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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

L’école des sages-femmes. Les enjeux sociaux de la formation obstétricale en France, 1786-1916 / The School for Midwives. The Social Issues of Obstetrical Training in France, 1786-1916

Sage-Pranchère, Nathalie 19 November 2011 (has links)
Dans les années 1780, une nouvelle politique française d’encadrement de la naissance choisit lasage-femme comme intermédiaire privilégié entre les attentes médico-administratives et lapopulation. Officialisé par la loi du 19 ventôse an XI sur l’exercice de la médecine, le métier desage-femme n’a plus dès lors qu’un point d’entrée possible et admis : la formation obstétricale.La thèse étudie le consentement des sages-femmes à leur mise en formation, sa chronologie et sesmodalités. Elle aborde la question de la part dans l’évolution de la profession et son renforcementau fil du siècle des dynamiques externes (État, administration, corps médical) et internes (sagesfemmeselles-mêmes). Ou comment les auxiliaires sans instruction de la naissance à la fin duXVIIIe siècle se muent en une profession médicale unifiée au début du XXe siècle.Au-delà, ce travail montre comment l’organisation administrative de la formation, les politiquesde recrutement et la forme des cours participent à la construction d’un nouvel agent sanitaire : lasage-femme qui se retrouve à assumer tour à tour les fonctions d’accoucheuse, de vaccinatrice, demédecin des pauvres ou encore de puéricultrice.En un siècle, les deux-tiers des départements français ont fondé un cours ou une écoled’accouchement. En un siècle, ce sont près de 45 000 sages-femmes qui ont été formées etdiplômées. Cette étude est celle de la construction d’une identité et d’une conscienceprofessionnelle permise par la formation obstétricale. / In the 1780s, the new French policy surrounding childbirth elected the midwife as theintermediary between the medical and administrative powers and the population. From themoment it was made official by the Law of Ventose 19, year XI on the practice of medicine, thesole gateway to midwifery has been obstetrical training.The thesis examines how midwives consented to this training, as well as the timeline of thisconsent and its modalities. It also examines how forces from without (government,administrative rules, physicians) as well as from within (the midwives themselves) created thedynamics allowing the profession to evolve and gain official status in the nineteenth-century—how from untrained birth assistants in the late eighteenth century, midwives turned into a unifiedmedical profession in the early twentieth century.Beyond, this study investigates how administrative guidelines, recruitment policies, trainingcontents and methods led to the creation of a new health worker: the midwife, in charge, byturns, of delivering babies, of performing smallpox vaccinations, of being a doctor to the poor,and of providing expert childcare.In the course of a single century, two-thirds of all French departments founded a midwiferytraining school. Over that century, nearly 45 000 midwives were trained and certified. This studydeals with the construction of a professional identity and a professional conscience, as a result ofobstetrical training.
12

Da superfície à carne : as fronteiras entre estético e reparador na formação e atuação no campo da cirurgia plástica

