Navegando por Palavras-chave "Medical Education"

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    Análise do currículo de um curso de medicina em implantação no interior do estado de Minas Gerais
    (Universidade Federal de São Paulo (UNIFESP), 2021) Barreiro, Francisca Raimunda De Souza [UNIFESP]; Ferreira, Beatriz Jansen [UNIFESP]; Universidade Federal de São Paulo
    The research aimed to analyze the curriculum of a medical course in implementation in the state of Minas Gerais in the light of articles 3o, 5o, 26, 29 of the Diretrizes Curriculares nacionais (DCN), of 2014. To achieve the objective, we opted for a qualitative methodology, with a descriptive and exploratory case study. The research instruments were composed of a case study, semi-structured interview and focus group. Data analysis occurred through content analysis in the thematic modality. The context was within the scope of a medical course at a private university in the interior of the State of Minas Gerais created in 2018, with the admission of two classes of students, with 50 students per class (100 students). The study population was composed of the Coordinator of the medical course, ten professors, and fifteen students. The research evidenced the challenges and potentialities of the curriculum of this medical course compared to that proposed in the new DCN of 2014, and the initial trajectory of the training of the medical professional in the different and possible teaching-learning scenarios in the Sistema Único de Saúde (SUS) network. It was inferred that this medical course, in its initial trajectory, responded to the proposals of the DCN 2014, however, being clear the concern of the interviewees with the possibility of “change of focus” for a technical training from the contact with medical specialties in Secondary and Tertiary Care, being a possible influencer the presence of teachers who do not understand, or even do not value the work of Primary Care, and who were not trained in the proposal of the Expanded Clinic. It was inferred that, although the students understand the importance of critical, ethical, reflective training, and for this the need for disciplines that bring scientific, social and philosophical support for this formation, they still have an insecurity about the possibility of such disciplines occupying the "space" of disciplines with biologicist content, and this impairs the quality of medical training. Weaknesses are scored in the agreement of teaching-service integration. Despite the recognition of the importance of the perspective of interprofessional training, there is still a distance between interprofessionality andmultiprofessionality. The greatest challenge pointed out by all interviewees was the student-centered teaching proposal, with its autonomy in the construction of learning, facilitated by the teacher, and the development of the course based on a methodology with emphasis on constructivism (active teaching-learning methodology). However, students and teachers admit that the construction of autonomy in learning involves the use of active methodologies.
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    Assédio moral na formação médica: uma análise de cluster
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-08) Tokeshi, Ana Bresser Pereira [UNIFESP]; Fidalgo, Thiago Marques [UNIFESP]; Universidade Federal de São Paulo
    Medical students and residents’ victims of moral harassment suffer from unnecessary and avoidable mental illness. This study aims to identify those who have suffered moral harassment and those who were disturbed by this violence. Methods: We conducted a retrospective cross-sectional survey to assess experiences of moral harassment during medical school and the disturbance caused. Using categorical data grouping Two Step Cluster analysis, we identified factors associated to each type of harassment (isolation, humiliation, academical, physical, verbal and sexual harassment). For that, we used as measures being victim of harassment and being disturbed by harassment. Results: The sample comprised 180 interns and 97.8% reported to have suffered some type of harassment during medical school. Among those, 6.8% did not report disturbance by the harassment suffered. Three clusters were identified: Group 1, 62.7% male, reported the lowest rates of being victims of aggression of all types during medical school, except for physical harassment, and the lowest rates of being disturbed by the harassment, except for verbal harassment; Group 2, 37.5% male, had the highest rates of all types of harassment, except for physical harassment, and were always disturbed by this violence, except regarding verbal harassment; Group 3, 28.1% male, had the highest rate of physical harassment, and individuals were all disturbed by isolation, physical, verbal and sexual harassment. Conclusions: Our findings suggest that harassment in Brazilian medical school has an extremely high prevalence and it is similar to some countries. Moral harassment causes disturbance in medical students, but not equally distributed among them. The groups that suffer more harassment and perceive it as more disturbing were mostly composed by females. To the best of our knowledge, this is the first study that used cluster analysis to evaluate harassment among medical students. Future studies, especially qualitative studies (interviews, focal groups, participative observation), may provide answers that allow us to better understand the perpetuation of these aggressions.
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    Atenção básica no SUS: publicações do campus São Paulo da UNIFESP, 1994-2009
    (Associação Brasileira de Educação Médica, 2012-09-01) Hayashida, Marina Zoega [UNIFESP]; Jacinto, Stéphanie Caroline Gigliotti [UNIFESP]; Puccini, Rosana Fiorini [UNIFESP]; Lacaz, Francisco Antonio de Castro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: Know and systematize scientific production of UNIFESP, campus São Paulo, that presented contributions to the consolidation of SUS, in primary health care, from 1994-2009. METHODS: Qualitative-quantitative study, using bibliographic data arising from scientific journals indexed to Pubmed, Medline, Lilacs and Scielo. RESULTS: 98 works were collected, from which we realized an increase in the number of publications since 2003, mainly for teachers and technicians linked to the Departments of Preventive Medicine, Nursing, Speech Pathology and Pediatrics. Many of them were carried out in partnership with other universities and services. The evaluation of the contents of the publications was done from the categorization into four themes: politics, planning and management; health education; morbidity and health promotion. CONCLUSION: The relationship that UNIFESP researches have with SUS network has become constructive in the last seven years: there are efforts to increase its stability, improving its dynamics, planning and management.
