Thesis (Ed. D.)--University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on August 14, 2007) Vita. Includes bibliographical references.

Η εργασία αυτή προτείνει το συνδυασμό δυο θεωριών μάθησης, της μετασχηματίζουσας και της τοποθετημένης μάθησης στην κοινότητα πρακτικής των ιατρών. Οι νεοεισερχόμενοι ιατροί μεταβαίνουν από την περιφερειακή συμμετοχή στη πλήρη ένταξη ανάλογα με τον τρόπο που είναι σχεδιασμένη η εκπαίδευσή τους και το βαθμό στον οποίο συνειδητοποιούν και ελέγχουν τα επιμέρους έργα και τις δραστηριότητες που εκτελούν. Οι ειδικευόμενοι, αλλά και οι πιο έμπειροι ιατροί πρέπει να είναι σε θέση να συνειδητοποιούν το βαθμό και τις διαδικασίες σταδιακής ένταξής τους σε μια κοινότητα πρακτικής και αφετέρου με τον κριτικό στοχασμό να είναι σε θέση να αναλύσουν τις εμπειρίες από τη συμμετοχή τους στην κοινότητα πρακτικής, να είναι δηλαδή σε θέση να υιοθετήσουν πρακτικές με κριτική οπτική και όχι με απλή αφομοίωση. / This work proposes the combination of two theories of learning, transformative and situated learning in the community of practice of doctors. The newcomer doctors transfer from peripheral membership in full membership depending on their education and the degree to which they realise and check the individual work and the activities they execute. The specializer and the most experienced doctors should be able to realise the degree and the procedure of their progressive integration in community of practice. Through critical reflection they should also be able to analyze their experiences from attending the community of practice, that is to say to be able to adopt practices critically, not only through mere assimilation.

Made available in DSpace on 2015-12-06T23:05:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2004 / A partir da importância atribuída à comunicação na relação médico-paciente com fator de boa adesão ao tratamento, surgiu o interesse em saber quando e como s contempla o ensino/aprendizagem de comunicação nos cursos de graduação em medicina. As recomendações sobre o desenvolvimento da competência "comunicação" preconizadas nas novas Diretrizes Curriculares Nacionais acrescentam uma justificava a mais para a pesquisa. Delimitado o campo da pesquisa, revisada a literatura e optado pelo referencial metodológico da pesquisa qualitativa, foram entrevistados doze egressos de cursos de medicina que estavam iniciando residência em Clínica Médica e nove professores, coordenadores de ensino de cursos de graduação em medicina. A análise da entrevistas, feita sob o olhar fenomenológico, privilegia o vivido. Aparece uma grande diversidade de concepções sobre o que seja a comunicação, contudo das falas dos entrevistadores emergem categorias de análise que mostram, em essência, uma tendência para considerar a competência comunicação como uma habilidade instrumental para se conseguir tirar informações e se fazer entender no procedimento médico. A temporalidade (o quando) também apresenta uma gama de possibilidades, distribuída entre as matérias iniciais e as atividades finais do curso. A forma (o como) de ensino/aprendizagem se distribui entre disciplinas básicas e atividades práticas. Em essência, o aprendizado se revela como produto da vivência pessoal ao longo do curso e da experiência na prática junto ao paciente. / The importance attributed to communication in the physician-patient relations as a factor of satisfactory adherence to treatment has spurred an interest in determining when and how the teaching/learning of communication in undergraduate medical courses should be contemplated. The recommendations on the development of the “communication” competence, advocated in the new National Curricular Guidelines, are one more reason to justify this study. Once the field of investigation was outlined, the literature reviewed and a choice of the qualitative research methodological criterion made, interviews were conducted with twelve graduates from the medical schools who were starting residency in Medical Practice and nine teachers who acted as area coordinators for undergraduate medical programs. The analysis of the interviews, made from a phenomenologic perspective, favors the experience lived. A broad range of concepts came up on what communication is, but, on the other hand, a number of analysis categories arose from the interviewees’ statements which show, in essence, a trend to consider communication competence as an instrumental skill to obtain information and make oneself understood in the medical procedure. Temporality (when) also points to a number of possibilities, spread out between the early disciplines and the final activities of the course. The form (how) of teaching/learning is distributed between basic disciplines and practical activities. Fundamentally, learning comes out as a product of personal experience throughout the course and of the practical experience with the patient. / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2015-12-06T23:44:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2006 / Este trabalho teve por finalidade conhecer a participação da iniciativa privada em projetos de educação continuada e congressos organizados pela Federação Brasileira das Associações de Ginecologia e Obstetrícia, Sociedade Brasileira de Clínica Médica e Sociedade Brasileira de Ortopedia e Traumatologia, com objetivo de aferir se estas sociedades poderiam organizar eventos e demais projetos sem o patrocínio externo e saber se as empresas que apóiam financeiramente tais atividades interferem na sua elaboração. A coleta de dados foi feita através de uma entrevista semi-estruturada aberta com os presidentes das três sociedades médicas. Os achados mostram que as instituições pesquisadas não poderiam arcar com os custos dos projetos de educação continuada sem o patrocínio das empresas farmacêuticas, e que 65% dos projetos desenvolvidos são integralmente financiados pelas mesmas. Outro dado importante é que a iniciativa privada não influencia o conteúdo científico dos projetos que patrocinam ou congressos dos quais participam, cabendo integralmente às entidades médicas pesquisadas a definição dos temas e autores. / This paper intended to study the private-sector involvement in continuing education issues and also in congresses organized by the Brazilian Federation of the Associations of Gynecology and Obstetrics, Brazilian Society of Medical Clinic and Brazilian Society of Orthopedics and Traumatology. The study aimed to verify whether such entities could, without using external sponsorship, organize events and other projects with the purpose of keeping their members updated, and find out whether the companies financially supporting such activities would interfere in the development of those events. Data were collected through an open semistructured enquiry with the presidents of three medical societies. The findings showed that the research institutions would not be able to bear the costs of continuing education without the sponsorship of pharmaceutical companies, since 65% of the projects developed are totally financed by these entities. Another important finding was that the private sector does not influence the scientific contents of the projects sponsored by them or of the congresses they participate in, and the medical entities enquired are fully in charge of defining both the themes and authors. / BV UNIFESP: Teses e dissertações

