., Results: One hundred twenty-five volunteers took the same exam at five different venues. The internal consistency was 0.62. Following a compensatory approach, 85% of students passed the exam. Communication assessment showed poorer results than those reported in the literature., Conclusions: Among Chilean medical students, the assessment of clinical outcomes in a collaborative way, through a valid and reliable exam, is feasible. A consensus on how to teach and assess clinical reasoning across the medical curriculum is required. The assessment of students' communication skills requires further development.

The objective structured clinical examination (OSCE) has been recognized as an effective evaluation tool in the health area and has been implemented by an important sector of educational institutions, the Faculty of Medicine and School of Nursing. The present article describes the OSCE organized by the Institute of Health Studies in collaboration with the University Schools of Catalan Nursing. Between the years of 2002 and 2009, OSCE annual exams took place with the participation of 1.803 students. The global results remained stable with a median grade of slightly less than 60%, and the competence component that evaluated communicative capacity was the one in which students obtained the best results. The reliability obtained surpassed the minimum recommended by international standards. It's important underline the positive value to the students of all aspects of the test. From this experience it seems evident that it would be useful to take advantage of the OSCE tests in order to show the students their strong points and ways to improve. We should highlight, not only as a goal but also as an opportunity the assessment by competencies that the European space of higher Education provides at the end of studies for a Nursing degree.

Background: Our institution adopted the Objective Structured Clinical Evaluation (OSCE) format to assess clinical skills of International Medical Graduates (IMGs) aiming to practice in Chile. The OSCE has clear advantages over oral exams due to its objective and structured nature., Aim: To report our experience with OSCE., Material and Methods: A team consisting of clinical specialists and medical educators with expertise in clinical simulation organized this OSCE cycle. IMGs were required to pass four clinical examinations (Internal Medicine, Surgery, Pediatrics and Obstetrics & Gynecology) where their respective general medical competences were evaluated. The latter were carefully selected from those issued by the Chilean Medical Evaluation policy-making body (EUNACOM). Each OSCE consisted of ten stations. Initially conceived to last five minutes each, they were afterwards expanded to seven minutes, after it was realized that most candidates had never been exposed to an OSCE examination before. A post-hoc analysis according to qualitative and psychometric quality criteria followed each OSCE., Results: The proportion of candidates passing the first two examinations of the cycle, were 65 and 75% respectively and reached 100% in the last ones. Lack of IMG familiarity with the OSCE system initially hampered their full expression of competencies. Extending the stations' duration to seven minutes subsequently rectified this situation, as well as potential adverse impacts on the validity of results., Conclusions: This evaluative process, which entails important consequences for the community and the IMGs, requires a meticulous and coordinated planning and post-hoc quality control.

Europa ha vivido el periodo de paz más extenso de su historia desde la Segunda Guerra Mundial. Sin embargo, esta “tranquilidad” ha sido interrumpida por los ataques terroristas contemporáneos. Hoy se necesita una Unión Europea fuerte, capaz de delimitar y fortalecer su política exterior, seguridad y defensa común para considerarse un actor político. Se presentan dos líneas para un nuevo sistema de seguridad para la región: dos organizaciones que integran las democracias liberales con intereses comunes (OTAN y UE). Además, una organización con una vocación menos inclusiva generada a partir de la CSCE (actualmente OSCE), para servir de punto de encuentro y crear la confianza entre sus miembros. Con estos escenarios, se busca tratar los asuntos de seguridad, mantener la paz y evitar el uso de la fuerza.

