Walking the Talk: "Reflexivity" to Advance Integration of Patient Reported Outcomes for Cancer Care Screening.

In this commentary, we propose the use of video-reflexive ethnography (VRE) as a means to support integration of patient-reported outcomes (PROs) in cancer care screening. As for any policy or intervention, the optimization of PROs depends on moving beyond their mere formal introduction, and depends on the integration of PROs in the everyday practice contexts of health care professionals (HPEs). The use of VRE allows for video-playback sessions among oncology professionals to support team-based learning and practice-change grounded in "reflexivity." Through a review of previous methods used to support organizational change in healthcare settings (e.g., policies, quality improvement initiatives, simulation sessions), we present some unsung advantages of VRE that can be applied to a complex integrated setting, such as cancer care. As opposed to other methods to create change, VRE does not dictate new measures, but rather supports "bottom-up" provider-initiated changes to health care practices and contexts, grounded in collaborative day-to-day practice. We argue that VRE optimizes PROs in cancer care by facilitating their effective and sustainable integration, to promote improved patient care.

Evidence of reliability and validity of the Brazilian Portuguese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration.

Interprofessional collaboration leads to better health outcomes. Measuring attitudes related to interprofessional collaboration is not a simple task, and in Brazil, there are few instruments for this evaluation. This study aimed to evaluate the evidence of validity and reliability of the Brazilian Portuguese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration in a population of undergraduate healthcare students. It included 108 undergraduates from medicine, nursing, physiotherapy, dentistry, pharmacy, psychology, and physical education academic programmes. The median age was 22 (18 and 58) and 75% were females. The scale comprises 20 items divided into two domains: working relationships, consisting of 12 items, and accountability, consisting of 8 items. The instrument showed good reliability (Cronbach's alpha = 0.77, 95% CI 0.71-0.83) and no item was considered inconsistent in improving the scale significantly. The scale demonstrated good evidence of validity and reliability for application among a population of Brazilian healthcare students.

[Traumatology-an interdisciplinary task: exclusively for educational purposes?] / Traumatologie ­ eine interdisziplinäre Aufgabe: nur in der Lehre?

BACKGROUND: Traumatology of the head and neck region is not only a part of otorhinolaryngology, but also has a large overlap with neighboring disciplines of the head and neck region. In Freiburg, an interdisciplinary lecture on "ENT emergencies" was implemented in the 21/22 winter semester. The aim was to provide an even more realistic view on interdisciplinary patient care and to make evident the areas of intersection of four of the major head disciplines (otorhinolaryngology, neurosurgery, ophthalmology, and maxillofacial surgery). MATERIALS AND METHODS: A new, special lecture in otorhinolaryngology was implemented as part of the regular online lecture series accompanying the semester. With reference to the clinical care of ENT emergencies, possible overlaps with neighboring disciplines were identified and explained by the discipline representatives or discussed in front of and with the auditorium. At the end of the semester, all participating students (n = 173) were invited to evaluate the seminar using the survey tool "EvaSys" (EvaSys GmbH, Lüneburg, Germany). In total, 78 students participated in the evaluation process. RESULTS: The new lecture concept was very well accepted and immediately ranked top among the interdisciplinary lecture titles within the ENT lecture series. The clear communication of the term "interdisciplinarity" in the sense of a complementary clinical cooperation was also very successful and was appreciated accordingly by students during the evaluation process. CONCLUSION: Pragmatic presentation of ideal clinical patient care using an interdisciplinary approach is possible within the regular ENT lecture series. This realistic portrayal, beyond any technical and/or professional differences, is of great interest to students and is considered clinically relevant. Thus, interdisciplinary lectures provide a valuable tool to teach the fundamental values of clinical interdisciplinary management for the best possible patient care.

Transdisciplinarity of India's master's level public health programmes: evidence from admission criteria of the programmes offered since 1995.

INTRODUCTION: In the Indian subcontinent, Master's-level Public Health (MlPH) programmes attract graduates of diverse academic disciplines from health and non-health sciences alike. Considering the current and futuristic importance of the public health cadre, we described them and reviewed their transdisciplinarity status based on MlPH admissibility criteria 1995 to 2021. METHODS: Using a search strategy, we abstracted information available in the public domain on MlPH programmes and their admissibility criteria. We categorized the admission criteria based on specified disciplines into Health science, Non-health science and Non-health non-science categories. We described the MlPH programmes by location, type of institution, course duration, curriculum, pedagogical methods, specializations offered, and nature of admission criteria statements. We calculated descriptive statistics for eligible educational qualifications for MlPH admission. RESULTS: Overall, 76 Indian institutions (Medical colleges-21 and Non-medical coleges-55) offered 92 MlPH programmes (Private-58 and Public-34). We included 89 for review. These programmes represent a 51% increase (n = 47) from 2016 to 2021. They are mostly concentrated in 21 Indian provinces. These programmes stated that they admit candidates of but not limited to "graduation in any life sciences", "3-year bachelor's degree in any discipline", "graduation from any Indian universities", and "graduation in any discipline". Among the health science disciplines, Modern medicine (n = 89; 100%), Occupational therapy (n = 57; 64%) is the least eligible. Among the non-health science disciplines, life sciences and behavioural sciences (n = 53; 59%) and non-health non-science disciplines, humanities and social sciences (n = 62; 72%) are the topmost eligible disciplines for admission in the MPH programmes. CONCLUSION: Our review suggests that India's MlPH programmes are less transdisciplinary. Relatively, non-medical institutions offer admission to various academic disciplines than the medical institutions in their MlPH programmes. India's Master's level public health programmes could be more inclusive by opening to graduates from trans-disciplinary backgrounds.

