Recruitment of medical graduates to general practice careers in the UK, as in other developed countries, remains challenging. Currently general practice attracts fewer doctors than health care planners anticipate will be needed to meet the burgeoning health needs of an ageing population. Understanding the factors that influence doctors in their career choices is important to manpower planners, the profession and society as a whole. A two year postgraduate foundation programme for all doctors was introduced into the UK in 2006. One of its main intentions was to provide doctors with postgraduate clinical attachments that would assist them in making informed career choices. This has resulted, for the first time, in large numbers of recent medical graduates experiencing several specialties before applying for specialty specific training programmes. The main aim of this thesis was to assess the influence of a four month postgraduate attachment in general practice in the second foundation year on doctors' career intent. It was hypothesised that the attachment would have a positive impact on recruitment to general practice careers. This hypothesis was tested using a combined quantitative and qualitative approach. A literature review examined career decision making in medicine. It was divided chronologically into sections covering decision making at school, university and in the early postgraduate years. In addition a section focussed on decision making in careers other than medicine. A validated career inventory (sci 59) measuring change in career preference was selected for use in this study. The output is in the form of career rankings among 59 medical specialties. In addition, a semi-structured interview questionnaire was developed based on themes emerging from the literature review and was refined following piloting. Interviews were recorded, transcribed and thematically analysed using NVivo 7. The study was conducted in the Kent, Surrey and Sussex Deanery between 2005 and 2008. Participants (n=225) included all doctors whose second foundation year programme included a four month attachment in general practice. They were sent a sci 59 questionnaire at the beginning of their attachment and a further questionnaire at the end. Those responding to both questionnaires were invited to take part in an interview. 112 participants completed sci 59 questionnaires at the beginning and end of their 4 months attachment. Initial analysis demonstrated a small, statistically non-significant improvement in career intent towards general practice. Using a measure that reflects movement in ranking between the two questionnaires, further analysis showed a small, statistically significant, improvement in the ranking of general practice among participants who had low initial rankings for general practice. 30 participants were interviewed. Placements in general practice during the second foundation year were generally regarded in a very positive light. Doctors particularly valued ongoing relationships with patients as well as involvement with local communities. They commented on the high quality of supervision and the structured learning environment of their attachments. General practice was also seen as a better lifestyle option than other main specialties as well as offering flexible working opportunities. New findings included the observation that career ranking for general practice improved following a four month postgraduate attachment in general practice among those less inclined to general practice as a career in the first place. Thematic analysis of transcribed interviews revealed enhanced respect, among foundation doctors, for general practice as a career option irrespective of their own eventual career intent. This improved regard for general practice among doctors intent on specialising may be important in the context of persisting disparagement of general practice by some students, clinicians and teachers. It may also be helpful in engendering mutual respect and more effective working relationships between specialists and generalists in the future.

No description available.

