Importance from the Economic Culture Upping for the Managers of the Medical Sceince University Volume 49- Issue 5

Fé Fernández Hernández^1*, Efraín Sánchez González² and Bergelino Záldivar Pérez³

• ¹Faculty of Medical Science, Head Department for Postgraduate Formation and Researching, Cuba
• ²Faculty of Medical Science, Methodologist from the Department for Postgraduate Formation and Researching, Cuba
• ³University for Physic Culture Sciences and Sports “Comandante Manuel Fajardo”, Profesor Universitario, Cuba

Received: April 07, 2023;   Published: April 20, 2023

*Corresponding author: Fé Fernández Hernández, Faculty of Medical Science, Head Department for Postgraduate Formation and Researching, Cuba

DOI: 10.26717/BJSTR.2023.49.007870

Abstract PDF

Introduction: The improvement in economic culture in the universities of Medical Sciences constitutes a challenge at present because its assimilation influences the actions of the managers of these times.

Objective: To argue the importance of economic culture for the managers of the University of Medical Sciences.

Materials and Methods: A descriptive study of the importance of economic culture for managers of the University of Medical Sciences was carried out. Historical-logical, inductive-deductive and comparative were used as theoretical methods. As an empirical method, the bibliographic review was used.

Results: The economy has indissoluble links with all social phenomena such as culture, a highly complex phenomenon that synthesizes the links between material life and spiritual life and in turn promotes social development aided by education. Therefore, the university in its governing role constitutes a managerial center where managers play an important role in decision-making, for which the formation of an economic culture according to the current conditions of society is substantial.

Conclusion: The improvement in economic culture for the academic managers of the University of Medical Sciences contributes to perfecting their managerial process by conceiving a cultural appropriation of knowledge, skills and tools of Economic Sciences for the optimization of managerial results.

Keywords: Economic Culture; Management; Medical Science University

The constant social changes, globalization, rapid technological progress, population aging and the current hygienic-epidemiological environment, define transformations in the political, economic and social spheres that impose new challenges on the Public Health sector, in charge of preserving, guaranteeing and promote the health and quality of life of the population [1]. In the context that is reviewed, one of the most important challenges in recent years lies in the quality of training and improvement of human resources. This process is directly linked to the political, economic and social changes that have been generated in the different countries, in which the social development of science, technique, practice and research have made it necessary to apply not in discourse, but in effective practice, the concepts of efficiency, quality and demand in the educational processes carried out by universities, increasingly committed and in interaction with society. Medical universities are also subject to change processes. Hence, exchanges on issues related to the importance of knowledge, quality, relevance and the need for new paradigms to understand and assume complex global and local problems gain relevance [1].

The postgraduate training process in the Public Health sector plays a determining role in the training and development of human resources from health conceptions that remake the role of professionals, in addressing problems comprehensively and based on the principles of the new scientific, technological and humanist university. For this, the academy is put at the service of the development of production and service sectors, by expanding its radius of action outside the university campus and bringing knowledge to the entities of the territory to change the academic and elitist conception that prevails in the educational centers. Postgraduate education is considered the highest level of the Higher Education system, which is responsible for offering professional growth processes. It is made up of two areas: professional development and academic training. The first is responsible for improvement activities and training, which systematically contributes to raising productivity, efficiency and quality of work. It is achieved through courses, diplomas and training, among others. For its part, postgraduate academic training is responsible for directing and controlling the training processes in the field of doctorates, master’s degrees and specialties [2,3].

In Cuba, in the field of medical sciences, specialties were the first expressions of academic postgraduate studies and the most represented organizational form [4]. Resolution 140 of 2019, of the Ministry of Higher Education, emphasizes the need to contribute to improving Health processes from the improvement of professional improvement with emphasis on professional performance, to achieve the necessary transformations in such a sensitive sector. like Public Health. It is inferred, as a result, that the institutional strategy to improve the medical university must achieve a conscious transformation of professional performance in the current Cuban health context. This, in itself, constitutes the essence of the effectiveness of any postgraduate improvement strategy [5].

