A ordem dos fatores altera o produto. Reflexões sobre educação médica e cuidados paliativos

“To heal sometimes, to relieve frequently, to comfort always.” This classic statement, summarising the doctor's role, is presented in a sequence that leads to an important educational error. What can be expected when the recommended order for the doctor's role is to cure, relieve and, ultimately, comfort? The logic is to think that we move from the main issue to the lesser one, to the details. When healing is not possible it can at least be relieved, and if it cannot be relieved, providing comfort still remains. To proceed in this sequence inevitably presents relief and comfort as a consolation prize to the doctor who was faced with an incurable, painful, and terminal disease. The resulting product of this process misconception ‐the physician‐ has important deficiencies. The author makes an extensive reflection on human and technical aspects of medical education. The reflection starts with the warnings coming from the patient, the doctor's mistakes, and enters into the necessary land of suffering and death, those scenarios that doctors should learn in their training, as they will be part of their professional activities. To assume the correct posture in this scenario requires a practical medical anthropology, imbued with philosophical values, and permeated by ethics. The reflection then leads to medicine as a science and art that also leads to the practice of palliative care with the required competence. As a conclusion the author proposes a Hippocratic‐Copernican shift in medical education, to avoid this misconception that yields important training deficiencies. While comfort is something that should always be given due to its high prevalence, the cure has a much lower prevalence. The medical education process should include this ratio to produce better doctors. Doctors must always know how to comfort and, depending on the circumstances and the diseases with which they encounter, they also should heal when cure is possible. That means, the order of the factors changes the product. The introduction of Palliative Care in the medical curriculum could facilitate change in the order of these factors.     

An Interactive Parents' Guide for Feeding Preschool-Aged Children: Pilot Studies for Improvement

There are few motivational materials to help families with limited resources develop optimal, practical feeding strategies for young children to reduce dietary risk for poor diet and weight status. Formative evaluation strategies consisting of both qualitative and quantitative data helped to refine the parent feeding guide Eat Healthy, Your Children are Watching, A Parent's Guide to Raising a Healthy Eater. An interdisciplinary planning team developed a five-topic, multimedia, interactive guide addressing the strategies most associated with improved diet quality and weight status of children aged 3 to 5 years. Research staff conducted iterative phases of field testing, reformatting, in-depth interviews, and materials testing with Head Start or Supplemental Nutrition Assistance Program–Education caregivers (N=38) of children aged 3 to 5 years during 2011 and 2012. Convergence of feedback from caregivers' interviews and each booklet's attention, relevance, confidence, and satisfaction subscale scores were used to determine and affirm areas for improvement. Lower than desired attention, relevance, confidence, and satisfaction scores (optimal score=5) in 2011 and too much text resulted in revisions and reformatting that improved scores from 3.8 to 4.9 in 2012. The revision of materials to reflect less text, additional white space, checklists of mealtime behaviors, and learning activities for preschool-aged children resulted in dramatically improved materials and greater acceptance by parents, as shown by both quantitative and qualitative evaluations. Formative evaluation procedures involving the use of data-based decision making allowed for the development of intervention materials that met the unique needs of the population served.     

Is problem-based learning an ideal format for developing ethical decision skills?

Ethical decision making is a complex process, which involves the interaction of knowledge, skills, and attitude. To enhance the teaching and learning on ethics reasoning, multiple teaching strategies have to be applied. A medical ethical reasoning (MER) model served as a framework of the development of ethics reasoning and their suggested instructional strategies. Problem-based learning (PBL), being used to facilitate students' critical thinking, self-directed learning, collaboration, and communication skills, has been considered effective on ethics education, especially when incorporated with experiential experience. Unlike lecturing that mainly disseminates knowledge and activates the left brain, PBL encourages “whole-brain” learning. However, PBL has several disadvantages, such as its inefficiency, lack of adequately trained preceptors, and the in-depth, silo learning within a relatively small number of cases. Because each school tends to utilize PBL in different ways, either the curriculum designer or the learning strategy, it is important to maximize the advantages of a PBL session, PBL then becomes an ideal format for refining students' ethical decisions and behaviors.     

Applied research in biotechnology as a source of opportunities for green chemistry start-ups

Applied research in biotechnology can be a source of inspiration for start-ups in green chemistry. The versatility of bioprocesses and the possibility of developing business models from research outcomes could create innovation ecosystems, including large economies and developing countries such as Colombia.The process of training young researchers is key to ensure the feasibility of these start-ups in the long term; however, many universities have curricula that are far from generating conditions that favor the development of new businesses. The integration between research groups, curriculum, and the industry are key elements to deepen the development of green chemistry-oriented ventures.This paper shows the lessons learned from Universidad Pontificia Bolivariana through its research group in biotechnology CIBIOT as a working model that integrates the curriculum and research. Case studies and reflections on technology-based entrepreneurship are shown.     

依托大学附属医院培养医学影像技术专业的问题与思考

我国医学影像技术专业开设时间短,办学依托模式在各高校间存在较大差异,其中基于大学附属医院培养医学影像技术专业的模式存在课程体系逻辑不合理、教研机构设置不健全、学生创新研究引导不足等弊端,同时本文提出缓解上述不利教育因素的方案,旨在进一步完善高校附属医院主导医学影像技术专业建设的模式,输出更优质的人才。     

香港两所护理学院护理本科课程设置的比较和启示

目的 通过对香港两所护理学院护理本科课程设置比较,为内地护理本科课程设置提供参考.方法 采用内容分析法、文献研究法等对香港两所护理学院的全日制四年护理本科课程进行横向比较.结果 两所护理学院课程设置的共同点为护理本科生教育标准、课程宗旨及目的 、护理本科毕业生要求、毕业生的出路及学生在校期间护理技能考试项目等均由香港护...     

基于全科医师职业能力的专科层次临床医学专业(全科医学方向)课程体系研究

目的 深入分析全科医师职业能力,构建专科层次临床医学专业(全科医学方向)的课程体系.方法 分层随机抽样选取社区卫生服务机构12名全科医师进行问卷调查和小组访谈,让其填写1个月的工作日志.基于全科医师职业能力的专科层次临床医学专业(全科医学方向)课程体系经两轮专家咨询(Delphi法)后确定.结果 社区全科医师的主要任务依次为留观患者、疾病诊治、常见症状诊治、社区健康教育、健康体检、健康咨询、慢病管理等.按全科医师工作任务和职业能力从"预防、保健、医疗、康复"四方面构建以社区为基础的课程体系.结论 建立基于全科医师职业能力的专科层次临床医学专业(全科医学方向)课程体系,推行"以社区为基础的教育结合社区为问题的学习"(CBE-PBL)的培养模式,才能适应社区卫生服务发展对全科医师培养的需要.