The character of the professional socialization experience is a subject of debate in the literature; one of the primary issues being the relative contributions of trainees to the nature of their socializing experience. As crucial as the clinical education experience is to the educational and professional development of medical students, it has received relatively little attention in the literature on professional socialization of physicians. The goals of this research were to understand, from the students' perspective, the character of the first clinical learning experience in the medical school career of a group of medical students and, given the character of that context, the role of student negotiations in their own education and professional socialization. This study employed a symbolic interactionist framework and the data collection methods of participant observation and unstructured interview. The data collection was conducted over a six-week period during which time the researcher experienced along with a group of six medical students their first clinical learning experience. These students perceived the clinical learning environment to be challenging, complex and frequently too busy to easily accommodate their learning needs. They recognized the enormity of their learning task and of their own incompetence. These were the basic perceptions that prompted the students to negotiate their clinical learning experience. Student negotiations took three basic forms: the creation of new learning opportunities, the manipulation of existing learning resources, and interpretation of events and behaviors. Students' negotiations were constrained by the structure of the education program and the students' own assertiveness. The study's findings indicate that the students were active negotiators of the content and the conduct of their own professional education and professional socialization. Even in the face of overwhelming demands on their intellectual and emotional resources, the students expressed their individual and collective intent for their educational experience. The study findings were similar to those of earlier studies of professional socialization, although new behaviors and behaviors inconsistent with those found in previous research were uncovered. Contributions to the literature on professional socialization and to an understanding of this phenomenon were made through the explanation of these inconsistencies.

Most research on medical professional socialization was conducted when medical students were almost uniformly white, upper- to upper-middle class, young men. Today 50% of medical students in Canada are women, and significant numbers are members of racialized minority groups, come from working class backgrounds, identify as gay or lesbian, and/ or are older. This research examined the impact of such social diversity on processes of corriing to identify as a medical professional, drawing on a survey of medical students in one third-year class, interviews with 25 third-year students, and interviews with 23 medical school faculty members. Almost all of the traits and processes noted by classic studies of medical professional socialization were found to still apply in the late 1990s. Students learn to negotiate complex hierarchies; develop greater self-confidence, but lowered idealism; learn a new language, but lose some of their communication skills with patients. They begin playing a role that becomes more real as responses from others confirm their new identity. Students going through this training process achieve varying degrees of integration between their medical-student selves and the other parts of themselves. There is a strong impetus toward homogeneity in medical education. It emphasizes the production of neutral, undifferentiated physicians - physicians whose gender, 'race/ sexual orientation, and social class background do not make any difference. While there is some recognition that patients bring social baggage with them into doctor-patient encounters, there is very little recognition that doctors do too, and that this may affect the encounter. Instances of blatant racism, sexism, and homophobia are not common. Nonetheless, students describe an overall climate in the medical school in which some women, students from racialized minority groups, gays and lesbians, and students from working class backgrounds seem to 'fif less well. The subtlety of these micro-level experiences of gendering, racialization and so on allows them to co-exist with a prevalent individual and institutional denial that social differences make any difference. I critique this denial as (unintentionally) oppressive, rooted in a liberal individualist notion of equality that demands assimilation or suppression of difference.

