Teaching and learning during internship placements of the Federal University of Pernambuco: preceptor´s perspective

Introdução: Os cursos de medicina do Brasil oferecem, nos seus dois ultimos anos, o estagio obrigatorio nas cinco areas basicas (clinica medica, cirurgia, pediatria, Saúde coletiva e gineco-obstetricia), chamado internato. O Internato e o periodo em que o estudante esta em contato direto com a o trabalho e pratica medica, sendo responsavel por uma parcela importante da formacao profissional. Estimulados pela publicacao das novas Diretrizes Curriculares para a graduacao em Medicina, os cursos implementaram uma ampliacao dos cenarios de pratica muito alem dos hospitais universitarios. Servicos de Saúde das redes municipais e estaduais passaram a compor os estagios do internato. Poucos cursos, porem, apresentam um conhecimento profundo dos cenarios de pratica da rede de Saúde e de como se desenvolve o ensino-aprendizagem facilitado por preceptores nesses servicos. Objetivo: O presente estudo dedicou-se a conhecer a realidade do Internato do Curso de Medicina da Universidade Federal de Pernambuco atraves da perspectiva do preceptor. Metodologia: Trata-se de um levantamento descritivo, de natureza qualitativa, em um corte transversal, que caracterizou um estudo de campo, aplicado as cinco areas basicas do internato e que envolveu vinte e um preceptores coordenadores de treze servicos de Saúde. Foram realizadas entrevistas, utilizando roteiros semi-estruturados, com os preceptores coordenadores dos servicos de Saúde envolvidos no internato, atraves de uma amostra criteriosa. Os criteriosprincipais foram: ser preceptor coordenador de ensino e atuante na pratica diaria de preceptoria. Para a avaliacao e critica dos dados foi adotada a analise de conteudo, realizada em tres etapas: pre-analise, analise e inferencias e interpretacoes. Resultados: Um total de vinte um preceptores foram entrevistados. As categorias tematicas mais relevantes para o estudo foram: expectativa do preceptor para a formacao medica durante o rodizio; modelos de ensino da preceptoria; Gestão do ensino e integracao ensino-servico. Os preceptores apresentam expectativas diversas entre si, porem coerentes na maior parte com os documentos que referencia a educacao medica, porem sem cita-los. Os preceptores apresentam modelos de ensino centrados no preceptor, no estudante e no problema, sendo os ultimos uma menor parte. A Gestão do ensino apresenta-se de forma pragmatica, organizando o encontro entre educador e educando, porem sem planejamento da acao pedagogica em si. A integracao ensino-servico esta representada atraves de acoes pontuais por parte da instituicao academica, porem a demanda dos preceptores abrange a educacao permanente e fatores motivadores para atuacao continua no ensino. As analises das categorias indicaram um afastamento importante entre as praticas cotidianas nos servicos e o preconizado nas Diretrizes Curriculares e no Projeto Politico Pedagogico do Curso de Medicina. Conclusoes: O estudo representa um aprofundamento sobre as atividades de ensino nos cenarios de pratica do internato. As categorias analisadas representam pontos cruciais para o aperfeicoamento da integracao ensino-servico. As expectativas dos preceptores abarcam o conteudo dos documentos formais, porem estes deverao ter acesso aos marcos referencias da reforma dos cursos de medicina para a devida apropriacao. Apesar de preconizado, o ensino problematizador e a pratica de poucos preceptores com uma formacao em educacao. Um programa de desenvolvimento docente do preceptor podera aproximar as praticas diarias nos cenarios. Os preceptores exercem uma Gestão de ensino focada na agenda de atividades, enquanto que a universidade executa poucas atividades de integracao. Acoes de integracao ensinoservico especificas poderao qualificar os estagios obrigatorios nos cenarios de praticas na rede de Saúde. Planejamentos participativos poderao apoiar a construcao de expectativas comuns entre servicos, academia e estudantes. Metodologias ativas de ensino da pratica medica poderao ser sugeridas em acordo com as concepcoes pedagogicas dos documentos de referencia. A Gestão do ensino podera ser alvo de acoes de educacao permanente para preceptores, a fim de aprimorar suas competencias educacionais. Outros estudos deverao abordar a perspectiva do estudante, do professor e do gestor, importantes para complementacao das informacoes obtidas no presente estudoBV UNIFESP: Teses e dissertaçõe

Discourse analysis of general practice in medical education: a comparative study of undergraduate medical education policy in the UK and Brazil