Schimitt, Marcelle January 2017 (has links)
A partir de uma abordagem do fenômeno das cirurgias plásticas enquanto algo que se conforma na prática, esta dissertação versa sobre os limites entre o reparador e o estético relativos a esses procedimentos. Tendo como espinha dorsal a formação das(os) médicas(os) e a constituição dessa especialidade da medicina, tais fronteiras serão abordadas a partir do entendimento de que não apenas auxiliam na conformação das cirurgias plásticas, mas são também constituídas em relação a essas últimas. Através da participação em eventos promovidos por Ligas de Cirurgia Plástica e entrevistas realizadas com graduandas, residentes, cirurgiãs e cirurgiões plásticos, este trabalho tem como objetivo construir uma narrativa, entre tantas outras possíveis, acerca dos modos como os limites entre o estético e o reparador têm se instituído discursivo-materialmente. Antes, contudo, parte-se de uma abordagem histórica a fim de uma compreensão mais situada a respeito de como essa especialidade tem se conformado ao longo do tempo. Por meio de diferentes investimentos esta dissertação trata, em síntese, sobre como esses procedimentos assumem diferentes realidades. Assim, contingências históricas, sociais, econômicas, políticas e materiais, entre inúmeras outras, são compreendidas de maneira indissociável como atuantes na conformação das cirurgias plásticas e dos limites concernentes a elas. Por fim, sugere-se que um entendimento dessas realidades enquanto múltiplas nos auxilia na construção de uma apreensão do conhecimento médico como algo que não está dado, mas como práticas histórico-materialmente situadas. Ainda, a partir da discussão central proposta por este trabalho são estabelecidos pontos de confluência entre as cirurgias plásticas e as fronteiras relativas ao corpo e aos binômios natureza/cultura, saúde/doença, forma/função, entre outros. / This dissertation addresses the limits between the cosmetic and the reconstructive surgeries from an approach of the plastic surgery phenomenon as something that conforms in practice. Having as a backbone the formation of the doctors and the constitution of this specialty of medicine, such boundaries will be approached from the understanding that they not only aid in the conformation of plastic surgeries but also are constituted of this last one. Through the participation in events promoted by Plastic Surgery Leagues and interviews with undergraduates, residents and plastic surgeons, this study aims to construct a narrative, among many others possible, about the ways in which the boundaries between the cosmetic and the reconstructive surgeries have been instituted discursive-materially. First, however, it starts with a historical approach in order to understand more about how this specialty has conformed over time. Through different investments, this dissertation deals, in short, with about how these procedures take on different realities. Thus, historical, social, economic, political, and material contingencies, among countless others, are understood as acting in the conformation of plastic surgeries and the limits concerning them. Finally, it suggests that an understanding of these realities as multiple helps us in constructing an apprehension of the medical knowledge as something that is not given but as historical-materially situated practices. Still, from the proposed discussion by this study, points of convergence between plastic surgeries and boundaries related to the body and to the binomials nature/culture, health/illness, form/function, among others, are established.
13

Significados atribuídos às práticas na atenção primária à saúde por estudantes de medicina / Meanings attribuited to primary health care practices by medical students

