Application and effectiveness of narrative medicine in clinical internship: with department of thoracic surgery as an example / 中华医学教育探索杂志

Objective:To investigate the effect of narrative medicine teaching on the academic performance and empathy ability of clinical interns in department of thoracic surgery.Methods:A total of 74 interns in the department of thoracic surgery, with the "5+3" integration major of clinical medicine in Chongqing Medical University, were divided into observation group and control group, with 37 interns in each group. The interns in the control group received traditional teaching, and those in the observation group received narrative medicine teaching in addition to traditional teaching. The two groups were compared in terms of department examination score, level of humanistic concern, empathy level, ability to handle doctor-patient relationship, degree of satisfaction with teaching, discipline interest, and job intention after graduation. SPSS 21.0 was used to perform the t-test and chi-square test. Results:Compared with the control group, the observation group had significantly better theoretical score [(85.16±10.04) vs. (79.73±8.27)], operational skill score [(85.32±8.77) vs. (79.70±7.56)], level of humanistic concern [(3.78±0.95) vs. (3.24±1.04)], empathy scale score [(104.89±12.90) vs. (96.57±11.00)], results of the questionnaire on doctor-patient communication skills, confidence in professional practice, and doctor-patient orientation [(52.59±10.15) vs. (72.59±5.86)], degree of satisfaction with teaching (89.2% vs. 64.8% in the control group), discipline interest [(3.86±1.08) vs. (3.05±1.12)], and job intention after graduation (29.7% vs. 8.1%).Conclusion:Narrative medicine introduced into clinical practice teaching can improve the effectiveness of teaching, the empathy ability of students, and the degree of satisfaction with teaching.

Educação em saúde bucal em uma pré-escola: planejamento estratégico para o desenvolvimento de atividades lúdicas / Oral health education in pre-school: strategic planning for the development of ludic activities

Trata-se de um relato de experiência, que descreve, sob estratégia narrativo-argumentativa, as significâncias político-pedagógicas atreladas ao planejamento estratégico de ações de educação em saúde bucal vivenciadas em um ambiente escolar e experimentadas por acadêmicos estagiários de um curso de Odontologia. Após análise detalhada, algumas inferências se destacaram: o reconhecimento do ambiente escolar como território fértil para o desenvolvimento de ações promotoras de saúde; a efetividade do instrumento "TPC" (Teorizar-Praticar-Criticar) no direcionamento dos acadêmicos estagiários no planejamento estratégico de atividades de educação em saúde bucal; a importância de se disseminar, em espaços científicos, os aprendizados advindos de experimentações práticas de estágios.

This is a report on an experience that describes, under a narrative-argumentative strategy, the political-pedagogical significance linked to the strategic planning of oral health education actions experienced in a school environment and experienced by university trainees from a Dentistry course. After a detailed analysis, some inferences were observed: the recognition of the school environment as a fertile territory for the development of health-promoting actions; the effectiveness of the "TPC" (Theorize-Practice-Criticize) instrument in directing university trainees in the strategic planning of oral health education activities; the importance of disseminating, in scientific spaces, the learning from practical experimentation during internships.

Meu Estágio Enfermagem: criação e avaliação de um protótipo de aplicativo para apoio no estágio curricular supervisionado em enfermagem / My Nursing Internship: creation and evaluation of an application prototype to support the supervised curricular internship in nursing

Introdução: O estágio curricular supervisionado é um importante instrumento utilizado na formação dos profissionais de enfermagem, que visa proporcionar aos alunos o aperfeiçoamento das técnicas de enfermagem e o desenvolvimento de uma visão crítica e reflexiva da profissão. Entretanto, não são poucas as dificuldades enfrentadas pelas envolvidos ao longo deste processo, incluindo questões burocráticas, organizativas e pedagógicas. Algumas dessas dificuldades podem ser amenizadas com o uso de tecnologias educacionais digitais especialmente desenvolvidas para esse fim, uma vez que permitem acesso a informações com bases científicas, controle de horários, realização de registros e cálculos, entre outras atividades pertinentes ao estágio. Objetivo: Desenvolver e avaliar um protótipo de aplicativo educacional para apoiar alunos e docentes durante os estágios. Método: Trata-se de uma pesquisa aplicada, exploratória e descritiva, de produção tecnológica. No desenvolvimento do protótipo do aplicativo, utilizou-se como referencial metodológico o Design Thinking, para os momentos de inspiração, implementação e ideação, precedido de revisão da literatura sobre as dificuldades enfrentadas pelos alunos e docentes durante os ECS. Posteriormente, foi desenvolvida a primeira versão do protótipo para interação com especialistas em inovação e tecnologia e alunos de enfermagem, resultando na nova versão submetida à avaliação de nove juízes docentes enfermeiros, nove especialistas em informática e nove alunos do curso técnico em enfermagem. Na avaliação do protótipo foram utilizados os instrumentos System Usability Scale, Net Promoter Score e de Avaliação da Qualidade Adaptado de Sperandio (2008). Na análise dos dados foram empregadas técnicas de estatísticas descritivas. Para concordância entre os avaliadores, adotou-se a análise AC1, de acordo com Gwet (2008). Resultados: Foi desenvolvido um protótipo de aplicativo de média fidelidade, com as seguintes funcionalidades: disponibilização das escalas de estágio, chat de comunicação entre docentes e alunos, registro de presença no estágio com geolocalização, disponibilização das técnicas de enfermagem, checklist das técnicas realizadas, recurso para cálculos de medicação e gotejamento, registros de enfermagem, consulta dos planos de trabalho docente, informações para segurança do paciente, código de ética e normas e rotinas dos estágios. Com base nas avaliações foi possível considerar a viabilidade do protótipo de aplicativo. As avaliações do score SUS alcançaram o melhor resultado possível, com valores de 91,4 e 91,9 entre os alunos e enfermeiros docentes, respectivamente. O NPS ficou na zona de excelência com média de respostas 94,4. Na avaliação da qualidade nos itens funcionalidade, confiabilidade, usabilidade, eficiência, manutenibilidade e portabilidade, a média das respostas dos enfermeiros docentes, alunos e especialistas em informática ficou dentro do esperado. Importantes sugestões foram feitas e permitirão novas implementações a partir da visão dos usuários finais. A avaliação dos especialistas em informática identificou a necessidade de melhorias, sobretudo nos itens confiabilidade, eficiência, manutenibilidade e portabilidade. A avaliação da concordância evidenciou a discordância dos avaliadores, o que reitera a necessidade de aperfeiçoar versões futuras do protótipo, bem como de considerar novas avaliações. Conclusão: O protótipo de aplicativo desenvolvido tem potencial para colaborar no desenvolvimento dos ECS em enfermagem, além de apresentar caráter inovador. Além disso, considera-se relevante a avaliação futura dos aspectos pedagógicos, não contemplados neste estudo

