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Introdução:A inserção das equipes de saúde bucal na Estratégia Saúde da Família, embora tardia, representa um avanço significativo para a ampliação da cobertura e da qualidade dos serviços odontológicos no Brasil. No entanto, aindaexistem muitosdesafiosnas práticas do cirurgião-dentista na Estratégia Saúde da Família. A atuação majoritariamente clínica prejudica a realização deum trabalho humanístico, resolutivo, interdisciplinar e multiprofissional. Objetivo:Relatar a experiência de atuação de uma cirurgiã-dentista residente na Atenção Primária em Saúde no município de Santo Estêvão, Bahia, Brasil, durante o Programa de Residência Multiprofissional em Saúde da Família da Universidade Estadual de Feira de Santana. Metodologia:Trata-se de um estudo qualitativo, do tipo relato de experiência, que visa descrever as atividades desenvolvidas durante o Programa de Residência Multiprofissional em Saúde da Família, da Universidade Estadual de Feira de Santana, no município de Santo Estêvão, Bahia, Brasil, no período de março de 2022 a novembro de 2023. Resultados:As atividades descritas abrangem as diferentes possibilidades de trabalho do cirurgião-dentista na Atenção Primária, envolvendo ações assistenciais através das consultas individuais e levantamento epidemiológico, educação permanente e em saúde com atuação nos grupos operativos e capacitações com os profissionais da rede e as ações de planejamento e gestão, através do desenvolvimento de estratégias para fortalecer a rede de atenção à saúde. Conclusões:É preciso motivar os profissionais de saúde bucal a repensarem suas práticas, tendo como ponto de partida o investimento e o estímulo à educação permanente e continuada. A especialização em saúde da família permite que cirurgiões-dentistas que atuam ou têminteresse em trabalhar no serviço público desenvolvam habilidades e práticas voltadas para uma assistência integral e multiprofissional da saúde, contribuindo para a consolidação do Sistema Único de Saúde (AU).
Introduction:The oral health team inclusion in the Family Health Strategy represents a significant advance in expanding the coverage and quality of dental services in Brazil. However, there arestill many challenges in the dental surgeons practices in the Family Health Strategy. The ppredominantly clinical approach hinders the achievement of ahumanistic, problem-solving, and interdisciplinary and multidisciplinary. Objective:To report the experience of a dental surgeon resident in Primary Health Care in the city of Santo Estêvão, Bahia, Brazil, during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana. Methodology:This is a qualitative study, experience report type, which aims to describe the activities developed during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana, in the city of Santo Estêvão, Bahia, Brazil, from March 2022 to November 2023. Results:The activities described cover the different work possibilities of dental surgeons in Primary Care, involving assistance actions through individual consultations and epidemiological surveys, ongoing health education with work in operative groups and training with network professionals, and planning and management actions through the development of strategies to strengthen the health care network. Conclusion:It is necessary to motivate oral health professionals to rethink their practices, with investment and encouragement for permanent and continuing education as a starting point. Specialization in family health allows dental surgeons who work or are interested in working in the public service to develop skills and practices aimed at comprehensive and multidisciplinary health care, contributing to the consolidation of the Unified Health System (AU).
Introducción: La inclusión de los equipos de salud dental en la Estrategia de Salud Familiar, aunque tardía, representa un avance significativo en la ampliación de la cobertura y la calidad de los servicios dentales en Brasil. Sin embargo, los cirujanos dentistas siguen enfrentándose a muchos retos em la Estrategia de Salud Familiar. El enfoque mayoritariamente clínico obstacualiza la realización de um enfoque humanista, resolutivo, interdisciplinario y multiprofesional.Objetivo:Reportar la experiencia de un cirujano dentista residente en Atención Primaria de Salud en el ayuntamiento de Santo Estêvão, Bahía, Brasil, durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana.Metodología:Se trata de un estudio cualitativo, del tipoinforme de experiencia, que tiene como objetivo describir las actividades desarrolladas durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana, en el ayuntamiento de Santo Estêvão, Bahía, Brasil, de marzo de 2022 a noviembre de 2023. Resultados:Las actividades descritas abarcan las diferentes posibilidades de trabajo del cirujano dentista en la Atención Primaria, implicando actividades asistenciales mediante consultas individuales y encuestas epidemiológicas, educación sanitaria continuada con actuación en los grupos operativos y capacitaciones con los profesionales de la red y actividades de planificación y gestión mediante el desarrollo de estrategias de fortalecimiento de la red de atención sanitaria.Conclusiones:Es necesario motivar a los profesionales de la salud dental a replantear sus prácticas, con la inversión y el fomento de la formación permanente y continua como punto de partida. La especialización en salud familiar permite a los cirujanos dentistas que trabajan o están interesados en trabajar en el servicio público desarrollar competencias y prácticas dirigidas a la atención sanitaria integral y multiprofesional, contribuyendo a la consolidación del Sistema Único de Salud (AU).
