Introduction

In recent decades, there has been an exponential increase in scientific research. However, the number of physicians involved has decreased [1,2]. Likewise, in Chile, a decrease has been reported in the number of state-funded research projects led by physicians in the National Fund for Scientific and Technological Development (FONDECYT) between 1984 and 2003 [3] and in the period from 2004 to 2013 in the National Fund for Health Research and Development (FONIS) [4]. At the undergraduate level, the number of papers presented at the Chilean Congress of Medical Students (CoCEM) has decreased [5], and low participation of medical students in national medical journal publications has been reported [6].

Research plays a fundamental role in training medical students, helping them develop skills such as critical thinking, teamwork, creativity, critical analysis of scientific literature, scientific writing, and leadership. These are essential competencies in the practice of medicine, as they improve clinical decision-making and enable better performance in their professional practice [7,8,9]. That is why many medical schools worldwide [10] and nationally [11] teach courses on scientific research methodology and evidence-based medicine. However, student participation in research projects remains low despite incorporating these subjects in medical curricula. Likewise, students' perception of the development of undergraduate research skills is negative [12].

In Latin America and particularly in Chile, student initiatives such as scientific societies and academies of medical students have increased [13]. The Scientific Society of Medical Students of the Universidad de Valparaíso (SOCEM-UV) is a nonprofit student organization that, as of 2024, has 52 years of experience. Its mission is to promote scientific research during undergraduate studies and the dissemination of knowledge in health sciences. In response to the aforementioned problems, in 2022, this society organized two national conferences to present scientific papers focused on clinical specialties and public health: the 1^st and 2^nd conference on medical research of the Universidad de Valparaíso.

Our research aims to describe the organization of both conferences, characterize the presentations and the participating students, and analyze the differences between the grades obtained by each university.

Methods

An analytical cross-sectional study was conducted, which included all the papers presented at the 1^st and 2^nd versions of the conference on medical research of the Universidad de Valparaíso held on March 5th, 2022, and November 19th of the same year, respectively. This article follows the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guideline for cross-sectional studies [14].

First, the organizational phases of the conference are described. Then, the presentations are characterized according to the following variables: type of work, either case report or research work; university category (public/state or private) according to its membership in the Consortium of Universities of the State of Chile (CUECH); sex and academic year of the first author; medical specialty area of the work; and ratings provided by the scientific committee reviewing the abstracts. Finally, the association between the ratings obtained by state universities versus private universities is analyzed. The data were extracted from the records and books of public abstracts of the Scientific Society.

The Stata 17 program was used for statistical analysis. Proportions, mean, and absolute numbers were used to describe the variables. The students' t-test was used to compare the means between the groups. A significance level of 5% was used.

Results

Description of the conference organization

The conference consisted of four main phases: registration, evaluation, selection, and presentation.

1. Registration phase. The corresponding author had to register the paper with the following mandatory documentation:

   1. Abstract.

   2. Declaration of authorship.

   3. Informed consent if it corresponded to a case report.

   4. Approval of an ethical-scientific committee if it corresponded to a primary research work.

      The organizing committee reviewed this documentation, and papers that did not adequately comply with it were excluded.

2. Evaluation phase. The papers accepted in the first stage were assigned according to thematic affinity to an evaluator from a committee of academics, mostly from the Universidad de Valparaíso. Thirty-five evaluators participated in the 1^st conference, and a total of 30 in the 2^nd conference. The evaluation was carried out using a rubric created by the organizing committee with a score from 1 to 7 for each item, based on the CAse REports (CARE) [15] and STROBE [14] guidelines (Table 1).

3. Selection phase. The best papers were selected according to the score obtained through the arithmetic mean of all the items evaluated in the previous stage. On the first day, 50% of the places were reserved for students from the Universidad de Valparaíso, while on the second day, there was no distinction by university. The cut-off scores were 5.13 and 6.06 for the first and second days, respectively.

4. Presentation phase. During the first conference, one author of each selected paper presented in virtual mode, given the restrictions associated with the COVID-19 pandemic. The second conference was held at the Faculty of Medicine of the Universidad de Valparaíso. All the submitted papers were published in a book of abstracts that is publicly accessible [16,17].