Objetivos: Verificar o nível de conhecimento basal sobre práticas de promoção da saúde bucal e mensurar os ganhos de conhecimento e a habilidade de aconselhamento de alunos do quinto ano do curso de medicina. Métodos: 148 alunos, divididos em quatro turmas 2007-A (grupo controle), 2007-B, 2008-A e 2008-B , receberam intervenções progressivas de ensino, presenciais (em 2007) e a distância (em 2008). A turma 2008-B recebeu também contatos ativos com especialista em promoção bucal. O ganho de conhecimento foi medido por provas escritas aplicadas antes e após a respectiva intervenção, e a habilidade de aconselhar foi avaliada por meio de exame clínico objetivo estruturado por estações (OSCE). Resultados: 92% dos alunos não consideravam adequado o seu nível basal de conhecimento em promoção da saúde bucal. O ganho de conhecimento das turmas 2008-A e 2008-B foi progressivo, e estatisticamente superior ao do grupo controle, assim como ocorreu com a habilidade de aconselhamento da turma 2008-B. Conclusão: O desempenho do grupo 2008-B foi significativamente superior àquele dos demais grupos / Objectives: The verification of the level of basal knowledge of 5th year medical students regarding the practice of oral health promotion and to measure growth in knowledge and the capability to advise. Method: 148 students, divided into 4 teams 2007-A (control group), 2007-B, 2008 e 2008-B received progressive teaching interventions, in presence (2007) and in distance (2008). The team 2008-B also received active contacts with a specialist in promoting oral. The growth in knowledge was measured by written tests applied before and after the respective intervention, and the capability to advise was assessed through the Objective Structured Clinical Examination per stations (OSCE). Results: 92% of the students found their initial base knowledge of oral health promotion insufficient. The growth in knowledge of teams 2008-A and 2008-B was considerable when compared to the control group. Team 2008-B also demonstrated an increased capability to advise on oral health. Conclusion: The performance of 2008-B group was significantly higher than all other groups

Introdução: Programas de Tutoria/Mentoring, por meio de uma relação próxima junto aos alunos, oferecem suporte e também um ambiente de reflexão para uma formação profissional. O interesse pelo tema é crescente dentro e fora do Brasil, entretanto, são poucos os estudos que examinam o mentoring considerando as experiências dos próprios alunos, tal como eles as vivenciam. Objetivo: Compreender a experiência vivida por alunos de Medicina na atividade de Tutoria/Mentoring da Universidade Federal de Minas Gerais (UFMG). Método: Pesquisa documental com análise fenomenológica dos relatórios produzidos pelos alunos ao final da atividade no 5º período do curso. Resultados: Os elementos experienciais presentes nos depoimentos deram origem a grupos de vivências em três conjuntos temáticos: 1. O contexto da tutoria - os alunos vivenciaram a necessidade e pertinências de suporte para o estudante de Medicina e a inserção da atividade no 5° período do curso; 2. O vivido na tutoria - a tutoria foi vivenciada como espaço de liberdade e abertura às necessidades dos estudantes, onde vários assuntos puderam ser discutidos. Nos encontros, os alunos vivenciaram uma nova qualidade de relação no contexto acadêmico, construída por meio do compartilhar dos desafios e fragilidades vivenciados ao longo do curso. Reconheceram ter conhecido mais e melhor seus colegas de turma e consideraram os tutores como pessoas disponíveis a acompanhá-los em sua formação; 3. A avaliação da experiência - os alunos, com poucas exceções, vivenciaram a tutoria de forma positiva, como uma ação de humanização do ambiente acadêmico, e recomendam sua continuidade e extensão para outros momentos do curso. Conclusões: A relação de tutoria mostrou contribuir tanto no enfrentamento das vicissitudes da formação quanto no exercício de habilidades como a escuta, a aceitação e a comunicação, fundamentais para a boa atuação do médico em seu cotidiano profissional. O Mentoring mostrou ser valioso referencial teórico e prático de atenção ao estudante ao contribuir tanto para o suporte pessoal e profissional ao estudante quanto para as demandas de formação em áreas humanísticas no currículo médico / Introduction: Mentoring Programs offer support and reflection for professional development through a close relationship with the students. Interest in Mentoring has increase in Brazil and around the world. However, few studies examine the mentoring considering the experiences of the students. Objective: To understand the lived experience of medical students of Federal University of Minas Gerais (UFMG) in the Mentoring Program. Method: Documentary research with phenomenological analysis of the reports students at the end of the Mentoring Program. Results: The elements present in the reports gave rise to three thematic groups of experiences: 1. The context of Mentoring - students experienced the need and relevance of support during the graduation , especially in the fifth period of the course; 2. Was lived in Mentoring - the students experienced mentoring as a space open to their needs, were many issues was freely discussed. In the meetings, the students experienced a new kind of relationship, built through the sharing of challenges and weaknesses faced throughout the medical course. They revealed having known better their classmates and their tutors were considered as persons available to accompany them in their training; 3. The experience\'s evaluation - the students, with few exceptions, have had a positive experience with Mentoring, as an act of humanization of the academic environment, and recommend its continuation and extension to other periods of course. Conclusions: The Mentoring relationship showed contribute in facing the vicissitudes of training and in the exercise of skills such as listening, acceptance and communication, fundamental skills to the good performance of the medical professional in your daily life.The experience of Mentoring students showed intersections between the student support and the demands of training in humanistic goals in medical education