Introduction: The supervised curricular internship is an important instrument used in the training of nursing professionals, which aims to provide students with the improvement of nursing techniques and the development of a critical and reflective view of the profession. However, there are many difficulties faced by those involved throughout this process, including bureaucratic, organizational and pedagogical issues. Some of these difficulties can be alleviated with the use of digital educational technologies specially developed for this purpose, as they allow access to scientifically based information, control of schedules, carrying out records and calculations, among other activities relevant to the internship. Objective: Develop and evaluate an educational application prototype to support students and faculty during internships. Method: This is an applied, exploratory and descriptive research of technological production. In the development of the application prototype, Design Thinking was used as a methodological framework, for moments of inspiration, implementation and ideation, preceded by a literature review on the difficulties faced by students and teachers during the ECS. Subsequently, the first version of the prototype was developed for interaction with innovation and technology specialists and nursing students, resulting in the new version being evaluated by nine nurse faculty judges, nine informatics specialists and nine students from the technical nursing course. In the evaluation of the prototype, the instruments System Usability Scale, Net Promoter Score and Quality Assessment Adapted from Sperandio (2008) were used. In the data analysis descriptive statistics techniques were used. For agreement between the evaluators, the AC1 analysis was adopted, according to Gwet (2008). Results: A prototype of a medium-fidelity application was developed, with the following features: availability of internship schedules, communication chat between professors and students, registration of internship attendance with geolocation, availability of nursing techniques, checklist of performed techniques, resource for medication and drip calculations, nursing records, consultation of teacher work plans, patient safety information, code of ethics and internship rules and routines. Based on the evaluations, it was possible to consider the feasibility of the application prototype. The evaluations of the SUS score achieved the best possible result, with values of 91.4 and 91.9 among students and teaching nurses, respectively. NPS was in the zone of excellence with an average of 94.4 responses. In assessing the quality of the items functionality, reliability, usability, efficiency, maintainability and portability, the average of the responses of professors, students and computer specialists was within expectations. Important suggestions were made and will allow new implementations from the end users' perspective. The assessment of computer specialists identified the need for improvements, especially in the items reliability, efficiency, maintainability and portability. The agreement assessment evidenced the evaluators' disagreement, which reiterates the need to improve future versions of the prototype, as well as to consider new assessments. Conclusion: The developed application prototype has the potential to collaborate in the development of ECS in nursing, in addition to presenting an innovative character. In addition, the future assessment of pedagogical aspects not covered in this study is considered relevant

Aprendizaje interprofesional en los internados de las carreras de la salud del Hospital Josefina Martínez / Interprofessional learning of interns at Josefina Martínez Hospital

