Learning methodology in surgical training

This manuscript aimed to review the literature data related to the surgical training program. This review showed some of the requirements to perform effective surgical training were direct supervision, predetermined repetitions according to surgical skill complexity, valid simulator models, number of students per model. This manuscript discussed how the surgical program could achieve competence using a critical thinking framework, integrated curriculum based on the rationale behind simulation training program.Esse manuscrito tem como objetivo revisar dados da literatura relacionados ao treinamento cirúrgico para  alunos de graduação me medicina.  Essa revisão demostrou que  alguns  pré requesitos são necessários para se realizar treinamento cirúrgico de maneira eficaz: supervisão direta, repetições  pré-determinadas de acordo com a complexidade  da atividade a ser ensinada, modelos de simuladores válidos, número de alunos por modelo. Esse manuscrito também  discutiu como o programa cirúrgico pode levar a competência  pelo desenvolvimento do pensamento crítico e pela integração curricular baseado no racional da  utilização de um programa de treinamento por  simuladores

Medical education assessment

Um dos aspectos mais críticos na educação em medicina é a avaliação de novos conhecimentos e habilidades. Essa avaliação deve testar memórias curta, longa e de recuperação. Quando o aluno obtiver todas essa etapas, a memória perdurará por anos permitindo a realização de atividades cirúrgicas eficientes e seguras a longo prazo. A maioria das avaliações são subjetivas, embora difícil de se realizar a avaliação objetiva é modalidade de ensino ideal.  Esse artigo descreveu algumas opções de avaliações objetiva como OSAST, destreza e escala de taxa global. Além disso, foi abordado os valores da avaliação somativa e formativa no processo de aprendizado do estudante de medicina.One of the most critical steps for medical education is the assessment. The assessment can be divided into short-term memory, long-term memory, and retrieval memory. If the student acquires all these memories steps, the surgical skill will be mind incorporate for years. As a healthcare provider, the medical community needs to transform training and learning to a valid and reliable activity. Most of the medical evaluations are subjective; an objective assessment is difficult but most desirable. The authors described some objective surgical skill assessment based on OSAST, dexterity and global rating scale. Moreover, we discussed the formative and summative assessment roles to the medical learning process

Reestruturação Curricular na Faculdade de Medicina da USP: Integrando Conteúdos e Valorizando Competências

Buscando o contínuo aprimoramento de seu processo de ensino-aprendizagem, a Faculdade de Medicina da USP desenvolveu, no período de 2011 a 2014, um conjunto amplo de atividades visando à reestruturação curricular do curso médico mediante a adoção de um currículo baseado em competências. Esse processo envolveu: (a) uma etapa preliminar que incluiu avaliação curricular externa e formação de oito grupos de trabalho temáticos com o objetivo de integrar conteúdos correlatos e (b) uma etapa de estruturação na qual foram desenvolvidos os conceitos e estratégias de integração básico-clínica, internato, avaliação, governança e capacitação docente. Discutiu-se amplamente todo o processo com a comunidade por meio de reuniões departamentais, congregações temáticas e reuniões de grupos de trabalho. Por aclamação, a congregação da FMUSP aprovou, em 2014, a nova estrutura, a qual teve sua implementação iniciada para os ingressantes em 2015.University of São Paulo Medical School (FMUSP) have been continuously seeking to maintain its leadership by making improvements on its teaching/learning process. From 2011 to 2014 we developed a pool of activities aiming a strong reformulation towards a competency based medical curriculum. It was developed as a two step approach. The first (preliminary) step, in which FMUSP’s curriculum was independently evaluated by foreign institutions and 8 thematic working groups were carried out aiming the initial integration of related contents. The second (structural development) step, in which the concepts and strategies have been developed regarding the basic-clinical integration, internship rotations, evaluation, governance and faculty development. The process was widely discussed within the community through departmental meetings, thematic open meetings and workshops. The new curriculum was approved by acclamation by the Faculty Senate in 2014 and had its implementation started for freshmen in 2015

Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria

OBJECTIVE: To compare the renal outcome in patients submitted to two different regimens of glycemic control, using the RIFLE criteria to define acute kidney injury. INTRODUCTION: The impact of intensive insulin therapy on renal function outcome is controversial. The lack of a criterion for AKI definition may play a role on that. METHODS: Included as the subjects were 228 randomly selected, critically ill patients engaged in intensive insulin therapyor in a carbohydrate-restrictive strategy. Renal outcome was evaluated through the comparison of the last RIFLE score obtained during the ICU stay and the RIFLE score at admission; the outcome was classified as favorable, stable or unfavorable. RESULTS: The two groups were comparable regarding demographic data. AKI developed in 52% of the patients and was associated with a higher mortality (39.4%) compared with those who did not have AKI (8.2%) (p<0.001). Renal function outcome was comparable between the two groups (p=0.37). We observed a significant correlation between blood glucose levels and the incidence of acute kidney injury (p=0.007). In the multivariate logistic regression analysis, only APACHE III scores higher than 60 were identified as an independent risk factor for unfavorable renal outcome. APACHE III scores>60, acute kidney injury and hypoglycemia were risk factors for mortality. CONCLUSION: Intensive insulin therapy and a carbohydrate-restrictive strategy were comparable regarding the incidence of acute kidney injury evaluated using RIFLE criteria

Statement of Second Brazilian Congress of Mechanical Ventilarion : part I

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