Cursos realizados pelo Canal Minas Saúde: percepções dos profissionais que atuam na atenção primária / Cursos realizados por el Canal Minas Salud: percepciones de los profesionales de la atención primaria / Courses offered by the Minas Health Channel: perception of primary care workers

RESUMO Objetivo Analisar a percepção dos profissionais de saúde que atuam na atenção primária sobre a contribuição dos cursos realizados pelo Canal Minas Saúde no seu processo de trabalho. Método Estudo exploratório, descritivo, com abordagem qualitativa do qual participaram 38 profissionais que atuam na atenção primária de três municípios pertencentes ao Estado de Minas Gerais. A coleta de dados ocorreu em 2014, com entrevistas semiestruturadas, sendo os dados analisados por meio da análise de conteúdo temática. Resultados Da análise dos dados emergiram três categorias: interesse pela capacitação e sua contribuição para a prática profissional; fatores intervenientes para mudança da prática profissional; e propostas de melhoria. Conclusão A análise dos dados evidencia que os cursos ofertados pelo Canal Minas Saúde ainda são insuficientes para a modificação da prática profissional. Faz-se necessário incorporar os pressupostos da educação permanente para possibilitar a articulação dos saberes necessários à transformação da prática.

RESUMEN Objetivo Analizar las percepciones de los profesionales de la salud que desempeñan sus tareas en la atención primaria sobre los cursos realizados por el Canal Minas Salud en cuanto a su contribución al proceso de trabajo. Método Investigación exploratoria, descriptiva, tipo cualitativa, en la cual participaron 38 profesionales de la atención primaria de salud de tres municipalidades del Estado de Minas Gerais. Los datos, recogidos en 2014 mediante entrevista semiestructurada, fueron analizaron según el análisis de contenido temático. Resultados Del análisis de los datos emergieron tres categorías temáticas: interés en la capacitación y su contribución a la práctica profesional; factores que intervienen en el cambio de la práctica profesional y propuestas de mejora. Conclusión El análisis de datos indica que los cursos ofrecidos por el Canal Minas Salud no son suficientes para modificar la práctica profesional. Habría que incorporar los principios de la educación continua en salud para permitir la articulación de los conceptos necesarios para la transformación de la práctica profesional.

ABSTRACT Objective To analyse how primary healthcare workers perceive the impact of the Health Channel Mines courses in their work process. Method This is a descriptive exploratory qualitative study conducted with 38 professionals working in primary health care units of three municipalities in the state of Minas Gerais, Brazil. Data were collected in 2014 by means of semi-structured interviews and subjected to thematic content analysis. Results Data analysis revealed the following three categories: interest in training and its contribution to professional practice; factors that alter professional practices; and proposals for improvement. Conclusion The study data demonstrated that the Mines Health Channel courses cannot single-handedly change professional practices. Continued and refresher education resources that enable the exchange and articulation of knowledge between the various specialities are needed to transform professional practices.

How can the postgraduate training program in pathology departments in India be improved.

There exists a wide variation in the competence of the postgraduate residents trained in pathology in different institutions across India. This results in strong disparities in the clinical diagnostic skills, teaching skills, research capabilities and the managerial skills of the graduates. The end users of this training, namely the community, clinicians and health care institutions would benefit from a more uniform and better trained pathologist. The article reviews the reasons for the variation in the quality of the training programs. The main deficiencies include, lack of well-defined criteria for recruitment of residents, training facilities, faculty resources, curriculum with well-defined learning objectives and competencies, hands-on experiences in diagnostic and research activities, diagnostic specimens and medical autopsies, exposure to molecular pathology, pathology informatics, electron microscopy, research experiences, communication skills, professional behavior and bioethics, business practices in pathology and quality assurance. There is also a lack of defined career tracks in various disciplines in laboratory medicine, standard protocols for evaluation and regional and national oversight of the programs. The steps for rectification should include defining the competencies and learning objectives, development of the curriculum including teaching methods, facilities and evaluation strategies, communication skills, professional behavior skills, teaching skills, legal aspects of practicing pathology and the various career pathways to subspecialties in pathology. The training should include defined exposure to molecular pathology, electron microscopy, quality control and assurance, laboratory accreditation, business aspects of pathology practice, review of literature, evidence-based medicine, medical autopsy and medical informatics. Efforts should be made to share human and laboratory resources between regional cooperation. The oversight and accreditation policies should be evolved and well-documented. Web-based platforms need to be developed for easy interaction among residents, faculty and administrators on a national level.

