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Authors
Abstract(s)
Introdução| Nos Ășltimos anos, existe a perceção de que o ensino prĂ©-graduado da cirurgia tem perdido preponderĂąncia, o que poderĂĄ refletir uma tendĂȘncia global de centralização nos Cuidados de SaĂșde PrimĂĄrios, uma tendĂȘncia para a subespecialização e um aumento no numerus clausus e no conhecimento mĂ©dico. No entanto, os cuidados cirĂșrgicos agudos continuam a ser uma das formas cruciais de intervenção mĂ©dica e nĂŁo devem ser alvo de desinvestimento, sendo que os conhecimentos e competĂȘncias cirĂșrgicas bĂĄsicas devem ser transversais a todos os mĂ©dicos recĂ©m-formados.
Objetivos| O objetivo final desta tese Ă© propor uma reforma curricular para o ensino da cirurgia na Faculdade de CiĂȘncias da SaĂșde da Universidade da Beira Interior (FCS-UBI).
Pretendeu-se, ainda, fazer um levantamento do currĂculo cirĂșrgico atual da FCS-UBI e auscultar a opiniĂŁo dos alunos quanto a este tema.
MĂ©todos| A pesquisa das recomendaçÔes nacionais e internacionais sobre os objetivos a atingir no final do Mestrado Integrado em Medicina em relação Ă s competĂȘncias cirĂșrgicas foi limitada a relatĂłrios oficiais, emitidos por ministĂ©rios ou Ordens dos MĂ©dicos locais. Os textos escolhidos foram âO Licenciado MĂ©dico em Portugalâ e o documento inglĂȘs âTomorrowâs Doctorsâ.
Foi realizado um Mapeamento Curricular - processo formal de recolha e registo das competĂȘncias e conteĂșdos ensinados - dirigido Ă ĂĄrea cirĂșrgica para todos os anos do MIM na FCS-UBI, utilizando documentos escritos (Fichas de Unidade Curricular submetidas a AgĂȘncia de Avaliação e Acreditação do Ensino Superior e informação constante na Intranet da FCS), entrevistas formais e informais a docentes, alunos e ex-alunos, reuniĂ”es estruturadas com 2 professores da FCS e a experiĂȘncia pessoal.
A opiniĂŁo dos alunos e ex-alunos acerca da sua experiĂȘncia com os conteĂșdos da cirurgia e ideias para melhorĂĄ-los no futuro foi recolhida atravĂ©s de entrevistas (n=34) e de um questionĂĄrio (n= 213).
Para a proposta de reforma curricular foram utilizadas ideias prĂłprias, decorrentes da experiĂȘncia pessoal, ideias resultantes de reuniĂ”es com o Diretor de Curso do MIM (Professor Miguel Castelo-Branco) e 2 cirurgiĂ”es participantes no ensino da FCS (Dr. Pedro Vaz, do Hospital Amato-Lusitano e Dra. Liliana Duarte, do Centro Hospitalar Tondela-Viseu) e revisĂŁo curricular de vĂĄrios cursos de medicina internacionalmente reconhecidos.
Utilizou-se tambĂ©m o resultado de vĂĄrias conversas informais tidas no contexto da apresentação dos mĂ©todos deste trabalho no II Congresso Nacional de Investigação em Educação MĂ©dica. Resultados| Foi feito um Mapeamento Curricular dos conteĂșdos de cirurgia da FCS-UBI, como ponto de partida para a proposta de reforma. Os alunos consideram que o tempo dedicado aos conteĂșdos da cirurgia (tanto a nĂvel teĂłrico como prĂĄtico) Ă© insuficiente, que existe uma discrepĂąncia entre os conteĂșdos lecionados nos vĂĄrios hospitais associados ao ensino da faculdade e que deveria existir um Bloco de Cirurgia, com a sua prĂłpria avaliação.
