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Papers by izabel rios
Revista Brasileira de Educação Médica, 2009
O presente artigo discute o surgimento da humanização no contexto histórico e cultural de nossa é... more O presente artigo discute o surgimento da humanização no contexto histórico e cultural de nossa época no momento em que a sociedade pós-moderna passa por uma revisão de valores e atitudes. Aprofunda o conceito de humanização e apresenta suas principais vertentes: a humanização como movimento contra a violência institucional na área da saúde, como princípio de conduta de base humanista e ética, como política pública para a atenção e gestão no SUS, como metodologia auxiliar para a gestão participativa, como tecnologia do cuidado na assistência à saúde. Nessa perspectiva, humanização é o processo, fundamentado no respeito e valorização da pessoa humana, que visa à transformação da cultura institucional por meio da construção coletiva de compromissos éticos e de métodos para as ações de atenção à saúde e de gestão dos serviços. Sua essência é a aliança da competência técnica e tecnológica com a competência ética e relacional. O texto discute brevemente as dificuldades para realizar a hu...
Revista Brasileira de Educação Médica, 2008
A integração curricular, atualmente, é apontada como importante estratégia de ensino, processo qu... more A integração curricular, atualmente, é apontada como importante estratégia de ensino, processo que envolve várias etapas, trabalho e compromisso de grupo. Este artigo relata a experiência de integração das disciplinas de humanidades médicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP). Ao longo de dois anos, constituiu-se um grupo composto pelas disciplinas da área de humanidades médicas, pesquisadores do Centro de Desenvolvimento da Educação Médica Professor Eduardo Marcondes (Cedem), alunos e professores de outras disciplinas interessados na área. Desenvolveu-se a integração temática e prossegue-se na integração metodológica.
Revista Brasileira de Educação Médica, 2021
Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remo... more Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remote learning, which, according to recent studies suggest an increase in depression, anxiety and behavioral disorders among university students. Medical training, which has a heavy load of psychological issues had to face this aggravating factor, reinforcing the need for support actions for students, such as mentoring programs. Mentoring programs offer empathetic and developmental support that encourages self-care, well-being and resilience. Experience report: A group of teacher-mentors from a medical school adapted the mentoring activities to a remote model, offering them to upper-level students who had already participated in mentoring, and, separately, to students who were newly enrolled in the medical course. In the remote format, the mentoring proposal was maintained as a "place of conversation", but on a digital platform. The technical follow-up was carried out by remote meetings of the group of teacher-mentors, and consultation with students through a self-administered online questionnaire. The data obtained were submitted to content analysis. Discussion: From March to December, 109 virtual mentoring meetings were held. The students considered the meetings satisfactory in terms of the quality of discussions, the mentors' attitudes and the emotional environment. The interactive development varied among groups, but it was observed to be easier in the groups of upper-level students. Among the newly-enrolled students, the recurring topic was the fear of poor performance in the tests, losing the semester, or not learning. Upper-level students highlighted the difficulties of adapting to remote learning and organizing their activities, and the decrease in practical activities. All groups reported fear of the pandemic, of death, of the worsening of parents' financial situation, and sadness about the loss of relatives to COVID-19. It drew the attention of the mentors the fact that the students, even in a welcoming space, kept the cameras turned off. Conclusion: For mentors and students, virtual mentoring worked as an important student support system. Upper-level students and first-year ones reported feeling cared for, supported and grateful, suggesting that the meetings allowed a good interaction and produced beneficial effects. A limitation of this study was the duration of the experiment. Therefore, it is recommended that the research be maintained.
