Actitud ante la pesquisa en estudiantes de las Ciencias Médicas de Cuba durante la COVID-19

RESUMEN Introducción: durante la situación epidemiológica existente por la COVID-19, los estudiantes de las ciencias médicas de Cuba desempeñaron labores de pesquisa activa. Objetivo: caracterizar la actitud ante la pesquisa en estudiantes de las Ciencias Médicas de Cuba durante la COVID-19. Método: estudio multicéntrico, observacional, descriptivo y transversal en estudiantes de las Ciencias Médicas de Cuba en el mes de julio de 2020. La muestra la constituyeron 200 estudiantes seleccionados mediante un muestreo tipo Snow boll. Para la recolección de la información se empleó un formulario de Google (Google Forms). Resultados: Se encontró predominio de estudiantes del sexo femenino (66,5 %), de edades entre 18 y 20 años (56,5 %), de la carrera de medicina (92,5 %) y del tercer año (25,5%). El 34,5% de los encuestados provenían de las universidades médicas de Holguín y Pinar del Río. El 87,5 % de los estudiantes encuestados refirieron haberse incorporado a la realización de las pesquisas activas, en el 87,0 % de los casos los familiares no presentaron ninguna objeción. El 66,0 % de los estudiantes encuestados le encontraron utilidad a esta tarea. El 79,5 % afirmó que su incorporación a la realización de las pesquisas activas en tiempos de la pandemia COVID-19 tuvo una gran influencia en su formación tanto profesional como humanista. El 68,5 % de los estudiantes manifestaron sentir apoyo de las distintas instituciones de salud. Conclusiones: Se mostró una gran disposición por parte de los estudiantes de Ciencias Médicas a la realización de la pesquisa activa

ABSTRACT: Introduction: during the epidemiological situation due to COVID-19, Cuban medical science students carried out active research tasks. Objective: to characterize the attitude towards the investigation in students of the Cuban Medical Sciences during COVID-19. Method: multicenter, observational, descriptive and cross-sectional study in Cuban Medical Sciences students in the month of July 2020. The sample consisted of 200 students selected by means of a Snow boll type sampling. To collect the information, a Google form (Google Forms) was used. Results: It was found a predominance of female students (66.5%), aged between 18 and 20 years (56.5%), of the medical career (92.5%) and of the third year (25.5 %). 34.5% of those surveyed came from the medical universities of Holguín and Pinar del Río. 87.5% of the surveyed students reported having joined the active investigations, in 87.0% of the cases the relatives did not present any objection. 66.0% of the surveyed students found this task useful. 79.5% affirmed that their incorporation into conducting active investigations in times of the COVID-19 pandemic had a great influence on their professional and humanistic training. 68.5% of the students expressed feeling support from the different health institutions. Conclusions: A great disposition was shown on the part of the students of Medical Sciences to carry out the active research.

Trabajo comunitario integrado de estudiantes de Ciencias Médicas frente a la COVID-19, Policlínico Rampa, 2020 / Integrated Community Work of Medical Sciences Students Facing COVID-19, Rampa Community Clinic, 2020

Introducción: En Cuba se realizan colosales esfuerzos para la prevención y control de la COVID-19, como es el pesquisaje activo realizado por estudiantes de Ciencias Médicas, a modo de trabajo comunitario integrado a la propia comunidad. Objetivo: Caracterizar el trabajo comunitario integrado desarrollado por estudiantes de Ciencias Médicas en el enfrentamiento a la COVID-19 en el área de salud del Policlínico Rampa. Métodos: Se realizó un estudio observacional de tipo descriptivo, retrospectivo, longitudinal, para analizar los datos provenientes del trabajo comunitario integrado. La pesquisa tuvo una primera etapa, entre marzo-julio 2020, al inicio de la pandemia en el país, y una segunda en septiembre-octubre 2020, dada la contingencia sanitaria existente en la capital. Se analizaron esencialmente las viviendas visitadas y las cerradas, personas pesquisadas, cantidad de adultos mayores, así como los sospechosos de contagio diarios. La evaluación del trabajo comunitario integrado se basó en la asistencia y la calidad de la pesquisa. Resultados: Se pesquisó como promedio por día el 21 por ciento del universo poblacional en la primera etapa y el 35 por ciento en la segunda etapa. El número de sospechosos detectados fue bajo. El número de viviendas visitadas y de adultos mayores pesquisados fue también superior durante la segunda etapa. Aunque el trabajo comunitario integrado fue más productivo y mejor evaluado en esa etapa, se consideró meritoria la pesquisa activa desarrollada por los estudiantes en ambos periodos. Conclusiones: El trabajo comunitario integrado realizado por estudiantes de las Ciencias Médicas, además de ser parte de su formación integral, representa un aporte necesario para enfrentar la COVID-19, de gran relevancia en un área con elevada prevalencia de adultos mayores(AU)