The development achieved by Public Health worldwide raises the need to integrate, within the teaching-learning process of this sector, the most relevant economic aspects that are related to the costs of the health-disease process, under the support of the Economy as a determinant of Public Health, whose epidemiological repercussion is manifested in consequent levels of morbidity and mortality associated with the process. For this reason, the academic directors of the Universities of Medical Sciences need to critically analyze the social reality from an economic perspective and identify the concepts related to the Public Health sector, in such a way that they integrate the knowledge so that its management is efficient [6].

Current trends in the process of improvement in economic culture of academic directors are focused on the needs of the organizations of the Faculties of Medical Sciences, the demands of the positions and the requirements of the areas in which they work, because in the undergraduate and postgraduate curricular training have not conceived sufficient knowledge and tools of economic aspects. This form of improvement, based exclusively on the perceived needs for the managerial performance of the academic directors of the Faculties of Medical Sciences, limits the effectiveness of the institutional strategy of improvement in economic culture and conditions the appropriation of this form of culture by part of managers, as well as the general and integral culture of these [7,8].

Managers must possess certain not only academic, but also organizational skills that allow planning, organization, execution and control of management and supervision actions. Considering these elements into account requires directing the efforts of the institutions to the permanent improvement of managers, so that they acquire the knowledge to guarantee the fulfillment of the objectives demanded by contemporary society.

In no way, improvement in economic culture can only be information, it must be interpreted as a formative element complemented with other disciplines, such as Health Sciences. This form of culture must be a reflection of the economic consciousness of the individual and society. Therefore, the role of institutional improvement strategies in economic culture, in medical universities, for the transformation of individual and social consciousness, in correspondence with a more rational managerial performance, is highlighted. The Economy by itself does not solve all social problems, but a large part of life in society revolves around economic issues [9]. Economics focuses on the study of the processes of production, distribution, commercialization and consumption of goods and services. In all of them, the social element is essential, where economic culture is a determinant of individual and social behavior. Therefore, knowing Economics knows how to live in Society [10].

Within the management or direction that articulates all the processes of an organization, the managers or directors are responsible for carrying out this task in a coordinated manner and oriented to the goals of the institutions. Managers must manage institutions with coherence and integration from a systemic, global vision, as a whole, not in isolated parts, of the organization.

Every medical decision has an implication on the economy and economic decisions influence in one way or another the health of the population. Hence, the relationship between the economy and health is an inseparable pairing. Economics not only studies monetary transactions; there are economic choices that do not have a direct monetary repercussion and nevertheless cost. In this sense, it should be considered that the value of a good or service, such as the training of human resources for the Public Health sector, is not determined by its price, because this economic category is just an expression of the real value of the considered good or service.

The Economy is also called the science of scarcity, because the administration of resources is the raison d’être of this social science. In turn, the insufficiency of resources forces decisions to be made that, outside the range of education and economic culture, would lack objective rationality. In the case of the academic directors of the University of Medical Sciences, it is even more important due to the relevance of decision-making from their management levels. The academic directors of the University of Medical Sciences must be convinced that the training of human resources is an economic service and constitutes the basis of multidimensional capitalization of the economic value of the human capital trained. The conscious recognition of this fact must be understood as the fundamental reason why the improvement in economic culture of academic directors must form an intrinsic part of the integral formation of these.

To argue the importance of economic culture for the managers of the University of Medical Sciences.

A descriptive study of the importance of economic culture for managers of the University of Medical Sciences was carried out. Historical-logical, inductive-deductive and comparative were used as theoretical methods. As an empirical method, the bibliographic review was used.

In order to address the aspects of improvement in economic culture, it is necessary to establish the relationship between the categories culture, development and education, necessary elements to understand the social historical development that precedes the phenomenon under study. The definition of culture has been highly debated due to the holistic approach that the term holds. The etymological origin of the word refers us to the Latin cultura, which means cultivation, and the Dictionary of the Royal Spanish Academy defines it as: «a set of knowledge that allows someone to develop their critical judgment» and in a third meaning defines it as: «a set of of ways of life and customs, knowledge and degree of artistic, scientific, industrial development, in a time, social group, etc.” [11]. The philosophical glossary defines it as “a set of distinctive, spiritual and material, intellectual and affective traits that characterize, seek new meanings and create works that transcend a society or social group in a given period. Through culture, man expresses himself, becomes aware of himself, and questions his accomplishments.

