Proposta de implantação do método avaliativo de competências clínicas (MINI-CEX) na residência médica em doenças infecciosas da Universidade Federal do Rio Grande do Norte – UFRN

Abstract

CONTEXT: The medical residency of infectious diseases aims at developing psychomotor abilities, ethnic values, attitudes and behaviors of the newly graduated doctor, exigencies seen as indispensable to the medical practice. It is known that the cognitive domain concerns exclusively the abilities of intellectual nature, though the evaluation of these students include not only this knowledge, but also psychomotor aspects and attitudes. Several evaluation methods of clinical abilities are in use in medical schools all over the world since the 1990’s. Among them, the Clinical Evaluation Exercise (Mini-CEX) stands out as evaluation tool whose pioneers were Norcini and collaborators. In the 1990’s, the American Board of Internal Medicine recommended this tool in the evaluation of clinical competences. Although the evaluation of clinical competences is indispensable in the medical residency programs, and their importance largely spread inside the academic community, this practice is not systematical in the medical residency of contagious diseases at Rio Grande do Norte Federal University. OBJECTIVES: Recover the knowledge accumulated by professors and preceptors of medical residency of infectious diseases in Rio Grande do Norte Federal University, which may relate to evaluation of clinical competences based on Mini-CEX. Thus, starting the evaluation of these competences in each residency. METHODOLOGY: interventional sectional study with patients, medical preceptors and infectious diseases resident students of first, second and third years, in Rio Grande do Norte Federal University, during 2015.1 academic semester. It consisted of three steps. In the first one, teachers and preceptors underwent a capacitation program in clinical evaluation. The training program followed the modality of open education, by means of active methods of teaching and learning. For example, down and up landscape, round of conversation and apprenticeship mediated by video focusing the usage of Mini-CEX as an evaluation method. One also tried to improve the evaluation tool used in medical residency. In the second step, the students discussed the importance of evaluation in clinical competences as apprenticeship tool. At the last one, professors and preceptors used Mini-CEX to evaluate the clinical competences of the resident students. RESULTS: The main result of this paper is to encourage the discussion and the reflection about the importance of evaluation of clinical competences in the medical residency with its several players: professors, preceptors and resident students in order to bring about paradigms and trends of teaching in medical residency, rescuing the knowledge about the evaluation methods. 54.16% of the visitors (professors and preceptors) and 100% of the students shared capacitation. Feedback disclosed as strong points of the process the opportunity of participation and the acquisition of new knowledge. Among the weak points, the study detected the short duration of the event. Suggestions pleaded repetition and enlargement of process and opened its doors to other colleagues that wish to take part in this process. CONCLUSION: This work states that even professors and preceptors responsible for guiding resident students in the practices of hospital do not care about evaluation methodologies, it is possible involve them in this process, capacitating them with the aid of adequate methodology and standing out the importance of their role in the formation of those professionals. However, it is essential that universities seize the climate of motivation and start evaluation of their clinical competences using this tool.