Aprendizagem baseada em casos clínicos no ensino de genética para medicina / Learning based on clinical cases in the teaching of genetics for medicine

Resumo Introdução: A necessidade premente de formar médicos autônomos e proativos implica novas abordagens didáticas e formas de mediar o conteúdo. Nesse contexto, a utilização de métodos ativos de ensino e aprendizagem pode incrementar o perfil do novo profissional. A Aprendizagem Baseada em Casos (ABC) é uma estratégia fundamentada na capacidade de o estudante relacionar teoria e prática com autonomia e tomada de decisão. A disciplina de genética aborda conteúdos que podem parecer distantes do cotidiano e da prática profissional futura, e, por isso, a necessidade de utilizar estratégias de ensino que facilitem a compreensão da aplicação desse conhecimento na prática médica. Objetivo: O presente trabalho teve por objetivo avaliar a ABC como abordagem pedagógica no processo de ensino-aprendizagem de genética para o curso de Medicina de uma instituição pública. Método: Aplicou-se um protocolo de método ativo composto por nove casos clínicos a 46 estudantes de Medicina da Universidade de Brasília que, posteriormente, foram divididos em nove grupos. Por meio de questionários, avaliaram-se o desempenho e as percepções em relação ao método. Os resultados quantitativos foram analisados por meio do teste t de Student. Resultado: O rendimento do trabalho em grupo foi estatisticamente maior em oito dos nove casos em comparação ao trabalho individual. A atividade foi considerada boa ou muito boa por 76% dos estudantes, e 90% mencionaram que houve aumento da motivação. Além disso, 71,4% destes demonstraram interesse em estudar mais sobre o assunto após a aula, 20% se consideraram capazes de ensinar o assunto a outras pessoas, e 42% avaliaram que acertariam todas ou a maioria das questões caso fossem submetidos a uma nova avaliação. Com relação ao trabalho em equipe, 38% relataram se sentir mais motivados. Por fim, 86% consideraram relevante ou muito relevante a discussão de casos clínicos para a formação profissional. Conclusão: Os resultados demostraram sucesso no uso do método ABC na abordagem de genética, porém apontaram que há dificuldades na utilização de métodos de ensino alternativos à aula expositiva. Apesar disso, fica explícito que a estratégia adotada pode levar à mobilização de conhecimentos prévios em situações da prática profissional.

Abstract Introduction: The pressing need to train autonomous and proactive professionals demands new ways of mediating content. In this context, the use of active teaching and learning methods can improve the profile of the new professional. Case-Based Learning (CBL) is a strategy based on the student's ability to relate theory and practice, with autonomy and decision-making. The discipline of Genetics addresses contents that may seem distant from everyday life and future professional practice, so it is necessary to use teaching strategies that facilitate the understanding of the application of this knowledge in medical practice. Objective: This study aimed to evaluate the CBL as a pedagogical approach in the teaching-learning process of Genetics for Medicine courses in a public institution. Methods: An active methodology protocol that consisted of nine clinical cases was applied to 46 medical students from Universidade de Brasília, who were later divided into nine groups. The performance and perceptions regarding the methodology were evaluated by questionnaires. Quantitative results were analyzed using Student's t test. Results: The performance of group work was statistically higher in 8 of 9 cases compared to individual work. Most students considered the activity good or very good (76%), but approximately half reported no increase in motivation. Moreover, 71.4% felt motivated to learn more about the subject after class and 20% considered they were able to teach the subject to others and 42% assessed they would get all or most of the questions correct if they were submitted to a new assessment. Regarding teamwork, 38% reported feeling more motivated. Finally, 86% considered the discussion of clinical cases relevant or very relevant for professional training. Final considerations: The results show, in general, success in the use of CBL on the study of genetic diseases but point out that there are difficulties in the use of alternative teaching methods to the lecture. Despite this, it is clear that learning based on clinical cases can lead to the mobilization of previous knowledge in situations of professional practice.

Assessing the reaction to and efficacy of the Screener drug discovery and development board game as a pedagogical tool in postgraduate courses

Screener, a board game supplemented with online resources, was introduced and distributed by the Brazilian Society of Pharmacology and Experimental Therapeutics to postgraduate programs as an instructional tool for the process of drug discovery and development (DDD). In this study, we provided a comprehensive analysis of five critical aspects for evaluating the quality of educational games, namely: 1) description of the intervention; 2) underlying pedagogical theory; 3) identification of local educational gaps; 4) impact on diverse stakeholders; and 5) elucidation of iterative quality enhancement processes. We also present qualitative and quantitative assessments of the effectiveness of this game in 11 postgraduate courses. We employed the MEEGA+ online survey, comprising thirty-three close-ended unipolar items with 5-point Likert-type response scales, to assess student perceptions of the quality and utility of Screener. Based on 115 responses, the results indicated a highly positive outlook among students. In addition, we performed a preliminary evaluation of learning outcomes in two courses involving 28 students. Pre- and post-quizzes were applied, each consisting of 20 True/False questions directly aligned with the game's content. The analysis revealed significant improvement in students' performance following engagement with the game, with scores rising from 8.4 to 13.3 (P<0.0001, paired t-test) and 9.7 to 12.7 (P<0.0001, paired t-test). These findings underscore the utility of Screener as an enjoyable and effective tool for facilitating a positive learning experience in the DDD process. Notably, the game can also reduce the educational disparities across different regions of our continental country.

Effectiveness of the Flipped Classroom in Health Sciences University Programs: A Literature Review / Efectividad del Aula Invertida en carreras universitarias de Ciencias de la Salud: Revisión de literatura / Efetividade da sala de aula invertida nas carreiras universitárias de ciências da saúde: revisão de literatura

Introduction: Higher education institutions have implemented active learning approaches, such as the Flipped Classroom, to promote the education of their students. Nevertheless, there is conflicting evidence regarding the benefits derived from its implementation. Objective: To determine the effectiveness of the Flipped Classroom application in the education of university students from Health Sciences undergraduate programs. Materials and methods: A systematized narrative review of the literature published between 2012 and 2022. Pubmed, SciELo, Scopus y Web of Science were used as sources of primary articles. A revised version of the Kirkpatrick model was used to assess the effectiveness of the Flipped Classroom. Results: 34 out of the 1020 retrieved articles reached the quantitative synthesis phase. Students value positively this didactic model and acknowledge its contributions in the development of attitudes, knowledge and skills. In contrast, some studies show an increase in the workload and stress levels of students. Conclusions: The evidence suggests that Flipped Classroom is a valid didactic model for the education of Health Sciences students. Future studies should consider the effectiveness of its implementation at a long term organizational level.