In the strictest sense, one usually speaks of material culture (technique, production experience and other material values) and spiritual culture (results in the field of science, art and literature, philosophy, morality of instruction, etc.) [12]. These ideas do not contain all the elements of culture, but they do help to interpret humanity’s ability to transform and create lifestyles according to their individual choices, closely linked to the economic, social and political conditions in which it develops. Culture is a historical phenomenon that develops depending on the change in social economic formations and by consensus of many authors, man created culture and the social conditions of existence and these, in turn, completed the human dimension, since they allowed the development of his potentialities and formed new forces in him. The human in man to a large extent is engendered by life in society [13]. It constitutes an essential concept to analyze society as a whole, since culture is the generalized expression of the degree of development achieved by it [13]. The dictionary of the Royal Spanish Academy [11] defines development as the action and effect of developing or developing, it is about increasing or increasing something of a physical, intellectual or moral order. Another of the definitions of interest, and one that more explicitly expresses the idea of development, is the definition formulated by the Club of Rome in its 1972 report, the result of the Project on the Human Condition, which defines it as: «Process that undergoes a society to achieve the well-being of the population, relating harmoniously with the natural environment, thus managing to satisfy material needs and establish the bases so that every individual can deploy their human potential” [14].

Development is understood as: “the condition of life of a society in which the authentic needs of groups and/or individuals are satisfied through the rational, that is, sustained use of natural resources and systems [15]. Both definitions express a broader vision, because they address the human character of the term, closely related to growth, involving its qualitative aspects, so that development represents a cultural, integral process, rich in values that encompasses the natural environment, the social relations, education, production, consumption and well-being [16]. According to Karl Marx, human development is not only a means but also the end for men and women to be rich, both for their productive powers and for the satisfaction of their material and spiritual needs. This dialectical-materialist approach served as the basis for cultural-historical psychology. Its definition of human development is assumed from it: «complex dialectical process, characterized by multiple periodicity, by a disproportion in the development of different functions or qualitative transformations from one form to another, by the complicated intertwining of processes of evolution, by the intertwined relationship between internal and external factors, and by the intricate process of difficulties and adaptation.” [17]. The concepts of development and culture, despite being one of the most densely imbued with ideology and prejudices, have been acting as powerful intellectual filters for the perception of the contemporary world. Therefore, they constitute guiding ideas of thought and behavior in modern times [18]. The integral development of man must take into account the components of the social organism that acts directly and indirectly in the formation of his personality, the influence of national and family tradition, the social context, his own person, as well as economic factors. That affect their development [19].

Men, in the development of their economic activities, create material goods mediated by emotions, feelings and traditions accumulated through their experiences, establishing social relations that imply economic exchange and cultural exchange through merchandise, which is the element of that exchange [20]. The economy has indissoluble links with all social phenomena, culture, as a highly complex social phenomenon that synthesizes the links between material life and spiritual life, is closely linked to the economy. In order to obtain the accumulated knowledge in the social historical development, education was needed because it constitutes a process of influence of man, at the same time that the effect of this influence is part of the cultural dimension and the development of personality, because culture It is not learned, it is acquired through the assimilation of the different activities. In the subject’s learning process, appropriation is one of the most diverse forms and resources through which, actively and in interaction with others, he endorses the knowledge, techniques, attitudes, values and ideals of the society in which he lives, becoming personal qualities the culture that characterizes society. In this process, culture is not only assimilated, but also builds critiques, enriches, and transforms it into a new legacy for future generations [20]. This process has an objective character since when human relations are established in the productive process, opinions and points of view arise that form the social conscience (the set of ideas, theories, social conceptions, which reflect the conditions of the material life of society, the mode of production of material goods) [21].

The highest level of social consciousness is ideology, which is nothing more than the system of conceptions of ideas: political, legal, moral, aesthetic, religious and philosophical, which in its development is inextricably linked to the economy. The ideology conditioned by the social superstructure and the historical context influences economic consciousness, as a form of social consciousness, which is manifested from the theoretical point of view, in the scientific knowledge of economic activity and production relations, which is expressed in the economic sciences and economic thought in a general sense. Therefore, the understanding of economic reality requires that the individual build a systemic vision of the social economic model in which he is inserted and, at the same time, be able to handle a series of specific information that enables him to act effectively within it. The individual must develop a series of specific skills for daily life, aimed at the proper use of their resources through habits and rational consumption behaviors and attitudes towards indebtedness and the use of money that facilitate efficient economic behavior and improve their quality of life. life [22]. Through this definition, it can be understood that the individual appropriation of economic culture is a complex process, given by the capacity of each human being to internalize its psychic particularities. In correspondence with the values, it is reflected in professional performance, thus considering human development as an integral process, which undergoes modifications in correspondence with social conditions, the capacity of the subjects and their learning [21].