Introduction: In Cuba, boundless efforts are being made for the prevention and control of COVID-19, such as the active screening carried out by students of Medical Sciences, as a community work integrated into the community itself. Objective: To describe the integrated community work fulfilled by students of Medical Sciences in the confrontation with COVID-19 in the health area of Rampa community clinic. Methods: An observational, descriptive, retrospective, longitudinal study was carried out to analyze the data from integrated community work. The investigation had a first stage, from March to July 2020, at the beginning of the pandemic in the country, and a second stage from September to October 2020, given the existing health contingency in the capital city. Essentially, the homes visited and closed were analyzed, as well as the people surveyed, the number of older adults, and the daily contagion suspects. The evaluation of integrated community work was based on the assistance and the quality of the research. Results: An average of 21percent of the population universe was surveyed per day in the first stage and 35percent in the second stage. The number of suspects detected was low. The number of homes visited and aged adults surveyed was also higher during the second stage. Although integrated community work was more productive and better evaluated in this stage, the active research carried out by the students in both periods was considered meritorious. Conclusions: The integrated community work carried out by students of Medical Sciences, in addition to being part of their comprehensive training, represents a necessary contribution to face COVID-19, of great relevance in an area with a high prevalence of aged adults(AU)

Contribución de la pesquisa estudiantil al enfrentamiento al COVID-19 en un área de salud / Contribution of the student research to the confrontation with COVID-19 in a health area

RESUMEN Fundamento: con los primeros casos de COVID-19 aparejado al desarrollo posterior de la enfermedad en Cuba se determinó la puesta en marcha de la pesquisa activa con un fuerte apoyo de los estudiantes de las ciencias médicas, con el antecedente del apoyo brindado por estos en campañas contra enfermedades transmisibles y los favorables resultados obtenidos. Objetivo: describir la contribución de la pesquisa estudiantil en el enfrentamiento a la COVID-19 en el Policlínico Universitario Ignacio Agramonte y Loynaz de Camagüey. Material y Métodos: se realizó un estudio cuantitativo, descriptivo, retrospectivo de los resultados relevantes de la pesquisa realizada por los estudiantes de las Ciencias Médicas, para identificar los pacientes con sintomatología respiratoria y brindar actividades educativas en el trimestre abril-mayo-junio del 2020 en el Policlínico Universitario Ignacio Agramonte de Camagüey. Resultados: Los valores más altos de la media diaria de los parámetros controlados fueron alcanzados en mayo con el 96.35% de casas visitadas, 90.54% de personas pesquisadas, 96.26% de mayores de 60 años y 92.76% de ancianos solos. Los principales síntomas encontrados fueron fiebre (44), secreción nasal (41) y dolor de garganta (55), realizándose un total de 897 092 actividades educativas. Conclusiones: la pesquisa estudiantil permitió identificar personas con sintomatología respiratoria, logró realizar la visita de un elevado porcentaje de viviendas y dentro de los pesquisados los adultos mayores tuvieron un número significativo. Las actividades de promoción de salud resultaron las herramientas utilizadas en el proceso de pesquisa activa.

