A preceptoria médica em medicina de família e comunidade: uma proposta dialógica com a andragogia / Medical preceptorship in family and community medicine: a proposal for dialogue with andragogy

Resumo: Introdução: O Brasil está em um amplo processo de fortalecimento das residências médicas nas áreas básicas, porém existe a necessidade de um currículo estruturado para qualificar a formação do preceptor. Objetivo: Este estudo teve como objetivo construir uma matriz dialógica para orientar a formação educacional da preceptoria em medicina de família e comunidade (MFC). Método: Por meio de um estudo qualitativo-analítico, analisaram-se três programas de preceptoria médica no Brasil: Associação Brasileira de Educação Médica, Hospital Sírio-Libanês e Hospital Alemão Oswaldo Cruz. Em seguida, uma proposta formativa foi apresentada contendo macrodiretrizes que possibilitem mudanças nos processos de ensino e aprendizagem para qualificação da prática preceptora em diálogo com a andragogia. Resultado: A matriz construída norteia-se pela aprendizagem do adulto, enfatizando a autonomia do aprendiz, em detrimento do controle da aprendizagem pelo educador. Envolve cinco dimensões: direcionalidade da formação; conteúdo; estratégias pedagógicas; concepções e estrutura formativa; e relação entre saúde, educação e pesquisa. Cada uma delas agrega um conjunto de diretrizes que valorizam o contexto e os princípios da formação em serviço no SUS; o desenvolvimento de competências acerca de conteúdos da atenção, gestão e educação em saúde; concepções e estruturas pautadas pela construção de vínculos significativos entre os sujeitos envolvidos no ato educativo, respeitando seus saberes prévios e experiências; estratégias pedagógicas colaborativas, trabalho com grupos operativos e o uso de tecnologias da informação e comunicação; e o estímulo à pesquisa como princípio educativo. Conclusão: A matriz considerou as necessidades da formação em MFC, baseando-se em aspectos-chave da andragogia. Acredita-se que ela possa promover mudanças nos processos de ensino-aprendizagem dos preceptores, com o objetivo de qualificar sua prática.

Abstract: Introduction: Brazil is in a broad process of strengthening medical residencies in basic areas, but there is a need for a structured curriculum to qualify the training of preceptors. Objective: To build a dialogic matrix to guide the educational training of preceptorship in Family and Community Medicine (FFM). Methodology: Through a qualitative-analytical study, three medical preceptorship programs in Brazil were analyzed, namely: Associação Brasileira de Educação Médica, Hospital Sírio-Libanês and Hospital Alemão Oswaldo Cruz. A training proposal was subsequently presented containing macro-guidelines that allow changes in the teaching and learning processes to qualify preceptor practice in dialogue with andragogy. Results: Based on andragogy, the resulting matrix emphasized the learner's autonomy, to the detriment of the educator's control of learning. It involves five dimensions: directionality of training; contents; pedagogical strategies; training concepts and structure; and the relationship between health, education and research. Each dimension included guidelines that value: the context and principles of in-service training in the SUS; the development of competences about the contents of health care, management and education; conceptions and structures guided by the construction of significant bonds between the subjects involved in the educational act, respecting their previous knowledge and experiences; collaborative pedagogical strategies, work with operative groups and the use of information and communication technologies; and encouraging research as an educational principle. Conclusion: The matrix considered the needs of FCM training, based on key aspects of andragogy. It can promote changes in the teaching-learning processes of preceptors, with the aim of qualifying their practice.

A quasi-experimental study to compare the acquisition of basic clinical skills in novice medical students taught by George and Doto’s five-step method compared to those taught by the traditional approach (SODOTO)

Objectives: The aim of this study was to compare the acquisition of basic clinical skills by George and Doto’s five step method compared to the Traditional SODOTO approach, and to ascertain the perception of the students regarding these diverse methods. Materials and Methods: Fifty-four 2nd MBBS 1st semester students posted in the Department of Medicine at GMERS, Gotri, were enrolled for the study. After teaching the theory, both groups were taught per abdomen (P/A) examination and respiratory system (R/S) examination – one system by the five-step method and the other by the SODOTO approach. Skill acquisition was tested by pre-validated checklists. Finally, feedback was collected on the perception of students using a pre-validated questionnaire. The data were analysed using GraphPad. Results: There was an average 20% improvement (P < 0.001) in the group taught by the five-step method compared to the one taught by the traditional approach (P/A – 45.14/60 [5.64] vs. 57.86/60 [1.83] [Group B vs. Group A]) (R/S examination – 26.17/40 [6.65] vs. 34.79/40 [3.56] [Group A vs. Group B]). Conclusion: George and Doto’s five-step method has been found to be more effective than the traditional SODOTO approach.