The integral development of man must take into account the components of the social organism that acts directly and indirectly in the formation of his personality, the influence of national and family tradition, the social context, his own person, as well as economic factors. That affect their development [22]. The need to optimize available resources led man to use the economy for his benefit within the framework of social relationships with his peers. Thus, the new knowledge that is acquired allows a greater degree of adaptability and survival; incorporating economic knowledge into daily life subject to the sociocultural conditions of the moment. Therefore, economic culture plays an important role in human society, because it contains all the cultural elements adopted by previous generations in the administration of economic resources [23]. The economic culture of human society establishes a frame of reference to regulate the social relations between its members. This culture was perfected and adapted to the extent that the main contradictions arising from the social relations of the individuals that make up society were resolved. In this way, the economic culture establishes the theoretical-practical paradigm of the socioeconomic behavior of man; this does not only concern professionals in Economic Sciences, it also constitutes a vital resource for social survival where all members of society interact [24]. In the international arena, the development of economic culture has been as heterogeneous as the social development of each region. However, in all cases, it has always been consistent with the degree of economic and social development achieved by said region [25].

The inclusion of economic knowledge in the pedagogical and educational process marked a turning point in the dynamics of social learning for socioeconomic development. Recognizing and deepening the study of economic culture, gave the educational teaching process a role of social leadership in the transformation of the environment based on social interests to the point of being responsible, to a superlative degree, for the development of relationships between the individuals who make up society. The institutionalization of teaching further accentuated the leading role of the educational teaching process for the development of economic culture. Particularly, Higher Education took the lead to promote its development in all social spheres, by allowing unprecedented levels of social development through economic culture. Thus, its development does not exclude any sector of society and demands from each of them a more intensive, committed and leading role in the development of humanity itself [26]. With the promotion of social relations, the inclusion of the most important elements from the economic point of view in the educational teaching process continues to be a growing and recurring need for all sciences. Graduates are needed with tools and potential that can be expressed in their professional performance in accordance with the social demands established by the corresponding historical context, therefore, this knowledge contributes to improving the skills of professionals who occupy management positions [27]. In the current context, all the projects that are carried out must be feasible from the economic point of view for the person (or persons) who approve it, as a necessary condition for its implementation. For this reason, economic culture has been introduced into economic, political and social development to the point of conquering a prominent and irrevocable place. This is yet another reason to recognize the need to use it in favor of promoting all human development [28-30].

In this way, it is impossible to deal with economic culture without addressing economic awareness, since it constitutes a form of social awareness and knowledge of it is of great value for the development of society [31].

Economic consciousness is the form of social consciousness that constitutes the closest and most direct reflection of the social being that springs from a given economic base; It is the product of the interaction of social subjects in productive activity, from which points of view, representations, feelings and moods arise, opinion systems and conceptions about economic life that stimulate their activity, strengthening, accelerating or retarding the development of the economic base [18]. Authors such as Silva, F. and Sánchez, F., address economic awareness from education, incorporating, in their criteria, the culture acquired by society in its development, in terms of the link between study and work and the contribution of development. From economic culture to the development of society [32,33]. In Latin America, pedagogues as important as Simón Rodríguez and José Martí expressed the educational value of linking study with work. The appreciation of these thinkers and the Marxist-Leninist theory contributed to the fact that Cuban education, together with its social project, was socialist [34,35]. The economic culture has a fundamental role in the formation of values that make it possible to give historical continuity to the Cuban socialist project, so it must promote knowledge of the economy in its general aspects such as: its functions, structure, its interdependence with the economic base and its relationship with ethics, with a view to promoting the study of its content of a profound political, ideological and axiological nature and, therefore, highly educational and developing that is revealed through the study of the situation of the world economy and the Cuban economy, as part of the knowledge system of economic culture [36]. To the extent that managers are prepared as professionals capable of recognizing the role of work, savings and efficiency in production and services, they will be able to respond to such pressing problems as the scarcity and depletion of natural resources, the degradation of social systems and economic and cyclical crises that allow the consolidation of an adequate economic culture where genuine care for economic resources prevails [37,38].

