Professional values at the beginning of medical school: a quasi-experimental study.

BACKGROUND: Teaching professionalism in medical schools is central to medical education and society. We evaluated how medical students view the values of the medical profession on their first day of medical school and the influence of a conference about the competences of this profession on these students' levels of reflection. METHODS: We studied two groups of medical students who wrote narratives about the values of the medical profession and the influence of the COVID-19 pandemic on these values. The first group wrote the narratives after a conference about the competences of the medical profession (intervention group), and the second group wrote the same narratives after a biochemistry conference (control group). We also compared the levels of reflection of these two groups of students. RESULTS: Among the 175 medical students entering in the 2022 academic year, 159 agreed to participate in the study (response rate = 90.8%). There were more references to positive than negative models of doctor‒patient relationships experienced by the students (58.5% and 41.5% of responses, respectively). The intervention group referred to a more significant number of values than the control group did. The most cited values were empathy, humility, and ethics; the main competences were technical competence, communication/active listening, and resilience. The students' perspectives of the values of their future profession were strongly and positively influenced by the pandemic experience. The students realized the need for constant updating, basing medical practice on scientific evidence, and employing skills/attitudes such as resilience, flexibility, and collaboration for teamwork. Analysis of the levels of reflection in the narratives showed a predominance of reflections with a higher level in the intervention group and of those with a lower level in the control group. CONCLUSIONS: Our study showed that medical students, upon entering medical school, already have a view of medical professionalism, although they still need to present a deeper level of self-reflection. A single, planned intervention in medical professionalism can promote self-reflection. The vision of medical professional identity was strongly influenced by the COVID-19 pandemic, positively impacting the formation of a professional identity among the students who decided to enter medical school.

A literatura de Stefan Zweig e a revelação de intervenientes da clínica psicanalítica / Stefan zweig’s literature and the disclosure of components of the psychoanalytic clinic

A importância da articulação entre psicanálise e literatura pode ser recuperada desde o exórdio da proposição freudiana. Tal relação é considerada componente fundamental na formação do analista e no material de investigação e revelação, configurando-se como campo possível de ilustração teórico-conceitual e material correlato à clínica. O presente artigo demonstra como a novela 24 horas na vida de uma mulher, de Stefan Zweig, autor austríaco reconhecido por Freud por suas produções literárias notáveis, revela e desvela elementos de grande valia para a psicanálise. Para tanto, será abordada a relação entre os dois campos de saber apontando no texto literário zweigiano a possibilidade da presença de alguns intervenientes precípuos – operadores e fenômenos como a transferência, a projeção, a identificação, e especialmente, a devastação feminina – que se evidenciam na clínica psicanalítica(AU)

The importance of the relationship between Psychoanalysis and Literature can be recovered from the exordium of the Freudian proposition. This connection is considered a fundamental component in the development of the analyst and a constructive material of research and revelation, configuring itself as a possible field of theoretical-conceptual illustration and a material correlated to the clinic. This article demonstrates how the novel “24 Hours in a Woman’s Life", from Stefan Zelig, an Austrian author recognized by Freud for his remarkable literary productions, reveals elements of great value to psychoanalysis. In order to do so, one will be discussed the relationship between the two fields of knowledge, pointing out in the Zweigian literary text the possibility of the presence of some key actors - operators and phenomena such as transference, projection, identification, and especially female devastation - of the psychoanalytic clinic(AU)

De uma clínica do refúgio: violência, trauma e escrita / On a clinic of refuge: violence, trauma and writing / De la clinique de refuge: violence, traumatisme et écriture / De una clínica del refugio: violencia, trauma y escrita

O artigo apresenta uma reflexão sobre as atuais políticas de migração e o status quo do refugiado, circunscrevendo algumas especificidades de sua configuração subjetiva. Elementos traumáticos e hiatos expressivos no âmbito da capacidade representacional revelam-se como contingências, corolário da exposição reiterada à precariedade e à violência. A partir de algumas ferramentas metapsicológicas e da interlocução entre psicanálise, cultura e literatura, desenvolvem-se os aspectos mais relevantes e idiossincráticos de uma clínica do refúgio. Para tanto, utiliza-se como recurso ilustrativo a narrativa de caráter fortemente autobiográfico Por que a criança cozinha na polenta (2004), da escritora romena Aglaja Veteranyi.

