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Abstract(s)
Introdução: O intuito primordial do percurso académico com seis anos em Medicina é dotar os alunos de um conjunto de conhecimentos e competências que lhes permitam exercer uma prática médica eficaz e segura. Estas competências revelam-se cada vez mais necessárias a nível de uma comunicação clínica adequada aos contextos e às pessoas, com repercussões positivas na qualidade da prática médica e na satisfação do utente e do profissional de saúde. É fundamental que o médico consiga interagir na entrevista clínica de modo a gerar confiança e empatia, recolhendo a informação útil e motivando para o cumprimento da terapêutica e para as mudanças de comportamento imprescindíveis para alcançar os melhores resultados. Desta forma, é essencial preparar os alunos para comunicar eficazmente e identificar os pontos fracos e fortes da sua formação nesta área.
Objectivos: 1) Analisar de forma descritiva a avaliação de competências essenciais de comunicação clínica pelos alunos dos 5º e 6º anos do curso de Medicina da FCS-UBI do ano lectivo 2011-2012, que estão a um passo da prática médica; 2) Analisar comparativamente os resultados por subgrupos: sexo, preferência de área na Medicina (se médica, cirúrgica ou médico-cirúrgica) e ano curricular e 3) Analisar o currículo da FCS-UBI, identificando os pontos fracos e fortes da formação em comunicação clínica.
Materiais e Métodos: Estudo de investigação, observacional e descritivo. Foi desenvolvido com base no instrumento Kalamazoo Consensus Statement, com respostas abertas e fechadas (escala de Likert de 5 níveis). O questionário foi aplicado através da mailing-list da FCS-UBI e pessoalmente, garantindo sempre o anonimato das respostas. Participaram 105 alunos dos 5º e 6º anos do Mestrado Integrado de Medicina da FCS-UBI (matriculados no ano lectivo 2011-2012), com uma média de 24,1 anos. A maioria dos participantes foi do sexo feminino (80,9%), frequentava o 5º ano (59,1%) e tinha preferência pelas áreas médico-cirúrgica (45,7%) e médica (44,8%). A análise estatística incluiu a descrição dos resultados obtidos e a comparação das amostras, realizada com base no SPSS® (Statistical Package for the Social Science) versão 19.0 e Microsoft Office Excel 2007®. Utilizaram-se frequências relativas e absolutas, médias, desvios-padrão, número máximo e número mínimo. Dada a ausência de distribuição normal dos dados, realizaram-se testes não paramétricos para comparar as amostras, considerando-se significativos os resultados com p<0,05. Foram também realizadas uma revisão dos conteúdos programáticos do curso relativos às competências comunicacionais e entrevistas aos docentes responsáveis dessas unidades pedagógicas.Resultados: Os alunos reconheceram a importância da comunicação clínica na prática médica. Reconheceram também que o curso de Medicina da UBI dá a devida importância a estas competências e sentem-se preparados para as exercer. Na hierarquizição de competências de entrevista clínica, os alunos priorizaram a relação médico-doente como a componente mais importante, seguida da realização de história clínica. Todas as competências comunicacionais foram avaliadas positivamente pelos alunos, com relevo para Utilizar uma linguagem acessível ao paciente, Perguntar ao paciente se este tem mais preocupações ou queixas e Estimular o paciente a falar sobre as suas preocupações. As competências comunicacionais com avaliação mais baixa foram Dar más noticias e Lidar com reclamações feitas por doentes. O sexo feminino avaliou melhor a Importância das competências de comunicação clínica na prática médica. Os alunos com maior interesse pela área médica auto-avaliaram-se tendencialmente pior do que aqueles com maior interesse nas áreas médico-cirúrgica ou cirúrgica. Relativamente a esta variável, foram observadas diferenças estatisticamente significativas nas competências Preparação no que se refere às competências de comunicação clínica e quase significativas em Colocar adequadamente questões abertas e fechadas, Encorajar uma parceria entre o médico e o paciente, Permitir ao paciente que complete o seu raciocínio e Recolher a informação necessária sobre o paciente, em que se observaram valores mais baixos no subgrupo com maior interesse pelas áreas médicas. Quanto à comparação dos resultados com a variável ano curricular, houve uma diferença quase estatisticamente significativa em Estabelecer uma relação (rapport) com o doente, em que os alunos do 6º ano obtiveram uma media mais elevada. De resto não foram observadas mais diferenças estatisticamente significativas.
