The impact and the challenges of implementing a faculty development program on health professions education in a Brazilian Medical School: a case study with mixed methods.

PURPOSE: Faculty development in health professions education is still challenging in developing countries like Brazil. Work overload and the lack of financial support hinder faculty members' participation. Ribeirão Preto Medical School founded its Center for Faculty Development in 2016. Since then, an essential skills module (ESMo) on health professions education (HPE) has been offered regularly to faculty members and preceptors of seven undergraduate programs. This case study aims to evaluate the impact of this Essential Skills Module on the educational practices of participants two years after attending the module and the challenges faced during the process. METHOD: The study used a mixed-method approach with a description of the demographic and professional profile data of the ESMo participants. Immediate post-ESMo perceptions (satisfaction and learning) of the participants were determined with structured instruments. Two years later, a semi-structured interview was conducted and recorded to determine the long-term effects (application of learning and behavior changing as an educator). NVIVO® software was used to store and systematize the thematic discourse analysis with a socio-constructivist theoretical framework interpretation. RESULTS: One hundred forty-six participants were included: 86 (59%) tenured faculty members, 49 (33,5%) clinical preceptors, and 11 (7,5%) invited teachers. Most were female (66%), and 56% had teaching experience shorter than ten years. 52 (69%) out of 75 eligible participants were interviewed. The immediate reaction to participating in the module was quite positive and 80% have already implemented an educational intervention in their daily activities. Discourses thematic analysis showed five emerging themes appearing in different frequencies: Changes in teaching activities (98%); Lack of previous pedagogical training (92.3%); Commitment and enthusiasm towards teaching (46.15%); Overlapping functions inside the institution (34.6%) and Challenges for student assessment (23%). CONCLUSION: This first in-depth evaluation of the long-term effects of a faculty development intervention in a Brazilian Health Profession Education school showed that participation positively changed participants' teaching & learning practices. These interventions consistently fostered a community of practice and valued faculty development processes in local and national scenarios.

O Desenvolvimento Docente na FMRP-USP: contexto histórico / Faculty Development at Ribeirão Preto School of Medicine at University of São Paulo (FMRP-USP): A contextualized historical review

O objetivo desse artigo é contextualizar historicamente as ações de desenvolvimento docente realizadas na Facul-dade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP) desde sua fundação até a criação do Centro de Desenvolvimento Docente para o Ensino (CDDE) para as Profissões da Saúde, que foi a primeira unidade formal da instituição para a educação para o ensino dos seus professores e preceptores. Apresentamos um pano-rama sobre o conceito atual de desenvolvimento docente, o papel de fundações internacionais de fomento e de regulamentações governamentais locais na consolidação dessas atividades no país, além de ações dos diretores e professores da Faculdade de Medicina, visando a capacitação profissional para o exercício da docência desde a sua fundação. Finalmente, abordamos o contexto de criação do CDDE, os profissionais participantes e dados da partici-pação docente nas cinco primeiras edições do "Módulo Básico" de ensino para as profissões da saúde na FMRP-USP, o primeiro e mais importante programa estruturado de capacitação docente oferecido pelo centro. (AU)

The objective of this article is to historically contextualize Faculty Development (FD) actions carried out at the Ribeirão Preto School of Medicine at University of São Paulo (FMRP-USP), since its foundation up until the creation of the Center for Faculty Development (CDDE) in Health Professions Education (HPE). CDDE is the first formal unit of the institution with the mission to support educators (Faculty Members and Preceptors) to improve their educa-tional practices: to teach, facilitate learning, assess, design curriculum, and evaluate programs. We present here an overview for the concept of Faculty Development, the role of international funding foundations and local govern-ment regulations in the consolidation of these activities in Brazil. We also describe the school administration actions and pioneer Faculty members that created the foundations for the first Faculty Development Center at FMRP-USP. Finally, we address the context of the creation of the CDDE and the describe participants characteristics of the first five editions of the Essentials Skills Module on HPE. (AU)

Tumor biological profile of patients up to 50 years of age in an inland city of São Paulo

Introduction: In Brazil, breast cancer screening is not performed in young women. However, although less frequent, the disease is generally more aggressive in this age group, with worse prognosis and refractoriness to treatment. Thus, the identification of specific subtypes by immunohistochemistry can help improve the effectiveness of treatments. Objectives: To evaluate the biological characteristics of breast tumors in patients under 50 years. Methods: This is an observational, longitudinal, retrospective study, based on data collected from medical records of the Hospital do Câncer de Franca, from January 2015 to February 2018. Results: The most frequent biological subtype was luminal B (42.5%), and the mean age of the women was 43.6 years. The most prevalent clinical staging was IIA (31%). Mastectomy with axillary drainage was the most used surgical treatment. A positive correlation was found between biological profiles and sociodemographic data, with a predominance of the luminal B subtype in women under 40 years and luminal A in those between 41 and 50 years. The mean tumor size was 4.2 cm, being larger in older and white patients. In multiparous women, the subtypes HER2 and luminal A and B stood out. Conclusion: Luminal B and luminal A biological profiles, as well as staging II and III, were the most prevalent. Mastectomy and axillary drainage were the most common surgical treatments. The employment of these procedures should be reviewed by the service in order to improve the quality of life of the patients treated, favoring the expansion of primary conservative surgeries or post-neoadjuvant chemotherapy.

Miofrioblastoma mamário em axila / Mammary myofibroblastoma in axila

Miofibroblastoma é um tumor benigno raro de mama, de origem mesenquimal. A localização em região axilar é ainda mais incomum. Tendo em vista a dificuldade em se estabelecer o diagnóstico diferencial baseado apenas nos achados clínicos e imaginológicos, a confirmação histopatológica é imprescindível no diagnóstico diferencial com tumor oculto de mama.

Myofibroblastoma is a rare and benign mesenchymal breast neoplasm. The axillary topography is further more uncommon. The histologic identification is important because the differencial diagnosis with malignant tumours of the breast. This report a case of mammary myofibroblastoma in axilla, wich was initially diagnosticated as an occult lobular carcinoma.