Tras las elecciones europeas de mayo de 2019, la Unión Europea (UE) abrió un nuevo ciclo político institucional para el período 2019-2024. El año 2020 inicia un tiempo clave para acometer cuestiones pendientes, como la salida del Reino Unido o el nuevo marco financiero plurianual 2021-2027, y afrontar nuevos retos, como la neutralidad climática y el desarrollo de la Europa de la Defensa. Además, el 9 de mayo de 2020, la UE conmemorará el 70.º aniversario de la Declaración Schuman, una evento importante y propicio para hacer balance y mirar hacia el futuro. Las contribuciones de este n.º 62/2020 de Cuadernos Europeos de Deusto abordan algunos de los temas y retos que la UE afrontará en los próximos años. Publicación en línea: 02 abril 2020

Following the European elections of May 2019, the European Union (EU) opened a new institutional political cycle for the period 2019-2024. The year 2020 initiates a new time when the EU will have to tackle pending issues, such as United Kingdom’s exit or the 2021-2027 multiannual financial framework, while addressing new challenges, such as the achievement of climate neutrality or the development of the European Defence. In addition, the EU will commemorate the 70th anniversary of the Schuman Declaration on 9 May 2020, which will be an important and propitious event to take stock of the European political project and look to the future. This issue 62/2020 of Deusto Journal of European Studies includes contributions that deal with some of the issues and challenges the EU will face in the coming years. Published online: 02 April 2020

En el año 1989 el símbolo de la división de Europa desaparecía gracias a un conjunto variado de circunstancias que convirtieron esa situación en insostenible. Uno de los ámbitos que más se vieron afectados fue el de la seguridad. Hoy 30 años después Europa sigue dividida en dos bloques y el nivel de enfrentamiento entre Moscú y Bruselas ha alcanzado cotas inimaginables a pesar de o quizás porque la OTAN se ha ampliado hasta la misma frontera con Rusia. Este trabajo pretende hacer una revisión de la literatura sobre seguridad europea al tiempo que dar una perspectiva coherente de lo que ha ocurrido en estos 30 años en los que Europa vive sin el Muro de Berlín. Para ello se dividirá el periodo elegido en cuatro períodos (1989-2001, 2001-2004, 2005-2013 y 2013 en adelante) en los que se estudiarán los siguientes aspectos: la importancia de los antiguos aliados soviéticos, la percepción de la arquitectura de seguridad y los conflictos en Europa. Recibido: 05 noviembre 2019 Aceptado: 13 enero 2020 Publicación en línea: 02 abril 2020

Fundamento y Objetivo: El Desarrollo Profesional Continuo (DPC) es un proceso de adquisición, mantenimiento y mejora de conocimientos, habilidades, actitudes y competencia profesional. En España, mantener la competencia es responsabilidad del profesional, para ello debe detectar objetivamente sus déficts formativos. Este estudio, pretende detectar diferencias en niveles de competencia clínica y déficits formativos, entre médicos de familia de distintas CC.AA. españolas, en el año 2005. Sujetos y método: Estudio descriptivo transversal. Se evaluaron 1158 médicos de 14 CCAA. Se utilizó como herramienta la Evaluación de Competencia Objetiva Estructurada (ECOE) de 15 estaciones. Se compararon las puntuaciones globales obtenidas, por competencias y área de conocimiento mediante ANOVA, y se estudió la fiabilidad de la prueba, mediante el alfa de Cronbach. Resultados: La puntuación global media fue 59,08 (DE 6,12), (IC 95%: 58,52-59,31). Se detectaron diferencias significativas entre Cataluña (63,65±5,2) y Castilla-León (55,37±5,78), Valencia (57,20±7,18), Andalucía (57,67±6,04), y Murcia (57,19±5,50). Por componente competencial, el mejor resultado correspondió al área de comunicación (80,11% del ideal) y el peor a atención familiar (45,54%). Por áreas de conocimiento, el mayor se obtuvo en dolor abdominal (75,94±14,70) y el menor en diabetes (43,36±15.97). El coeficiente de fiabilidad global de la prueba, alfa de Cronbach, fue 0,79. Conclusiones: Este estudio muestra el mapa competencial de los médicos de familia españoles y las diferencias existentes entre CCAA. La competencia es globalmente buena. Este tipo de estudio aporta una visión integral al médico de familia sobre su DPC, que le servirá de guía en su formación, para conseguir la excelencia profesional y mantenerla.Objective: The Continuous Professional Development (CPD) is a process of acquisition, maintenance and improvement of knowledge, abilities, attitudes and professional competence. In Spain, the manteinance of the clinical competence is responsibility of the professional. The professional for it must detect his déficts of formation objectively. This study detects differences in levels of clinical competence and deficits of formation in general practitioners of different Spanish Communities, in 2005. Method: Cross sectional study. 1158 doctors of 14 Communities were evaluated. The Objective Structured Clinical Examination (OSCE) was used as a tool with 15 different clinical situations. The global scores were compared. By competitions and area of knowledge by means of ANOVA. The reliability of the test was assessed of alpha Cronbach. Results: The global score average was 59.08 (SD 6,12)(IC 95 58,52-59,31). Significant differences were detected between Cataluña (63,65 SD 5,2) and Castilla Leon (55,37 SD 5,78), Valencia (57,20 SD 7,18), Andalucia (57,67 SD 6,04) and Murcia(57,19 SD 5,50). By competential component, the best result corresponded to the area of communication (80.11% of ideal) and the worse one to family attention (45,54%). By areas of knowledge was detected, the greater in abdominal pain (75,94 SD 14,70) and the minor in diabetes (43,36 SD 15.97). The global coefficient of reliability of the test was 0,79. Conclusions: This study shows to the competential map of the Spanish general practitioner and the existing differences between Communities. The clinical competence is globally good. This type of study contributes to an integral vision of the general practitioner on its CPD, it will serve to him as a guide in their formation, to obtain the professional excellence and to maintain it.

