Marcio José de Almeida

Integralidade da saúde: norteando mudanças na graduação dos novos profissionais

The strong changes happened in the health sector with the creation of the Brazilian Unified Health System had forced a reflexion about the formation of the new health professionals. However, the substitution of the dominant health care system, centered in the illness, hospital and super specialized assistance, by attentions models that value the integrality, the humanized care and the healths promotion, was not yet conquered and depends, in great measured, on the formations profile and the practice of the health professionals. It is in the distance between the new professionals formation and the users necessities of the system that is the great obstacle of the relation of health services and health education. This essay tries to formulate an understanding about the necessity of a more integral formation for a more integral service. It aims to give subsidize to affirm that the integrality of the health actions must be preceded by the integrality of the thought and health education.

Movimentos de mudança na formação em saúde: da medicina comunitária às diretrizes curriculares

Este ensaio busca refletir as diversas iniciativas pro-mudanca na formacao superior em saude implantadas no Brasil. Esta analise historica faz-se necessaria tendo em vista a importância da sistematizacao e difusao das experiencias anteriores para o auxilio na construcao das novas propostas pro-mudanca. Estamos hoje refletindo sobre processos ativos de ensino-aprendizagem por termos vivenciado propostas como a da Medicina Comunitaria, o Projeto de Integracao Docente Assistencial, o Programa UNI, o movimento da Rede UNIDA, a Lei de Diretrizes Curriculares, Educacao Permanente em Saude e o Curso de Ativadores. Avancamos a partir da construcao da tentativa anterior. Nao e necessaria a descoberta da roda a todo momento. Ela pode ser adaptada e voltar a girar. O olhar para as experiencias do passado e para as necessidades do presente ajuda na construcao do futuro almejado.

Gestão da escola médica: crítica e autocrítica

University management, and mainly that of the undergraduate medical school, has not been an issue recognized and valued by the academic community. However, medical formation depends largely on good management practices. This turns even more relevant when the school is undergoing changes. This essay addresses nine topics related to management from a critical and self-critical viewpoint: 1. Medical self-sufficiency; 2. The administrative and academic dichotomy; 3. The primacy of last-minute solutions over strategies; 4. Continuing education of teachers; 5. Lack of skills to form and maintain work teams.; 6. Incomplete partnerships; 7. Multi-professional teaching; 8. Networking; 9. Weak theoretic production. This analysis aims at contributing to better perspectives for the medical school and for the work of its current and future managers.

Teste de progresso e avaliação do curso: dez anos de experiência da medicina da Universidade Estadual de Londrina

Progress testing is a longitudinal assessment method covering the full cognitive content considered pertinent to the curriculum of undergraduate medical education. Several medical schools in the world and in Brazil have been applying this test. The medical school of the State University of Londrina, Brazil, introduced the test in 1998 in order to evaluate the course and the learning performance of the students. The purpose of this paper was to present the implementation process of progress testing as an evaluation method and some of the results observed during this period. Among these results were increasing participation of students in the test; the students showed progress in their overall medical knowledge in each test, however with lower scores than expected in ethics, public health and internal medicine. These results reflect the structure of the curriculum as well as the strong and weak points of the course. It is concluded that progress testing is a good indicator in the self-assessing process but that further studies into techniques for analyzing the results are necessary to be able to determine the cognitive progress of the students during the course.

Aspectos sociopolíticos da epidemia de toxoplasmose em Santa Isabel do Ivaí (PR)

In 2002, due to a toxoplasmosis epidemic Santa Isabel do Ivaí, Paraná State, was the focus of sanitary investigations. Four hundred and twenty six individuals had serology suggestive of acute T. gondii infection (IgM reactor), considered the largest outbreak of toxoplasmosis ever reported in the world. This research was meant to identify actions carried out by the sanitation and health services sector at that time, highlighting the political conflicts that took place during the process and identifying the measures taken by the sanitary authorities during and after the epidemic period. This is an interdisciplinary study aimed at understanding major problems of public health like this one. The investigation was based on the contents of documents--press and institutional--and interviews. According to official data, the epidemic was caused by the contamination of one of the water reservoirs that supply the city. This research showed that political and social factors, as the party instability and the level of political dependence of local society, were largely responsible for the occurrence of the epidemic and for the difficulties faced by the health agents during such crisis.

Ativação de mudanças na formação superior em saúde: dificuldades e estratégias

The graduate course on Activation of Change in Higher Education for Health Professionals, launched in 2005, triggered numerous processes of change. However, few activated changes are shared with the scientific community. The current article analyzes difficulties and strategies experienced by alumni of the activation course in Parana State, Brazil, during the implementation of changes in their local and regional settings. The study adopted a qualitative research methodology with thematic analysis as proposed by Bardin. The sources were secondary data from course monographs and primary data from semi-structured interviews with the monograph authors, which were characterized as action plans. Of the 57 Parana alumni, 25 sent their monographs and 21 were interviewed. The analysis revealed structural, methodological, administrative, financial, and mainly human difficulties. Informative, motivational, and persuasive strategies proved efficient for overcoming various barriers. Since these difficulties and strategies were unveiled, they can be considered in the organization of future plans for change, thereby increasing the odds of the proposals success.