Revista Brasileira de Educação Médica
Apesar de a atenção primária à saúde (APS) ser essencial para a formação médica, as percepções do... more Apesar de a atenção primária à saúde (APS) ser essencial para a formação médica, as percepções dos profissionais das equipes de saúde da família (eSF) sobre o processo ensino-aprendizagem foram pouco estudadas, em particular em municípios nos quais o modelo de gestão da APS é indireto, como na cidade de São Paulo. O objetivo deste estudo foi analisar as percepções de profissionais das eSF sobre as barreiras e os facilitadores do processo ensino-aprendizagem dos estudantes de medicina na APS, no município de São Paulo. Método: Trata-se de uma pesquisa qualitativa. Foram realizadas entrevistas semiestruturada com 12 profissionais das eSF (quatro médicos, quatro enfermeiros e quatro agentes comunitários de saúde), que atuavam em unidades básicas de saúde (UBSs) localizadas na zona leste do município de São Paulo e que recebiam estudantes de Medicina do primeiro ano ao internato. As entrevistas foram gravadas e transcritas, lidas e relidas, sendo identificadas unidades de significado de acordo com os pressupostos da análise de conteúdo. Resultados: Os entrevistados destacaram as seguintes barreiras relacionados ao processo ensinoaprendizagem na APS: 1. excesso de pacientes agendados e escassez de tempo para discussão do caso com os estudantes; 2. inadequada estrutura física do serviço de saúde; 3. falta de preparação dos profissionais; e 4. falta de articulação ensino-serviço-comunidade. Os aspectos reconhecidos como fatores facilitadores do processo ensino-aprendizagem foram: 1. qualificação do serviço de saúde e da equipe; 2. integração com a eSF e com equipe multiprofissional; e 3. preparação dos preceptores médicos. Conclusões: Os resultados têm implicações para os profissionais da APS, as instituições de ensino superior e os gestores da saúde da APS estudados. O aprimoramento das relações e articulações entre as instituições de ensino, os gestores dos serviços de saúde, os profissionais de saúde e a comunidade é condição necessária para efetivar o processo ensino-aprendizagem e garantir o desenvolvimento de competências para a qualidade do cuidado na APS. Assim, o preparo dos profissionais de saúde, a adequação do espaço físico da UBS, a reflexão sobre o agendamento e estratégias para garantir tempo para discussão do caso e espaço para feedback podem contribuir para mitigar as barreiras ao processo ensino-aprendizagem na APS.
Revista Brasileira de Educação Médica
: Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and re... more : Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remote learning, which, according to recent studies suggest an increase in depression, anxiety and behavioral disorders among university students. Medical training, which has a heavy load of psychological issues had to face this aggravating factor, reinforcing the need for support actions for students, such as mentoring programs. Mentoring programs offer empathetic and developmental support that encourages self-care, well-being and resilience. Experience report: A group of teacher-mentors from a medical school adapted the mentoring activities to a remote model, offering them to upper-level students who had already participated in mentoring, and, separately, to students who were newly enrolled in the medical course. In the remote format, the mentoring proposal was maintained as a “place of conversation”, but on a digital platform. The technical follow-up was carried out by remote meetings of the group of teacher-mentors, and consultation with students through a self-administered online questionnaire. The data obtained were submitted to content analysis. Discussion: From March to December, 109 virtual mentoring meetings were held. The students considered the meetings satisfactory in terms of the quality of discussions, the mentors’ attitudes and the emotional environment. The interactive development varied among groups, but it was observed to be easier in the groups of upper-level students. Among the newly-enrolled students, the recurring topic was the fear of poor performance in the tests, losing the semester, or not learning. Upper-level students highlighted the difficulties of adapting to remote learning and organizing their activities, and the decrease in practical activities. All groups reported fear of the pandemic, of death, of the worsening of parents’ financial situation, and sadness about the loss of relatives to COVID-19. It drew the attention of the mentors the fact that the students, even in a welcoming space, kept the cameras turned off. Conclusion: For mentors and students, virtual mentoring worked as an important student support system. Upper-level students and first-year ones reported feeling cared for, supported and grateful, suggesting that the meetings allowed a good interaction and produced beneficial effects. A limitation of this study was the duration of the experiment. Therefore, it is recommended that the research be maintained.
Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ tra... more Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ training, the perceptions of primary care workers about the teaching-learning process have been overlooked, particularly in municipalities where PHC management is performed by a private organization instead of the government, such as in the city of São Paulo. Objective: to analyze the perceptions of primary care workers about barriers and facilitators of medical students’ teaching-learning process in PHC in the city of São Paulo. Method: we conducted a qualitative research. We performed in-depth interviews with 12 primary care workers from the family health teams (four physicians, four nurses and four community health workers), who worked in primary care clinics in the east region of the city and received medical students, from 1st-year to internship students. The interviews were recorded, transcribed and afterwards, they were repeatedly read. We identified thematic units following the cont...
![Research paper thumbnail of [Family Health Support Centers: challenges and opportunities from the perspective of primary care professionals in the city of São Paulo, Brazil]](https://attachments.academia-assets.com/79024935/thumbnails/1.jpg)
](Cadernos de saude publica, 2012
Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capac... more Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capacity of primary healthcare. Prior to their implementation in the West Side of the city of São Paulo, Brazil, a series of workshops were held for primary healthcare professionals to prepare a proposal for such centers. Hermeneutic analysis was used to study the transcribed material. The thematic categories were: role, constitution, and functioning of the NASF, relationship with family health teams, and interdisciplinarity. The participants' expected the NASF to be an empowering device for comprehensiveness of care, intervening in an existing culture of unnecessary referrals while fostering linkage with other levels of care. The participants also expected the NASF to contribute to the discussion on health professionals' training and stimulating reflection with policymakers on health indicators based exclusively on the number of consultations. These indicators fail to reflect the imp...