Avaliação dos cursos de extensão universitária realizados pela Faculdade de Medicina de Ribeirão Preto da USP entre 2002 e 2008 / Evaluation of the university extension courses promoted by the Medical School of Ribeirão Preto of the University of São Paulo between 2002 and 2008

Introdução: A RESOLUÇÃO da Comissão de Cultura e Extensão da Universidade de São Paulo- CoCEx-5072 da Universidade de São Paulo(USP) regulamentou os cursos de extensão universitária. A Faculdade de Medicina de Ribeirão Preto da USP(FMRP-USP) passou a incentivar que diversos cursos não regulamentados fossem oficializados. Diversos empecilhos foram detectados, sendo necessário reavaliar o processo. Metodologia: Foram avaliados 106 cursos de extensão universitária realizados entre 2002 e 2008. Obteve-se dados referentes ao tipo de curso, Departamento responsável, regularidade e número de vagas oferecidas, comparando-se com a situação dos cursos no Sistema Apolo-USP. O trâmite dos processos foi avaliado através da diferença em dias entre o início e o final do processo. Todos os cursos que tiveram os certificados emitidos e anexados ao processo foram classificados como concluídos. Resultados: 1) O número de cursos regulamentados realizados pela FMRP-USP é baixo, sendo muito inferior à sua potencialidade; 2) A maioria dos cursos compreende cursos de curta duração (Difusão) esão reproduzidos em caráter anual; 3) A Comissão de Cultura e Extensão da FMRP-USP não dispõe de pessoal suficiente para gerenciamento dos cursos, dificultando ações de orientação e tramitação de processos...

Background: University of São Paulo(USP) CoCEx-5072 resolution regulates university extension courses. The Medical School of Ribeirão Preto USP(MSRP-USP) has adhered and incentivates documentation of all courses conducted. Several problems were identified, being mandatory process reconducted between 2002 and 2008 were evaluated. Data regarding course type, duration, regularity and number of attendees were recovered and compared with the official USP Apolo web system. Duration of process was calculated through the difference between date of beggining and end of process. All courses were considered concluded when certification was emited. Results: 1)The number of courses conducted by MSRP-USP is low, much inferior to its potential; 2) Th majority of courses comprehends short duration courses (Difusion) conducted on a yearly basis; 3)There were problems with personal for guiding and documenting the courses in the MSRP-USP...

O Compadrio nos Eventos Científicos da Tocoginecologia Sócio Ativo

É inegável a importância dos eventos científicos na educação médica continuada do tocoginecologista nas diversas áreas de conhecimento da especialidade. Os cursos, seminários, jornadas e congressos responsabilizam-se sobremaneira pelo ensinamento e pela sedimentação dos avanços tecnológicos e farmacológicos que, diuturnamente, são incorporados à atividade médica, além de contribuírem para a atualização e reciclagem em temas básicos da prática tocoginecológica.

Evaluación de un programa de educación médica continua para la atención primaria en la prescripción de hipoglucémicos / An evaluation of a continuing medical education program for primary care services in the hypoglycemic agent’s prescription in diabetes mellitus type 2

OBJETIVO: Evaluar el efecto en la prescripción de hipoglucémicos de un programa de educación médica continua en unidades de medicina familiar (UMF). MATERIAL Y MÉTODOS: Se realizó un estudio observacional que comparó dos grupos (con y sin programa) con dos cortes transversales (antes y después). La unidad de análisis fue la consulta. El periodo de análisis comprendió seis meses anteriores y seis posteriores a la institución del programa. La principal variable de resultado fue la prescripción adecuada, evaluada mediante dos criterios: elección e indicación correctas. El análisis incluyó modelos de regresión logística, se aplicó la técnica de dobles diferencias y se ajustó por variables relativas al paciente, la consulta y la UMF; las más relevantes fueron sexo, obesidad, otras afecciones, número de consultas, número de medicamentos, tamaño de la clínica, grupo y etapa. RESULTADOS: Se obtuvo un incremento atribuible al programa de 0.6 por ciento en la probabilidad de prescripción adecuada y de 11 por ciento en la elección correcta en pacientes obesos.

