Preceptors' perception of their role as educators and professionals in a health system.

BACKGROUND: Preceptorship fulfills the requirements of International Guidelines regarding the training of health care professionals as a method of teaching in clinical settings, during the daily work routine. This study aims to analyze the preceptors' perceptions about preceptorship and their role as educators. METHODS: Data were collected via a questionnaire with 35 five-point Likert-type scale statements and analyzed using quantitative and qualitative approaches. The qualitative analysis consisted of two open-ended questions: (1) What is Preceptorship? And (2) What is your perception of the preceptor's role as an educator? RESULTS: Out of 619 invited Brazilian preceptors from different health care professions, 327 (52.8%) participated in the study. Among them, 80.7% were females, 35.2% were nurses and 8.9% were physicians. Factor analysis revealed five factors: Pedagogical Competence (F1), Support and educational resources (F2), Educational program planning (F3), Teaching-service integration (F4), and Student presence in the clinical setting (F5). About F1, F3, and F5, professionals from the northeast region had a more positive perception than professionals from the southeast. The item analysis revealed that preceptors learn from the students and consider the service network co-responsible for their training. However, they agreed that only a small part of the health care team participates in the program. Participants described preceptorship as an educational task in a clinical setting, in which active learning methods are used for the training of health care professionals. Preceptorship was considered a bridge between the Unified Health System and the Academic Practice. They envisioned their educator role as a model, tutor, leader, supervisor, and mentor. CONCLUSION: Preceptors expressed a critical view about the nature of preceptorship and their role as educators, recognizing its challenges as well as its potential in clinical settings.

[The development of autonomy among adolescents with Down syndrome based on the pedagogy of Paulo Freire]. / O desenvolvimento da autonomia em adolescentes com síndrome de Down a partir da pedagogia de Paulo Freire.

Autonomy is a process that enables us to understand and act on the environment and on ourselves. During adolescence, transformations result in the development of autonomy. Adolescents with Down syndrome (ADS) have perceptual-cognitive limitations and few opportunities to acquire autonomy. The development of autonomy in an occupational therapy group, with dyads of ADS and their main caregivers was analyzed. The evaluation of the materials produced in the therapeutic process pointed to four categories of analysis: self-perception, perception of the other, shared experience and change of attitude. The results show symbiotic relationships between the dyad, which hamper the individuation process and limit the opportunities to carry out activities independently. The therapeutic process based on Paulo Freire's pedagogy raised the level from an ingenuous to a critical awareness, resulting in changes in the attitudes of caregivers in relation to the identification of potential and acceptance of their own limitations and the ADS under care. This symbiosis complicates the individuation process and the access to experiences necessary for the development of autonomy. The therapeutic process can modify the attitudes of caregivers and foster continuity in development and autonomy.

A autonomia é um processo que nos capacita a compreender e agir sobre nós mesmos e sobre o ambiente. Na adolescência, transformações resultam no desenvolvimento da autonomia. Adolescentes com Síndrome de Down (ASD) têm limitações percepto-cognitivas e poucas oportunidades para aquisição de autonomia. Analisamos o desenvolvimento da autonomia em um grupo terapêutico de Terapia Ocupacional, com díades de ASD e seus principais cuidadores. A análise dos materiais documentais produzidos no processo terapêutico apontou quatro categorias de análise: autopercepção, percepção do outro, vivência compartilhada e mudança de atitude. Os resultados mostram relações simbióticas entre a díade, que dificultam o processo de individuação e limitam as oportunidades para realização das atividades de modo independente. O processo terapêutico baseado na pedagogia freiriana mobilizou de uma consciência ingênua para crítica, acarretando mudanças nas atitudes dos cuidadores em relação à identificação de potenciais e aceitação de limitações próprias e do ASD cuidado. Essa simbiose dificulta o processo de individuação e o acesso a experiências necessárias para o desenvolvimento de autonomia. O processo terapêutico pode modificar as atitudes dos cuidadores e propiciar continuidade do desenvolvimento e autonomia.

Medical Students' Perception of Their Educational Environment and Quality of Life: Is There a Positive Association?

