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2.
Ear Nose Throat J ; 98(3): 139-142, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30938243

RESUMO

IMPORTANCE:: Otolaryngology residents take the otolaryngology training examination (OTE) yearly to assess their fund of knowledge. The Accreditation Council for Graduate Medical Education (ACGME) milestone evaluations are also conducted semiannually. Accurate prediction of training examination performance allows identification of residents who are performing well and those who need targeted remediation. Prior studies in other specialties have attempted to use milestone evaluations to help predict in-training examination scores. OBJECTIVE:: In this study, we aim to identify whether ACGME milestone evaluation scores predict OTE performance. DESIGN:: Milestone ratings and OTE scores for residents at 2 US otolaryngology residency programs were collected. Multivariate analysis was achieved using linear mixed modeling. We considered a 2-tailed P value of ≤ .05 as statistically significant. SETTING:: Two US otolaryngology residency programs. PARTICIPANTS:: Forty-eight otolaryngology residents postgraduate years 2 to 5. RESULTS:: Otolaryngology training examination scores and ACGME milestone evaluations were collected from 48 residents from postgraduate year 2 to 5 between the years 2014 and 2017. One hundred eight OTE scores were available. Linear mixed-effect models were constructed, and after adjusting for level of training and OTE year, the total milestone rating made a negligible impact in estimating OTE percentage correct (ß = -.01, P = .9). Similarly, total milestone rating demonstrated a minimal contribution in approximating OTE national stanine score after adjusting for the level of training (ß = -.003, P = .9). CONCLUSIONS AND RELEVANCE:: In our study, ACGME milestone evaluations are not predictive of residents' OTE performance. What these milestone evaluation data mean and how they should be used continues to be an unanswered question. We should aim to identify the most effective applications of the milestone data collected yearly by otolaryngology programs.


Assuntos
Educação , Avaliação Educacional/métodos , Internato e Residência , Otolaringologia/educação , Competência Clínica , Educação/métodos , Educação/normas , Humanos , Internato e Residência/métodos , Internato e Residência/normas , Estados Unidos
3.
J Nurs Manag ; 27(5): 1047-1054, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30963649

RESUMO

AIM: To explore the effectiveness of a clinical reasoning teaching workshop (CRTW) in preceptors' teaching ability, self-efficacy of clinical reasoning teaching. BACKGROUND: Preceptors' teaching skills are crucial for training novice nurses. How to enhance preceptors' teaching ability is a pertinent concern in clinical practice. METHODS: This study comprised two stages. At stage I, we administered a pre- to post-test single group with 33 participants to investigate the changes in preceptors' knowledge and self-efficacy in clinical reasoning teaching after clinical reasoning teaching workshop. At stage II, a quasi-experimental design was adopted to assess the effectiveness of the clinical reasoning teaching workshop by comparing the preceptors' teaching ability by novice nurses. There were 22 nurses' preceptors who underwent the clinical reasoning teaching workshop and 70 nurses with preceptors who did not undergo clinical reasoning teaching workshop and matched with preceptors' age and working experience. RESULTS: After clinical reasoning teaching workshop, preceptors' knowledge and self-efficacy of clinical reasoning teaching ware increased significantly. Novice nurses (study group) scored their preceptors' teaching ability significantly higher than nurses' (control group). CONCLUSION: The clinical reasoning teaching workshop can enhance preceptors' teaching ability and confidence, thereby improving their teaching ability. IMPLICATIONS FOR NURSING MANAGEMENT: A well-designed workshop with appropriated teaching method can allow preceptors to learn effectiveness. Clinical reasoning teaching workshop can be used in the training of preceptors.