A análise curricular confirmou que as competências de comunicação clínica são leccionadas durante o curso na unidade curricular “Bases Psicológicas da Medicina”, especificamente na unidade pedagógica de “Comunicação clínica e relação médico-doente”. As entrevistas realizadas aos docentes responsáveis pela unidade curricular indicaram duas ideias principais: 1) a necessidade de definir melhor um perfil de competências comunicacionais desejável no aluno que termina o mestrado em Medicina; e 2) garantir a formação nas valências comunicacionais, éticas e jurídicas, integrando de forma equilibrada a informação / conhecimentos e as competências nestas áreas.
Conclusão: Os alunos inquiridos reconhecem a importância da comunicação na prática médica. Reconhecem que a FCS-UBI lecciona de forma eficaz as competências chave de comunicação e entrevista clínicas. Sentem-se efectivamente preparados para as exercer. Os resultados indicam como pontos a melhorar no ensino da comunicação clínica no curso de Medicina da FCS-UBI a comunicação de más notícias e a capacidade de lidar com reclamações.
Introduction: The primary purpose of the six academic years in Medicine is to provide students with a set of knowledge and skills to pursue medical practice in an efficient and safety friendly manner. These skills tend to be increasingly needed to an appropriate clinical communication that fits contexts and people, with positive effects on the quality of clinical practice and on users’ and health professionals’ satisfaction. It is essential that doctors can interact in the clinical interview in order to build trust and empathy, gathering useful information and motivating towards the fulfillment of therapy and behavioral changes that are needed to achieve the best results. It is fundamental to prepare students to communicate effectively and to identify the strengths and weaknesses of their training in this area. Objectives: 1) Descriptional analysis of the self-assessment clinical communication core competencies of the students of the 5th and 6th year enrolled in the medical school of FCSUBI 2011-2012 school year, who are one step away from medical practice; 2) Comparative analysis of the results by subgroups: sex, favorite medical area of practice (if medical, surgical or medical-surgical) and academic year, and 3) analysis of the curriculum of FCS-UBI medical course, identifying the strengths and weaknesses of the training on clinic communication. Materials and Methods: This research is observational and descriptive. Its development was based on the instrument Kalamazoo Consensus Statement with open and closed questions (answers in a Likert scale of 5 levels). The questionnaire was administered both through the mailing list of FCS-UBI and personally, always insuring the anonymity of responses. A total of 105 students, with an average of 24.1 years of age, in the 5th and 6th years of the Master of Medicine FCS-UBI, enrolled in the academic year 2011-2012, participated in this study. Most of the participants were female (80.9%), attended the 5th year (59.1%) and had a preference for both medical-surgical (45.7%) and medical areas (44.8%). The statistical analysis included the description of the results and the comparison of samples which was performed using the SPSS ® (Statistical Package for Social Science) version 19.0 and Microsoft Office Excel 2007 ®. We used the absolute and relative frequencies, means, standard deviations, maximum and minimum numbers. Due to the lack of normal distribution of data, non-parametric tests were performed to compare samples, considering results as significant as p <0.05. A review of the syllabus of the course related to communication skills and interviews with the teachers responsible for teaching these units were also conducted. Results: The students recognized the importance of clinical communication skills in medical practice. They also recognized that the medical course of FCS-UBI gives proper importance to these skills and feel prepared for the practice. In the hierarchy of clinical interview skills, students prioritized the doctor-patient relationship as the most important item, followed by conducting the clinical history. All communication skills addressed in the questionnaire were evaluated positively by the participants, with emphasis on Using language that is accessible to the patient, Asking the patient if he has more concerns or complaints and Encouraging the patient to talk about their concerns. Communication skills with lower rating were Giving bad news and Dealing with complaints made by patients. The importance of clinical communication skills in medical practice was highly rated by the female respondents. Participants with greater interest in medical fields rated themselves lower than those with greater interest in medical-surgical and surgical fields. For this variable, there were statistical differences close to significance in Putting open and closed questions properly, Encouraging a partnership between doctor and patient, Allowing the patient to complete their reasoning and Collecting the necessary information about the patient. The lower values were observed in the subgroup with the highest interest in the medical fields. The comparison of the results using the variable academic year, shown a statistically significant difference in Establishing a relationship (rapport) with the patient, where 6th grade’s students had a higher average. Furthermore, there were no statistically significant differences. The curriculum analysis confirmed that clinic communication and interview skills are taught during the course in the discipline “Psychological Basis of Medicine”, specifically in the educational unit “Clinical communication and patient-doctor relationship”. The interviews with some teachers indicated two main ideas: 1) the need to define a profile of communication skills desirable in the student who completes the master's degree in medicine, and 2) the provision of training in communication, ethical and legal fields, integrating evenly information / knowledge and skills in these areas. Conclusion: Surveyed students recognize the importance of communication skills in medical practice. They recognize also that FCS-UBI teaches the key clinical communication and interview skills. They feel well prepared for the exercise of these skills. The results indicate the communication of bad news and the ability to deal with complaints as areas for improvement in the teaching of clinical communication skills in the medical course of FCSUBI.