Conclui-se que existe evidĂȘncia estatĂstica de os candidatos da UBI apresentam, no processo de escolha da especialidade, uma menor apetĂȘncia pelas especialidades cirĂșrgicas face aos candidatos das outras Universidades.
PropĂ”e-se a criação de um Bloco de Cirurgia, transversal desde o 3Âș ao 6Âș ano, com a separação consequente das especialidades constituintes do Bloco de Digestivo atual: a Cirurgia Geral e a Gastroenterologia. TambĂ©m se recomenda o fim das aulas teĂłricas nos diferentes hospitais e o inĂcio de seminĂĄrios a decorrer na FCS-UBI, do 3Âș ao 5Âș ano.
ConclusĂ”es| O conhecimento teĂłrico e prĂĄtico da cirurgia Ă© essencial a qualquer mĂ©dico e devem ser fornecidas bases sĂłlidas a nĂvel prĂ©-graduado. O novo currĂculo proposto concentra a cirurgia num bloco, transversal a vĂĄrios anos, com a sua prĂłpria avaliação, de forma a reforçar a aprendizagem nesta ĂĄrea. O currĂculo proposto responde Ă s necessidades expressas pelos alunos, bem como fornece o currĂculo cirĂșrgico prĂ©-graduado mais adequado de acordo com recomendaçÔes nacionais e internacionais, Ă imagem de vĂĄrios dos cursos de medicina considerados como os melhores no mundo (ranking Times Higher Education).
Introduction| In the past few years, a perception exists that the pre-graduate teaching of surgery has experienced a diminished role and this may reflect a global tendency of centralization in the Primary Health Care, a tendency for sub specialization, and an increase in the number of medical students and medical knowledge. However, acute surgical care remains one of the most crucial forms of medical intervention and must not suffer a loss of investment, as basic surgical knowledge and skills must be common ground for every new doctor. Goals| The final goal for this work is to propose a change to the Faculty of Health Sciences of the University of Beira Interiorâs (FCS-UBI) surgical curriculum. A mapping of the current surgical curriculum in the faculty was also made and the studentsâ opinions about this issue were collected. Methods| The search for the national and international recommendations for the final objectives of the medical course was limited to official reports, made by ministries and Regional Medical Councils. The chosen documents were âO Licenciado MĂ©dico em Portugalâ, from Portugal, and âTomorrowâs Doctorsâ, from the United Kingdom. A Curriculum Map, a formal process for the collection of the contents and skills taught in a course which is directed at the surgical area for every year of the medical course in FCS-UBI, was made using written documents (sheets of the Curricular Units that were submitted for evaluation by the AE3ES and information in the facultyâs website), formal and informal interviews with teachers and current or former students, structured meetings with two faculty teachers, and personal experience. The studentsâ opinions about their experience with surgeryâs contents and ideas to upgrade them in the future were collected through interviews (n=34) and a questionnaire (n=213). For the newly proposed curriculum, ideas came from the writerâs experience, meetings with the director of the medical course in the FCS-UBI (Professor Miguel Castelo-Branco), and two surgeons participating in the facultyâs teaching (Dr. Pedro Vaz, from Hospital Amato-Lusitano and Dr. Liliana Duarte, from Centro Hospitalar Tondela-Viseu), as well as from curricular reviews of various internationally-acknowledged medical courses. Additionally, the results of many informal talks in the context of the presentation of the methods of this work in the II National Congress of Investigation in Medical Education were used. Results| A Curriculum Mapping was made with the surgical contents of the FCS-UBI, as introduction of the work for the new proposed curriculum. Students think that the time dedicated to surgery (theory and practice) is insufficient; that there is a discrepancy between taught subjects in the different hospitals that participate in the schoolâs teaching and that there should be a surgery subject with its own assessment. There is statistical evidence that the candidates from FCS-UBI have, in the process of choosing a medical specialty, less tendency to pick a surgical specialization compared with candidates from other Universities. The creation of a surgery subject is advised from the 3rd to 6th year with the subsequent separation of the medical specialties that make the current digestive subject: General Surgery and Gastroenterology. The end of the theoretical classes in different hospitals is also advised, with the classes taking place at the FCS-UBI facilities from 3rd to 5th year. Conclusions| Theorical and practical knowledge of surgery are essential to any doctor and a solid basis must be given in the pre-graduate level. The new proposed curriculum concentrates surgery into a subject, taking place over many years in the course with its own assessment in order to reinforce learning in this area of contents. The proposed curriculum answers studentâs necessities while providing more adequate pre-graduate surgical curriculum, and respecting national and international reports like many of the medical courses regarded as the best in the world (Times Higher Education ranking).