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    Avaliação da disciplina observação da prática médica pelos graduandos de medicina da UNIFESP - Escola Paulista de Medicina
    (Associação Brasileira de Educação Médica, 2010-12-01) Garcia, Juliana Augusta Plens de Moura [UNIFESP]; Rampim, Danielle Bianchini [UNIFESP]; Schor, Paulo [UNIFESP]; Silva, Julieta Freitas Ramalho da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The article discusses the need to deal with physician-patient relations at the affective level, which requires models for humanization of care during undergraduate medical training. In 2003, the UNI-FESP School of Medicine launched a course on Observation of Medical Practices as part of the regular curriculum for first-year medical students. The observation was followed by discussion of experiences with lectures, reflection, and debate with medical faculty from various specialties. The aim of the study was to assess the immediate and long-term impact of the course on the 30 first to third-year undergraduates (10 students per year), using a quantitative (5 multiple-choice questions) and qualitative questionnaire (3 open questions, categorized after analysis and consensus between the two authors). The authors concluded that the course allowed presentation of medical practices to the early medical undergraduates, who had little previous contact with this reality. Over the course of the years, a change was observed in the students' perception of Observation of Medical Practice: students in the initial years tended to value emotional support for patients, while as the years went by the undergraduates focused more on the knowledge in their field of learning and their future professional work
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    Avaliação da evolução da empatia em alunos do quarto ano da graduação em medicina da UNIFESP em 2012
    (Associação Brasileira de Educação Médica, 2014-03-01) Thomazi, Lívia [UNIFESP]; Moreira, Fernanda Gonçalves [UNIFESP]; De Marco, Mario Alfredo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: This study consisted of reassessing empathy demonstrated by fourth-year medical students at UNIFESP after a prior evaluation in 2009 when the students were in the first year of the course, and a consequent comparison of the results obtained. METHOD: A validated instrument known as the Empathy Inventory (Falcone, 2008) was used to measure empathy among 80 fourth-year students at UNIFESP Medical School. The inventory features 40 questions in a Likert scale that assess four factors related to the ability to empathize: Adoption of a Perspective, Interpersonal Flexibility, Altruism and Emotional Sensitivity. RESULTS: Empathy among medical students at UNIFESP showed no statistically significant change from 2009 to 2012. CONCLUSION: The increased contact that students have with patients at the beginning of the course combined with the high number of curricular subjects focused on the humanities possibly explains the result. Students at the institution are able to develop the technique giving it a more humanist character and learning from the beginning how to treat patients, rather than illnesses.
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    Avaliação de empatia em residentes de especialidades clínicas e cirúrgicas da Universidade Federal de São Paulo (UNIFESP)
    (Associação Brasileira de Educação Médica, 2013-09-01) Suartz, Caio Vinícius [UNIFESP]; Quintana, Maria Inês [UNIFESP]; Lucchese, Ana Cecília [UNIFESP]; De Marco, Mario Alfredo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    In the field of health, empathy is defined as an attribute with cognitive and emotional dimensions that enables an understanding of inner experience and a perspective of the patient as a unique individual, plus the ability to communicate this understanding to the patient. The role of empathy is to identify and understand the patient's feelings, thus promoting an increase in trust, loyalty and respect between doctor and patient. Therefore, the following study was aimed at evaluating the empathy 3rd to 5th year medical residents from the Federal University of São Paulo to verify any possible differences between the empathy of physicians and surgeons and their relationship with the professional profile.
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    A avaliação do tutor realizada pelos discentes no Curso de Medicina da Unimontes
    (Universidade Federal de São Paulo (UNIFESP), 2011) Barreto, Nair Amélia Prates [UNIFESP]; Sonzogno, Maria Cecília [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To analyze the meaning assigned by the tutor for the evaluations performed by students of Medical Course at State University of Montes Claros on their performance regarding commitment, responsibility, technical ability, interest in the student individual needs and feedback provided by the students. Methodology: A qualitative, descriptive and exploratory study, whose subjects were 11 tutors of the Specific Content Module of the first and seventh periods of the second half of 2009. Structured interviews with analysis and interpretation of results were used to collect data according to thematic analysis. Results: The tutors were mostly female professors with master's and specialist course; predominance of the 40- hour work week system. Tutors of the first period had higher education and degree and have been working since a long time in the higher education, greater workloads and with more time working in mentoring. All tutors of the 7th period have employment in other institutions. The thematic categories observed in the interviews are: aspects that influenced the choice of tutoring; training in tutoring; knowledge of the evaluation performed by students at the end of each module; tutor´s idea regarding evaluation and tutor´s perception on evaluation via Intranet. Aspects that influenced the choice of tutoring: invitation and needs of the institution, interest in PBL methodology. Only a few teachers were trained; some subjects became tutors observing the action of other tutors. The evaluations performed by the students showed that they were not involved, as well as teachers and administrators were not committed to the results. Regarding the evaluation´s concept aspect, it was observed that all individuals know and understand the importance of conducting such a process, but some teachers are not interested in the students’ evaluations which support the changes. Conclusions: The teacher´s evaluation performed by the students should be a further stimulus for development of skills that allow us to reflect on the thought and criticism about the practice and praxis, on considering the individual and the other, and cooperative strategies on learning and multiple intelligence teaching approaches converging to allow different perspectives and practices of evaluation as a tool to measure the quality of teaching-learning process - aiming the objectives of the course. We expect that these findings will contribute to improve the academic staff´s perception about their role in the construction and curricular organization and therefore in the formation of new physicians, as provided in this Pedagogical Politic Project of this course.
