Contribuições do internato curricular em atenção primária à saúde na evolução de competências por estudantes de graduação em Medicina

Abstract

The curricular internship is one of the privileged spaces for learning in medical education. The incorporation of Primary Health Care (PHC) as a mandatory area, with defined workload, is one of the consequences of National Curriculum Guidelines (NCG) implementation. The aim of this study was to evaluate the impact of the internship at Primary Health Care in the students’ perception. The data were collected before and after the four months’ immersion in supervised activities at PHC, in 10 cities of central-west region in RS, taking into account two big analysis categories: (1) on the knowledge of population healthy reality and the appreciation of some risk factors for chronic non-communicable disease (CNCD); (2) on the changing of perception about security, autonomy, problem-solving, doctor-patient relationship and the relationship with other professionals. The design of consecutive cross-sectional study was used, with a sample consisting of 153 academics in the last semester in medical graduation. It can be concluded that the internship at PHC influenced significantly coherence perception between the medical decisions that were taken by students and the real health needs perceived in the population that was attended. This study also noted a significant increase in competences of personal security and confidence in decision-taking, which positively impacted their capability of solving the clinical problems experienced. In the conducted epidemiological survey, it was reached a resoluteness of 92% assisted cases. Practically all the surveyed students felt prepared to work in PHC in the end of the internship. There was also a substantial change, in the increase of recommendations to stop smoking, to reduce the intake of fat and salt, as well as recommendations to increase the use of fibrous food. The internship in PHC was also able to positively change the routine of measure blood pressure of patients, as well as advice to maintaining a healthy weight, when it was a medical consultation. The study noted in conducted epidemiological survey that Systemic Arterial Hypertension (SAH) was the most prevalent pathology. The activity was also capable to positively change students’ perception about the nature of medical work, in addition to be attributed to internship, the improvement in the relationship with other professionals working in the units. The results prove the importance of PHC in changing some skills and behavior of the medical students at Federal University of Santa Maria (UFSM).