Santos, Everson Vagner de Lucena 16 June 2016 (has links)
Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2016-12-13T11:37:47Z No. of bitstreams: 1 Everson Vagner de Lucena Santos.pdf: 2926796 bytes, checksum: 6cc9e91b01873a085fb4598211ccdd94 (MD5) / Made available in DSpace on 2016-12-13T11:37:47Z (GMT). No. of bitstreams: 1 Everson Vagner de Lucena Santos.pdf: 2926796 bytes, checksum: 6cc9e91b01873a085fb4598211ccdd94 (MD5) Previous issue date: 2016-06-16 / Medical training has been undergoing significant changes based on the new national curricular guidelines for the medical course, with emphasis on the insertion of the medical student in several scenarios that stimulate critical and reflexive formation, focusing on Primary Health Care. Considering this is a scenario of meaningful learning that fosters personal relationships, this research aimed at understanding the meanings attribuited to primary health care practices by medical students. This study was a qualitative research conducted at the Integrated Faculties of Patos, using the in-depth interview technique with medical students attending between the 1st and the 4th semester of course. The composition of the study population took into consideration a research participation invitation and a plurality of criteria, such as gender, age, place of origin, semester in progress, scholarship/financing, medical kinship, and previous graduation degree, totalizing 9 students who attended the theoretical saturation criterion. The interviews were conducted from December2015 to February 2016 and continually recorded in digital audio, lasting from 25 to 90 minutes. The research was approved by the Ethics Committee of the Catholic University of Santos and the interviews were carried out after clarification and signing of the Free and Informed Consent Form. The analytical interpretation was developed based on stages such as pre-analysis, exploitation of the material, treatment of results obtained, and interpretation. The selection of analytical categories was performed by means of anchoring the reading and the substrate, extracted from the empirical data, producing an understanding of the meaning attributed to contradictions, diversities, and tensions that were guided by the Theory of Meaning ful Learning developed by David Ausubel. The empirical data of the study identified the understanding of meanings attributed to the teaching-learning process in Primary Health Care and its practices for the professional dimension and within the scope of the individual's singularity. The findings showed the meanings in different scopes (teaching-learning, professional and personal training) are in agreement with the postulates of the egress profile published in the national curricular guidelines for medical courses, stating the importance of the insertion of the student in spaces of Primary Health Care of the Brazilian National Health System since the beginning of the course, because it is significant for the egress profile and also an indication of a change in medical training and practices in Brazil. / A formação médica vem sofrendo mudanças significativas com base nas novas diretrizes curriculares nacionais para o Curso de Medicina, com destaque à inserção do estudante de medicina em diversos cenários que estimulem a formação crítica e reflexiva, com ênfase na Atenção Primária à Saúde. Sendo este um cenário de aprendizagens significativas que fomenta as relações pessoais, esta pesquisa pretendeu compreender os significados atribuídos às práticas dos estudantes do Curso de Medicina de Patos-PB no eixo da Atenção Primária à Saúde. O estudo foi desenvolvido nas Faculdades Integradas de Patos e trata-se de uma pesquisa de abordagem qualitativa, por meio da técnica de entrevista em profundidade com estudantes do 1º ao 4º semestre do curso de medicina. A composição da população de estudo considerou a livre adesão do convite de participação da pesquisa e a pluralidade de critérios, tais como sexo, idade, local de procedência, período em curso, bolsista/financiamento, parentesco médico e presença de graduação prévia, tendo participado 9 estudantes obedecendo o critério de saturação teórica. As entrevistas foram realizadas de dezembro/2015 a fevereiro/2016 e foram gravadas em áudio digital de forma ininterrupta que duraram entre 25 minutos a 90 minutos. A investigação foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Católica de Santos e as entrevistas só foram realizadas com esclarecimento e assinatura do Termo de Consentimento Livre e Esclarecido. O percurso analítico-interpretativo desdobrou-se nas etapas de pré-análise, exploração do material e tratamento dos resultados obtidos e interpretação. A eleição das categorias analíticas foram realizadas por meio da ancoragem da leitura e o substrato, extraído dos dados empíricos, produziu compreensão ao significado atribuído as contradições, diversidades e tensões que foram norteados pelo referencial teórico metodológico da Aprendizagem Significativa de David Ausubel. Os dados empíricos do estudo identificaram a compreensão de significados atribuídos ao processo de ensino-aprendizagem no eixo Atenção Primária à Saúde e das práticas da atenção primária à saúde para a dimensão profissional e no âmbito da singularidade do sujeito. Os achados do estudo que mostrou os significados nos diferentes âmbitos (ensino-aprendizagem, para formação profissional e pessoal) vão de encontro com os postulados do perfil de egresso publicado nas diretrizes curriculares nacionais para os cursos de graduação em medicina, ao constatar, preliminarmente, que a inserção do estudante desde o início da graduação nos espaços de Atenção Primária à Saúde no Sistema Único de Saúde é um passo importante, pois é significativo para o perfil de egresso que a mesma atribui e indicativo de mudança na formação e prática médica no Brasil.
14