Description of the submitted papers and participants

A total of 399 papers were received, and after the evaluation and selection phases, 169 papers were selected. Figure 1 shows the flow chart for selecting the papers for each day according to the different phases.

Figure 1

Work selection flowchart.

Source: Prepared by the authors based on the study results.

Full size

The characterization of the papers submitted is shown in Table 2. Twenty-one universities participated: nine were state or public, and 12 were private. Those with the highest number of papers submitted were Universidad de Valparaíso (38.5%), Universidad de Chile (9.5%), Universidad de Concepción (8.3%), Universidad Andrés Bello (8.3%) and Universidad San Sebastián (7.1%).

A total of 797 authors participated, of whom 56.7% (n = 452) were women. First authorship was higher among the female authors (56.2%), and almost all corresponded to students in the internship cycle (97.6%). Most of the submitted papers were case reports (92.9%), and the specialties that received the greatest number of papers were internal medicine (32.5%), pediatrics (18.3%), and surgery (13%).

Figure 2 shows the scores obtained in each of the case reports. The best-evaluated item was the title (6.66 ± 0.76), and the worst score was for the discussion (6.17 ± 0.84). When analyzing the data by type of university, private universities obtained higher scores overall and in each item, with six out of eight statistically significant results (Table 3).

Figure 2

Scores per item in case reports.

Source: Prepared by the authors based on the study results.

Full size

Research papers represented a minority of the overall total (12/169), and their submission was distributed equally between state and private universities. The overall average was 6.55 ± 0.22. When differentiated by type of university, the state universities obtained an average score of 6.52 ± 0.14, while the private ones were 6.59 ± 0.29. In both types of universities, the worst-rated items were results (6.0 ± 0.85) and discussion (6.25 ± 0.97). In contrast, the best-rated item for private universities was the title (7.0 ± 0.0); in state universities, it was both the title and keywords (7.0 ± 0).

Discussion

A total of 169 scientific papers were submitted from 21 Chilean state and private universities. Most of the papers received were case reports in the area of internal medicine, followed by pediatrics and surgery. Most of the participants were women doing their internships at state universities. In the case reports, the best-rated item was the title, and the worst was the discussion. Case reports from private universities obtained a statistically significant higher score in six of the eight evaluated items.

The categorical predominance of the participation of students in the internship cycle could be explained by the greater proximity to patients and specialists due to their clinical practices, greater preparation by being in higher courses, and the incentive of presenting papers at scientific congresses as an item of relevance in the applications for medical specialties. On the other hand, only 2.4% of the participants were students in their first to fifth year. This fact could be associated with phenomena such as lack of interest in undergraduate research or insufficient preparation in the area by universities. Therefore, a major challenge is to achieve active participation of medical students in science communication since the first years. This would contribute to internalizing the value and practice of undergraduate research and would later result in specialists dedicated to clinical medicine [18,19,20].

On the other hand, the predominance of case reports as the most commonly used methodology could be explained by the greater proximity of students to patients and by the fact that it is less complex, particularly when considering the great care and academic load associated with the medical career and, especially, with the internship cycle. This is one of the main barriers to research during medical school, as reported by other studies [21,22]. Although case reports are recognized as an important educational strategy in the health sciences [23], a pending challenge is the participation of students in more complex primary research projects that generate a higher level of evidence. This could contribute to internalizing the value of research and better developing research skills [7,9,24], including creativity, teamwork, and the development of oral and written expression.

Four of the five specialties that received the greatest number of papers correspond to the mandatory internships of the Chilean medical curriculum: internal medicine, pediatrics, general surgery, and gynecology-obstetrics. Likewise, these results coincide with national [25] and international studies [26], corroborating that these are the medical specialties of greatest interest among the student body. In our conference, neurology, psychiatry, and public health stood out as the group with the second highest number of papers received, below the four specialties already mentioned. Psychiatry is also reported in these studies among the specialties of greatest interest, but neurology and public health are not.