Revista Brasileira de Educação Médica, 2020
Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ tra... more Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ training, the perceptions of primary care workers about the teaching-learning process have been overlooked, particularly in municipalities where PHC management is performed by a private organization instead of the government, such as in the city of São Paulo. Objective: to analyze the perceptions of primary care workers about barriers and facilitators of medical students’ teaching-learning process in PHC in the city of São Paulo. Method: we conducted a qualitative research. We performed in-depth interviews with 12 primary care workers from the family health teams (four physicians, four nurses and four community health workers), who worked in primary care clinics in the east region of the city and received medical students, from 1st-year to internship students. The interviews were recorded, transcribed and afterwards, they were repeatedly read. We identified thematic units following the cont...
Resumo: Introducao: As mudancas de vida do estudante quando ingressa na Faculdade de Medicina tor... more Resumo: Introducao: As mudancas de vida do estudante quando ingressa na Faculdade de Medicina tornam os primeiros anos os mais vulneraveis para desenvolver estresse psicologico e suas consequencias. Em 2020, essa condicao se agravou devido a pandemia de Sars-CoV-2. Para dar suporte aos alunos, varias escolas medicas desenvolvem programas de mentoria, entretanto a adesao deles costuma ser baixa. Objetivo: Este estudo teve como objetivos criar um modelo de mentoria - denominada “Mentoria de Acolhimento” - como suporte psicossocial e pedagogico aos alunos ingressantes, e estudar seu processo de implementacao e os resultados para maior adesao e efetividade. Metodo: Com um desenho metodologico do campo da ciencia da implementacao, utilizaram-se tecnicas e instrumentos de pesquisas qualitativas e quantitativas para compor um estudo de metodos mistos. Obtiveram-se os dados qualitativos em reunioes com os mentores e os dados quantitativos em questionarios eletronicos anonimos para os alunos...
Organicom, Sep 13, 2017
O artigo apresenta a experiência da gestão da humanização no Hospital Universitário da Universida... more O artigo apresenta a experiência da gestão da humanização no Hospital Universitário da Universidade de São Paulo, a importância do trabalho desenvolvido em rede e os resultados de um estudo de caso realizado no período de 2011 a 2014. A proposta é refletir sobre o conceito da humanização na área da saúde pública e a relevância da busca de parcerias que possam contribuir com a qualidade do trabalho desenvolvido. O primeiro passo nesse sentido foi identificar as relações que podem ser estabelecidas entre conceitos e técnicas da humanização na área da saúde e a interface com conceitos e técnicas da administração contemporânea e da comunicação institucional. No âmbito da investigação científica ou da atuação profissional, a área da comunicação é uma grande aliada, mas continua sendo um campo a ser explorado pela área da saúde, já que os desafios são muitos e bastante complexos.
Introduction: The humanization of assistance is associated to empathy, embracing, and effective c... more Introduction: The humanization of assistance is associated to empathy, embracing, and effective communication, being part of the medical training. According to its nature, humanization requires methods that involve affections and stimulates critical thinking. Objective: Extensive literature shows the benefits of the arts in medical education; however, there are still few studies on dancing, the subject of this study, which was carried out by medical students and whose aim was to investigate hospital dancing in the teaching of humanization, from the perspective of medical students. Method: A qualitative action research study was designed, in which medical students performed choreographies for patients, companions and employees in three different wards of the teaching hospital. The action consisted of continuous cycles in the planning of interventions, performance, observing, reflection, and re-planning of subsequent actions, in a systematic manner and controlled by the researchers. D...
Revista de Medicina
The fast spread of the COVID-19 epidemic has imposed unprecedented challenges to contemporary soc... more The fast spread of the COVID-19 epidemic has imposed unprecedented challenges to contemporary society, impacting several aspects of human life globally. Strict social distancing protocols had to be implemented in affected countries to contribute to reduce viral dissemination, and consequently, limit acquisition of new infections. Health systems were compelled to put emergency plans in place to cope with the overburden of potentially severe cases needing hospitalization, with the ultimate aim to preserve as many lives as possible. Academic health systems worldwide were required to propose novel strategies to maximize healthcare outcomes while mitigating negative impact on medical education.[...]