Assuntos
Educação/normas , Preceptoria/métodos , Ensino/educação , Adulto , Atitude do Pessoal de Saúde , Educação/estatística & dados numéricos , Feminino , Humanos , Masculino , Mentores/educação , Mentores/estatística & dados numéricos , Preceptoria/normas , Competência Profissional/normas , Pesquisa Qualitativa , Inquéritos e Questionários , Ensino/normas , Ensino/estatística & dados numéricos
4.
Khirurgiia (Mosk) ; (1): 89-94, 2019.
Artigo em Russo | MEDLINE | ID: mdl-30789615

RESUMO

Robotic surgery is a future method of minimal invasive surgery. Robot-assisted radical prostatectomy (RARP) is a common method of surgical treatment of prostate cancer. Due to significant differences of the surgical technique of RARP compared to open or laparoscopic radical prostatectomy (LRP) new methods of training are needed. At the moment there are many opinions how to train physicians best. Which model is the most effective one remains nowadays controversial. OBJECTIVE: Analyze currently available data of training methods of RARP. Determine the most effective training model and evaluate its advantages and disadvantages. Establish a standardized plan and criteria for proper training and certification of the entire surgical team. MATERIAL AND METHODS: Literature review based on PubMed database, Web of Science and Scopus by keywords: robot-assisted radical prostatectomy, training of robot-assisted prostatectomy, training in robot-assisted operations, a learning curve of robot-assisted prostatectomy, virtual reality simulators (VR-simulators) in surgery. RESULTS: According to the literature in average 18 to 45 procedures are required for a surgeon to achieve the plateau of the learning curve of the RARP. Parallel training, pre-operative warm-up and the use of virtual reality simulators (VR-simulators) can significantly increase the learning curve. There are many described models of RARP training. CONCLUSIONS: The absence of accepted criteria of evaluation of the learning curve does not allow to use this parameter as a guide for the surgeon's experience. Proper training of robotic surgeons is necessary and requires new methods of training. There are different types of training programs. In our opinion the most effective training program is when a surgeon observes the performance of tasks or any steps of operation on the VR-simulator, then he performs them and analyzes mistakes by video recording. Then the surgeon observes real operations and performs some steps of the operation which are already leant on the simulator under supervision of the mentor and analyzes mistakes by video recording. Thus, mastering first the simple stages under supervision of a mentor, the surgeon effectively adopts the surgical experience from him. It is necessary to train not only the surgeons but also the entire surgical team.


Assuntos
Prostatectomia/educação , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/educação , Simulação por Computador , Educação/normas , Humanos , Curva de Aprendizado , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/educação , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Modelos Educacionais , Equipe de Assistência ao Paciente/normas , Prostatectomia/instrumentação , Prostatectomia/métodos , Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Realidade Virtual
6.
J Evid Based Integr Med ; 24: 2515690X18823696, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30789055

RESUMO

North American naturopathic medicine is a distinct form of practice that is woven into the larger fabric of integrative medicine; in a number of US states and Canadian provinces, naturopathic doctors enjoy a wide scope of practice, including the ability to make diagnoses, order tests, use medical technology, write prescription drugs, and perform minor surgeries. However, the basic premise of naturopathic medicine and its guiding principles-considering the whole person and supporting healthy lifestyle behaviors-is the unifying approach in clinical practice. In the 1970s, homeopathy-considered in many circles to be a hypothesis-driven, fringe form of alternative medicine-became embedded into the training and practice of North American naturopathic doctors. Since the earliest days of its theory (circa 1800), homeopathy has escaped, and continues to escape, biological plausibility; however, the persistence of this modality (and the insistence by both its consumers and practitioners that it provides benefit) speaks to the role of expectations, beliefs, values, agency, context effects, and the placebo-at-large. It is our contention that the progression of professional naturopathic medicine in the 21st century requires a major transition in how it approaches the subject of homeopathy. We propose that students should be encouraged to critically analyze the tenets of homeopathy, its lesser known history, and the idea of homeopathy as a biomedicine that simply awaits untold chemicophysical mechanisms. Furthermore, the modality of homeopathy should be incorporated into the larger context of placebo studies, narrative medicine, ethics, and psychotherapeutic techniques.


