Medical empathy and clinical self-efficacy are key professional competencies that are difficult to develop through traditional classroom-based training alone. At the Faculty of Medicine of FES Iztacala (UNAM), the curriculum includes a community practice component in the Practica Clinica I module that is rarely implemented in practice, creating a gap between the formal and real curriculum.
This quasi-experimental pre-post study evaluates the effect of a structured Service-Learning (SL) intervention - a community anthropometry and somatometry assessment session conducted at a primary school - on medical empathy, perceived clinical self-efficacy, and clinical report performance in 35 fourth-semester medical students.
Medical empathy will be measured using the Jefferson Scale of Empathy, Student version (JSE-S), validated in Spanish for Latin American populations. Clinical self-efficacy will be measured using the Medical Self-Efficacy Scale (EAM), a 5-item Likert instrument developed by the principal investigator (Cronbach's alpha=0.818, McDonald's omega=0.862). Clinical performance will be assessed using a standardized 33-point rubric evaluated blindly by two independent faculty members, with inter-rater reliability calculated using the Intraclass Correlation Coefficient (ICC).
Children participating in the community session will receive a personalized health report with their anthropometric results and, if clinically relevant findings are detected, will be referred to the University Health Clinic (CUSI) at FES Iztacala at no cost.
Enrolled in the fourth semester of the Medico Cirujano (MD) program at FES Iztacala, UNAM
Registered in the Practica Clinica I module during the study period
Signed informed consent prior to any data collection
Present at both pre-intervention and post-intervention measurement sessions
Previous enrollment in the Practica Clinica I module
Prior documented clinical experience outside the university setting (internships, clinical rotations in other programs)
Absence from the community intervention session for any reason
Failure to complete at least one of the three measurement instruments at either time point
Single group
Community Service-Learning Anthropometric Assessment
BehavioralA single-session community Service-Learning activity conducted at Escuela Primaria Jesus Garcia (C.T. 15DPR1779L). Medical students perform weight, height, BMI, body circumferences (waist, hip, arm), body segments, and waist-hip ratio measurements on consenting school children. Students complete a simplified clinical history form and produce a written clinical report including anthropometric data, interpretation using WHO/CDC reference tables, relevant findings, and health recommendations. Each participating child's family receives a sealed personalized results envelope. Students with clinically significant findings are referred to CUSI (FES Iztacala). Duration: one full day. Supervised by faculty members from FES Iztacala.
Change in Medical Empathy Score (JSE-S)
Change from baseline in total score on the Jefferson Scale of Empathy, Student version (JSE-S). Scale range: 20-140. Higher scores indicate greater empathy. Used with permission from Thomas Jefferson University.
Change in Perceived Clinical Self-Efficacy Score (EAM)
Change from baseline in total score on the Medical Self-Efficacy Scale (EAM), a 5-item Likert instrument (range 5-25) developed by the principal investigator. Cronbach's alpha=0.818, McDonald's omega=0.862.
Change in Clinical Report Performance Score (Standardized Rubric)
Change in total score on a 7-dimension, 33-point standardized rubric evaluating the clinical anthropometry report. Dimensions: basic anthropometric measurements, body circumferences, body segments, use of reference values, clinical interpretation, recommendations, and report structure. Evaluated blindly by two independent faculty members. Inter-rater reliability assessed with ICC (two-way absolute agreement model).
Correlation Between Change in Empathy and Change in Clinical Self-Efficacy
Pearson or Spearman correlation coefficient between the change score (post minus pre) in JSE-S and the change score (post minus pre) in EAM.
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Luis Angel Flores Sagrero
Lead sponsor
Universidad Nacional Autonoma de Mexico
Sponsor institution
Universidad Nacional Autonoma de Mexico
Collaborator
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