Revista Brasileira de Educação Médica
RESUMO Introdução O uso de habilidades de comunicação está associado a desfechos positivos na con... more RESUMO Introdução O uso de habilidades de comunicação está associado a desfechos positivos na consulta médica e no cuidado à saúde, como melhora da adesão aos tratamentos, da satisfação de médicos e pacientes, e da relação entre eles. Isto é ainda mais significativo na Atenção Primária à Saúde (APS), que é um espaço de cuidado integral de saúde. Uma comunicação efetiva é aquela em que todos os participantes interagem de modo a trocar informações e em que, ao final, todas as partes tenham o mesmo entendimento sobre o problema, acordem sobre as medidas a tomar e se sintam entendidas em suas necessidades. Para que este tipo de comunicação aconteça, o ensino dessas habilidades deve ocorrer de forma adequada e contínua, durante toda a formação médica. Até o momento, não existe um instrumento brasileiro que cumpra esta finalidade. No Brasil, têm-se utilizado guias internacionais para este ensino. No entanto, dos guias mais usados internacionalmente e mais citados na literatura da área, ne...
Revista Brasileira de Educação Médica
Medical training is current topic of discussion both on the national and international stage due ... more Medical training is current topic of discussion both on the national and international stage due to changes in contemporary society and the consequent health demands. In Brazil, insertion into the workplace of the Primary Health Care (PHC) student is recommended throughout the medical course. However, such insertion is hampered by inadequate practical scenarios, the lack of preceptors, insufficient training of general practitioners to receive students, teachers without adequate training in teaching in the area and resistance by teachers of traditional disciplines. This article describes and analyzes a model for insertion into PHC and Family and Community Medicine (FCM) of students from a medical course in São Paulo, the challenges of teaching-management integration and the actions that help to address these issues. The proposal is based on educational objectives aimed at developing competences (knowledge, skills and attitudes) so that the student can offer comprehensive care, unders...
International Journal of Ethics Education
Values and attitudes are strongly influenced by the subjective elements of the organizational cul... more Values and attitudes are strongly influenced by the subjective elements of the organizational culture of the medical school. The objective of this research was to better understand the medical school environment and the difficulties in training doctors in humanism in clinical practice. Qualitative research focused on subjective aspects of the teacher-student relationship, such as ethics and respect for differences, was conducted in a traditional Brazilian medical school. We used the technique of ethnographic observation and interviews with students and teachers. The data were analysed according to three categories: 1. self and other, 2. misuse of technology, and 3. models of teacher-student interactions. Over 12 months, we observed 22 teachers and 128 students (8 groups of 14-18 students), and we interviewed 9 teachers and 19 students, who were recognized as key-interviewees. Our analyses revealed that the medical school environment enables doctors and medical students' feelings of intellectual superiority, selfish and excessive competitiveness; inability to see the patient as a whole; overvaluation and excessive use of technology; role modelling of nonempathic behaviours; and behaviours showing disrespect, discrimination, and violence. These findings reveal attitudes that hamper the doctor-patient relationship, and some underlying issues of critical importance to the humanistic training of medical students. This study shows the need for institutional humanistic values to be adopted and applied to everyone. Perhaps an educational process that uses ethics more than academic disciplines should be used as a method of thinking and acting, which may encourage institutional changes that improve medical education as a whole.
Revista Brasileira de Educação Médica
RESUMO Em contexto nacional e internacional, discute-se a formação médica devido às mudanças na s... more RESUMO Em contexto nacional e internacional, discute-se a formação médica devido às mudanças na sociedade contemporânea e suas demandas de saúde. No Brasil, preconiza-se a inserção do aluno na Atenção Primária à Saúde (APS) durante todo o curso médico. Tal inserção é dificultada pelos cenários práticos inadequados, pela falta de preceptores, pela formação insuficiente dos médicos generalistas para receber estudantes, pelos docentes sem capacitação adequada para o ensino na área e pela resistência de docentes de disciplinas tradicionais. Este artigo descreve e analisa um modelo de inserção da APS e Medicina de Família e Comunidade (MFC) em um curso médico no município de São Paulo, os desafios da articulação ensino-gestão e as ações que ajudam a enfrentá-los. A proposta parte de objetivos educacionais que visam desenvolver competências (conhecimentos, habilidades e atitudes) para que o aluno possa oferecer cuidado integral, compreendendo o indivíduo no contexto de vida familiar, soci...
