Assessment of undergraduate clinical reasoning in geriatric medicine: application of a script concordance test.

A challenging aspect of geriatric practice is that it often requires decision-making under conditions of uncertainty. The Script Concordance Test (SCT) is an assessment tool designed to measure clinical data interpretation, an important element of clinical reasoning under uncertainty. The purpose of this study was to develop and analyze the validity of results of an SCT administered to undergraduate students in geriatric medicine. An SCT consisting of 13 cases and 104 items covering a spectrum of common geriatric problems was designed and administered to 41 undergraduate medical students at a medical school in São Paulo, Brazil. A reference panel of 21 practicing geriatricians contributed to the test's score key. The responses were analyzed, and the psychometric properties of the tool were investigated. The test's internal consistency and discriminative capacity to distinguish students from experienced geriatricians supported construct validity. The Cronbach alpha for the test was 0.84, and mean scores for the experts were found to be significantly higher than those of the students (80.0 and 70.7, respectively; P < .001). This study demonstrated robust evidence of reliability and validity of an SCT developed for use in geriatric medicine for assessing clinical reasoning skills under conditions of uncertainty in undergraduate medical students. These findings will be of interest to those involved in assessing clinical competence in geriatrics and will have important potential application in medical school examinations.

Undergraduate teaching of pediatrics in medical schools of the state of Rio de Janeiro.

OBJECTIVE: The aim of this study is to describe and analyze the teaching of pediatrics in medical schools of the state of Rio de Janeiro in terms of structure, hour load, insertion into the Medical course curriculum, objectives, syllabuses, learning scenarios, and evaluation methods. METHODS: A cross-sectional study of 16 pediatric courses of medical schools of the state of Rio de Janeiro was carried out using exploratory and descriptive research methods. The data were obtained at the investigated schools from the Teaching Coordinators of the Pediatric courses, and institutional documents were also analyzed. RESULTS: The insertion of pediatric education into the Medical course curriculum, the learning environments and the criteria for the selection of contents were not so different among the investigated courses. Pediatric education corresponds to 10.07% of the total hour load of the medical course; this rate is very close to the one recommended by Southern Cone pediatric associations. Pediatric medical education begins in the third year in most of the undergraduate courses. Cognitive development in the learning process and student-centered evaluation, predominantly based on written tests, are highlighted. Among the analyzed courses, the percentage of practical activities ranges from 0 to 60% in the pre-internship period. CONCLUSIONS: The teaching of pediatrics in medical schools of the state of Rio de Janeiro gives priority to general medical education; in the pre-internship period, expositive lectures prevail; primary health care settings are used; evaluation is focused on written tests, placing special emphasis on cognitive aspects in most courses.

Undergraduate teaching of pediatrics in medical schools of the state of Rio de Janeiro

OBJECTIVE: The aim of this study is to describe and analyze the teaching of pediatrics in medical schools of the state of Rio de Janeiro in terms of structure, hour load, insertion into the Medical course curriculum, objectives, syllabuses, learning scenarios, and evaluation methods.METHODS: A cross-sectional study of 16 pediatric courses of medical schools of the state of Rio de Janeiro was carried out using exploratory and descriptive research methods. The data were obtained at the investigated schools from the Teaching Coordinators of the Pediatric courses, and institutional documents were also analyzed. RESULTS:The insertion of pediatric education into the Medical course curriculum, the learning environments and the criteria for the selection of contents were not so different among the investigated courses. Pediatric education corresponds to 10.07% of the total hour load of the medical course; this rate is very close to the one recommended by Southern Cone pediatric associations. Pediatric medical education begins in the third year in most of the undergraduate courses. Cognitive development in the learning process and student-centered evaluation, predominantly based on written tests, are highlighted. Among the analyzed courses, the percentage of practical activities ranges from 0 to 60% in the pre-internship period. CONCLUSIONS: The teaching of pediatrics in medical schools of the state of Rio de Janeiro gives priority to general medical education; in the pre-internship period, expositive lectures prevail; primary health care settings are used; evaluation is focused on written tests, placing special emphasis on cognitive aspects in most courses.

O preceptor na residência médica em Pediatria: principais atributos / The preceptor in medical residencies in Pediatrics: main attributes

Objetivos: Analisar o perfil dos preceptores e os atributos considerados por eles como importantes para o exercício desta função em dois programas de residência médica em Pediatria no Rio de Janeiro. Métodos: Através de dois programas de residência médica em pediatria do Rio de janeiro, um universitário outro não, foram obtidas informações sobre sexo, idade, tempo de formado, tempo em que atua na preceptoria, formação preparo específico para o ensino, e a citação de até cinco atributos que julgassem necessários a um bom preceptor. Os dados foram consolidados e discutidos no texto. Resultados: dos 90 participantes , 70 por cento eram mulheres, 74 por cento tinham entre 30 e 49 anos, 87 por cento formaram-se entre 10 e 29 anos atrás. Metade deles afirmou não ter preparo específico para o ensino, e a outra metade cursou disciplinas de Pedagogia Médica e Didática Especial em seus respectivos cursos de pós-graduação. As categorias de atributos mais citadas foram exercício da tutoria, ética e humanismo, domínio do conteúdo, capacidade de educação permanente, capacidade didática. Conclusões: Os preceptores apontam o desafio de um exercício de tutoria calcado na prática médica assistencial onde a responsabilidade profissional, o relacionamento humano, a capacidade de organização, a prática avaliativa e o domínio do conteúdo constituem eixos orientadores da própria prática. A estes eixos, acrescentam os aspectos éticos e humanisticos e sua capacidade de educação permanente. No entanto, sentem a necessidade de uma capacitação didática para o desempenho de suas função