[Interprofessional health education in the Region of the Americas from a nursing perspectiveEducação interprofissional em saúde na Região das Américas na perspectiva da enfermagem]. / Educación interprofesional en salud en la Región de las Américas desde la perspectiva de la enfermería.

This study presents a reflective analysis of the implementation of interprofessional education in undergraduate nursing courses, considering as an example the curricula of undergraduate nursing careers in Brazil. Despite investments to advance interprofessional education, its practice is not institutionalized in the curricula of undergraduate courses. These findings represent a limitation for the implementation of interprofessional education in nursing courses, and the case of Brazil allows to learn lessons for the education of nursing professionals in other countries of the Region of the Americas. Recommendations are provided for training, management and intersectoral articulation of health and education services, with emphasis on primary health care and the Sustainable Development Goals, aimed at educational institutions wishing to implement interprofessional education.

Neste estudo, foi realizada uma análise reflexiva sobre a implementação da educação interprofissional em cursos de graduação em enfermagem, considerando como exemplo os currículos dos cursos de graduação em enfermagem no Brasil. Apesar dos investimentos para avançar a educação interprofissional, sua prática não está institucionalizada nos currículos de graduação. Esses achados representam uma limitação para a implementação da educação interprofissional em cursos de enfermagem, e o caso do Brasil fornece lições para a formação de profissionais de enfermagem em outros países da Região das Américas. Medidas de treinamento, gestão e articulação intersetorial de serviços de saúde e educação, com ênfase nos cuidados primários de saúde e nos Objetivos de Desenvolvimento Sustentável, são recomendadas para instituições educacionais que desejam implementar a educação interprofissional.

Perspectives Against Racism: educational and socialization efforts at the departmental level.

The current heightened social awareness and anxiety triggered by escalating violence against Black Americans in the United States demands a safe space for reflection, education, and civil discourse within the academic setting. Too often there is an unmet need paired with a collective urgent desire to better understand the chronic existing structural, social, educational, and health inequities affecting disadvantaged populations, particularly Black Americans. In this perspective, the authors provide insight into a shared learning approach that provided a forum to discuss Perspectives Against Racism (PAR). Unlike existing top-down approaches, faculty, trainees, and staff were engaged in leading a series of focused discussions to examine unconscious bias, promote awareness of implicit biases, and reflect on individual and collective roles and responsibilities in working toward becoming antiracist. An existing 1-h graduate elective seminar course was dedicated to creating a space for learning, discussion, and exchange of ideas related to the experience and existence of racism (personal and institutional/systemic). A goal of each session was to go beyond didactics and identify mechanisms to implement change, at the level of the individual, department, and institution. This perspective of the shared experience may provide an adaptable framework that can be implemented in an academic setting at the departmental, center, or institutional level.

The benefits and challenges of a rural community-based work-ready placement program for allied health students.

INTRODUCTION: Rural and remote Australia has a shortage of allied health clinicians. The provision of quality rural placement experiences for allied health students has been a significant strategy to address these health workforce shortages. Service learning rural placements are providing allied health services in small rural towns where previously allied health services were limited or did not exist. Published literature has little detailed description of the origin or nature of particular placement programs. METHODS: An increase in Commonwealth funding for rural allied health clinical placements led to the development of an innovative service learning placement model in northern New South Wales, the Rural Community-Based Work-Ready Placement Program. During this placement, students were paired for 4-10 full-time weeks in a preschool, school or aged care facility. The program's fundamental properties included cultural and social equity education, providing continuous service throughout the year, and quality improvement initiatives in placement sites. The program was underpinned by an interdisciplinary approach that included interdisciplinary placements, interdisciplinary supervision and a structured interdisciplinary education program. RESULTS: The program required investment in stakeholder engagement and in the alignment of universities' requirements for student learning outcomes and the sites' specific needs. Clinical supervisors had to adapt to supervising students from various disciplines and universities across several sites, towns and services. The program provided students with opportunities to work autonomously, problem-solve and to initiate and implement quality improvement projects at each site. CONCLUSION: Careful selection of students, adequate preparation and management of students' expectations were important contributors to the success of the program. Providing a continuous service is an ongoing logistical challenge.

University Staff Insights on Interprofessional Education and Student-Led Clinic Opportunities at an Australian University.