Revista Brasileira de Educação Médica, 2009
O presente artigo discute o surgimento da humanização no contexto histórico e cultural de nossa é... more O presente artigo discute o surgimento da humanização no contexto histórico e cultural de nossa época no momento em que a sociedade pós-moderna passa por uma revisão de valores e atitudes. Aprofunda o conceito de humanização e apresenta suas principais vertentes: a humanização como movimento contra a violência institucional na área da saúde, como princípio de conduta de base humanista e ética, como política pública para a atenção e gestão no SUS, como metodologia auxiliar para a gestão participativa, como tecnologia do cuidado na assistência à saúde. Nessa perspectiva, humanização é o processo, fundamentado no respeito e valorização da pessoa humana, que visa à transformação da cultura institucional por meio da construção coletiva de compromissos éticos e de métodos para as ações de atenção à saúde e de gestão dos serviços. Sua essência é a aliança da competência técnica e tecnológica com a competência ética e relacional. O texto discute brevemente as dificuldades para realizar a hu...
Revista Brasileira de Educação Médica, 2008
A integração curricular, atualmente, é apontada como importante estratégia de ensino, processo qu... more A integração curricular, atualmente, é apontada como importante estratégia de ensino, processo que envolve várias etapas, trabalho e compromisso de grupo. Este artigo relata a experiência de integração das disciplinas de humanidades médicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP). Ao longo de dois anos, constituiu-se um grupo composto pelas disciplinas da área de humanidades médicas, pesquisadores do Centro de Desenvolvimento da Educação Médica Professor Eduardo Marcondes (Cedem), alunos e professores de outras disciplinas interessados na área. Desenvolveu-se a integração temática e prossegue-se na integração metodológica.
Revista Brasileira de Educação Médica, 2021
Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remo... more Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remote learning, which, according to recent studies suggest an increase in depression, anxiety and behavioral disorders among university students. Medical training, which has a heavy load of psychological issues had to face this aggravating factor, reinforcing the need for support actions for students, such as mentoring programs. Mentoring programs offer empathetic and developmental support that encourages self-care, well-being and resilience. Experience report: A group of teacher-mentors from a medical school adapted the mentoring activities to a remote model, offering them to upper-level students who had already participated in mentoring, and, separately, to students who were newly enrolled in the medical course. In the remote format, the mentoring proposal was maintained as a "place of conversation", but on a digital platform. The technical follow-up was carried out by remote meetings of the group of teacher-mentors, and consultation with students through a self-administered online questionnaire. The data obtained were submitted to content analysis. Discussion: From March to December, 109 virtual mentoring meetings were held. The students considered the meetings satisfactory in terms of the quality of discussions, the mentors' attitudes and the emotional environment. The interactive development varied among groups, but it was observed to be easier in the groups of upper-level students. Among the newly-enrolled students, the recurring topic was the fear of poor performance in the tests, losing the semester, or not learning. Upper-level students highlighted the difficulties of adapting to remote learning and organizing their activities, and the decrease in practical activities. All groups reported fear of the pandemic, of death, of the worsening of parents' financial situation, and sadness about the loss of relatives to COVID-19. It drew the attention of the mentors the fact that the students, even in a welcoming space, kept the cameras turned off. Conclusion: For mentors and students, virtual mentoring worked as an important student support system. Upper-level students and first-year ones reported feeling cared for, supported and grateful, suggesting that the meetings allowed a good interaction and produced beneficial effects. A limitation of this study was the duration of the experiment. Therefore, it is recommended that the research be maintained.
