INTRODUCTIONLearning medicine is not a lonely journey and is no longer a passive act. Doctors at both junior and senior levels participate in this complex process, thereby facilitating learning and consolidating and updating knowledge daily. Santos et al. 1 described facilitators as doctors who are more experienced and who thus help in the professional development of undergraduates, medical residents and their peers. These authors referred to the work of Vygotsky, 2 for whom "the learning process comes from outside sources and is conceived through individual interactions with the world". Furthermore, they postulated that the role of facilitators (preceptors) is to enable some situations in which apprentices' knowledge assimilation and production becomes transformed. The preceptor's main role is therefore to facilitate the acquisition of theory and skills by stimulating his/her pupils to make their own discoveries.Residency is characterized by in-service learning, i.e. training during practice within a scenario in which residents may become role models, in accordance with statements based on educational strategies for teaching and learning. Therefore, it is crucial to balance teaching, learning and healthcare assistance.The most remarkable characteristic of medical residency is its in-service training, in which teaching is integrated with practice scenarios, so as to build a model for physicians' ideological, ethical and professional identity. The professional competence that is expected at the end of a medical residency program needs to go beyond technical knowledge. It also encompasses skills and attitudes that show effective team capabilities, leadership, communication skills, empathy, self-control and metacognition. 3 Sternszus et al. 4 investigated the importance of resident role models in the education and career choices of medical students, in a cross-sectional survey-based study. Their study was the first to illustrate that resident role models are perceived by medical I MD. Doctoral Student, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil. orcid.org/0000-0001-8413-0619 II MD. Professional Master's Student, Centro ABSTRACTBACKGROUND: There is extensive evidence, mainly from the United States and Canada, that points towards the need to train medical residents in teaching skills. Much of the "informal curriculum", including professional values, is taught by residents when consultants are not around. Furthermore, data from the 1960s show the importance of acquiring these skills, not only for residents but also for all doctors. Teaching moments can be identified in simple daily situations, like discussing a clinical situation with patients and their families, planning patients' care with the healthcare team or teaching peers and medical students. The aim here was to examine the significance of resident teaching courses and estimate the effectiveness of these courses and the state of the art in Brazil. METHODS:We conducted a review of the literature, using the MEDLINE, PubMed, SciELO and LILAC...

RESUMO A residência médica, instituída legalmente no Brasil em 1977 pelo Decreto nº 80.281, é considerada a melhor estratégia de ensino em cenário de prática, sendo o padrão ouro da especialização médica. A característica mais marcante da residência é o treinamento em serviço, que articula ensino no cenário de prática, além de construir um perfil profissional. Os residentes desenvolvem também a função docente. Pesquisas americanas estimam que exerçam tal função em boa parte de suas atividades, chegando a um quarto do período total de tempo de seus programas de residência. Esse processo de ensino-aprendizagem durante a residência ainda é pouco estudado, principalmente no Brasil. O objetivo deste estudo foi realizar uma ampla revisão narrativa sobre RaT (Resident as Teacher), tema pouco explorado na literatura brasileira, avaliando historicamente o processo de ensino-aprendizagem dos programas de residência médica. Foi realizada uma revisão na literatura acerca do processo de ensino-aprendizagem da residência médica no Brasil e no mundo. Diversos países estão implementando treinamentos formais de ensino denominados programas de Resident as Teacher (RaT). Somente nos EUA, mais de 50% dos programas de residência têm alguma forma de treinamento RaT. Vários programas foram desenvolvidos e se diferenciam no conteúdo, na duração e no formato, porém são baseados em atributos de ensino considerados essenciais ao ensino. No que diz respeito ao conteúdo, os programas RaT enfatizam predominantemente o modelo preceptor minuto (One Minute Preceptor – OMP), a estrutura de ensino clínico do Programa de Desenvolvimento da Faculdade de Stanford ou os domínios mostrados por Irby como essenciais à excelência em ensino clínico. Em conclusão, sugere-se que os programas brasileiros de residência médica invistam em estudos e, consequentemente, em estratégias efetivas para aprimorar as técnicas de ensino para médicos residentes.

