Mauro Toledo Sirimarco

Erro médico: a perspectiva de estudantes de medicina e direito

Recent decades have witnessed an increase in the societal implications of medical error, a subject in which Medicine and Law intertwine. This study focused on medical error from the perspective of medical students and law students, assessing their level of interest and information and the need to discuss the topic during undergraduate education and how it occurs in each field, in their view. A cross-sectional, descriptive, observational study was conducted at the Federal University in Juiz de Fora, Minas Gerais State, in 2008 with 185 medical students and 119 law students. 88.7% of the medical students and 92.4% of the law students reported knowledge of medical error. The interest was due to the fact that medical error is currently a widely discussed issue. The students thought the issue should be addressed in their undergraduate education (97.8% of medical students and 94.9% of law students). It is important to discuss such a current issue in undergraduate education in both medicine and law, because of the potential for decreasing the vicious circle of errors, iatrogenesis, and law suits, in addition to fostering reflection on the role of medical education in the ethical training of young professionals.

Cursinhos preparatórios para prova de residência médica: expectativas e opiniões

Medical Residency (MR) is known as the best form for a doctor to start his professional life and to developing his skills in a specialty. There is however a discrepancy between the number of graduate/ candidates for Medical Residency and the number of vacancies. In this context, students in the 5th and 6th years of Medical School are sacrificing their medical graduation during their internships to dedicate themselves to Preparatory Courses (PCs) for the Medical Residency. This study sought to investigate the expectations of the students with regard to RM as well as/ their opinion about the creation of the PCs. 70.83% of the students of the 7th, 8th and 9th semesters/ of the Medical School (MS) answered questionnaires with eight objective questions. They all stated to know the PC method; 76%/ intended to enroll; out of those who did not intend on to enroll, 63.17% claim that the/ main reason/ is poor financial conditions. 59.45% disapproves the current method of admission tests for MR. In conclusion, it is necessary to adapt the current teaching methods of the medical school to the model of admission tests for MR. The criteria for admission to MR should be adjusted, also considering the practical skills. The medical schools should always make inexpensive, up-to-date and modern educational material available to the students.

Situação vacinal dos discentes da Faculdade de Medicina da UFJF-MG

Os profissionais da area de saude estao expostos a varios tipos de riscos ocupacionais, sendo o de maior impacto o risco biologico, devido ao contato direto com material orgânico potencialmente contaminado. A manutencao da situacao vacinal atualizada e uma das ferramentas que devem ser empregadas neste contexto, alem da adocao de medidas universais de biosseguranca, sendo a educacao fundamental neste processo. Avaliamos a situacao vacinal e a percepcao sobre risco biologico dos discentes da Faculdade de Medicina da UFJF em estudo observacional transversal (n = 136 alunos). Oitenta e nove alunos (65,4%) referiram estar com o cartao vacinal atualizado. Noventa e sete alunos (71,3%) receberam o esquema da hepatite B, e 99 (72,8%) o do tetano. Oitenta e seis 86 alunos (63,2%) declararam ter recebido orientacao sobre imunizacao durante o curso. Setenta e tres alunos (53,7%) ja foram expostos a material potencialmente contaminado em suas atividades academicas, e 97 deles (71,3%) usam equipamentos de protecao individual (EPI) nestas. Identificamos falhas na imunizacao (hepatite B e tetano), expondo os discentes a riscos desnecessarios. A orientacao relativa a imunizacao se mostrou insuficiente. A significativa taxa de exposicao a risco biologico e o insatisfatorio uso de EPIs verificados demandam maior atencao, a fim de prevenir acidentes.

Health professionals and the delivery bad news: patient perspectives

Introduction: “Bad news” includes those that alter drastically and negatively patients’ view of their future. Delivery of bad news is relevant in the context of healthcare and can have irreparable impact, posing a threat to life, to personal, family, and social welfare. Studies addressing this issue from the perspective of patients and on the use of specific protocols are scarce. Objective: to assess the quality of bad news delivery through the eyes of patients. Methods: A cross-sectional study based on the SPIKES protocol with 500 participants. Results: in 10% of cases, news was delivered by non-medical professionals, 5% by phone and 17% in a non-private space. About 1/3 of the sample considered that the professional was unprepared for breaking bad news, and 60% of respondents considered themselves unprepared to receive such news. Transmission was considered to be friendly (34%), calm (43%) or indifferent (15%). Calm and sincerity were cited as important when receiving bad news. Conclusions: delivery of bad news must be based on a good doctor-patient relationship. After bad news are broken, while most patients are expected to report feelings of grief, despair, and sadness, such feelings can be exacerbated when news are transmitted tactlessly or indifferently. Among important areas for improvement, finding a private place to convey the news is one of the least complex to implement. The main aspects patients mentioned as requirements for professionals to deliver bad news more humanely are behavioral aspects.

Students' perspectives on the parallel curriculum in medical schools

Introduction: the term “curriculum” can be interpreted as a “grid” of courses and the contact hours in an education institution. There is a formal curriculum, consisting of taught content and practical activities officially organized by the faculty, and a parallel curriculum (PC) covering activities that although not determined by the institution are relevant to a medical education. For students, structuring the CP comes with numerous motivations but is not without obstacles. Objective: to define the profile of activities developed, motivation, difficulties, and satisfaction among students performing extracurricular activities (EA). Methods: 10-question structured interviews with 280 medical students. Results: most respondents (96.4%, n=270) had already taken part in at least one EA, making it the most popular optional course in the formal curriculum. 55.4% (n=155) wished to include improvement courses and 45% (n=126) professional training. The main motivation was the desire to enhance the curriculum, cited by 73.9% (n=207). Main obstacles were the limited number of takings (51.8% n=145), and conflict of schedules (50%, n=140). Conclusions: This sample showed a high number of students engaged in EA, especially among those that lead to practice improvement, CV enhancement and score better in residency requirements. Being closer to graduation represented a risk factor for completing these EA. Most EAs are supervised by teaching physicians and were considered highly satisfactory. With this in view, we suggested that some of the extracurricular activities be included in the formal curriculum, prioritizing the improvement of clinical practice. This addition has the potential of increasing the level of training and result in more skilled and confident medical professionals.