Many Thai scholars are skeptical that Thai medical doctors can utilize knowledge and skills in Thailand from experience acquired when they study abroad, due to cultural differences, including a hierarchical culture that places importance on seniority and can prevent medical doctors seeking to actualize those new skills when they return to work in Thailand. Despite growing interest in and study of globalization, there are few existing studies that explore the relationship between social and individual consequences of formal study abroad programs. Nor are there many studies that apply sociological theory on the professions to less developed countries, or that focus on the relationship between power and culture in medical education in Thailand. This thesis will explore these topics by first reviewing and discussing three main bodies of sociological literature on medical professionalization, educational institutions, and study abroad. Given the gaps in the literature, it proposes a comparative study that relies on in-depth interviews with two groups of Thai medical doctors: those who have studied abroad and those who have not. The comparative design will allow the researcher to gain leverage on the consequences of study abroad to individual career trajectories, as well as the broader healthcare system, and contributes to the building of new sociological theory. Despite the many challenges that Thai doctors who go abroad face in adapting and actualizing new skills, I hypothesize that study abroad alters Thailand’s social hierarchy through the creation of a new class of “international doctors,” endowed with new skills, knowledge and cultural capital. While the benefits of belonging to this elite class may not be manifested immediately, due to the seniority system, they become apparent over time.

