[Medical education and the integration of teaching and health care activities]. / Formação médica e integracão de atividades docentes e assistenciais.

A research project involving eighty first-year medical students who observed the experiences of first-time patients admitted to a university hospital in South-eastern Brazil was undertaken during the first semester of 1989. The students conducted 260 interviews and followed the patients through from the time of admittance, observing the patients' expectations, values and attitudes towards minor complaints. The objective of the experience was to open a forum for discussion about excessive specialization and inadequacies in the curriculum in preparing the future medical professional to meet the needs of the population. Both the criticisms in the students' testimonies and the data collected at the interviews, as well as the concrete facts and practical proposals regarding the modification of the curriculum, concur with the Edinburgh Declaration of 1988. They point to the need for the adoption of a mode by which teaching and assistance activities, might be integrated from the very beginning of the physician's training.

[Patient satisfaction at a university hospital]. / A satisfação do usuário em hospital universitário.

The results of a research project into the level of satisfaction/dissatisfaction of 158 first-time patients attending by an University hospital, Brazil, are presented. The interviews were carried out by first year medical students as part of a comprehensive project concerned with the restructuring of the Medical Curriculum. Its prime objective was to expose the students to patients/consumers as early as possible in their studies. After an introductory training program, the students asked the patients arriving at the hospital out-patient clinic for permission to observe them throughout the attendance given. A questionnaire was used which covered the various aspects of the consumers relationship with a medical institution (socio-economic variables, "art of care", outcome of the medical encounter and suggestions for improvement). Both patients and students were able to perceive the different problems that patients confront in the course of their dealings with a medical institution (reception, registration, nursing, social service and medical attention). The data showed a difference of opinion between students and patients regarding several aspects of the satisfaction/dissatisfaction items, partly because of their different social class status and party due to the different expectations regarding medical care.