Introducción: las dinámicas de atención en salud requieren que los profesionales que componen el equipo de salud trabajen en for-ma colaborativa. Sin embargo, durante su formación, las oportunidades de aprendizaje con otras disciplinas son escasas. Se reportan los resultados del primer proyecto para promover el aprendizaje interprofesional en los internos que rotan por el Hospital Josefina Martínez. Método: de marzo a julio 2018, se realizó un taller constituido por dos sesiones, en cada rotación de internado. Participaron internos de cinco carreras en forma conjunta (kinesiología, odontología, nutrición, fonoaudiología y terapia ocupacional). Se adaptó la encuesta de disposición al aprendizaje interprofesional, para ser aplicada antes y después de cada taller. Se calcularon las medianas, rangos intercuartílicos (Q1; Q3y se compararon los puntajes mediante test de Wilcoxon. Resultados: hubo una disposición positiva inicial al aprendizaje interprofesional, con mejoría significativa después de los talleres en todas las dimensiones de la encuesta: Trabajo en equipo y colaboración (<0,001), trabajo centrado en el paciente (<0,001), y sentido de identidad profesional (<0,05). La diferencia del puntaje global de la encuesta también fue significativa (<0,001). Conclusiones: se demostró un cambio favorable y significativo en las respuestas de los internos después de los talleres, en todas las dimensiones de la encuesta. En los comentarios, destacaron la relevancia de aprender con estudiantes de otras carreras, describiendo que aumentó su conocimiento sobre éstas y reforzando el impacto que dicha integración tiene en mejorar la atención y resolución de problemas en salud.

Background: The dynamics of health care require that the health professionals work collaboratively; however, during their training, learning opportunities with other disciplines are infrequent. The results of the first project to promote interprofessional learning in the clinical internship at Hospital Josefina Martínez are reported. Methods: From March to July 2018, two workshops for each internship rotation were carried. Students from fivecareers participated together (Kinesiology, Dentistry, Nutrition, Speech Therapy, and Occupa-tional Therapy). The readiness to interprofessional scale survey was adapted, to be applied before and after each workshop. Medians, interquartile range (Q1; Q3) were calculated, and the Wilcoxon test was used to compare the results. Results: There was an initial po-sitive readiness for interprofessional learning, with a significant improvement in all the dimensions of the survey, after the workshops: Teamwork and collaboration (<.001), patient-centered care (<.001), and sense of professional identity (<.05). The differences from the overall survey were also significant (<0.001). Conclusions: A favorable change was demonstrated in the responses of the students after the workshops, overalland in all the dimensions of the survey. In the comments, the students highlighted the relevance of learning with students from other careers, describing that it increased their knowledge about different professions and strengthening the impact that this integration has in improving attention and resolving health problems.

Evaluation of innovative teaching mode on obstetrics and gynecology for clinical interns / 中华医学教育探索杂志

Objective@#To evaluate an innovative teaching mode on obstetrics and gynecology for clinical interns.@*Methods@#A total of 195 students from Grade 2015 of Clinical Medicine (Group 2018) were enrolled to receive the innovative teaching mode. This mode was based on organ integration medicine,focused on solving problems and improving teacher-student interaction, and provided creative homework and more clinical practice for students. The teaching results were evaluated objective and structured clinical examinations and questionnaire, and by comparing their scores with those of the former two grades (Grade 2013 and 2014). The statistical analysis was performed with SPSS 21.0.@*Results@#Scores of objective and structured clinical test in Group 2018 was higher than those in the two groups former of the same period, and the difference was statistically significant (P<0.05). Satisfaction in Group 2018 was higher than that in the former two groups (P<0.05).@*Conclusion@#The their innovative teaching mode can help students to integrate theories with practice and cultivate ability of clinical thinking.

Evaluation of innovative teaching mode on obstetrics and gynecology for clinical interns / 中华医学教育探索杂志

Objective To evaluate an innovative teaching mode on obstetrics and gynecology for clinical interns. Methods A total of 195 students from Grade 2015 of Clinical Medicine (Group 2018) were enrolled to receive the innovative teaching mode. This mode was based on organ integration medicine, focused on solving problems and improving teacher-student interaction, and provided creative homework and more clinical practice for students. The teaching results were evaluated objective and structured clinical examinations and questionnaire, and by comparing their scores with those of the former two grades (Grade 2013 and 2014). The statistical analysis was performed with SPSS 21.0. Results Scores of objective and structured clinical test in Group 2018 was higher than those in the two groups former of the same period, and the difference was statistically significant (P<0.05). Satisfaction in Group 2018 was higher than that in the former two groups (P<0.05). Conclusion The their innovative teaching mode can help students to integrate theories with practice and cultivate ability of clinical thinking.

Ganho de Conhecimento no Internato Médico em Psiquiatria Não Reduz Estigmatização dos Transtornos Mentais / Increased Knowledge among Psychiatric Medical Interns does not Reduce the Stigmatization of Mental Disorders

