RÉSUMÉ
RESUMO O objetivo deste estudo foi traduzir, validar e avaliar um instrumento britânico de auxílio à escolha da especialidade médica. Esse instrumento processa as respostas a 130 questões e fornece uma classificação de 59 especialidades médicas, em ordem decrescente de recomendação, em função do ajuste do perfil do candidato às características das especialidades. As dez primeiras recomendações são consideradas positivas, e as dez últimas, negativas. A tradução e a adaptação semântica seguiram os passos técnicos recomendados para esse tipo de trabalho, resultando no instrumento em português denominado SCIB (Special Choice Inventory - Brasil). A melhor versão das questões traduzidas foi escolhida. Em seguida, o instrumento foi aplicado a 120 médicos brasileiros (85 médicos especialistas e 35 médicos residentes), representando 38 diferentes especialidades. Foi também aplicado a 79 estudantes dos dois últimos anos do curso de graduação em Medicina. Os participantes da amostra de médicos responderam a um questionário no qual indicavam duas outras especialidades que cogitariam exercer além da atual, bem como outras três que dificilmente exerceriam. O instrumento foi considerado adequado ou muito adequado à realidade brasileira por 85,8% (103/120) dos médicos e por 73,4% (58/79) dos estudantes. Entre estes últimos, 60,8% (48/79) consideraram a escala útil ou muito útil. Os resultados da aplicação do SCIB permitiram verificar que a concordância global das recomendações positivas do instrumento foi de 67,5% (81/120) com a especialidade atualmente exercida e de 72,5% (87/120) com as especialidades que os participantes cogitaram exercer. A concordância entre as recomendações negativas da escala e as especialidades que os médicos dificilmente exerceriam foi de 87,5% (105/120). Os dados das etapas de tradução e adaptação do instrumento original trouxeram elementos para a validação de face, de conteúdo e semântica do instrumento. As respostas dos 120 médicos e os dados da reaplicação da escala a 40 deles permitiram verificar que o SCIB tem homogeneidade, consistência interna e reprodutibilidade satisfatórias. Em conclusão, a tradução e a adaptação de uma escala britânica de auxílio à escolha da especialidade médica no Brasil foram bem-sucedidas. O instrumento resultante teve desempenho muito satisfatório quando aplicado a médicos especialistas e residentes. O SCIB deve, então, constituir uma promissora ferramenta de apoio na escolha da especialidade médica, além de poder ser utilizado na investigação científica nessa área.
ABSTRACT The purpose of this study was to translate, validate and evaluate a British specialty choice inventory. This tool processes the answers to 130 items and returns a 59-medical specialty ranking, in decreasing order of recommendation, based on the candidate's profile adjustments to specialty characteristics. The top 10 and the bottom 10 recommendations are considered positive and negative ones, respectively. Translation and semantic adaptation followed the standard procedures described in the specialized literature, and resulted in a Brazilian Portuguese version named SCIB (Special Choice Inventory — Brasil). The best version of each translated item was chosen. SCIB was then applied to 120 Brazilian physicians (85 specialists and 35 residents) representing 38 different specialties. SCIB was also applied to 79 senior medical students. Participant physicians indicated in a structured questionnaire two specialties they could have chosen apart from the current one, as well as three specialties they would unlikely choose. SCIB was regarded as adequate or very adequate to the Brazilian conditions by 85.8% (103/120) of the physicians and 73.4% (58/79) of the students. Among the latter, 60.8% (48/79) regarded the inventory useful or very useful. For the physicians, SCIB positive recommendations included their current specialty in 67.5% (81/120) of the cases, and any of the specialties they could have chosen in 72.5% (87/120) of the cases. SCIB negative recommendations included any of the specialties that participants would unlikely choose in 87.5% (105/120) of the cases. The translation and adaptation procedures provided data for SCIB validation concerning the face, content and semantic aspects. Answers from the 120 physicians and data from a test-retest study involving 40 participants showed that SCIB has satisfactory levels of homogeneity, internal consistency and reproducibility. In conclusion, translation and adaptation for use in Brazil of the Sci59, a British inventory for assisting medical specialty choice, was successful and resulted in the, SCIB, a tool whose performance was very satisfactory. SCIB can thus be seen as a promising tool for assisting medical specialty choice, as well as for research in this field.
RÉSUMÉ
Background. Traditional lecture-based teaching of anatomy tends to focus on the discipline per se rather than relating it to clinical conditions. As a result, students often lose interest in the basic sciences. We hypothesized that a lecture format that encourages students to relate anatomy to case presentations might help them in appreciating clinical relevance. We therefore proposed to develop, implement and evaluate innovative interactive clinical anatomy lectures (ICALs) for first year medical students of our institution as a method to implement the ‘early clinical exposure’ teaching strategy being promoted by the Medical Council of India. Methods. The first year medical students (n=150) were divided into two groups by lottery: the study group (n=75) and the control group (n=75). The study group received nine ICALs along with traditional gross anatomy lectures (TGL) and dissection. The control group received only TGL along with dissection. A post-test in clinical anatomy was conducted for both groups. The responses of the study group on TGL and ICALs on their learning and understanding of the clinical conditions were collected using the nominal group technique. Results and conclusion. It is feasible to introduce early clinical exposure within lectures even with 150 students. There was a statistically significant (p<0.001) difference in the mean post-test scores of the two groups, which shows that ICALs are effective in correlating anatomical and clinical information to students. The nominal group technique responses of the study group showed that they appreciated it as a better method of teaching and learning. Natl Med J India 2015;28:291–4