INTRODUCTION: Medical school curricula are shifting away from passive traditional lecture styles to a more engaging active learning style. This includes flipped-classroom and problem-based learning. While there is evidence that active learning promotes memory retention, critical thinking and self-directed learning, it is also met with resistance from both educators who lack the time or pedagogical training and students who have grown comfortable with passive lecture-based learning. In 2015, Boston University School of Medicine implemented an active learning online learning module, Softchalk, utilized by first year students in an integrated course, Principles Integrating Science and Medicine. Based on survey analysis, Softchalk was a successful learning tool and was once again used in 2016. Improvements were made to Softchalk for the upcoming 2016 class. These consisted of making the learning modules more condensed, consistent and Softchalk was no longer requiring them to be completed for a grade. OBJECTIVE: Assess and compare 2015 vs. 2016 survey results to gauge the student’s perceived effectiveness of Softchalk. METHODS: A mixed-methods survey analysis study was administered to first year medical students enrolled in the biochemistry course at Boston University School of Medicine (total of 180 matriculates). The survey was a voluntary and anonymous. It consisted of two open-ended free response questions and six Likert Scale questions. RESULTS: Softchalk has been incorporated into the curriculum for two years, 2015 and 2016 and thus student responses were compared. There was a significant difference in both student perception of Softchalk providing a foundation for the course (p= 0.001) and helping the students stay on track (p=0.024). However, there was no significant difference between the 2015 and 2016 cohorts in regards to Softchalk providing more effective questions (p= 0.08) or the use of Softchalk as a teaching tool (p=0.051). In the free-response questions, student responses were compared and showed that Softchalk was much more favorable in 2016 than 2015. CONCLUSION: Perceptions of Softchalk were much more favorable in 2016 in comparison to 2015. This thesis is arguing that the main factor in the increased perception of Softchalk was based on the fact that it was no longer required to complete. In 2015, Softchalk was presented as an optional tool for learning instead of another requirement to complete. Students who utilized Softchalk were more likely to have a favorable outlook because it conducive to their learning style. In addition, Softchalk allows students to develop self-directed learning skills by allowing them to be in control of their learning experience, which becomes increasingly important for the clinical clerkship learning and beyond.

Este estudo teve o propósito de analisar o quanto a graduação prepara os acadêmicos de Medicina para o enfrentamento com a morte, assim como buscou compreender o que significa para os alunos, sujeitos desta pesquisa, o enfrentamento com a morte em sua prática educativa no cotidiano hospitalar. Realizou-se uma pesquisa com abordagem quantitativa e qualitativa. Primeiro foi aplicado um questionário semi-estruturado, com os alunos do oitavo semestre do curso de Medicina da Universidade Federal do Rio Grande do Sul. Posteriormente, foram ouvidos, através de entrevistas gravadas, cinco alunos entre o décimo primeiro e décimo segundo semestre do curso. Através da análise de conteúdos das respostas, foi possível conhecer suas expectativas e frustrações em relação às temáticas da morte e do morrer. Pela análise dos questionários e das entrevistas, pode-se perceber o medo, o sentimento de impotência e até mesmo a banalização da morte, o que implica a necessidade de um ensino mais apropriado sobre este tema, bem como espaços de discussão e de aproximação com a morte e o morrer dos pacientes dentro dos campos das práticas educativas. Os acadêmicos referem o desejo de uma formação capaz de re (pensar) a emoção e razão, médico e paciente, professor e aluno, a cura e o cuidado, a vida e a morte. / This study proposed to analyze how much the graduation prepares the Medicine academics to face the death as it wanted to understand what it means to the students, subjects of this research, the cope with death in their educational practice daily in the hospital. A research was made up with quantitative and qualitative approach. First, it was made a semi-structured survey with the students of the eighth semester of the Medicine School of Universidade Federal do Rio Grande do Sul. Later, were listened to, through recorded interviews, five students between the eleventh and the twelfth semester of the course. Through the analysis of the contents of the answers, it was possible to know their expectations and frustrations on issues of death and dying. From the analysis of the surveys and interviews, we could notice fear, the feeling of powerlessness and even the trivialization of death, which implies in the need for a more appropriate teaching on this topic, as well as more area for discussions and approach with death and dying of patients in the educational practices. The academics refer to a desire for training able to re (think) the emotion and reason, physician and patient, teacher and student, cure and care, life and death.