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Humanos , Feminino , Assistência Odontológica , Odontólogos , Equipe de Saúde Bucal , Internato e Residência , Atenção Primária à Saúde , Estratégias de Saúde Nacionais , Pesquisa QualitativaRESUMO
Assessment is an essential component for all educational programs and must check competence acquirement while foster and promote learning. Progress Test (PT) is well recognized to assess cognitive knowledge, clinical reasoning and decision making in the clinical context, offering important information about the individual performance and program quality. It is widely used in Brazilian and international medical schools; however, it still has little role in assessing medical residents in Brazil. We present the experience of a PT pilot implementation in an Infectious Diseases residency program over two years. The first, second and third-year residents did four serial exams with 40 multiple choice questions (item)/each. Preceptors were trained on best practices on item writing. All the items were reviewed by a panel of experts and, after approval, included in the item bank. All participants answered a survey on their perceptions about the experience. The final score was higher for the third-year residents in all exam applications. The level of satisfaction was high among the participants, who mentioned the learning opportunity with the exam and the feedback. PT can improve residents' assessment along the training period and residents' performance should guide review and improvement of the programs.
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Competência Clínica , Avaliação Educacional , Internato e Residência , Humanos , Avaliação Educacional/métodos , Brasil , Projetos Piloto , Inquéritos e Questionários , Infectologia/educação , Avaliação de Programas e Projetos de SaúdeRESUMO
Background: The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic. Methods: We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using descriptive statistics and the Mann-Whitney U test. Results: The final analysis included 105 responses (40% response rate). We received 62 surveys (59%) from general medicine residents and 43 surveys (41%) from specialty medicine residents, with a higher response rate from junior level trainees in both groups. We found no significant differences between general and specialty residents on the level of burnout, impact on clinical experience, or future career due to COVID-19, though there was a significant difference between resident groups on the perceived impact of COVID-19 on learning. Conclusion: Specialty medicine residents reported a negative perception of the pandemic's impact on their learning during residency suggesting a greater impact on training than was perceived by the general medicine residents. Residents from general and specialty medicine programs reported similar levels of burnout and similar perceptions of the pandemic's impact on their clinical experience and future career prospects. Understanding the impacts of the COVID-19 pandemic on resident education and well-being should serve graduate medical education administrators well and prepare them for future interruptions in the traditional learning process.
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OBJECTIVE: Define and develop a set of entrustable professional activities (EPAs) to link clinical training and assessment of the hospital components of neonatal care in neonatology medical residency programs. METHODS: An exploratory study was conducted in two phases using a modified Delphi approach. In the first phase, a committee of five neonatology residency program coordinators drafted an initial set of EPAs based on the national matrix of competencies and on EPAs defined by international organizations. In the second phase, a group of neonatal care physicians and medical residents rated the indispensability and clarity of the EPAs and provided comments and suggestions. RESULTS: Seven EPAs were drafted by the coordinators´ committee (n = 5) and used in the content validation process with a group (n = 37) of neonatal care physicians and medical residents. In the first Delphi round, all EPAs reached a content validity index (CVI) above 0.8. The coordinators´ committee analyzed comments and suggestions and revised the EPAs. A second Delphi round with the revised EPAs was conducted to validate and all items maintained a CVI above 0.8 for indispensability and clarity. CONCLUSION: Seven entrustable professional activities were developed to assess residents in the hospital components of neonatal care medicine. These EPAs might contribute to implementing competency-based neonatology medical residency programs grounded in core professional activities.
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OBJECTIVE: To describe the characteristics of research training and scholarly activity during pediatrics residency in Canada and identify facilitators and barriers to resident scholarly activity. STUDY DESIGN: We conducted a mixed-methods, cross-sectional survey of pediatrics residents in Canada from April to June 2023. Trainees and medical education experts developed the 55-item survey, pilot tested, and distributed electronically to residents in all 17 Canadian residency programs. Responses were complemented with program-level data from pediatrics residency program directors. RESULTS: Of 644 Canadian pediatrics residents, 230 (36%) responded. Resident respondents conducted various types of scholarly projects, including retrospective clinical study (22%), qualitative research (15%), quality improvement (13%), and medical education research (12%). Discordance between the field of career interests and primary scholarly projects was common. Among respondents, 20% had abstracts accepted at national or international conferences, and 12% had manuscripts submitted to peer-reviewed journals. Resident respondents' self-perceived progress in their scholarly projects were discrepant from their actual progress. Key themes related to barriers and facilitators to scholarly activity included protected time for research, mentorship, and research skills training. CONCLUSIONS: The research training and scholarly activity of pediatrics residents in Canada is variable. Establishing national standards, implementing progress monitoring mechanisms with tailored support, and offering flexible protected research time are important next steps.
