Changes in medicine course curricula in Brazil encouraged by the Program for the Promotion of Medical School Curricula (PROMED)

<p>Abstract</p> <p>Background</p> <p>The Program for the Promotion of Changes in Medical School Curricula (PROMED) was developed by the Brazilian Ministries of Health and Education. The objective of this program was to finance the implementation of changes to the curricula of medical schools directed towards the Brazilian national healthcare system (SUS). This paper reports research carried out together with the coordinators responsible for the PROMED of each medical school approved, in which interviews were used to evaluate whether this financial support succeeded in stimulating changes. The aim of this study was to evaluate the impact of this program three years after implementation in the universities that received funding.</p> <p>Methods</p> <p>The 19 course coordinators of the medical schools in which the PROMED project was implemented were interviewed using a questionnaire containing 12 questions for qualitative analysis. This paper focuses partially on the reports of the results of this qualitative analysis. Laurence Bardin's.</p> <p>Results</p> <p>The universities interviewed were found to have some common concerns: the decoupling of basic and professional training difficulties in achieving proximity to the network of services; insufficient funding; and the emphasis of most teachers being on teaching hospitals and specialization. These findings indicate that the direction of curriculum reform (PROMED) is toward providing a targeted training for this system.</p> <p>Conclusion</p> <p>The interviewees were aware that this program would trigger future changes in all aspects of healthcare and represents an ongoing challenge to the academic field. PROMED provided the momentum for change in the nature of medical training in Brazil and was seen as powerful enough to override other processes and as a basis for guidance regarding the methodology, pedagogical approach and scenarios of practical experience.</p

Dysthanasia: nursing professionals' perception

Dysthanasia means slow and painful death without quality of life. This study aimed to know whether nurses identify dysthanasia as part of the final process of the lives of terminal patients hospitalized at an adult ICU. This is an exploratory-qualitative study. Data were collected through semi-structured interviews with ten nurses with at least one year of experience in an ICU, and interpreted through content analysis. Results indicate that nurses understand and identify dysthanasia, do not agree with it and recognize elements of orthonasia as the adequate procedure for terminal patients. We conclude that nurses interpret dysthanasia as extending life with pain and suffering, while terminal patients are submitted to futile treatments that do not benefit them. They also identify dysthanasia using elements of orthonasia to explain it.Distanasia significa muerte lenta, con sufrimiento y sin calidad de vida. En esta investigación se buscó conocer si los enfermeros identifican la distanasia como parte del proceso final de la vida de personas en estado terminal, internadas en una UTI para adultos. El estudio es de naturaleza exploratoria, con abordaje cualitativo. Los datos fueron recolectados por medio de entrevista semiestructurada con 10 enfermeros con un mínimo de un año de experiencia en UTI; los datos fueron interpretados por el análisis de contenido. Se obtuvo como resultado que los enfermeros comprenden e identifican la distanasia y se oponen a la misma, presentando elementos de ortotanasia como procedimiento adecuado para pacientes en estado terminal. Se concluye que los enfermeros interpretan la distanasia como el prolongamiento de la vida con dolor y sufrimiento, en el cual los pacientes terminales son sometidos a tratamientos fútiles que no traen beneficios. También identifican la distanasia, usando elementos de la ortotanasia para hacerla explicita.Distanásia significa morte lenta, sofrida e sem qualidade de vida. Nesta pesquisa buscou-se conhecer se os enfermeiros identificam a distanásia como parte do processo final da vida de pessoas em terminalidade, internadas em UTI adulto. O estudo é de natureza exploratória, com abordagem qualitativa. Os dados foram coletados por meio de entrevista semiestruturada com 10 enfermeiros com, no mínimo, um ano de experiência em UTI, e interpretados pela análise de conteúdo. Teve-se como resultado que os enfermeiros compreendem e identificam a distanásia e se opõem à mesma, trazendo elementos da ortotanásia como procedimento adequado para pacientes em terminalidade. Conclui-se que os enfermeiros interpretam a distanásia como o prolongamento de vida com dor e sofrimento, onde os pacientes terminais são submetidos a tratamentos fúteis que não trazem benefícios. E também identificam a distanásia, usando elementos da ortotanásia para explicitá-la