Purpose: Organizational and university staff buy-in and advocacy are critical considerations in planning successful interprofessional education (IPE) initiatives in healthcare, such as interprofessional student-led clinics (SLCs). This study was designed with the purpose of gaining deeper insight into current views and perspectives of academic and professional staff at an Australian university, as a precursor to planning IPE and SLC activities. Methods: All academic and professional staff from within the School of Health Sciences were invited to participate in the study. In-depth-qualitative interviews were conducted with 16 staff to explore academic and professional staff perspectives on IPE and SLCs. Reflexive thematic analysis was used to analyse the data. Results: Findings are grouped within five themes that incorporate broad perspectives on the tensions and possibilities of IPE and establishment of SLCs: Academic and professional staff commitment; Better/smarter IPE; Student-led clinic potential; Vision and innovation; and Strategy and resourcing. The themes reflect the high value placed on IPE by academic and professional staff and incorporate innovative ideas on how to prepare students for a rapidly changing and evolving healthcare environment. A reticence towards standard models of university based SLCs was expressed. Conclusion: Academic and professional staff insights suggest university leaders need to develop a greater strategic focus on improving IPE. Effective engagement with staff is required to support IPE planning and implementation. If considering implementation of SLCs, contemporary fit-for-purpose models should be explored such as partnerships with primary healthcare providers, community wellness facilities, and hospital clinics rather than traditional university-based clinics.

Evaluation of a virtual practice placement: A model to increase student capacity.

AIM: To describe the development and evaluation of a novel virtual practice placement. BACKGROUND: Health systems around the world face the challenge of recruiting and retaining sufficient nursing staff to provide high quality care. The need to train more nurses makes it hard to provide sufficient and varied high quality student placements to all students. This paper reports the result of one approach to the provision of a novel virtual placement for pre-registration student nurses. DESIGN: Online virtual placement evaluated by a questionnaire conducted after the placement. METHODS: A total of 195 students attended the virtual practice placement between 10th October 2022 and the 10th March 2023. The survey consisted of eight questions, of which one invited a qualitative response. RESULTS: A total of 188 students completed the questionnaire and provided feedback. Of these 84 were adult nursing students, 67 child, 36 mental health and one learning disability student. The virtual placement required considerable resources to run, however was deemed as valuable by most students. When asked to rate the overall experience out of 5, the median scores were consistently high: adult (Mdn=5), child (Mdn=4), learning disability (Mdn=5) and mental health (Mdn=5) and mean values consistently high across fields: adult (M=4.73), child (M=5), learning disability (M=5) and mental health (M=4.67). Qualitatively, there were four main themes that emerged from the questionnaire responses: increased understanding of community healthcare and holistic approaches to care; developing interpersonal skills; a positive impact on their future career opportunities and the value of realistic case studies. CONCLUSIONS: Virtual placements are a viable addition to traditional placements. However, they require careful planning and considerable resources including experienced and dedicated facilitators. Principles for the delivery of virtual placements were produced to replicate and share best practice.

Nursing students' opinion on the use of Escape ZOOM® as a learning strategy: Observational study.

The teaching-learning process has gone through major changes due to the COVID-19 pandemics and it has been left to professors to adapt the teaching process and find ways to keep students engaged. There has been a need to establish collaborative and active strategies for working in the online environment. The development of a game for both teaching and evaluating de interdisciplinary learning content on an online platform may create a gameful experience and stimulating environment that makes complex learning goals achievable. To analyze how nursing students feel in relation to their participation and learning in an Escape Room activity taking place in an online environment. This is a descriptive and exploratory cross-sectional cohort study. The study was carried out in a higher education institution. The sample consisted of 73 students. After implementation of Escape Zoom® in the first semester of 2021, adapted questionnaires to assess students' satisfaction and perception of learning were applied. In the Educational Practices Questionnaire, all statements obtained greater than 70% agreement, which revealed students' satisfaction, especially with learning with colleagues. As for learning, 93.2% of students' statements expressed that the Escape Zoom® favors teamwork and 91.8% of student's statements agreed that the activity is effective for learning and would recommend it to other colleagues. The Escape Zoom® is an effective teaching strategy, perceived with satisfaction by students as a form of learning with colleagues, in a game-oriented way. It also has the potential to promote the development of soft skills.

The untapped potential of Instagram to facilitate rheumatology academia.

Instagram allows for graphical and visual information exchange. This paper aims to explore the current landscape of rheumatology on Instagram and analyse the accounts available based on their objectives and level of engagement. The search term "#rheumatology" reveals 62 results, leaving 55 after careful exclusion. On grouping into "educational", "broadcasting", "support", and a combination of all three, an analysis is carried out using the total number of posts, follower counts, number of caption characters (last 10 posts), likes per post (last 10 posts), archived stories, reels, IgTV (Instagram Television) videos, hashtags, and links in bio. The analysis reveals that 29 accounts (52.7%) disseminate educational content, 36 (65.4%) are run by organisations, and 22 (40.0%) are of an institute or clinic. Character counts (rho 0.44, p = 0.0006) and videos (likes for ten posts 149 vs. 54, p = 0.006) positively correlate with the number of likes, while hashtag use and post count have no statistical significance with likes. Reels and IgTV videos are infrequently used (18.18%, 3.6%). The rheumatology social media landscape is in its nascency and currently split into educational and broadcasting accounts with a significant overlap between the two. The positive correlation of character counts and videos and the negative correlation of hashtag use and post count with likes lay the case for quality content to improve engagement. Social media editors may ensure quality content for rheumatology education using Instagram. Key Points • The current landscape of Instagram use in rheumatology is limited and largely orientated towards educative content. • Likes on Instagram are positively correlated with caption character counts and videos. • Using currently underutilised tools like videos, engaging captions, and infographics may enhance the utility of Instagram in rheumatology education.