RESUMO Introdução Considerando a prevalência dos transtornos mentais, é essencial que qualquer médico seja capaz de prestar assistência qualificada e humanizada a pessoas em sofrimento psíquico. No entanto, o usual estigma e a falta de conhecimento no manejo das doenças mentais por parte dos médicos podem representar uma barreira de acesso e ineficiência importante enfrentada pelos pacientes no sistema de saúde. Objetivo Estimar o ganho de aprendizado percebido e a redução de estigma em relação a pessoas portadoras de esquizofrenia por estudantes de Medicina após a exposição ao estágio obrigatório no internato numa escola médica pública no Distrito Federal. Método Estudo quasi-experimental para avaliação de impacto de programa educacional durante o internato médico em saúde mental. A amostra consistiu em 35 estudantes do último ano do curso de Medicina. Foram aplicados questionários para aferição do grau e tipificação do estigma em relação à esquizofrenia e à autopercepção sobre manejo de medicamentos e sobre tratamento de doenças psiquiátricas. Os instrumentos utilizaram uma escala do tipo Likert de três pontos para aferição dos resultados. Os questionários foram aplicados imediatamente antes e após a exposição ao programa educacional, que teve duração de quatro semanas. Os valores médios de autopercepção e estigma foram comparados entre os dois momentos empregando-se o teste t de Student emparelhado. Resultados Não houve mudança significativa do grau de estigmatização nas dimensões avaliadas (estereótipo total, p = .230; preconceito percebido, p = .172; distância social, p = .209; direitos civis, p = .837). Quanto à autopercepção de conhecimento, os valores médios do número de resposta igual a 3 e a soma no momento pós- são significativamente maiores que no momento pré- (p = .007 e p < .0001, respectivamente). Os ganhos não se mostraram associados significativamente com as variáveis demográficas. Conclusão A despeito do ganho em conhecimento, a imersão em saúde mental no internato do curso de Medicina ao longo de quatro semanas não se mostrou eficaz para mudança no estigma. É possível que a curta duração da intervenção implique contato insuficiente com o portador de doença mental para redução do estigma. Sugerimos a realização de novos trabalhos com ampliação da amostra e com desenhos experimentais.

ABSTRACT Introduction Considering the high prevalence of mental illnesses, it is essential for any physician to offer proper treatment and attention to people with these disorders. Nevertheless, the usual stigma and lack of knowledge regarding the management of mental disorders on the part of physicians can represent a significant barrier to treatment and inefficiency faced by patients in the health care system. Objective This study aimed to measure the gain of psychiatric knowledge and the reduction in the stigmatization of people with schizophrenia by medical students after exposure to the compulsory internship program at a public medical school in the Federal District. Methods Quasi-experimental study to evaluate the impact of the training program during medical internship in the final year of undergraduate medical training. The sample was 35 final-year medical students. Questionnaires were applied to measure the degree and type of stigma in relation to schizophrenia and self-perception regarding the drug management and treatment of psychiatric diseases. A three-point Likert scale was used to measure the results. The questionnaires were applied immediately before and after exposure to the four-week training program. The medical values of self-perception and stigma were compared between two moments using the Student's t test. Results: There was no statistically significant difference found between stigmatization before and after the intervention (total stereotype, p = 0.230; perceived prejudice, p = 0.172; social distance, p = 0.209; civil rights, p = 0.837). Regarding self-perception of knowledge, the number of items reaching total confidence and the mean values after the training were significantly improved (p = 0.007 and p < 0.0001, respectively). There was no correlation with sociodemographic characteristics. Conclusion Despite the knowledge gain, medical students failed to show any improvement in the degree of stigma held after immersion in a 4-week practical psychiatric training program. The short duration of the intervention might have meant that the students' contact with patients was insufficient to reduce stigma. More studies are needed with larger groups and experimental designs.

Avaliação da aprendizagem no estágio supervisionado de enfermagem em saúde coletiva / Assessment of learning in the supervised internship in nursing in collective health / Evaluación de aprendizaje durante la práctica o residencia de enfermería en salud colectiva

Resumo Neste ensaio teórico-reflexivo, desenvolvemos uma discussão a respeito da avaliação da aprendizagem no processo de formação da assistência de Enfermagem em Saúde Coletiva no decorrer do estágio supervisionado. Dialogamos com autores da Saúde Coletiva e da avaliação da aprendizagem por competências, principalmente da medicina, que foram pioneiros nesse debate, empregando o modelo hierárquico-conceitual de avaliação de competências proposto por George Miller. Procuramos contribuir ao apresentar possibilidades de métodos, instrumentos e procedimentos de avaliação da aprendizagem em contextos somativos ou formativos, perspectivas e tendências da avaliação do processo de ensino-aprendizagem na área da Enfermagem. Constatamos que a avaliação por competências necessita ser mais discutida para estar alinhada às mudanças curriculares em curso e às demandas de formação de perfis profissionais em consonância com as necessidades e princípios do Sistema Único de Saúde.

Abstract In this thoughtful theoretical essay, we developed a discussion regarding the assessment of learning in the process of training for care in Nursing in Collective Health throughout the supervised internship. We had conversations with the authors of Collective Health and of the assessment of learning by competencies, mainly those involved in medicine, who were pioneers in this debate, using the hierarchical-conceptual model of assessment by competencies proposed by George Miller. We sought to make a contribution by presenting the possibilities of methods, tools and procedures for the assessment of learning in summative or formative contexts, and the perspectives and tendencies of the assessment of the teaching-learning process in the field of Nursing. We verified that the assessment by competencies needs to be more discussed in order to be in line with the ongoing syllabus changes and the demands for the training of professional profiles that is in accordance with the needs and principles of the Unified Health System (Sistema Único de Saúde, SUS, in the Portuguese acronym).