OBJECTIVE: To evaluate the impact of a continuing medical education program on family doctors to improve prescription of hypoglycemic drugs. MATERIAL AND METHODS: An observational study was conducted with two groups of comparison (with-without program) and before-after periods. The unit of analysis was the visit. The period of evaluation comprised six months before and six after implementing the program. The outcome variable was the appropriateness of prescription that was based upon two criteria: appropriate selection and proper indication of the drug. Logistic regression models and the double differences technique were used to analyze the information. Models were adjusted by independent variables related with the patient, the visit and the PCC, the more relevant ones were: sex, obesity, conditions other than diabetes, number of visits in the analyzed period, number of drugs prescribed, size of the PCC and period. RESULTS: the program increases 0.6 percent the probability of appropriate prescription and 11 percent the probability of appropriate choice of the hypoglycemic drug in obese patients.

The JICA training course, community-based cancer prevention for the Asian Pacific countries, fiscal years 2004 and 2005 (epidemiological approach).

Communicable diseases are still major causes of deaths in developing countries. Cancer incidence, however, increased 19% between 1990 and 2000, mainly in this same developing world (Stewart and Kleihaus, 2003), and malignant neoplasms are now the second leading cause of mortality in these countries (WHO, 2003). Limitations of medical facilities and equipment mean that prevention is indispensable for cancer control (Mikheev et al., 1994). However, human resources concerning cancer prevention are limited, and encouragement of their development should be taken as a first priority. To assist in this aim, the present training course was designed by the Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Japan, and has been annually conducted since 1999, supported by the Japan International Cooperation Agency (JICA) (Takezaki, 2001; 2002; 2003; Wakai, 2004). The course targets doctors and public health workers who are responsible for community-based cancer prevention in developing countries to promote the introduction of comprehensive procedures, focusing mainly on primary prevention but also including screening for secondary prevention of cancer.

La educación en Fundación Dolor: su historia, filosofía y fundamentos de la labor docente / Education in Fundación Dolor: history, philosophy and teaching bases

En el presente artículo se analiza fundamentalmente la filosofía que sostiene el Departamento de Docencia e Investigación de la Fundación Dolor en lo referente a la actividad docente destinada a la formación de recursos humanos calificados. Después de un breve análisis sobre la situación educativa en nuestro país, se plantea la importancia de la "modelación de la mente" como herramienta de gran jerarquía para alcanzar los mejores resultados en el educando. Sin desmerecer los adelantos tecnológicos, se considera y examina la educación presencial como sistema educativo por excelencia. Se fundamentan las razones de exámenes con respuestas abiertas sobre aquellos con respuestas sugeridas. Los criterios de farmacoeconomía en la formación del experto en dolor y medicina paliativa son remarcados con énfasis y se advierte sobre la influencia negativa que la industria farmacéutica ejerce sobre los profesionales ("prescriptor dirigido"). Finalmente, se reflexiona sobre principios ético-morales que atañen al profesional, dado que la medicina sin ética no es medicina.

Avaliação da competência médica - reflexão crítica / Assessment of medical competency - critical evaluation

A evolução exponencial do conhecimento aumentou a importância da educação médica continuada e em fomentado discussões sobre as melhores estratégias. As evidências científicas apontam que a eficácia das abordagens tradicionais tem se revelado insuficiente para cumprir os objetivos de informar e originar mudanças na conduta e na aquisição de habilidades, necessárias à prática médica. Não obstante as variadas abordagens, o aspecto mais importante na incorporação de novos conhecimentos è o compromisso pessoal em ministrar cuidado médico de alto nível. Aspecto também relevante é a tendência mundial na certificação e na recertificação dos profissionais médicos. Premido pela evolução de novas técnicas e pela demanda da sociedade por cuidados médicos cada vez mais eficientes, ocorre o aumento da exigência da competência profissional. Nesse cenário, surgem propostas tanto das entidades médicas como de órgãos governamentais no sentido de exigir dos especialistas a participação em programa de atualização em intervalo de tempo regular.

