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Abstract Introduction: Institutional evaluation is an important tool for the constant improvement of medical courses, especially when they take the student's opinion as one of their focuses. Objective: The main objective of this study is to investigate which methods are used to conduct institutional evaluations involving student opinion through a scoping systematic review. Methodology: In compliance with the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR)", the searches were conducted in a standardized form, involving at least two researchers and consulting the Lilacs, Scielo, Pubmed, and Embase databases and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), using the software Rayyan, to signal duplicates and allow an independent and unbiased evaluation by the two reviewers. The inclusion criteria used were: Studies published between 2009 and 2019, containing the methodology of evaluation, which assessed medical courses and in which this evaluation was carried out by students at some stage. Also, the following exclusion criteria were used: studies written in languages other than Portuguese, English, French and Spanish; evaluations of a specific pedagogical intervention or limited to some subjects; and articles focusing on student self-assessment. The restriction of time and languages carries the risk of selection bias. Results: 2355 records were found and 12 articles were included. Most studies created their questionnaire and used mostly quantitative scales, although many also included some type of qualitative analysis with written questions. Most of the studies dealt with an occasional analysis and not with a project of permanent evaluation of the institution. Conclusion: Publications in the field of institutional evaluation that involve students and describe the questionnaire are still rare, especially when related to permanent evaluations.
Resumo Introdução: A avaliação institucional é uma importante ferramenta para o constante aperfeiçoamento dos cursos de Medicina, principalmente quando tomam a opinião discente como um de seus pontos. Objetivo: O estudo teve por objetivo averiguar, por meio de uma revisão sistemática de escopo, quais os métodos utilizados para realizar avaliações institucionais que contem com base na opinião discente através de uma revisão sistemática de escopo. Método: Em conformidade com o "Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA- ScR)", as buscas foram realizadas de modo padronizado, envolvendo no mínimo dois pesquisadores, e consultando as bases Lilacs, SciELO, PubMed, Embase e o banco de teses da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes). Por meio do software Rayyan, marcaram-se os estudos duplicados, o que permitiu a avaliação cega e independente dos dois revisores em cada etapa . Os critérios de inclusão utilizados foram: estudos publicados entre 2009 e 2019, que avaliassem cursos de Medicina e em que alguma etapa da avaliação tivesse sido realizada por estudantes. Adotaram-se os seguintes critérios de exclusão: trabalhos em idiomas diferentes do português, inglês, francês e espanhol; avaliações de uma intervenção pedagógica específica ou limitada a algumas disciplinas e artigos com foco na autoavaliação do aluno. Resultados: Foram encontrados 2.355 registros e incluídos 12 artigos. A maior parte dos trabalhos criou um questionário próprio e utilizou-se majoritariamente de escalas quantitativas, embora muitos tenham também incluído algum tipo de análise qualitativa com questões abertas. A maior parte dos estudos referia-se a uma análise pontual e não de a um projeto de avaliação permanente da instituição. Conclusão: Publicações no campo de avaliação institucional que envolvam os discentes e descrevam o questionário ainda são raras, principalmente quando se trata de avaliações permanentes.
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INTRODUCTION: Yellow September (YS) is a Brazilian suicide prevention campaign implemented in 2015, however, its effectiveness in reducing mortality is still unknown. MATERIAL AND METHODS: This is an ecologically interrupted time series study that analyses the evolution of suicide rates in Brazil between 2011 and 2019 and its association with the implementation of YS at a national level. Data was provided by the Mortality Information System. A segmented interrupted series regression analysis was performed, using a generalized linear Poisson model, with correction for seasonal trends. RESULTS: There was an increase in the annual rates of suicide deaths between 2011 and 2019, with 4.99 and 6.41 suicides per 100,000 inhabitants, respectively. The null hypothesis, that the YS did not change the historical trend of growth in suicides in Brazil after its implementation, was affirmed. However, there was an eventual significant increase of 6.2% in the risk of mortality in 2017 and of 8.6% in 2019. DISCUSSION: The results are consistent with the literature, which proposes that campaigns focused solely on publications through the media generate unsound findings regarding the effective reduction in the number of deaths by suicide. Conclusions: The lack of initiative in multisectoral actions may explain the failure of YS on changing deaths by suicide, therefore the development of new lines of action focused on training professionals and expanding the care network could make it an effective instrument in reducing mortality from suicide. CONCLUSIONS: The lack of initiative in multisectoral actions may explain the failure of YS on changing deaths by suicide, therefore the development of new lines of action focused on training professionals and expanding the care network could make it an effective instrument in reducing mortality from suicide.
RESUMO
Abstract: Introduction: During the Sars-CoV-2 pandemic, social distancing measures and various other stress factors may have been responsible for impacts on medical students' mental health. Objective: The purpose of this study is to describe the mental health status of medical students at a college in northeastern Brazil, in the context of the COVID-19 pandemic, investigate symptoms of anxiety and depression, and assess resilience, as well as its possible associated factors. Methodology: A cross-sectional qualitative and quantitative method was used. Data were collected using an online questionnaire among students enrolled in the medical school; data were further processed using quantitative and qualitative statistical analysis separately. The following scales were applied: Generalized Anxiety Disorder Screener (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Wagnild and Young's Resilience Scale (RS-25). Results: About one-third of the students lived with moderate or severe anxiety symptoms, almost half had moderate to severe depressive symptoms, and more than half were classified as having low or moderately low resilience. Conclusion: Our findings highlight the difficulty in maintaining high levels of resilience and that the presence of depression or anxiety would be related to lower resilience scores in medical students during remote education. Further studies are needed to establish a causal link with the pandemic.
Resumo Introdução: Durante a pandemia de Sars-CoV-2, medidas de distanciamento social e vários outros fatores de estresse foram responsáveis por impactos na saúde mental dos estudantes de Medicina. Objetivo: Este estudo teve como objetivos descrever o estado de saúde mental de estudantes de Medicina de uma faculdade do Nordeste brasileiro, no contexto da pandemia de Covid-19, investigar sintomas de ansiedade e depressão, e avaliar a resiliência e fatores associados. Método: Utilizou-se um método qualitativo e quantitativo transversal. Coletaram-se os dados por meio de questionário on-line aplicado a alunos matriculados na Faculdade de Medicina. Em seguida, os dados foram processados separadamente por meio de análises estatísticas quantitativa e qualitativa. Adotaram-se os seguintes instrumentos: Generalized Anxiety Disorder Screener (GAD-7), Patient Health Questionnaire-9 (PHQ-9) e Wagnild e Young's Resilience Scale (RS-25). Resultado: Cerca de um terço dos estudantes convivia com sintomas moderados ou graves de ansiedade, quase metade apresentava sintomas depressives de moderados a graves, e mais da metade foi classificada como tendo resiliência baixa ou moderadamente baixa. Conclusão: Nossos achados destacaram que houve dificuldade em manter altos níveis de resiliência e que a presença de depressão ou ansiedade estaria relacionada a menores escores de resiliência em estudantes de Medicina durante o ensino a distância. Mais estudos são necessários para estabelecer um nexo de causalidade com a pandemia.
