RSS-Feed abonnieren

DOI: 10.1055/s-0043-1770127
Clinical Simulation in the Training of Obstetrics and Gynecology Resident from the Perspective of Medical Residency Programs
A Simulação Clínica na Formação do Residente em Obstetrícia e Ginecologia na Perspectiva do Programa de Residência Médica
Abstract
Objective This study analyzes the role of clinical simulation in internal medical residency programs (IMRP) in Obstetrics and Gynecology (OB/GYN), attributed by the supervisors, in the training of residents in the city of São Paulo (SP).
Methods Cross-sectional descriptive, qualitative, and exploratory approach. Semi-structured interviews were performed with ten supervisors of Medical Residency programs in Obstetrics and Gynecology. Interviews were analyzed by means of content analysis under the thematic modality, starting with the core the role of clinical simulation in Obstetrics and Gynecology Medical Residency Programs.
Results Supervisors view Clinical simulation as: a complementary tool for the teaching and learning process, a possibility of a safe teaching and learning environment, an opportunity to learn from mistakes, a support for professional practice committed to patient safety, a learning scenario for teamwork, a scenario for reflection on the work process in Obstetrics and Gynecology, a scenario for evaluative processes in the medical residency. Still according to supervisors, Clinical Simulation favors decision-making and encourages the resident participation in activities.
Conclusion Supervisors recognize Clinical Simulation as a powerful pedagogical tool in the learning process of resident doctors in Obstetrics and Gynecology Residency Programs.
Resumo
Objetivo O presente estudo analisa o papel da Simulação Clínica em programas de Residência Médica (PRM) de Obstetrícia e Ginecologia, atribuído pelos supervisores, na formação do residente no município de São Paulo (SP).
Métodos Abordagem qualitativa, transversal, de natureza exploratória e descritiva. Foram realizadas entrevistas semiestruturadas com dez supervisores de programas de Residência Médica de Obstetrícia e Ginecologia. Para análise das entrevistas foi realizada análise de conteúdo na modalidade temática partindo do seguinte núcleo: o papel da simulação clínica nos Programas de Residência Médica de Obstetrícia e Ginecologia.
Resultados A Simulação Clínica, na visão dos supervisores, emerge como: ferramenta complementar para o processo de ensino e aprendizagem; possibilidade de um ambiente de ensino e aprendizagem seguro; possibilidade de aprendizagem a partir do erro; suporte para prática profissional comprometida com a segurança do paciente; cenário de aprendizagem para o trabalho de equipe; cenário de reflexão sobre o processo de trabalho em Obstetrícia e Ginecologia; favorecimento na tomada de decisão; cenários de processos avaliativos na residência; e, por fim, estímulo à participação dos residentes nas atividades.
Conclusão Os supervisores reconhecem a Simulação Clínica como uma ferramenta pedagógica potente no aprendizado dos médicos residentes em Obstetrícia e Ginecologia.
Keywords
simulation training - internship and residency - obstetrics and gynecology department hospital - health human resource training - patient safetyPalavras-chave
treinamento por simulação - internato e residência - unidade hospitalar de ginecologia e obstetrícia - capacitação de recursos humanos em saúde - segurança do pacienteContributors
All authors participated in the concept and design of the study, as well as in the analysis and interpretation of data; draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.