PSYCHOSOCIAL ASPECTS OF HEALTH CARE EXPERIENCES IN WOMEN WITH VULVOVAGINAL PAIN: PATIENT AND PHYSICIAN PERSPECTIVES

Boyer, STEPHANIE 24 April 2014 (has links)
Vulvodynia, a common form of chronic vulvovaginal pain, is conceptualized as a multifactorial chronic pain condition. Research has examined the role of numerous physiological, psychological, and social factors in the development and maintenance of vulvodynia, however, health care experiences have not been closely examined in this clinical population. Three online studies were conducted to investigate the health care experiences of women with chronic vulvovaginal pain. Study 1 examined pelvic examination (PE) experiences in women with and without chronic pain during intercourse. During their last PE, women with pelvic and vulvovaginal pain reported significantly more pain and anxiety compared to women without pain during intercourse. Various predisposing (first PE experience), examination (quality of patient- physician interaction, physician gender), and psychological factors (vaginal penetration cognitions, body image) predicted PE ratings in women with and without pain during intercourse. Study 2 more broadly examined pain and adjustment in women with vulvovaginal pain. Pain-related beliefs (i.e., attributional style, perceived control) were related to health care variables and predicted adjustment. First, global attributions predicted depressive symptoms and pain-related cognitions/responses after controlling for pain severity and interference. Second, chance beliefs moderated the relationship between pain-related cognitions/responses and internal attributions. Third, women with higher chance and lower physician pain beliefs reported lower social support. Study 3 investigated the knowledge, attitudes, and comfort of Canadian medical residents in Family Medicine and Obstetrics and Gynecology (OBGYN) about vulvodynia. OBGYN residents later in their training reported greater knowledge and comfort with vulvodynia and its symptoms than their more junior counterparts; ratings did not significantly differ between specialties. Residents did report significantly more positive attitudes toward patients with ii vulvovaginal pain of identifiable pathology in comparison to patients with no physical findings. Comfort discussing sexuality in medical practice was a significant predictor of knowledge, attitudes, and comfort with vulvodynia after controlling for demographics/training variables. These findings offer a multidimensional perspective on the role of health care in biopsychosocial models of vulvovaginal pain, and have implications for the assessment and treatment of vulvodynia and Genito-Pelvic Pain/Penetration Disorder. / Thesis (Ph.D, Psychology) -- Queen's University, 2014-04-24 16:39:05.723
15

Prescribing in teaching hospitals:exploring social and cultural influences on practices and prescriber training

Page, Meredith Ann January 2008 (has links)
Master of Pharmacy / Medicines are a fundamental healthcare intervention, but the benefits they provide depend entirely on the way in which they are used. This begins with prescribing, a complex task with substantial risks. Systematic evaluation of biomedical factors may be viewed as an essential component of this task, but prescribers also integrate an array of individual, social, cultural, environmental and commercial factors into their prescribing decisions. Furthermore, social and cultural characteristics of the prescriber’s workplace may influence how well prescribing decisions are carried out. Whilst numerous research efforts have helped to construct an in-depth understanding of non-biomedical influences on GP’s prescribing patterns, the characteristics of corresponding sorts of influences in teaching hospitals have not been well determined. In hospitals, supervised medical trainees, registrars and consultants prescribe within the framework of medicines management systems involving nurses, pharmacists and patients. Currently, little is known about whether each of these groups has distinct beliefs, attitudes and values that may affect either prescribing behaviour or how prescribing skills of medical trainees are acquired. The aim of this study was to explore the social and cultural dynamics of prescribing and prescriber training in teaching hospitals. To do this, established qualitative methods were employed. Junior doctors, registrars, consultants, nurses, and pharmacists from two metropolitan teaching hospitals were sampled purposively and invited to participate in semi-structured interviews. A brief questionnaire was used to collect demographic and contextual information. In the interviews, participants were asked about their attitudes towards prescribing, their perceptions of roles and responsibilities, how they communicated prescribing decisions, their perceptions of influences on prescribing, and their perceptions of factors contributing to prescribing errors. Participants were also asked for their opinions on various aspects of new prescriber training. Sampling proceeded until redundancy of themes was established. A pilot study was conducted with one participant from each professional group to optimise the interview schedule, and then using this tool, a further 38 participants were interviewed. In total, eight consultants, eight registrars, nine junior doctors, eleven pharmacists, and seven nurses participated. Using reiterative content analysis of a third of all transcripts, a coding scheme was developed, which was used to label and categorise the remaining transcripts. Categories were further developed and refined. The resultant core themes were cross indexed against the five different health professional types using thematic charts to explore patterns. The main lines of enquiry for this research were mapped, the properties of these categories and interrelationships explored in detail, and a model of the prescribing process was developed. Prescribing at the teaching hospitals was a complex process consisting of multiple steps undertaken by several different health professionals of varying levels of experience from three different health care disciplines. Because of the intricate separation of responsibilities, the operation of the process was highly reliant on the behaviours of each player and their relationships with each other. Key prescribing decisions associated with patient admissions were made, almost exclusively, by medical teams. Prescribing was therefore chiefly characterised by factors influencing the behaviours of the doctors. Their behaviours were influenced by factors relating to their individual characteristics (eg, knowledge, skills, experience); but also by a web of socio-cultural determinants inherent to the environment in which they worked. These factors were related to: the organisational structure of the prescribing process; the knowledge characteristics of the doctors; the communication patterns they used; the underlying assumptions they made about prescribing; and the work environment.
16