Introduction: Despite increasing research on medical education, the field of medical education policy, including general practice teaching, has been overlooked. Discourse analysis has recently been introduced to investigate education policy in medical education. This research analyses general practice development in undergraduate medical education policy in both the UK and Brazil. In the UK, general practice is consolidated as an academic field of medical knowledge, whilst in Brazil, it is being established. The historical context of the specialty in each country and the participation of general practitioners in medical schools are considered. Two main dimensions of medical education are emphasized: the alignment with health care systems and the outlook for medical care workforce. The aim of this research was to depict the discursive continuities and discontinuities characterizing general practice knowledge in undergraduate medical education policy in two distinctive contexts. // Method: Foucauldian discourse analysis was used to investigate the representation of general practice as a field of medical knowledge in undergraduate medical education policy in a comparative study design. This research method offers a critical perspective of power relations in policy documents by exploring what is made thinkable and legitimate. It supports the analysis of the assumptions of truth that delineate the frontiers of general practice.// Results: General practice knowledge holds a discursively fragile position in both countries, a consequence of the differences in discursive polarities. The polarities consisted of (a) academic and non-academic knowledge and (b) specialist and non-specialist knowledge in the UK; and (a) public and private health care and (b) generalist and specialist knowledge in Brazil. The similarities included a close relationship between medical education and national health systems. In the UK, the biomedical discourse directs the portrayal of general practice, whereas in Brazil, the counter-discursive element opposed to this biomedical discourse predominates. // Conclusion: The predominant discourses in medical education policy places general practice knowledge in a fragile position compared to other medical fields. A policy focused on the reflexive cycle between academy and practice and between general and specific knowledge could help strengthen general practice knowledge in undergraduate medical education. This could produce stronger, more stable and authoritative thinking in this area of medical science

Saúde do homem: dicas para médicos

Este folheto faz parte dos materiais didáticos dos cursos de especialização para trabalhadores vinculados à Atenção Básica ofertados pela UFPE. Apresenta as disfunções sexuais e os distúrbios de armazenamento e ou miccionais que podem acometer o homem

Quimioprofilaxia para prevenção de hanseníase e sua implantação no Brasil: uma explicação introdutória para não epidemiologistas

The occurrence of leprosy has decreased in the world but the perspective of its elimination has been questioned. A proposed control measure is the use of post-exposure chemoprophylaxis (PEP) among contacts, but there are still questions about its operational aspects. In this text we discuss the evidence available in literature, explain some concepts in epidemiology commonly used in the research on this topic, analyze the appropriateness of implementing PEP in the context of Brazil, and answer a set of key questions. We argue some points: (1) the number of contacts that need to receive PEP in order to prevent one additional case of disease is not easy to be generalized from the studies; (2) areas covered by the family health program are the priority settings where PEP could be implemented; (3) there is no need for a second dose; (4) risk for drug resistance seems to be very small; (5) the usefulness of a serological test to identify a higher risk group of individuals among contacts is questionable. Given that, we recommend that, if it is decided to start PEP in Brazil, it should start on a small scale and, as new evidence can be generated in terms of feasibility, sustainability and impact, it could move up a scale, or not, for a wider intervention.A ocorrência de hanseníase tem diminuído no mundo apesar de que a perspectiva de sua eliminação tem sido questionada. Uma proposta para o controle da endemia é a quimioprofilaxia pós-exposição entre contatos (post-exposure chemoprophylaxis, PEP), embora ainda existam dúvidas quanto aos seus aspectos operacionais e generalização de resultados. Nesse texto nós discutimos as evidências disponíveis na literatura, explicamos alguns conceitos epidemiológicos comumente encontrados em pesquisa sobre PEP e a implantação da PEP no contexto brasileiro. Nós argumentamos que: (1) a estimativa em diferentes estudos do numero de contatos necessário para receber PEP para prevenir um novo caso de hanseníase (number needed to treat, NNT) não é facilmente generalizável; (2) áreas cobertas pelo programa de saúde da família são as áreas prioritárias onde PEP poderia ser implantado; (3) não existe necessidade de segunda dose da quimioprofilaxia; (4) o risco de resistência à droga usada na PEP parece ser muito pequeno; (5) questionamos a necessidade de teste sorológico para identificar indivíduos entre os contatos que tenham maior risco de doença. Nós opinamos que, se houver uma decisão para se iniciar PEP no Brasil, essa intervenção deveria ser iniciada em pequena escala e, à proporção que novas evidências são geradas sobre a factibilidade, sustentabilidade e impacto da intervenção, a intervenção com PEP poderia ou não ser usada em larga escala

Níveis disfuncionais de ansiedade relacionada ao Coronavírus em estudantes de medicina: Dysfunctional levels of Coronavirus-related anxiety in medical students

As preocupações com a saúde mental das pessoas afetadas pela pandemia de coronavírus não foram abordadas adequadamente. Isso é surpreendente, uma vez que tragédias em massa, particularmente aquelas que envolvem doenças infecciosas, muitas vezes desencadeiam ondas de medo e ansiedade elevados que são conhecidos por causar perturbações maciças no comportamento e no bem-estar psicológico de muitos na população. Assim, o objetivo desse trabalho é demonstrar os níveis disfuncionais de ansiedade relacionada ao coronavírus em estudantes de medicina. Para isso, foi realizado uma revisão sistemática sobre a temática

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others