Collaborating and teaching a synchronous, multi-university, virtual course: Health policy and access to dental care.

PURPOSE: In response to COVID-19, dental educators have been tasked with maintaining the quality of education while reducing cost, increasing efficiency, and leveraging technology. METHODS: This collaborative, multisite virtual health policy course used the Staged Self-Directed Learning Model (SSDL) to lead a diverse group of students studying health policy. Twelve Core sessions were offered with three additional sessions in August or December for a total of 15 total synchronous Zoom sessions that covered policy issues on supply, demand, and need for dental care. RESULTS: Twenty-eight students, seven lead instructors, and two course directors from six schools reported positive feedback on the course format, use of technology and the SSDL model, and breadth of topics presented. Participation by universities in four states with differing health policies stimulated virtual classroom discussions. CONCLUSION: In conclusion, collaborative interinstitutional virtual teaching and learning is cost effective, efficient, and engaging for students. This model has the potential to continue even when institutions are no longer affected by COVID-19.

Dispositional Humility Of Clinicians In An Interprofessional Primary Care Environment: A Mixed Methods Study.

OBJECTIVES: Dispositional humility in professionals is a character trait that allows one to monitor self-centered occupational drive and to pay attention to the needs of other professionals. The aim of this study is to test whether or not clinicians working in interprofessional team care environments identify the character trait of humility as an important factor for successful collaborative relationships. This study aimed to revise a concept map of dispositional humility created through literature review. DESIGN: An explanatory sequential mixed-methods study was composed of the HEXACO personality test and the Integrative Medicine Attitude Questionnaire, followed by summative and directed content analyses of one-on-one interview data in order to identify the element of dispositional humility. SETTING: In the State of Washington, USA, where physicians (MD/DO), nurse practitioners (NP) and naturopathic clinicians (ND) serve Medicaid patients in community clinics. PARTICIPANTS: 6 MDs, 4 NPs, and 11 NDs. RESULTS: Twenty-one primary care clinicians were enrolled. Fifteen clinicians completed the interview. It was observed that the: 1) honesty-humility trait (p<0.01), conscientiousness (&p<0.01), and openness to experience (p<0.05) domains of primary care clinicians were statistically significantly higher than the reference standards; 2) attitudes toward integrative medicine did not differentiate the different clinician types; and 3) qualitative data supported the component of dispositional humility as a desirable trait in professionals with whom they would like to work. CONCLUSION: To maintain high-quality patient care while working as a team, limiting self-interest while focusing on the needs of others may be necessary and in the best interest of patients. An attitude of accepting the principles of integrative medicine has permeated this sample of primary healthcare workers. Both quantitative and qualitative analyses revealed that humility was viewed as an important character trait for successful interprofessional collaboration. A revised concept map of dispositional humility to enhance collaborative relationships was created.

Improving Treatment of Elderly Patients by Interprofessional Education in a Quality Network of Geriatric Medicine: Protocol for Evaluating an Educational Initiative.

BACKGROUND: All statistics on the development of demand for care for multimorbid elderly patients highlight the acute pressure to act to adequately respond to the expected increase in geriatric patient population in the next 15 years. Against this background, great importance must be attached to the improvement of cross-occupational group and cross-sector treatment of these patients. In addition, many professionals in the health care sector often have little knowledge about the special treatment and care needs of the elderly. OBJECTIVE: The Quality Network of Geriatric Medicine in north-west Germany is the body responsible for the project; with its member organizations, it provides care for over 400,000 inpatients and is thus one of the largest associations for geriatrics in Germany. The Quality Network conducts binding evaluated qualification measures for staff involved in the treatment and care of multimorbid elderly patients. The training offers are especially intended for staff who have not yet been trained in working with elderly patients. This approach is intended to improve the expertise of various occupational groups on different hierarchy levels, to include patients and their family members in the evaluation process, and to initiate changes within the organizations. METHODS: Various instruments are used in the evaluation of qualification measures: besides written surveys and questionnaires, structured work groups (consensus groups) and interviews are conducted. The evaluation starts before the qualification measures to determine the starting point and then continues during the measure and after its completion. This allows major findings to be integrated directly into the ongoing qualification program. At least 100 trainings on geriatric topics, 80 consensus groups, and 120 patients (and family members) are going to be included in the study. RESULTS: The evaluation of the educational initiative is funded by the State of Northrhine-Westfalia (Germany; LZG TG 71 001 / 2015 and LZG TG 71 002 / 2015). The results of the study will be published after review and approval by the state authorities - presumably by the end of 2019. The before and after comparison of the treatment-related outcomes at the beginning and near the completion of the educational initiative gives insights into how transfer-oriented education can improve the treatment of elderly patients across sector lines for inpatients as well as outpatients. The evaluation of the implementation of educational content in day-to-day work and occupational groups is to facilitate recommendations about economically sensible use of educational resources and about further adjustments to the training content. CONCLUSIONS: The evaluation develops the foundation for targeted and needs-oriented qualification measures as well as transfer in cross-sector, multiprofessional networks. Instruments and results will be published and provided to other health care networks and institutions. The Quality Network will implement the results of the evaluation process in its member institutions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/11067.