Resumen En este ensayo teórico reflexivo, desarrollamos una discusión acerca de la evaluación de aprendizaje en el proceso de formación de asistencia de Enfermería en Salud Colectiva durante la práctica o residencia. Dialogamos con autores sobre Salud Colectiva y la evaluación de aprendizaje por competencias, principalmente de la medicina, que fueron pioneros en este debate, empleando el modelo jerárquico-conceptual de evaluación de competencias propuesto por George Miller. Buscamos contribuir al presentar posibilidades de métodos, instrumentos y procedimientos de evaluación de aprendizaje en contextos sumativos o formativos, perspectivas y tendencias de la evaluación del proceso de enseñanza-aprendizaje en el área de Enfermería. Constatamos que la evaluación por competencias necesita ser más discutida para alinearse a los cambios curriculares en curso y a las demandas de formación de perfiles profesionales de acuerdo a las necesidades y principios del Sistema Único de Salud.

Establishment and educational measurement of department examination system of clinical practice internship / 中华医学教育探索杂志

Objective To set up a standardized examination system for clinical internship at the de-partment level, and to evaluate the system using educational measurement method. Methods All the 327 clinical five-year and eight-year intern trainees who took clinical internship in the spinal orthopedics de-partment of a teaching hospital from July 1, 2014 to June 30, 2016 were selected as the research subjects. All the subjects took the standardized examination, educational and measurement methods such as general descriptive analysis, project relevance analysis and grader consistency analysis were executed to assess the content validity of the system, the relevance of the project and the consistency of the scorers. Statistical calculation was executed by SPSS 23.0 software. Results The average score of all 312 trainees included was controlled at (80.07±4.67), the lowest score was 70.01, and the highest score was 90.01, which reflected that the overall difficulty was moderate, the difference was reasonable and the scores were evenly distributed. To the theory, skills, medical records, teachers' score and the reward plus, normalized regression coeffi-cients were 0.479, 0.473, 0.118, 0.135 and 0.364 respectively, which were in good agreement with the scores of each item in the total score. To the theory, skills and teacher evaluation, the analysis of variance of the total score showed that the P values were both ≥0.05 with no significant difference between the groups, so the consistency of the scorers were satisfactory. The P values of variance analysis of the two items of the medical record and bonus points were 0.000 and 0.002 respectively, with significant differences among the groups, the scorers were less consistent. Conclusion The standardized examination system can meet the requirements of comprehensive, full-scale, quantitative and stable feedback teaching effect. The system of internship practice examination must be able to withstand continuous implementation and repeated correc-tion over many years, so as to ensure the teaching quality.

Application of case-based multidisciplinary team teaching mode in clinical practice teaching of gynecology / 中华医学教育探索杂志

Objective To explore the feasibility and evaluate the teaching effect of case-based multidisciplinary team teaching mode in clinical practice teaching of gynecology.Method According to different grade,120 students were divided into experimental group and control group (60 students per group).The teaching content contained three malignant tumor cases,which were cervical cancer,endometrial cancer and ovarian cancer.The course needed 12 periods totally.The experimental group received multidisciplinary team (MDT) teaching mode,and the control group received traditional lecture-based learning teaching mode (LBL).Teaching effect evaluation and test scores would be analyzed at the end of teaching.SPSS19.0 was used for t test and chi-square test.Results Our results showed that the theory test scores,practical skills test scores,the paperwork scores and the total scores of the students in MDT group were significantly higher than those in the traditional group (P＜0.05).At the same time,the students' self-evaluation scores in the ability of information retrieval,acquisition,understanding,comprehensive and the ability of self-learning,learning interest,enthusiasm and teamwork were significantly higher than the traditional group (P＜0.05).Conclusion MDT teaching mode is feasible,which can improve teaching effect and students' quality,and is worthy of advocating and popularization.

The application of multiple intelligences theory in obstetrics and gynecology clinical internship teaching for the medical students / 中华医学教育探索杂志

Objective To explore the practical effects of multiple intelligence theory applied in Obstetrics and Gynecology clinical internship teaching for the medical students.Methods The Eight-year program medical students in the classes of 2009 and 2010 were collected,among which 45 students in theexperimental group were taught by multiple intelligence theory,and 40 students in the control group were taught by traditional teaching methods.The results determined by the questionnaire survey,written test scores,operation test scores,medical documents writing results,usual performance and teachers' job evaluation.The data were analyzed by SPSS 17.0 statistical software,chi-square test and t test.Results Compared with control group,the written test scores,operation test scores,medical documents writing results,usual performance,the student questionnaire and teachers' self work evaluation of the experimental group were significantly higher (89.720 ± 8.147) vs.(81.140 ± 9.142),(88.230 ± 4.328) vs.(80.360 ± 5.621),(86.530 ± 2.641) vs.(81.580 ± 2.036),(87.650 ± 3.957) vs.(82.360 ± 6.392),which showed statistically significant difference (P＜0.05).The experimental group students think the teaching methods with multiple intelligence theory are novel,producing following positive effects in fully inspiring learning initiative,fostering the ability of independent study,enlightening clinical thinking,strengthening collective cooperation and improving the ability of doctor-patient communication and problem-solving etc.Conclusions It shows that the application of multiple intelligences theory in Obstetrics and Gynecology clinical internship for the medical students could motivate the students' self-confidence and enthusiasm,and contribute to train high quality medical talent,Meanwhile,the higher requirements are needed for teachers.It is worth promoting the application.