ABSTRACT Background: with the first cases of COVID-19 coupled with the subsequent development of the disease in our country, it determined the start of the active research with strong support from medical science students, with the antecedent of the support provided by them in campaigns against communicable diseases and the favorable results obtained. Objective: to describe the contribution of the student research in the confrontation with COVID-19 at the university clinic Ignacio Agramonte y Loynaz in Camagüey. Material and Methods: a quantitative, descriptive, retrospective study of the relevant results of the research carried out by students of Medical Sciences was carried out, to identify patients with respiratory symptoms and provide educational activities in the April-May-June quarter of 2020 at the university clinic Ignacio Agramonte y Loynaz in Camagüey. Results: the highest values of the daily mean of the controlled parameters were reached in May with 96.35 % of houses visited, 90.54 % of people surveyed, 96.26 % of those over 60 years old and 92.76 % of the elderly alone. The main symptoms found were fever (44), runny nose (41) and sore throat (55), carrying out a total of 897 092 educational activities. Conclusions: the student research allowed identifying people with respiratory symptoms, managed to visit a high percentage of homes and among those surveyed, older adults had a significant number. Health promotion activities were tools in the active research for the containment of the disease.

Pesquisa activa, contribución desde la Atención Primaria de Salud para el control de la COVID-19 / Active research, contribution from the Primary Health Care for the control of COVID-19

RESUMEN Los primeros casos de enfermos por la COVID-19 o Síndrome respiratorio agudo severo por coronavirus 2, (SARS-CoV-2) se reportaron en China, extendiéndose rápidamente por todo el mundo, lo que hizo considerarla como una nueva pandemia. El objetivo fue describir algunas particularidades de la pesquisa activa, en la Atención Primaria de Salud, para la detección de casos sintomáticos, contactos y sospechosos de la enfermedad. La pesquisa activa posibilita utilizar los recursos humanos propios de cada territorio: médicos, enfermeras, tecnólogos, estudiantes, promotores de salud, debidamente capacitados sobre el problema que se va a investigar. Logra la cobertura, amplitud y sostenibilidad necesarias para detectar precozmente la enfermedad, de ahí que sea una peculiaridad de Cuba en el enfrentamiento a la COVID-19. Esta experiencia de intervención social, ha sido utilizada como una herramienta para el control de este problema de salud, junto a otras, que logran aumentar los conocimientos de la población, fomentar la participación comunitaria y promover cambios en los comportamientos de riesgo, incluyendo el incremento de la precepción y la auto- responsabilidad. La pesquisa activa de la COVID-19, constituye un método de trabajo en la Atención Primaria de Salud. Esta tecnología sanitaria, contribuye a detectar casos presuntivos o sospechosos y sus contactos, y diagnosticar la enfermedad en estadios iniciales. La educación para la salud durante el enfrentamiento antipandémico, contribuye a la disminución del número y la gravedad de los enfermos (AU).

SUMMARY The first cases of patients with COVID-19 or Severe Acute Respiratory Syndrome due to Coronavirus 2, (SARS-CoV-2) were reported in China, spreading rapidly throughout the world, which made it consider as a new pandemic. To describe some peculiarities of active research in Primary Health Care, for the detection of symptomatic cases, contacts and suspects of the disease. Active research makes it possible to use the human resources of each territory: doctors, nurses, technologists, students, health promoters, duly trained on the problem to be investigated. It achieves the necessary coverage, breadth and sustainability to detect the disease early, hence it is a peculiarity of Cuba in the confrontation with COVID-19. This experience of social intervention has been used as a tool for the control of this health problem, along with others, which manage to increase the knowledge of the population, encourage community participation and promote changes in risk behaviors, including increasing of perception and self-responsibility. The active investigation of COVID-19 constitutes a working method in Primary Health Care. This health technology contributes to detecting suspected or suspected cases and their contacts, and diagnosing the disease in early stages. Health education during the pandemic confrontation contributes to the decrease in the number and severity of patients (AU).