Revista Brasileira de Educação Médica
Apesar de a atenção primária à saúde (APS) ser essencial para a formação médica, as percepções do... more Apesar de a atenção primária à saúde (APS) ser essencial para a formação médica, as percepções dos profissionais das equipes de saúde da família (eSF) sobre o processo ensino-aprendizagem foram pouco estudadas, em particular em municípios nos quais o modelo de gestão da APS é indireto, como na cidade de São Paulo. O objetivo deste estudo foi analisar as percepções de profissionais das eSF sobre as barreiras e os facilitadores do processo ensino-aprendizagem dos estudantes de medicina na APS, no município de São Paulo. Método: Trata-se de uma pesquisa qualitativa. Foram realizadas entrevistas semiestruturada com 12 profissionais das eSF (quatro médicos, quatro enfermeiros e quatro agentes comunitários de saúde), que atuavam em unidades básicas de saúde (UBSs) localizadas na zona leste do município de São Paulo e que recebiam estudantes de Medicina do primeiro ano ao internato. As entrevistas foram gravadas e transcritas, lidas e relidas, sendo identificadas unidades de significado de acordo com os pressupostos da análise de conteúdo. Resultados: Os entrevistados destacaram as seguintes barreiras relacionados ao processo ensinoaprendizagem na APS: 1. excesso de pacientes agendados e escassez de tempo para discussão do caso com os estudantes; 2. inadequada estrutura física do serviço de saúde; 3. falta de preparação dos profissionais; e 4. falta de articulação ensino-serviço-comunidade. Os aspectos reconhecidos como fatores facilitadores do processo ensino-aprendizagem foram: 1. qualificação do serviço de saúde e da equipe; 2. integração com a eSF e com equipe multiprofissional; e 3. preparação dos preceptores médicos. Conclusões: Os resultados têm implicações para os profissionais da APS, as instituições de ensino superior e os gestores da saúde da APS estudados. O aprimoramento das relações e articulações entre as instituições de ensino, os gestores dos serviços de saúde, os profissionais de saúde e a comunidade é condição necessária para efetivar o processo ensino-aprendizagem e garantir o desenvolvimento de competências para a qualidade do cuidado na APS. Assim, o preparo dos profissionais de saúde, a adequação do espaço físico da UBS, a reflexão sobre o agendamento e estratégias para garantir tempo para discussão do caso e espaço para feedback podem contribuir para mitigar as barreiras ao processo ensino-aprendizagem na APS.
Revista Brasileira de Educação Médica
: Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and re... more : Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remote learning, which, according to recent studies suggest an increase in depression, anxiety and behavioral disorders among university students. Medical training, which has a heavy load of psychological issues had to face this aggravating factor, reinforcing the need for support actions for students, such as mentoring programs. Mentoring programs offer empathetic and developmental support that encourages self-care, well-being and resilience. Experience report: A group of teacher-mentors from a medical school adapted the mentoring activities to a remote model, offering them to upper-level students who had already participated in mentoring, and, separately, to students who were newly enrolled in the medical course. In the remote format, the mentoring proposal was maintained as a “place of conversation”, but on a digital platform. The technical follow-up was carried out by remote meetings of the group of teacher-mentors, and consultation with students through a self-administered online questionnaire. The data obtained were submitted to content analysis. Discussion: From March to December, 109 virtual mentoring meetings were held. The students considered the meetings satisfactory in terms of the quality of discussions, the mentors’ attitudes and the emotional environment. The interactive development varied among groups, but it was observed to be easier in the groups of upper-level students. Among the newly-enrolled students, the recurring topic was the fear of poor performance in the tests, losing the semester, or not learning. Upper-level students highlighted the difficulties of adapting to remote learning and organizing their activities, and the decrease in practical activities. All groups reported fear of the pandemic, of death, of the worsening of parents’ financial situation, and sadness about the loss of relatives to COVID-19. It drew the attention of the mentors the fact that the students, even in a welcoming space, kept the cameras turned off. Conclusion: For mentors and students, virtual mentoring worked as an important student support system. Upper-level students and first-year ones reported feeling cared for, supported and grateful, suggesting that the meetings allowed a good interaction and produced beneficial effects. A limitation of this study was the duration of the experiment. Therefore, it is recommended that the research be maintained.
Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ tra... more Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ training, the perceptions of primary care workers about the teaching-learning process have been overlooked, particularly in municipalities where PHC management is performed by a private organization instead of the government, such as in the city of São Paulo. Objective: to analyze the perceptions of primary care workers about barriers and facilitators of medical students’ teaching-learning process in PHC in the city of São Paulo. Method: we conducted a qualitative research. We performed in-depth interviews with 12 primary care workers from the family health teams (four physicians, four nurses and four community health workers), who worked in primary care clinics in the east region of the city and received medical students, from 1st-year to internship students. The interviews were recorded, transcribed and afterwards, they were repeatedly read. We identified thematic units following the cont...
Cadernos de saude publica, 2012
Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capac... more Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capacity of primary healthcare. Prior to their implementation in the West Side of the city of São Paulo, Brazil, a series of workshops were held for primary healthcare professionals to prepare a proposal for such centers. Hermeneutic analysis was used to study the transcribed material. The thematic categories were: role, constitution, and functioning of the NASF, relationship with family health teams, and interdisciplinarity. The participants' expected the NASF to be an empowering device for comprehensiveness of care, intervening in an existing culture of unnecessary referrals while fostering linkage with other levels of care. The participants also expected the NASF to contribute to the discussion on health professionals' training and stimulating reflection with policymakers on health indicators based exclusively on the number of consultations. These indicators fail to reflect the imp...