Andragogic principles in case-based discussion among medical interns in a tertiary hospital

Background@#Andragogy, the theory of adult learning is relevant to medical education especially in the clinical internship learning context. It focuses on the students, faculty, and patients interacting together while developing competencies as future practitioners. Medical interns are active adult learners, enhancing their development of knowledge, skills, and positive attitudes, and pursuing professionalism as they participate in case-based discussions (CBD).@*Objectives@#The study sought to identify the basic principles of andragogy while medical interns participate in case-based discussions including the end-of-course satisfaction. It also determined the selected demographic factors associated with the andragogic principles. @*Methodology@#Respondents included 80 interns by convenience sampling who rotated at the Department of Ophthalmology and Visual Sciences in a tertiary referral hospital. The study used a combination of descriptive quantitative and qualitative research design. A valid instrument using the Adult Learning Principles Design Elements Questionnaire (ALPDEQ) was used to measure the medical intern's andragogic orientation as well as end-of-course satisfaction. A direct, non-participant observation of case-based discussions conducted at the department was done by the researcher and research associate. @*Results and Conclusion@#The occurrence of andragogic principles specifically motivation, experience, need to know, readiness, and self-directedness was observed during the conduct of case-based discussion. There was no association between principles of andragogy and demographic factors such as age, gender, civil status, medical school, preparatory medical course, and place of origin. CBD is an effective learning strategy, which provides medical interns adequate venues to be self-directed and apply the principles of andragogy in a workplace-based setting.

Terapia ocupacional y andragogía: un llamando a la inclusión desde el fin del mundo / Occupational therapy and andragogy: an invitation to the inclusion from the end of the world

Se presenta un estudio cuantitativo destinado a determinar el interés por estudiar de adultos mayores institucionalizados de la ciudad de Punta Arenas, junto con la identificación de factores favorecedores y obstaculizadores. Se incluyó a 18 adultos mayores institucionalizados residentes del Establecimiento de Larga Estadía del Adulto Mayor de Punta Arenas. Se obtiene que el 80 por ciento de los adultos mayores encuestados reportan un alto interés por estudiar, con particular énfasis en las mujeres. Se encontró una correlación positiva: a mejor constitución de red social de apoyo (familia e institución de residencia), mayor interés por estudiar. La mayor parte quisiera terminar sus estudios inconclusos, y manifiestan interés en estudiar historia, idiomas e incluso, estudios universitarios. Los resultados de esta investigación invitan a reflexionar sobre la imagen negativa que tiene la sociedad acerca de esta etapa de la vida, sobre la necesidad de cambio para poder ofrecer los espacios necesarios para seguir desarrollándose, especialmente en el ámbito educativo, donde la andragogía es esencial para garantizar la participación, inclusión y contribución de los adultos mayores en la sociedad. Aquí la Terapia Ocupacional tiene una responsabilidad social trascendental.

Quantitative study designed to determine the interest in studying the institutionalized older people in Punta Arenas city, along with the identification of factors favoring and hindering. The sample included 18 institutionalized elders residents of long-stay Facility for the Elderly of Punta Arenas. The 80 precent of older people report a high interest in the study, with particular emphasis on women. It founds a positive correlation: a better incorporation of social support network (family and institution of residence), greater interest in studying. Most want to finish their studies unfinished, and expressed interest in studying history, languages and even higher education. The results of this research invite to reflection on the negative image that society has about this stage of life, about the need for change in order to provide the necessary space for further development, especially in education, which is essential andragogy to ensure participation, inclusion and contribution of older people in society. Here the Occupational Therapy has a crucial social responsibility.

Senior Resident Training on Educational Principles (STEP): A Proposed Innovative Step from a Developing Nation / 보건의료교육평가

Resident-as-teacher courses are pretty common in Western medical schools however they are a rarity in Asian and developing countries. The current report is a scholarly analysis of a three day orientation program for senior residents in order to improve their functioning by providing new template either for supplementing basic workshops for faculty or to advocate a change in system. The experience gained by Medical Education Unit of University College of Medical Sciences can be used to conduct training breeding grounds at national or regional levels. Resident as teachers educational interventions need to be designed taking into account their impact on education system.

The Fundamental Principles of Adult Education and their Suggestions / 医学教育

1) In the field of adult education, there is a lateral relationship of “learning/teaching” between learners and teachers. And the both collaborate for the purpose of “the attainment of the most desirable learning activity” as the subject of learning and the subject responsible for the facilitation of learning.<BR>2) Adult learners have peculiar features in each of the following aspects;‘self-concept’, ‘learning experience’‘the readiness for learning’‘the orientation for learning’‘the motivation for learning’.<BR>3) Self-directed learning is based on the idea of andragogy (the art and science of helping adults learn), and the learners actively and mutually make up their learning plans and put them into practice themselves.<BR>4) Most of the lifelong learning activities in present Japan can be divided into three types (or stages):‘Teacher (and others)-directed learning’, ‘Self-directed learning’ and ‘Self-directed and Mutual transforming leaning’. And in each, the different roles of educators are reguired.<BR>5) The values of adult education such as ‘equality’‘sympathy’‘cooperation’‘mutuality’ and ‘educativeness’ should be consciously shared between learners and teachers in the professional field and in the process of professional training.