Caracterización del comportamiento académico en estudiantes de medicina frente a la pesquisa de la COVID-19 / Characterization of academic behavior in medical students against the COVID-19 research / Caracterização do comportamento acadêmico de estudantes de medicina frente à pesquisa COVID-19

RESUMEN Introducción: la pesquisa activa de la COVID-19 por estudiantes de medicina, permite la detección de casos sospechosos y positivos de la enfermedad y potencian las habilidades de la asignatura Medicina Comunitaria. Objetivo: determinar el comportamiento académico frente a la pesquisa activa en los estudiantes de segundo año de la carrera Medicina pertenecientes al municipio Manzanillo, así como las habilidades prácticas adquiridas que justifican los contenidos proporcionados por la asignatura Medicina Comunitaria; en el período del 17 de marzo al 15 de mayo del 2020. Método: se realizó estudio observacional-descriptivo-transversal. El universo constituido por 170 estudiantes, distribuidos en las cinco áreas de salud del municipio. Se estudiaron variables como: áreas de salud del territorio, sexo, evaluación de las actividades, vías de adquisición de conocimientos y habilidades adquiridas. Los datos fueron procesados según la estadística descriptiva. Resultados: la totalidad de los estudiantes designados por la facultad fueron incorporados a la pesquisa, predominó las femeninas con el 85,3% y evaluación de excelente en las actividades realizadas en el 88,8%. La capacitación impartida por profesores del segundo año fue la vía principal de adquisición de conocimientos con 98,8%. Consiguieron y consolidaron las habilidades propuestas por la asignatura Medicina Comunitaria. Conclusiones: existió mayor cantidad de estudiantes participando en la pesquisa en la Policlínica Universitaria Francisca Rivera Arocha. Predominaron las féminas con evaluaciones de excelente en las actividades realizadas. La vía principal de adquisición de los conocimientos fue mediante la capacitación dirigida por el colectivo de profesores del segundo año de la carrera de Medicina y lograron adquirir y consolidar las habilidades propuestas por la asignatura Medicina Comunitaria.

ABSTRACT Introduction: the active research of the COVID-19 by medical students, allows the detection of suspicious and positive cases of the disease and enhances the skills of the Community Medicine subject. Objective: to determine the academic behavior against the active research in the second year students of the Medicine career belonging to the Manzanillo municipality, as well as the acquired practical skills that justify the contents provided by the Community Medicine subject; in the period from March 17 to May 15, 2020. Method: an observational-descriptive-cross-sectional study was carried out. The universe made up of 170 students, distributed in the five health areas of the municipality. Variables such as: health areas of the territory, sex, evaluation of activities, ways of acquiring knowledge and acquired skills were studied. The data was processed according to descriptive statistics. Results: all the students designated by the faculty were incorporated into the research, the female ones predominated with 85.3% and the evaluation of excellent in the activities carried out in 88.8%. The training given by second year teachers was the main way of acquiring knowledge with 98.8%. They achieved and consolidated the skills proposed by the Community Medicine subject. Conclusions: there was a greater number of students participating in the research at the Francisca Rivera Arocha University Polyclinic. Females predominated with excellent evaluations in the activities carried out. The main way of acquiring knowledge was through training led by the group of teachers of the second year of the Medicine career and they managed to acquire and consolidate the skills proposed by the Community Medicine subject.

RESUMO Introdução: a pesquisa ativa do COVID-19 por estudantes de medicina, permite a detecção de casos suspeitos e positivos da doença e aprimora as habilidades da área de Medicina Comunitária. Objetivo: determinar o comportamento acadêmico frente à pesquisa ativa nos estudantes do segundo ano da carreira de Medicina pertencentes ao município de Manzanillo, bem como as habilidades práticas adquiridas que justificam o conteúdo fornecido pela disciplina de Medicina Comunitária; no período de 17 de março a 15 de maio de 2020. Método: estudo observacional-descritivo-transversal. O universo foi composto por 170 estudantes, distribuídos nas cinco áreas de saúde do município. Foram estudadas variáveis ​​como: áreas de saúde do território, sexo, avaliação de atividades, formas de aquisição de conhecimentos e habilidades adquiridas. Os dados foram processados ​​de acordo com a estatística descritiva. Resultados: todos os alunos designados pelo corpo docente foram incorporados à pesquisa, os do sexo feminino predominaram com 85,3% e a avaliação de excelente nas atividades realizadas em 88,8%. A formação ministrada pelos professores do segundo ano foi a principal forma de aquisição de conhecimento com 98,8%. Eles alcançaram e consolidaram as habilidades propostas pela disciplina de Medicina Comunitária. Conclusões: houve um maior número de estudantes participantes da pesquisa na Policlínica Francisca Rivera Arocha University. O sexo feminino predominou com excelentes avaliações nas atividades realizadas. A principal forma de aquisição de conhecimento foi por meio da formação liderada pelo grupo de professores do segundo ano da carreira em Medicina e eles conseguiram adquirir e consolidar as habilidades propostas pela disciplina de Medicina Comunitária.