Processo de aprendizagem colaborativa entre residentes e estudantes de graduação em Odontologia em um hospital universitário de Curitiba / Collaborative learning process between residents and undergraduate Dentistry students at a university hospital in Curitiba

Com o reconhecimento do exercício da Odontologia Hospitalar e sua aprovação como uma nova especialidade pelo Conselho Federal de Odontologia em 2023, e validação das novas Diretrizes Curriculares Nacionais para o Curso de Odontologia homologadas em 2021, os cursos de graduação em Odontologia no Brasil tendem a qualificar futuros profissionais em formação para atuar em ambiente hospitalar, de forma sistematizada. Isso visa propiciar aosestudantes uma vivência interprofissional inerente aos hospitais, favorecendo a interação positiva entre várias áreas da saúde. Este estudo descritivo tem como objetivo relatar a experiência no processo de aprendizagem colaborativa entre profissionais de saúde residentes do Programa de Residência Multiprofissional em Saúde do Idoso, na área profissional de Odontologia, de um Hospital Universitário de Curitiba e estudantes de graduação do curso de Odontologia de uma instituição de ensino superior. Durante odesenvolvimento de diferentes atividades acadêmicas, observou-se que a utilização desta metodologia de ensino-aprendizagem caracterizou-se como uma ferramenta importante, buscando fortalecer as trocas de vivências práticas, propiciando discussões entre estudantes e profissionais residentes, por meio da mediação dos docentes, os quais buscavam sempre incentivar a construção do conhecimento crítico reflexivo, oportunizando uma experiência de formação discente interprofissional ampliada (AU).

Con el reconocimiento de la práctica de la Odontología Hospitalaria y su aprobación como nueva especialidad por el Consejo Federal de Odontología en 2023, y la validación de las nuevas Directrices Curriculares Nacionales para la Carrera de Odontología aprobadas en 2021, las carreras de pregrado en Odontología en Brasil tienden a capacitar a los futuros profesionales en formación para trabajar en el entorno hospitalario, de forma sistemática. Se pretende proporcionar a los estudiantes una experienciainterprofesional inherente a los hospitales, favoreciendo la interacción positiva entre las diversas áreas de la salud. Este estudio descriptivo tiene como objetivo relatar la experiencia en el proceso de aprendizaje colaborativo entre profesionales de lasalud residentes en el Programa de Residencia Multidisciplinaria en Salud del Adulto Mayor, en el área profesional de Odontología, en un Hospital Universitario de Curitiba y estudiantes de pregrado de la carrera de Odontología en Curitiba de una institución de educación superior. Durante el desarrollo de diferentes actividades académicas, se observó que el uso de esta metodología de enseñanza-aprendizaje se caracterizó como una herramienta importante, buscando fortalecer el intercambio de experiencias prácticas, promoviendo el debate entre estudiantes y profesionales residentes, a través de la mediación de los docentes. que siempre buscó incentivar la construcción de conocimientos reflexivos críticos, brindando una experiencia ampliada de formación interprofesional de los estudiantes (AU).

With the recognition of the Hospital Dentistry practice,its approval as a new specialty by the Federal Dental Council in 2023 and validation of the new National Curricular Guidelines for the Dentistry Course approved in 2021, undergraduate Dentistry courses in Brazil tend to qualify future professionals in training to work in a hospital environment, in a systematic manner. This aims to provide students with an interprofessional experience inherent to hospitals, favoring the positive interaction between various health specialties. This descriptive study reportsthe experience in the collaborative learning process between health professionals residentsof the Multiprofessional Residency Program in Elderly Health in the professional area of Dentistry at a University Hospital in Curitiba,and undergraduate Dentistry students from a higher education institutionin Curitiba. During the development of different academic activities, it was observed that the use of this teaching-learning methodology was characterized as an important tool, seeking to strengthen the exchange of practical experiences, promoting discussions betweenstudents and resident professionals, by the mediation of professors, who always encourage the construction of critical reflective knowledge, providing an expanded interprofessional student training experience (AU).