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-03-26T12:27:16Z No. of bitstreams: 1 Marlene Moraes Rosa Chinelato.pdf: 1185592 bytes, checksum: cf91202b9db659313f80badcc23c2a03 (MD5) / Made available in DSpace on 2018-03-26T12:27:16Z (GMT). No. of bitstreams: 1 Marlene Moraes Rosa Chinelato.pdf: 1185592 bytes, checksum: cf91202b9db659313f80badcc23c2a03 (MD5) Previous issue date: 2018-02-09 / Objective: This descriptive research of qualitative approach aimed to analyze the students ' perception of the undergraduate course of Medicine of a University Center in the northwest Paulista about their performance in the progress test, as well as the impact of this perception in the short term and, from that, propose adjustments actions for the continuous improvement of the teaching-learning process.The sample of convenience was made up by twenty participants, after approval of the research at the Ethics Committee on Research. The technique of focal groups was applied in two distinct moments to collect the qualitative data. The content analysis of the focal groups was based on Bardin (2011). Results: Ten students of the fifth period took part in the first focal group and ten students of the eighth period took part in the second group. The analysis of the content of the interviews resulted in the identification of three categories:1. Inappropriate conditions; 2.PT as a pedagogical tool; 3. Antagonistic feelings. Conclusion: The students that were interviewed consider the ProgressTest a relevant "pedagogical tool" that allows self-assessment and correction of learning gaps.&n bsp; However, the performance results of PT and the received feedback determine antagonistic feelings according to the period they are taking, of frustration for the fifth period students and security for the students of the eighth period. The impact determined by the performance in the short-term PT did not promote changes in the study plan of the students that were interviewed. It is necessary to implement strategies for the delivery of the formative feedback in a reflexive way, which allows the discussion of the issues and the results of the course/classes enhancing the teaching-learning process / Objetivo: Esta pesquisa descritiva de abordagem qualitativa objetivou analisar a percepção dos estudantes do curso de graduação de Medicina de um Centro Universitário do noroeste paulista sobre o seu desempenho no Teste de Progresso, bem como o impacto desta percepção em curto prazo e, a partir disto, propor ações de ajustes para o melhoramento contínuo do processo ensino-aprendizagem. A amostra de conveniência foi constituída por vinte participantes após aprovação da pesquisa no Comitê de Ética em Pesquisa. Utilizou-se a técnica de grupos focais em dois momentos distintos para coletar os dados qualitativos. A análise de conteúdo dos grupos focais fundamentou-se em Bardin (2011). Resultados: Participaram do primeiro grupo focal dez estudantes do quinto período e do segundo grupo, dez estudantes do oitavo período. A análise de conteúdo das entrevistas resultou na identificação de três categorias: 1. Condições inadequadas; 2. TP como ferramenta pedagógica; 3. Sentimentos antagônicos. Conclusão: Os estudantes entrevistados consideram o Teste de Progresso uma “ferramenta pedagógica” relevante que permite a autoavaliação e a correção das lacunas de aprendizagem. Entretanto, os resultados de desempenho do TP e o feedback recebido determinam sentimentos antagônicos, de acordo com o período que estão cursando, de frustração para os alunos de quinto período e de segurança para os alunos do oitavo período. O impacto determinado pelo desempenho no TP, a curto prazo, não promoveu mudanças no plano de estudo dos estudantes entrevistados. É preciso considerar estratégias para a entrega do feedback formativo, que permita a discussão das questões e dos resultados do curso/turmas, de forma reflexiva, potencializando o processo ensino-aprendizagem

