Formação médica e simulação clínica: um estudo com graduandos de medicina
Data
2024-11-26
Autores
Duarte, Yasmin 
Orientadores
Batista, Sylvia Helena Souza da Silva
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O processo de reorientação da formação em saúde no Brasil, vivenciado nas duas décadas do século XXI, tem enfatizado a necessidade de articulação teoria e prática, bem como o protagonismo e engajamento dos e das estudantes em contextos de aprendizagem significativa. No campo da formação médica no Brasil, a Lei do Programa Mais Médicos e as Diretrizes Curriculares Nacionais para Cursos de Medicina (2014) trazem a ênfase na aprendizagem ativa, realçando a Simulação Clínica como cenário a ser estimulado e vivenciado na graduação. A simulação clínica inserese no processo de ensino e aprendizagem, caracterizandose pela utilização de atores ou participação de usuários/as para situações de prática clínica. Objetivo: avaliar, junto com estudantes participantes da pesquisa, um Guia de Processo de Aprendizagem em Contextos de Simulação Clínica na Formação Médica. Metodologia: estudo quantiqualitativo, abrangendo Escala de Satisfação com as Experiências Clínicas Simuladas (ESECS) e entrevista semi estruturadas com estudantes. Como participantes foram envolvidos graduandos de Medicina de instituições privadas localizadas na Região da Baixada Santista/SP. O processo de análise de dados abrangeu análise de conteúdo, do tipo temática e os dados quantitativos foram analisados por meio do Statistical Package for the Social Sciences (SPSS), versão 20 para Windows, utilizando estatística descritiva com medidas de tendência central, dispersão e frequência. A comparação das pontuações apresentadas entre os dois semestres e entre os dois gêneros foi realizada por meio do teste U de MannWhitney. Resultados e Discussão: a partir de 71 respostas, obtevese dados relativos à caracterização: maioria do gênero feminino (63,4%) e a média de idade foi de 26 ± 7 anos. Todos e todas as participantes participaram de cenários de simulação durante a graduação, com média de 15 ± 8 participações como expectador e 8 ± 5 participações como atuante. A mediana da pontuação total do ESECS foi de 8,8 pontos, com intervalo interquartílico de 8,1 a 9,2 pontos (n=71). As dimensões prática, realismo e cognitiva apresentaram pontuações, em mediana, de 8,6 [8.0 – 9.2], 9,0 [8.4 – 9.8] e 8,7 [7.7 – 9.3] pontos, respectivamente. Foram realizadas entrevistas com 7 estudantes de medicina, sendo 04 do gênero feminino e 03 do gênero masculino, dos 6º (3 estudantes) e 7º (4 estudantes) semestres. Os principais núcleos de significados identificados foram: avaliação da simulação clínica na aprendizagem médica, incluindo conforto, alegria e satisfação; aprendizagem em simulação clínica e antecipações do trabalho médico: fortalezas, fragilidades dos contextos de simulação clínica; e o guia como ferramenta de apoio no aprendizado médico. Conclusão: As análises empreendidas sinalizam que uma abordagem bem estruturada e uma preparação adequada são essenciais para que a simulação clínica alcance seus objetivos pedagógicos, conforme evidenciado pela literatura existente. O papel do docente e a clareza na criação dos cenários foram considerados fundamentais para o sucesso das simulações. A elaboração do Guia Prático: Processo de Aprendizagem em Contextos de Simulação Clínica como Produto Técnico Educacional, emergiu e foi validado/avaliado durante a presente pesquisa, representa um avanço na estruturação e acessibilidade das informações para os estudantes sobre simulação clínica na educação médica.
