IZABEL CRISTINA RIOS
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina
Instituto de Medicina Física e de Reabilitação, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
Instituto de Medicina Física e de Reabilitação, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
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- Barriers and Facilitators of the Teaching-Learning Process of Medical Students in Primary Care in the City of São Paulo(2020) SILVA, Moniquelly Barbosa da; RIOS, Izabel; VITAL JÚNIOR, Pedro Félix; SILVA, Andréa Tenório Correia daAbstract: 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 content analysis principles. Results: the barriers to medical students’ teaching-learning process in PHC were the following: (1) excessive number of scheduled patients and scarcity of time for discussion; (2) inadequate infrastructure of primary care clinics; (3) lack of training; and (4) ineffective integration among faculty, healthcare workers, managers and the assisted population. The facilitating factors of the teaching-learning process were: (1) high quality of healthcare services; (2) integration among primary care teams, interdisciplinary teams, and students; and (3) well-trained medical preceptors. Conclusions: our results have implications for PHC professionals, educational institutions, and managers. The improvement of the integration among educational institutions, health services managers, primary care workers, and the population is a condition to reach the effectiveness in the teaching-learning process, and to ensure the development of essential competencies for PHC assistance quality. Thus, the training of health professionals, improving the primary care clinic infrastructure, and creating strategies to ensure enough time for discussion and feedback could contribute to mitigate barriers to medical students’ teaching-learning process in PHC.
- Medicina de Família do Primeiro ao Sexto Ano da Graduação Médica: Considerações sobre uma Proposta Educacional de Integração Curricular Escola-Serviço(2017) SILVA, Andréa Tenório Correia da; MEDEIROS JUNIOR, Martim Elviro de; FONTÃO, Paulo de Nogueira; SALETTI FILHO, Haraldo Cesar; VITAL JUNIOR, Pedro Félix; BOURGET, Monique Marie Marthe; RIOS, Izabel CristinaABSTRACT Medical education has been heavily debated in both national and international contexts due to changes in society and public health demands. In Brazil, it is postulated that learning in Primary Health Care (PHC) should occur throughout the entire medical course. Learning in PHC has faced some barriers such as inadequate environment for medical practice, including a lack of supervisors and general practitioners with insufficient training to assist students, lack of lecturers with expertise in the area, and resistance from traditional faculties to include PHC in the curriculum. This paper addresses an educational model to include PHC and family medicine in a medical school curriculum in the city of São Paulo, Brazil. Furthermore, we describe the challenges of tying in educational and managerial objectives in the context of primary care services, and how to overcome such challenges. Our proposal is based on using educational objectives to develop student competencies (knowledge, skills and attitudes) so they can provide comprehensive care as regards the individual’s background (social, family and environmental). Students are exposed to increasingly complex educational content that requires connecting new knowledge to previous knowledge. The innovative aspect of this educational project is its integration of planning and educational management, involving the following strategies to achieve a better quality learning process: (1) Students in primary care services from the first to the last semester of the course; (2) Hiring family doctors as faculty members; (3) Integrating PHC and family medicine with the contents of other subjects such as epidemiology, public health policies and evidenced-based medicine; (4) Using problem-solving methodologies suitable both to the studied theme and to student and lecturer profiles; (5) Formative evaluations; (6) Improving teaching skills for lecturers and field supervisors; (7) Implementing practices to encourage students to work in multi-professional teams; (8) Motivating students to take part in interchange programs with national and international institutions; and (9) Encouraging the publications of books, scientific papers and research into PHC and family medicine. Several factors facilitate the success of this educational proposal, including: PHC and family medicine being underlying matters in the political-pedagogical faculty project; the educational setting being that of an institution with a long history of health education, public care provision and contributions to service-learning integration; the close relationship between health service managers, lecturers and supervisors, which facilitates coordination between the theoretical content and practice in PHC; the investments made to develop supervisor teaching skills, to support their participation in the debate about relevant family medicine content, and in the discussion about integrating theory with practice; and finally the human resource policies that raise the value of family doctors who are also supervisors. We hope this experience contributes to enhancing the debate about PHC and family medicine educational models in medical courses, and the related challenges and possibilities within medical training.