Assuntos
Educação Médica , Homeopatia/educação , Naturopatia , Médicos/normas , Canadá , Educação/normas , Educação Médica/normas , Humanos , Naturopatia/normas
7.
J Nurses Prof Dev ; 35(3): 144-151, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30762844

RESUMO

Educational preparation for nurse preceptors helps reduce anxiety and stress in precepting. A quality improvement project was initiated in a large U.S. West Coast federal healthcare system to evaluate an existing training program for preceptors. A new 2-day preceptor workshop was subsequently created to address identified gaps. Results demonstrated statistically significant gains in preceptors' essential knowledge and skills required in precepting, and room for improvement in faculty teaching techniques and course materials.


Assuntos
Competência Clínica/normas , Educação/normas , Preceptoria/métodos , Competência Clínica/estatística & dados numéricos , Educação/métodos , Avaliação Educacional/métodos , Humanos , Inquéritos e Questionários
9.
Chest ; 155(3): 554-564, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30392792

RESUMO

BACKGROUND: Pulmonary medicine specialists find themselves responsible for the diagnosis and management of patients with sleep disorders. Despite the increasing prevalence of many of these conditions, many sleep medicine fellowship training slots go unfilled, leading to a growing gap between the volume of patients seeking care for sleep abnormalities and the number of physicians formally trained to manage them. To address this need, we convened a multisociety panel to develop a list of curricular recommendations related to sleep medicine for pulmonary fellowship training programs. METHODS: Surveys of pulmonary and pulmonary/critical care fellowship program directors and recent graduates of these programs were performed to assess the current state of sleep medicine education in pulmonary training, as well as the current scope of practice of pulmonary specialists. These data were used to inform a modified Delphi process focused on developing curricular recommendations relevant to sleep medicine. RESULTS: Surveys confirmed that pulmonary medicine specialists are often responsible for the diagnosis and treatment of a number of sleep conditions, including several that are not traditionally considered related to respiratory medicine. Through five rounds of voting, the panel crafted a list of 52 curricular competencies relevant to sleep medicine for recommended inclusion in pulmonary training programs. CONCLUSIONS: Practicing pulmonary specialists require a broad knowledge of sleep medicine to provide appropriate care to patients they will be expected to manage. Training program directors may use the list of competencies as a framework to ensure adequate mastery of important content by graduating fellows.


Assuntos
Educação , Pneumologia , Medicina do Sono , Currículo/normas , Técnica Delfos , Educação/métodos , Educação/normas , Bolsas de Estudo/métodos , Bolsas de Estudo/organização & administração , Humanos , Comunicação Interdisciplinar , Pneumologia/educação , Pneumologia/métodos , Melhoria de Qualidade , Medicina do Sono/educação , Medicina do Sono/métodos , Medicina do Sono/normas
10.
Nurse Educ Pract ; 34: 7-11, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30393028

RESUMO

Achieving adequate bioscience learning and assessment in pre registration nursing programs has been problematic for many decades. This has been discussed extensively in national and international health care literature. Despite this, the quantity and quality of bioscience content appears currently in many UK registered nursing programs, to be in a period of decline. Sub optimal bioscience knowledge of registered nurses has been consistently correlated with avoidable morbidity and mortality. An increasing evidence base indicates that a higher level of educated registered nurse, leads to improved health outcomes. It is therefore clear that continuing to fail to address the bioscience problem in nursing education has the potential to incur considerable adverse impact on the UK populations' health. The recent publication of new Nursing and Midwifery Council (NMC) standards of proficiency for registered nurses, and standards for pre-registration nursing programs require nurse education providers across the UK, to write new curriculum. The purpose of this discussion paper is to present the case for enhanced bioscience content within these.