PURPOSE: To assess perceptions of educational environment of students from 22 Brazilian medical schools and to study the association between these perceptions and quality of life (QoL) measures. METHOD: The authors performed a multicenter study (August 2011 to August 2012), examining students' views both of (1) educational environment using the Dundee Ready Education Environment Measure (DREEM) and (2) QoL using the World Health Organization Quality of Life Assessment, abbreviated version (WHOQOL-BREF). They also examined students' self-assessment of their overall QoL and medical-school-related QoL (MSQoL). The authors classified participants' perceptions into four quartiles according to DREEM total score, overall QoL, and MSQoL. RESULTS: Of 1,650 randomly selected students, 1,350 (81.8%) completed the study. The mean total DREEM score was 119.4 (standard deviation = 27.1). Higher total DREEM scores were associated with higher overall QoL and MSQoL scores (P < .001 for all comparisons) and younger ages (P < .001). Mean overall QoL scores were higher than MSQoL scores (mean difference, 1.35; 95% confidence interval [CI] 1.28-1.43; P < .001). Multinomial regression models showed significant dose-response patterns: Higher DREEM quartile scores were associated with better QoL. The psychological health domain of WHOQOL-BREF was most closely associated with DREEM scores (odds ratio 4.70; 95% CI = 3.80-5.81). CONCLUSIONS: The authors observed a positive association between QoL measures and DREEM scores. This association had a dose-response effect, independent of age, sex, and year of medical training, showing that educational environment appears to be an important moderator of medical student QoL.

O desenvolvimento da autonomia em adolescentes com síndrome de Down a partir da pedagogia de Paulo Freire / The development of autonomy among adolescents with Down syndrome based on the pedagogy of Paulo Freire

Resumo A autonomia é um processo que nos capacita a compreender e agir sobre nós mesmos e sobre o ambiente. Na adolescência, transformações resultam no desenvolvimento da autonomia. Adolescentes com Síndrome de Down (ASD) têm limitações percepto-cognitivas e poucas oportunidades para aquisição de autonomia. Analisamos o desenvolvimento da autonomia em um grupo terapêutico de Terapia Ocupacional, com díades de ASD e seus principais cuidadores. A análise dos materiais documentais produzidos no processo terapêutico apontou quatro categorias de análise: autopercepção, percepção do outro, vivência compartilhada e mudança de atitude. Os resultados mostram relações simbióticas entre a díade, que dificultam o processo de individuação e limitam as oportunidades para realização das atividades de modo independente. O processo terapêutico baseado na pedagogia freiriana mobilizou de uma consciência ingênua para crítica, acarretando mudanças nas atitudes dos cuidadores em relação à identificação de potenciais e aceitação de limitações próprias e do ASD cuidado. Essa simbiose dificulta o processo de individuação e o acesso a experiências necessárias para o desenvolvimento de autonomia. O processo terapêutico pode modificar as atitudes dos cuidadores e propiciar continuidade do desenvolvimento e autonomia.

Abstract Autonomy is a process that enables us to understand and act on the environment and on ourselves. During adolescence, transformations result in the development of autonomy. Adolescents with Down syndrome (ADS) have perceptual-cognitive limitations and few opportunities to acquire autonomy. The development of autonomy in an occupational therapy group, with dyads of ADS and their main caregivers was analyzed. The evaluation of the materials produced in the therapeutic process pointed to four categories of analysis: self-perception, perception of the other, shared experience and change of attitude. The results show symbiotic relationships between the dyad, which hamper the individuation process and limit the opportunities to carry out activities independently. The therapeutic process based on Paulo Freire's pedagogy raised the level from an ingenuous to a critical awareness, resulting in changes in the attitudes of caregivers in relation to the identification of potential and acceptance of their own limitations and the ADS under care. This symbiosis complicates the individuation process and the access to experiences necessary for the development of autonomy. The therapeutic process can modify the attitudes of caregivers and foster continuity in development and autonomy.

I Fórum Paulista de Serviços de Apoio ao Estudante de Medicina — Forsa Paulista — “A Carta de Marília” / I Forum of Paulista Medical Student Support Services — Forsa Paulista — “The Letter of Marília”

RESUMO No dia 12 de maio de 2016, estiveram reunidos na cidade de Marília, no I Fórum de Serviços de Apoio aos Estudantes de Medicina (Forsa), realizado durante o 10° Congresso Paulista de Educação Médica (CPEM), representantes de serviços de apoio discente, bem como docentes e estudantes de Medicina, a fim de discutir e elencar estratégias de fortalecimento dos serviços de apoio à saúde discente, estritamente necessárias no contexto violento em que se inserem as escolas médicas. Foi criado um documento, denominado “A Carta de Marília”. Em 13 de outubro de 2016, esse documento foi referendado pelo XI Fórum Cobem dos Serviços de Apoio (Forsa Cobem) durante o 54º Congresso Brasileiro de Educação Médica na cidade de Brasília.

ABSTRACT On May 12, 2016 the first Forum for Support Services for Medical Students (Forsa) held in the city of Marilia during the 10th Paulista Congress of Medical Education (CPEM), gathered representatives of student support services, as well as teachers and medical students in order to discuss and rank strategies to enhance the services to support student health, strictly necessary in the violent setting in which medical schools operate. A document was created and named “The Letter of Marilia.” On October 13, 2016, this document was endorsed by the XI COBEM Forum for Support Services (FORSA COBEM) during the 54th Brazilian Medical Education Congress in Brasília.