Introduction: The process of reorienting health training in Brazil, experienced in the two decades of the 21st century, has emphasized the need of theorical and practical articulation, as well as the protagonism and engagement of students in meaningful learning contexts. In the field of medical training in Brazil, the Mais Médicos Program Law and the National Curricular Guidelines for Medical Courses (2014) emphasize active learning, performing Clinical Simulation as a scenario to be stimulated and experienced during graduation. Clinical simulation is part of the teaching and learning process, characterized by the use of actors or user participation in clinical practice situations. Objective: evaluate, together with students participating in the research, a Learning Process Guide in Clinical Simulation Contexts in Medical Training. Metodology: quantitative and qualitative study, covering the Satisfaction Scale with Simulated Clinical Experiences (SSSCE) and semi structured interviews with students. As participants, medical students from private institutions located in the Baixada Santista / SP region were involved. The data analysis process included content analysis, thematic type and quantitative data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 20 for Windows, using descriptive statistics with measures of central tendency, dispersion and frequency. The comparison of scores presented between the two semesters and between the two genders was carried out using the MannWhitney U test. Results and Discussion: From 71 responses, data related to characterization were obtained: the majority were female (63.4%) and the average age was 26 ± 7 years old. Each and every participant joined the simulation scenarios during graduation, with an average of 15 ± 8 participations as a spectator and 8 ± 5 participations as an actor. The median SSSCE total score was 8.8 points, with an interquartile range of 8.1 to 9.2 points (n=71). The practical, realism and cognitive dimensions presented median scores of 8.6 [8.0 – 9.2], 9.0 [8.4 – 9.8] and 8.7 [7.7 – 9.3] points, respectively. Interviews were carried out with 7 medical students, 4 females and 3 males, from the 6th (3 students) and 7th (4 students) semesters. The main core meanings identified were evaluation of clinical simulation in medical learning, including comfort, joy and satisfaction; learning in clinical simulation and anticipations of medical work: strengths, weaknesses of clinical simulation contexts; and the guide as a support tool in medical learning. Conclusion: The analyzes undertaken indicate that a well structured approach and adequate preparation are essential for clinical simulation to achieve its pedagogical objectives, as evidenced by the existing literature. The role of the teacher and clarity in creating the scenarios were considered fundamental to the success of the simulations. The development of the Practical Guide: Learning Process in Clinical Simulation Contexts as a Technical Educational Product, emerged and was validated/evaluated during this research, represents an advance in the structuring and accessibility of information for students about clinical simulation in medical education.
Introduction: The process of reorienting health training in Brazil, experienced in the two decades of the 21st century, has emphasized the need of theorical and practical articulation, as well as the protagonism and engagement of students in meaningful learning contexts. In the field of medical training in Brazil, the Mais Médicos Program Law and the National Curricular Guidelines for Medical Courses (2014) emphasize active learning, performing Clinical Simulation as a scenario to be stimulated and experienced during graduation. Clinical simulation is part of the teaching and learning process, characterized by the use of actors or user participation in clinical practice situations. Objective: evaluate, together with students participating in the research, a Learning Process Guide in Clinical Simulation Contexts in Medical Training. Metodology: quantitative and qualitative study, covering the Satisfaction Scale with Simulated Clinical Experiences (SSSCE) and semi structured interviews with students. As participants, medical students from private institutions located in the Baixada Santista / SP region were involved. The data analysis process included content analysis, thematic type and quantitative data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 20 for Windows, using descriptive statistics with measures of central tendency, dispersion and frequency. The comparison of scores presented between the two semesters and between the two genders was carried out using the MannWhitney U test. Results and Discussion: From 71 responses, data related to characterization were obtained: the majority were female (63.4%) and the average age was 26 ± 7 years old. Each and every participant joined the simulation scenarios during graduation, with an average of 15 ± 8 participations as a spectator and 8 ± 5 participations as an actor. The median SSSCE total score was 8.8 points, with an interquartile range of 8.1 to 9.2 points (n=71). The practical, realism and cognitive dimensions presented median scores of 8.6 [8.0 – 9.2], 9.0 [8.4 – 9.8] and 8.7 [7.7 – 9.3] points, respectively. Interviews were carried out with 7 medical students, 4 females and 3 males, from the 6th (3 students) and 7th (4 students) semesters. The main core meanings identified were evaluation of clinical simulation in medical learning, including comfort, joy and satisfaction; learning in clinical simulation and anticipations of medical work: strengths, weaknesses of clinical simulation contexts; and the guide as a support tool in medical learning. Conclusion: The analyzes undertaken indicate that a well structured approach and adequate preparation are essential for clinical simulation to achieve its pedagogical objectives, as evidenced by the existing literature. The role of the teacher and clarity in creating the scenarios were considered fundamental to the success of the simulations. The development of the Practical Guide: Learning Process in Clinical Simulation Contexts as a Technical Educational Product, emerged and was validated/evaluated during this research, represents an advance in the structuring and accessibility of information for students about clinical simulation in medical education.
Descrição
Citação
DUARTE, Yasmin. Formação Médica e Simulação Clínica: um estudo com graduandos de medicina. 2024. 92 f. Dissertação (Mestrado Profissional em Ensino em Ciencias da Saúde) - Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Santos, 2024.