The educational field has been suffering with important changes through the past few years and it is getting harder to understand how complex is to educate. In Brazil, according to the "Lei de Diretrizes Básicas da Educação" (Statute of Basic Guidelines to Education - SBGE - in free translation to English), providing education is an obligation of the family and the State, inspired by principles of freedom and ideals of human sympathy, and it is meant to allow the students complete development, their preparation to exert their rights and duties with society and their professional qualification. It is known that the Education is not an impartial field, but it is under strong politic influence, making the educational aims to be based on market logics, productionist and capitalist. Thought this perspective, the way teachers evaluate have turned into a strategy to control the professional formation in accordance with work organized in productivity and goals, typical of the political and productive neoliberal economic system. The emphasis is on the evaluation and measurement of behaviours and attitudes that must meet pre-defined objectives, thereby increasing the punitive and classificatory perspective of evaluation. At the Schoolof Medicine in the Federal University of Alagoas (Faculdade de Medicina da Universidade Federal de Alagoas - FAMED-UFAL), the evaluations have been the subject of internal criticism since the implementation of the new curriculum and there is a teacher-student discontent regarding this educational element. This study aimed to promote a broader understanding of the student's evaluation at FAMED-UFAL under the teachers' perspective. For technical research reasons, the qualitative method was chosen to develop the research, using an exploratory approach and phenomenography as a research strategy. The study revealed three different profiles of evaluators; the orthodox; the insightful and the evaluator that invests in a diagnostic evaluation. In addition, there was insufficient theoretical knowledge about the evaluation process and the relationship of teaching to the globalized and capitalized world; resistance to teamwork; failed modes of relating planning and decision- making; failure or denial of understanding of the political-pedagogical transformative emancipatory role. This study generated a technical report in two formats, written and filmed, for the coordination, collegiate and teachers of the course medicine course of FAMED / UFAL. It presents the results of research as well as some recommendations for institutional development and teaching in the field of evaluation. / O campo da educação vem sofrendo importantes mudanças ao longo dos últimos anos, e cada vez mais se torna difícil entender a complexidade que envolve o ato de educar. No Brasil, de acordo com a LDB, a educação é dever da família e do Estado, inspirada nos princípios de liberdade e nos ideais de solidariedade humana, e tem por finalidade o pleno desenvolvimento do educando, seu preparo para o exercício da cidadania e sua qualificação para o trabalho. Sabe-se que a educação não é neutra, sofre forte influência política, que define os objetivos educacionais baseados na lógica de mercado produtivista e capitalista. Nessa perspectiva, as práticas avaliativas surgem como estratégias de controle para garantir uma formação profissional adequada ao trabalho organizado em metas e produtividade, característico do sistema político e produtivo econômico neoliberal. A ênfase incide na avaliação e mensuração de comportamentos e atitudes que devem atender a objetivos pré-definidos, crescendo assim a perspectiva punitiva e classificatória da avaliação. No âmbito da FAMED/UFAL, a avaliação tem sido alvo de críticas internas desde a implementação do novo currículo, e há um descontentamento docente-discente em relação a esse elemento pedagógico. O presente estudo objetivou promover uma compreensão mais ampla sobre o fenômeno da avaliação do discente no curso de medicina da UFAL sob a perspectiva dos docentes. Para desenvolvimento da pesquisa, optamos pelo método qualitativo, de caráter exploratório, utilizando como estratégia de investigação a fenomenografia. O estudo revelou três perfis de avaliadores; os tradicionais; os criteriais, e os que investem em uma avaliação diagnóstica. Além disso, verificou-se insuficiência de conhecimento teórico sobre o processo de avaliar e sobre a relação do trabalho docente com o mundo globalizado e capitalizado; resistência para o trabalho em equipe; insuficiência dos modos de relação para o planejamento e tomada de decisões; insuficiência ou negação da compreensão do papel político-pedagógico transformador, emancipador. Este estudo gerou um relatório técnico, elaborado em dois formatos, escrito e vídeo, destinado à coordenação, colegiados e docentes do curso de medicina FAMED/UFAL. Nele, estão apresentados os resultados da pesquisa, bem como algumas recomendações para o desenvolvimento institucional e docente no campo da avaliação.

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.

This study examines the accelerating of expertise by training novices to attend to the situational cues that experts notice to solve problems. The purpose of this qualitative study is to examine and expand upon training of expertise by using the expertise-based training (XBT) approach as a guide. Specifically, the study investigated a strategy for targeting the beginning of situation awareness and pattern recognition. Medical and nursing student participants were asked to interactively observe videotaped simulated nursing scenarios for the presence of errors, with experts’ observations of the same clips provided as feedback. Participants were cued to reflect upon how their observations differed from experts’ observations of the same video clips. The study qualitatively analyzed the scenario observations and focus group responses to determine if the students expanded their basic level of clinical judgment. The study found that the students enjoyed the scenarios even while promoting cognitive dissonance as the errors generated a substantive discussion. The potential benefits of the study to nursing education, along with other fields that employ simulator training, will be in discovering new ways to employ the simulator for maximum efficiency and effectiveness.