Assuntos
Disciplinas das Ciências Biológicas/métodos , Currículo/normas , Educação/normas , Disciplinas das Ciências Biológicas/tendências , Educação/métodos , Educação em Enfermagem/métodos , Educação em Enfermagem/normas , Humanos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários , Reino Unido
11.
Nurse Educ Today ; 72: 12-17, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30384082

RESUMO

BACKGROUND: Higher education teachers are increasingly challenged to adopt student-centered approaches. AIMS: To determine the strategic guidelines which promote a conceptual change in higher education students, in the context of student-centered approaches to teaching. METHODOLOGY: Integrative literature review, using the PICO method, applied to the ERIC and EBSCO electronic databases. We analyzed 10 articles that were published between 2012 and 2016. RESULTS: We identified four thematic categories: dissonance between concepts and approaches to teaching; mixed approaches with ICTs association; digital simulation; approaches employed in large classes. CONCLUSION: The use of new pedagogical practices promotes the involvement of students, improves critical and creative thinking, reduces apathy and contributes to peer-learning.


Assuntos
Educação/tendências , Ensino/tendências , Educação/normas , Humanos , Ensino/normas
12.
Eval Program Plann ; 72: 88-96, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30321687

RESUMO

Outcome evaluation is very important for program evaluation and has been becoming increasingly so in the age of accountability. Typically, outcome evaluation is conducted for a single program from a single perspective. However, in a real-life situation, many programs exist in a system, and the effects could be viewed from various perspectives. The authors illustrate a typology of program effects in a system. It moves from the paradigm of a single program's single effect to that of a set of programs' multiple effects. Methodological implications are discussed.


Assuntos
Pesquisa Comportamental/organização & administração , Educação/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Pesquisa Comportamental/normas , Criança , Pré-Escolar , Educação/normas , Feminino , Humanos , Avaliação de Programas e Projetos de Saúde/normas , Melhoria de Qualidade/organização & administração , Reprodutibilidade dos Testes , Fatores Socioeconômicos
13.
Child Psychiatry Hum Dev ; 50(2): 230-244, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30078112

RESUMO

Fathers are consistently underrepresented in parenting interventions and practitioners are an important target for change in interventions to enhance father engagement. This research examined the effects of two practitioner training programs in improving practitioner rated competencies and organizational father-inclusive practices. Two studies were conducted, each with a single group, repeated measures (pre, post and 2-month follow-up) design. Study 1 (N = 233) examined the outcomes of face-to-face training in improving practitioner ratings of competencies in engaging fathers, perceived effectiveness and use of father engagement strategies, organizational practices and rates of father engagement. Study 2 (N = 356) examined online training using the same outcome measures. Practitioners in both training formats improved in their competencies, organizational practices and rates of father engagement over time, yet those in the online format deteriorated in three competencies from post-training to follow-up. The implications for delivering practitioner training programs to enhance competencies and rates of father engagement are discussed.


Assuntos
Educação , Pai , Poder Familiar/psicologia , Competência Profissional , Adulto , Educação/métodos , Educação/normas , Pai/educação , Pai/psicologia , Feminino , Humanos , Masculino , Projetos de Pesquisa
14.
Isr J Health Policy Res ; 7(1): 67, 2018 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-30551742