Sentimentos de acadêmicos de enfermagem no estágio curricular sob a ótica de heidegger / Sentimientos de estudiantes de enfermería en la práctica curricular bajo la óptica de heidegger / Feelings of nursing students in the curriculum internship from the perspective of heidegger

RESUMO: Objetivo: compreender os sentimentos dos acadêmicos de Enfermagem durante o Estágio Curricular Obrigatório. Método: pesquisa qualitativa com referencial teórico metodológico da Fenomenologia: descrição, redução e compreensão, e analisada sob a ótica de Heidegger. A coleta de dados ocorreu no segundo semestre de 2016, utilizou-se a técnica de grupo focal com 13 acadêmicos na Escola de Enfermagem de uma Universidade Pública de Minas Gerais. Resultados: emergiram nos depoimentos sentimentos de insegurança, medo, cobrança pessoal, solidão, angústia, alegria, felicidade e tristeza. Conclusão: a maturidade psicológica e algumas características pessoais serão fatores que facilitarão a vivência e compreensão desses sentimentos, favorecendo o crescimento pessoal e profissional. A universidade, conhecendo essas experiências, pode também contribuir com estratégias para amenizá-las, auxiliando na promoção de saúde mental.

RESUMEN: Objetivo: Comprender los sentimientos de los estudiantes de Enfermería durante la Práctica Curricular Obligatoria. Método: Investigación cualitativa con referencial teórico metodológico de la Fenomenología: descripción, reducción y comprensión; analizada bajo la óptica de Heidegger. Datos recolectados durante el segundo semestre de 2016, utilizándose la técnica de grupo focal con 13 alumnos en la Escuela de Enfermería de una universidad pública de Minas Gerais. Resultados: Emergieron en los testimonios sentimientos de inseguridad, miedo, culpa personal, soledad, angustia, alegría, felicidad y tristeza. Conclusión: La madurez psicológica y algunas características individuales serán factores que facilitarán la experiencia y comprensión de estos sentimientos, favoreciendo el crecimiento personal y profesional. La universidad, conociendo tales experiencias, puede también contribuir con estrategias para aliviarlas, colaborando en la promoción de la salud mental.

ABSTRACT: Objective: to comprehend the feelings of Nursing students during the Mandatory Curricular Internship. Method: qualitative study using the theoretical methodological framework of Phenomenology: description, reduction and comprehension, and analyzed from the perspective of Heidegger. The data collection took place in the second half of 2016 using the focus group technique, with 13 students of the Nursing School of a Public University of Minas Gerais. Results: feelings of insecurity, fear, personal accountability, loneliness, anguish, joy, happiness and sadness emerged in the statements. Conclusion: psychological maturity and some personal characteristics are factors that can facilitate the experience and comprehension of these feelings, favoring the personal and professional growth. Knowing these experiences, the university can also contribute with strategies to ease them, aiding in the promotion of mental health.

Estágio curricular supervisionado: relato dos desafios encontrados pelos (as) estudantes / Supervised internship: challenges faced by students

Trata-se de um relato de experiência de duas estudantes de enfermagem em Estágio Curricular Supervisionado (ECS) da Universidade Federal da Fronteira Sul, desenvolvido de agosto a dezembro de 2014 na atenção hospitalar. O objetivo foi analisar a percepção de estudantes de enfermagem sobre o Estágio Curricular Supervisionado no processo de formação. Durante a realização das atividades, as estudantes identificaram duas categorias, a primeira delas focaliza 'o papel do professor mediador e a articulação entre academia e serviço' e a segunda destaca 'o papel do ECS na formação'. A inserção do estudante no campo de atuação da prática é um requisito legal, contudo, merece reflexão, a preparação da universidade/serviço/estudante visando melhor desenvolvimento do estudante no processo de transição do ser graduando ao ser enfermeiro. Dessa forma, embora sejam reais e explícitos os conflitos vivenciados pelo estudante, durante o período de ECS é perceptível o quanto esta exposição à prática diária o fortalece, impelindo-o na transposição de seus limites. Logo, o ECS contribui significativamente no processo de formação possibilitando ao estudante elementos essenciais para o exercício profissional.

This is a case report of two nursing students in the Supervised Internship (ECS) from the Federal University of Fronteira Sul, developed from August to December 2014 in hospital care. This study aims to analyze the perception of nursing students on the Supervised Internship on the educational process. During the activities, the students identified two categories, the first focusing on the 'role of the supervising professor and the relationship between university and health services' and the second on the 'role of ECS in the educational process'. The students' insertion in the practice field is a legal requirement; however, it deserves reflection, preparation of the university/service/student for the best development of the student in the transition process from being an undergraduate to becoming a nurse. Thus, although there are real and explicit conflicts experienced by the students during the ECS period, it is noticeable how this exposure to daily practice strengthens and encourages students in implementing and overcoming their limits. Therefore, the ECS significantly contributes to the educational process, providing the students with essential elements for the professional practice.