The economic improvement of the academic directors of the Faculties of Medical Sciences constitutes today a concern for the University of Medical Sciences, an important condition for professional improvement, which implies that it must be deepened in it, in accordance with scientific progress and the demands that society imposes on educational institutions [39,40]. The directors of the Faculties of Medical Sciences face dissimilar simultaneous challenges, which are manifested in assistance, teaching and management, which is why they must have sufficient academic training to face these dilemmas, adapt to the new circumstances and continue with the process of training human capital for the Public Health sector [41]. Within the necessary multidisciplinary training of the academic directors of the University of Medical Sciences, improvement in economic culture plays a relevant role, which has been highlighted by several professionals in these sciences, especially in light of the new millennium and particularly with the arduous economic struggle that current Cuban society is waging [42]. It is a fact that Health Sciences are not alien to Economic Sciences and vice versa. On the one hand, from the economic perspective, health is considered an economic well while, from the point of view of health sciences, the economic factor is a determinant of health, whose size and scope depend on the particularities of the object. Of incidence. However, the economic culture of academic managers must go much further than understanding these primary truths [43].

Cultivating the economic culture does not convert the directors of the Medical Sciences Universities into a professional of Economic Sciences, but it does provide them with very useful tools that allow a better understanding of their social environment, which in turn can have a positive effect on the direction, leadership and conduct of the management process where it works [44]. An adequate economic improvement allows the directors of the Medical Sciences Universities to have solid arguments that explain the social role of the Medical Sciences professional in current Cuban society, both from the institutional and social point of view. Therefore, the improvement in economic culture for the academic directors of the University of Medical Sciences should not be simply one more option, but a powerful tool that contributes to the improvement in the formation of the necessary human capital of Medical Sciences [45]. Universities, due to their status as academic and research centers linked to scientific, technical and social progress, must guarantee the updating and concretion of the best scientific-technical experiences and, consequently, offer improvement programs that meet the requirement of generating, from his intervention, new knowledge that guarantees sustainable human and social development through the coherent articulation of methodological, academic and research activities, oriented towards professional development. Professional improvement constitutes an essential structuring element of the training of professionals in the Faculties of Medical Sciences. It establishes a close link based on the strategy that is organized in each institution with the objective of raising professional development and achieving university excellence that is declared as a political and pedagogical purpose for Higher Education [12].

Postgraduate education in the National Health System has, among its fundamental objectives, the continuous and systematic improvement of professionals, as well as the development of skills, which together with the social health policy, generates opportunities to establish an alternative dynamic in the search for the contents closest to the needs and contextual social values, where the economic culture must occupy what corresponds to it according to the needs of the faculty, despite the fact that it is not fully aware of it [46]. It is not necessary to wait for the last period of training of the Medical Sciences professional to introduce economic culture in undergraduate training and, therefore, it would not be prudent to leave it to chance [13]. From this argument it is inferred the importance that these researchers attach to the cultivation of economic culture in the academic training of professionals in Medical Sciences in our country. Others warn about the impact on the integrality that the Medical Sciences professional obtains thanks to the process of postgraduate improvement, where the acquisition of an adequate economic culture perfects said integrality [14].The necessary organization of the pedagogical process, which promotes the acquisition of the economic culture of the different subjects involved, must fulfill an economic and labor function that is expressed in the preparation of the subject to be inserted, in a special way, in the productive life of society. , as a protagonist in the creation of goods that can be material and spiritual that make it possible to satisfy needs and contribute to development [15]. In this way, economic culture is considered an essential part of a much more complex process to achieve an integral culture that goes from the appropriation of knowledge, skills, values and attitudes that emanate from economic activity to active participation in the transformation of the society and self transformation of the subject. For this reason, economic culture must be conceived as an individual and social need that characterizes the modes of action of individuals towards economic activity [47].