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    Brazilian Residents' Attitude and Practice Toward Sexual Health Issues in Pregnant Patients
    (Wiley-Blackwell, 2012-10-01) Vieira, Teresa Cristina Souza Barroso [UNIFESP]; Souza, Eduardo de [UNIFESP]; Abdo, Carmita Helena Najjar; Torloni, Maria Regina [UNIFESP]; Santana, Tânia das Graças Mauadie; Leite, Alessandra Plácido Lima; Nakamura, Mary Uchiyama [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Hosp Perola Byington; Univ Estadual Ciencias Saude Alagoas
    Introduction. Sexual difficulties and questions regarding sexual function are frequent in pregnancy, yet they are infrequently discussed in academic communities, medical schools, and residency programs. Embarrassment, lack of experience, inadequate communication skills and insufficient knowledge on how to deal with sexual complaints, and questions in pregnancy are common, especially among young health professionals. Aim. the aim of this study was to assess and compare the attitude and behavior of Brazilian residents in three different medical programs (obstetrics-gynecology, internal medicine, and psychiatry) toward sexual health issues of pregnant patients. Methods. Survey conducted in a single Brazilian university using anonymous self-responsive questionnaires on how residents deal with sexual health issues of obstetric patients. A total of 154 residents from the three different programs (47 obstetrics-gynecology, 33 psychiatry, 74 internal medicine) participated. Main Outcome Measures. Attitude and practice of medical residents regarding sexual health issues of pregnant patients. Results. Less than 20% of the residents reported that they routinely asked obstetric patients about their sexual health, although almost 70% stated this should be part of every history. Psychiatry residents were significantly more likely to actively seek information about the sexual health of obstetric patients than others (57.6%, 17%, 4.1%, psychiatry, obstetrics-gynecology, internal medicine, respectively, P < 0.001). Although over 80% answered that most obstetric patients react well or indifferently to questions about sexual function, less than 25% of the residents reported being completely confident answering these questions, and 71% of them admitted that they lacked specific knowledge in the area of sexual dysfunctions. the two main obstacles in evaluating patients' sexuality were lack of specific knowledge and not enough time to explore these aspects in medical consultations, reported by 71% and 20% of all participants, respectively. Conclusions. Most residents do not feel comfortable or confident and lack specific knowledge and skills to deal with questions related to sexual problems during pregnancy. Vieira TCSB, de Souza E, Abdo CHN, Torloni MR, Santana TGM, Leite APL, and Nakamura MU. Brazilian residents' attitude and practice toward sexual health issues in pregnant patients. J Sex Med **;**:****.
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    Comparação entre os cursos ‘Treinamento em Emergências Cardiovasculares Avançado’ e ‘Advanced Cardiovascular Life Support’ no treinamento do atendimento à parada cardiorrespiratória para alunos de graduação de Medicina
    (Universidade Federal de São Paulo (UNIFESP), 2021) Furtado, Fabricio Nogueira [UNIFESP]; Almeida, Dirceu Rodrigues de [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Cardiopulmonary arrest (CA) is a prevalent condition associated with a high mortality rate. Thus, it is important that medical students receive adequate training for the treatment of this condition. Objective: To compare the "Advanced Cardiovascular Emergency Training" (TECA) course with the "Advanced Cardiovascular Life Support" (ACLS) course in the training of CA management to medical students. Methods: 119 last graduation year medical students were included. The students were divided into 2 groups: TECA group consisted of 56 students who participated in the TECA course and 63 students in the ACLS course, named ACLS group. Both groups performed a mannequin simulated CA care before and after participating in each course and a multiple choice test after training. Performance in simulated care was compared through structured assessment score, time to onset of chest compression and time to perform defibrillation after collapse, as well as the number of correct answers in the multiple choice assessment. Results: After training, TECA group presented statistical higher grade than the ACLS group in the evaluation of the simulated case attendance (10,0 points vs 9,0 points; p<0,001). There was no statistical difference between the groups in time to onset of chest compression (19,0 sec vs 19,5 sec; p = 0,500) and time to defibrillation (48,0 sec vs 48,0 sec; p = 0,740). TECA group students had a better performance in questions related to acute heart failure treatment (4,0 vs 3,0; p < 0,001). There was no significant difference in the number of correct answers on arrhythmia, cardiopulmonary resuscitation, acute myocardial infarction and stroke. Conclusions: TECA course provided greater adherence to CA care protocol, without prejudice to the time to start chest compression or time to defibrillation. In addition, it added training in acute heart failure management.