Introduction: Higher education institutions have implemented active learning approaches, such as the Flipped Classroom, to promote the education of their students. Nevertheless, there is conflicting evidence regarding the benefits derived from its implementation. Objective: To determine the effectiveness of the Flipped Classroom application in the education of university students from Health Sciences undergraduate programs. Materials and methods: A systematized narrative review of the literature published between 2012 and 2022. Pubmed, SciELo, Scopus y Web of Science were used as sources of primary articles. A revised version of the Kirkpatrick model was used to assess the effectiveness of the Flipped Classroom. Results: 34 out of the 1020 retrieved articles reached the quantitative synthesis phase. Students value positively this didactic model and acknowledge its contributions in the development of attitudes, knowledge and skills. In contrast, some studies show an increase in the workload and stress levels of students. Conclusions: The evidence suggests that Flipped Classroom is a valid didactic model for the education of Health Sciences students. Future studies should consider the effectiveness of its implementation at a long term organizational level.

Introducción: Las instituciones de educación superior han implementado enfoques activos de aprendizaje como el Aula Invertida para favorecer la formación de sus estudiantes. Sin embargo, existe evidencia diversa respecto de los beneficios derivados de su implementación. Objetivo: Determinar la efectividad de la aplicación del Aula Invertida en la formación de estudiantes universitarios de carreras de pregrado de las Ciencias de la Salud. Materiales y métodos: Se realizó una revisión narrativa sistematizada de la literatura publicada entre 2012 y 2022, utilizando Pubmed, SciELo, Scopus y Web of Science como fuentes de artículos primarios. Se utilizó la versión revisada del modelo de Kirkpatrick para valorar la efectividad del Aula Invertida. Resultados: Se obtuvieron 1020 artículos, 34 de ellos ingresaron a la fase de síntesis cuantitativa. Los estudiantes valoran positivamente este modelo didáctico y reconocen su aporte en el desarrollo de actitudes, conocimientos y habilidades. Algunos estudios mencionan un aumento de la carga de trabajo y niveles de estrés en los estudiantes. Conclusiones: La evidencia sugiere que Aula Invertida es un modelo didáctico válido para la formación de estudiantes de las Ciencias de la Salud. Futuros estudios deberían considerar la efectividad de su implementación a nivel organizacional y a largo plazo.

Percepción del Aprendizaje Activo Virtual de la Anatomía Humana, por Estudiantes de la Universidad Austral de Chile / Student Perceptions of Active Learning for the Practice of Virtual Human Anatomy, a Study at the Universidad Austral de Chile

Ante la pandemia del coronavirus, hubo que reinventar la forma de hacer las actividades prácticas de laboratorio de anatomía humana, la necesidad de que sean exclusivamente virtual, elevó la exigencia. La imposibilidad de trabajar con material orgánico demandó que al menos las imágenes a utilizar fueran de alta calidad. Para lo anterior, se usaron fotografías de disecciones del laboratorio de anatomía, más digitalizaciones de estructuras humanas de nuestro laboratorio en formato 3D disponibles en la plataforma web https://anatomiahumana3d.com. No obstante lo anterior, se detectó cierto grado de desidia por parte de los estudiantes y escasa participación en las actividades prácticas. Para resolver esto se implementó una modalidad de Aprendizaje Activo, específicamente de Aula Invertida, con el fin de que sea el propio estudiante quien genere su conocimiento. Una vez terminado el proceso de enseñanza aprendizaje bajo la nueva modalidad, se realizó un estudio descriptivo, a fin de detectar falencias y proponer mejoras respecto a la metodología aplicada. Los resultados arrojaron un nivel de satisfacción por sobre el 80 %, en tanto, que solo el 5 % de los estudiantes contestó como aceptable las diferentes dimensiones evaluadas, demostrando como el sistema de aula inversa fue bien recibida por los estudiantes. Sin embargo es prudente generar futuros estudios que ayuden a mejorar este tipo de metodología, como también seguir innovando en las estrategias didácticas que aporten a la comprensión de la anatomía humana.

SUMMARY: In the context of the COVID-19 pandemic it was necessary to reinvent the way of doing practical activities in the human anatomy laboratory and the need for these to be exclusively online, raised the requirement. Due to the impossibility of using organic samples, high-quality images had to be used. Therefore, photographs of dissections from our human anatomy laboratory were used, as well as digitalization of human structures from our laboratory in a three-dimensional (3D) format available on the web platform https://anatomiahumana3d.com. However, a certain degree of laziness on the part of the students and low participation in the practical activities was detected. To solve this problem, an Active Learning modality was implemented, specifically the Flipped Classroom, so that the students themselves generate their knowledge. Once the teaching-learning process was completed under the new modality, a descriptive study was carried out to detect shortcomings and propose improvements to the methodology applied. The results showed a level of satisfaction above 80 % and only 5 % of the students evaluated the different dimensions as acceptable demonstrating how the Flipped Classroom system was well received by the students. To conclude, it is prudent to generate future studies that help to improve this type of methodology, as well as to continue innovating in didactic strategies that contribute to the understanding of human anatomy.

Impacto de la metodología de debate como técnica de enseñanza- aprendizaje en población universitaria

El objetivo principal de la presente investigación es determinar la influencia entre las habilidades de pensamiento crítico, técnicas de oratoria y argumentación en las dinámicas de debates en el ámbito educativo, las cuales integran dentro de sus ambientes y herramientas de aprendizaje grupos de debates y el desarrollo de procesos cognitivos de orden superior. La metodología utilizada fue de corte mixta. Dentro de los resultados, existen hallazgos significativos que avalan el desarrollo de destrezas en la metodología de debate, permitiendo concluir su influencia en la potenciación de habilidades cognoscitivas, interpersonales y académicas.

The main objective of the present research is to determine the influence between critical thinking skills, public speaking techniques, and argumentation on the dynamics of debates in the educational environment, which integrate within their environments and learning tools debate groups and the development of higher order cognitive processes. The methodology used was mixed. Within the results, there are significant findings that support the development of skills in the debate methodology, by allowing to conclude its influence on the enhancement of cognitive, interpersonal, and academic skills.

