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Journal Cover Acta Médica Portuguesa
  [SJR: 0.148]   [H-I: 15]   [0 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0870-399X - ISSN (Online) 1646-0758
   Published by Ordem dos Médicos Homepage  [1 journal]
  • Me, the Editor-In-Chief and the Puzzle Work

    • Authors: Rui Tato Marinho
      Pages: 783 - 785
      Abstract: N/A.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Medical Education in Portugal

    • Authors: João Carlos Ribeiro, Helena Donato, João Massano, Rui Tato Marinho
      Pages: 786 - 787
      Abstract: N/A.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Continuing Medical Education in Portugal: A New Era'

    • Authors: Madalena Patrício, António Vaz-Carneiro
      Pages: 788 - 789
      Abstract: N/A.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Narrative Medicine: An Optative Course at the Faculty of Medicine of
           Lisbon

    • Authors: Maria do Céu Machado, João Lobo Antunes
      Pages: 790 - 792
      Abstract: N/A.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • On the Future of Portuguese Physician-Scientists

    • Authors: Célia Azevedo Soares, João Incio, Miguel Reis Ferreira, João Barbosa-Breda, Liliana Páris, José Luís Sandoval
      Pages: 793 - 795
      Abstract: N/A.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Associations Between the Big Five Personality Traits and a Medical School
           Admission Interview

    • Authors: Isabel Lourinho, André Moreira, Rui Mota-Cardoso, Milton Severo, Maria Amélia Ferreira
      Pages: 796 - 802
      Abstract: Introduction: Personality has became popular in medical student’s selection. However, few research exists about the association between the big five personality traits and the existent medical school selection tools. Our aim was to study which personality traits were selected by a medical school admission interview.
      Material and Methods: One hundred ninety four graduate applicants that had applied to the Faculty of Medicine of the University of Porto through the graduate entry approach, after ranked on previous achievement, were interviewed between the academic years of 2011 and 2013. From these, 181 (93.3%) answered to the NEO Five-Factor Inventory that assesses high order personality traits of openness to experience, conscientiousness, extraversion, agreeableness and neuroticism. Admission interview corresponded to the second phase of the seriation process. Every applicant was interviewed and scored by three interviewers on seven dimensions asesssed by Lickert scale (1-10). Interview score was the sum of the dimensions. Linear mixed effects model and respective regression coefficients were used to estimate the association between personality traits from each interviewer’s score. Final models were adjusted for gender, interviewers and previous achievement.
      Results: Openness to experience (Beta = 0.18: CI 95%: 0.05; 0.30) had the strongest association with interview score followed by the interaction effect between the extraversion and conscientiousness traits (Beta = 0.14; CI 95%: 0.02; 0.25). Also, applicants scored higher when their gender was opposite to the interviewers.
      Discussion: Previous achievement and interview score had no association.
      Conclusion: Our admission interview selected different personality traits when compared to other selection tools. Medical schools should be aware of the implications of the adopted selection tools on the admitted medical student’s personality because it can help providing beneficial interventions.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Transition from Secondary School to Medical School: The Role of Self-Study
           and Self-Regulated Learning Skills in Freshman Burnout

    • Authors: Joselina Barbosa, Álvaro Silva, Maria Amélia Ferreira, Milton Severo
      Pages: 803 - 808
      Abstract: Introduction: The transition from secondary to higher education is a challenging and demanding period for medical students. The ability to manage study time effectively and to be a self-regulated learner is essential to cope with the exponential growth of knowledge in medical education. Thus, the purpose of our study was to measure self-regulated learning skills and self-study across secondary higher education transition and to explore its effect on academic burnout in the first year of medical school.
      Material and Methods: We collected data from 102 (43%) freshman medical students on self-regulated learning, academic achievement, and hours of self-study/week relative to last year of secondary school (at the beginning of academic year) and the first year of medical school (at the end of academic year). Burnout data was collected at the end of academic year.
      Results: Among the 102 participants, 12% were at risk of burnout. Self-directedness at secondary school and higher education, and strategies for learning and assessment at higher education were protective factors against academic burnout. However, secondary selfdirectedness has an indirect effect on academic burnout mediated by self-directedness in the first year of medical school. In addition, self-study during class period was a risk factor for burnout.
      Conclusion: Our results support the premise that students experience mental health problems from an early stage at medical school. Empowering medical students to develop strategies for learning assessment and self-direction will help them manage their learning and, consequently, promote their well-being. Finally, we found that it is not academic performance that influences burnout but the time dedicated to study.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • A Brief Course on Clinical Communication Skills: A MultiCentered Study

