Problem-based learning: a strategy for building resilience

This work is the result of a collegiate reﬂection and describes a problem-based activity for building resilience. We believe that it is essential to analyze the factors that inﬂuence the development of resilience in health sciences students, to design educational intervention strategies that contribute to the development of support networks.

In the literature, we can find studies that relate these factors to the academic performance of students, finding levels of correlation that suggest a multifactorial behavior among them, which hinders their attention at a social and educational level (Curtis et al., 2017;Miletic et al., 2015;Zvauya et al., 2017).
We believe that working on and building better health science students' resilience will increase their academic performance and equip them for a demanding work environment (Hopkins et al., 2016;Wald, 2020). From an evolutionary point of view, species must possess the resilience to adapt socially to disadvantaged environments or Inclán-Rubio V, Sampieri Cabrera R MedEdPublish https://doi.org/10.15694/mep.2020.000288.1 Page | 2 represent obstacles in their individual and collective development. Under this concept, we allow ourselves to classify resilience into three groups: 1. Acquired resilience Life stories and family history can be a way to build resilience in community members. It depends on the obstacles they have had to face and how they have been overcome (coping).

Self-managed resilience
The development of personal and group leadership capacities can contribute to the design of crisis coping strategies.

Reflective resilience
Learning from their own mistakes can help build and build resilience.
In higher education settings, the development of competencies that contribute to students' academic training is encouraged, forgetting about stress management, coping, and the development of resilience (Bandini et al., 2017;Dolev et al., 2019). For this reason, we believe that it is essential to include content in educational programs that promote the development of resilience, from an academic perspective (Stegers-Jager, Cohen-Schotanus and Themmen, 2017; Arvandi et al., 2016).
In this sense, project-based learning can be an educational tool that contributes to developing coping skills. The elements established can represent fundamental challenges for students at the cognitive, organizational, and teamwork levels.
We propose that students develop a research protocol in the different areas of the medical career (biomedical, social, educational and/or clinical) and that the topic is selected according to the students' interests. The project must contain elements that promote continuous and self-regulated learning. The aspects of the protocol must be detailed from its planning, development, and execution.
There will be four challenges that students will face: • Information search and selection skills: to promote this ability, students will be guided to develop bioinformatics skills. Topics related to search algorithms and database selection should be included.
• Organizational: The students' level of organization and planning is evaluated, focusing on self-management strategies for work and time.
• Cognitive: It will be analyzed that students fully understand the topic they are developing. The evaluation will be done through seminars with experts that promote students' interest in the chosen topic.
• Confidence development: participation and development of collegiate activities will be encouraged. Students discuss the information presented by their academic peers. These sessions may be online seminars, round tables, and conversations.
The activities will be guided by an academic mentor who, in coordination with a psychosocial tutor, will monitor the level of motivation of the students, the possible problems they face, and will work on ways of coping.
Building resilience will be up to the individual participant and will only be helpful if trust can be established between Inclán-Rubio V, Sampieri Cabrera R MedEdPublish https://doi.org/10.15694/mep.2020.000288.1 Page | 3 students and their mentors and tutors. We are convinced that strategies such as these can contribute to the formation and development of support networks that would beneficially add to the training of medical students (Crossman, 2015;Ayala et al., 2017). Health science students need to form social support networks that allow them to overcome any adversity. We believe that educational intervention in academic settings is necessary to allow them to feel confident about themselves and that they are part of a work team (Slavin and Chibnall, 2016;Thompson et al., 2016).
A problem in medical schools is over-saturated curricula of cognitive components, which generate a significant stress load on students; not everyone can bear it, and most experienced frustration and anxiety (Dinis et al., 2020;Abu-Ghazaleh, et al., 2016).
We are convinced that the permanent and close collaboration of educational administrators, teachers, and researchers is essential to establish programs and strategies in favor of the mental health of students (Donohoe et al., 2020). In addition, the complexity and diversity of students that we have in public universities in developing countries should motivate us to establish academic support programs with high efficiency and low resources, which generate spaces for reflection for learning and that contribute to the formation of our students (Bacchi et al., 2020).
Likewise, we must begin to study the possibility of establishing academic programs that train leaders in health who promote healthy lifestyles and social responsibility. The authors are convinced that the changes in education that we are experiencing due to the COVID-19 pandemic should leave us lessons on how to train the new generation of health professionals (Cao et al., 2020).
The time to strategize is now; it is in our hands to be able to do it; we have the infrastructure, the digital media, and the trained human capital to achieve it. We have never been so willing to make changes that benefit our people. Adverse and, in some cases, traumatic situations aroused the resilience of many of us, and in others, it needs to be strengthened.

Take Home Messages
It is a challenge to establish strategies to achieve resilience since it implies first having a situation from which to have recovered, it would be irresponsible to do damage to see the response of individuals. Therefore, we propose an activity that is easy to carry out and that can help to strengthen the support networks of students and generate better levels of self-confidence.
The limitations of the study are that the study has not been tested, but it is a crucial time to do so.

Notes On Contributors
Dr. Raul Sampieri Cabrera, Head of the academic section of the Physiology Department of the UNAM Faculty of Medicine. She is interested in studying the psychosocial factors that participate in the academic performance of students. ORCiD: https://orcid.org/0000-0001-7733-1105.
Dr. Virginia Inclán-Rubio, Head of the Physiology Department of the UNAM School of Medicine. She is interested in developing resilience in medical students.