Diretrizes curriculares do curso médico: o "GPS" precisa ser reprogramado? / National curriculum guidelines for the medical course: does the "GPS" need rerouting?

Resumo: Introdução: As Diretrizes Curriculares Nacionais (DCN) constituem as direções para formação do currículo de um curso. As DCN do curso médico atual foram instituídas há quase uma década. Nesse período, o mundo passou por mudanças sem precedentes, e a educação médica não pode ficar para trás. Desenvolvimento: O ensino médico no Brasil teve nos últimos 100 anos três principais modelos de ensino: desde o flexneriano, passando pela Problem-Based Learning (PBL), até o atual ensino baseado em competências. O entendimento de que o aluno é o centro do processo ensino aprendizagem já está enfatizado nas DCN de 2014, mas será que esse conceito está sendo implementado na prática das instituições de ensino superior? Como as DCN podem ajudar a guiar de forma mais clara e efetiva uma formação médica que vá além do conhecimento técnico e lapidar um profissional humanizado, ético e com olhar para o indivíduo e para a comunidade? Será que precisaremos "reprogramar" o Global Positioning System (GPS), a rota, das DCN depois de enfrentarmos tantas mudanças decorrentes da pandemia da Covid-19? Conclusão: Apesar dos desafios, há crescente envolvimento do corpo docente das instituições de ensino superior nas melhorias necessárias para a formação médica atual.

Abstract: Introduction: The National Curriculum Guidelines (NCG) provide the directions which an undergraduate course must follow. The current NCGs for the medical course were established almost a decade ago. In this period, the world has undergone unprecedented changes and medical education cannot be left behind. Development: Medical education in Brazil has been based on three main models in the last one hundred years: the Flexnerian, Problem-Based Learning (PBL), and the current competency-based learning. The concept that the student is the center of the teaching-learning process was already emphasized in the 2014 NCG, but is this actually implemented in practice by the universities? How can the NCG help guide a more clear and effective medical education that goes beyond technical knowledge and shapes a humanized ethical professional who views the needs of both the individual and the community? Is it necessary to reroute the GPS of the NCG after so many changes caused by the Covid-19 pandemic? Conclusion: Despite the challenges faced, university faculties are increasing their involvement in implementing the changes required for today's medical education.

Self-regulated learning e ensino médico: revisão de literatura / Self-regulated learning and medical education: a literature review

Resumo: Introdução: A aprendizagem autorregulada (self-regulated learning - SRL) é o processo ativo que o aluno realiza para atingir seus objetivos de aprendizagem. No ensino médico, pelo fato de o ambiente clínico ser propício para o desenvolvimento da SRL, há potencial benefício na aplicação dessa ferramenta no processo de ensino-aprendizado, embora as diferenças em seus cenários de aplicação exijam uma análise mais aprofundada. Objetivo: Este artigo apresenta uma revisão da literatura sobre o histórico do desenvolvimento da SRL, sua aplicabilidade e avaliação em estudantes de Medicina por meio de escala validada, além dos fatores que a influenciam, como métodos de ensino e questões demográficas e socioculturais. Método: Realizou-se uma busca com o descritor self-regulated learning nas plataformas PubMed e SciELO e na revista Medical Education Online para artigos em inglês publicados entre 2010 e 2021. Resultado: A busca nas bases de dados resultou em 198 artigos, dos quais foram selecionados 100 para a análise crítica. Desses 100 artigos, selecionaram-se 31 que preenchiam os critérios desta revisão. Conclusão: A SRL é um conceito contemporâneo considerado pilar no processo educacional. Trata-se de ferramenta de grande valor em psicologia educacional. A aplicabilidade da SRL no contexto do ensino médico demonstra-se efetiva e traz consigo especificidades sobre a autorregulação do estudante de Medicina. Contudo, são necessários novos estudos acerca do tema, de modo a permitir o desenvolvimento de métodos instrucionais eficazes com sua utilização.

Abstract: Introduction: Self-regulated learning (SRL) is the active process that students perform to achieve their learning goals. In medical education, the development of SRL is favoured by the clinical environment, hence there is potential benefit in applying this tool in the teaching-learning process, although the differences in its application scenarios require deeper analysis. Objective: The aim of this article is to present a literature review on the development of SRL, its applicability and evaluation in medical students using a validated scale, and the factors that influence it, such as teaching methods and demographic and sociocultural issues. Method: A search was performed on the Pub-med and Scielo platforms and the online Medical Education Journal for articles in English published between 2010 and 2021 using the descriptors "Self-regulated learning". Results: The database search resulted in 198 articles, of which 100 were selected for critical analysis. Of these, 31 articles were selected based on meeting the criteria of this review. Conclusions: SRL is a contemporary educational concept and considered a pillar in the educational process. It is a valuable tool in educational psychology. Its applicability in the context of medical education proves to be effective and brings with it specificities in relation to the self-regulation of medical students. However, further studies on the subject are necessary to allow for the development of effective instructional methods to support its use.

Educação (remota) on-line e Covid-19: experiência de professores na educação médica mediada por metodologias ativas / Online (remote) education and Covid-19: teachers' experience in medical education mediated by active methodologies

Resumo: Introdução: Em 2020, a fim de conter a progressão da pandemia do coronavírus, determinou-se o distanciamento social por redução da interação entre as pessoas. As instituições de ensino foram fechadas, e adotou-se o ensino-aprendizagem a distância aplicado por tecnologias digitais para a continuidade do estudo. O fechamento de uma universidade comunitária em Santa Catarina, no curso de Medicina, implicou uma situação disruptiva quanto ao formato de ensino, visto que se utilizam metodologias ativas que não haviam sido aplicadas digitalmente até o momento. Dessa circunstância, pergunta-se como o corpo docente percebe e vivencia essa nova realidade. Objetivo: Pretendeu-se conhecer a experiência de professores do primeiro ao quarto ano de graduação médica com metodologias ativas durante as atividades do ensino remoto no advento da pandemia do coronavírus para entender as repercussões na aprendizagem. Método: Trata-se de uma pesquisa de campo, com objetivo exploratório e abordagem quanti-qualitativa. O trabalho passou por apreciação do Comitê de Ética em Pesquisa. Os participantes foram contatados eletronicamente para responder, na plataforma Google Forms, a um questionário dividido em duas etapas com perguntas objetivas e descritivas relativas à vivência deles no ensino remoto. A exploração de dados ocorreu por estatísticas, análise temática de conteúdo e análise de correlação, confrontando-se os resultados com o referencial teórico. Resultado: Responderam à pesquisa 29 professores. A maioria deles se sentiu ao menos parcialmente preparada para atuar no ensino remoto, e orientações e busca por auxílio não se correlacionaram com o preparo. Facilidades e fragilidades relacionadas à tecnologia foram observadas. Computador, celular e Google Meet foram os recursos mais utilizados. Materiais do presencial necessitaram de adaptações, não sendo satisfatórias em alguns casos. As atividades pedagógicas foram cumpridas dentro do proposto, entretanto, para dois terços dos docentes, houve prejuízo na qualidade do ensino, e metade deles mudou de conduta para mediação de aulas virtuais. Conclusão: A passagem para o ensino digital foi um desafio para professores. A aprendizagem foi comprometida, porém observaram-se benefícios e potencialidades. Como há um processo de mudança na sociedade com o propósito de consolidar a educação digital, são essenciais as devidas capacitações para apoiar esse processo em metodologias ativas.