    • Authors: Camila Franco, Renato Franco, Milton Severo, Maria Amélia Ferreira
      Pages: 809 - 818
      Abstract: Introduction: This paper describes and analyses the results of a multicenter course on clinical communication skills with the use of the
      learning in small groups, patient actors and feedback. The aim of the course was to encourage participants to develop a more effective clinical communication to recognize the different manifestations of the same disease in different patients (disease versus illness).
      Material and Methods: The course was applied to third and fourth year medical students in three Brazilian universities and one university in Portugal. The evaluation was performed using scales regarding the participants’ point of view, multiple choice questionnaire, a self-efficacy and attitudinal questionnaire.
      Results: The study was conducted in 69 participants at the four universities. The overall evaluation of the course (from 1 - 5) was 4.70
      (SD 0.494), the self-evaluation on participation was 4.07 (SD 0.671); and the evaluation about the use of simulated patients 4.51 (SD 0.501). The multiple choice questionnaire and self-efficacy scale showed significant improvement.
      Discussion: The course methods had an excellent evaluation by students regardless of the context in which the course has been applied. Furthermore, it allowed an improvement on the knowledge and attitude of students regarding clinical communication.
      Conclusion: It was possible to develop a multi-centric learning strategy for clinical communication with a high evaluation by students who came from a Portuguese university in a cooperation project with teachers from Brazilian universities.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • An Objective Structured Clinical Exam to Assess Semiology Skills of
           Medical Students

    • Authors: Vitor Hugo Pereira, Pedro Morgado, Mónica Gonçalves, Liliana Costa, Nuno Sousa, João José Cerqueira
      Pages: 819 - 825
      Abstract: Introduction: Mastery of history taking and physical exam skills is a key competence of medical students. Objective Structured Clinical Examinations are the gold standard to assess these competencies, but their implementation in Portugal is poorly documented. We describe the implementation and our seven years experience with a high-stakes Objective Structured Clinical Examination to assess these skills in the School of Medicine, University of Minho.
      Material and Methods: Our Objective Structured Clinical Examination is in place since 2010 and has been subject to continuous improvements, including the adoption of a standard setting procedure and an increase in the number of stations.
      Results: Grades in our exam are well distributed and discriminate among students. History taking grades are lower and have remained stable throughout the years while physical examination scores have risen. The exam is reliable, with internal consistency above 0.45 and a G-coefficient of 0.74. It is also feasible, with a total testing time of approximately 20 hours for 140 students, and the involvement of 18 standardized patients and 18 faculty assessors. More importantly, it was able to engage the students, who recognize its importance.
      Discussion: The most important validity criterion of our, and any Objective Structured Clinical Examination, would be predictive validity,
      the ability to predict the performance of students in the clinical context.
      Conclusion: Our approach to a high-stakes Objective Structured Clinical Examination shows that it is feasible, reliable, valid and fair and can be implemented with success in the Portuguese setting.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • An Overview of Teaching Communication of Bad News in Medical School:
           Should a Lecture be Adequate to Address the Topic'

    • Authors: Filipe Coutinho, Anisha Ramessur
      Pages: 826 - 831
      Abstract: Introduction: Delivering bad news is very common in medical daily practice. Several studies have shown a lack of effective communication skills amongst medical students, particularly concerning how to deliver bad news. The SPIKES protocol allows communicating bad news in a 6-step method. The aim of this study is to investigate the perspective of students related to this subject.
      Material and Methods: A 45 minute lecture “Breaking Bad News” was given to 160 students in the fifth and sixth years of the Medicine course, using the SPIKES’ protocol training. After the lecture, an online survey was given to all students, and a cross-sectional and descriptive analysis of data extracted from survey was undertaken.
      Results: Fifty-four students (21% of overall) answered the online survey. Eighty three percent said that theme should have an important role in their further daily medical practice, and most of students rated the physicians’ role as challenging. Sixty percent of students expressed that communicating bad news was an integral part of the medical course curriculum. Regarding the SPIKES´ protocol, 48% felt that the first step would be the easiest to put in practice, and 40% felt that the fifth step related to “Emotions” would be the most difficult.
      Discussion: In general, the students would like to gain competencies in breaking bad news using a practical approach Conclusions: Students highly valued theoretical and practical approaches in teaching of communication of bad news. Therefore, we encourage a combination approach in pre-graduate medical education.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Undergraduate Teaching in Geriatrics and Pediatrics in Portuguese Medical
           Schools: An Observational Study