Ensino médico e o perfil do profissional de saúde para o século XXI

IntroducaoA proximidade do final do Seculo XX faz com que se passe a viver, no dia-a-dia, o clima de reflexoes, expectativas e projecoes que caracterizam asemana entre o Natal e o Ano Novo. O titulo deste artigo e o tema do Painelque o motivou refletem esse clima.Ha uma certa “mistica” em torno de abordagens desse tipo e seria dificilescrever algo sobre “o perfil do profissional de saude para o proximo seculo”sem cair num certo exercicio de futurologia. Nada contra os futurologos.Mas prefiro um terreno mais palpavel e exercitar algumas analises acercados “anos iniciais do Seculo XXI”. Afinal, esses anos estao proximos e seradurante os mesmos que as diretrizes das politicas para o ensino medico,para a saude e para a educacao serao executadas pelos Governosrecentemente eleitos.Alem de algumas ideias apresentadas por ocasiao do Painel realizado emBotucatu, entendo ser pertinente incluir no artigo alguns conteudos queabordei em estudo recentemente concluido (Almeida, 1997) e tambemoutros elementos que constam da “Contribuicao para as novas diretrizescurriculares dos cursos de graduacao da area de saude” (REDE UNIDA,1998), de cuja sistematizacao participei diretamente.

Percepções de participantes quanto ao curso de ativação de processos de mudança na formação superior de profissionais de saúde

Analisa-se a percepcao de participantes do curso de especializacao em ativacao de processos de mudanca na formacao superior dos profissionais de saude quanto a participacao no curso. Trata-se de um estudo qualitativo, realizado com egressos do curso residentes no Parana. A coleta de dados ocorreu de fevereiro a abril de 2007. Trabalhou-se com dados secundarios, trabalhos de conclusao de curso (TCC) e dados primarios, entrevistas semiestruturadas realizadas com autores de TCC que se caracterizassem como planos de acao. Como se tratava de planos de acao 21 TCC, suas autoras foram entrevistadas. Todos os participantes entrevistados eram do sexo feminino. O curso ajudou a identificar o desconforto vivenciado na realidade das participantes, forneceu ferramentas para a mudanca e propiciou a experiencia de utilizacao das mesmas. Entretanto, o curso de ativadores nao conseguiu, apos seu encerramento, manter a articulacao desses novos atores do movimento pro-mudanca.

A avaliação institucional no curso de Medicina da Universidade de Londrina: uma experiência inovadora

ABSTRACT TheundergraduatemedicalcourseoftheStateUniversity ofLondrinaelaboratedaproposalforinstitutionalevaluation in the context of the national panorama and of the reality of the region, which was implanted in2003. The Integrated Evaluation System (SIAMed) analyzes all components of the curriculum and wascarried out in three phases: internal evaluation, external evaluation and re-evaluation. These three phasestookplacefrom2003to2005.Theresultsallowedidentifyingthepositiveandnegativeaspectsofthecourse,which were discussed with all people involved. As a con sequence, new solutions for the identified problemswereproposedandapproved,andwillbeimplementedin2006–2008.Theevaluationprocesscontributedtoconsolidating the integrated medical course of the State University of Londrina. 217 REVISTA BRASILEIRA DE EDUCACAO MEDICA32 (2) : 217 – 229 : 2008 * Os autoresdesteartigoparticiparamdo Grupo de Trabalho que coordenou o processo de avaliacaodo curso deMedicina da UEL no periodo 2003-2005. 1 Universidade Estadual de Londrina - UEL, Londrina, Brasil.

Cursos de Medicina com currículos inovadores são mais caros? Análise de custos do Curso Integrado de Graduação em Medicina da Universidade Estadual de Londrina

The aim of this prospective case study was to conduct a cost analysis of the Integrated Problem-Based Medical Course of the Health Sciences Center of the State University of Londrina, Brazil, during the fiscal year 2005. This analysis was done in two phases. First, using a Cost Construction Model, the administrative and educational faculty contact hours during all educational activities were identified through analysis of documents and interviews with the teaching body and students. Second, all direct and indirect costs required for supporting the course were added through a Cost Absorption Method done by the Planning and Development Office of the University, which included all shared costs. In 2005 the medical course had 502 medical students enrolled and 284 teachers (222,2 full-time equivalents) were necessary to accomplish all educational and management tasks. For the first four years 18,932 and for the internships (years five and six) 33,352 faculty contact hours were needed. The hours allocated for administrative tasks amounted to 13.173. The estimated cost for the first four years was R