DEVELOPMENT OF THE CLINICAL REACTION FROM THE USE OF THE PROBLEM-BASED LEARNING: EXPERIENCE REPORT OF THE UFPE MEDICAL CLINIC LEAGUE

Abstract

Introduction: Medical knowledge has evolved greatly over time, both in relation to the pathophysiological knowledge of diseases, as the available therapeutic and prophetic arsenal. Despite this, clinical practice is still very much dependent on the medical ability to make a correct diagnosis and, from this, define the best conduct. In this scenario, medical schools have the challenge of facilitating the acquisition of this competence by students, as it is one of the greatest attributes to be developed during the medical course. Objectives: To describe the relevance of the mentoring activities of the medical clinic academic league (LACM-UFPE) for medical education. Methodology: We found 657 articles published from 2013 to 2018, in Portuguese and English. The Health Sciences Descriptors (DeCS) used were Problem-Based Learning and Education, Medical to search the PubMed database. Of this total, 7 articles fit the objectives of this study, serving as the basis for its composition. Results: The process of constructing clinical reasoning has been the focus of numerous investigations, which gave rise to two theoretical approaches: procedural and structural theory. LACM-UFPE uses the structural method, that is, it believes that the clinical reasoning depends on the acquired knowledge, which produces diagnostic hypotheses. Biomedical knowledge would be stored in memory composing this structural basis and thus the diagnostic competence would be determined by the professional’s ability to process these structures in memory. In Problem-Based Learning (PBL), used in LACM-UFPE tutorials, learning starts from problems or situations that aim to generate doubts, imbalances or intellectual disturbances. This method contains strong practical motivation and cognitive stimulation to generate creative solutions. The elaboration of good problems is fundamental in PBL. The problem is a tool that the teacher uses to motivate the student to retrieve knowledge stored in memory, instigate scientific doubts, integrate knowledge and direct the study. When applied, the PBL activates conceptual meanings, improving learning, broadening horizons, creating interdisciplinary knowledge and arousing interest in related learning. The situations presented in the LACM-UFPE tutorials are based on real cases obtained in the admissions of the Medical Clinic ward of the Hospital das Clinicas-UFPE, and this allows students to visualize the practical application of their knowledge, reinforcing them. Conclusion: Since clinical reasoning needs thinking to be understandable in the process of reaching a diagnosis, PBL is a relevant method for learning, as the tutor is described as the educator who is concerned with teach the student to “learn to learn”. Thus, LACM-UFPE’s tutoring activities have a positive impact on the formation of the future physician.