Health professionals are characterized by making economic decisions, especially those who work in direct patient care. Which treatment would be better to recommend from the available alternatives? How much can a patient benefit from one treatment or another? What impact does neglecting epidemiological surveillance have on primary care? How many years of life potentially lost does a risk factor imply for a patient? These are daily questions for Public Health Sciences whose questions are answered from an economic perspective [48]. Life is considered sacred and very valuable among other things because of its finitude. Therefore, the lifetime and life itself can be considered as economic resources on which it is necessary to make the best decision in order to optimize their use [48]. In this sense, the role of the Health Sciences professional, and particularly of the Medical Sciences, is decisive due to its direct impact on the patient’s decision. For this reason, training competent professionals with an economic perspective in decision-making and in their interaction with the patient constitutes a constant objective need for the National Health System. Postgraduate training in terms of economic culture, understood in terms of the culture of optimizing results through decision-making, should be sufficient to provide the health leader with strategies and scientific methodologies that contribute to decisions that optimize the use of time. Of life and life itself [49]. Postgraduate training for health managers must constantly face the challenge imposed by the paradigm of the divorce between Public Health and the Economy. In this way, Higher Education is responsible for showing the close interrelationship between the two. In addition, it has the constant commitment to improve and deepen the relationships established between Economic Sciences and Health Sciences with the purpose of positively affecting society, by increasing living standards and quality [50].

The great contribution of the Marxist doctrine to Economic Theory was to identify the special merchandise labor force as a creator of value, capable of transforming inputs into a final product, whether these are tangible or not. Therein lies the essence of the value of human capital for Health Sciences: the ability to transform the environment that surrounds them based on well-defined objectives to optimize the individual and social well-being of the community where they work [51]. For this reason, the human capital in Health Sciences will be increasingly revalued to the extent that it is capable of incorporating more knowledge of Economic Sciences in its daily performance through the acquisition and cultivation of a consistent economic culture. This Public Health challenge becomes more acute to the extent that Cuban society advances towards higher levels of development, because the commitment of the country’s political leadership with economic and social development will only be fulfilled if individual and social human health corresponds to with the needs to satisfy for development. For this reason, the acquisition of economic culture in professionals of the Health Sciences is a social and political necessity [52]. The effectiveness and efficiency of improvement in terms of economic culture for the Public Health sector must pass the filter of discriminating the specific and particular needs for improvement in terms of economic culture, ranked according to priority level. In other words, each natural and/or legal person at the service of Public Health must be aware of the importance of improving themselves in terms of economic culture and must be given the corresponding place in the improvement priorities. In this way, both at a personal and institutional level, improvement in terms of economic culture will better fulfill its role in the corresponding context [53]. The aforementioned implies that there is a very significant institutional responsibility regarding the improvement in economic culture for the Public Health sector, due to the social commitment of these legal persons with the social development of the community where they work. Health institutions must have their improvement needs well defined in terms of economic culture and involve all the individuals at their service in this improvement process according to the particular needs of each individual that are pre-established according to the social development strategy to be followed [54].On the other hand, improvement in economic culture for the health sector, in addition to contemplating the specific and particular needs for improvement, must be consistent with the characteristics of each health institution. In addition, the improvement in economic culture for the health sector should not be massive, but in accordance with the defined priorities. This argument does not exclude carrying out a large-scale economic improvement activity, but rather alludes to the role that the improvement strategy must play in the organization and use of the specific form of improvement in terms of economic culture [55].

The problems of the economy, in its broadest sense, are reflected in each of the sectors that comprise it. Public Health is not excluded from this statement. Like any other activity, health services consume resources to fulfill the purpose of maintaining and raising the state of health [56-58]. It is not necessary to be an economist to understand the dynamics of Public Health by monitoring the expenditure of the approved budget, but the way in which social wealth is created and the destination of these resources, including the sector, must be of individual and social interest. of Public Health. The economic culture defines a rational lifestyle, in accordance with the social precepts established by a community that is not alien to the professionals of the Public Health Sciences. Therefore, economic culture is present, in one way or another, in all the individuals that make up society, to the degree that each individual has cultivated an economic culture consistent with the historical moment in which they live, they will be able to adapt and integrate better to the social context and better perform as a human being from an individual, professional or social point of view [59]. Social and human development is limited by the real availability of resources necessary to sustain this development. No social sector in any context has unlimited availability of resources to support said development because these resources are scarce. For this reason, the optimal degree of development to be achieved by each sector will be determined by the most efficient, effective and effective use that it makes of its available resources [60]. Common terms of economic culture such as those already mentioned (efficiency, effectiveness, and efficacy) are in common and daily use at all social levels by all individuals, often empirically, without becoming aware of the influence of economic culture on your own decision. This fact in itself does not deny the social role of economic culture, but rather accentuates it [61].