Experiência no uso das ferramentas de abordagem familiar por uma equipe da Estratégia Saúde da Família / Experiencia en el uso de herramientas de abordaje familiar por un equipo de Estrategia de Salud de la Familia / Family Health Strategy team's experience in the use of family approach tools

Problema: Experiência da intervenção de uma equipe multiprofissional da Estratégia Saúde da Família (ESF) em uma família por meio das ferramentas de abordagem familiar. Entre os problemas identificados no caso estão a sobrecarga de trabalho da paciente índice, diagnóstico de Transtorno do Espectro Autista (TEA) nos filhos dela, etilismo crônico do esposo e relacionamento hostil no ciclo familiar. Método: Estudo descritivo, qualitativo, de relato de experiência, desenvolvido em uma família da área de abrangência da equipe da ESF no segundo semestre de 2019, escolhida em razão da hiperutilização do serviço pela paciente índice. As ferramentas aplicadas foram o genograma, ecomapa, Fundamental Interpersonal Relations Outcome (FIRO), problem, roles, affect, communication, time in life, illness, coping with stress, environment/ecology (PRACTICE) e ciclo de vida familiar. Resultados: Com a aplicação das ferramentas foram identificadas as estruturas e modos de compartilhamento das relações familiares, os problemas de saúde presentes, os possíveis vínculos identificados e o estágio no ciclo de vida. Como modos de intervenção, a equipe propôs consultas de cuidado em saúde, assistência psicológica e escutas qualificadas. Além disso, por meio de reuniões intersetoriais, foi solucionado o problema escolar que afetava a condição de saúde da paciente. Conclusão: A aplicação das ferramentas foi um excelente método para realizar o estudo, pois permitiu uma visão global da família, além de identificar fragilidades a serem corrigidas ou minimizadas com recurso a intervenções pela equipe de saúde.

Problem: Intervention experience of a multidisciplinary team of the Family Health Strategy (ESF) through family approach tools. Among the problems identified in the case are the work overload of the index patient, diagnosis of autism spectrum disorder (ASD) in her children, husband's chronic alcoholism and hostile relationship within the family circle. Method: Descriptive and qualitative experience report. Developed by an ESF team in a family in the coverage area. Experience conducted in the second half of 2019. The tools applied were the genogram, ecomap, FIRO, PRACTICE and the family life cycle. The tools were chosen because of the index patient's frequent use of the ESF's services. Results: Through the application of the tools, the structures and ways of sharing family relationships, the health problems, the possible bonds identified and the stage in the life cycle were identified. As modes of intervention, the team proposed health care consultations, psychological assistance and qualified listening. In addition, through intersectional meetings, a school problem that affected the patient's health condition was solved. Conclusion: The application of the tools was an excellent method to carry out the study. It allowed a global view of the family, in addition to identifying weaknesses to be corrected or minimized, through interventions by the health team.

Problema: Experiencia de la intervención de un equipo multidisciplinario de la Estrategia Salud de la Familia (ESF) en una familia a través de herramientas de abordaje familiar. Entre los problemas identificados en el caso están la sobrecarga de trabajo de la paciente índice, diagnóstico de Trastorno del Espectro Autista (TEA) en sus hijos, alcoholismo crónico del marido y relación hostil dentro del ciclo familiar. Método: Estudio descriptivo, cualitativo de relato de experiencia desarrollado en una familia de la zona de cobertura del equipo de la ESF en el segundo semestre de 2019. Las herramientas aplicadas fueron el genograma, ecomapa, F.I.R.O., P.R.A.C.T.I.C.E. y el ciclo de vida familiar, elegido por la sobreutilización del paciente índice de los servicios de la ESF. Resultados: Mediante la aplicación de las herramientas se identificaron las estructuras y formas de compartir las relaciones familiares, los problemas de salud presentes, los posibles vínculos identificados y la etapa del ciclo de vida. Como modos de intervención, el equipo propuso la consulta de salud, la asistencia psicológica y la escucha cualificada. Además, a través de reuniones intersectoriales se solucionó un problema escolar que afectaba el estado de salud del paciente. Conclusión: La aplicación de las herramientas fue un método excelente para la realización del estudio, ya que permitió una visión global de la familia, además de identificar debilidades a ser corregidas o minimizadas, a través de intervenciones del equipo de salud.

Educación Interprofesional en Salud en el contexto neoliberal: incongruencias y desafíos / Interprofessional Health Education in the neoliberal context: inconsistencies and challenges / Educação interprofissional em Saúde no contexto neoliberal: incongruências e desafios

Resumen Se trata de un artículo crítico y reflexivo que pretende discutir algunas de las incoherencias e incompatibilidades estructurales del modelo propuesto para la formación y atención en salud denominado Educación Interprofesional y Práctica Colaborativa (EIPC), en el contexto de racionalidad neoliberal de los países latinoamericanos. Se destaca cómo este modelo puede contestar dicha racionalidad, siendo relevante para la instauración de subjetividades profesionales críticas y éticas con su contexto. De esta manera se pretende contribuir a la creciente literatura sobre perspectivas críticas de la formación y el trabajo en salud.(AU)

Abstract This article addresses the new approach to training and healthcare work referred to as Interprofessional Education and Collaborative Practice (IECP). It focuses on some of the inconsistencies and structural incompatibilities of the model with the broader context of neoliberal rationality, with an emphasis on Latin-American countries. We suggest that IECP can contest such rationality and, in fact, develop a critical professional ethic. With that we intend to contribute to the growing literature on critical perspectives about training and working in health.(AU)