Publikationsverlauf
Eingereicht: 03. Februar 2022
Angenommen: 20. Januar 2023
Artikel online veröffentlicht:
20. Juni 2023
© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Polavarapu HV, Kulaylat AN, Sun S, Hamed OH. 100 years of surgical education: the past, present, and future. Bull Am Coll Surg 2013; 98 (07) 22-27
- 2 Rowe T. Medical education 2.0. J Obstet Gynaecol Can 2012; 34 (11) 1019-1020
- 3 Caccia N, Nakajima A, Scheele F, Kent N. Competency-based medical education: developing a framework for obstetrics and gynaecology. J Obstet Gynaecol Can 2015; 37 (12) 1104-1112
- 4 Listening AV. J Obstet Gynaecol 2016; 38 (02) 104-107
- 5 ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice?. Acad Med 2007; 82 (06) 542-547
- 6 Ten Cate O. Nuts and bolts of entrustable professional activities. J Grad Med Educ 2013; 5 (01) 157-158
- 7 Costa JGF. et al. Práticas contemporâneas do ensino em saúde: reflexões sobre a implantação de um centro de simulação em uma universidade privada. Rev Bras Pesq Saúde. 2013; 15 (03) 85-90 . Available from: https://periodicos.ufes.br/rbps/article/view/6330
- 8 Macedonia CR, Gherman RB, Satin AJ. Simulation laboratories for training in obstetrics and gynecology. Obstet Gynecol 2003; 102 (02) 388-392
- 9 Araujo ALLS, Quilici APO. O que é simulação e por que simular. In Quilici AP. et al. Simulação clínica do conceito a aplicabilidade. 1 ed. São Paulo: Atheneu: 2012. . p. 1-16
- 10 Bardin L. Análise de conteúdo. Tradução: Luís Antero Reto, Augusto Pinheiro. São Paulo: Edições; 2016
- 11 Franco MLPB. Análise de Conteúdo. 5 ed. Campinas-SP: Autores Associados Ltda; 2018
- 12 McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 2011; 86 (06) 706-711
- 13 Satin AJ. Simulation in Obstetrics. Obstet Gynecol 2018; 132 (01) 199-209
- 14 Andreatta PB, Bullough AS, Marzano D. Simulation and team training. Clin Obstet Gynecol 2010; 53 (03) 532-544
- 15 Everett EN, Forstein DA, Bliss S. et al; Undergraduate Medical Education Committee, Association of Professors of Gynecology and Obstetrics, Crofton, MD. To the Point: The expanding role of simulation in obstetrics and gynecology medical student education. Am J Obstet Gynecol 2019; 220 (02) 129-141
- 16 Romão GS, Abrão KC, de Sá MFS. O ensino por meio da simulação na residência médica. [Internet]. Femina 2019; 47 (08) 473-478 Available from https://www.febrasgo.org.br/pt/femina
- 17 Thomas GW, Johns BD, Marsh JL, Anderson DD. A review of the role of simulation in developing and assessing orthopaedic surgical skills. Iowa Orthop J 2014; 34: 181-189
- 18 Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB. Simulation in healthcare education: a best evidence practical guide. AMEE Guide No. 82. Med Teach 2013; 35 (10) e1511-e1530
- 19 Ericsson KA. The influence of experience and deliberate practice on the development of superior expert performance. In Ericsson KA. et al. (eds.) The Cambridge Handbook of Expertise and Expert Performance. New York, NY: Cambridge University Press; 2006. . p. 683-703
- 20 Humes JC, Weir L, Keyser EA, Molina MM. The Dying Art of Vaginal Hysterectomy: A Novel Simulation. Cureus 2019; 11 (12) e6362
- 21 Galland J, Abbara S, Terrier B. et al. Simulation en santé et médecine interne : quel avenir?. Rev Med Interne 2018; 39 (06) 414-420
- 22 Maslovitz S, Barkai G, Lessing JB, Ziv A, Many A. Recurrent obstetric management mistakes identified by simulation. Obstet Gynecol 2007; 109 (06) 1295-1300
- 23 Argani CH, Eichelberger M, Deering S, Satin AJ. The case for simulation as part of a comprehensive patient safety program. Am J Obstet Gynecol 2012; 206 (06) 451-455
- 24 Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M. Interprofessional education: effects on professional practice and healthcare outcomes (update). Cochrane Database Syst Rev 2013; 2013 (03) CD002213
- 25 Merién AER, van de Ven J, Mol BW, Houterman S, Oei SG. Multidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review. Obstet Gynecol 2010; 115 (05) 1021-1031
- 26 American College of Obstetricians and Gynecologists. Preparing for clinical emergencies in obstetrics and gynecology. Committee Opinion No. 590. Obstet Gynecol 2014; 123 (03) 722-725
- 27 Rodriguez-Paz JM, Mark LJ, Herzer KR. et al. A novel process for introducing a new intraoperative program: a multidisciplinary paradigm for mitigating hazards and improving patient safety. Anesth Analg 2009; 108 (01) 202-210
- 28 Hammoud MM, Nuthalapaty FS, Goepfert AR. et al; Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee. To the point: medical education review of the role of simulators in surgical training. Am J Obstet Gynecol 2008; 199 (04) 338-343
- 29 Nalesnik SW, Mills CS, Olsen CH, Haffner WH, Zahn CM. Creating an ideal objective structured clinical exam for an obstetrics and gynecology medical student clerkship. Am J Obstet Gynecol 2005; 193 (04) 1544-1550
- 30 Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005; 27 (01) 10-28
- 31 Rall M, Manser T, Howard S. Key elements of debriefing for simulator training. Eur J Anaesthesiol 2000; 17 (08) 516-517 Available from https://journals.lww.com/ejanaesthesiology/fulltext/2000/08000/key_elements_of_debriefing_for_simulator_training.11.aspx
- 32 Smith PP, Choudhury S, Clark TJ. The effectiveness of gynaecological teaching associates in teaching pelvic examination: a systematic review and meta-analysis. Med Educ 2015; 49 (12) 1197-1206