Abstract: Introduction: In 2020, aiming to contain the progression of the Coronavirus pandemic, social distancing was determined by reducing interactions between people. The educational institutions were closed and distance teaching-learning was applied using digital technologies for study continuity. The closing of a community university in Santa Catarina, in the medical course, implied in a disruptive situation regarding the teaching format, since they use active methodologies and these had not been applied digitally up to that moment. From these circumstances, one asks how the faculty perceives and experiences this new reality. Objective: This study aimed to understand the experiences of educators teaching from the first to the fourth year of medical school using active methodologies during the remote education activities at the emergence of the Coronavirus pandemic aiming at understanding the impacts on learning. Method: This is a field research with an exploratory objective and a quantitative-qualitative approach. This study has been analyzed by the Research Ethics Committee. The participants were contacted by electronics means and were invited to answer a two-step questionnaire using the Google Forms platform, containing objective and descriptive questions regarding their experience with remote teaching. Data analysis was performed by statistics, by thematic content analysis and by correlation analysis, and the findings were compared using the theoretical reference. Result: Twenty-nine teachers answered the survey. Most of them felt, at least, partially prepared to work in the remote education and guidance and requests for help were not related to the preparation. Facilities and weaknesses related to the technology were observed. Computers, cell phones and Google Meet were the recourses most often used. Adaptations for the materials used in face-to-face classes were necessary, but in some cases, they were not satisfactory. The pedagogical activities were accomplished within the proposed ones, but two-thirds of the teachers believed there were losses related to study quality and half of them adjusted their behavior to virtual class mediation. Conclusion: The transition to the digital teaching format constituted a challenge for the teachers. The learning process was compromised; however, benefits and potentials were observed. A change is occurring in society and digital teaching is being solidified and training is essential to support this process in active methodologies.

Effectiveness of a SNAPPS in psychiatric residents assessed using objective structured teaching encounters: a case-control study

ABSTRACT BACKGROUND: Residents play the role of teachers in almost one-quarter of their activities in residency programs. OBJECTIVE: To evaluate whether a 45-minute class using summarize, narrow, analyze, probe, plan, and select (SNAPPS) could improve psychiatry residents' case discussion skills in diverse practical learning settings. DESIGN AND SETTING: This case-control, randomized, blinded study was conducted in a psychiatry hospital at Fortaleza-Ceará. METHODS: Using "resident as teacher" (RaT), objective structured teaching encounters (OSTEs), and SNAPPS, we conducted a study with 26 psychiatry residents. We analyzed video footage of psychiatric cases in three settings: outpatient, nursing, and emergency. An intervention was held two months later with the residents, who were then assigned to two groups: group A (lecture on SNAPPS) and group B (lecture on a topics in psychiatry). Shortly after the lectures, they were video recorded while discussing the same cases. Three blinded examiners analyzed the videos using an instrument based on the Stanford Faculty Development Program (SFDP-26). RESULTS: We found high internal consistency among external examiners and an interaction effect, group effect, and moment effect (P < 0.05). The residents who received the SNAPPS lecture scored significantly higher than their counterparts who received a traditional case presentation. CONCLUSION: This study indicates the efficacy of SNAPPS over traditional case presentation in all three settings as assessed by OSTEs and supports its implementation to improve the teaching of clinical reasoning.

Challenges and perspectives in research and teaching of host pathogen interaction topics: new post-pandemic times to Brazil and other South American countries

Here is our proposal to improve learning in biomedical sciences for graduate and undergraduate courses with a broad vision integrating disciplines such as molecular cell biology, biochemistry, and biophysics around concepts of pathogen interaction within vertebrate and invertebrate hosts. Our paradigm is based on the possibility offered by the pandemic to have remote activities that give access to students and researchers from different places in Brazil and Latin American countries to discuss science. A multidisciplinary view of host-pathogen interaction allows us to understand better the mechanisms involved in the pathology of diseases, as well as to formulate broad strategies for the diagnosis, treatment, and control of thereof. The approach to integrating heterogeneous groups in science involves the critical analysis of national scientific resource distribution, where only some have the possibilities to conduct competitive scientific research. Solid theoretical training, contact, collaboration with groups of excellence, and training within a multidisciplinary network are our proposals for a permanent platform of scientific strengthening and dissemination for Latin America. Here we will review the concept of host-pathogen interaction, the type of institutions where it is taught and researched, new trends in active teaching methodologies, and the current political context in science.

Student satisfaction with the Service-Learning methodology: an added value in the training of thee nursing degree / Satisfacción de los alumnos con la metodología de Aprendizaje-servicio: un valor añadido en la formación del título de enfermería

Abstract: Objective: To evaluate the effect on the satisfaction of nursing students and the participants of Service-Learning methodology in the development of Health Education workshops. Materials and methods: Service-Learning project was designed in four stages: 1) students training in knowledge about Community Nursing and Health Education; 2) development of healthy workshops for its implementation in associations; 3) implementation of the workshops; 4) reflection on Service-Learning impact. An ad hoc questionnaire was developed to assess students' satisfaction. It was also evaluated the workshops' participant's satisfaction. Results: students reported having a very high level of satisfaction by increasing their scores after improving Service-Learning methodology in the subject. In addition, participants who received health promotion workshops developed by nursing students reported a positive impact on their health. Conclusion: development of Service-Learning methodology associated with health education implies high level of satisfaction in nursing students and a social impact for the community.