Introduction| In the past few years, a perception exists that the pre-graduate teaching of surgery has experienced a diminished role and this may reflect a global tendency of centralization in the Primary Health Care, a tendency for sub specialization, and an increase in the number of medical students and medical knowledge. However, acute surgical care remains one of the most crucial forms of medical intervention and must not suffer a loss of investment, as basic surgical knowledge and skills must be common ground for every new doctor. Goals| The final goal for this work is to propose a change to the Faculty of Health Sciences of the University of Beira Interiorâs (FCS-UBI) surgical curriculum. A mapping of the current surgical curriculum in the faculty was also made and the studentsâ opinions about this issue were collected. Methods| The search for the national and international recommendations for the final objectives of the medical course was limited to official reports, made by ministries and Regional Medical Councils. The chosen documents were âO Licenciado MĂ©dico em Portugalâ, from Portugal, and âTomorrowâs Doctorsâ, from the United Kingdom. A Curriculum Map, a formal process for the collection of the contents and skills taught in a course which is directed at the surgical area for every year of the medical course in FCS-UBI, was made using written documents (sheets of the Curricular Units that were submitted for evaluation by the AE3ES and information in the facultyâs website), formal and informal interviews with teachers and current or former students, structured meetings with two faculty teachers, and personal experience. The studentsâ opinions about their experience with surgeryâs contents and ideas to upgrade them in the future were collected through interviews (n=34) and a questionnaire (n=213). For the newly proposed curriculum, ideas came from the writerâs experience, meetings with the director of the medical course in the FCS-UBI (Professor Miguel Castelo-Branco), and two surgeons participating in the facultyâs teaching (Dr. Pedro Vaz, from Hospital Amato-Lusitano and Dr. Liliana Duarte, from Centro Hospitalar Tondela-Viseu), as well as from curricular reviews of various internationally-acknowledged medical courses. Additionally, the results of many informal talks in the context of the presentation of the methods of this work in the II National Congress of Investigation in Medical Education were used. Results| A Curriculum Mapping was made with the surgical contents of the FCS-UBI, as introduction of the work for the new proposed curriculum. Students think that the time dedicated to surgery (theory and practice) is insufficient; that there is a discrepancy between taught subjects in the different hospitals that participate in the schoolâs teaching and that there should be a surgery subject with its own assessment. There is statistical evidence that the candidates from FCS-UBI have, in the process of choosing a medical specialty, less tendency to pick a surgical specialization compared with candidates from other Universities. The creation of a surgery subject is advised from the 3rd to 6th year with the subsequent separation of the medical specialties that make the current digestive subject: General Surgery and Gastroenterology. The end of the theoretical classes in different hospitals is also advised, with the classes taking place at the FCS-UBI facilities from 3rd to 5th year. Conclusions| Theorical and practical knowledge of surgery are essential to any doctor and a solid basis must be given in the pre-graduate level. The new proposed curriculum concentrates surgery into a subject, taking place over many years in the course with its own assessment in order to reinforce learning in this area of contents. The proposed curriculum answers studentâs necessities while providing more adequate pre-graduate surgical curriculum, and respecting national and international reports like many of the medical courses regarded as the best in the world (Times Higher Education ranking).
Description
Keywords
Cirurgia CompetĂȘncias CirĂșrgicas CurrĂculo Educação MĂ©dica Medicina