Los violentos conflictos que estallaron en las regiones que conformaban Yugoslavia obligaron a las principales instituciones europeas a incluir en sus programas políticas que tiendan a mejorar la situación de las minorías. Las instituciones supranacionales europeas, el Consejo de Europa, la OSCE, así como la Unión Europea emprenden actualmente constantes esfuerzos por erigir mecanismos que contribuyan a mejorar la situación de las minorías. Estos mecanismos consisten, por un lado, en la elaboración de documentos y convenciones que ofrecen directrices para una política de los Estados miembros hacia las minorías y, por otro, en el apoyo directo a proyectos concretos que tienen como fin lograr una mayor integración y entendimiento entre los grupos mayoritarios y minoritarios. Este artículo se propone exponer y analizar ambas medidas.

El artículo discute sobre el potencial de la actual Presidencia española del Consejo de la UE y la Presidencia kazaja de la OSCE para coordinar esfuerzos en convertir a Asia Central en un área de interés más prominente para la política europea. Aporta un análisis de los intereses y de las principales áreas de interacción de las dos organizaciones en Asia Central y propone una reflexión sobre el impacto que tan improbable asociación podría tener en cambiar las perspectivas mutuas y en desarrollar una visión a largo plazo para la UE y la OSCE en Asia Central.

El presente artículo pretende dar a conocer las motivaciones, finalidades y contenido sustancial de las recomendaciones de Bolzano/Bozen, adoptadas por el Alto Comisionado de la OSCE para las Minorías Nacionales en octubre de 2008. Las recomendaciones siguen la estela de documentos similares elaborados con la asistencia de expertos europeos e impulsados por el alto comisionado como expresión de su labor de intermediación normativa en materia de protección de minorías nacionales.