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    Concepções de práticas docentes de professores que vivenciaram a transição curricular no curso médico da Unimontes
    (Universidade Federal de São Paulo (UNIFESP), 2010) Souza, Anderson Gonçalves de [UNIFESP]; Sonzogno, Maria Cecília [UNIFESP]; http://lattes.cnpq.br/8179958381249653; http://lattes.cnpq.br/1293459110231326; Universidade Federal de São Paulo (UNIFESP)
    No ano de 2002, o Curso Médico da UNIMONTES passou por uma grande transformação com a mudança de currículo, abandonando uma metodologia tradicional de ensino e passando a utilizar uma metodologia ativa, baseada no ABP (Aprendizado Baseado em Problemas). É interessante ressaltar que muitos dos docentes do currículo tradicional, embora tivessem migrado para essa nova metodologia, davam a impressão de que continuavam a praticar o currículo tradicional dentro de uma metodologia ativa. A fim de estudar sobre semelhantes questões, foi realizada, neste trabalho, uma revisão dos documentos relativos a políticas públicas de educação que norteiam as tomadas de decisões sobre currículo, projetos pedagógicos (LDB, Diretrizes Curriculares para o Curso de Medicina, as Conferências Internacionais de Saúde), bem como o processo de ensino-aprendizagem, habilidades, competências e atitudes. Objetivou-se analisar a concepção de ensino-aprendizagem dos docentes do curso médico da UNIMONTES. Para tanto, desenvolveu-se uma pesquisa quantitativa e qualitativa, com predomínio do caráter qualitativo devido ao enfoque a questões sociais. Esta pesquisa foi realizada na UNIMONTES (Universidade Estadual de Montes Claros) e os sujeitos que a constituíram foram os professores, docentes do curso médico antes da mudança de currículo que ocorreu no ano de 2002, e que continuaram docentes de conteúdo específico no ABP. Além disso, foram aplicados questionários com questões objetivas, estruturadas para avaliar idade; formação didática e profissional; tempo de docência; capacitação para trabalhar com metodologias ativas e questões dissertivas nas quais os professores falavam sobre os documentos oficiais (LDB e Diretrizes Curriculares para o Curso de Medicina), as Conferências Internacionais, o processo de ensino-aprendizagem, as metodologias ativas e os currículos como meio de aprendizagem. Como resultados, notou-se a existência de uma população heterogênea com formação diversa, predominando o número de especialistas em relação ao número de mestres, destacando que a grande maioria participou de alguma formação para trabalhar com metodologia ativa. Porém, pouco se conhece sobre os Documentos Oficiais que regem a educação brasileira, bem como a importância das Conferências Internacionais para a Saúde. Existem concepções equivocadas sobre o processo de ensino-aprendizagem e existem diferenças na forma de trabalhar as habilidades, competências e atitudes. Entende-se que o ABP propicia maior oportunidade de aprendizagem, pois leva o estudante a ser mais crítico e a buscar ativamente o conhecimento. Nota-se que houve um progresso dentro da UNIMONTES com a adoção de metodologia ativa no curso médico; entretanto, há necessidade de maior capacitação docente, tanto por treinamentos internos com cursos de aperfeiçoamento para trabalhar com metodologias ativas quanto com a profissionalização dos docentes com titulações de mestres e doutores.
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    Conhecimento e interesse em ética médica e bioética na graduação médica
    (Associação Brasileira de Educação Médica, 2008-12-01) Almeida, Alessandro de Moura; Bitencourt, Almir Galvão Vieira; Neves, Nedy Maria Branco Cerqueira; Neves, Flávia Branco Cerqueira Serra; Lordelo, Marina Da Rocha [UNIFESP]; Lemos, Kleuber Moreira; Nuñez, Geila Ribeiro; Barbetta, Marcelo Campos; Athanazio, Rodrigo Abensur [UNIFESP]; Nery-filho, Antônio; Universidade Federal da Bahia; Escola Bahiana de Medicina e Saúde Pública; Universidade Federal de São Paulo (UNIFESP); Instituto do coração da Bahia Hospital Ana Nery; Universidade Federal da Bahia Hospital Universitário Professor Edgar Santos
    OBJECTIVES: To evaluate the interest and knowledge about Medical Ethics and Bioethics in medical graduation. METHODS: Transversal and descriptive study. Two different questionnaires were applied with questions about the interest in Medical Ethics and Bioethics and the knowledge about the Brazilian Code of Medical Ethics (CME), one to professors and the other to students. RESULTS: One hundred and one professors and 331 students answered the questionnaires. The Brazilian CME had been read by 86.2% of the teachers and by 100% of the students. The importance given to the discipline Medical Ethics, on a scale from 1 to 5, was similar among teachers and students (4.7 ± 0.7 vs. 4.5 ± 0.8; p = 0.086); however the self-evaluation on knowledge about this subject was higher in the first group (3.4 ± 0.9 vs. 3.2 ± 0.7; p = 0.017). In a block with 9 questions, the right answer was given by 5,0 ± 1.9 of teachers and 5.9 ± 1.5 of students (p < 0,001); the mean of correct answers were related to the reading of the CME. CONCLUSIONS: The present study presents unpublished data about the perception of medical teachers and students about medical ethics and bioethics and can be useful for improving the teaching of these disciplines in our medical schools.
