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.

BACKGROUND: In 2009, the Government of the Republic of Vietnam adopted legislation requiring all clinicians to complete continuing medical education (CME) credits in order to maintain licensure. Several CME in-person and distance-based courses have been developed and as of 2015, a national distance-based electronic learning (eLearning) network was being established. However, the uptake of CME courses remained low despite high clinician demand. Vietnam’s high mobile phone ownership rate of 1.4 mobile subscriptions per person presents an opportunity to leverage this for CME. This study investigated how mobile technologies could strengthen delivery of distance-based CME courses and improve national CME program administration. METHODS: A literature and policy review was conducted. Qualitative methods were employed to collect and analyze key informant interviews of 52 global and Vietnamese experts, including selected policy makers. Interviews were supplemented by six focus group discussions with Vietnamese physicians, nurses, midwives and physician assistants. Transcripts were analyzed using an inductive coding methodology. A framework was developed to organize and present results for government consumption. RESULTS: Globally, examples and supporting evidence related to mobile technologies for CME were limited. Experts reported three main use cases for using mobile technology for CME in Vietnam: 1) delivery of CME courses (N=34; 65%); 2) registration and tracking of CME credits (n=28; 54%); and 3) sending alerts and reminders on CME opportunities (n=23; 44%). The national CME policy environment in Vietnam was supportive of introducing mobile technologies within the eLearning network. However, there was a widespread lack of awareness and capacity to design and deliver distance-based CME courses. Mobile phone ownership was high and health workers reported interest in acquiring CME credits via mobile. Financing options to develop and implement distance-based CME courses were limited. CONCLUSION: Despite the paucity of evidence related to mobile technologies for learning, there is potential to innovate and strengthen the evidence base using these technologies for CME in Vietnam. Introducing mobile technologies within the national eLearning network would improve clinicians’ access to CME, particularly in rural areas, and can strengthen national CME program administration. Key recommendations were developed to provide the government with concrete steps for national level adoption.

Os problemas dermatológicos afetam aproximadamente um terço da população em algum momento da sua vida e, em aproximadamente 10 a 15% de todas as consultas médicas, a queixa principal deve-se a um problema dermatológico. A despeito desta importância, diversos estudos têm demonstrado deficiências no ensino de dermatologia nos cursos de graduação em medicina. Os sistemas de educação a distância baseados na internet representam uma das alternativas para corrigir esta deficiência e oferecer um maior contato do estudante de medicina com a especialidade. Considerando este cenário, o objetivo deste estudo foi desenvolver um programa de educação a distância em dermatologia para estudantes de graduação em medicina e avaliar o impacto deste mecanismo de ensino no aprendizado dos alunos. Foi realizado um estudo prospectivo incluindo estudantes do segundo ano da Faculdade de Medicina da Universidade de Tecnologia e Ciências de Salvador Bahia Brasil. Os 44 alunos selecionados foram divididos em dois grupos; o grupo que participou de atividades presenciais apenas e o grupo que participou das atividades presenciais associado ao curso de educação a distância (curso híbrido). Todos os alunos foram submetidos a uma avaliação pré e pós curso e o desempenho foi comparado entre os dois grupos. Os estudantes que participaram do curso híbrido apresentaram escores pós-teste superiores (8,9 ± 0,8) aos obtidos pelos alunos que participaram apenas das aulas presenciais (7,75 ± 0,98). Esta diferença foi estatisticamente significante (p <0,05). Os resultados indicaram que o desempenho dos alunos de graduação , do curso de educação a distância em dermatologia associado a atividades presenciais, foi superior ao curso presencial apenas / Dermatological disorders affects approximately one third of the general population. It is estimated that 10 to 15% of all office visits are for dermatologic complaints. Despite this fact, in medical school, the available time for teaching dermatology is usually very limited. The internet based distance education represents a viable alternative to provide greater contact with medical student with this specialty and meet the current deficiencies. Given this scenario, the objective of this study was to develop a program of internet based distance education in dermatology to undergraduate medical students and evaluate the impact of this tool on student learning. This prospective study included student form the second year of School of Medicine at the University of Technology and Science of Salvador Bahia Brazil. The 44 selected students were divided into two groups: the group that participated in classroom activities and the group that participated in classroom activities associated with distance education course (blended course). Tests were applied for all students before and after the course and both scores were evaluated. Students who participated of online discussions associated with face-to face activities had statistically higher post-test scores (8.9±0.8) than those who participated of the classroom activities alone (7.75±0.98). This difference was statistically significant (p <0.05). The results indicated superior performance of undergraduate students who participated in the course of distance education in dermatology associated with classroom activities (blended course) compared to classroom activities alone

Test anxiety has been a problem for many individuals not only in the workforce, but also in many schools and colleges (Driscoll, Evans, Ramsey & Wheeler 2009). According to Driscoll et al., when compared to high school students and the general public (17%), nursing students are shown to have over double (55-60%) the rate of moderately high to high test anxiety. Cognitive test anxiety can account for a 7 to 8% drop in test grades, which can drop test score’s an entire letter grade (Cassady & Johnson, 2001). The purpose of this research is to explore the level of test anxiety in East Tennessee State University (ETSU) nursing students using the Cassady Cognitive Test Anxiety Scale. This study, “Test Anxiety and Nursing Students” was conducted at a Bachelor of Science in Nursing program for students at a large regional university. The Cassady Cognitive Test Anxiety Scale was administered to 220 nursing students one week prior to a major test at the end of the class period. All of the students completing the surveys volunteered to do so. After collection, data was analyzed using IBM Statistical Product and Service Solutions (SPSS) version 18.0.2. This study confirmed the findings of Driscoll et al. (2009) and Cassady et al. (2001), that nursing students have a higher occurrence of test anxiety. Intervention has the potential to improve test scores. This allows for ETSU students to have a better first-pass rate on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and improve student retention rates. In addition, it provides the opportunity for further research interventions to reduce test anxiety for nursing students.

Securing and Excelling in a Pharmacy Residency is a practical guide and handbook for pharmacy students seeking a residency, residents currently enrolled in a program, and residency program leadership. This user-friendly text encourages high-quality pharmacy residency training, which elevates the individual, the profession, and ultimately patient care. Answering the need for residency training and improvement raised by the ASHP/ACCP joint 2020 initiative, Securing and Excelling in a Pharmacy Residency uniquely prepares students for the increasingly competitive pharmacy residency market. This one-of-a-kind resource is also helpful to guide individuals currently enrolled in a residency and their mentors. This valuable resource also addresses options after residency training, priceless guidance for both current residents and faculty advisers.

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