El examen MIR es un punto estratégico capaz de promover cambios en cascada en su entorno, con repercusiones tanto en la etapa de licenciatura como en la de especialización. Actualmente, la implantación de un nuevo currículo basado en competencias y las nuevas metodologías de entrenamiento y evaluación, aconsejan adecuar el examen MIR a las necesidades actuales. El rediseño del examen MIR requiere incrementar el número de preguntas y apoyarlas con iconografía, y relacionarlas con competencias predeterminadas, a la vez que se incorpora la evaluación objetiva de habilidades. Este cambio requiere más tiempo para realizar los exámenes, una gestión más ágil, equipos multidisciplinares de diseño y centros acreditados. El soporte informático debe dar cobertura al 100% de las actividades del examen MIR. La equidad, la transparencia y la accesibilidad deben ser los valores del examen MIR.The MIR examination constitutes a strategic point which is capable of promoting cascading changes in its environment with repercussions at both the undergraduate and specialisation stages. At present, the implementation of a new skills-based syllabus and new training and evaluation methodologies make it necessary to adapt the MIR examination to current needs. The redesign of the MIR examination requires an increase in the number of questions; these must be supported with iconography and related to predetermined competences along with the incorporation of objective skills evaluation. This change requires more examination time, more efficient management, multi-disciplinary design teams and accredited centres. Information technology support must provide 100% cover to the MIR examination activities. Equity, transparency and accessibility must be the values of the MIR examination.

El artículo pretende analizar la dimensión mediterránea de la CSCE desde su creación hasta la actualidad (1972-1994). En primer lugar, se examinan las características particulares de este proceso diplomático en el cual se inserta la cuestión mediterránea; a continuación los debates que dan lugar a su creación y las políticas que genera; y se concluye con el estudio de su evolución y desarrollo en el marco de las reuniones CSCE.

Resumen: Introducción: el examen clínico objetivo estructurado (ECOE) se ha posicionado como una herramienta clave para evaluar habilidades de manera óptima y fiable. Este estudio buscó analizar las tendencias y el perfil de la producción científica sobre su uso en ciencias de la salud. Materiales y métodos: se realizó un estudio descriptivo y transversal a datos bibliométricos. Se incluyeron 844 artículos sobre el ECOE publicados en revistas indexadas en Scopus entre 2018 y 2022. Se realizó un análisis descriptivo y transversal a datos bibliométricos con la herramienta Scival. Resultados: el número de publicaciones se ha incrementado desde 2018 hasta 2022, la mayor parte de estas están en revistas científicas de alto impacto. La mayor parte de artículos tuvo colaboración nacional (42,4%) y la colaboración internacional presentó más citas por cada publicación (6,5). La institución con mayor actividad científica fue la Harvard University, además de ser la de mayor impacto. Las revistas Currents in Pharmacy Teaching and Learning y Medical Science Educator tienen más publicaciones, pero la Journal of Educational Evaluation for Health Professions (1.744) tiene un mayor impacto normalizado. Zabar Sondra es quien lidera la producción científica, pero MacArio Alex (0,91) tiene un mayor impacto ponderado. Conclusiones: la investigación se ha incrementado, principalmente en revistas científicas de mayor prestigio e impacto, y con colaboración nacional más frecuente; además, existe mayor participación de autores e instituciones de Norteamérica. Abstract: Introduction: The objective structured clinical examination (OSCE) has positioned itself as a key tool to assess skills optimally and reliably. This study sought to analyze the trends and profile of the scientific production on its use in health sciences. Materials and methods: A descriptive and cross-sectional study was carried out on bibliometric data. We included 844 articles on OSCE published in journals indexed in Scopus between 2018 and 2022. A descriptive and cross-sectional analysis was performed to bibliometric data with the Scival tool. Results: The number of publications has increased from 2018 to 2022, most of these are in high impact scientific journals. Most articles had national collaboration (42.4%) and international collaboration presented more citations per publication (6.5). The institution with the highest scientific activity was Harvard University, in addition to being the one with the highest impact. The journals Currents in Pharmacy Teaching and Learning and Medical Science Educator have more publications, but the Journal of Educational Evaluation for Health Professions (1,744) has a higher normalized impact. Zabar Sondra leads in scientific output, but MacArio Alex (0.91) has a higher weighted impact. Conclusions: Research has increased, mainly in scientific journals of greater prestige and impact, and with more frequent national collaboration; in addition, there is greater participation of authors and institutions from North America.