Resumen: Objetivo: Evaluar la satisfacción de los estudiantes de enfermería y los participantes, con la metodología Aprendizaje Servicio en el desarrollo de talleres de Educación para la Salud. Materiales y Método: El proyecto de Aprendizaje-Servicio se diseñó en cuatro etapas: 1) Formación de estudiantes en conocimientos sobre Enfermería Comunitaria y Educación para la Salud; 2) Desarrollo de talleres saludables para su implementación en asociaciones; 3) Implementación de los talleres; 4) Reflexión sobre el impacto del Aprendizaje-Servicio. Se desarrolló un cuestionario ad hoc para evaluar la satisfacción de los estudiantes. También se evaluó la satisfacción de los participantes de los talleres. Resultados: Los estudiantes informaron tener un nivel de satisfacción muy alto, al aumentar sus puntajes luego de mejorar la metodología de Aprendizaje-Servicio en la asignatura. Además, los participantes que recibieron talleres de promoción de la salud, desarrollados por estudiantes de enfermería, reportaron un impacto positivo en su salud. Conclusión: El desarrollo de la metodología de Aprendizaje-Servicio asociado a la educación en salud, implica un alto nivel de satisfacción en los estudiantes de enfermería y un impacto social para la comunidad.

Model Making, An Interesting Method of Learning Anatomy: Students’ perceptions

Background: The knowledge of anatomy is very essential for the safe and efficient clinical practice. There has been a lot of efforts, made over recent years to promote active learning in students through innovative teaching techniques. Model making is one such type of active and self directed learning. The aim of the study is to introduce model making as a technique of learning Anatomy.The objective was to evaluate the students’ perceptions about various aspects of model making, as a technique of learning anatomy Material and Methods: Convenient sample of one hundred first year MBBS students were divided into four groups for different model making activities. Each group of twenty five was divided into six and nineteen. Group of nineteen did the routine dissection and the other of six did the model of structures under the cover of gluteus maximus, parotid gland, cavernous sinus with its relations or perineal pouches at various time intervals. Anonymous feedback was taken from students through a questionnaire using a Likert five-point grading scale. The number and percentage of students responding to each item was noted. The mean rating for each item was calculated. Results: A majority of students were positive about the use of model making in anatomy.94%, 93%, and 91% of the students felt that model making was useful in learning anatomy,should be used for teaching other topics also and helped in long term memory respectively. Conclusion: Students perceived that model making when used along with dissection would promote meaningful learning and deep understanding of anatomy.

Burnout e metodologia ativa de ensino-aprendizagem entre estudantes de Medicina de universidade em tríplice fronteira / Burnout and active teaching-learning methodology among medical students at a university in a triple border region

Resumo: Introdução: A metodologia de ensino-aprendizagem constitui importante fator na formação do estudante de Medicina e pode estar associada também à exposição de fatores estressantes crônicos que culminam em sofrimento mental como é observado na síndrome de burnout (SB). Objetivo: Este estudo teve como objetivos determinar a prevalência da SB e analisar suas dimensões e a relação com a metodologia ativa de ensino-aprendizagem entre estudantes de Medicina de uma universidade de tríplice fronteira. Método: Trata-se de estudo transversal realizado com 279 acadêmicos do curso de Medicina que responderam a questionários sociodemográfico, de hábitos de vida e de aspectos do processo ensino-aprendizagem, e ao Inventário de Burnout de Maslach (IBM). Verificou-se associação entre a SB e as variáveis sociodemográficas, os hábitos de vida e o processo ensino-aprendizagem, por meio do teste de qui-quadrado de Pearson, do teste exato de Fisher e do teste t de Student. Realizaram-se análise descritiva dos dados, análise bivariada e regressão logística multivariada. Resultado: A prevalência de burnout foi de 4,7%, com 26,2% de alta exaustão emocional, 37,6% de alta despersonalização e 20,4% de baixa realização profissional. Os estudantes de Medicina avaliados neste estudo possuem níveis baixos ou moderados de SB. A insatisfação com o aprendizado da metodologia ativa, a falta de compreensão do fundamento da metodologia ativa e a percepção de que a minoria/nenhum docente aplica a metodologia ativa adequadamente foram preditores importantes associados ao burnout. Conclusão: Esta investigação pode servir para que escolas médicas possam desenvolver estratégias institucionais para enfrentamento dessa realidade no sentido de reduzir o risco do desenvolvimento de SB entre os estudantes de Medicina.

Abstract: Introduction: The teaching-learning methodology is an important factor in the training of medical students and may also be associated with the exposure to chronic stressors that culminate in mental suffering, as observed in the Burnout Syndrome (BS). Objective: To determine the prevalence of Burnout Syndrome and analyze its dimensions and the relationship with the active teaching-learning methodology in medical students at university located in a triple-border region. Method: Cross-sectional study with 279 medical students who answered questionnaires on sociodemographic data, life habits, aspects of the teaching-learning process and the Maslach Burnout Inventory (IBM). There was an association between the BS and sociodemographic variables, life habits and the teaching-learning process, using Pearson's Chi-Square tests, Fisher's exact test and Student's T test. Descriptive data analysis, bivariate analysis and multivariate logistic regression were performed. Result: The prevalence of Burnout was 4.7%, with 26.2% of high Emotional Exhaustion, 37.6% of high Depersonalization and 20.4% of low Professional Achievement. The medical students evaluated in this study have low or moderate levels of BS. Dissatisfaction with the active methodology learning, the lack of understanding of the foundation of the active methodology and the perception that the minority/none of the teachers apply the active methodology adequately were important predictors associated with Burnout. Conclusion: This investigation can help medical schools to develop institutional strategies to face this reality aiming to reduce the risk of the development of BS among medical students.