Regarding women’s participation in scientific research, historically, they have been underrepresented [27]. In the last decade, a low percentage of women were reported as first authors in high-impact journals [28]. During the last five years in Chile, according to data provided by the National Agency for Research and Development (ANID), the participation of women as lead researchers or project directors was only 40% [29]. When diagnosing gaps among universities of the Consortium of State Universities of Chile, in 2002, it was reported that only 36.2% of research projects were led by women and that only 29.2% of publications were made by women [30]. Interestingly, our findings show results in the opposite direction, reporting a higher participation of women as first authors.

Medicine and teaching are intrinsically linked. The role of the physician-teacher is essential for training future physicians and researchers [31]. However, teaching may be less valued than other roles in the medical profession, such as clinical care, management, and research [32]. One of the described barriers to student participation in research is the lack of adequate mentoring and guidance by a research faculty member [22,33]. In this regard, in both conferences, many physicians and academics participated voluntarily, which may reflect the willingness and interest of the faculty. However, at the same time, it may also indicate the lack of relevant instances that facilitate the exchange between teachers, researchers, and students.

Undergraduate research education is crucial for developing essential skills for medical practice, such as the critical analysis of scientific evidence [7,8,9]. In routine clinical practice, facing a patient who seeks medical advice for any clinical condition implies a systematized and critical approach that allows evaluating different diagnostic hypotheses and indicating treatments according to the best available evidence. Together, students and professionals should be relevant actors in generating new evidence, linking clinical reflection, the needs of patients, and the different health devices.

Although these competencies may be the objective of different subjects taken throughout the career, few universities involve integrative subjects of scientific research methodology and evidence-based health [11]. There is a persistent perception among students of low research skills and multiple limitations to engaging in research. Among these, the lack of knowledge, lack of teaching advice, and poor preparation and experience stand out [9,21,34]. In our conferences, the worst evaluated item for case reports and research papers was the discussion and the results section for research papers. These sections of the paper probably have the highest critical and reflective demands, which could reflect the results of the previously discussed problems. Other barriers that have been described for developing undergraduate research are the lack of time due to academic and care overload, the lack of funding, the absence of an adequate research culture that fails to internalize its social and professional value, and the lack of interest from universities [12,22,34]. To address these challenges, multiple actors must coordinate action and recognize research as a pillar in medical training. In Table 4, based on the presented results and the reviewed literature, we propose a series of recommendations for promoting scientific research in the medical career.

Among the limitations of this study, we can mention that, given the inclusion criteria for the first conference, there was an overrepresentation of participants from the organizing institution (38.5% of the papers came from the Universidad de Valparaíso), which could make it difficult to extend these results to the national reality. On the other hand, almost all the papers corresponded to case reports. In addition, only the abstracts were evaluated and not the complete article; thus, the sections could not be analyzed in greater depth. Finally, this work did not evaluate the students' perception of their training in research and the possibilities of accomplishing it, which is valuable information regarding the problems discussed.

Conclusions

The higher participation of internship students compared to students in lower years, as well as the higher prevalence of case reports as opposed to other types of studies, together with the evaluation results that point to discussion as the lowest rated item (section with the highest critical and reflective demands), may reflect several problems described in the literature. These include deficient research skills and multiple barriers to becoming involved in research from the early stages of the career or participating in studies with a higher level of evidence. These include a lack of time due to academic and care overload and a lack of knowledge in developing a research project. In light of our findings, it is necessary to encourage student participation from the first years of the career and their involvement in projects with a higher level of evidence. Therefore, we propose a series of recommendations that include transversal and coordinated research training for each training cycle, updating the requirements for graduation and incentive to medical specialties competitions, ensuring adequate institutional support, facilitating the link between researchers and students, and encouraging student inclusion in projects and competitive funds.

On the other hand, further studies are needed to analyze in greater depth the participation of medical students in scientific research projects, presentations at congresses, and publications in scientific journals. In addition, more studies with qualitative methodology are needed to help identify the barriers and elements that facilitate developing undergraduate scientific research.