The Public Health sector does not escape the reality described above. The health professional must be able to act and perform with economic rationality, beyond what simple instinct dictates, based on an economic culture solid enough to protect their behavior. The economic culture should serve as a theoretical-practical and methodological reference for the Public Health professional in their work performance, by perfecting their skills and sense of rationality. The development of economic culture must penetrate deep into the thinking of the Public Health professional until it merges in their conscience in the form of economic conscience. The health professional must be prepared to know how to properly manage the resources. This implies, for example, that they must know the approximate quantity of medication of each type that should be available in an emergency room and why; what type of medication itself is more effective in treating a specific patient, according to their symptoms, or what medical therapy a specific patient should follow according to their condition. In all these cases, the decisions of the health professional are based on the same techniques that are used to carry out a market study, in this case of the Public Health market. However, the most evident example of the relationship between Health Sciences and Economic Sciences is Health Economics. This is a relatively young science, but in itself, it represents the practical way in which Economic Sciences are used in Public Health Sciences. This science is present in the administration of Public Health and is a solid tool for an adequate management of the economic resources available for Public Health, to which we owe, for example, the studies of the economic burden and cost of the disease, very useful tools in Public Health for decision-making, whose impact on the administration of Public Health is unquestionable. It is also present in the conception, projection and execution of the budgets of the health institutions based on their primary interests. The result of these activities has a direct impact on the provision of health services of the institutions involved, whose optimal efficiency will depend on the degree of application of the economic culture of health professionals in the relevant service [62].

In addition, it is used for decision-making based on cost-utility, cost-effectiveness and cost-benefit relationships, relationships widely used by Public Health professionals, which are taken as the basis for prioritizing priority levels according to interests. Primary and secondary that determine the object of the decision. Therefore, it is evident that an adequate economic culture is decisive in the social impact of the service provided to society by health professionals [63].

The knowledge and application of techniques and tools that lead to an intense use of resources are of singular practical importance. In this sense, among the main axes of the strategies of the National Health System, the fight for efficiency and quality has been prioritized, as well as the sustainability of this system [17]. Scientific research carried out in the field of Health Economics must have, as its main purpose, solving the problems associated with efficiency in the sector. The economic analysis developed on scientific bases is an important starting point to achieve this purpose. The object of study of both also determines the interrelation and interdependence between the Economy and Public Health. On the one hand, Economics focuses its study on the individual and social interrelation of the subjects that constitute the study population. On the other hand, Public Health focuses its attention on individuals and societies with the aim of studying, modifying and optimizing the individual and social well-being of the study population. For this reason, the social aspect must be the cause of convergence based on the welfare of society in both cases. To achieve the aforementioned convergence, Public Health professionals need a solid foundation in economic culture that allows them to contribute to the necessary relationship between Public Health and the Economy. In this regard, improvement in terms of economic culture must play a leading role that serves as an integral guide so that Public Health professionals are sufficient in their professional skills from the point of view of economic culture, where the interrelation between Public Health, Economics, Pedagogy and Higher Medical Education of, as a result, a finished product that promotes, encourages and deepens the integration of the Economy with Public Health through economic culture [64].

