Razonamiento clínico en carreras de la salud: percepción de estudiantes y docentes / The perception of teachers and students about clinical reasoning in health care careers

BACKGROUND: Clinical reasoning (CR) is a training mainstay in health care careers. AIM: To describe the perception of students and teachers about the development of clinical CR in Kinesiology and Dentistry careers. MATERIAL AND METHODS: Exploratory descriptive qualitative study, with 12 informants (six teachers and six students), applying a script of questions through a semi-structured interview. A thematic inductive data analysis was carried out. RESULTS: Two hundred thirty-five meaning units, 38 codes, seven subcategories and three categories were collected. CR was reported as a basic analysis process in health care training. Its necessary elements are knowledge, a learning environment and a facilitator teacher, among others. Motivation, analysis models, variability and exposure are reported as facilitating factors for the development of CR. Teacher paternalism, resistance to change and few learning opportunities are presented as obstacles. Active strategies such as clinical cases, simulation and clinical practice are perceived as facilitators for the development of CR. Those situations where the student does not assume a leading role such as lectures and activities in large groups, are considered as obstacles. CONCLUSIONS: Both students and teachers point to CR as an analysis process that is indispensable in both careers. Exposure to variable educational experiences through active educational strategies in small groups encourages CR.

Mejorando la elaboración de las hipótesis iniciales para el razonamiento clínico diagnóstico en estudiantes de kinesiología: una propuesta metodológica / Improving the development of initial hypotheses for clinical diagnostic reasoning in physical therapy students: a methodological proposal

El Razonamiento Clínico es un proceso fundamental para identificar los déficits en un paciente y formular un diagnóstico kinesiológico. El objetivo de este estudio es describir parte de la metodología y sus resultados, en el marco del curso de Razonamiento Clínico de la carrera de Kinesiología en la Universidad Finis Terrae, para mejorar el proceso de formulación de hipótesis iniciales para la evaluación kinesiológica. MUESTRA : MATERIALES Y MÉTODOS Los estudiantes fueron evaluados según la cantidad, coherencia y sintaxis de estas hipótesis iniciales, además de los dominios a los que pertenecían, al inicio y al final de la intervención que consistió en 3 actividades (2 clases presenciales y un informe de actividad de campo clínico). Las clases presenciales tenían como temas la Clasificación Internacional de la Funcionalidad, Salud y Enfermedad (CIF) de la OMS, y su rol en el razonamiento clínico diagnóstico; y la importancia de las hipótesis iniciales dentro del modelo hipotético deductivo de razonamiento y cómo escribirlas, junto con el uso de una herramienta (una "Tabla Hipocrática Modificada") para sistematizar la formulación de hipótesis iniciales con respecto a déficit en estructuras corporales. El informe de campo clínico integró todo lo anterior durante la evaluación de un paciente real. RESULTADOS La evaluación final mostró un aumento significativo en la cantidad (promedio ± DS inicial 10,1 ± 8,57, final 27 ± 9,23, p < 0,001) de hipótesis planteadas y en su coherencia con respecto a la información disponible. CONCLUSIÓN La sistematización descrita para la formulación de hipótesis diagnósticas en los estudiantes de kinesiología resulta en una mayor cantidad y calidad en sus hipótesis, validando esta metodología para la enseñanza inicial del razonamiento clínico diagnóstico en kinesiología

Clinical Reasoning is a fundamental process to identify deficits in a patient and state a diagnosis. The goal of this study is to describe part of the methodology and its results, within the framework of the Clinical Reasoning course of the Kinesiology career at Finis Terrae University, implemented to improve the process of formulating initial hypotheses for kinesiological evaluation. MATERIALS AND METHODS The students were evaluated according to the quantity, coherence and syntax of these initial hypotheses, in addition to the domains to which they belonged, at the beginning and at the end of the intervention that consisted of 3 activities (2 face-to-face classes and an activity report). The face-to-face classes had as topics the International Classification of Functioning, Health and Disease (ICF), WHO, and its role in diagnostic clinical reasoning; and the importance of initial hypotheses within the hypothetical deductive model of reasoning and how to write them, together with the use of a tool (a "Modified Hippocratic Table") to methodize the formulation of initial hypotheses regarding deficits in body structures. The report integrated all of the above during the evaluation of a real patient. RESULTS The final evaluation showed a significant increase in the quantity (mean ± initial SD 10.1±8.57, final 27±9.23, p < 0.001) of hypotheses raised and in their consistency to the available information. Conclusion: The Systematization described for formulating diagnostic hypotheses in kinesiology students results in a greater quantity and quality of their hypotheses, validating this methodology for the initial teaching of diagnostic clinical reasoning in kinesiology.

Go tani and his influence on the kinesiology field in the brazilian scientific context / Go tani e sua influência no campo da cinesiologia no contexto científico brasileiro

ABSTRACT This study aimed to group some perspectives on Go Tani's epistemological activity in the context of Brazilian Physical Education (PE), establishing his contributions and reflections on Kinesiology for the structuring of undergraduate and graduate Physical Education in Brazil. This is a bibliographical and exploratory study, which prioritized Tani's production on the most varied platforms and the materials that circulated about Kinesiology in national and international literature. Finally, through the theoretical review, it was possible to identify that the PE field is a scenario full of disputes and that even with the transformations of paradigms that infer the legitimate alternatives in the scientific context, the relationships that are established between the different schools of PE thought have erupted in a process of mutual incomprehension that contributes to the circularity of perspectives and the maintenance of beliefs in the field.