    • Authors: Mariana Amaral, Filipa Matias, Lígia Massena, Nuno Cardoso
      Pages: 832 - 838
      Abstract: Introduction: Motivated by the contracting nature of the Portuguese age pyramid, and thereby the ever increasing geriatric population, the aim of this study was to compare the number of European Credit Transfer and Accumulation System Credits dedicated to Geriatrics with Pediatrics in Portuguese Medical Schools.
      Material and Methods: An observational, descriptive and cross-sectional study was conducted and included six Portuguese Medical Schools that have six years of training and a total of 360 credits. The study plans were obtained from the medical schools’ websites or requested. Schools were grouped in modular/classic teaching methodology and the courses were categorized in mandatory/optional and specific/related. The credits of Geriatrics and Pediatrics were compared.
      Results: Four schools had classical methodology and two had a modular one. Overall, they had more credits dedicated to Pediatrics than Geriatrics. Three schools offered mandatory courses specifically oriented to Geriatrics (1.5 - 8 credits) compared to all schools mandatory courses courses on Pediatrics (5.7 - 26.5 credits). The ratio of averages of mandatory specific courses (Pediatrics/Geriatrics) was 12.4 in the classical and 1.5 in the modular group.
      Discussion: Pediatrics teaching has revealed to be superior to Geriatrics in all categories. Based on our results, we consider the Portuguese Geriatrics’ undergraduate teaching sub-optimal.
      Conclusion: Nowadays, geriatric population is quantitatively similar to pediatric population. Efforts should be made to adequate Geriatrics teaching to our reality in order to provide a more adequate health care to this age group.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Medical Residency´ Satisfaction in Portugal

    • Authors: Miguel Bigotte Vieira, Pedro Godinho, Nuno Gaibino, Raquel Dias, Agostinho Sousa, Inês Madanelo, Francisco Ribeiro-Mourão, Mariana Brandão, Sónia Duarte, Tiago Meirinhos, Ana Luísa Catarino, Cláudio Espírito Santo, Ricardo Caiado, Ricardo Marques, Ana Gonçalves Ferreira, Carlos Ramalheira, João Valente Jorge, Marta Losada, Mário Santos, Edson Oliveira, João Paulo Farias, José Manuel Silva
      Pages: 839 - 853
      Abstract: Introduction: In the last years, the global context of medical education and Medical Residency programs in Portugal suffered substantial changes. The primary objective of this study was to evaluate and characterize medical residents´ satisfaction with medical residency
      programs in Portugal and to identify features that could be improved.
      Material and Methods: We utilized as model the survey Postgraduate Hospital Educational Environment Measure that has been developed in the United Kingdom and is specifically targeted to medical residents. The survey was translated and adapted to the Portuguese reality. The survey was available online during April and May of 2016.
      Results: A total of 3456 responses were obtained, corresponding to a response rate of 35%. Endocrinology/Nutrition, Cardiology, Anesthesiology, Family Physician and Gastroenterology were the specialties in which the degree of satisfaction was higher, while Forensic Medicine, Medical Oncology, Internal Medicine, General Surgery and Pneumology showed the lowest level of satisfaction.
      Discussion: This study presented a high response rate when compared to previous studies. Portuguese medical residents presented high levels of satisfaction. Depending on year of medical residency, region, type of specialty and type of hospital marked asymmetries were noticed.
      Conclusion: The survey´s results should constitute in the future a support tool for the implementation of local and national measures relating to the medical residency. It is advisable to regularly conduct satisfaction surveys to medical residents.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • SOAP Methodology in General Practice/Family Medicine Teaching in Practical
           Context

