Strategy to improve the results of the theoretical state examination of the medical career


Strategy to improve the results of the theoretical state examination of the medical career


Estrategia para mejorar los resultados del examen teórico estatal de la carrera de Medicina



Lliliam Artiles Duarte1, Lourdes María Jaime Valdés2, Tomás Pérez Rodríguez3

1 Villa Clara University of Medical Sciences. Cuba. E-mail:
2 Villa Clara University of Medical Sciences. Cuba. E-mail:
3 Villa Clara University of Medical Sciences. Cuba. E-mail:




Learning assessment is an essential part of the teaching-learning process that makes possible its own direction, as well as the control and assessment of the modes of performance that the students acquire through their development when verifying the degree to which the objectives proposed are reached. A strategy was designed to improve the results of the state theoretical exam in sixth year students of the medical career that was created according to the deficiencies detected in the school year 2011-2012 at Villa Clara University of Medical Sciences. It is in the interest of the authors to share the meaningful results that have been reached with the implementation of this strategy by reversing the results of the theoretical state examination.

MeSH: assessment, education, medical, evaluation tools


La evaluación del aprendizaje es una parte esencial del proceso enseñanza aprendizaje que posibilita su propia dirección, así como el control y la valoración de los modos de actuación que los estudiantes adquieren a través de su desarrollo al comprobar el grado con el que se alcanzan los objetivos propuestos. Se diseñó una estrategia para mejorar los resultados del examen teórico estatal en el estudiante del sexto año de la carrera de Medicina creado a partir de las deficiencias detectadas en el curso escolar 2011-2012, en la Universidad de Ciencias Médicas de Villa Clara. Es interés de los autores compartir las experiencias positivas que ha permitido alcanzar la implementación de esta estrategia al revertir los resultados del examen estatal teórico.

DeSC: evaluación, educación médica, instrumentos de evaluación.



In Cuba, since the 1990s, the culmination of studies in medical science careers is assumed through the state examination, as a certification of the quality of graduates. It is an official verification of the level of competence obtained before graduation and at the beginning of the exercise as a professional in the National Health System, which implies an enormous social responsibility, since when passing the examination it is recognized and authorized to take direct action related to people's health of.1,2

As it is known, the learning assessment is an ongoing process that starts with the first teacher-student contact and culminates in a value of judgment according to the educator's goals and interests. Likewise, the teaching-learning process is a system in which each of its components are interrelated, where the objectives are the leading category, and the assessment is the regulatory mechanism of the system, it is considered as the instrument of quality control of the product resulting from the process.3

The exercise to measure the scientific-technical basis of the professional performance is in the written examination. It is an instrument that allows teachers to learn about the learning that their students have achieved, and reports on the teaching difficulties of students and deficiencies in the learning process, either due to lack of study, lack of feedback from teachers or Insufficient control of the consolidation of theoretical knowledge.4-6 The analysis of the results is used to establish a measurement plan in order to improve the assessment instruments, self-study of the students and the teaching strategy in the technical-scientific and pedagogic aspects of the contents in which deficiencies have been detected.7-9

In consideration of the precept described above, at Villa Clara University of Medical Sciences a strategy was implemented to improve the results of the theoretical state exam in the sixth year of the medical career, which was conceived according to the shortcomings identified in the 2011-2012 school year. It has been applied from November 2012 to current time with satisfactory results in the fulfillment of the objective for which it was created. The authors consider appropriate to divulge its essence in order to socialize it with colleagues from other institutions in order to achieve a better preparation of medical students for the state examination.

Preparation begins in the first year of the career; the professors of the subjects of the integrative discipline participate through the in-service training, as well as in the different practical and theoretical assessments that are carried out. Likewise, the year teaching-staff of the 6th year composed by teachers of the different rotations of the internship, Comprehensive General Medicine (MGI), Internal Medicine, Pediatrics and Surgery, since the beginning of the school year start to prepare them with more emphasis on future graduates, materializing it in the following actions:

  • Differentiated attention to students with greater difficulties in each rotation
  • In Primary Health Care (PHC), tutors with the best preparation and teaching rank are placed in the doctor´s offices.
  • Since the beginning of the course students are offered consulting lessons by the head professor of each rotation.
  • Work is done to familiarize students with the type of questions used in the test.
  • An assessment guide of the state practical exam is given for better self-preparation.
  • The plan topics scheduled for each school year is analyzed in the year teaching staff on February, to teach to interns in the form of panoramic lectures to prepare them for the state exam and it is informed to all areas on March.
  • A panoramic conference is taught on how to carry out the state practical examination in each teaching site, following all aspects of the methodological guide and how their professional work and performance should be, the same preparation is offered the day of the draw for placement in the examining boards where they will perform the practical exercise in each teaching site.

