RESUMO
Las entrevistas clínicas son una parte esencial del quehacer médico. La comunicación efectiva es una parte integral del diagnóstico, aumentan la satisfacción de los pacientes, su aceptación del tratamiento y contribuyen a un mejor uso de los recursos de salud. A pesar de lo anterior, el entrenamiento en las Escuelas de Medicina chilenas no es suficiente como para establecer una adecuada comunicación entre médico y paciente, ni para manejar las emociones que surgen en la entrevista. La mayoría de los clínicos aprende a entrevistar intuitivamente o bien lo hace imitando a sus profesores. Este trabajo describe un estudio realizado en tres Facultades de Medicina, dos públicas (Universidad de Chile y Universidad de Concepción) y otra privada (Universidad de los Andes). Para ello se filmaron entrevistas realizadas por 122 estudiantes que estaban ingresando a la etapa clínica de su formación, que luego fueron revisadas independientemente por dos jueces entrenados en aplicar una pauta de evaluación previamente validada. Se describen las características de estas entrevistas
Assuntos
Humanos , Masculino , Feminino , Entrevistas como Assunto , Guias de Prática Clínica como Assunto , Competência Clínica/estatística & dados numéricos , Anamnese , Educação de Pacientes como Assunto , Relações Médico-Paciente , Distribuição por SexoRESUMO
El descubrimiento del poder antipsicotico de las fenotiazinas marca una de las revoluciones psiaquiátricas más importantes en la historia del tratamiento de los pacientes con esquizofrenia. Posteriormente el desarrollo de otros medicamentos como el halaoperidol cimentó la importancia de su uso. desafortunadamente estos tratamientos, solamente paliatativos tiene serios efectos neurológicos secundarios. El descubrimiento de la clozapina, hace casi 30 años, y su uso en pacientes resistentes al tratamiento revolucionó el mundo académico y comercial impulsando la sintesis de nuevos compuestos con propiedades antipsicoticas. La Risperiodona, la Olanzapina, el Sertindole, la Quetiapina y la Ziprasidona son nuevos antipsicoticos que ofrecen ventajas terapéuticas y menos efectos secundarios en comparación con los antipsicoticos convencionales. El autor propone que estos medicamentos reemplacen los medicamentos convencionales en el tratamiento de los pacientes con esquizofrenia.
Assuntos
Antipsicóticos , Esquizofrenia , Dopamina , Clozapina , Risperidona , HomeossicóticosRESUMO
To assess the feasibility of a distance medical education program prepared in a written format, 90 physicians aged 25 to 29 years old and with 1 to 4 years of medical practice, working mostly in rural locations, participed in the program. The sending of 10 ussues with medical topics was programmed. The topics were selected according to the results of an survey done among physicians of the region. Each issue contained an evaluation that had to be returned to the authors. Eigthy two physicians completed the program and 59 returned the evaluations. The mean obtained score in the cognitive evaluation was 80ñ6 points (range 68 to 97 points) of a scale from 0 to 100. The qualitative survey revealed a high degree of approval of the issue's format, contents and evaluation system. The favorable effect on patients' management and on the detection and control of chronic diseases was emphasized. This distance medical education program had a good receipt and compliance among physicians and contributed to continuing medical training
Assuntos
Humanos , Masculino , Feminino , Adulto , Educação Médica Continuada/métodos , Avaliação Educacional/métodosRESUMO
The aim of this work was to assess an independent study program on hypertension using a computer multimedia program developed by the authors. Twenty-four randomly chosen students participated in the program and 76 students that continued to attend to classical lectures were used as controls. At the end of the program, a cognitive test with 40 multiple choice questions and an opinion questionnaire were applied. The experimental group had higher grades in the test than controls (71,4 and 64,6 percent respectively p<0,001) and a highly favourable opinion of the program. It is concluded that computer teaching programs are useful and feasible alternative to lectures
Assuntos
Humanos , Masculino , Feminino , Adulto , Educação de Graduação em Medicina/métodos , Hipertensão , Software , Estudantes de Medicina/estatística & dados numéricos , Instrução por Computador/métodosRESUMO
The aim of this work was to study the feasibility of applying problem-based learning methodologies to first year medical students. During 1992, they participated in tutorial gruops composed by ten students, that undertook the study of 3 clinical problems from biological, psychological and social perspective. Cognitive tests that included multiple choice and developmental questions were used for assesment. An anonymous enquiry about the students opinion towards the educational experience was also applied. Students achieved 76 percent of the predetermined goals for each problem. Scoring was better for developmental than multiple choice questions. The experience had a great acceptance among students, that considered as positive features the learning motivation, the stimulus for active participation, the achievement of personal expectancies, the integration of knowledge areas and the encouragement of team work and information seeking