Rinaldo Henrique Aguilar-da-Silva

Desenvolvimento docente e a formação de médicos

Based on the results obtained in the self-assessment performed by 28 medical schools (MS) making part of the Project Evaluation of Change Trends (Caem/Abem), this paper examines the behavior of medical schools according to the predominant alternatives (traditional, innovative, progressive) with regard to the four vectors comprising the axis Teaching Development: Pedagogical Training; Technical-Scientific Up-Dating; Participation in Assistance Services and Management. Although half of these MS consider themselves traditional, the group recognizes the importance and influence of this axis in the medical education process, considering it essential for supporting the implemented changes and ensuring interaction between University, Health Services and Community from the perspective of integrality. For this group of 28 medical schools, the axis Teaching Development is very far from the recommendations of the National Curriculum Guidelines.

Cenários de prática e a formação médica na assistência em saúde

This paper presents and analyzes the results of the self-assessment performed by 28 Brazilian medical schools (BMES) participating in the project elaborated by the Commission of Evaluation of the Medical Schools of the Brazilian Association of Medical Education, with regard to the axis Sceneries of Practice, one of the five relevant axes in the education of the medical professional. This axis comprises three vectors: the setting for medical practice used by the school; learning, and the chance to live the spontaneous demands of health assistance in practice. As refers to the vector setting used for practice, 75% of the schools use mainly primary, secondary and tertiary care units of the health system, another 25% use predominantly the secondary care hospital and the outpatient unit of the proper institution. With regard to participation of the teaching body, 75% affirm providing extensive participation under the guidance of the professors in different practical settings and the rest provides selected and partially supervised activities. With regard to the vector Sceneries for Practice, 25% of the schools only offer practical training linked to the department and specialties/disciplines, one third offers practical training covering different programs and nearly half of the schools (43%) offer practical training throughout the course utilizing the services in all care levels in an integrated way. Not always the justifications and evidences corresponded to the situation of innovation or transformation of the curricula as perceived by the schools.

Tendências de mudanças em um grupo de escolas médicas brasileiras

The purpose of this study of Caem/Abem conducted in a group of twenty-eight Brazilian medical schools was to show the trends in the changes made for meeting the National Curricular Guidelines and consolidating the Brazilian Health System and represents the first stage of the Project for evaluating the change trends in the undergraduate courses of the Brazilian medical schools. The schools answered the self-evaluation instrument according to the proposed methodology. The results show that the course is perceived as inter-relation of five main axes: the world of work, the pedagogical project, the pedagogical approach, sceneries of practice and qualification of teachers. In the perception of their social actors, the greater part of the schools of this group (75%) can be classified as advanced and innovative, strongly tending to the transformations commended for the health sector. The item Qualification of Teachers shows minor advances than the others, indicating in this moment of the process a disproportion in the dynamics of actions for consolidating the changes. It shows the need for deepening the study by developing evaluation processes and constructing qualitative and quantitative indicators that allow identifying and monitoring the changes.

Projeto pedagógico e as mudanças na educação médica

This paper describes the results of the first moment of the Caem/Abem project as refers to the axle Pedagogical Approach, one of the five axles relevant for evaluating the change trends in the medical school. It analyzes how the actors involved in the undergraduate course perceive and situate the school in the society by establishing its political and pedagogical mission. When classifying the group of 28 studied medical schools according to one of the three alternatives (traditional, innovative, advanced), this axle shows in the first place an advanced situation followed by innovative in the second place as refers to the vectors Biomedical and Socio-Epidemiological profile of the future professional and application of technology. With regard to the vectors focusing production of knowledge, the schools show difficulties in producing and extending the research lines beyond the biomedical areas. It also seems hard for them to articulate undergraduate and graduate courses and permanent education with view to the health needs of the population.

Projeto de avaliação de tendências de mudanças no curso de graduação nas escolas médicas brasileiras

The Project for evaluating change trends in the undergraduate course of Brazilian medical schools proposed by the Evaluation Commission of Medical Schools (Caem) of the Brazilian Association of Medical Education (Abem) arose from the need to assess and follow up the changes occurring in the medical schools after national and international movements that recommended that the education of the medical professional should be adapted to the current health demands, especially in Brazil after the homologation of the National Curricular Guidelines for the medical undergraduate course. Composed by professors, students and specialists in the subject, the Caem discussed and approved the project based on the thesis that adopted five relevant conceptual axes in medical education - working world, pedagogical project, pedagogical approach, sceneries of practice and teaching development. The project proposes a work in three steps to be carried out in the schools: 1) application of the self-assessment instrument with analysis of data by the Commission and feedback to the schools; 2) approximation of change trends pointed out by the schools and identification of involved social actors as well as construction of indicators allowing to verify and follow up the changes, and 3) systematization and presentation of data and elaboration of the report according to the principles of National System for Evaluation of Higher Education (Sinaes). This article shows the details of the project and the resulting adhesion of the schools when it was launched in 2006.

