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No. of bitstreams: 1 Dissertação Gláucia Cadar.pdf: 1979450 bytes, checksum: c68bb72757bbc97735f13c2c524e55d7 (MD5) Previous issue date: 2018-03-28 / Introduction: The effect of the use of the concept map on the promotion of significant learning has already been well evaluated, but its impact on the development of clinical reasoning is not well known yet. Objective: To evaluate the impact of the formulation of conceptmaps on the diagnosis accuracy of medical students. Methodology: Experimental assessment of students on the 6th (six) semester of the Medical School of the Jose do Rosario Vellano University - UNIFENAS. 46 students were divided into two groups: concept map (GM) (n = 24) and control group (CG) (n = 22). The assessment was carried out in two stages: training and evaluation. During the training stage, the students solved 6 clinical cases, corresponding to two clinical syndromes (jaundice and chest pain) and were initially allowed one and a half minute to read the case and write the most likely diagnosis. Thereafter, students of the GM group were instructed to formulate a concept map and indicate the final diagnosis and two differential diagnoses. Instead of working on a concept map, students on the CG were instructed to engage in a distracting task. The evaluation stage was carried out a week later, and the participants provided diagnoses for other eight clinical cases, with no specific orientations. Results: There was a significant reduction on the performance of the students comparing step 2 (evaluation) and step 1 (training) (p = 0.032) and no significant statistical association was found between the use of concept maps and students' performance in neither of the two stages (p = 0.577).In the analysis stratified by clinical syndrome, a statistically significant difference between the students' performance in each clinical syndrome was observed (p < 0.001), with a decrease in diagnosis accuracy in the cases of chest pain, whilst the performance for the cases of jaundice do not show a significant difference between the training and the evaluation stages. This observed pattern does not differ between the GM group and the control group (p = 0.467). Conclusion: The formulation of a concept map guided towards pathophysiology mechanisms has not improved the diagnosis accuracy of medical students. Further studies are needed to clarify the influence and the format of use of concept maps guided towards pathophysiology mechanisms of diseases on the improvement of clinical reasoning. / Introdução: O efeito do uso do mapa conceitual na promoção da aprendizagem significativa já foi bem avaliado, mas o seu impacto no desenvolvimento do raciocínio clínico ainda é pouco estudado. Objetivo: Avaliar o impacto da elaboração de mapas conceituais, baseados na fisiopatologia de doenças, sobre a acurácia diagnóstica de estudantes de Medicina. Metodologia: Estudo experimental com estudantes do 6° período do curso de Medicina da Universidade José do Rosário Vellano - UNIFENAS. Participaram do estudo 46 alunos, divididos em dois grupos: mapa conceitual (GM) (n=24) e controle (GC) (n=22). O estudo foi realizado em duas fases: fase 1-de treinamento e fase 2 - de avaliação. Na fase 1, de treinamento, os alunos resolveram 6(seis) casos clínicos, correspondentes a duas síndromes clínicas (icterícia e dor torácica) e tiveram, inicialmente, um minuto e meio para ler o caso e listar o diagnóstico mais provável. Em seguida, os alunos do grupo mapa conceitual (GM) foram orientados a confeccionar mapa conceitual e apontar o diagnóstico final e dois diagnósticos diferenciais. Em vez do mapa conceitual, os alunos do GC foram orientados a realizar uma atividade distratora. A fase 2 de avaliação foi conduzida uma semana após a GM e os participantes deram o diagnóstico de outros oito casos clínicos, sem orientação específica. Resultados: Houve uma redução significativa no desempenho dos alunos comparando-se a fase 2 (avaliação) com a fase 1 (treinamento) (p = 0,032) e não houve associação, estatisticamente significativa, entre o uso do mapa conceitual e o desempenho dos alunos em nenhuma das duas fases (p=0,577). Na análise estratificada por síndrome clínica observa-se uma diferença, estatisticamente significativa, entre o desempenho dos alunos em cada síndrome clínica (p<0,001), com piora na acurácia diagnóstica de casos de dor torácica, enquanto o desempenho para os casos da síndrome ictérica não difere entre a fase de treinamento e a fase de avaliação. Este padrão observado não difere entre o grupo GM e o GC (p=0,467). Conclusão: A elaboração do mapa conceitual, orientada para mecanismos fisiopatológicos, não melhorou a acurácia diagnóstica em estudantes de Medicina. Novos estudos são necessários para esclarecer a influência e formato do uso dos MC direcionado aos mecanismos fisiopatológicos das doenças no aprimoramento do raciocínio clínico.

Student employees (N=86) at a major research institution participated in a new hire orientation training and then responded to questionnaires measuring ten transfer behaviors and eight work environment constructs measuring support, frequency of contact, cohesion, and general means efficacy. Supervisor ratings of trainee performance were used to measure transfer behaviors.

El aprendizaje visuomotor condicional es un paradigma en el que las asociaciones estímulo-respuesta se aprenden a través de una recompensa. Un experimento típico se desarrolla de la siguiente forma: cuando se presenta un estímulo a un sujeto, éste debe decidir qué acción realizar de entre un conjunto. Una vez seleccionada la acción, el sujeto recibirá una recompensa en el caso de que la acción escogida sea correcta. En este tipo de tareas interactúan distintas regiones cerebrales, entre las que destacan el córtex prefrontal, el córtex premotor, el hipocampo y los ganglios basales. El objetivo de este proyecto consiste en estudiar la dinámica neuronal subyacente a esta clase de tareas a través de modelos computacionales. Proponemos el término processing pathway para describir cómo ejecuta esta tarea el cerebro y explicar los roles e interacciones entre las distintas áreas cerebrales. Además, tratamos el procesamiento anómalo en una hipótesis neurodinámica de la esquizofrenia. / Conditional visuomotor learning is a paradigm in which stimulus-response associations are learned upon reward feedback. A typical experiment is as follows: Upon a stimulus presentation, a subject has to decide which action to choose among a number of actions. After an action is selected, the subject receives reward if the action was correct. Several interacting brain regions work together to perform this task, most prominently the prefrontal cortex, the premotor cortex, the hippocampus, and the basal ganglia. Using computational modeling, we analyze and discuss the neurodynamics underlying this task. We propose the term processing pathway to describe how the brain performs this task and detail the roles and interactions of the brain regions. In addition, we address aberrant processing in a neurodynamical hypothesis of schizophrenia.

Diss. (sammanfattning) Umeå : Umeå universitet, 2010.