The topics taught by subjects in the panoramic conferences are:

Comprehensive General Medicine

  • Specific activities of (CGM) (screening, Home admission).
  • Health promotion, its actions. Health Education Techniques. Concept of community participation.
  • Changes in growth and development.
  • Health prevention. Levels of prevention. Examples that appear in the (CGM) book.
  • Transmissible disease care. Control of tuberculosis outbreak.
  • Involution of the elderly, preparation of their food.
  • Health determinants. Way and lifestyle. Risk factors for chronic non transmissible diseases.
  • Prenatal care. Organic cytology.
  • Family. Groups and collectives. Stages of the life cycle. Classification of the family. Family intervention.
  • Herbal and Folk Medicine. Theories that support it. Explain them. Moxibustion. Acupuncture. Electro acupuncture. Ear-puncture acupressure.
  • Accidents. Immunizations. Scheme of vaccination, anatomical time and place and disease which it protects against.
  • Community-based rehabilitation. Modalities, principles, objectives. Concept of deficiency and disability.
  • Comprehensive health situation analysis. Concept. Objective. Steps to follow, action plan.
  • Comprehensive care for chronic non transmissible diseases.


  • Acute abdomen.
  • Hernias.
  • Trauma of the thorax.
  • Breast affections.
  • Surgical superficial infections.
  • Upper digestive tract bleeding.
  • Lower Digestive tract bleeding. Anus-rectal conditions.
  • Healing.
  • Esophagus cancer.
  • Peripheral arterial and venous vascular disorders.
  • Hypovolemic shock.

Internal Medicine

  • Ischemic heart disease.
  • Heart failure.
  • Arterial hypertension.
  • Diabetes mellitus.
  • Inflammatory pneumopathies.
  • Bronchial asthma and chronic obstructive pulmonary disease.
  • Exogenous intoxication.
  • Hydro mineral imbalance.


  • Tuberculosis.
  • Acute lower tract respiratory infection.
  • Asthma
  • Acute diarrheal diseases.
  • Hydro mineral imbalance.
  • Intestinal parasitism.
  • Malnutrition.
  • Soft tissue infections.
  • Congenital heart disease.
  • UTI
  • Glomerulonephritis.
  • Accidents.
  • Child abuse.
  • Infections of the nervous system.
  • SIRS.
  • Sepsis.
  • Anemia.
  • Convulsion.
  • Psychomotor development.


  • Prenatal care.
  • RPC.
  • Gestorragias.
  • Alterations at the end of gestation. IUGR, preterm and prolonged pregnancy.
  • High blood pressure and pregnancy.
  • Anemia.
  • Urinary sepsis.
  • Diabetes and pregnancy.
  • Benign conditions of the vulva, vagina and neck.
  • Malignant conditions of the uterus.
  • Pelvic inflammatory disease.

With the strategy designed and implemented, the students have been better prepared to face the state exam. Their results at Villa Clara University of Medical Sciences have contributed to a better quality of the graduate.


Declaration of interests

The authors declare no conflict of interest.



1. Salas Perea RS, Salas Mainegra A. Los modos de actuación profesional y su papel en la formación del médico. EDUMECENTRO [Internet]. 2014 [citado 13 Ene 2017];6(2):[aprox. 16 p.]. Disponible en:

2. Salas Perea RS. Los procesos formativos, la competencia profesional y el desempeño laboral en el Sistema Nacional de Salud de Cuba. Educ Med Super [Internet]. 2012 [citado 12 Ene 2017];26(2):[aprox. 3 p.]. Disponible en: 3. Núñez Martínez M, Suárez Denis A, Llano Arana L. Plan de acciones para mejorar resultados de exámenes estatales. Perfil Terapia Física y Rehabilitación. Cienfuegos 2008-2012. Medisur [Internet]. 2014 [citado 12 Ene 2017];12(1):[aprox. 8 p.]. Disponible en:

4. Vicedo Tomey A. Cinco propuestas doctrinales en relación con la formación por competencias. Educ Med Super [Internet]. 2011 [citado 16 Ene 2017];25(3):[aprox. 20 p.]. Disponible en:

5. Trujillo Saínz ZC, Guerra Pando JA, Henríquez Trujillo D. El examen estatal, referencia de utilidad en la labor metodológica del colectivo de carrera en la especialidad de Estomatología. Rev Ciencias Méd de Pinar del Río [Internet]. 2012 [citado 12 Ene 2017];16(3):[aprox. 10 p.]. Disponible en:

6. Gutiérrez Martore S. López Cruz T, Legañoa Alonso J, Marrero Fente A. Caracterización del examen estatal escrito de Estomatología de la Universidad Médica de Camagüey. Rev Hum Med [Internet]. 2013 [citado 16 Ene 2017];13(3):[aprox 17 p.]. Disponible en:

7. Echezabal de la Flor E, Flor Santalla MA de la, Echezabal Benítez E, Hernández Manzort ME, Rivera Rivas N. Una reflexión sobre el sistema de evaluación final de los alumnos de la carrera de medicina. Rev Ciencias Méd de Pinar del Río [Internet]. 2015 [citado 16 Ene 2017];19(6):[aprox. 11 p.]. Disponible en:

8. Díaz Rojas PA, Leyva Sánchez E. Metodología para determinar la calidad de los instrumentos de evaluación. Educ Med Super [Internet]. 2013 [citado 20 Ene 2017];27(2):[aprox. 16 p.]. Disponible en:

9. Cordero Miranda Y. Necesidades de aprendizaje sobre la elaboración de instrumentos evaluativos escritos. Educ Med Super [Internet]. 2013 [citado 19 En 2017];27(2):[aprox. 4 p.]. Disponible en:



Submitted: February 28 2017.
Accepted: July 20 2017.



Lliliam Artiles Duarte. Villa Clara University of Medical Sciences. Cuba. E-mail:

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