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-04-03T11:16:04Z No. of bitstreams: 1 Jorge Enrique Mendoza Salcedo.pdf: 1111025 bytes, checksum: 0084f4a46fa4c16cbe04e36561f7628f (MD5) / Made available in DSpace on 2018-04-03T11:16:04Z (GMT). No. of bitstreams: 1 Jorge Enrique Mendoza Salcedo.pdf: 1111025 bytes, checksum: 0084f4a46fa4c16cbe04e36561f7628f (MD5) Previous issue date: 2018-02-23 / Introduction: The fundoscopy is part of the physical examination, being important in the diagnosis and prognosis of various pathologies. The teaching and learning of this technique, however, may become difficult if only patients are used for this purpose. Objective: Create a medical simulator of easy access and manufacture, to aid teaching the technique of direct fundoscopy. Materials and Methods: After testing several materials, we constructed an eye model using materials easily available on the internet. Plastic ball (pokeball); a slide transparency viewer; an inkjet printable transparency film. Result: We constructed a low-cost eye model, which can be used for teaching and training fundoscopy techniques. The model was tested during theoretical-practical classes to 10 physicians, who approved the model. Conclusion: Using simple and easy access materials, it is possible to construct models that help in the learning process of direct fundoscopy technique / Introdução: A fundoscopia constitui parte do exame físico e possui papel importante no diagnóstico e no prognóstico de diversas patologias. O ensino e o aprendizado da técnica, entretanto, podem ser mais difíceis, caso apenas pacientes sejam utilizados para aquele fim. Objetivo: Criar um simulador de fundo de olho, que seja acessível e cuja fabricação seja simples, a fim de auxiliar no ensino da técnica de fundoscopia direta. Material e Métodos: Após testar diversos materiais, construiu-se um modelo de olho humano por meio de utensílios acessíveis pela internet: uma bola de plástico (pokebola), um monóculo para transparência e um vinil adesivo transparente para impressora jato de tinta. Resultado: Criou-se um modelo de olho de baixo custo, que pode ser utilizado no ensino e no treinamento da técnica de fundoscopia. O modelo foi testado durante aula teórico-prática apresentada a 10 médicos, os quais aprovaram o modelo. Conclusão: Utilizando materiais simples e de fácil acesso, é possível construir modelos que auxiliam no processo de aprendizagem da técnica da fundoscopia direta

Este é o resultado de estudo desenvolvido com alunos da Faculdade de Medicina da Universidade Federal de Pelotas, com o objetivo de analisar a contribuição da Psicanálise na educação médica. No ensino da Medicina, a Psicanálise é apontada, desde Freud, como importante forma de melhorar a capacidade de atendimento de pacientes. O modelo de ensino de Psicologia Médica, implantado por Abuchaim (1980), na FAMED/UFPEL, de fundamentação psicanalítica, propõe o acompanhamento longitudinal do aluno durante o curso, estimula seu contato com as pessoas e com situações comuns da vida, instigando questões provocadas pelas vicissitudes do inconsciente e seu debate. O presente estudo utiliza o método psicanalítico de pesquisa. Foram ouvidos os alunos/monitores do Projeto de Extensão “Relação Médico-Paciente em Estudantes de Medicina”, de 2009, em grupos focais e feita análise de enunciação de seu discurso. Esta destaca temas como o saber, seus desdobramentos simbólicos e os sofrimentos diante do enfrentamento da morte. A referência a expectativas, diante de exigências e demandas do meio social também é notável. A tecedura de um aprendiz é feita com aqueles que ensinam a língua e vinculam o sujeito a um contexto que integra exigências do superego, ideais e contingências da vida. Demandas superegóicas insaciáveis e cruéis são capazes de embrutecer pessoas e significar um alto risco a estudantes de medicina. Nesse sentido, questiona-se: eles podem suportar como Quíron, ser feridos em seu narcisismo? O aluno/monitor, suposto-saber em um grupo, demonstra capacidades de construir as bases para sustentar relações transferenciais. Isso se verifica, quando ele tem a coragem de dirigir-se ao outro, suportando o não saber, o que pressupõe a verdade do inconsciente como fundamento. Ao sustentar a estranheza, fazendo o corte na ilusão de um saber absoluto, o grupo cria possibilidades de que surjam as diferenças de cada um, oportunizando, através do enfrentamento do vazio, o surgimento de estilos próprios. Carregado das marcas de suas singularidades e responsabilidades, o sujeito é convocado a aprender diante dos desafios. / This is the result of a study undertaken with students in the Federal University of Pelotas School of Medicine (FAMED-UFPEL), aiming to evaluate the contribution of psychoanalysis in medical education. Psychoanalysis in the teaching of medicine has been recognized, since Freud, as an important means to improve the ability of patient care. The teaching model of Medical Psychology established by Abuchaim (1980) in FAMED-UFPEL, of psychoanalytic background, proposes longitudinal follow-up of students during