RESUMO
BACKGROUND: Hypertension is the most prevalent risk factor for cardiovascular disease globally. Roughly one-third of the adult population has hypertension. However, most people diagnosed with hypertension do not benefit from blood pressure control with pharmacologic interventions: they are overdiagnosed and overtreated and might experience negative psychosocial consequences of being labelled. These consequences are relevant outcomes that need to be assessed and validly measured to identify all benefits and harms related to interventions designed to prevent cardiovascular disease. OBJECTIVES: To develop a pool of items with high content validity for a draft version of a condition-specific questionnaire to measure the psychosocial consequences of being labelled with mild hypertension. METHODS: We selected relevant items from existing Consequences of Screening (COS) questionnaires. These items belonged to two groups: COS core items and potential condition-specific items. All items were originally in Danish and were translated into Brazilian Portuguese using the dual-panel method. Individual and group interviews were conducted with people with mild hypertension and low risk for cardiovascular disease, and were designed to test the translated items for face and content validity and were also used to generate new relevant items. Structured individual interviews were conducted to categorise all the items into domains. RESULTS: The Brazilian Portuguese dual-panel translation of both groups of items was found to be relevant for adults diagnosed with hypertension. We generated 52 new items to achieve high content validity. The result was a set of 132 items divided into 22 domains in 2 parts. Part I was directed at the general population, whereas part II was directed only at people diagnosed with hypertension and it consisted of 38 items in 8 domains. Twelve items remained as single items. High content validity was achieved with the pool of 132 items divided into 22 domains in 2 parts. DISCUSSION: High content validity was achieved for a condition-specific questionnaire measuring the psychosocial consequences of being labelled with mild hypertension. This instrument encompassed 132 items divided into 22 domains in 2 parts. Thereby, a draft of the Consequneces of Hypertension questionnaire (COH) was developed. The psychometric properties of this questionnaire will be discussed in a diferent paper.
RESUMO
Objetivo: Apresentar os passos adotados para a construção de um currículo de competências dentro do programa de residência em medicina de família da Faculdade de Medicina da Universidade de São Paulo; descrever características e diretrizes fundamentais do currículo de competências relacionadas aos seus três atributos centrais: ferramentas de aprendizado, metodologias docentes e processos avaliativos; e, por fim, descrever comparações do uso de instrumentos de avaliação pelo nosso programa de residência e outras experiências na literatura. Métodos: Levantamento e análise das principais experiências internacionais em treinamento de médicos de família; realização de uma série de oficinas e workshops; criação de grupos de trabalho com áreas, temas e responsabilidades específicas para estudo, apresentação e definição coletiva. Resultados: Elaboração de um currículo de competências apoiado em um modelo quintidimensional de competências. Conclusão: O estabelecimento de um currículo baseado em competências é vital para organizar o programa de residência. O uso de referenciais internacionais, nacionais e a contribuição das pessoas envolvidas no programa de residência favorecem a organização das competências ao mesmo tempo em que se respeitam as singularidades do programa de residência. Desafios são encontrados para aplicar o currículo na prática do dia-a-dia.
Objective: To present the steps taken to build a competency curriculum in family medicine residency program of the within the Medical School of the University of São Paulo; to describe fundamental characteristics and guidelines of the competency curriculum related to its three central attributes: learning tools, teaching methodologies and evaluation processes; and finally, to describe comparisons of the use of evaluation instruments by our residency program and other experiences in the literature. Methods: Review and analysis of the main international experiences in training of family physicians; conducting a series of workshops and creation of working groups with specific areas, themes and responsibilities for study, presentation and collective definition. Results: Elaboration of a competency curriculum based on a five-dimensional competence model. Conclusion: Establishing a competency-based curriculum is vital to in the organization of the residency program. The use of international and national references and the contribution of the people involved in the residence program favor the organization of competences while respecting the singularities of the residency program. Challenges are encountered in implementing the curriculum in the practice of the day.
Objetivo: Presentar los pasos adoptados para la construcción de un currículo de competencias dentro del programa de residencia en medicina de familia de la Facultad de Medicina de la Universidad de São Paulo; describir características y directrices fundamentales del currículo de competencias relacionadas a sus 3 atributos centrales: herramientas de aprendizaje, metodologías docentes y procesos de evaluación; y por último, describir comparaciones del uso de instrumentos de evaluación por nuestro programa de residencia y otras experiencias en la literatura. Métodos: Levantamiento y análisis de las principales experiencias internacionales en capacitación de médicos de familia; realización de una serie de talleres; creación de grupos de trabajo con áreas, temas y responsabilidades específicas para estudio, presentación y definición colectiva. Resultados: Elaboración de un currículo de competencias apoyado en un modelo de cinco dimensiones de competencias. Conclusión: El establecimiento de un currículo basado en competencias es vital para organizar el programa de residencia. El uso de referencias internacionales, nacionales y la contribución de las personas implicadas en el programa de residencia favorecen la organización de las competencias mientras se respetan las singularidades del programa de residencia. Los desafíos se encuentran para aplicar el currículo en la práctica del día a día.