Prescribing in teaching hospitals:exploring social and cultural influences on practices and prescriber training

Page, Meredith Ann January 2008 (has links)
Master of Pharmacy / Medicines are a fundamental healthcare intervention, but the benefits they provide depend entirely on the way in which they are used. This begins with prescribing, a complex task with substantial risks. Systematic evaluation of biomedical factors may be viewed as an essential component of this task, but prescribers also integrate an array of individual, social, cultural, environmental and commercial factors into their prescribing decisions. Furthermore, social and cultural characteristics of the prescriber’s workplace may influence how well prescribing decisions are carried out. Whilst numerous research efforts have helped to construct an in-depth understanding of non-biomedical influences on GP’s prescribing patterns, the characteristics of corresponding sorts of influences in teaching hospitals have not been well determined. In hospitals, supervised medical trainees, registrars and consultants prescribe within the framework of medicines management systems involving nurses, pharmacists and patients. Currently, little is known about whether each of these groups has distinct beliefs, attitudes and values that may affect either prescribing behaviour or how prescribing skills of medical trainees are acquired. The aim of this study was to explore the social and cultural dynamics of prescribing and prescriber training in teaching hospitals. To do this, established qualitative methods were employed. Junior doctors, registrars, consultants, nurses, and pharmacists from two metropolitan teaching hospitals were sampled purposively and invited to participate in semi-structured interviews. A brief questionnaire was used to collect demographic and contextual information. In the interviews, participants were asked about their attitudes towards prescribing, their perceptions of roles and responsibilities, how they communicated prescribing decisions, their perceptions of influences on prescribing, and their perceptions of factors contributing to prescribing errors. Participants were also asked for their opinions on various aspects of new prescriber training. Sampling proceeded until redundancy of themes was established. A pilot study was conducted with one participant from each professional group to optimise the interview schedule, and then using this tool, a further 38 participants were interviewed. In total, eight consultants, eight registrars, nine junior doctors, eleven pharmacists, and seven nurses participated. Using reiterative content analysis of a third of all transcripts, a coding scheme was developed, which was used to label and categorise the remaining transcripts. Categories were further developed and refined. The resultant core themes were cross indexed against the five different health professional types using thematic charts to explore patterns. The main lines of enquiry for this research were mapped, the properties of these categories and interrelationships explored in detail, and a model of the prescribing process was developed. Prescribing at the teaching hospitals was a complex process consisting of multiple steps undertaken by several different health professionals of varying levels of experience from three different health care disciplines. Because of the intricate separation of responsibilities, the operation of the process was highly reliant on the behaviours of each player and their relationships with each other. Key prescribing decisions associated with patient admissions were made, almost exclusively, by medical teams. Prescribing was therefore chiefly characterised by factors influencing the behaviours of the doctors. Their behaviours were influenced by factors relating to their individual characteristics (eg, knowledge, skills, experience); but also by a web of socio-cultural determinants inherent to the environment in which they worked. These factors were related to: the organisational structure of the prescribing process; the knowledge characteristics of the doctors; the communication patterns they used; the underlying assumptions they made about prescribing; and the work environment.
17

