Financial Culture Among Medical Executives: Asessment and Work Plan in Santiago de Cuba

Abstract

Introduction: Introduction: The efficient management of resources in higher medical education institutions requires managers with strong financial skills, particularly in contexts of limited resources such as the Cuban healthcare system. Objective: To design, implement and validate a comprehensive methodology for developing financial literacy skills specifically tailored to the needs of managers at medical universities, taking into account the particularities of the Cuban institutional context and the health sector. Methods: A quasi-experimental study with a pre- and post-test design was conducted between January and March 2025, involving all 33 members of the board of directors. The initial assessment used a validated questionnaire (α=0.83) that evaluated five dimensions of financial literacy. This was supplemented by semistructured interviews with eight executives to explore qualitative perceptions. A documentary analysis of the 2018–2024 professional development plan further supported the identification of needs. The proposed methodology was structured into five theoretical and practical modules and was implemented through face-to-face sessions, practical workshops and group consultations. Results: The assessment revealed that 57.6% of managers were unfamiliar with basic financial concepts, 51.5% lacked training, and 84.8% felt uncertain when making decisions. The methodology developed included modules on conceptual foundations, budget management, economic evaluation in healthcare, financial transparency and practical integration. The post intervention evaluation showed significant improvements: mastery of basic concepts increased from 42.4% to 78.8% (p<0.001) and low self perceived knowledge decreased from 84.8% to 36.4% (p<0.001). The qualitative analysis revealed four emerging categories: self-perceived limitations, assessment of the training experience, professional transformation and institutional impact, with expressions indicating changes in attitude and behaviour. Conclusions: The methodology proves highly effective in developing financial literacy among medical education leaders, addressing the specific needs identified in the institutional assessment. The combination of quantitative and qualitative evidence supports its applicability in similar contexts.