La pesquisa activa. Primer eslabón del enfrentamiento a la COVID-19 en el Policlínico Docente "Antonio Maceo" / Active research. First link in the confrontation with the COVID-19 in Antonio Maceo Teaching Polyclinic

Introducción: Las circunstancias que envuelven la aparición y desarrollo de la COVID-19, requirió se pusiera en marcha un programa de pesquisaje activo en todo el país, apoyados en las experiencias de campañas anteriores ante enfermedades transmisibles, adoptándose nuevas estrategias ajustadas a las actuales circunstancias. Objetivo: Describir los resultados de la pesquisa activa como estrategia de enfrentamiento a la COVID-19 en el Policlínico Docente Antonio Maceo. Material y Métodos: Se realizó un estudio cuantitativo, descriptivo, con carácter retrospectivo de los resultados de la pesquisa activa realizada por estudiantes y profesores, para identificar personas con sintomatología respiratoria de la COVID- 19, del 1 al 30 de abril. Se utilizó el cálculo de promedio y porcentaje como métodos descriptivos. Resultados: En 90,3 por ciento de las viviendas visitadas por día se alcanzó pesquisar 85 por ciento de estas, por Consultorio Médico de la Familia y 63,5 por ciento de los habitantes. Se identificaron personas con sintomatología respiratoria en 96,6 por ciento de los consultorios. Conclusiones: El trabajo realizado a través de la pesquisa activa, permitió identificar casos con síntomas respiratorios relacionados con la COVID-19. Se logró pesquisar diariamente de manera efectiva un alto porciento de viviendas y adultos mayores. Las acciones de promoción de salud realizadas por estudiantes y profesores con la oportuna vigilancia por el Médico y Enfermera de la Familia fueron elementos fundamentales que contribuyeron a detener el avance de la enfermedad(AU)

Introduction: The circumstances that involve the emergence and development of COVID-19, required the implementation of an active research program throughout the country supported by the experiences from previous campaigns against communicable diseases, adopting new strategies adapted to the current circumstances. Objective: To describe the results of the active research as a strategy to confront the COVID-19 in the Antonio Maceo Teaching Polyclinic. Material and Methods: A quantitative, descriptive, retrospective study of the results of the active research made by students and teachers to identify people with respiratory symptoms of COVID-19 was conducted from April 1srt to April 30th. The calculation of average and percentage was used as descriptive methods. Results: Of the 90.3 percent of the homes visited daily, 85 percent of them and 63.5 percent of the inhabitants were investigated by the Family Doctor´s Offices. Persons with respiratory symptoms were identified in 96.6 percent of the doctor´s offices. Conclusions: The work carried out through the active research allowed to identify cases with respiratory symptoms related to COVID-19. A high percentage of houses and elderly people were effectively investigated daily. The health promotion actions carried out by students and teachers with the timely surveillance by the Family Doctor and Family Nurse were fundamental elements that contributed to stop the advance of the disease(AU)

Experiencia de la pesquisa activa de COVID-19 en Cienfuegos / Experience the active search of COVID-19 in Cienfuegos