Resumo Trata se de um artigo crítico e reflexivo que pretende discutir algumas das incoerências e incompatibilidades estruturais do modelo proposto para a formação e atenção em saúde denominado Educação Interprofissional e Prática Colaborativa (EIPC), no contexto de racionalidade neoliberal dos países latino-americanos. Destaca-se que este modelo pode contestar tal racionalidade, sendo relevante para a instauração de subjetividades profissionais críticas e éticas com seu contexto. Desta maneira, pretende-se contribuir com a crescente literatura sobre perspectivas críticas sobre a formação e o trabalho em saúde.(AU)

Oficina culinária como estratégia didático-pedagógica interdisciplinar na formação do nutricionista / Culinary workshop as an interdisciplinary didactic-pedagogic strategy in the training of nutritionists

Os objetivos deste estudo foram relatar a experiência da utilização de oficinas culinárias como estratégia didático-pedagógica na disciplina de educação nutricional, e analisar as percepções dos estudantes quanto à interdisciplinaridade e aplicabilidade na atuação profissional, pela análise de conteúdo temática. Este é um relato de experiência da utilização de oficinas culinárias durante a disciplina de Educação Nutricional no curso de nutrição de uma universidade pública. Foram quantificados os tipos de receitas selecionadas e seus respectivos princípios dietéticos e/ou dietoterápicos. Identificamos que 80% das receitas selecionadas priorizavam o conteúdo de nutrientes dos ingredientes como princípio dietético/dietoterápico e somente 20% consideraram aspectos sensoriais e culturais. Na análise qualitativa, foram identificados três eixos temáticos: (1) O olhar do estudante sobre a oficina culinária; (2) O aprendizado da oficina culinária para sua prática profissional; (3) A racionalização da alimentação. A oficina foi considerada uma experiência inovadora e enriquecedora para a formação acadêmica, principalmente pela interdisciplinaridade. Conclui-se que o uso de oficinas culinárias como estratégia didático-pedagógica interdisciplinar nos cursos de Nutrição pode trazer benefícios na formação dos futuros nutricionistas (AU)

The objectives of this study were to report the experience of using culinary workshops as a didactic-pedagogical strategy in the nutrition education discipline, and analyze the students' perceptions regarding interdisciplinarity and applicability in their professional practices through thematic-content analysis. This is an experience report on the use of culinary workshops during the nutritional education discipline in the nutrition course of a public university. The types of recipes selected and their respective dietetic/diet therapy principles were quantified. We found that 80% of the selected recipes were based on the nutritional composition of foods and only 20% considered sensory and cultural aspects. In the qualitative analysis, 3 thematic axes were identified: (1) The student's perception of the culinary workshop; (2) The learning in the culinary workshop for their professional practice; (3) The rationalization of food. The workshop was considered an innovative and enriching experience for academic training, mainly due to its interdisciplinarity. It is concluded that the use of culinary workshops as an interdisciplinary didactic-pedagogical strategy in Nutrition courses can bring benefits to the training of future nutritionists (AU).

Luchas comunitarias por la subsistencia en la vereda Granizal: entre la esperanza y la desesperanza

Objetivo: develar las tensiones percibidas por los actores comunitarios en el poblamiento y conformación del territorio durante la práctica de la Facultad de Medicina de la Universidad de Antioquia en la vereda Granizal entre 2009 y 2018. Metodología: estudio hermenéutico que usó técnicas de la teoría fundamentada para recolección y análisis. Se realizaron once entrevistas en profundidad a líderes y dos grupos focales a madres comunitarias, docentes y líderes y se analizaron con técnicas de codificación abierta, axial y selectiva. Resultados: existe una tensión permanente entre un liderazgo de diferentes matices y la unidad comunitaria, que recibe diversas amenazas por el desalojo persistente de sus espacios vitales por actores fuera de la ley ligados al narcotráfico, al vacío de Estado y a los intereses internos por el poder. Dicha tensión busca ser superada mediante el esfuerzo colectivo para aprender a subsistir y a través de los vínculos que nacen de la confianza generada con la Universidad y la Facultad de Medicina con su práctica, que han apoyado la comprensión progresiva de la determinación social del proceso salud-enfermedad, lo que ha permitido lograr mayor bienestar. Conclusiones: en Granizal existen unas luchas comunitarias constantes por vencer las privaciones de los mínimos vitales de subsistencia, en las cuales, la autonomía y el desarrollo humano se debaten entre la esperanza y la desesperanza por mantener la firmeza en la construcción del tejido social y en la búsqueda de salidas que posibiliten la vida y el bienestar.

Objective: to reveal the tensions perceived by community actors in the settlement and conformation of the territory during the internship of the School of Medicine of Universidad de Antioquia in the rural settlement Granizal between 2009 and 2018. Methods: Hermeneutic study that used Grounded Theory techniques to collect and analyze data. Eleven in-depth interviews with leaders were conducted and two focus groups with community mothers, teachers and leaders were carried out which were analyzed with open, axial and selective coding techniques. Results: there is a permanent tension between leadership with different shades and the community unity which receives various threats due to the permanent eviction of their vital spaces by outlaw actors linked to drug trafficking, to the absence of the State and to internal interests for power. This tension seeks to be overcome through the collective effort to learn to survive and through the links that are born from the trust generated with the University and the internship of the Faculty of Medicine that has supported the progressive understanding of the social determination of the health-disease process which has allowed for greater wellbeing. Conclusions: There are constant community struggles in Granizal to overcome the deprivations of subsistence vital minimums, in which autonomy and human development are debated between hope and despair to maintain firmness in the construction of the social fabric and in the search for solutions that make life and wellbeing possible.