Revista Brasileira de Educação Médica, 2020
Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ tra... more Abstract: Introduction: Although Primary Health Care (PHC) is essential for medical students’ training, the perceptions of primary care workers about the teaching-learning process have been overlooked, particularly in municipalities where PHC management is performed by a private organization instead of the government, such as in the city of São Paulo. Objective: to analyze the perceptions of primary care workers about barriers and facilitators of medical students’ teaching-learning process in PHC in the city of São Paulo. Method: we conducted a qualitative research. We performed in-depth interviews with 12 primary care workers from the family health teams (four physicians, four nurses and four community health workers), who worked in primary care clinics in the east region of the city and received medical students, from 1st-year to internship students. The interviews were recorded, transcribed and afterwards, they were repeatedly read. We identified thematic units following the cont...
Resumo: Introducao: As mudancas de vida do estudante quando ingressa na Faculdade de Medicina tor... more Resumo: Introducao: As mudancas de vida do estudante quando ingressa na Faculdade de Medicina tornam os primeiros anos os mais vulneraveis para desenvolver estresse psicologico e suas consequencias. Em 2020, essa condicao se agravou devido a pandemia de Sars-CoV-2. Para dar suporte aos alunos, varias escolas medicas desenvolvem programas de mentoria, entretanto a adesao deles costuma ser baixa. Objetivo: Este estudo teve como objetivos criar um modelo de mentoria - denominada “Mentoria de Acolhimento” - como suporte psicossocial e pedagogico aos alunos ingressantes, e estudar seu processo de implementacao e os resultados para maior adesao e efetividade. Metodo: Com um desenho metodologico do campo da ciencia da implementacao, utilizaram-se tecnicas e instrumentos de pesquisas qualitativas e quantitativas para compor um estudo de metodos mistos. Obtiveram-se os dados qualitativos em reunioes com os mentores e os dados quantitativos em questionarios eletronicos anonimos para os alunos...
Organicom, Sep 13, 2017
O artigo apresenta a experiência da gestão da humanização no Hospital Universitário da Universida... more O artigo apresenta a experiência da gestão da humanização no Hospital Universitário da Universidade de São Paulo, a importância do trabalho desenvolvido em rede e os resultados de um estudo de caso realizado no período de 2011 a 2014. A proposta é refletir sobre o conceito da humanização na área da saúde pública e a relevância da busca de parcerias que possam contribuir com a qualidade do trabalho desenvolvido. O primeiro passo nesse sentido foi identificar as relações que podem ser estabelecidas entre conceitos e técnicas da humanização na área da saúde e a interface com conceitos e técnicas da administração contemporânea e da comunicação institucional. No âmbito da investigação científica ou da atuação profissional, a área da comunicação é uma grande aliada, mas continua sendo um campo a ser explorado pela área da saúde, já que os desafios são muitos e bastante complexos.
Introduction: The humanization of assistance is associated to empathy, embracing, and effective c... more Introduction: The humanization of assistance is associated to empathy, embracing, and effective communication, being part of the medical training. According to its nature, humanization requires methods that involve affections and stimulates critical thinking. Objective: Extensive literature shows the benefits of the arts in medical education; however, there are still few studies on dancing, the subject of this study, which was carried out by medical students and whose aim was to investigate hospital dancing in the teaching of humanization, from the perspective of medical students. Method: A qualitative action research study was designed, in which medical students performed choreographies for patients, companions and employees in three different wards of the teaching hospital. The action consisted of continuous cycles in the planning of interventions, performance, observing, reflection, and re-planning of subsequent actions, in a systematic manner and controlled by the researchers. D...
Revista de Medicina
The fast spread of the COVID-19 epidemic has imposed unprecedented challenges to contemporary soc... more The fast spread of the COVID-19 epidemic has imposed unprecedented challenges to contemporary society, impacting several aspects of human life globally. Strict social distancing protocols had to be implemented in affected countries to contribute to reduce viral dissemination, and consequently, limit acquisition of new infections. Health systems were compelled to put emergency plans in place to cope with the overburden of potentially severe cases needing hospitalization, with the ultimate aim to preserve as many lives as possible. Academic health systems worldwide were required to propose novel strategies to maximize healthcare outcomes while mitigating negative impact on medical education.[...]