Introduction: The primary purpose of the six academic years in Medicine is to provide students with a set of knowledge and skills to pursue medical practice in an efficient and safety friendly manner. These skills tend to be increasingly needed to an appropriate clinical communication that fits contexts and people, with positive effects on the quality of clinical practice and on users’ and health professionals’ satisfaction. It is essential that doctors can interact in the clinical interview in order to build trust and empathy, gathering useful information and motivating towards the fulfillment of therapy and behavioral changes that are needed to achieve the best results. It is fundamental to prepare students to communicate effectively and to identify the strengths and weaknesses of their training in this area. Objectives: 1) Descriptional analysis of the self-assessment clinical communication core competencies of the students of the 5th and 6th year enrolled in the medical school of FCSUBI 2011-2012 school year, who are one step away from medical practice; 2) Comparative analysis of the results by subgroups: sex, favorite medical area of practice (if medical, surgical or medical-surgical) and academic year, and 3) analysis of the curriculum of FCS-UBI medical course, identifying the strengths and weaknesses of the training on clinic communication. Materials and Methods: This research is observational and descriptive. Its development was based on the instrument Kalamazoo Consensus Statement with open and closed questions (answers in a Likert scale of 5 levels). The questionnaire was administered both through the mailing list of FCS-UBI and personally, always insuring the anonymity of responses. A total of 105 students, with an average of 24.1 years of age, in the 5th and 6th years of the Master of Medicine FCS-UBI, enrolled in the academic year 2011-2012, participated in this study. Most of the participants were female (80.9%), attended the 5th year (59.1%) and had a preference for both medical-surgical (45.7%) and medical areas (44.8%). The statistical analysis included the description of the results and the comparison of samples which was performed using the SPSS ® (Statistical Package for Social Science) version 19.0 and Microsoft Office Excel 2007 ®. We used the absolute and relative frequencies, means, standard deviations, maximum and minimum numbers. Due to the lack of normal distribution of data, non-parametric tests were performed to compare samples, considering results as significant as p <0.05. A review of the syllabus of the course related to communication skills and interviews with the teachers responsible for teaching these units were also conducted. Results: The students recognized the importance of clinical communication skills in medical practice. They also recognized that the medical course of FCS-UBI gives proper importance to these skills and feel prepared for the practice. In the hierarchy of clinical interview skills, students prioritized the doctor-patient relationship as the most important item, followed by conducting the clinical history. All communication skills addressed in the questionnaire were evaluated positively by the participants, with emphasis on Using language that is accessible to the patient, Asking the patient if he has more concerns or complaints and Encouraging the patient to talk about their concerns. Communication skills with lower rating were Giving bad news and Dealing with complaints made by patients. The importance of clinical communication skills in medical practice was highly rated by the female respondents. Participants with greater interest in medical fields rated themselves lower than those with greater interest in medical-surgical and surgical fields. For this variable, there were statistical differences close to significance in Putting open and closed questions properly, Encouraging a partnership between doctor and patient, Allowing the patient to complete their reasoning and Collecting the necessary information about the patient. The lower values were observed in the subgroup with the highest interest in the medical fields. The comparison of the results using the variable academic year, shown a statistically significant difference in Establishing a relationship (rapport) with the patient, where 6th grade’s students had a higher average. Furthermore, there were no statistically significant differences. The curriculum analysis confirmed that clinic communication and interview skills are taught during the course in the discipline “Psychological Basis of Medicine”, specifically in the educational unit “Clinical communication and patient-doctor relationship”. The interviews with some teachers indicated two main ideas: 1) the need to define a profile of communication skills desirable in the student who completes the master's degree in medicine, and 2) the provision of training in communication, ethical and legal fields, integrating evenly information / knowledge and skills in these areas. Conclusion: Surveyed students recognize the importance of communication skills in medical practice. They recognize also that FCS-UBI teaches the key clinical communication and interview skills. They feel well prepared for the exercise of these skills. The results indicate the communication of bad news and the ability to deal with complaints as areas for improvement in the teaching of clinical communication skills in the medical course of FCSUBI.
Description
Keywords
Prática da medicina - Comunicação clínica Prática da medicina - Competência comunicacional Profissional de saúde - Competência comunicacional Estudante de medicina - Formação em comunicação
Citation
Publisher
Universidade da Beira Interior