Made available in DSpace on 2015-12-10T14:22:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-08-21. Added 1 bitstream(s) on 2015-12-10T14:28:17Z : No. of bitstreams: 1 000853888.pdf: 5099523 bytes, checksum: 37b8c6a63d4cab2843e5aa8b0f83a164 (MD5) / Na última década, fez-se um grande esforço, no âmbito das graduações de profissões da saúde, para reorientar a formação de modo a melhor atender às necessidades do Sistema Único de Saúde. Influenciaram este processo as novas Diretrizes Curriculares Nacionais das profissões da saúde e o relevante papel indutivo realizado pelos Ministérios da Saúde e Educação para se alcançar uma formação mais humanizada e desenvolvida mediante processo de ensino-aprendizagem em diferentes cenários e com práticas de interprofissionalidade. A educação interprofissional tem sido apontada como uma ferramenta capaz de promover mudanças nos cenários de ensino, buscando práticas eficientes para o enfrentamento dos problemas sociais e de saúde. E vem sendo, cada vez mais, valorizada dado o seu potencial na formação de profissionais de saúde mais preparados para o trabalho em equipe, característica essencial para se alcançar um cuidado integral de indivíduos, famílias e comunidades. Nesta perspectiva, o objetivo deste estudo foi compreender a percepção e a vivência de educação interprofissional, nas disciplinas de Interação Universidade, Serviços e Comunidade I e II, entre discentes dos cursos de Medicina e Enfermagem da Faculdade de Medicina de Botucatu. Para tanto, realizou-se pesquisa de natureza qualitativa, que teve a entrevista semiestruturada como instrumento de coleta de dados. A organização e análise dos dados empregada foi orientada segundo o Método de Análise de Conteúdo proposto por Bardin. Como resultados, emergiram três categorias temáticas: A experiência de Educação interprofissional permite que o aluno compreenda melhor o colega do outro curso; Aprender sobre o outro traz benefícios para a formação profissional; O papel do professor-tutor como mediador no processo de formação profissional. Os alunos consideram o colega como uma fonte de aprendizado, o que pode facilitar o compartilhamento de... / In the last decade a great effort has been taken, within the undergraduate courses of Professional Health Care, in order to redefine the formation for a better assistance in the Public Health System in Brazil. This process had some multiple influences, such as the National Guidelines for Education and the Health and Education Ministry so that a most humanized and developed formation could be reached, focusing in teaching-learning in different sceneries with inter professional scope. The interprofessional education has been pointed out as a valuable tool, able to promote changes in the teaching scenery, focusing in efficient practices to deal with social and health problems. It has become even more valuable given its potential in the formation of professionals of health strengthening their understanding to work in teams, crucial to reach an integral care for the individuals, families and communities. In this perspective, the aim of this study was to understand the perception and experiences in inter professional education during the subject Interaction among University, Services and Community I and II among students of the Medical and Nursing undergraduate courses at the Medicine College in Botucatu. To reach this purpose, a survey with qualitative scope was performed, in which the students of the medical and nursing courses were interviewed using a semi structured instrument. The organization and data analysis were guided according to the method of Thematic Content Analyses of Bardin. As a result three categories were raised: The experience in inter professional education allowing the student to better understand his colleagues from the other courses; Learning about the Other brings benefits to his professional formation; The role of professor-tutor as a mediator in the professional formation. The students consider the colleague as a source of learning, which can make it easier to share knowledge and to have an approach with the ...

Orientador: Antônio de Pádua Pithon Cyrino / Coorientador: Janete Pessuto Simonetti / Banca: Marina Peduzzi / Banca: Marcelo Viana da Costa / Resumo: Na última década, fez-se um grande esforço, no âmbito das graduações de profissões da saúde, para reorientar a formação de modo a melhor atender às necessidades do Sistema Único de Saúde. Influenciaram este processo as novas Diretrizes Curriculares Nacionais das profissões da saúde e o relevante papel indutivo realizado pelos Ministérios da Saúde e Educação para se alcançar uma formação mais humanizada e desenvolvida mediante processo de ensino-aprendizagem em diferentes cenários e com práticas de interprofissionalidade. A educação interprofissional tem sido apontada como uma ferramenta capaz de promover mudanças nos cenários