RESUMO Introdução Na residência médica, os residentes exercem o duplo papel de professor e aprendiz. Treinamentos de como ensinar residentes a exercer a função de docência com qualidade estão sendo implementados em todo o mundo e são denominados programas de Residente como Professor (Resident as Teacher – RaT). De acordo com as Diretrizes Curriculares Nacionais do Curso de Graduação em Medicina, pode-se aprender a estabelecer objetivos educacionais e matriz de competência, além de habilidades como comunicação, empatia, mediação de conflitos, entre outras. A implementação desses programas deve ser baseada na compreensão do contexto de cada residência médica na qual se deseja inseri-los, e os residentes também devem conhecer as potencialidades de cada cenário de atuação da sua especialidade para promover uma docência eficaz. Objetivo O objetivo do estudo foi o desenvolvimento de uma estrutura de programa de treinamento de docência (RaT) dividido em módulos e detalhado com suas respectivas referências bibliográficas. Metodologia Realizou-se uma revisão de literatura sobre ensino médico e testaram-se alguns métodos em cenário de prática durante uma dissertação de mestrado, utilizando a técnica SNAPPS, e durante uma tese de doutorado, utilizando a técnica OMP. Resultado Foi construído um programa de treinamento de docência nas residências médicas baseado nos resultados positivos encontrados na literatura sobre ensino médico. Propõe-se que cada módulo tenha a duração de um mês aproximadamente, com atividades de um turno por semana. O formato da discussão pode variar de acordo com cada especialidade e com o número de residentes de cada programa. Sugere-se a realização de flipped classroom (sala de aula invertida) com o envio do referencial bibliográfico de suporte sobre os temas aos residentes por e-mail uma semana antes da realização de cada módulo. Diversas atividades podem ser postas em prática em cada módulo para sedimentação do material estudado. Conclusão Após a estruturação de um roteiro a ser implementado pelos programas de residência médica no Brasil, espera-se que os residentes desempenhem com maior eficácia o papel que muitos já exercem na prática e que consequentemente o nível de aprendizagem dos alunos de graduação e internos melhore.

Teaching is a complex activity for which multiple methods are needed in order to properly evaluate it. Teaching performance can be directly examined and students' results can be highlighted. All assessment methods have their strong and weak points and any method used in isolation will provide an incomplete image of academic staff members' teaching skills. Goe et al. 1 described five measurable aspects of teaching efficacy. They asked whether the teaching was doing the following: (1) helping with learning; (2) contributing towards enhancement of academic, social and attitudinal performance; (3) using multiple resources to engage students in learning opportunities; (4) promoting civic values and respect for diversity; and (5) collaborating with the institution, peers and families to help students succeed, particularly those with a higher chance of failing. The method most used for assessing the act of teaching comprises direct observation of the activity. This can be done by directors, other academic staff members (supervisors) or external evaluators (locally or with the aid of video-recorded performances). These evaluations are, in general, more time and resource-consuming than are estimates centered on tests that are based on teaching efficacy, such as national and international examinations on students' performance. Standardized tests provide a more economical and efficient way of making reliable measurements of the content acquired by students. 2 Evaluations are routine events in the lives of university students worldwide. Their methods take different shapes, but one of the methods within medical education consists of assessments of simulated situations that have been developed specifically to assess clinical skills. Since the famous neurologist Howard Barrows 3 used trained actors to evaluate his residents' examination

BACKGROUND: Residents play the role of teachers in almost one-quarter of their activities in residency programs. OBJECTIVE: To evaluate whether a 45-minute class using summarize, narrow, analyze, probe, plan, and select (SNAPPS) could improve psychiatry residents' case discussion skills in diverse practical learning settings. DESIGN AND SETTING: This case-control, randomized, blinded study was conducted in a psychiatry hospital at Fortaleza-Ceará. METHODS: Using "resident as teacher" (RaT), objective structured teaching encounters (OSTEs), and SNAPPS, we conducted a study with 26 psychiatry residents. We analyzed video footage of psychiatric cases in three settings: outpatient, nursing, and emergency. An intervention was held two months later with the residents, who were then assigned to two groups: group A (lecture on SNAPPS) and group B (lecture on a topics in psychiatry). Shortly after the lectures, they were video recorded while discussing the same cases. Three blinded examiners analyzed the videos using an instrument based on the Stanford Faculty Development Program (SFDP-26). RESULTS: We found high internal consistency among external examiners and an interaction effect, group effect, and moment effect (P < 0.05). The residents who received the SNAPPS lecture scored significantly higher than their counterparts who received a traditional case presentation. CONCLUSION: This study indicates the efficacy of SNAPPS over traditional case presentation in all three settings as assessed by OSTEs and supports its implementation to improve the teaching of clinical reasoning.