The practice and exploration of integration of clinical teaching pattern management in traditional Chinese medicine / 国际中医中药杂志

Current undergraduate education in traditional Chinese Medicine combines classroom teaching with a small number of practical courses, which has showed its limitations of increasingly bad medical environment and employment situation. Nanjing University of Chinese Medicine explored new ways and means of medical education in recent years. Therefore, reforming based on the integration of clinical teaching pattern for TCM Bachelor has been carried out step by step. It meant that classroom teaching and clinical practice were fully integrated by moving classroom in the affiliated hospitals. It has been proved to work. With the experiences of the development, we have successfully explored a mature mean for the integration clinical teaching pattern. Here, we discussed the codes of such practice in order to strive to maximize the effectiveness of such practice.

The experience about apprentice teaching ofJingui Yaolue / 国际中医中药杂志

Jingui Yaolue is a part ofTreatise on Cold-Attack and Miscellaneous Diseases. Because of the archaic words, students lost the interest on it. So it became the questions that how to make students interested in learning theJingui Yaolue and to make traditional Chinese medicine(TCM) classical guide clinical treatment. Thus, a try has been made to teach the TCM classic in the clinical practice apprentice setting rather than the classrooms. Here, some experiences about apprentice teaching in clinical practice of Jingui Yaolue were shared.

Exploration on application of 3D printed models in the orthopedic clinical internship teaching at basic-level hospital / 中华医学教育探索杂志

Objective To evaluate the effect of 3D printed skeletal model in orthopedic clinical in-ternship teaching . Methods From October 2015 to October 2016 , 30 undergraduate clinical medical internship students were divided into traditional teaching group and 3D model teaching group randomly. 1 teaching ward round was conducted for each student. Teaching rounds were conducted according to routine procedures in traditional teaching group, while the 3D model teaching group used the patient's 3D print skeletal model to assist in teaching rounds and perform simulated surgery. All students were tested in theory and practice, and the teaching evaluation was carried out by questionnaire. Data were imputed into SPSS 19.0 for comparison between the two groups using t-test. Results Students in 3D model teaching group significantly outperformed than those in traditional teaching group in theoretical achievement [(92.27±4.56) vs. (86.87±5.30)] and practical achievement [(90.07±4.61) vs. (82.53±5.03)] (P<0.01). In respects of pro-moting theoretical knowledge, enhancing surgical participation, hands-on ability exercise, teaching attraction and overall satisfaction, students in 3D model teaching group gave a better evaluation of teaching they had received than those in the traditional teaching group (P<0.01). Conclusion 3D printed skeletal model is an effective teaching tool, and its application in clinical internship teaching at basic-level hospital can signifi-cantly improve teaching effectiveness and satisfaction. It is worth further exploration and promotion.

Qualitative and quantitative research of preventive medicine's clinical internship / 中华医学教育探索杂志

Objective To provide improvement measures and recommendations to improve preven-tive medicine's clinical internship. Methods 88 third-year students and 82 fifth-year students of preventive medicine in Sichuan University were surveyed. Then 81 valid questionnaires of the third grade and 79 valid questionnaires of the fifth grade were input into EpiData, and SPSS 17.0 was used to analyze the data. Then, in-depth interviews were conducted among 6 employees and 2 professional teachers of the employing units, and the interview records were organized to form an interview summary. Results The third-year preventive medicine students who are preparing to take part in the clinical internship know little about the clinical in-ternship, which accounts for only 0％and 92.59％(75) think that the internship content should be different with the clinical medicine, in the meantime 44.44％ (36) think chief resident should be the internship teacher. For the fifth-year preventive medicine students who have finished the clinical internship, only 3.80％(3) is very satisfied with clinical internship;84.81％(67) are considered to take into account the pro-fessional characteristics of the clinical practice; meanwhile, the satisfaction of the knowledge or the ability learned from the clinical internship as well as the help in the post-graduation job is only 8.86％ (7); the employer's and professional teachers consider that the related clinical internship program of the preventive medicine student should be suitable for prevention medical students , and at the same time , preventive medicine students should focus on learning clinical knowledge related to disease prevention. Conclusion The clinical internship of preventive medicine needs further improvements, such as adjusting practice con-tents, learning teacher, management methods to form a clinical practice system characterized by preventive medicine so as to meet the needs of employers and students.

Formação para o sus: uma análise sobre as concepções e práticas pedagógicas em saúde coletiva / Training for the uhs: an analysis of the pedagogical conceptions and practices in public health / Formación para el sus: un análisis sobre las concepciones y prácticas pedagógicas en salud colectiva