de ensino, buscando práticas eficientes para o enfrentamento dos problemas sociais e de saúde. E vem sendo, cada vez mais, valorizada dado o seu potencial na formação de profissionais de saúde mais preparados para o trabalho em equipe, característica essencial para se alcançar um cuidado integral de indivíduos, famílias e comunidades. Nesta perspectiva, o objetivo deste estudo foi compreender a percepção e a vivência de educação interprofissional, nas disciplinas de Interação Universidade, Serviços e Comunidade I e II, entre discentes dos cursos de Medicina e Enfermagem da Faculdade de Medicina de Botucatu. Para tanto, realizou-se pesquisa de natureza qualitativa, que teve a entrevista semiestruturada como instrumento de coleta de dados. A organização e análise dos dados empregada foi orientada segundo o Método de Análise de Conteúdo proposto por Bardin. Como resultados, emergiram três categorias temáticas: A experiência de Educação interprofissional permite que o aluno compreenda melhor o colega do outro curso; Aprender sobre o outro traz benefícios para a formação profissional; O papel do professor-tutor como mediador no processo de formação profissional. Os alunos consideram o colega como uma fonte de aprendizado, o que pode facilitar o compartilhamento de... / Abstract: In the last decade a great effort has been taken, within the undergraduate courses of Professional Health Care, in order to redefine the formation for a better assistance in the Public Health System in Brazil. This process had some multiple influences, such as the National Guidelines for Education and the Health and Education Ministry so that a most humanized and developed formation could be reached, focusing in teaching-learning in different sceneries with inter professional scope. The interprofessional education has been pointed out as a valuable tool, able to promote changes in the teaching scenery, focusing in efficient practices to deal with social and health problems. It has become even more valuable given its potential in the formation of professionals of health strengthening their understanding to work in teams, crucial to reach an integral care for the individuals, families and communities. In this perspective, the aim of this study was to understand the perception and experiences in inter professional education during the subject "Interaction among University, Services and Community I and II" among students of the Medical and Nursing undergraduate courses at the Medicine College in Botucatu. To reach this purpose, a survey with qualitative scope was performed, in which the students of the medical and nursing courses were interviewed using a semi structured instrument. The organization and data analysis were guided according to the method of Thematic Content Analyses of Bardin. As a result three categories were raised: The experience in inter professional education allowing the student to better understand his colleagues from the other courses; Learning about the Other brings benefits to his professional formation; The role of professor-tutor as a mediator in the professional formation. The students consider the colleague as a source of learning, which can make it easier to share knowledge and to have an approach with the ... / Mestre

Most research on medical professional socialization was conducted when medical students were almost uniformly white, upper- to upper-middle class, young men. Today 50% of medical students in Canada are women, and significant numbers are members of racialized minority groups, come from working class backgrounds, identify as gay or lesbian, and/ or are older. This research examined the impact of such social diversity on processes of corriing to identify as a medical professional, drawing on a survey of medical students in one third-year class, interviews with 25 third-year students, and interviews with 23 medical school faculty members. Almost all of the traits and processes noted by classic studies of medical professional socialization were found to still apply in the late 1990s. Students learn to negotiate complex hierarchies; develop greater self-confidence, but lowered idealism; learn a new language, but lose some of their communication skills with patients. They begin playing a role that becomes more real as responses from others confirm their new identity. Students going through this training process achieve varying degrees of integration between their medical-student selves and the other parts of themselves. There is a strong impetus toward homogeneity in medical education. It emphasizes the production of neutral, undifferentiated physicians - physicians whose gender, 'race/ sexual orientation, and social class background do not make any difference. While there is some recognition that patients bring social baggage with them into doctor-patient encounters, there is very little recognition that doctors do too, and