A mixed method investigation of the Rubber Hand Illusion

Lewis, Elizabeth January 2016 (has links)
Embodiment is the experience of one's own body. It is often studied using the Rubber Hand Illusion (RHI). This illusion varies the consistency between visual, tactile and proprioceptive signals to elicit a change to embodiment. Changes to embodiment are typically measured using a single sensory outcome measure of proprioceptive drift, which is interpreted as a proxy measure of embodiment. This approach obscures the unique contribution of other modalities such as vision and touch. The work presented in this thesis uses a mixed method approach to investigate the unique contribution of visual, tactile and proprioceptive modalities within the multisensory process of embodiment. In study one, a qualitative analysis showed that when visual-tactile discrepancies were present in the RHI, participants described both body ownership and body extension type changes to embodiment, and changes to tactile perception. In study two, psychophysical measurements of the RHI showed changes to visual, tactile and proprioceptive aspects of embodiment, suggesting that embodiment in the RHI could be measured using multiple sensory outcomes. Studies three and four assessed the utility of measuring multiple sensory outcomes of the RHI, by exploring changes to embodiment following internal and external forms of body perception training. Study three showed that brief body scan meditation, as a form of internal body perception training, reduced the longevity of the visual sensory outcome of the RHI and that this reduction was negatively correlated with improvements in interoceptive sensitivity. Study four showed that learning about the body through anatomical dissection training, as a form of external body perception training, reduced the longevity of the visual sensory outcome measure and decreased interoceptive sensitivity, but only in medical students who were high in trait personal distress. Collectively, these findings suggest that aspects of the multisensory processes of embodiment can become specialised and identify some unique contributions of individual sensory modalities to embodiment. The proprioceptive sensory outcome appears to be stable over time but the visual sensory outcome is a longer-term change to embodiment, which is susceptible to interference from body perception training. In study five, confirmatory factor analysis was used to assess the psychometric properties of an embodiment change questionnaire measuring body ownership, body extension and perceived causality in the RHI. Factor scores from the questionnaire were correlated with visual and proprioceptive outcome measures of the RHI and measures of trait empathy. The results suggested factor scores had better convergent validity than the standard illusion score used in previous research. This work has improved subjective and perceptual measures of the RHI and specified ways that individual sensory modalities provide a unique contribution to embodiment. The methods developed have further applications for studying the multisensory process of embodiment and investigating embodiment in a number of clinical groups.
18

Da superfície à carne : as fronteiras entre estético e reparador na formação e atuação no campo da cirurgia plástica

Schimitt, Marcelle January 2017 (has links)
A partir de uma abordagem do fenômeno das cirurgias plásticas enquanto algo que se conforma na prática, esta dissertação versa sobre os limites entre o reparador e o estético relativos a esses procedimentos. Tendo como espinha dorsal a formação das(os) médicas(os) e a constituição dessa especialidade da medicina, tais fronteiras serão abordadas a partir do entendimento de que não apenas auxiliam na conformação das cirurgias plásticas, mas são também constituídas em relação a essas últimas. Através da participação em eventos promovidos por Ligas de Cirurgia Plástica e entrevistas realizadas com graduandas, residentes, cirurgiãs e cirurgiões plásticos, este trabalho tem como objetivo construir uma narrativa, entre tantas outras possíveis, acerca dos modos como os limites entre o estético e o reparador têm se instituído discursivo-materialmente. Antes, contudo, parte-se de uma abordagem histórica a fim de uma compreensão mais situada a respeito de como essa especialidade tem se conformado ao longo do tempo. Por meio de diferentes investimentos esta dissertação trata, em síntese, sobre como esses procedimentos assumem diferentes realidades. Assim, contingências históricas, sociais, econômicas, políticas e materiais, entre inúmeras outras, são compreendidas de maneira indissociável como atuantes na conformação das cirurgias plásticas e dos limites concernentes a elas. Por fim, sugere-se que um entendimento dessas realidades enquanto múltiplas nos auxilia na construção de uma apreensão do conhecimento médico como algo que não está dado, mas como práticas histórico-materialmente situadas. Ainda, a partir da discussão central proposta por este trabalho são estabelecidos pontos de confluência entre as cirurgias plásticas e as fronteiras relativas ao corpo e aos binômios natureza/cultura, saúde/doença, forma/função, entre outros. / This dissertation addresses the limits between the cosmetic and the reconstructive surgeries from an approach of the plastic surgery phenomenon as something that conforms in practice. Having as a backbone the formation of the doctors and the constitution of this specialty of medicine, such boundaries will be approached from the understanding that they not only aid in the conformation of plastic surgeries but also are constituted of this last one. Through the participation in events promoted by Plastic Surgery Leagues and interviews with undergraduates, residents and plastic surgeons, this study aims to construct a narrative, among many others possible, about the ways in which the boundaries between the cosmetic and the reconstructive surgeries have been instituted discursive-materially. First, however, it starts with a historical approach in order to understand more about how this specialty has conformed over time. Through different investments, this dissertation deals, in short, with about how these procedures take on different realities. Thus, historical, social, economic, political, and material contingencies, among countless others, are understood as acting in the conformation of plastic surgeries and the limits concerning them. Finally, it suggests that an understanding of these realities as multiple helps us in constructing an apprehension of the medical knowledge as something that is not given but as historical-materially situated practices. Still, from the proposed discussion by this study, points of convergence between plastic surgeries and boundaries related to the body and to the binomials nature/culture, health/illness, form/function, among others, are established.
19