Postgraduate Education arose because of the impetuous development of the productive forces and of Education in general. In the particular case of Higher Education, It constitutes the highest level within the national education system [65]. Training is a process that develops permanently, throughout the life of the human being. It has a dynamic that is personal and is shaped through systematized learning at school, daily life, in the family, the community and, in general, in the system of social relationships established by the subject [66,67]. The professional training process is a priority aspect in any educational system and the continuity of this training translates permanently, for the sake of professionalization processes oriented in a way that guarantees the quality of the effective and efficient preparation of professionals, from a constant update that leads to professional and social development, expressed in the performance of their professional and academic activities, as well as sociocultural enrichment [67,68]. The training and improvement processes agree that they contribute to the improvement and development of professional and academic activities, as well as the enrichment of their cultural heritage. However, professional improvement differs from training, firstly, because of its continuous and permanent nature and, secondly, because of the level of approach to professional practice that occurs to a greater degree than in the second. Both have common features and complement each other in the ongoing training process of professionals, but they have features that differentiate them [19]. The existence of different positions consulted allowed us to establish different starting points and thus recognize the diversity of terms that are associated with the definition of performance such as job performance, professional performance and job performance, among others. Within the references addressed, the research assumes the epistemological support of Advanced Education, from where an important group of researchers work with this term, find common features in its conceptual definition, which reveals diversity from unity. This allows us to deduce that, in its systematization, the conceptual, procedural and attitudinal apparatus has been built around professional performance, which reaches the parameterization of its objects of study. Given the need and the challenges of having more knowledge, as well as effective and real access to it, the university is projected with a new dimension that responds to the historical evolution of postgraduate education. The challenges of Higher Education for this century raise the need for a new educational process, based on the principles of excellence, quality and relevance. Schools and faculties of Medicine throughout the world, to a greater or lesser extent, have started this work with a special characteristic: that of integrating education into production processes and services [69]. One of the challenges that has been raised in many countries in recent years represents the quality of training and improvement of human resources. This process has been directly linked to the political, economic and social changes that have been generated in the different countries, in which the social development of science, technique, practice and research have forced to apply not in the discourse, but in effective practice, the concepts of efficiency, quality and demand in the educational processes carried out by universities, increasingly committed and in interaction with society [70].

The development and consolidation of the pedagogical model of the new university takes place in a social and historical context marked by conditions different from the existing models, which implies a rethinking of the theoretical foundations assumed up to the present, or its contextualization in the new educational scenarios, which allows higher education institutions not only to adapt to new contexts but, above all, to anticipate future scenarios. The changes that derive from the continuous development of the current Cuban university precipitate with a growing dynamic and the spaces that demand, more and more, a high quality in the training and improvement of teachers and managers are greater, since the demands are more heterogeneous and they vary constantly. For this reason, the need to contribute to the continuous improvement of the managers who work in the faculties of medical sciences increases, who must be able to link the task, not only with the realities of the external context, but also with their own demands, all which requires the fulfillment of new performances.

The analysis of professional performance that has been established in recent times has shown from the consulted referents, that it is a variable to measure the transformation and improvement of the preparation of managers. This describes the ability of an individual to carry out actions, duties and obligations of their position or professional functions that a job requires. It is expressed in the actual behavior or conduct of the worker, in relation to the other tasks to be fulfilled, during the exercise of his profession. From the conception of Advanced Education, postgraduate education is promoted based on a process system, which promotes and demands the production of new knowledge and new qualities of knowledge itself; shaped by activity; to improve professional performance.

This conception responds to a set of reasonable assumptions that provide methodological support to these processes with their regularities, principles and laws that, when fulfilled, reveal a marked personological approach because it expresses the characteristics of the subjects that are involved in the process. The design of an improvement and training strategy for the academic directors of the University of Medical Sciences is conditioned to the development of new technologies, economic and social changes, the forms of university management in order to incorporate new knowledge and achieve a professional improvement oriented to the development of increasingly complex and responsible activities. As part of the study related to the process of professional improvement that is the object of study of this research, the link between performance and human improvement with economic culture in the managers of the University of Medical Sciences is considered relevant.

The theoretical-methodological foundations that support the research recognize economic culture as a historical process directly linked to the social development of man himself. Therefore, the process of improvement in economic culture of the academic directors of the Universities of Medical Sciences, confirms the relevance of the problem, as well as the need for its treatment. The improvement in economic culture for the academic directors of the University of Medical Sciences, must distinguish the needs for improvement, ranked according to individual and institutional level of priority. The academic director of the Universities of Medical Sciences must perform with economic rationality, based on a solid economic culture, which supports the development of their managerial functions. In the process of professional improvement of the academic directors of the Universities of Medical Sciences, the economic culture contributes to the continuous and permanent improvement of their managerial performance.

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