that this may affect the encounter. Instances of blatant racism, sexism, and homophobia are not common. Nonetheless, students describe an overall climate in the medical school in which some women, students from racialized minority groups, gays and lesbians, and students from working class backgrounds seem to 'fif less well. The subtlety of these micro-level experiences of gendering, racialization and so on allows them to co-exist with a prevalent individual and institutional denial that social differences make any difference. I critique this denial as (unintentionally) oppressive, rooted in a liberal individualist notion of equality that demands assimilation or suppression of difference. / Arts, Faculty of / Sociology, Department of / Graduate

Made available in DSpace on 2015-05-14T16:53:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-08-22Bitstream added on 2015-05-14T16:58:37Z : No. of bitstreams: 1 000829096.pdf: 1749660 bytes, checksum: 4f39f584313c8cc5bdcc377486b10188 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A partir da constituição de 1988, com a implantação do Sistema Único de Saúde (SUS), o Brasil reorganiza um conjunto de ações públicas de saúde com a premissa de construção de um novo modelo de atenção, valorizando a atenção primária à saúde (APS). A Estratégia de Saúde da Família (ESF) passa a ser desenvolvida, a partir dos anos de 1990, tendo a visita domiciliar (VD) como uma das suas ações prioritárias. Atribui-se ao SUS responsabilidade pela formação profissional na área de saúde. Na mesma direção, buscando contribuir à superação do abismo entre a formação médica especializada e fragmentada e a concepção da integralidade do cuidado humano, foram homologadas pelo Ministério da Educação (MEC) as Diretrizes Curriculares Nacionais (DCN) da Graduação em Medicina, em 2001, e reformuladas e novamente aprovadas pelo MEC, em 2014. Em ação conjunta, desde 2002, os Ministérios da Saúde e da Educação fomentam políticas destinadas à reforma curricular das escolas médicas, objetivando a implantação das DCN e a maior aproximação do ensino médico às necessidades do SUS. Destacam-se, entre outros, nessa perspectiva, dois programas: o Programa de Incentivo às Mudanças Curriculares nos Cursos de Medicina (PROMED) e o Programa de Reorientação Profissional em Saúde (PRO-Saúde). O presente trabalho compreende a necessidade de estabelecimento de uma agenda ampla, longitudinal e complexa para qualificar a produção de saúde, com a participação de usuários, famílias, trabalhadores da saúde, gestores, estudantes, professores universitários e sociedade civil e nesse sentido assume a visita domiciliar na APS, como um ponto, nas redes de atenção, que pode tensionar o modelo de atenção que abstrai a doença da vida de cada ser singular ou do coletivo e como uma possível ferramenta que pode ampliar o olhar, a escuta e a possibilidade de desenvolvimento de relações mais horizontais entre todos ... / From 1988's constitution, with the implementation of the health system (SUS), Brazil reorganizes a group of public health actions, with the presupposition of the formation of a new model of attention, giving value to primary health attention. The family health strategy begins to be developed, from 1990's, having the home visit with one of its priorities actions. Assigning to SUS the responsibility for professional formation on the health area. At the same direction, looking for contributing to overcome the abyss between fragmented specialized medical formation and the conception of the integrality of the human care, It was approved by Education's Ministry the National Curriculum Guidelines of the medical graduation, in 2001, this guidelines was reformulated and approved by Education's Ministry again, in 2014. Complementing, since 2002, the Health's Ministry and Education's Ministry, both are bringing up policies aimed for curricular reform of medical schools, looking for the implementation of the National Curriculum Guidelines and approaching the second grade to the health system's necessities. This academic work understanding the necessities to set up of a broad agenda, complex enough to qualify the health production, with the participation of the users, families, health workers, managers, students, universities' teachers and civil society, assuming the home visit at the primary health attention, as main point of attention, that can lead to tensioning the attention model that abstracts the disease of the each human being life, singular or collective and as a possible tool that might provide the necessary magnification to looking, listening and possibility to develop relationship more horizontal between all people involved in it. Therefore, the objective of this study is analyzing the process of teaching and learning at the action of realizing of the home visit during the medicine course, from conceptions of the teachers of medical ...