RESUMO

BACKGROUND: Physiotherapy has a vital role in helping patients manage and overcome musculoskeletal pain. Healthcare providers' beliefs about pain are associated with the beliefs of their patients. This study evaluated the attitudes, beliefs and level of pain neuroscience knowledge among Israeli Bachelor-level physiotherapy students. METHODS: First-year (n = 29, before pain course), second-year (n = 28, immediately after pain course and before clinical placements), and fourth-year (n = 28, post-clinical placements) physiotherapy students completed the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS, range 15-105, lower scores indicate a more positive attitude) to assess pain attitudes and beliefs. The Neurophysiology of Pain Questionnaire (NPQ, range 0-19, higher scores indicate more pain-related knowledge) was also completed to measure pain neuroscience knowledge. Two separate one-way ANOVAs with post hoc analyses were used to compare HC-PAIRS and NPQ results between the three groups of students. Pearson correlations were determined between HC-PAIRS and NPQ. RESULTS: HC-PAIRS scores of the first-year students were significantly higher than those of second- and fourth-year students (p = 0.011, p < 0.001, respectively), with no difference between second- and fourth-year students; indicating that first-year students had less-positive attitudes toward the ability of individuals with musculoskeletal pain to function. Similarly, NPQ scores showed that first-year students differed from second- and fourth-year students (p < 0.001, p < 0.001, respectively). The HC-PAIRS and NPQ correlation among the fourth-year students yielded a moderately negative association (r = - 0.462, p = 0.01), indicating that pain neuroscience knowledge was associated with less belief that chronic pain justifies disability. CONCLUSIONS: A specific curriculum about pain during physiotherapy undergraduate education contributes to a more positive evidenced-based attitude to musculoskeletal pain and patient function. The association between pain neuroscience knowledge and positive attitudes and beliefs regarding pain were enhanced after clinical placements, demonstrating that learning improves when integrated into practice. Due to the impact of pain training and the expected benefits to patient care, health policy decision makers and educators should verify that the pain curriculum is current with the best research evidence. Future studies with larger samples that include students from other healthcare disciplines, including medicine are warranted.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Dor Musculoesquelética/psicologia , Fisioterapeutas/educação , Estudantes/psicologia , Adulto , Análise de Variância , Atitude do Pessoal de Saúde , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Currículo/tendências , Educação/métodos , Educação/normas , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Fisioterapeutas/psicologia , Fisioterapeutas/normas , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
16.
Curr Pharm Teach Learn ; 10(8): 1138-1148, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30314551

RESUMO

BACKGROUND AND PURPOSE: Increasing aging populations in the United States means an increasing number of persons with Parkinson's disease (PD) and Alzheimer's disease (AD) requiring competent pharmaceutical care. The workshop was designed and implemented to integrate pharmacology and therapeutics in management of PD and AD, and evaluate efficacy of students' high-cognitive thinking, and self-rated knowledge improvement, confidence, and interest in the subject. EDUCATION ACTIVITY AND SETTING: Third-year pharmacy students participated in a three-hour workshop comprised of a foundational knowledge quiz from pathophysiology, pharmacology and therapeutics, performance on high-cognitive thinking in clinical scenarios, and hands-on activities in pharmacology and therapeutics related to PD and AD care. Pre- and post-education, Likert-style questions assessed students' self-rated confidence, interest and knowledge improvement. Descriptive statistics, paired t-test, and chi-square analyses were performed using Stata 10.1 statistical software (College Station, TX: Stata Corp LP). FINDINGS: Eighty-four of 93 students (90.3%) completed all workshop activities. Students' ability to apply knowledge in complex case mediation problems was not associated with performance on baseline quiz questions (Pearson r: 0.03-0.17). Completion of structured, hands-on active learning integrating clinical pharmacology and therapeutics had measurable immediate benefit solving high-cognitive order problems in clinical scenarios (p < 0.05). Hands-on activity also increased mean self-rated confidence (p < 0.01). Students (85.6%) reported knowledge improved "somewhat" or "very much" after the activity. Mean scores before and after hands-on activity were not associated with interest in the topic. SUMMARY: Structured, hands-on workshops can aid comprehension of taught/lectured material and its application to PD and AD, and is a way for instructors to close gaps between didactic lecture and clinical practice.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Educação/métodos , Doença de Parkinson/tratamento farmacológico , Desenvolvimento de Programas/métodos , Distribuição de Qui-Quadrado , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Currículo , Gerenciamento Clínico , Educação/normas , Avaliação Educacional/métodos , Humanos , Estudantes de Farmácia/estatística & dados numéricos
17.
Curr Pharm Teach Learn ; 10(7): 975-981, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30236436