the course, encouraging their contact with people and with common life situations, prompting questions that are provoked by the vicissitudes of the unconscious, and their debate. The study uses the psychoanalytic method of research. Student-monitors in the 2009 extension project "Doctor-Patient Relationship in Medical Students" were heard in focus groups, and their speech was subjected to discourse analysis. The analysis highlights issues such as knowledge, its symbolic aftermath, and the suffering brought by facing death. The reference to expectations regarding requirements and demands from the social environment is also remarkable.The weaving of a learner is made with those who teach the lingo and bind the subject to a framework that integrates superego demands, ideals and life contingencies. Insatiable and cruel superego demands can brutalize people and pose a significant risk for medical students. Can they endure, as Chiron, to be injured in their narcissism? The student-monitors, as supposed-to-know in a group, demonstrate the ability to build the foundation for sustaining transference relationships, as they have the courage to address the other supporting the not knowing, which presupposes the truth of the unconscious as a foundation. By supporting the strangeness and cutting the illusion of absolute knowledge, the group creates possibilities that arise from each other’s differences, providing the opportunity, through the facing of the void, for the emergence of their own style. Born of the trademarks of their singularities and responsibilities, the subject is called to learn in the face of the challenges.

Recognising Acute Deterioration: Active Response (RADAR) is a simulation based teaching session using simulated patients to portray acutely unwell adult hospital patients. The genesis, development and progress of RADAR will be discussed along with the findings of questionnaires and focus groups from two further cycles of action research. Readers will become aware of the impact which RADAR makes to the evidence and learning surrounding the recognition and assessment of clinical deterioration in adult hospital patients. The study investigated the impact of simulation on medical students’ confidence in recognising and responding to clinical deterioration in adult hospital patients using simulation, simulated patients and moulage (make-up).

Due to increasing societal demands, accountability and economic constraints, there has been a paradigm shift in the healthcare culture with a move to formally train medical educators. This has resulted in the professionalisation of medical education, with various development initiatives including postgraduate qualifications. The demand for these qualifications in medical education can be judged by the increase in providers, from 2 to 31 in the UK and from 7 to 124 worldwide over the last two decades. However, detailed information about the influence and effectiveness of such courses remains sparse. This study investigated the impact of postgraduate qualifications in medical education on graduates’ educational identities, practices and career progression. The study design is mixed methods using the explanatory model. The first study comprised of an online survey of graduates from the Centre for Medical Education, Dundee between 2008 and 2012. The data collected were sequentially explored in more depth through semi-structured interviews in the second study. To increase the range and scope of enquiry a third study was carried out, which involved a 10 month follow-up of a new cohort of face-to-face students (2013/14) through the course and to the workplace. The quantitative data were analysed using non-parametric statistics on SPSS 21, and constructivist grounded theory analysis was used for the qualitative data in ATLAS.ti 7. I found that a qualification in medical education enhances theoretical foundations in educational practices, with increased self-efficacy and engagement in scholarly activities. The qualification encourages transformational changes and epistemological development as a teacher, researcher, leader and learner. Many participants attributed their career progression to the qualification. The graduates were able to lead various educational changes in the workplace and they described substantial performance attainments. I also found their work environment and personal factors influenced the impact of these qualifications. A conceptual framework based on an increased understanding of the identity development of healthcare educators was also developed. This is the first study on the long-term effects of a degree-awarding course in medical education on healthcare professionals worldwide. The findings have implications for the educators, course directors, healthcare organisations and professionalisation of the speciality.