    • Authors: Luiz Miguel Santiago, Isabel Neto
      Pages: 854 - 859
      Abstract: Introduction: Medical records in General Practice/Family Medicine are an essential information support on the health status of the patient and a communication document between health professionals. The development of competencies in General Practice/Family Medicine during pre-graduation must include the ability to make adequate medical records in practical context. As of 2012, medicine students at the University of Beira Interior have been performing visits using the Subjective, Objective, Assessment and Plan - SOAP methodology, with a performance evaluation of the visit, with the aim to check on which Subjective, Objective, Assessment and Plan - SOAP aspects students reveal the most difficulties in order to define improvement techniques and to correlate patient grade with tutor evaluation.
      Material and Methods: Analysing the evaluation data for the 2015 - 2016 school year at the General Practice/Family Medicine visit carried out by fourth year students in medicine, comparing the averages of each item in the Subjective, Objective, Assessment and Plan - SOAP checklist and the patient evaluation.
      Results: In the Subjective, Objective, Assessment and Plan - SOAP, 29.7% of students are on the best grade quartile, 37.1% are on the best competencies quartile and 27.2% on the best patient grade quartile. ‘Evolution was verified/noted’ received the worst grades in Subjective, ‘Record of physical examination focused on the problem of the visit’ received the worst grades in Objective, ‘Notes of Diagnostic reasoning / differential diagnostic’ received de worst grades in Assessment and ‘Negotiation of aims to achieve’ received the worst grades in Plan. The best tutor evaluation is found in ‘communication’.
      Discussion: Only one single study evaluated student´s performance under examination during a visit, with similar results to the present
      one and none addressed the patient’s evaluation.
      Conclusion: Students revealed a good performance in using the Subjective, Objective, Assessment and Plan - SOAP. The findings represent the beginning of the introduction of the Subjective, Objective, Assessment and Plan - SOAP to the students. This evaluation
      breaks ground towards better ways to teach the most difficult aspects.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Biomedical Simulation: Evolution, Concepts, Challenges and Future Trends

    • Authors: Carla Sá-Couto, Luís Patrão, Francisco Maio-Matos, José Miguel Pêgo
      Pages: 860 - 868
      Abstract: Biomedical simulation is an effective educational complement for healthcare training, both at undergraduate and postgraduate level. It enables knowledge, skills and attitudes to be acquired in a safe, educationally orientated and efficient manner. In this context, simulation provides skills and experience that facilitate the transfer of cognitive, psychomotor and proper communication competences, thus changing behavior and attitudes, and ultimately improving patient safety. Beyond the impact on individual and team performance, simulation provides an opportunity to study organizational failures and improve system performance. Over the last decades, simulation in healthcare had a slow but steady growth, with a visible maturation in the last ten years. The simulation community must continue to provide the core leadership in developing standards. There is a need for strategies and policy development to ensure its coordinated and cost-effective implementation, applied to patient safety. This paper reviews the evolutionary movements of biomedical simulation, including a review of the Portuguese initiatives and nationwide programs. For leveling knowledge and standardize terminology, basic but essential concepts in clinical simulation, together with some considerations on assessment, validation and reliability are presented. The final sections discuss the current challenges and future initiatives and strategies, crucial for the integration of simulation programs in the greater movement toward patient safety.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
  • Teaching Psychology in Medicine: The Context, Methodologies and
           Doctor’s Professional Identity

    • Authors: Silvia Ouakinin
      Pages: 867 - 874
      Abstract: Introduction: Teaching Psychology in medical curriculum has been the subject of numerous dissertations that focus on the relevance of this knowledge for doctors, at a general level.
      Methods: A non-systematic review of the relevant literature, particularly from the last decade, as well as national and international recommendations addressing the need for integration of behavioural and social sciences in medical training, was performed.
      Results: The literature supports the existence of preconceptions and negative attitudes towards the role of psychology in medical education, demonstrated by research in various european and american universities. The socio-cultural context, the different methodologies and barriers experienced by teachers in medical education are listed and provide the matrix for a more comprehensive discussion of the development of the doctor’s identity.
      Conclusion: Revisiting the experience of many years of teaching Medical Psychology, it is considered that the process of integration of this curricular area should occur horizontally and vertically throughout the course, stressing the need for the pedagogical training of teachers. Concepts that arise from personal reflection, adjusted to the reality of our education and the basic principles that guide it, are elaborated in order to integrate the teaching of Psychology in Medicine, emphasizing its importance and utility in the competencies and abilities of future doctors.
      PubDate: 2016-12-30
      Issue No: Vol. 29, No. 12 (2016)
       
 
 
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