Nydia Bonet,MD, Brenda Mirabal, MD, MPH, UPR School of Medicine, Department of Pediatrics, San Juan, PR
BACKGROUND: Homicides are the first cause of death for youths > 15 years in PR. Males are affected 14 times more than females. Thousands of youths are incapacitated physically, mentally or emotionally by intentional injuries in PR every year. In order to prevent intentional injuries and reduce costs to society it is necessary to identify the risks and protective factors of intentional injuries in this population. The LCME expect students to be prepared for their role in addressing the medical consequences of common societal problems. At the UPR SOM Pediatric Clerkship, a new requisite was begun in academic year 2008-09 were students completed a reflective exercise on this topic in order to increase awareness. OBJECTIVES: Provide the students the opportunity to recognize that intentional injuries and homicides are a serious public health problem in the youth population in PR and motivate reflection in order to develop plausible preventive measures. Strategy: Students are required to read the article entitled “Homicides Among Children and Young Adults-Puerto Rico, 1999-2003, MMWR” and write a reflective essay describing their thoughts and ideas about this problem. RESULTS: Thirty-six students out of a 106 have completed the Course. All students recognized youth violence and homicides as a serious public health problem. Common themes discussed in the students’ exercises were: the role of families, government programs, schools and communities in teaching youths about positive values and pro-social skills; and the role of physicians and health professionals in early identification of risk factors and patient education in clinical interventions. Students also expressed the need for collaboration between different sectors of society to reduce and prevent this problem. CONCLUSION: Reflective exercises promote introspection, critical thinking and analysis and are helpful when dealing with complex social problems. It is essential that future physicians become aware of their role in the identification of risk factors and the importance of promotion of preventive strategies to address the social problems prevalent in their community.