ABSTRACT
Abstract: Introduction: The development of clinical reasoning to diagnose diseases and order ancillary tests, such as radiology imaging, is based on history-taking and physical examination skills, which are developed during the semiology course. Objective: We aimed to evaluate the results of the innovative integration of two courses in the medical curriculum at our institution: Medical Semiology and Clinical Radiology. Methods: The sample consisted of 184 fifth-semester medical students attending the two courses simultaneously. Extra-class semiology-radiology sessions based on theoretical and practical topics integrating radiological images and semiological signs were conducted, and the results were assessed by applying a semi-structured questionnaire to the participants, in which all 18 items were rated on a scale from 0 (worst) to 10 (best). The normality hypothesis in score distribution was verified by the Kolmogorov-Smirnov test and the Shapiro-Wilk test. The distribution of the 18 scores were summarized by descriptive statistics and compared by Friedman's test, with post-hoc test in pairwise comparisons adjusted by Bonferroni test. Correlations between the scores were determined by Spearman's Rank Correlation Coefficients. Results: The overall mean score for the semiology-radiology sessions was high (8.55). Students were satisfied with the selection of clinical cases (8.46) and found that the semiology-radiology sessions contributed to the development of their clinical reasoning (8.58). Conclusion: Medical schools are facing new challenges in medical education. The innovative concept of Radiology-Semiology integrated teaching modality affects the students' self-perception ability to interpret radiological images and might be an educational strategy trend.
Resumo: Introdução: O desenvolvimento do raciocínio clínico para diagnosticar doenças e solicitar exames complementares, como os radiológicos, baseia-se na história e no exame físico, desenvolvidos durante o curso de Semiologia. Objetivo: Nosso objetivo foi avaliar os resultados da integração inovadora de duas disciplinas no currículo médico em nossa instituição: Semiologia Médica e Radiologia Clínica. Métodos: A amostra foi composta por 184 estudantes de Medicina do quinto semestre que participaram das duas disciplinas simultaneamente. Realizaram-se sessões extraclasse de semiologia e radiologia, baseadas em tópicos teóricos e práticos, integrando imagens radiológicas com sinais semiológicos. Avaliaram-se os resultados por meio da aplicação de um questionário semiestruturado aos participantes, no qual todos os 18 itens foram classificados em uma escala de 0 (pior) a 10 (melhor). A hipótese de normalidade na distribuição dos escores foi verificada pelos testes de Kolmorov-Smirnov e Shapiro-Wilk. As 18 distribuições de pontuação foram resumidas por estatística descritiva e comparadas pelo teste de Friedman, com teste post hoc em comparações pareadas ajustadas por Bonferroni. As correlações entre as pontuações foram determinadas pelos coeficientes de correlação de classificação de Spearman. Resultados: O escore médio geral para as sessões de semiologia e radiologia foi alto (8,55). Os estudantes ficaram satisfeitos com a seleção de casos clínicos (8,46) e descobriram que as sessões de semiologia-radiologia contribuíram para o desenvolvimento de seu raciocínio clínico (8,58). Conclusão: As escolas médicas enfrentam novos desafios na educação médica. O conceito inovador da modalidade de ensino integrado de radiologia-semiologia afeta a capacidade de autopercepção dos alunos para interpretar imagens radiológicas e pode ser uma tendência de estratégia educacional.
Subject(s)
Humans , Radiology/education , Clinical Diagnosis/education , Education, Medical/methods , Schools, Medical , Surveys and Questionnaires , CurriculumABSTRACT
BACKGROUND: Longevity, combined with a higher prevalence of obesity, particularly visceral obesity, has been associated with an increased risk of cardiovascular diseases. Insulin resistance (IR) is an important link between visceral obesity and cardiovascular diseases. An important association has been found between sagittal abdominal diameter, visceral obesity and IR. The objective of this study is to evaluate sagittal abdominal diameter as a marker of visceral obesity and correlate it with IR in older primary health care patients. METHODS: A cross-sectional study was performed with 389 patients over 60 years of age (70.6 ± 6.9), of whom 74% were female. Their clinical, anthropometric and metabolic profiles were assessed and their fasting serum insulin level was used to calculate the homeostasis model assessment insulin resistance (HOMA-IR). Sagittal abdominal diameter was measured in the supine position at the midpoint between the iliac crest and the last rib with abdominal calipers. RESULTS: Sagittal abdominal diameter was significantly correlated with anthropometric measures of general and visceral obesity and with HOMA-IR in both genders. There was no change in the association between sagittal abdominal diameter and HOMA-IR after adjusting for age, sex, diabetes and hypertension. CONCLUSION: It is feasible to use sagittal abdominal diameter in older primary care patients as a tool to evaluate visceral obesity, which is an indicator of cardiovascular risk.
ABSTRACT
OBJECTIVE: to evaluate the knowledge growth of the members of the Trauma, Resuscitation and Emergency League in comparison with a nonparticipating group, with similar characteristics, at the Fluminense Federal University. METHODS: we evaluated 50 league members and 50 non-members (control group) through questionnaires applied at the beginning and end of a school year. We used a generalized linear model, with interaction effect between groups and tests (multiple comparisons with Bonferroni correction). We included the following control variables: gender, period, age, and attendance to some other course on a similar topic. RESULTS: there was an increase of 22 percentage points (p<0.001) for the group with more than 75% presence in the League compared with the eight points in the control group (p<0.05). There was no statistically significant growth for the group with less than 75% presence. CONCLUSION: the growth of knowledge was significantly higher in the group that assiduously participated in the League, which reinforces its importance in complementing the traditional content of medical courses.