Objectivo: amostrar as tensões percebidas pelos atores comunitários no povoamento e conformação do território durante a prática da Faculdade de Medicina da Universidade de Antioquia no vilarejo Granizal entre 2009 e 2018. Metodologia: estudo hermenêutico que usou técnicas da teoria fundamentada para coleta e análise. Realizaram-se onze entrevistas a fundo a líderes e dois grupos focais a mães comunitárias, docentes e líderes e se analisaram com técnicas de codificação aberta, axial e seletiva. Resultados: existe uma tensão permanente entre uma liderança de diferentes matizes e a unidade comunitária, que recebe diversas ameaças pelo despejar persistente de seus espaços vitais por atores fora da lei e conectados com o narcotráfico, a o vazio do Estado e aos interesses internos pelo poder. Esta tensão procura ser superada mediante o esforço coletivo para aprender a subsistir e a través dos vínculos que nascem da confiança gerada com a Universidade e a Faculdade de Medicina com sua prática, que tem apoiado a compreensão progressiva da determinação social do processo saúde-doença, o que tem permitido lograr maior bem-estar. Conclusões: em Granizal existem umas lutas comunitárias constantes por vencer as privações dos mínimos vitais de subsistência, nas quais, a autonomia e o desenvolvimento humano, se debatem entre a esperança e a desesperança por manter a firmeza na construção do tecido social e na busca de saídas que possibilitem a vida e o bem-estar.

Desafios da formação docente em cursos de Enfermagem no norte do Brasil na perspectiva da Educação Interprofissional / Desafíos de la formación docente en cursos de enfermería en el norte de Brasil desde la perspectiva de la educación interprofesional / Challenges for faculty training in nursing courses in Northern Brazil from the perspective of interprofessional education

O objetivo do estudo foi analisar os desafios da formação desenvolvida pelos docentes atuantes em cursos de Enfermagem da região norte do Brasil, na perspectiva da Educação Interprofissional. Trata-se de uma pesquisa descritiva, exploratória e qualitativa realizada em universidades públicas. Doze docentes participaram de entrevista semiestruturada. Utilizou-se a análise de conteúdo e cinco categorias foram selecionadas: 1) Compromisso do ensino e do trabalho com a integralidade do cuidado; 2) Aprimoramento do ensino, pesquisa e extensão na perspectiva da educação interprofissional; 3) Atuação integrada entre os profissionais da Saúde; 4) Necessidade de desenvolvimento docente alinhado aos princípios da educação interprofissional; e 5) Educação Permanente em Saúde como estratégia indutora do ensino e prática interprofissional. A Educação Interprofissional é um campo robusto e complexo. Logo, é fundamental uma prática docente capaz de empreender processos formativos inovadores, induzindo mudanças que impactem positivamente a formação e o trabalho em saúde.(AU)

Resumen Análisis de los desafíos de la formación desarrollada por los docentes que actúan en cursos de enfermería en la región norte de Brasil, desde la perspectiva de la educación interprofesional. Se trata de una investigación descriptiva, exploratoria y cualitativa realizada en universidades públicas. Doce docentes participaron en la entrevista semiestructurada. Se utilizó el análisis de contenido y se seleccionaron cinco categorías: 1) Compromiso de la enseñanza y del trabajo con la integralidad del cuidado; 2) Perfeccionamiento de la enseñanza, investigación y extensión desde la perspectiva de la educación interprofesional; 3) Actuación integrada entre los profesionales de la salud; 4) Necesidad de desarrollo docente alineado a los principios de la educación interprofesional; y 5) Educación permanente en salud como estrategia inductora de la enseñanza y de la práctica interprofesional. La educación interprofesional es un campo robusto y complejo. Por lo tanto, es fundamental una práctica docente capaz de emprender procesos formativos innovadores, induciendo cambios que impacten positivamente la formación y el trabajo en salud.(AU)

Abstract Study analyzing the challenges of training developed by teachers working in nursing courses in the Northern Region of Brazil, from the interprofessional education perspective. A descriptive, exploratory, qualitative research conducted in public universities in which twelve professors participated in a semi-structured interview. Content analysis was used, and five categories were selected: 1) Commitment to teaching and working with comprehensive care; 2) Improvement of teaching, research, and community extension from the perspective of interprofessional education; 3) Integrated action among health professionals; 4) Need for teaching development aligned to interprofessional education principles; 5) Continuing education in health as a strategy to induce interprofessional teaching and practice. Interprofessional education is a robust and complex field. Therefore, a teaching practice capable of undertaking innovative formative processes is key, inducing changes that positively impact training and work in health.(AU)