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Pesquisa Biomédica , Internato e Residência , Pediatria , Canadá , Humanos , Pediatria/educação , Estudos Transversais , Pesquisa Biomédica/educação , Masculino , Feminino , Inquéritos e Questionários , AdultoRESUMO
Considerable resources are dedicated on an annual basis to the podiatric medicine and surgery residency interview by both students and programs. Despite this, relatively little is known about student perception of the process, nor the format and content of interview. The objective of this investigation was to study and organize experiences of fourth-year podiatric medical students following the 2024 Centralized Residency Interview Program (CRIP) process. An anonymous and voluntary survey was developed and made available to fourth year podiatric medical students. It was relatively common for there to be academic, social/personal, case work-up, and rapid-fire academic question components to the interview. It was also very common to be provided with the opportunity to ask programs questions. It was relatively uncommon for there to be ethical/moral questions, personality/psychologic assessments, logic assessments, and hands-on demonstrations. The most common hands-on demonstrations were suturing, hand ties and performance of fixation principles. Relatively high yield academic topics included plain film radiography interpretation, rearfoot/ankle osseous trauma, diabetic foot infection, advanced imaging interpretation, and fixation constructs/principles. When evaluating programs, students placed high value on surgical volume, surgical variety, relative resident autonomy, program location, exposure to outpatient clinics, salary, future connections as a program alumnus, unique off-service rotations, exposure to business management/coding/billing, scope of practice, exposure to inpatient management, resident salary, and who the senior co-residents would be. The results of this investigation provide unique information for both medical students and residency programs with respect to the perception, format and content of the podiatric residency interview process.
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Internato e Residência , Entrevistas como Assunto , Podiatria , Estudantes de Medicina , Podiatria/educação , Humanos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Seleção de Pessoal , Masculino , FemininoRESUMO
OBJECTIVE: This study assessed 2 modalities for teaching responsible conduct of research and human subjects protection (RCR/HSP) to surgical residents in Guatemala-an "off the shelf" online curriculum and a new in-person curriculum specific to the local context. METHODS: In 2018, 160 surgical residents in 3 large urban hospitals in Guatemala City completed 2 online programs in RCR/HSP. Residents in the intervention arm also completed 7 weeks of in-person training. Pre- and post-assessments tested awareness of key concepts with particular attention to international and Guatemalan research regulations. Group differences in matched (pre- and post-) mean scores were analyzed using t-tests. RESULTS: One hundred forty residents completed pre- and post-training assessments and were included in the analytic sample. Overall mean scores improved modestly from 52.7 to 58.7 points out of 100. Intervention-arm trainees reported greater confidence in recognizing ethical issues, understanding legal and ethical requirements for research, and identifying, reporting and avoiding scientific misconduct than control-arm trainees. CONCLUSION: Given the limited availability of RCR/HSP faculty, financial resources, and time in the surgical training schedule, the investigators recommend that academic authorities in Guatemala consider online training programs in RCR/HSP in all surgical residency programs as an affordable and scalable strategy to build ethical research skills in its surgical workforce. Investment in human resources to support in-person ethics education as a way to build self-efficacy in ethical decision-making should be considered.
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Resumo O artigo objetiva analisar a percepção de participantes sobre o efeito de intervenções desenvolvidas no âmbito de um projeto que integra o Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS). Adotou-se o desenho metodológico de avaliação normativa, na perspectiva da abordagem de pesquisa qualitativa. Na pesquisa, foram envolvidos 21 profissionais de saúde de cinco projetos de intervenção, representando as cinco regiões brasileiras. As mudanças percebidas e tangibilizadas foram constatadas como resultado das intervenções. Dentre as conclusões, destaca-se que houve convergência entre percepções e intencionalidades do projeto avaliado.
Abstract The article aims to analyze the participants' perception of the effect of interventions developed within a project nested in the Support Program for Institutional Development of the Unified Health System (PROADI-SUS). We adopted normative assessment from the perspective of a qualitative research approach. Twenty-one health professionals from five intervention projects representing the five Brazilian regions were involved in the research. The changes perceived and made tangible were identified as a result of the interventions. Among the conclusions, we underscore a convergence between perceptions and intentions of the evaluated project.
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Objective: To determine the prevalence of anxiety, depression and burnout in residents of Gynecology and Obstetrics during COVID-19 pandemic in Brazil and its associated factors. Methods: Cross-sectional study involving all regions of Brazil, through the application of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the Maslach Burnout Inventory (MBI-HSS) instrument. Multivariate analysis was performed after adjusting the Poisson model. Results: Among the 719 participating medical residents, screening was positive for anxiety in 75.7% and for depression in 49.8% of cases. Burnout syndrome was evidenced in 41.3% of the physicians studied. Those with depression are more likely to have anxiety (OR 0.797; 95%CI 0.687 - 0.925) and burnout syndrome (OR 0.847 95%CI 0.74 - 0.97). Residents with anxiety (OR 0.805; 95%CI 0.699 - 0.928) and burnout (OR 0.841; 95%CI 0.734 - 0.963) are more likely to have depression. Conclusion: High prevalence of anxiety, depression and burnout were found in residents of Gynecology and Obstetrics in Brazil, in addition to important correlations between anxiety-depression and depression-burnout.