A tradicional formação médica no Brasil tem reconhecido no hospital o lugar por excelência para a aprendizagem prática do estudante - enfatizando as tecnologias duras e os procedimentos - em detrimento da Atenção Primária à Saúde, ainda que esta seja, reconhecidamente, capaz de resolver cerca de 80% dos problemas de saúde. Embora este cenário venha se alterando paulatinamente no século XXI, em especial após a publicação das Diretrizes Curriculares Nacionais para o Curso de Graduação em Medicina, ainda permanecem dúvidas sobre os melhores modos para viabilizar a inserção de forma exitosa. Com base nestas premissas, o presente artigo tem por escopo contextualizar este debate e apresentar propostas para consecução de processos ensino-aprendizagem na Atenção Básica.
RESUMO Diante das atuais demandas sociais, tornou-se imprescindível para a educação médica a transição-Learning.-Medical Students.-Medical Education. ABSTRACT Given current social demands, it has become essential for medical education to break from the traditional model of biological reductionist and training based only at hospitals and redefine itself towards a holistic care (integrality). The construction of new training practices in health with the use of new outdoor scenarios, in partnership with (Unified National Health System -SUS), assumed a key role. In 2005 the Centro Universitário Serra dos Órgãos (Unifeso) incorporated into its curriculum the Problem-Based Learning and the insertion of medical undergraduates into Basic Health Units
The prevailing undergraduate medical training process still favors disconnection and professional distancing from social needs. The Brazilian Ministries of Education and Health, through the National Curriculum Guidelines, the Incentives Program for Changes in the Medical Curriculum (PROMED), and the National Program for Reorientation of Professional Training in Health (PRO-SAÚDE), promoted the stimulus for an effective connection between medical institutions and the Unified National Health System (SUS). In accordance to the new paradigm for medical training, the Centro Universitário Serra dos Órgãos (UNIFESO) established a teaching plan in 2005 using active methodologies, specifically problem-based learning (PBL). Research was conducted through semi-structured interviews with third-year undergraduate students at the UNIFESO Medical School. The results were categorized as proposed by Bardin's thematic analysis, with the purpose of verifying the students' impressions of the new curriculum. Active methodologies proved to be well-accepted by students, who defined them as exciting and inclusive of theory and practice in medical education.
O presente artigo tem por escopo analisar as concepções dos agentes comunitários de saúde (ACS), de quatro unidades da Estratégia de Saúde da Família (ESF) do município de Teresópolis-RJ, acerca da relação entre o ambiente e o processo saúde-doença, à luz dos referenciais da educação ambiental (EA). Para tanto, foi realizado um estudo qualitativo, a partir do conteúdo das respostas obtidas por meio de entrevista. Pôde-se observar que as percepções dos ACS são consistentes, no sentido de correlacionar a existência de um ambiente degradado com o processo saúde-doença. Entretanto, evidenciaram-se dificuldades, do ponto de vista dos ACS, em relação (1) ao trabalho desta idéias junto à comunidade e (2) à inoperância do poder público em viabilizar processos de articulação saúde-ambiente, aspectos essenciais para promoção da saúde (PS) e o cultivo de ambientes saudáveis.
Background: To make an analysis and propose solutions to improve the teaching and learning process in the scenario of the Basic Family Health Units (BFHU). Method: First phase: Authors conducted a qualitative-quantitative study with students and preceptors of Primary Care containing open and closed questions from medical schools. The closed questions were presented as descriptive statistics and the open ones from the creation of categories. It was pointed out the perception of the main problems for teaching learning. Second phase: Meetings were held from students and respective preceptor for 6 months, using electronic portals, through the application of new questionnaires, using the Likert scale in pre and post evaluation. Results: On the first phase, 40% of the students considered as a problem the degree of training of the local preceptor. A similar result was found in the speech of the teacher, which categorization revealed a lack of adequacy between training and performance in Primary Care in most of the categories created. Based on our results, we used the BHFU to apply new strategies little used for teaching and learning, in order to improve health practices, such as the use of the Evidence Based Health portal, which has shown greater navigability and offers studies with clinical evidence criteria. On the second phase, the authors identified an improvement in the quality of learning both by the preceptor and by the students. Conclusions: The use of electronic portals can be a tool that legitimized or enhance the teaching and learning (teaching/learning space) in BHFU.
Background Worldwide, primary care is for most people the gateway into many health systems. Offering solutions to the demands of the communities served requires the constant preparation of professionals, especially doctors and medical undergraduate students. We analyze and propose ways to improve the teaching and learning processes facilitated by the Basic Family Health Units (BFHUs) based on the use of electronic portals with evidence-based medicine criteria. Method First phase: The authors conducted a qualitative-quantitative study on students and instructors of primary care (PC) medicine by administering a survey of open- and closed-ended questions at medical schools. The closed-ended questions were studied with descriptive statistics, and open-ended questions were analyzed via the creation of categories. Perceptions of major teaching and learning problems were then identified. Second phase: Meetings were held with students and their instructors for 6 months and involved the use of electronic portals and the application of new questionnaires using a Likert scale for pre- and postevaluation. Results In the first phase, 40% of the students considered local instructor training levels a problem. A similar result was found regarding teachers’ lectures, revealing a lack of adequate PC training and performance. Building on our results, we focused on BFHUs to apply new strategies for teaching and learning, such as the use of the Evidence-Based Health (SBE) Portal, which includes several databases with clinical evidence criteria. In the second phase, the authors identified an improvement in the quality of learning among instructors and students. This outcome improved safety in daily clinical practice in PC, possibly with better results for its users. Conclusions The use of electronic portals can facilitate BFHU teaching and learning and promote the health of users.
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