Investigation on students' active learning behavior during independent experimental design education of medical function / 中华医学教育探索杂志

Objective:To evaluate the teaching effectiveness of independent experimental design from students' active learning behavior, and further provide the basis for advancing the reform of functional experimental teaching and teaching quality.Methods:In June 2019, 186 undergraduates (5-year-programme and 8-year-programme) of Xiangya School of Medicine were included in the teaching research. Self-administered questionnaires were applied to characterize students' active learning behavior in independent experimental design education. Spearman rank correlation analysis and Logistic regression analysis were used in the study. SPSS 23.0 was used for descriptive analysis of the data.Results:During the independent experimental design, 85.0%(158/186) of the students thought it was necessary and important to conduct independent experimental design education; 72.6%(135/186) of the students tentatively raised new scientific questions; 97.8%(182/186) of the students actively searched literature; 77.4%(144/186) of the students participated in reply positively. The value of correlation coefficient of actively learning behavior "tentatively raising new science questions" and teaching effectiveness "improving the ability of scientific thinking" was 0.81. And only 42.5%(79/186) of the students agreed that students needed to summarize after reporting.Conclusion:Independent experimental design education is welcomed and widely accepted by students, which has effectively improved the capacity for scientific research and innovation spirit of students. Whether students' active learning behavior can be fully mobilized in the education practice is closely related to the teaching effect. And the cultivation of leadership and leading consciousness still need to be improved.

O uso de metodologias ativas de ensino-aprendizagem em pediatria: uma revisão narrativa / The use of active teaching-learning methodologies in pediatrics: a narrative review

Resumo: Introdução: O modelo tradicional de ensino médico possui uma ideia biocêntrica dos problemas de saúde, hipervalorizando os aspectos biológicos do paciente, sem considerar os demais aspectos envolvidos no processo saúde-doença. Esse método é centrado no professor, e o aluno atua como receptor passivo do conhecimento. Em contrapartida, nas metodologias ativas, o estudante possui papel ativo no processo de ensino-aprendizagem, construindo um conhecimento crítico e reflexivo. Objetivo: Este estudo teve como objetivos analisar a importância das metodologias ativas no ensino de Pediatria I do curso de Medicina da Universidade Federal de Minas Gerais (UFMG) e propor adaptações que permitam a aplicação dessas metodologias no período de ensino remoto emergencial (ERE). Método: Trata-se de uma revisão narrativa, com dados obtidos de forma independente pelos autores, por meio de busca abrangente e não sistemática no PubMed e na SciELO. Primeiro, realizaram-se a busca e a análise de dados das principais metodologias ativas, e, posteriormente, os achados foram aplicados à disciplina de Pediatria I do curso de Medicina da UFMG, incluindo suas adaptações para a implementação no ERE. Resultados: Analisaram-se a problematização, a aprendizagem baseada em problemas e o fishbowl como recursos didáticos das metodologias ativas. Esses métodos reforçam a curiosidade, a autonomia, a motivação e as capacidades crítica e reflexiva do aluno. Ademais, promovem integração entre teoria e prática, incentivo do trabalho em equipe e estímulo para o estudante se conscientizar sobre os problemas sociais existentes. Conclusão: Assim, o uso das metodologias ativas no ensino em Pediatria I possibilita alcançar os objetivos da disciplina, tanto no modo presencial quanto no ERE, e atingir as expectativas das diretrizes brasileiras sobre a formação médica.

Abstract: Introduction: The traditional model of medical education has a biocentric perspective of health problems, overestimating biological aspects of the patient, without considering the other aspects involved in the health-disease process. This method is teacher-centered and the student acts as a passive recipient of knowledge. On the other hand, in active methodologies the student plays an active role in the teaching-learning process, building critical and reflective knowledge. Objective: This study aims to analyze the importance of active methodologies in the teaching process of Pediatrics I on the Medicine course at the Federal University of Minas Gerais and to propose changes in these methodologies so they can be employed during the period of Emergency Remote Education (ERE). Method: It is a narrative review, with data obtained independently by the authors through a broad and non-systematic search in PUBMED and SCIELO. Data on the main active methodologies were collected and analyzed, and the findings were subsequently applied to Pediatrics I, including their adaptation to implementation in the ERE. Results: The problematization, problem-based learning and fishbowl methodologies were analyzed as didactic resources of active methodologies. These methods reinforce the student's curiosity, autonomy, motivation and critical and reflective thinking skills. Furthermore, they promote integration between theory and practice learning, encourage teamwork and encourage students to become aware of existing social problems. Conclusion: Using active methodologies in the teaching process of Pediatrics I makes it possible to achieve the objectives of this discipline, both in face-to-face and remote learning, and reach the expectations of the Brazilian Guidelines on medical education.

Disponibilidade para educação interprofissional em cursos orientados por métodos ativos de ensino-aprendizagem / Readiness for interprofessional education in undergraduate courses based on active learning methods

Resumo: Introdução: A educação interprofissional (EIP) desenvolve competências colaborativas, aprimora a segurança do paciente e melhora a qualidade da atenção à saúde. A disponibilidade para aprendizagem compartilhada relaciona-se diretamente com a EIP. Objetivo: Este estudo teve como objetivo analisar a disponibilidade dos estudantes para a EIP, de acordo com os ciclos e cursos. Método: Trata-se de estudo transversal, descritivo, de abordagem quantitativa. Utilizou-se a Readiness for Interprofessional Learning Scale (RIPLS) via formulário eletrônico. Os testes Mann-Whitney e qui-quadrado foram utilizados para analisar respectivamente variáveis contínuas e categóricas. Nas análises para verificar as diferenças nas pontuações dos fatores 1. trabalho em equipe e colaboração (TEC), 2. identidade profissional (IP) e 3. atenção à saúde centrada no paciente (ACP), além da pontuação global da RIPLS, os cursos e ciclos foram comparados por meio do teste Kruskal-Wallis. Resultado: Participaram do estudo 506 estudantes, com taxa de respostas de 32,6%, dos cursos de Enfermagem, Farmácia, Fisioterapia, Fonoaudiologia, Medicina, Nutrição, Odontologia e Terapia Ocupacional de uma universidade pública brasileira. As pontuações dos fatores 1, 2 e 3 e a pontuação global da RIPLS não apresentaram diferenças entre os sexos. Os estudantes do curso de Farmácia apresentaram menor disponibilidade para o fator 3 (ACP) quando comparados com os alunos de Enfermagem, Fisioterapia, Medicina, Odontologia e Terapia Ocupacional (p = 0,007). Os discentes de Fonoaudiologia e Nutrição apresentaram menor pontuação no mesmo fator em comparação com os de Odontologia e Terapia Ocupacional (p = 0,007). Os estudantes de Farmácia (p = 0,004) e Medicina (p = 0,016) foram menos propícios a obter maior pontuação no fator 1 (TEC), enquanto os de Terapia Ocupacional obtiveram maior chance para maior disponibilidade no mesmo fator (p = 0,024). No fator 2 (IP), os estudantes do quinto ciclo foram menos propensos a atitudes positivas (p = 0,046). Observou-se que os estudantes de Terapia Ocupacional apresentaram atitude mais favorável para a EIP expressa tanto no fator 3 (p = 0,034) quanto na pontuação global (p = 0,027), enquanto os alunos do curso de Farmácia apresentaram menor chance para melhor disponibilidade no fator 3 (p = 0,003) e na pontuação global (p = 0,003). Conclusão: Considerando a relevância da EIP no processo de reorientação da formação de profissionais de saúde para a construção da integralidade do cuidado e alinhamento com o Sistema Único de Saúde, este estudo pretende contribuir para a reflexão acerca das diferenças na disponibilidade para EIP entre cursos de graduação na área da saúde.