Orientador: Eliana Goldfarb Cyrino / Coorientador: Alice Yamashita Prearo / Banca: Janete Pessuto Simonetti / Banca: Tiago Rocha Pinto / Banca: Mara Regina Lemes de Sordi / Banca: Gustavo Tenório Cunha / Resumo: A partir da constituição de 1988, com a implantação do Sistema Único de Saúde (SUS), o Brasil reorganiza um conjunto de ações públicas de saúde com a premissa de construção de um novo modelo de atenção, valorizando a atenção primária à saúde (APS). A Estratégia de Saúde da Família (ESF) passa a ser desenvolvida, a partir dos anos de 1990, tendo a visita domiciliar (VD) como uma das suas ações prioritárias. Atribui-se ao SUS responsabilidade pela formação profissional na área de saúde. Na mesma direção, buscando contribuir à superação do abismo entre a formação médica especializada e fragmentada e a concepção da integralidade do cuidado humano, foram homologadas pelo Ministério da Educação (MEC) as Diretrizes Curriculares Nacionais (DCN) da Graduação em Medicina, em 2001, e reformuladas e novamente aprovadas pelo MEC, em 2014. Em ação conjunta, desde 2002, os Ministérios da Saúde e da Educação fomentam políticas destinadas à reforma curricular das escolas médicas, objetivando a implantação das DCN e a maior aproximação do ensino médico às necessidades do SUS. Destacam-se, entre outros, nessa perspectiva, dois programas: o Programa de Incentivo às Mudanças Curriculares nos Cursos de Medicina (PROMED) e o Programa de Reorientação Profissional em Saúde (PRO-Saúde). O presente trabalho compreende a necessidade de estabelecimento de uma agenda ampla, longitudinal e complexa para qualificar a produção de saúde, com a participação de usuários, famílias, trabalhadores da saúde, gestores, estudantes, professores universitários e sociedade civil e nesse sentido assume a visita domiciliar na APS, como um ponto, nas redes de atenção, que pode tensionar o modelo de atenção que abstrai a doença da vida de cada ser singular ou do coletivo e como uma possível ferramenta que pode ampliar o olhar, a escuta e a possibilidade de desenvolvimento de relações mais horizontais entre todos ... / Abstract: From 1988's constitution, with the implementation of the health system (SUS), Brazil reorganizes a group of public health actions, with the presupposition of the formation of a new model of attention, giving value to primary health attention. The family health strategy begins to be developed, from 1990's, having the home visit with one of its priorities actions. Assigning to SUS the responsibility for professional formation on the health area. At the same direction, looking for contributing to overcome the abyss between fragmented specialized medical formation and the conception of the integrality of the human care, It was approved by Education's Ministry the National Curriculum Guidelines of the medical graduation, in 2001, this guidelines was reformulated and approved by Education's Ministry again, in 2014. Complementing, since 2002, the Health's Ministry and Education's Ministry, both are bringing up policies aimed for curricular reform of medical schools, looking for the implementation of the National Curriculum Guidelines and approaching the second grade to the health system's necessities. This academic work understanding the necessities to set up of a broad agenda, complex enough to qualify the health production, with the participation of the users, families, health workers, managers, students, universities' teachers and civil society, assuming the home visit at the primary health attention, as main point of attention, that can lead to tensioning the attention model that abstracts the disease of the each human being life, singular or collective and as a possible tool that might provide the necessary magnification to looking, listening and possibility to develop relationship more horizontal between all people involved in it. Therefore, the objective of this study is analyzing the process of teaching and learning at the action of realizing of the home visit during the medicine course, from conceptions of the teachers of medical ... / Doutor

This study analysed the learning environment of undergraduate medical and health sciences students of the School of Medicine University of Zambia who were studying at the Ridgeway Campus. Premised on the theory that learner’s perception of the learning environment determines approach to learning and learning outcome, the study utilized a descriptive, quantitative, and non-experimental design to articulate the issues that characterise the learning environment of the programmes. The aim was to provide framework based on these, and use it to propose a strategy for improving the learning environment of the School. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was administered to 448 participants from year 2 to year 7 classes of medicine, pharmacy, and physiotherapy programmes. Total DREEM, subscale, and individual items’ scores were analysed statistically and compared by analysis of variance among the programmes. The issues determined formed the framework for strategy development, and strategic options were proposed based on evidence obtained from literature. With a global DREEM score of 119.3 ± 21.24 (59.7 %), the students perceived their learning environment as “more positive than negative.” One sample binomial test of hypothesis for categorical variables returned a p value <0.05, with a verdict to ‘reject the null hypothesis,’ thereby confirming a more positive than negative perception. Subscale scores also showed ‘more positive’ perception. There were no significant differences between scores from the different programmes when compared by Games Howell test, P> 0.05, thereby upholding the second hypothesis. Analysis of individual items revealed problems in six items, which were summarised into four strategic ssues: inadequate social support for stressed students, substandard teaching and mentoring, unpleasant accommodation, and inadequate physical facilities. The implications of the findings for theory and practice were discussed and strategic options proposed to address the issues. The study concludes that analysis of the learning environment of medical schools provides more insight for strategic planning and management. / Health Studies / D.Litt. et Phil. (Health Studies)