RESUMEN Introducción: La pesquisa incluye acciones para identificar estado de salud individual en grupos de población y factores de riesgo; se emplea, además, para descubrir de forma temprana la morbilidad oculta. Objetivo: Describir el comportamiento del pesquisaje activo de COVID 19 realizado por estudiantes de las ciencias médicas en el área 3 del municipio de Cienfuegos y proponer acciones para su perfeccionamiento. Método: estudio descriptivo de corte transversal realizado entre el 19 de marzo y el 2 de mayo de 2020. Aplicados métodos teóricos que de conjunto con la revisión documental del reporte diario de la actividad de los 130 estudiantes y la dinámica grupal permitieron cumplimentar los propósitos previstos. Resultados: La asistencia de los estudiantes disminuyó los fines de semana, así como otros indicadores como son las viviendas visitadas, pacientes pesquisados y viviendas cerradas. Los pacientes con infecciones respiratorias agudas (IRA) decrecieron y aumentó la diferencia entre viviendas a visitar y visitadas diariamente. Como resultado de la dinámica grupal realizada, se proponen acciones de planificación y organización de la pesquisa donde destacan la reasignación de universo, capacitación de estudiantes y el registro de información; las acciones de ejecución se dirigen a reordenar la actividad y ampliar las actividades de promoción realizadas. Las acciones de control refuerzan los mecanismos supervisión de la actividad, así como la divulgación y reconocimiento de los mejores resultados de trabajo. Discusión: Una vez confrontados los resultados con otros estudios y experiencias, las insuficiencias identificadas en las primeras semanas de pesquisa posibilitaron proponer un grupo de acciones para perfeccionar el proceso dirigidas a la planificación y organización, ejecución y control de la actividad.

ABSTRACT Introduction: The research includes actions to identify individual health status in population groups, identify risk factors and discover hidden morbidity early. Objective: to describe the behavior of the COVID 19 active screening carried out by students of medical sciences in area 3 of the municipality of Cienfuegos and propose actions for its improvement. Method: Descriptive cross-sectional study carried out between March 19 and May 2, 2020. Theoretical methods applied that together with the documentary review of the daily report of the activity of the 130 students and the group dynamics allowed to fulfill the planned objectives. Results: Student attendance decreased on weekends, as well as other indicators such as houses visited, patients searched and houses closed. Patients with acute respiratory infections (ARI) decreased and the difference between dwellings to be visited and visited daily increased. As a result of the group dynamics carried out, research planning and organization actions are proposed, highlighting the reassignment of the universe, student training and information registration; the execution actions are aimed at reordering the activity and expanding the promotional activities carried out; finally, the control actions reinforce the mechanisms for supervising the activity, as well as the dissemination and recognition of the best work results. Discussion: Once confronted the results with other studies and experiences, the insufficiencies identified in the first weeks of research made it possible to propose a group of actions to improve the process aimed at planning. and organization, execution and control of the activity.

Opiniones de actores de salud sobre la estrategia de búsqueda activa de casos de tuberculosis / Opinions of health stakeholders on the active search strategy for tuberculosis cases

Introducción: La pesquisa activa de casos de tuberculosis en la Atención Primaria de Salud como parte del programa de control de la enfermedad en Cuba, tiene retos de implementación que requieren ser estudiados. Objetivo: Explorar las opiniones de los actores de salud involucrados en la implementación de la pesquisa activa de casos de tuberculosis en Las Tunas. Métodos: Se realizó un estudio cualitativo, en dos etapas, anidado en un estudio de intervención en Las Tunas. En la primera etapa (septiembre-diciembre, 2010) se entrevistaron médicos y enfermeras de la familia de los municipios Jobabo y Las Tunas; y en la segunda etapa (marzo, 2012), todos los jefes de programa (provincial y municipales) y un experto en tuberculosis. Se utilizaron categorías de análisis deductivas e inductivas. Resultados: La pesquisa activa de casos de tuberculosis se reconoció como un procedimiento novedoso asociado a la búsqueda de sintomáticos respiratorios en el hogar, la dispensarización y el trabajo con grupos vulnerables. Al inicio hubo barreras para la implementación del procedimiento, posteriormente fue aceptado. Las ventajas fueron: diagnóstico oportuno e incremento del número de casos pesquisados, entre otras. La falta de tiempo, el incremento en la carga de trabajo y la fluctuación del personal fueron las principales dificultades. Conclusiones: El estudio proporciona información valiosa para la implementación del procedimiento como parte del programa de control de la tuberculosis. Devela la brecha entre la percepción de los actores involucrados en la implementación de intervenciones en salud en estudios pilotos y la que tienen los implicados en su puesta en práctica(AU)