RESUMO O presente estudo objetivou agrupar algumas perspectivas sobre a atividade epistemológica de Go Tani no contexto da Educação Física (EF) brasileira, estabelecendo suas contribuições e reflexões a partir da Cinesiologia para a estruturação da graduação e da pós-graduação em Educação Física no Brasil. Trata-se de um estudo bibliográfico e exploratório, o qual priorizou a produção de Tani nas mais variadas plataformas, bem como os materiais que circularam sobre a Cinesiologia na literatura nacional e internacional. Por fim, através da referida revisão teórica, foi possível identificar que o campo da EF é um cenário repleto de disputas e que mesmo com as transformações dos paradigmas que inferem nas alternativas legítimas no contexto científico, as relações que são estabelecidas entre as distintas escolas de pensamento da EF têm eclodido num processo de interincompreensão que contribui com a circularidade de perspectivas e a manutenção de crenças no campo.

Opinión de estudiantes de kinesiología relacionado con precauciones estándar, vista de enfermería / Opinion of kinesiology students related to standard precautions, nursing view

INTRODUCCIÓN: Las precauciones estándar corresponden a un grupo de prácticas de prevención de infecciones que se aplican en la atención a todos los pacientes, tiene como objetivo prevenir la transmisión cruzada de microorganismos entre pacientes. OBJETIVO: Develar la opinión de las/os estudiantes de Kinesiología de la Universidad Mayor-Temuco con relación a las Precauciones Estándar. METODOLOGÍA: Estudio cualitativo, descriptivo y exploratorio, estudio intrínseco de caso, la muestra no probabilística, intencionada: 12 sujetos estudiante de kinesiología 2018; criterio de inclusión: haber aprobado la asignatura de Cuidados Básicos del Enfermo; recogida de datos: entrevistas en profundidad, se utilizaron notas de campo y se manejó el método de comparación constante, además esquema de la reducción progresiva. RESULTADOS: Para la categoría de significado de precauciones estándar surge medida de protección y seguridad para usuario y tratante; para precauciones estándar utilizadas en prácticas clínicas emerge las subcategorías de elementos y técnicas de barrera en forma análoga nace como categoría aplicabilidad de precauciones estándar de ella se desprenden campos clínicos, eventos clínicos del usuario y técnicas y procedimientos; para la categoría factores facilitadores: docente y estudiantes; en tanto factores obstaculizadores: curriculum. CONCLUSIONES: En los estudiantes existe un conocimiento deficiente y conceptos aislados sobre PE, utilizan principalmente guantes y lavado de manos; menor grado uso de mascarilla y pechera. Destaca positivamente conocimiento docente; factores obstaculizadores: aspectos teóricos deficientes curriculares; considerar modificaciones curriculares en aspectos conceptuales y procedimentales.

BACKGROUND: the standard precautions correspond to a group of infection prevention practices that are applied in the care of all patients, it aims to prevent the cross-transmission of microoganisms between patiens. OBJETIVE: to reveal the opinion of Kinesiology students at the Universidad Mayor-Temuco regarding standard precautions. METHODOLOGY: Qualitative, descriptive, and exploratory study, intrinsic case study, non-probabilistic sample, intentional: 12 subjects, kinesiology student of the year 2018; For data collection, in-depth interviews were used, field notes and the constant comparison method were used, in addition to the progressive reduction scheme. RESULTS: 173 units of meaning emerge, for the category of meaning of standard precautions, protection and security measure for user and trafficker arises; For standard precautions used in clinical practices, the subcategories of barrier elements and techniques emerge, the most mentioned, in an analogous way, the applicability of standard precautions is born as a category of clinical fields, clinical events of the user and techniques and procedures; for the category facilitating factors: teacher and student are the least mentioned; as impeding factors: curriculum. CONCLUSIONS: There is a deficient knowledge and isolated concepts about SP, mainly use gloves and hand washing; less degree the use of masks and scrubs. It is positively highlighted teacher's knowledge, and some of the hindering factors are the lack of theoretical aspects of the curriculum and the consideration for curriculum modifications to compensate conceptual and procedural aspects.

Percepción de la calidad y la importancia de sus componentes en la formación universitaria de kinesiología / Quality perception and importance of its components in the university formation of kinesiology

El estudio se interesa en conocer la percepción que, estudiantes de diferentes niveles de formación universitaria en kinesiología, tienen sobre la importancia de diversos aspectos de la calidad de su preparación profesional. Un grupo de 149 estudiantes participaron voluntariamente en este estudio que utilizó un diseño no experimental transversal descriptivo. El instrumento mide la importancia de 10 aspectos de la calidad tales como los recursos, la perfección, cultura, procesos y prestigio, entre otros. Permite conocer la puntuación directa de importancia atribuida a cada uno de ellos, así como la jerarquización de estos. Los resultados indican aquellos aspectos a los que se les asigna importancia en un nivel manifiesto no son los mismos que en un nivel implícito. Los resultados son discutidos en torno a la relación entre los diferentes aspectos de la calidad, las condiciones contextuales y las diferencias de atribución causal(AU)

The study was aimed at identifying the perceptions of students at the various levels of kinesiology at the university about the importance of several aspects of the professional preparation quality. A group of 149 students willingly participated in this study that used a non-experimental cross-sectional and descriptive design. The instrument measures the importance of ten quality aspects such as resources, perfection, culture, processes and prestige, among others. It also allows knowing the direct scoring of importance attached to each of them as well as their hierarchization. The results pointed to those aspects to which manifest importance is given, which are not the same as those given implicit importance. The results were discussed in terms of their relationship among the various aspects of quality, contextual conditions and causal attribution(AU)