Rapport à l’apprendre et développement d’une culture de recherche en formation médicale professionnalisante : l’effet du contexte pédagogique en médecine et en maïeutique / Relationship between knowledge acquisition and the development of research culture in medical education : impact of the environment on medical and midwifery education

Nadjafizadeh, Marjan 08 January 2016 (has links)
L’approche du monde étudiant ne peut être envisageable sans évoquer l’aptitude à apprendre. Les manières d’étudier, les modes d’appropriation du savoir et les variables qui peuvent influencer la qualité d’apprentissage constituent désormais un champ de recherche largement investi. La conception des étudiants de leur apprentissage ainsi que les pratiques d’étude propres à chaque filière peuvent expliquer le type d’approche développée par l’apprenant. Étant donné que la validation d’un cursus universitaire passe aussi par la réalisation d’un travail de recherche, nous nous sommes intéressés à deux types de formations médicales professionnalisantes. À travers une démarche compréhensive, le sens donné à l’apprentissage de la recherche par des étudiants en médecine et en maïeutique a été saisi. Compte tenu du sens accordé par l’apprenant à son apprentissage en général, à celui de la recherche et au regard de l’environnement pédagogique perçu, une typologie d’approches a permis de différencier le profil d’apprentissage des étudiants. La formation à et par la recherche a contribué à faire évoluer la conception des étudiants attachés malgré tout à l’utilité du savoir. Le saut qualitatif attendu à l’issue du travail de recherche ne se produit pas avec la même intensité chez tous les apprenants. Il s’avère qu’une approche en profondeur, une perception positive de l’environnement d’études et une prise de conscience de la valeur du savoir en tant que telle sont en interaction avec une forme élaborée du rapport à l’apprendre. Cependant, un accompagnement pédagogique pertinent permettrait à l’apprenant de mieux saisir le sens de son apprentissage et de gagner en réflexivité / Apprehending the students' world cannot be undertaken without thinking about their ability to learn. How to be a student, the way to study and approaches as well as the variables that can affect the quality of learning have been studied for a considerable time. The way students conceptualise their learning, together with the study approaches specific to each profession could explain the learning style of individual students. It would be useful to investigate how students conceptualise their learning for university diplomas that lead to a degree as well as a professional qualification and normally require the undertaking of some research. We have explored the example of two health professions - medicine and midwifery. An interpretative comprehensive paradigm was used to understand the meaning given to the learning of research theory and practice by medical and midwifery students. Bearing in mind the meaning given by learners to their overall learning, to the more specific learning of research methodology as well as their perception of their learning environment, a typology of approaches has enabled the identification of various learning profiles for these students. The education to and by research does not occur at the same level in all learners. This study has found that the combination of an deep approach to learning, a positive perception of the study environment and an awareness of the usefulness of knowledge for its own sake all come into play and exercise an influence of their relation to learning. However, an appropriate teaching support also helps the learner better apprehend the meaning of learning and encourages reflection
20