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    Da aprendizagem fragmentada ao desafio de uma formação integral: narrativas da construção do saber
    (Universidade Federal de São Paulo (UNIFESP), 2019-07-02) Araujo, Joao Felix Leandro de Sousa [UNIFESP]; Kinker, Fernando Sfair [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    For years medical training has been carried out in a fragmented way, reducing the complexity of the individual to organs and systems, neglecting socio-cultural aspects, as well as the dynamics and the interaction of the individual in the family and community sphere. Recently, with the last change made in the National Curricular Guidelines of the Undergraduate Course in Medicine (NCG) in 2014, the proposal arises that medical education should have an expanded formative character, with a general, critical, reflexive and ethical formation in purpose to form an egress enabled for action at different levels of health care, able to handle various pathological conditions indistinctly, to perform the coordination of care and management of the clinic. The objective of this study is to analyze the perceptions, expectations and experiences of undergraduate students of the third year of medicine at the Centro Universitário São Camilo, in the context of a discipline with a comprehensive approach to care, trying to understand the phenomenon of knowledge formation, starting with it is a logic of teaching fragmented by focal specialties, until arriving at one whose focus on integral care is the counterpoint of the previous formation. This is a qualitative, descriptive study, guided by the documental analysis of field diaries produced by the students, the researcher's field diary, and discourse analysis in conversation wheels, aiming to discuss the ideas and experiences in the outpatient clinic visits, as well as their role in the student's formation as a future generalist. The conclusion that has been reached is that even many changes that the medical curriculum has undergone over the last decades, we still have a categorized, fragmented formation with few moments to reflect on the practice, even in a non-flexible Fordist model, where more emphasis is placed on the content to be taught than the subjects' autonomy. At the same time, it has advanced in many dimensions of teaching, having demonstrated the research experience that the dialogic and reflexive process of teaching can contribute much with a quality education and that values the ethical aspects of care.
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    Dealing with Female Sexuality: Training, Attitude, and Practice of Obstetrics and Gynecology Residents from a Developing Country
    (Wiley-Blackwell, 2015-05-01) Vieira, Teresa Cristina Souza Barroso [UNIFESP]; Souza, Eduardo de [UNIFESP]; Silva, Ivaldo da [UNIFESP]; Torloni, Maria Regina [UNIFESP]; Ribeiro, Meireluci Costa [UNIFESP]; Nakamura, Mary Uchiyama [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    IntroductionThere is little research on how obstetrics and gynecology (Ob/Gyn) residents deal with female sexuality, especially during pregnancy.AimThe aim of this study was to assess the training, attitude, and practice of Ob/Gyn residents about sexuality.MethodsA cross-sectional survey of Brazilian Ob/Gyn residents enrolling in an online sexology course was conducted. A questionnaire assessed their training in sexuality during medical school and residency and their attitude and practice on sexual issues during pregnancy.Main Outcome MeasuresTraining, attitude, and practice of Ob/Gyn residents regarding sexuality were the main outcome measures.ResultsA total of 197 residents, from 21 different programs, answered the online questionnaire. Mean age was 27.92.2, most were female (87%), single (79%), and had graduated in the last 5 years (91%). Almost two-thirds (63%) stated that they did not receive any training at all and 28% reported having only up to 6 hours of training about sexuality in medical school. Approximately half of the respondents (49%) stated that they had received no formal training about sexuality during their residency up to that moment and 29% had received 6 hours of training. Over half (56%) never or rarely took a sexual history, 51% stated that they did not feel competent or confident to answer their pregnant patients' questions about sexuality, and 84% attributed their difficulties in dealing with sexual complaints to their lack of specific knowledge on the topic.ConclusionThe vast majority of Brazilian Ob/Gyn residents enrolling in a sexuality course had little previous formal training on this topic in medical school and during their residency programs. Most residents do not take sexual histories of pregnant patients, do not feel confident in answering questions about sexuality in pregnancy, and attribute these difficulties to lack of knowledge. These findings point to a clear need for additional training in sexuality among Brazilian Ob/Gyn residents. Vieira TCSB, de Souza E, da Silva I, Torloni MR, Ribeiro MC, and Nakamura MU. Dealing with female sexuality: Training, attitude, and practice of obstetrics and gynecology residents from a developing country. J Sex Med 2015;12:1154-1157.
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    Desempenho docente no contexto PBL: essência para aprendizagem e formação médica
    (Associação Brasileira de Educação Médica, 2013-06-01) Almeida, Enedina Gonçalves; Batista, Nildo Alves [UNIFESP]; Universidade Estadual de Montes Claros; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To investigate the opinions of teachers from the medical course at Unimontes about experiences in active learning and the PBL curriculum. METHODS: A group of 38 teachers, tutors, module builders and coordinators, instructors and preceptors, from the first, fourth and sixth years. Quantitative (questionnaire, analyzed and expressed in graphs) and qualitative (semi-structured interviews with subsequent content analysis) approaches were used. RESULTS: A change in posture was identified by the teachers, particularly in terms of: greater responsibility for student learning (44 mentions), teacher's active participation in the curricular construction (37 mentions) and a learning facilitation role played by teachers (32 mentions). A lack of teacher commitment/involvement was found (27 mentions) and teachers' inexperience with the PBL (12 mentions). CONCLUSION: Active learning has been recognized as the basis for future professional activities and the PBL as a potential curriculum-guiding strategy. The curriculum proved to be essentially challenging in relation to teacher commitment/ability to play diverse, multidisciplinary and learning facilitator roles. Further studies are still required into the repercussions of teacher performance and the learning differentials of the PBL on medical practice and public health needs.