Abstract: Introduction: Interprofessional Education (IPE) helps develop collaborative skills, enhance patient safety and improve the quality of health care. Readiness for shared learning is directly related to IPE. Objective: To analyze Readiness for IPE among students, according to the cycles and courses. Method: This cross-sectional, descriptive study adopted a quantitative approach and used the Readiness for Interprofessional Learning Scale (RIPLS) via an electronic form. Mann-Whitney and chi-square tests were used to analyze the continuous and categorical variables, respectively. Analyses to ascertain differences between scores for the factors (1) Teamwork and Collaboration (TEC), (2) Professional Identity (IP), (3) Patient-Centered Health Care (ACP), and the overall RIPLS score, used the Kruskal-Wallis test to compare courses and cycles. Result: A response rate of 32.6% was attained from a sample of 506 students from the Nursing, Pharmacy, Physiotherapy, Speech Therapy, Medicine, Nutrition, Dentistry and Occupational Therapy courses of a Brazilian public university. The scores for factors 1, 2 and 3, and the overall RIPLS score did not differ between genders. Pharmacy students reported a lower Readiness for factor 3 (ACP) compared to students in Nursing, Physiotherapy, Medicine, Dentistry and Occupational Therapy (p=0.007). Speech therapy and Nutrition reported lower scores for the same factor compared to Dentistry and Occupational Therapy (p=0.007). Pharmacy students (p=0.004) and medicine students (p=0.016) were less likely to obtain a higher score in factor 1(TEC), while Occupational Therapy students were more likely to report greater Readiness in the same factor (p=0.024). In factor 2 (IP), fifth grade students were less likely to have positive attitudes (p=0.046). It was observed that Occupational Therapy students showed a more favorable attitude towards IPE expressed both in factor 3 (p=0.034) and in the overall score (p=0.027), while students in the Pharmacy course were less likely to report better readiness in factor 3 (p=0.003) and in the overall score (p=0.003). Conclusion: Considering the relevance of IPE in the process of redirecting health care training to build comprehensive care and ensure alignment with the Unified Health System, this study aims to reflect on the differences in readiness for IPE between undergraduate courses in health area.

Modelo de oficinas de qualificação em Aprendizagem Baseada em Equipes com docentes de Medicina / A model for qualification workshops in team-based learning with medicine teachers

Resumo: Introdução: A Aprendizagem Baseada em Equipes (ABE) tem se mostrado, em todo o mundo, uma ferramenta pedagógica promissora nas mais diversas realidades, ao estimular o autoaprendizado do aluno e potencializar a habilidade de trabalhar em equipe. Todavia, são escassos os estudos que envolvam a qualificação de docentes para a prática dessas atividades. Objetivo: Dessa forma, o presente estudo objetivou relatar um modelo de oficina de qualificação docente em ABE e a avaliação feita pelos participantes acerca da metodologia empregada, com docentes do curso de Medicina de uma instituição privada de ensino superior de Belém, no Pará. Método: Trata-se de uma pesquisa-ação intervencionista realizada por meio de questionários elaborados pelos próprios dos autores para avaliar a satisfação, as críticas e as recomendações dos docentes acerca das oficinas propostas. Resultados: Percebeu-se que 81,2% dos participantes atribuíram "satisfação máxima" às oficinas e os demais as classificaram como "satisfatórias". Dessa forma, houve aprovação da técnica empregada por todos os docentes. Quando indagados sobre os pontos negativos nas oficinas, os mais citados foram: horários e dias escolhidos (18,7%); pouco tempo para estudo individual (15,6%); deslocamento, carga horária extensa e falhas no convite para inscrição nas oficinas (12,5%). Quando questionados sobre os pontos positivos, os mais citados foram: utilizar a própria ABE para ensinar ABE (93,7%); qualidade dos artigos escolhidos para estudo prévio (87,5%); e alta aplicabilidade prática (81,2%). Por fim, 93,7% dos participantes referiram se sentir confiantes para conduzir atividades de ABE em suas práticas diárias. Conclusão: Os participantes demonstraram boa aceitação e satisfação com relação à metodologia empregada nas oficinas, permitindo assim que possam aplicar essa estratégia de ensino com maior segurança e assertividade em suas rotinas diárias. Espera-se que este trabalho possa contribuir para a aprendizagem sobre essa estratégia educacional e descomplicar e tornar acessível a sua aplicação, para assim estimular docentes e instituições não familiarizados com a ABE a introduzir essa valiosa ferramenta em suas matrizes pedagógicas.

Abstract: Introduction: Team-Based Learning (TBL) has proven to be a promising pedagogical tool in the most diverse realities around the world, stimulating student self-learning and enhancing the ability to work in teams. However, there are few studies involving the qualification of teachers to practice these activities. Objective: Thus, the present study aimed to report a model of a teacher qualification workshop in TBL and the evaluation made by the participants about the methodology used, with teachers of the medical course of a private higher education institution in Belém/PA/Brazil. Method: This was an interventionist action research conducted through questionnaires by the authors to assess teacher satisfaction, criticisms and recommendations about the proposed workshops. Results: It was found that 81.2% of the participants rated the workshops as providing "maximum satisfaction" and the rest classified them as "satisfactory". Thus, all the teachers approved of the technique used. When asked about the negative points in the workshops, the most frequently cited were: selected times and days (18.7%); little time for individual study (15.6%); and commuting, extensive workload and failures in the invitation to enroll in the workshops (12.5% each item). On the other hand, when asked about the positive points, the most frequently cited were: using the TBL itself to teach TBL (93.7%); quality of the articles chosen for previous study (87.5%); and high practical applicability (81.2%). Finally, 93.7% of the participants reported feeling confident to conduct TBL activities in their daily practices. Conclusion: In this and the vast majority of studies with TBL, the participants demonstrated good acceptance and satisfaction regarding the methodology used in the workshops, thus allowing them to apply this teaching strategy with greater security and assertiveness in their daily routines. It is hoped that this work can contribute to learning about this educational strategy and that it can simplify its application and enhance its accessibility, in order to stimulate teachers and institutions unfamiliar with TBL to introduce this valuable tool in their activities.