Resumo O preparo pedagógico do docente da área da saúde, diante das exigências da educação contemporânea e das diretrizes curriculares nacionais, tem relação direta com a formação de profissionais para atender às necessidades do Sistema Único de Saúde. Fundamentado nessa premissa, este estudo buscou analisar perfil de formação, bases da ação e planejamento pedagógico do docente de enfermagem orientador de estágio em Saúde Coletiva de instituições de ensino superior de dois municípios do centro-oeste paulista, à luz das políticas públicas de educação e saúde. Os dados obtidos foram submetidos à análise de conteúdo, modalidade temática. A análise empreendida apontou que a prática pedagógica dos 11 docentes entrevistados sofria influência da cultura institucional da educação superior brasileira. As atividades rotineiras estavam calcadas em conteúdos das ciências biológicas, organizados sob a égide da assistência de enfermagem; na exposição oral e reprodução de técnicas biomédicas; na desarticulação entre teoria e prática e no isolamento do trabalho docente. Concluiu-se que as competências docentes nas dimensões educacionais, organizacionais e relacionais precisam ser ampliadas em direção ao planejamento da ação pedagógica, aproximando-se dos referenciais teóricos e filosóficos do SUS e da educação contemporânea, em busca de uma prática integrada, coletiva, democrática, promotora da saúde e da qualidade de vida.

Abstract The pedagogical preparation of educators in the health area, in the face of the demands of contemporary education and of the Brazilian curriculum guidelines, is directly related to the training of professionals to meet the needs of the Unified Health System. Based on this premise, this study investigates the training profile, the bases of the action, and the pedagogical planning of the professor of nursing who is the advisor of the internship in Collective Health at colleges in two mid-western municipalities in the state of São Paulo, Brazil, under the light of the public policies of education and health. The data obtained were submitted to thematic content analysis. The analysis showed that the pedagogical practice of the 11 professors surveyed was influenced by the institutional culture of Brazilian higher education. Routine activities were modeled based on biological science contents, organized under the aegis of nursing care; on oral and reproductive biomedical techniques; on the disarticulation between theory and practice, and on the isolation of teaching. It was concluded that the teaching skills in the educational, organizational, and relational dimensions need to be enhanced towards the planning of pedagogical action, approaching the theoretical and philosophical references of the UHS and contemporary education, seeking an integrated, collective, democratic, and practice promoting health and quality of life.

Resumen La preparación pedagógica del docente del área de la salud, frente a las exigencias de la educación contemporánea y las directrices curriculares nacionales, guarda una relación directa con la formación de profesionales para atender las necesidades del Sistema Único de Salud. Fundamentado en esa premisa, este estudio buscó analizar perfil de formación, bases de la acción y planificación pedagógica del docente de enfermería orientador de la pasantía en Salud Colectiva de instituciones de enseñanza superior de dos municipios de la región centro oeste del estado de San Pablo, Brasil, a la luz de las políticas públicas de educación y salud. Los datos obtenidos se sometieron a análisis de contenido, modalidad temática. El análisis llevado a cabo señaló que la práctica pedagógica de los 11 docentes entrevistados presentaba influencia de la cultura institucional de la educación superior brasileña. Las actividades rutinarias estaban inspiradas en contenidos de las ciencias biológicas, organizados en torno a la asistencia de enfermería; en la exposición oral y reproducción de técnicas biomédicas; en la desarticulación entre teoría y práctica y en el aislamiento del trabajo docente. Se concluyó que las competencias docentes en las dimensiones educativas, organizacionales y relacionales deben ser ampliadas en dirección a la planificación de la acción pedagógica, aproximándose a las referencias teóricas y filosóficas del SUS y de la educación contemporánea, en busca de una práctica integrada, colectiva, democrática, promotora de la salud y la calidad de vida.

Study on clinical internship for clinical pharmacy bachelor bridged to clinical pharmacist training / 中华医学教育探索杂志

Clinical internship is for bachelor students to learn how to integrate theories in textbooks with clinical practice.Clinical pharmacist training is for pharmacists to obtain and enforce the capability of rational use of drugs.These two are at the different stages of clinical pharmacist cultivation mode.They are different in teaching nature,goal and students' background.The necessity of clinical internship bridged to clinical pharmacist training is discussed in this paper and after the convergence,the teaching design of chnical internship program bridged to the training is characterized by basic education which focuses on basic theories,knowledge and skills of clinical medicine and clinical pharmacy relevant to a certain common disease.The optimized internship program will work as a good foundation for students to face the challenges of clinical pharmacist training after graduation from school.

Application of flipped classroom in training of basic nursing manipulation for undergraduate nursing students / 现代临床护理

Objective To explore the effect of flipped classroom on basic nursing operation training for undergraduate nursing students. Methods One hundred full-time nursing undergraduate students now conducting clinical internship in our hospital were randomized equally into experiment group and control group. The control group was treated with traditional teaching model in three nursing operation modules including intravenous infusion , venous blood collection and intramuscular injection while the teaching methodology of flipped classroom was used in the experiment group. The two groups were compared in terms of performances in theoretical knowledge and skills and the evaluation from the students. Results The achievements of the experiment group was significantly better than those of the control group in respect of achievements in the examinations of three theoretical knowledge and nursing operation skills (P<0.01). More than 88.00%nursing students agreed on the teaching mode in the aspects of learning attitude and knowledge mastering, more than 90.00%nursing students accepted this teaching mode in the aspect of ability and 96.00%of them would like to adopt this mode. Conclusions The methodology of flipped classroom is effective in cultivating the habit of nursing students′autonomous learning. It also stimulates the nursing students′interest in learning and improves the quality of teaching.