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    Ensino-aprendizagem da política nacional de medicamentos (RENAME e URM) na Graduação Médica da Universidade Federal do Tocantins
    (Universidade Federal de São Paulo (UNIFESP), 2014-03-21) Andrade, Elizangela Braga [UNIFESP]; Goldenberg, Paulete [UNIFESP]; http://lattes.cnpq.br/8655470743072105; http://lattes.cnpq.br/6173321272814063; Universidade Federal de São Paulo (UNIFESP)
    O estudo teve por objetivo geral caracterizar o ensino sobre a Política Nacional de Medicamentos (PNM) na graduação médica da Universidade Federal do Tocantins, focalizando a instituição e seus atores - coordenador do curso, docentes e alunos. Trata-se de um estudo descritivo, em caráter exploratório, apoiado em abordagem qualitativa, que comportou três movimentos investigativos. O primeiro se propôs a identificar, por meio do Projeto Político e Pedagógico, as disposições relativas ao ensino disponibilizado na instituição. O segundo, através de entrevistas semiestruturadas, buscou apreender o ensino da questão do medicamento na perspectiva do coordenador do curso e de docentes das disciplinas de Saúde Coletiva, Saúde da Família: Vivências em Atenção Básica I, Farmacologia Básica e Farmacologia Médica. O terceiro movimento, por sua vez, utilizando a estratégia de grupos focais, viabilizou a qualificação deste ensino sob a perspectiva de estudantes no ciclo básico (sétimo período) e no internato (nono e décimo períodos). Para efeito de análise, foi utilizada a técnica de análise do conteúdo, modalidade temática. Os resultados mostram que o PPP especificou o propósito de formar o aluno para atuar no SUS, com conhecimento aprimorado para as necessidades da população amazônica. Para tanto, em conformidade às Diretrizes Curriculares Nacionais, preconiza a articulação entre a instituição formadora e os serviços de saúde. De forma coerente, ao lado da valorização do ensino pela prática, na perspectiva pedagógica, o projeto aponta para o recurso às metodologias de participação ativa do aluno. No entanto, o PPP não permite antever o tratamento político explícito da questão dos medicamentos. As ementas das áreas de conhecimento da Saúde Coletiva e Farmacologia não abordam a questão formalmente e seus conteúdos não se cruzam. No Internato, algumas áreas discutem o tema, mas de forma pontual. Na perspectiva do coordenador do curso a temática não é priorizada na universidade como deveria. Os professores, por sua vez, afirmaram a falta de preparo a respeito da PNM. Segundo eles não constam do conteúdo programático das disciplinas a abordagem sobre a RENAME. A URM constitui tema mais valorizado, particularmente na Farmacologia, prevalecendo o foco restrito do ensino ao tratamento individual. Os estudantes declararam, enfim, que não foram orientados de forma sistemática sobre a assistência farmacêutica no SUS e reconheceram que esta falta de orientação compromete a prescrição e o acesso dos pacientes aos medicamentos (por eles) indicados. Diante do exposto, emerge a sugestão de aprimorar a relação teórico-prática desde o início do curso, sendo apontada “a prescrição e o acesso aos medicamentos no SUS” como temática relevante a ser explorada em todas as oportunidades existentes no currículo.
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    Estado atual do ensino da laparoscopia nas residências médicas de ginecologia e obstetrícia do Brasil
    (Universidade Federal de São Paulo, 2023-02-15) Kikuchi Fernandes, Carla Ferreira [UNIFESP]; Sartori, Marair Grafio Ferreira [UNIFESP]; Ruano, José Maria Cordeiro; http://lattes.cnpq.br/8840004947952367; http://lattes.cnpq.br/2545470341657690; http://lattes.cnpq.br/5105239766790064
    Introdução: A residência médica é considerada o mais importante passo após a graduação e o melhor método de ensino para cirurgiões Em 2020, o Brasil atingiu a marca de quinhentos mil médicos. Por ser um país de grandes dimensões, com diversidades culturais e desigualdade socioeconômica, conhecer o estado atual do ensino nos Programas de Residência Médica de Ginecologia e Obstetrícia (PRMGO) é essencial para melhorar a qualidade do ensino aos médicos e a assistência aos pacientes. Objetivo: Caracterizar o ensino de laparoscopia nos PRMGO do Brasil. Objetivos secundários: Avaliar as características dos preceptores dos programas de laparoscopia e determinar os cenários das práticas dos treinamentos. Método: Estudo descritivo transversal, com avaliação de questionário enviado aos Coordenadores dos PRMGO brasileiros, no período de fevereiro de 2019 a abril 2021. Resultados: Enviouse o questionário para 175 Coordenadores de PRMGO e houve 90 respostas (51,4%). Foram excluídos 5 registros. Dos 85 programas, 67 têm treinamento em laparoscopia. Os programas localizavam-se em 50% no Sudeste, concentrando-se nas capitais. Os coordenadores têm média 45,4 anos, 62,7% são do sexo masculino e 37,3% realizam ativamente laparoscopia. O responsável pelo setor de laparoscopia apresenta experiência avançada na maior parte dos serviços, assim como os preceptores. Os residentes participam ativamente das cirurgias exceto em 1 serviço e em 39,4% têm treinamento em laboratório ou centro de treinamento cirúrgico. No laboratório, a maior parte tem treinamento com simulador físico. Apenas 28,9% dos serviços sem laboratório têm planejamento de montar estrutura nos próximos 3 anos. Dos 26 serviços com treinamento fora do Centro cirúrgico, 80,8% têm treinamento como parte formal do currículo e 61,5% têm períodos reservados dentro da grade horária. Somente 46,2% têm mais de 20 horas de treinamento formal por ano. Em 38,5% dos serviços, o treinamento não é avaliado. A maior parte dos serviços avaliaram ser “importante” o treinamento em laparoscopia no laboratório antes de entrar em cirurgias, ser “importante” avaliação objetiva da aptidão em laparoscopia e ser “importante” ter um laboratório no serviço. Conclusão: O ensino de laparoscopia nos no Brasil apresenta ensino heterogêneo e desigual, sendo que 20% dos programas não apresentam ensino em laparoscopia. Os preceptores dos serviços com treinamento em laparoscopia têm experiência avançada e participam dos treinamentos de laboratório e de centro cirúrgico. Apenas 23,5% (20) programas analisados têm laboratório ou centro de treinamento próprio. Dos 65 serviços sem laboratório 29,9% não têm planejamento de montar a médio prazo um centro de treinamento.
