Desenvolvimento de competências em ecocardiografia do médico residente em cardiologia

Abstract

The Medical Residences represent the gold standard for the training of specialists, being performed through training supervised by expert preceptors, in the work environment, often without proper curriculum planning and education. Curricular changes in medical education have been discussed in the last decades, aiming at a more humanistic and resolutive formation, with evaluation models and more consistent certifications. Competency-based curricula have been observed in training programs in various health areas, already a wellestablished reality in medical education in the United States and Europe. In Brazil, there is no consensus about the methodology of training in echocardiography for the medical resident of Cardiology, nor the necessary minimum competencies nor even an assessment system that provide a formative characteristic. The purpose of this project was to use active teaching-learning methods to improve the development of skills in echocardiography of the medical resident in cardiology at Onofre Lopes University Hospital. The study was exploratory, prospective and descriptive, involving the residents of the cardiology at Onofre Lopes University Hospital, residents from other national institutions, and the echocardiography preceptors. It was developed in the following steps: 1) Literature review 2) Development of a Direct Observed Procedural Skills (DOPS), training of preceptors and application of the DOPS tool 3) Collective construction of the competency matrix in echocardiography for the cardiology resident, following the modified Delphi methodology to obtain the consensus among the specialists. The description of the competences to be evaluated by the DOPS were developed collectively by the specialists and the tool was applied to 10 cardiology residents during the project, with 07 residents of HUOL and 03 of other national institutions. The assessments meetings, registered through the DOPS tool, allowed a descriptive analysis of various technical and educational aspects, strengthening the resident-preceptor relationship. The consensus of the competency matrix in echocardiography was achieved in the first round of the modified Delphi strategy, with a high concordance rate, with more than 50% among all competencies and domains presented, being the panel of specialists composed of 05 participants (83.3%) of those initially selected. The incorporation of tools and active teaching-learning strategies allowed the standardization of the training in echocardiography of the cardiology resident of the University Hospital Onofre Lopes, improving the acquisition of specific skills.