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- ItemSomente MetadadadosEnsino de erros inatos do metabolismo na formação do pediatra geral(Universidade Federal de São Paulo (UNIFESP), 2019-04-29) Almeida, Claudia Bezerra De [UNIFESP]; Batista, Nildo Alves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The aim of this research was to investigate the Inborn Errors of Metabolism (IEM) education in pediatrician training, during residency, in the city of São Paulo, from the perspective of the supervisors. As a qualitative research, with a descriptive and exploratory approach, the supervisors were questioned individually through semi structured and structured interviews intended to characterize IEM teaching in residency; to describe the competencies developed during residency; and to discuss challenges and suggestions to improve IEM teaching in Pediatric residency. The data produced was submitted to content and thematic analysis, thematic modality. All the supervisors recognized the relevance of IEM teaching and described specific situations in theoretical and practical teaching during residency, however, in most cases IEM was not included in the program. The supervisors were questioned about the resident’s capability to diagnose and initially approach patients with metabolic diseases, and most of them asserted that the residents could suspect and refer IEM cases. The interviewees raised six challenges for IEM teaching: unprepared preceptors; two-years is not enough time to teach IEM in residency; the resident's lack of fundamental knowledge; difficulty in experiencing IEM cases; difficulty in accessing specialized staff; and difficulty in accessing diagnostic tests and specific therapies. And the suggestions proposed were: insertion or emphasis of IEM theoretical teaching in the program; increasing the accessibility to Metabolic centers; promoting internship in IEM; training specialists or adding of specialized teams in the service; promoting IEM theoretical teaching to pediatricians and residency preceptors; a longer duration of residency; and evaluation of resident’s knowledge in IEM. From the results, we were able to determine IEM teaching difficulties to improve these aspects of education in Pediatrician training.
- ItemSomente MetadadadosImplantação de um programa de Residência Médica em Medicina de Família e Comunidade no Sistema Único de Saúde (SUS) de município de grande porte da região metropolitana de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2019-07-26) Oliveira, Denize Ornelas Pereira Salvador de [UNIFESP]; Pinto, Nicanor Rodrigues da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Faced with the challenge of expanding access to and improving Primary Health Care quality in Brazil, the development of medical specialists in Family and Community Medicine (MFC) stands out as a central issue. In Brazil, the Ministries of Health and Education have been promoting public policies to address this gap and some Brazilian municipalities have strategically taken over the responsibility to organize and offer of places of medical residency in MFC. This study aims to describe and analyze the experience of implantation of the Medical Residency Program in Family and Community Medicine (PRMMFC) linked to the municipal administration of the Unified Health System (SUS) in the municipality of São Bernardo do Campo (SBC), highlighting the strategies adopted to attract and retain medical residents between 2013 to 2017. For that matter a qualitative applied research in the form of a case study was carried out. Public documents from local SUS management were used as source of information and evidence, as well as semi-structured interviews that were perfomed with key informants, including municipal SUS managers, residents, preceptors and coordinator. The data analysis was performed using the technique of Content Analysis and the theoretical framework of the Policy Cycle Approach. It was observed that the process of implantation of the PRMMFC within the SUS of SBC adopted strategies to attract residents that considered the dynamics of the labor market and used local processes of structuring and qualification of SUS. Investment in the training of preceptors; support for the role of residents and preceptors in the work process; offer of practice scenarios in a diversified service network and the actors commitment with the construction of the local SUS were identified as strategic elements for attraction and retention of medical residents. The adoption of a supplemental amount to the regular medical residency wages, which was enacted through a municipal law, appears to have been a fundamental element to attract and retain medical residents. The role of the program coordination in the implementation of program was highlighted, which points to the need for national studies on the role of supervision /director. As limitations of the implantation of the PRMMFC were mentioned: the low adherence of preceptors of other levels of the health care network under municipal SUS administration, the internal disagreements among managers about the concept of health care network and the failure to monitor and assess pedagogical processes pela Comissão de Residência Médica.
- ItemAcesso aberto (Open Access)Manual Para Implantação De Um Ambulatório De Cosmiatria Para Os Serviços Credenciados De Formação Em Cirurgia Plástica(Universidade Federal de São Paulo (UNIFESP), 2018-08-17) Santos, Leandro Menezes Lopes Dos [UNIFESP]; Haddad, Alessandra [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Cosmiatry is an area of medicine that aims to expand and extend procedures for maintaining the beauty and appearance of the skin and its appendix. In the majority of accredited training services in Plastic Surgery by the Brazilian Society of Plastic Surgery (SBCP) there are no specific outpatient clinics for attendance and training in Cosmiatry. Objective: To develop a Manual for the implantation of an Ambulatory of Cosmiatry for Accredited Training Services in Plastic Surgery in Brazil. Method: A review of the literature was made on the bases Scielo, Pubmed, Lilacs, selected articles on Cosmiatry. Researched as norms of the National Agency of Sanitary Surveillance (ANVISA) and of the Brazilian Association of Technical Norms (ABNT) for the implantation of medical outpatient clinics. A manual has been created with this data. A questionnaire was applied for method validation using a statistical method - Delphi methodology, together with a group of specialists. Results: Creation of a manual with the selection of contents validated by 7 judges, plastic surgeons with expertise in Cosmiatry, for the implementation of an outpatient clinic for teaching and training in this area. The manual was published in printed and electronic form. Conclusion: A manual was developed for implantation of a Cosmiatry outpatient clinic for Accredited Training Services in Plastic Surgery in Brazil.