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    Estilo de vida e formação médica: impacto sobre o perfil nutricional
    (Associação Brasileira de Educação Médica, 2012-09-01) Mota, Maria Carliana; Souza, Daurea Abadia de; Mello, Marco Tulio de [UNIFESP]; Tufik, Sergio [UNIFESP]; Crispim, Cibele Aparecida [UNIFESP]; Universidade Federal de Uberlândia; Universidade Federal de São Paulo (UNIFESP)
    The training of the medical profession imposes harmful changes to lifestyle, which predisposes to weight gain. The aim of this study was to review the prevalence of overweight and obesity and possible causative factors in these rates in medical students (MS) and residents physicians (RP). We conducted a search of the databases online: PubMed / Medline (U.S. National Library of Medicine), Scielo and Lilacs with the keywords: medical students and residents associated with each of the terms: body mass index (BMI), obesity, overweight, food intake, sendentarism and sleep, and using the translation of these terms for the English language Thirty one studies were selected, where 25 were performed with EM, five with MR and one with both the populations. Sixteen studies indicated high prevalences of overweight and obesity (ranging between 15% and 83%). Regarding factors associated with weight gain, have stand out inadequate food intake. The excessive daytime sleepiness, sleep deprivation and sedentarism were widely identified. These results underscore the need to develop actions to minimize the negative effects of routine imposed by the process of medical training, especially those aspects related to excess weight.
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    A Estratégia Saúde da Família como cenário de aprendizagem: Análise de uma experiência de interação ensino-serviço na formação médica
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-26) Fassina, Vanessa [UNIFESP]; Mendes, Rosilda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The implementation of National Curricular Guidelines for medical graduation, from 2001, led to initial changes in training through the integration of teaching with the health system and also through the decentralization of the hospital learning scenario to Primary Care. The update, in 2014, has maintained the objective of providing a generalist, humanistic, critical and reflexive education, which favors the interaction of users and health professionals since the first years of graduation. From this perspective, it is proposed the use of new teaching methodologies and expansion of the learning scenarios that privilege the active participation of the student in the knowledge construction. As the activities take place in a practice context, the challenge is to permanently involve the professionals in the training process. This qualitative study, with the researcher's implication, aims to analyze the perception of students and teachers of a private university in the state of São Paulo, health professionals and municipal management in order to identify the contributions that the teaching-service interaction can offer for the production of a meaningful learning space in medical training. To obtain the data, it was conducted round table discussions with the students of the first, third and fifth periods of the Medicine course, semi-structured interviews with health professionals and municipal management and university teachers, as well as the elaboration of a research diary. The data were analyzed using the Content Analysis technique, with the disclosure of three categories of meaning. The first, Learning scenario: the practice in the health unit, which revealed that the insertion of students in a Family Health Unit favored the development of the physician patient relationship, experience the physician's work routine besides knowing the specificity and complementarity of the professions, however, there was little opportunity to practice what they learned in theory. The second, Learning scenario: opportunities and limitations of Home Visit, the home was a scenario in which students could learn more about the patients' life and not only have the punctual contact in the search of diseases; they could also develop skills such as communication and listening, but they complained about the repetitive frequency that they go to the houses and stay with the same families. The last one, (Un) meetings between students and health professionals, the fragile contact between them led to a lack of opportunity for creating a relationship and acquiring knowledge through the interprofessional practice. This study showed that the Family Health Strategy can contribute as a space for the production of meaningful learning, and it is necessary to recompose the relationships between subjects involved, as well as a permanent space for discussion about this new role of services training.