A preceptoria no internato do curso médico da universidade do estado do amazonas: a perspectiva de preceptores. / The preceptorship of medical internship of The University of state Amazonas: the perspective of the preceptor

Couceiro, Kátia do Nascimento. January 2015 (has links)
Made available in DSpace on 2018-06-18T13:12:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2015 / Este trabalho tem por objetivo analisar a preceptoria desenvolvida no internato do curso médico da Universidade do Estado do Amazonas (UEA). O desenho da pesquisa foi um estudo descritivo com 28 preceptores da UEA. A coleta de dados deu-se por meio de um questionário com questões fechadas e uma entrevista semiestruturada. A intenção era fazer um levantamento das atividades desenvolvidas na preceptoria; conhecer o preparo dos preceptores, os pontos fortes e os nós críticos da preceptoria na UEA, as sugestões para o aprimoramento da preceptoria, e as qualidades de um bom preceptor. A análise dos dados foi feita por tema. Os resultados quanto às motivações para atuar como preceptor apontados foram o gosto pela docência e a possibilidade de aprimorar a formação médica. Os preceptores percebem sua atuação como uma oportunidade de compartilhar o seu conhecimento com os estudantes. Referem-se à pós-graduação e à prática clínica como espaços importantes de formação. Gostariam, entretanto, de ter um melhor preparo pedagógico para a sua atuação, assim como a possibilidade de aprimorar sua titulação acadêmica. No que se refere às atividades que desenvolvem, foram apontadas as práticas nos diferentes cenários, as discussões teóricas e o estudo de caso. Como nós críticos, destacam a necessidade de melhores cenários de prática, a restrita integração com a equipe de saúde, o desafio de despertar o interesse discente, e a necessidade de maior número de preceptores. Os pontos fortes da preceptoria citados indicam a relação médico paciente e a interação com os alunos. Como sugestões para aperfeiçoar a preceptoria, destacam a adequação dos cenários de prática, a contratação de preceptores, a melhora da qualidade dos estudantes ingressantes, e o oferecimento de possibilidade de atualização. Valorizam como principais competências de um bom preceptor as relativas aos domínios afetivo-moral, relacionais e de aquisição e uso do conhecimento. Os dados possibilitaram a laboração de um relatório técnico, a ser apresentado na instituição no intuito de colaborar para o aperfeiçoamento do curso médico. / The medical internship is the last cycle of medical education and preparation for your preceptor has been much discussed pedagogical practice, although there is scarcity of papers on this activity in undergraduate teaching. The objective of this research is to analyze the preceptorship developed during internship medical students at the University of the State of Amazonas (UEA). The research design was a descriptive study with 28 preceptors at UEA. To collect data, a questionnaire with closed questions and a semi - structured interview seeking to characterize the activities in the preceptorship, the meaning and the preparation of preceptors, strengths and critical nodes of preceptorship in UEA, suggestions for improving the same and were used qualities of a good teacher. Data were analyzed using thematic analysis. The main motivations to act as preceptor were a taste for teaching and the opportunity to enhance medical training. Preceptors perceive their work as an opportunity to share their knowledge with students. Refer to graduate and clinical practice as important areas of training, however would like a better educational preparation for their performance, and enhance possibility of their academic titles. The main activities are the practices in different scenarios, in addition to theoretical discussions and case study. As critics we need to highlight the best practice scenarios, the limited integration with the healthcare team, the challenge pique student interest and need for greater numbers of preceptors. Refer to as strengths preceptorship mainly doctor patient relationship and interaction with students. Present as main suggestions to improve the adequacy of preceptorship practice scenarios, hiring tutors, improve the quality of incoming students and offering upgradeability. Value as key skills of a good preceptor those relating to affective- moral domain , in addition to relational and acquisition and use of knowledge . The data allowed the preparation of a technical report to be submitted by the institution, as to collaborate in the improvement of the medical course.

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