Revista Brasileira de Educação Médica
RESUMO Introdução O uso de habilidades de comunicação está associado a desfechos positivos na con... more RESUMO Introdução O uso de habilidades de comunicação está associado a desfechos positivos na consulta médica e no cuidado à saúde, como melhora da adesão aos tratamentos, da satisfação de médicos e pacientes, e da relação entre eles. Isto é ainda mais significativo na Atenção Primária à Saúde (APS), que é um espaço de cuidado integral de saúde. Uma comunicação efetiva é aquela em que todos os participantes interagem de modo a trocar informações e em que, ao final, todas as partes tenham o mesmo entendimento sobre o problema, acordem sobre as medidas a tomar e se sintam entendidas em suas necessidades. Para que este tipo de comunicação aconteça, o ensino dessas habilidades deve ocorrer de forma adequada e contínua, durante toda a formação médica. Até o momento, não existe um instrumento brasileiro que cumpra esta finalidade. No Brasil, têm-se utilizado guias internacionais para este ensino. No entanto, dos guias mais usados internacionalmente e mais citados na literatura da área, ne...
Revista Brasileira de Educação Médica
Medical training is current topic of discussion both on the national and international stage due ... more Medical training is current topic of discussion both on the national and international stage due to changes in contemporary society and the consequent health demands. In Brazil, insertion into the workplace of the Primary Health Care (PHC) student is recommended throughout the medical course. However, such insertion is hampered by inadequate practical scenarios, the lack of preceptors, insufficient training of general practitioners to receive students, teachers without adequate training in teaching in the area and resistance by teachers of traditional disciplines. This article describes and analyzes a model for insertion into PHC and Family and Community Medicine (FCM) of students from a medical course in São Paulo, the challenges of teaching-management integration and the actions that help to address these issues. The proposal is based on educational objectives aimed at developing competences (knowledge, skills and attitudes) so that the student can offer comprehensive care, unders...
International Journal of Ethics Education
Values and attitudes are strongly influenced by the subjective elements of the organizational cul... more Values and attitudes are strongly influenced by the subjective elements of the organizational culture of the medical school. The objective of this research was to better understand the medical school environment and the difficulties in training doctors in humanism in clinical practice. Qualitative research focused on subjective aspects of the teacher-student relationship, such as ethics and respect for differences, was conducted in a traditional Brazilian medical school. We used the technique of ethnographic observation and interviews with students and teachers. The data were analysed according to three categories: 1. self and other, 2. misuse of technology, and 3. models of teacher-student interactions. Over 12 months, we observed 22 teachers and 128 students (8 groups of 14-18 students), and we interviewed 9 teachers and 19 students, who were recognized as key-interviewees. Our analyses revealed that the medical school environment enables doctors and medical students' feelings of intellectual superiority, selfish and excessive competitiveness; inability to see the patient as a whole; overvaluation and excessive use of technology; role modelling of nonempathic behaviours; and behaviours showing disrespect, discrimination, and violence. These findings reveal attitudes that hamper the doctor-patient relationship, and some underlying issues of critical importance to the humanistic training of medical students. This study shows the need for institutional humanistic values to be adopted and applied to everyone. Perhaps an educational process that uses ethics more than academic disciplines should be used as a method of thinking and acting, which may encourage institutional changes that improve medical education as a whole.
Revista Brasileira de Educação Médica
RESUMO Em contexto nacional e internacional, discute-se a formação médica devido às mudanças na s... more RESUMO Em contexto nacional e internacional, discute-se a formação médica devido às mudanças na sociedade contemporânea e suas demandas de saúde. No Brasil, preconiza-se a inserção do aluno na Atenção Primária à Saúde (APS) durante todo o curso médico. Tal inserção é dificultada pelos cenários práticos inadequados, pela falta de preceptores, pela formação insuficiente dos médicos generalistas para receber estudantes, pelos docentes sem capacitação adequada para o ensino na área e pela resistência de docentes de disciplinas tradicionais. Este artigo descreve e analisa um modelo de inserção da APS e Medicina de Família e Comunidade (MFC) em um curso médico no município de São Paulo, os desafios da articulação ensino-gestão e as ações que ajudam a enfrentá-los. A proposta parte de objetivos educacionais que visam desenvolver competências (conhecimentos, habilidades e atitudes) para que o aluno possa oferecer cuidado integral, compreendendo o indivíduo no contexto de vida familiar, soci...