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    Acesso aberto (Open Access)
    Evaluation of self-perception of mechanical ventilation knowledge among Brazilian final-year medical students, residents and emergency physicians
    (Hospital Clinicas, Univ Sao Paulo, 2017) Tallo, Fernando Sabia [UNIFESP]; Vieira Abib, Simone de Campos {UNIFESP]; de Andrade Negri, Alexandre Jorgi; Cesar Filho, Paulo; Lopes, Renato Delascio [UNIFESP]; Lopes, Antonio Carlos
    OBJECTIVE: To present self-assessments of knowledge about mechanical ventilation made by final-year medical students, residents, and physicians taking qualifying courses at the Brazilian Society of Internal Medicine who work in urgent and emergency settings. METHODS: A 34-item questionnaire comprising different areas of knowledge and training in mechanical ventilation was given to 806 medical students, residents, and participants in qualifying courses at 11 medical schools in Brazil. The questionnaire's self-assessment items for knowledge were transformed into scores. RESULTS: The average score among all participants was 21% (0-100%). Of the total, 85% respondents felt they did not receive sufficient information about mechanical ventilation during medical training. Additionally, 77% of the group reported that they would not know when to start noninvasive ventilation in a patient, and 81%, 81%, and 89% would not know how to start volume control, pressure control and pressure support ventilation modes, respectively. Furthermore, 86.4% and 94% of the participants believed they would not identify the basic principles of mechanical ventilation in patients with obstructive pulmonary disease and acute respiratory distress syndrome, respectively, and would feel insecure beginning ventilation. Finally, 77% said they would fear for the safety of a patient requiring invasive mechanical ventilation under their care. CONCLUSION: Self-assessment of knowledge and self-perception of safety for managing mechanical ventilation were deficient among residents, students and emergency physicians from a sample in Brazil.
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    A Extensão Universitária e a Formação Médica: contribuições da experiência da participação no projeto Cananéia da UNIFESP
    (Universidade Federal de São Paulo (UNIFESP), 2010) Santos Júnior, Carlos Francisco dos [UNIFESP]; Maia, José Antonio [UNIFESP]; http://lattes.cnpq.br/6800730020293642; http://lattes.cnpq.br/4654790367926039; Universidade Federal de São Paulo (UNIFESP)
    O presente trabalho voltou-se para o estudo da articulação, no contexto acadêmico, da Extensão como um componente do processo de Ensino-Aprendizagem e Pesquisa, tomando como objeto o Projeto Cananéia, da Universidade Federal de São Paulo. Esta iniciativa, realizada no Município de Cananéia (SP) a partir de 1997, foi desenvolvida a partir da iniciativa dos próprios estudantes, recebendo amplo apoio da Pró-Reitoria de Extensão. Dentre os objetivos iniciais do Projeto, situavam-se a melhoria da qualidade de vida dos habitantes da área, materializando o compromisso social da Universidade, e ao mesmo tempo ampliar os cenários de formação de estudantes de diversos cursos da área da saúde da Universidade. Promovendo a inserção do estudante na realidade social do país, a Extensão afigura-se como um campo fértil de formação, problematizando tanto o Ensino como a Pesquisa acadêmica. Além disto, a Extensão tem o potencial de atender à construção do perfil profissional previsto nas Diretrizes Curriculares para os diversos cursos de Graduação, que atualmente norteiam as formulações curriculares e balizam os financiamentos federais a escolas médicas. Assim, esta pesquisa teve como objetivo caracterizar, sob a ótica de discentes e gestores participantes do Projeto Cananéia, da Pró-Reitoria de Extensão da UNIFESP, experiências educacionais que influenciaram o processo de formação, no âmbito do Curso de Medicina. A população de estudo consistiu em alunos do Curso Médico da UNIFESP, bem como gestores, que participaram do Projeto Cananéia. Utilizou-se como estratégia de coleta de dados a entrevista semiestruturada, cujos resultados foram submetidos à análise de conteúdo, construindo-se unidades de registro, de contexto e categorias, definidas por proximidade temática. Como resultados mais significativos observamos a valorização, pelos sujeitos de pesquisa, da educação da população, como uma forma de empoderamento da mesma. Aspectos relacionados à prática interdisciplinar, à resolutividade e à Formação no contexto das relações interpessoais, com bases dialógicas com a comunidade, e não por ações não previamente planejadas pelos participantes. Ficou claro que as atividades extensionistas não são “extracurriculares”, mas devem fazer parte do currículo formal das instituições, trazendo para o planejamento educacional iniciativas de pessoas ou de pequenos grupos, como um elemento fundamental na formação do futuro profissional médico. Foi evidenciado também um deslocamento de atividades meramente assistenciais para a educação em saúde, como estratégia prioritária de mudanças sociais, embora os estudantes tenham reconhecido seu despreparo para atividades educacionais voltadas para a saúde. Como estratégias de trabalho, foram privilegiadas ações conjuntas de discussão, fortemente permeadas pelo componente lúdico e ligadas às condições de obtenção de renda pela população. Em decorrência do engajamento dos estudantes no Projeto, estes ressaltaram um significativo impacto em sua formação humanística, reflexiva, ética e socialmente responsável. Por fim, houve um reconhecimento explícito da extensão como um campo legítimo para o fomento da pesquisa no contexto do SUS. Os relatos dos estudantes permitem concluir que as atividades extensionistas são estratégias eficazes para aproximar, de forma singular, a formação médica do perfil do egresso preconizado nas Diretrizes Curriculares para os Cursos de Graduação em Medicina.