Equipes de aprendizagem ativa na educação em saúde: ensino-serviço-comunidade na prevenção da contaminação por Covid-19 / Active learning teams in health education: teaching-service-community for the prevention of Covid-19 / Equipos de aprendizaje activo en la educación en salud: enseñanza-serviciocomunidad en la prevención de la contaminación por Covid-19

Considerando o cenário mundial de pandemia do coronavírus, o presente estudo objetiva apresentar um modelo de formação para educação em saúde, constituído por Equipes de Aprendizagem Ativa (EAA), integrando ensino-serviço-comunidade para prevenção da contaminação por Covid-19. Esse modelo reúne nas EAA, supervisionadas por um docente, discentes da área da Saúde, professores e estudantes do ensino médio e agentes comunitários de saúde. O modelo proposto utiliza vídeos do Projeto Homem Virtual acerca do vírus SARS-CoV2 e pode ser ofertado nas modalidades remota, presencial ou híbrida. Assim, essa proposta de formação contribui para o enfrentamento da pandemia na perspectiva da educação em saúde. Ademais, a estruturação desse modelo permite que sua aplicabilidade seja versátil no que se refere às temáticas abordadas nos cursos, bem como no que diz respeito aos integrantes das EAA. (AU)

Against the backdrop of the coronavirus pandemic, this study presents an active learning teams (ALTs) training model for health education as part of teaching-service-community for the prevention of Covid-19 infection. Supervised by an academic staff member, the teams were made up of health students, high school teachers and students, and community health workers. The model uses videos from the Virtual Man Project about the SARS-CoV2 virus and can be offered in remote, face-to-face or hybrid formats. The training model contributes to the response to the pandemic in the field of health education. In addition, the model's versatile structure means it can be applied across different topics addressed by the courses and to different members of the ALTs. (AU)

Considerando el escenario mundial de pandemia del coronavirus, el presente estudio tiene el objetivo de presentar un modelo de formación, constituido por Equipos de Aprendizaje Activos (EAA), para Educación en Salud, integrando enseñanza-servicio-comunidad para prevención de la contaminación por Covid-19. Ese modelo reúne en las EAA, supervisadas por un docente, a discentes del área de la salud, profesores y estudiantes de la enseñanza media y agentes comunitarios de salud. El modelo propuesto utiliza vídeos del Proyecto Hombre Virtual sobre el virus SARS-CoV2 y puede ofrecerse en las modalidades remota, presencial o híbrida. Por lo tanto, esta propuesta de formación contribuye al enfrentamiento de la pandemia bajo la perspectiva de la Educación en salud. Además, la estructuración de este modelo permite que su aplicabilidad sea versátil en lo que se refiere a las temáticas abordadas en los cursos, así como en lo que se refiere a los integrantes de las EAA. (AU)

Practice of Oral Case Presentations (OCPs) Teaching Method Utilizing a Playful Learning Approach / 医学教育

Many papers on medical education emphasize the idea that obtaining structure through the practice of Oral Case Presentations (OCPs) is essential and efficient to brush up presentation skills. However, psychological resistance to giving a public presentation is an obstacle in learning OCPs. The aim of this survey is to evaluate the educational effect of our teaching method using a playful learning approach for presentation. This study was conducted by using an anonymous self-administered questionnaire for medical students during their clinical clerkship. One hundred twenty eight students participated in this survey.　Didactics and small group discussions took place during the first week of clerkship, and participants were asked to give presentations about their original theme during the second week. Questionnaires were distributed before and after the end of each session. The results showed that psychological resistance to presentations decreased, positive feelings increased, and students became more aware of the purpose, place, and subject of their presentations. Each parameter statistically improved at each phase. A playful learning approach is effective in teaching presentations, including OCPs.

Retos de la implementación del aprendizaje basado en equipos en los programas de medicina / The challenges of implementing team-based learning to the medical major programs

Introducción: El aprendizaje basado en equipos es una estrategia de enseñanza y de aprendizaje centrada en el alumno, en la cual el profesor tiene un rol facilitador. Este constituye un método pedagógico de aprendizaje activo que mejora la motivación hacia el aprendizaje y lleva a los alumnos a aplicar sus conocimientos para resolver problemas y combinar la teoría con la práctica. Los avances en educación médica a nivel mundial han llevado a las escuelas de medicina a optar por este tipo de estrategias. Objetivo: Identificar los retos de la implementación del aprendizaje basado en equipos en los programas de medicina. Resultados: Mediante la aplicación del aprendizaje basado en equipos en los programas de medicina, se identificaron los factores de sobrecarga laboral y de estudio con incidencia en los participantes en la estrategia, la necesidad de garantizar entrenamiento previo a los actores del proceso, la importancia de la realización de una adecuada distribución de los grupos de trabajo, y los recursos adicionales que deben garantizarse. Conclusiones: Para obtener beneficios pedagógicos de forma plena, la implementación del aprendizaje basado en equipos debe ser sistemática, lo que requiere procesos de formación y preparación, tanto de los estudiantes como de los profesores. Como cualquier cambio, demandará convicción, tiempo y ajustes a lo largo del proceso(AU)

Introduction: Team-based learning is a student-centered teaching and learning strategy, in which the teacher has the role of a facilitator. It constitutes an active learning pedagogical method that improves motivation towards learning and leads students to apply their knowledge to solve problems and combine theory with practice. Advances in medical education worldwide have led medical schools to opt for such strategies. Objective: To identify the challenges of implementing team-based learning in the medical major programs. Results: Through the application of team-based learning to the medical major programs, such factors as work and study overloads were identified as having an impact on the strategy participants, together with the need to guarantee prior training to the process stakeholders, the importance of adequate distribution of the working groups, and the additional resources that must be guaranteed. Conclusions: In order to obtain full pedagogical benefits, the implementation of team-based learning must be systematic, a process requiring training and preparation processes for both students and teachers. Like any change, it will demand conviction, time and adjustments throughout the process(AU)