Mundo do trabalho no contexto da formação médica

This paper analyzes the behavior of 28 Brazilian medical schools as refers to the axle Labor Market, one of the five axles of the research instrument of the Caem/Abem project. This axle deals with the lack of professionals for providing primary care services to the population and to the employment of the future professional; the economical basis of the medical practice; and to the mediating role of insurances, health plans and similar institutions. The group of schools, although identifying this issue as rarely addressed in medical education, recognizes its relevance for adapting the political-pedagogical project, the didactic-pedagogical approach and the sceneries of practice, and for practicing in the undergraduate course a critical-reflexive analysis of the professional space of health care services.

Implicações do estresse oxidativo sobre o metabolismo eritrocitário de pessoas com Síndrome de Down

Downs Syndrome carriers are under endogenous and chronic oxidative stress that can result from an excessive SOD-1enzyme activity. This work describes some indicators and adaptations of the defense system faced with oxidative damage. We observed that, in Downs Syndrome individuals, the presence of oxidative stress (with an increase of 48% in the SOD-1 activity) induced several adaptations of the erythrocyte metabolism, with a reduction of methemoglobin, through an increase of methemoglobin reductase activity (29%) which guaranteed the efficiency of oxygen transportation. The increase of GSH (61%) would propitiate the maintenance of the integrity of the membrane, essential to the functional integrity of erythrocytes. The decrease in the hemoglobin and hematocrit concentrations, possibly, results from the increase in the activity of the glucose-6-phosphate dehydrogenase enzyme, and a reduction in the half-life of erythrocytes. The effects of these adaptations on blood oxygenation require further investigations.

Relato de experiência de um novo modelo curricular: aprendizagem baseada em problemas, implantada na unidade educacional do sistema endocrinológico na 2ª série do curso médico da Faculdade de Medicina de Marília - Famema

INTRODUCTION AND OBJECTIVES This paper reports the experience with the Endocrine System Educational Unit (ESEU), built by a transdisciplinar team, carried out in the 2nd grade of Famema medical course. The aim was to integrate teaching and learning in order to graduate medical doctors who would approach the human being from the social, psychological and biological aspects. METHOD The ESEU was used, and the evaluations (closed and open fields) were carried out by students and tutors based on two criteria: satisfactory (S) and unsatisfactory (U) for the unit development, conferences, learning objectives and problems. RESULTS 92% of the students found the unit development S and 8% found it U. The unit development was considered S by 66% tutors, and 33% did not answer. Conferences were evaluated by students only and were considered S by 97%. The educational objectives were considered S by 88% of the tutors and 96% of the students; the problems were considered S by 80% of the tutors and 88% of the students. CONCLUSION Evaluations corroborate the transdisciplinar teamwork in integrating biological, psychological and social dimensions and in articulating basic and clinical disciplines in the unit building up. In spite of that, the comments made in the evaluation open fields show the need for both students and tutors to think deeper on each step of the tutorial process.

Professional profile of dentists who are members of the Family Health Strategy city of Marília, São Paulo: the challenge of interprofessional work

INTRODUCTION: The inclusion of oral health professionals within the Family Health Strategy was legislated in December, 2000, by the Ministery of Health. These professionals are included in a new context which challenges the traditional education of fragmented knowledge and presents the challenge of interprofessional work. OBJECTIVE: To analyze the profile and the interprofessional practice of dentists working in the FHS in the city of Marilia, Sao Paulo. MATERIAL AND METHOD: In 2012, a structured questionnaire and an adaptation of the Readiness Interprofissional Learning Scale (RIPLS), given to 34 dentists working in the FHS in the city of Marilia, Sao Paulo, were used to collect data. Descriptive statistics and the nonparametric Kruskal-Wallis analysis of variance with SNK multiple comparisons post-test, at a significance level of p < 0.05, were used for data analysis. RESULT: The dentists are in the 31 to 40 year age range (70.6%), are mostly women (82.4%) and 79.41% hold a specialization in Public and Family Health. Comparisons of the differences of the mean scores of the responses among professionals, with and without graduate study in this area, were statistically significant in the statements regarding the amount of human resources and interprofessional work. CONCLUSION: Graduate study in Public and Family Health provides dentists with background on the integration of teamwork, the understanding about the process of interprofessional work, the enhancement of common and collaborative professional skills and thus minimizes the effects of an incomplete health team. It is considered that professionals without graduate study are restricted to their traditional and reductionist preparation.