ABSTRACT
A pandemia de Covid-19 impactou significativamente a educação médica, em especial o currículo paralelo, que engloba diversas atividades extracurriculares, tais quais: ligas acadêmicas, estágios, projeto de extensão, iniciação científica, monitoria e disciplinas optativas. Este estudo pretende analisar o resultado da pandemia de Covid-19 sobre o currículo paralelo sob a ótica de acadêmicos de Medicina. Trata-se de um estudo exploratório-descritivo, com recorte transversal, por meio de questionário online via Google Forms® com perguntas na escala tipo Likert. A amostra foi composta por 340 estudantes de Medicina, cursando do 4º ao 12º período, de Curitiba, Paraná. A modalidade onlinefacilitou a submissão de trabalhos científicos, bem como a acessibilidade a eventos médicos, que obtiveram maior adesão dentre as atividades avaliadas. Destaca-se a participação em pesquisas científicas, em especial pelos alunos do ciclo básico/clínico. Logo, a maioria dos participantes concordam que existem adaptações a serem mantidas no período pós pandemia.
The Covid-19 pandemic has significantly impacted medical education, especially the parallel curriculum, which encompasses several extracurricular activities, such as academic leagues, internships, extension projects, undergraduate research projects, teaching assistance, and elective courses. This study aims at analyzing the result of the Covid-19 pandemic on the parallel curriculum from the perspective of medical students. This is an exploratory-descriptive, cross-sectional study, using an online questionnaire via Google Forms® with Likert-type scale questions. The sample consisted of 340 Medicine students, from the 4th to the 12th terms, from Curitiba, Paraná. The online modality facilitated the submission of scientific papers, as well as the accessibility to medical events, which had the highest adherence among the evaluated activities. Participation in scientific research stands out, especially for students in the basic/clinical cycle. Therefore, most participants agree that there are adaptations to be maintained in the post-pandemic period.
La pandemia de Covid-19 impactó la educación médica, especialmente en el currículo paralelo, que incluye actividades extracurriculares, como: ligas académicas, pasantías, proyectos de extensión, iniciación científica, seguimiento y optativas. Este estudio pretende analizar el resultado de la pandemia de Covid-19 en el currículo paralelo desde la perspectiva de los estudiantes de medicina. Se trata de un estudio exploratorio-descriptivo, transversal, utilizando un cuestionario online a través de Google Forms® con preguntas en escala tipo Likert. La muestra se compone por 340 estudiantes de medicina del 4º al 12º período, en Curitiba, Paraná. La modalidad online facilitó el envío de trabajos científicos y la accesibilidad a eventos médicos, ue obtuvo mayor adhesión entre las actividades evaluadas. Cabe destacar la participación en la investigación científica, especialmente de los estudiantes del ciclo básico/clínico. Así, la mayoría de los participantes está de acuerdo de que hay adaptaciones que deben mantenerse en el período posterior a la pandemia.
ABSTRACT
ABSTRACT Objective: To analyze literature data about unnecessary exposure of pediatric emergency patients to ionizing agents from imaging examinations, nowadays and during times of COVID-19. Data sources: Between April and July 2020, articles were selected using the databases: Virtual Health Library, PubMed and Scientific Electronic Library Online. The following descriptors were used: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] and [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Inclusion criteria were articles available in full, in Portuguese or English, published from 2016 to 2020 or from 2019 to 2020, and articles that covered the theme. Articles without adherence to the theme and duplicate texts in the databases were excluded. Data synthesis: 61 publications were identified, of which 17 were comprised in this review. Some imaging tests used in pediatric emergency departments increase the possibility of developing future malignancies in patients, since they emit ionizing radiation. There are clinical decision instruments that allow reducing unnecessary exam requests, avoiding over-medicalization, and hospital expenses. Moreover, with the COVID-19 pandemic, there was a growing concern about the overuse of imaging exams in the pediatric population, which highlights the problems pointed out by this review. Conclusions: It is necessary to improve hospital staff training, use clinical decision instruments and develop guidelines to reduce the number of exams required, allowing hospital cost savings; and reducing children's exposure to ionizing agents.
RESUMO Objetivo: Analisar dados da literatura sobre exposição desnecessária de pacientes da emergência pediátrica a agentes ionizantes dos exames de imagem, na atualidade e em tempos de COVID-19. Fontes de dados: Entre abril e julho de 2020 ocorreu a seleção dos artigos, utilizando-se as bases de dados: Biblioteca Virtual em Saúde, PubMed e Scientific Electronic Library Online. Utilizaram-se os descritores: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] e [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Incluíram-se artigos disponíveis na íntegra, em português ou inglês, publicados no período de 2016 a 2020 ou de 2019 a 2020, e artigos que contemplassem o tema. Excluiu-se artigos sem aderência com a temática e textos duplicados. Síntese dos dados: Identificaram-se 61 publicações, sendo 17 utilizadas para a elaboração desta revisão. Alguns exames de imagem utilizados nos Setores de Urgência e Emergência (SUEs) pediátricos, por emitirem radiação ionizante, aumentam a possibilidade de desenvolver malignidades futuras nas crianças. Destarte, há instrumentos de decisão clínica que possibilitam diminuir requisições de exames desnecessários, evitando a sobremedicalização e os gastos hospitalares. Ademais, com a pandemia da COVID-19, cresceu a preocupação com o uso excessivo de exames de imagem na população pediátrica, o que reafirma a problematização deste estudo. Conclusões: Veem-se como necessárias a capacitação da equipe hospitalar, a utilização de instrumentos de decisão clínica e a confecção de protocolos que possam avaliar a singularidade da criança. Isso permitirá reduzir o número de exames requeridos, possibilitando economia de custos hospitalares e redução da exposição de crianças a agentes ionizantes.
ABSTRACT
OBJECTIVE: To analyze literature data about unnecessary exposure of pediatric emergency patients to ionizing agents from imaging examinations, nowadays and during times of COVID-19. DATA SOURCES: Between April and July 2020, articles were selected using the databases: Virtual Health Library, PubMed and Scientific Electronic Library Online. The following descriptors were used: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] and [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Inclusion criteria were articles available in full, in Portuguese or English, published from 2016 to 2020 or from 2019 to 2020, and articles that covered the theme. Articles without adherence to the theme and duplicate texts in the databases were excluded. DATA SYNTHESIS: 61 publications were identified, of which 17 were comprised in this review. Some imaging tests used in pediatric emergency departments increase the possibility of developing future malignancies in patients, since they emit ionizing radiation. There are clinical decision instruments that allow reducing unnecessary exam requests, avoiding over-medicalization, and hospital expenses. Moreover, with the COVID-19 pandemic, there was a growing concern about the overuse of imaging exams in the pediatric population, which highlights the problems pointed out by this review. CONCLUSIONS: It is necessary to improve hospital staff training, use clinical decision instruments and develop guidelines to reduce the number of exams required, allowing hospital cost savings; and reducing children's exposure to ionizing agents.