Estudos recentes apontam para a importância de investigações mais abrangentes sobre o universo da formação médica, ressaltando que essa não é constituída somente de habilidades e procedimentos, mas, principalmente, por um complexo quadro de atitudes. Percebe-se que a carga horária do curso é extenuante e, mesmo assim, muitos estudantes se envolvem com uma infinidade de atividades extras durante a sua formação, construindo vasto currículo paralelo. Este estudo objetivou investigar as concepções dos estudantes de uma Faculdade de Medicina sobre as vivências, peculiaridades e papéis das atividades extracurriculares durante a formação médica. A investigação foi orientada pela abordagem qualitativa e estruturada em três etapas: pré-inquérito por meio da aplicação de questionário aos estudantes do 1º ao 6º ano de Medicina (n=423); entrevistas individuais, segundo roteiro semi-estruturado (n=24) e entrevistas em dois grupos focais constituídos por três encontros (n=14). Na 1ª etapa do estudo, os resultados apontaram que 90% dos participantes do 2º ano até o 4º ano do curso participam de atividades extracurriculares que estão vinculadas ao contexto universitário e despendem, em média, mais de 8h semanais. A participação em ligas acadêmicas foi a atividade mais freqüentemente relatada pelos estudantes do 1º ao 4º ano, sendo que “aproximar da prática médica" foi o principal motivo apontado nesse quesito. Em relação ao 5º e ao 6º ano, as participações em atividades de iniciação científica e monitorias foram as mais relatadas e motivadas pela “contribuição para o currículo". A Atlética, entidade estudantil que objetiva a participação em competições desportivas, obteve o envolvimento constante dos estudantes durante todos os anos do curso. Os dados advindos das entrevistas individuais revelaram que os estudantes de medicina identificam seu envolvimento com atividades extracurriculares como tentativa de preencher lacunas curriculares, suplementar o curso, integrar-se com os colegas de diferentes anos, atenderem indagações profissionais futuras e/ou proporcionar o distanciamento do cotidiano médico. A utilização da estratégia em grupo focal, alicerçada na abordagem do Sociodrama Educacional, possibilitou que conflitos e contradições, relativos ao cotidiano da formação médica, acabassem por emergir. Apesar dos benefícios apontados pelos estudantes, os dados levantados evidenciam sentimentos de insegurança e conflitos decorrentes da dificuldade deles em conciliar as atividades extracurriculares, o lazer e o curso. Além disso, as percepções dos estudantes sugerem a necessidade premente de ocupação do tempo livre, manifestando um antagonismo diante das insatisfações advindas do vulnerável período do curso médico. / Recent studies show the importance of more including inquiries on the universe of the medical formation, standing out that this is not only constituted of abilities and procedures, but, mainly, for a complex group of attitudes. The schedule of the course is exhausting, thus, many students involve themselves with an infinity of extra activities during their formation, constructing a vast parallel curriculum. This study aimed at inquiring the perceptions of students at a Medical School about their experiences and peculiarities, as well as the role of extracurricular activities during the medical formation. The inquiry was guided by the qualitative and structuralized boarding in three stages: pre-inquiry through the questionnaire application from 1st to 6th year of Medicine students (n=423); individual interviews, according to semi-structuralized script (n=24) and interviews in two focal groups consisting by three meetings (n=14). In the 1st stage of the study, the results had pointed that 90% of the participants of 2nd to 4th year of the course participate of extracurricular activities that are tied with the university context and expend, on average, 8h weekly. The participation in academic leagues was the activity more frequently told by the 1st to 4th year students, where “to approach to the medical practice" was the main reason pointed in this question. Regarding the 5th and 6th year, the participation in activities of scientific initiation and monitorized had been told and motivated by the “contribution for the curriculum". The “Atlética", an entity for students that objective the participation in sporting competitions, got the constant envolvement of the students during every year of the course. The resulting data of the individual interviews had disclosed that the medicine students identify their envolvement with extracurricular activities as an attempt to fill curricular gaps, to suplement the course, to combine themselves with the colleagues of different years, to take care of future professional investigations and/or to keep away from the medical routine. The use of the strategy in focal group, based on the approach of the Educational Sociodrama, made possible the appearance of conflicts and contradictions, related to the daily routine of the medical formation. Although the benefits students pointed, data evidence feelings of unreliability and decurrent conflicts because of their difficulty in conciliating the extracurricular activities, the leisure and the course. Moreover, the perceptions of the students suggest the necessity of free time occupation which serves as possible “counterpart" from the contradictions and dissatisfactions of the vulnerable period of the medical course.