Introduction: The active case finding of tuberculosis in Primary Health Care as part of the disease control program in Cuba, has challenges at implementation that need to be studied. Objective: To explore the opinions of the health stakeholders involved in the implementation of active case finding of tuberculosis in Las Tunas. Methods: A qualitative study was carried out in two stages, nested in an intervention study in Las Tunas. In the first stage (September-December, 2010) family doctors and nurses in Jobabo and Las Tunas municipalities were interviewed; and in the second stage (March 2012), all program managers (provincial and municipal) and an expert on tuberculosis were interviewed. Deductive and inductive analysis categories were used. Results: The active case finding of tuberculosis was recognized as a novel procedure associated with the screening for respiratory symptoms among all family members during home visits, classification of the entire population into risk groups and working with vulnerable groups. At the beginning there were barriers to the implementation of this procedure, which was subsequently accepted. Timely diagnosis and increase in the number of cases investigated were the advantages, among others. The lack of time, the increase in workload and the staff turnover were the main difficulties. Conclusions: This study provides valuable information for implementing this procedure as part of tuberculosis control program. It reveals the gap between the perception of the stakeholders involved in the implementation of health interventions in pilot studies and from those engaged in their implementation(AU)

A model for attracting physicians to rural areas by improving residency training programs, part 1 / 医学教育

A shortage of physicians in rural areas has become a serious problem of the new residency training program in Japan. To address this problem, we propose a model for attracting physicians to rural areas by improving residency training programs and by evaluating a curriculum introduced at Kainan Hospital, a community hospital. In this first paper, we describe the short-term evaluation of the curriculum.1) We introduced clinical teams in which residents were able to actively participate in clinical practice as team members by being supervised by senior physicians. We also introduced teaching rounds and case conferences for residents.2) Focus-group interviews of residents showed that "giving educational opportunities to residents" and "an explicit policy of the hospital to improve the residency training program" are examples of ways to improve residency programs.3) The number of residents working at Kainan Hospital increased. The residency training program was somewhat improved.4) An effective and easily generalized way to provide residents with more learning opportunities is to involve clinicians in teaching residents in hospitals.

Extensão Universitária e Formação Médica: Uma Análise da Experiência dos Bolsistas no Programa Escola Cidadã

Resumo: Relata-se uma experiência universitária no programa de Extensão "Escola Cidadã" - parceria UNI-RIO/município de Queimados, objetivando0 formar uma rede interdisciplinar de apoio ao ensino fundamental. Sob a ótica da pesquisa qualitativa, enfoca atividades do grupo de alunos de Medicina, utilizamos: questionários de avaliação, respondidos pelos bolsistas em 1996; observação de campo, atas, plano de ação e relatórios de 1996 e 1997. O trabalho de Extensão: proporcionou aos alunos o conhecimento de uma realidade social que validou e interligou as diferentes disciplinas do currículo; permitiu a concretização e conhecimentos de cunho social e humanístico, mostrando a necessidade de uma formação social para o médico; possibilitou o trabalho interprofissional (Medicina, Biomedicina, Biologia, Enfermagem, Pedagogia, Música, Nutrição e Teatro), entrevendo a necessidade de busca de interdisciplinaridade. Ao fomentar "o estado de apetite científico" dos alunos, evidenciou que a prática de Extensão concretiza sua função articuladora entre Ensino e Pesquisa, mostrando ser indispensável a indissociabilidade das três funções universitárias para a formação de profissionais com visão participativa e crítica.

Summary: This article delas with the report of a college experience at the extension program "Escola Cidadã" - a partnership between UNI-RIO/Secretaria de Educação, Cultura e Desporto do município de Queimados (Department of Education, Culture and Soprts of the City of Queimados), aiming to build an interdisciplinary net as a support to primary schools. Analysing it under the optics of qualitative research, focusing on the activities of a group of Medical students, we have used questionnaires, answered by interns, in 1996, field observation, plans of action and reports from 1996 to 1997. The work of extension provided the students with knowledge about a social reality that legitimated and interwined the different disciplines of the course; allowed the concreting of social and humanistic knowledge; made possible an interprofessianl work (Medicine, Biomedicine, Biology, Nursing, Pedagogy, Music, Nutritionh and Drama), catching a glimpse of the need to search for interdisciplinarity; by stimulating the 'state of scientifical appetite' of the studentes, it was made evident that the practice of extension pronounces its function as the articulator between teaching and research, marking clear the indispensable indissolution of the three university functions for the formation of professionals with a critical, participative vision.