A especialização profissional / The professional specialization in cardiology

A especialização médica tornou-se necessária em decorrência dos inúmeros avanços no conhecimento das doenças e da aquisição de novas técnicas, o que repercute tanto no diagnóstico como na terapêutica. Entretanto, o tempo monstrou que não se pode deixar de lado a formação básica, e que a capacitação profissional deve ser encarada de forma séria e continuada. O título de especialista é fornecido seguindo regras explícitas dos Conselhos Regional e Federal de Medicina, por meio da Associação Médica Brasileira, esta vinculadas às sociedades de especialidades. Serve como comprovação para a sociedade civil da qualificação do profissional médico em determinada especilidade sendo válido apenas quando registrado no Conselho Regional de Medicina. A revalidação do título de especilista é um tema atual, tendo como finalidade o estímulo à educação continuada sendo uma ferramenta de comprovação do esforço desse profissional para mater-se atualizado e, portanto, preparado para oferecer a seus pacientes o que a medicina tem de mais atual.

Primary care psychiatry: pertinent Arabian perspectives

There is substantive evidence of significant psychiatric morbidity among primary care patients, mainly in the form of anxiety and depressive disorders. A careful critical approach is essential for ensuring the cultural relevance, validity and reliability of the psychiatric screening instruments used to identify such morbidity. Most psychiatric morbidity among primary care patients passes undetected by the primary care practitioners. This will inevitably lead to unnecessary investigation and medication and the continuation of suffering for patients. Comorbidity and physical presentation in most instances contribute significantly to failure to detect psychiatric disorders. To deal with this problem of hidden psychiatric morbidity, carefully designed educational and training programmes need to be tailored to address the particular weaknesses and needs of primary care doctors

Impact of the national protocol for malaria treatment on prescribing patterns in Gezira state, Sudan

A cross-sectional study to assess the impact of the national protocol for malaria treatment was conducted in a town in Gezira state, central Sudan, in 2001. Most of the 165 doctors and medical assistants interviewed [80.0%] had not been trained in the protocol and many [57.5%] were still using their own protocols. Analysis of 410 prescriptions showed chloroquine was the most common antimalarial drug used [69.5% of prescriptions]. Compared with a study before implementation of the protocol, more prescriptions met the protocol st and ards for correct chloroquine dose, whereas regimens for administration of intravenous quinine were still inadequate. The study showed a lack of continuous supervision, training and follow-up in the protocol guidelines and negative attitudes of hospital specialists towards the protocol

El desarrollo profesional médico continuo en el Uruguay de cara al siglo XXI / Continuing medical professional development in Uruguay as the country faces the 21st century

This paper outlines the evolution of the concept of continuing medical professional development in Uruguay, as that professional development has progressed from independent and varied efforts that were not coordinated or evaluated to a plan that is aimed at improving the quality of educational activities and programs and making them accessible to all the physicians in the country. In contrast to countries where scientific societies and medical associations preside over continuing professional development, in Uruguay the Graduate School of the School of Medicine of the University of the Republic has taken on managing and developing this process. The key objective of this process is for the Graduate School to work in conjunction with other leading players in professional development to create a national system of continuing medical professional development. This system should be interinstitutional and include both public and private entities. By having the key public institutions (the Graduate School and the Ministry of Public Health) working with private entities (medical associations, scientific societies, and health care institutions), there should be an adequate balance of interests. The national professional development system should work in the most decentralized manner possible and should be based on a network of units distributed around the entire country, but with centralized coordination. The system's interinstitutional character should ensure high technical and ethical standards as well as a balance among the governmental, commercial, professional, and university components. This system should serve as the basis for extending this activity to all health personnel in Uruguay. While the national system is still being finalized, the Graduate School has implemented a process of accrediting institutions that are involved in continuing professional medical development. The aim of this accreditation process is to improve the educational offerings for physicians and to generate practical experience that will serve the future system