RESUMO

BACKGROUND: The integration of interprofessional education (IPE) into health professional curricula is critical to ensuring safe and efficient delivery of patient care. The intent of this manuscript is to describe the results of a pilot study designed to evaluate the impact of a large-scale interprofessional medication error prevention workshop on student perceptions of team-based patient care in the prevention of medication errors. INTERPROFESSIONAL EDUCATION ACTIVITY: Pharmacy, medical, and physician assistant students' perceptions of the role of multidisciplinary patient care teams in preventing medication errors were evaluated before and after participating in a three-hour interprofessional medication errors prevention workshop utilizing a modified version of the validated Attitudes Towards Health Care Teams Scale. DISCUSSION: When comparing student attitudes among the three schools, statistically significant differences in student perceptions across the items and subscales (e.g., quality of care/process and physician centrality) captured in the instrument utilized were identified. Additionally, differences in the responses of pharmacy, medical, and physician-assistant students were found, highlighting the areas where healthcare education can be targeted to bridge the gap in opinion. IMPLICATIONS: We demonstrated an overall positive impact of an interprofessional medication errors prevention-themed workshop on the attitudes of the participating healthcare students. Future directions and research initiatives focusing on the role of IPE and the influence of IPE workshops on team-based performance are indicated to validate the influence of this method of education on the attitudes of post-graduate healthcare trainees and healthcare practitioners.


Assuntos
Educação/normas , Pessoal de Saúde/educação , Erros de Medicação/prevenção & controle , Percepção , Atitude do Pessoal de Saúde , Educação/métodos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Equipe de Assistência ao Paciente/tendências , Projetos Piloto
18.
J Orthop Trauma ; 32 Suppl 7: S18-S20, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30247394

RESUMO

Routine surgical skills training is known to advance a surgeon's technical proficiency. However, orthopaedic providers in low-income countries have limited access to skills training programs. International academic partnerships can augment locally available orthopaedic education, improving the quality of and capacity to deliver orthopaedic care in low-income countries. The objective of this study is to provide a practical guide to delivering an orthopaedic skills training course in a low-resource setting. The information provided is based on the experiences of the authors, along with specific feedback from previous course participants in Haiti.


Assuntos
Países em Desenvolvimento/economia , Procedimentos Ortopédicos/educação , Procedimentos Ortopédicos/normas , Ortopedia/educação , Competência Clínica , Educação/normas , Saúde Global , Haiti , Humanos , Procedimentos Ortopédicos/economia , Ortopedia/economia , Ortopedia/normas , Avaliação de Programas e Projetos de Saúde
20.
Nurs Forum ; 53(4): 585-591, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30132907

RESUMO

BACKGROUND: Integrating cardiopulmonary resuscitation (CPR) in undergraduate education would help to increase the rate of bystander CPR. However, few qualified trainers are available for this purpose. Training student nurses to become CPR trainers on campus could reduce this shortage. PURPOSE: The purposes of this study were to assess CPR skills of students from nonmedical majors and to examine the effectiveness of the three tiers model for CPR training. SETTINGS: One public university in Jordan. PARTICIPANTS: Student nurses and undergraduates from nonmedical majors. METHOD: Five student nurses attended CPR training courses based on the American Heart Association CPR guidelines. The trainees provided the same CPR training to a sample of 197 undergraduates from nonmedical majors. The participants were asked to imagine a real-life scenario of out-of-hospital cardiopulmonary arrest and to perform CPR on a manikin. Assessment of skills was made before and after training, using a structured observational checklist. RESULTS: In the pretest, participants showed poor CPR skills with a pass rate of only 4%. In the posttest, participants demonstrated significant improvement: t(196) = 26.78, P = 0.00. CONCLUSION: The three tiers model for CPR training would be an effective strategy to compensate for the shortage in the number of certified CPR trainers.


Assuntos
Reanimação Cardiopulmonar/educação , Educação/normas , Estudantes/estatística & dados numéricos , Adulto , Feminino , Humanos , Jordânia , Masculino , Estudantes de Enfermagem/estatística & dados numéricos
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