This paper discusses current migration policies and the status quo of refugees by circumscribing some specificities of its subjective configuration. Traumatic elements and expressive hiatuses belonging to the representational capacity show to be contingencies, a corollary of repeated exposure to precariousness and violence. Based on some metapsychological tools and the interlocution between psychoanalysis, culture and literature, the most relevant and idiosyncratic aspects of the clinic of refuge are developed. To achieve that, the strongly autobiographical narrative "Why the Child is Cooking in the Polenta" by Romanian writer Aglaja Veteranyi is used as an illustrative resource.

Cet article présente une réflexion sur les politiques migratoires actuelles et le statu quo du réfugié, circonscrivant certaines spécificités de sa configuration subjective. Les éléments traumatiques et les lacunes d'expression dans le domaine de la capacité de représentation se révèlent comme des contingences, corollaire d'une exposition répétée à la précarité et à la violence. À partir d'outils métapsychologiques et l'articulation entre la psychanalyse, la culture et la littérature, on développe les aspects les plus pertinents et idiosyncratiques d'une clinique du refuge. À cette fin, le roman fortement autobiographique « Pourquoi l'enfant cuisait dans la polenta ¼ de l'écrivain roumaine Aglaja Veteranyi est utilisé à titre d'illustration.

El artículo presenta una reflexión sobre las actuales políticas de migración y el status quo del refugiado, circunscribiendo algunas especificidades de su configuración subjetiva. Elementos traumáticos y brechas expresivas en el ámbito de la capacidad representacional se revelan como contingencias, corolario de la exposición reiterada a la precariedad y a la violencia. A partir de algunas herramientas metapsicológicas y de la interlocución entre el psicoanálisis, la cultura y la literatura, se desarrollan los aspectos más relevantes e idiosincrásicos de una clínica del refugio. Para ello, se utiliza como recurso ilustrativo una narrativa de carácter fuertemente autobiográfico: ¿Por qué se cuece el niño en la polenta?, de la escritora rumana Aglaja Veteranyi.

Dieser Artikel analysiert die aktuelle Migrationspolitik und den Status Quo der Flüchtlinge, wobei einige Besonderheiten ihrer subjektiven Konfiguration näher betrachtet werden. Traumatische Elemente und expressive Lücken im Rahmen der Repräsentationsfähigkeit offenbaren sich als Kontingenz, als Konsequenzen der wiederholten Einwirkung von Prekarität und Gewalt. Basierend auf einigen metapsychologischen Begriffen und der Verknüpfung von Psychoanalyse, Kultur und Literatur werden die bedeutenden und idiosynkratischen Aspekte einer Klinik der Zuflucht entwickelt. Außerdem wird ebenfalls das Buch „Warum das Kind in der Polenta kocht" der rumänischen Schriftstellerin Aglaja Veteranyi als darstellendes Mittel verwendet.

De uma metapsicologia borderline e sua relação com o manejo clínico na conjugalidade / On a borderline metapsychology and its relationship with clinical management in conjugality

A instituição de novos paradigmas e a fragmentação de valores tradicionais constituem-se como marcas da contemporaneidade. A clínica reflete as transformações da cultura e é convocada a se ocupar de configurações subjetivas que podem se apresentar sob a forma de quadros denominados borderline, circunscritas pela presença de elementos traumáticos e hiatos expressivos no âmbito da capacidade representacional dos sujeitos. Considerando-se a importância para a práxis psicanalítica e a escassez de trabalhos que se dediquem à conjugalidade nas patologias narcísico-identitárias e seu tratamento, o objetivo deste trabalho é realizar uma reflexão teórica acerca de uma metapsicologia dos casos limítrofes e as especificidades de seu manejo clínico no contexto do atendimento de casais.(AU)

The institution of new paradigms and the fragmentation of traditional values constitute marks of contemporaneity. The clinic reflects the transformations of the culture and is called upon to deal with subjective configurations that may occur in the form of conditions so-called borderline, circumscribed by the presence of traumatic elements and expressive gaps within the scope of the representational capacity of the subjects. Considering the importance for the psychoanalytical praxis and the scarcity of works devoted to conjugality in narcissistic-identitary pathologies and their treatment, the objective of this work is to carry out a theoretical reflection about a metapsychology of borderline cases and the specificities of its clinical management in the context of the care of couples.(AU)