- ItemSomente MetadadadosPrevalência da síndrome de burnout em residentes de cirurgia plástica no brasil.(Universidade Federal de São Paulo (UNIFESP), 2019-11-30) Lima, Edson Luiz De [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Plastic Surgery residency represents one of the most demanding training programs, with its residents undergoing constant stress and competition to prove their competence. As a result, this population may be more susceptible to Burnout Syndrome. Objective: Assess the prevalence of Burnout Syndrome among plastic surgery residents in Brazil. Methods: Primary, clinical, observational, descriptive, and cross-sectional study, conducted between November 2017 and February 2018. An online survey was conducted using a validated instrument, the Maslach Burnout Inventory, which, after due authorization, was sent to the residents of programs accredited by the Brazilian Society of Plastic Surgery and/or by the Ministry of Education. Burnout Syndrome was assessed by three dimensions (emotional exhaustion, depersonalization and personal accomplishment) and related to socio-demographic and occupational characteristics. Results: 68.5% (89/130) of plastic surgery residents obtained scores that were predictive of Burnout. Factors associated with Burnout Syndrome included: lack of leisure time (p=0.028), nights on call (p=0.042), having other jobs, in addition to the residency (p=0.009), worklife balance problems (p <0.001) and social and family relationship problems (p = 0.035). Conclusion: 68.5% of plastic surgery residents had symptoms of Burnout.
- ItemSomente MetadadadosResidência Médica Em Centro De Atenção Psicossocial: Reflexões Sobre Uma Formação Singular Em Psiquiatria Santos(Universidade Federal de São Paulo (UNIFESP), 2017-11-07) Unzueta, Leandro Bernardello [UNIFESP]; Uchôa-Figueiredo, Lúcia da Rocha [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Inaugurated in 2014 in the city of São Bernardo do Campo, a medical residency in psychiatry with a unique format until then, which is developed entirely within the scope of psychiatric reform, using the units of the Psychosocial Attention Network (RAPS) as training spaces. In addition, it is also a medical residency associated with a Municipal Health Department and not a Higher Education Institution (HEI), a unique difference that brings important singularities to the formation. The main objective of this research is to analyze and discuss the training experience of these residents through the analysis of their respective discourses. For this, semi-structured interviews were conducted with all residents of the first and second year, and the first academic year was given almost exclusively in a Psychosocial Care Center (CAPS). The collected data were analyzed using Discourse Analysis, in an attempt to identify contradictory, contrasting or similar meanings of dispute or partnership, thus evidencing the discursive positioning of the residents and their learning in the course of their experience. It is based on the hypothesis that there are differences between the traditional medical training, based on the guidelines of the Flexner Report, with the training model experienced in the CAPS that differs by its structure and practice. The results point out that a CAPS training provides greater challenges, as well as greater opportunities for learning and reflection according to the present characteristic elements, which we tried to highlight in this research. As a consequence, there is a training model that provides the psychiatrist with a broader perception of health users, as well as a more critical perspective on their actions.
- ItemSomente MetadadadosViolação Do Sigilo Profissional Em Mídias Sociais Por Acadêmicos De Medicina, Residentes E Cirurgiões De Um Hospital Universitário(Universidade Federal de São Paulo (UNIFESP), 2017-03-29) Silva, Diego Adao Fanti [UNIFESP]; Colleoni Neto, Ramiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: this study aims to identify, in the surgical environment, those who share more patient’s information through social medias and those who are unaware of the confidentiality rules of these medias. Methods: 5th and 6th graduates of Medicine, surgical residents and attending surgeons from the university hospital at the Federal University of São Paulo were surveyed between June and December, 2015. A questionnaire was applied evaluating demographic data, characteristics of mobile technologies use and social medias access, and knowledge regarding professional secrecy preservation on these medias. Results: 156 individuals (52 graduates, 51 residents and 53 attending surgeons; mean age 24, 28, and 59, respectively) participated in the study. Patient’s information was shared on social medias by 53% of the graduates, 86% of the residents and 32% of the attending surgeons (p < 0.05). Confidentiality preservation policies were unknown to 69% of graduates, 80% of residents and 62% of attending surgeons (p = 0.124). Knowledge regarding protocols to guide health care professionals about safe use of social medias was referred by 0% of graduates, 15% of residents and 22% of attending surgeons (p = 0.002). Conclusions: residents shared more patient’s information on social medias compared to graduates and attending surgeons. Knowledge regarding confidentiality rules was low for the 3 groups.