Correa, Cyntia Pace Schmitz; Hermuche, Lina Santana; Lucchetti, Alessandra Lamas Granero; Ezequiel, Oscarina da Silva; Lucchetti, Giancarlo

doi:10.1590/1806-9282.65.10.1241

Acessibilidade / Reportar erro

Brasil

Revista da Associação Médica Brasileira

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Rev. Assoc. Med. Bras. 65 (10) • Out 2019 • https://doi.org/10.1590/1806-9282.65.10.1241 copiar

Current status of Brazilian interprofessional education: a national survey comparing physical therapy and medical schools

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

OBJETIVOS

Investigar quantas escolas médicas e de fisioterapia brasileiras possuem iniciativas e cursos relacionados à EIP nos currículos, avaliando as barreiras e fatores associados com essa implementação e comparando as diferenças entre esses dois cursos.

MÉTODOS

Essa pesquisa nacional foi conduzida em 2017 e incluiu representantes das escolas médicas e de fisioterapia no Brasil. As ofertas de atividades interprofissionais, assim como as opiniões e barreiras para implementação, foram avaliadas.

RESULTADOS

Um total de 76 (33,9%) escolas médicas e 159 (41.4%) escolas de fisioterapia respondeu aos questionários. Pelo menos 68,4% das escolas médicas e 79,2% das escolas de fisioterapia possuem iniciativas de EIP, embora o número de cursos obrigatórios e estágios ainda seja baixo. Apesar de reconhecer a importância da EIP na educação em saúde, os representantes das escolas percebem como barreiras a falta de integração entre os cursos, associada a cronogramas incompatíveis e uma falta de suporte institucional. Na fisioterapia, existe menor percepção de barreiras e uma grande incorporação de cursos obrigatórios no currículo.

CONCLUSÃO

Esses resultados auxiliarão no desenvolvimento de futuras intervenções que promovam a EIP no currículo dos países em desenvolvimento.

Educação interprofissional; Estudantes de medicina; Fisioterapia

		Total (n=235)	Medicine (n=76)	Physical Therapy (n=159)	p
Type of University	Public Private	68 (28.9%) 167 (71.1%)	36 (47.4%) 40 (52.6%)	32 (20.1%) 127 (79.9%)	<0.001
Region	South Southeast Center-West Northeast North	59 (25.1%) 97 (41.3%) 19 (8.1%) 46 (19.6%) 14 (6.0%)	16 (21.1%) 35 (46.1%) 4 (5.3%) 16 (21.1%) 5 (6.6%)	43 (27.0%) 62 (39.0%) 15 (9.4%) 30 (18.9%) 9 (5.7%)	0.616
Respondent	Director Dean/coordinator Other professors	11 (4.7%) 199 (84.7%) 25 (10.6%)	5 (6.6%) 61 (80.3%) 10 (13.2%)	6 (3.8%) 138 (86.8%) 15 (9.4%)	0.408
Students graduating yearly		64.0 (44.1)	87.7 (43.3)	52.7 (39.9)	<0.001
Type of IP Activity	Interprofessional Multidisciplinary Both None	81 (34.5%) 41 (17.4%) 97 (41.3%) 16 (6.8%)	24 (31.6%) 15 (19.7%) 28 (36.8%) 9 (11.8%)	57 (35.8%) 26 (16.4%) 69 (43.4%) 7 (4.4%)	0.149
Do you have any IP Activity?	Yes No	178 (75.7%) 57 (24.3%)	52 (68.4%) 24 (31.6%)	126 (79.2%) 33 (20.8%)	0.076
Mandatory IP Courses	Yes No	93 (39.6%) 142 (60.4%)	21 (27.6%) 55 (72.4%)	72 (45.3%) 87 (54.7%)	0.010
Elective IP courses	Yes No	86 (36.6%) 149 (63.4%)	26 (34.2%) 50 (65.8%)	60 (37.7%) 99 (62.3%)	0.665
Mandatory Clerkship	Yes No	80 (34.0%) 155 (66.0%)	13 (17.1%) 63 (82.9%)	67 (42.1%) 92 (57.9%)	<0.001
Elective Clerkship	Yes No	21 (8.9%) 214 (91.1%)	7 (9.2%) 69 (90.8%)	14 (8.8%) 145 (91.2%)	0.919
Other IP Activities	Yes No	172 (73.2%) 63 (26.8%)	50 (65.8%) 26 (34.2%)	122 (76.7%) 37 (23.3%)	0.085
Extension project	Yes No	165 (70.2%) 70 (29.8%)	49 (64.5%) 27 (35.5%)	116 (73.0%) 43 (27.0%)	0.223
Training Project	Yes No	46 (19.6%) 189 (80.4%)	20 (26.3%) 56 (73.7%)	26 (16.4%) 133 (83.6%)	0.080
Undergraduate Research Project	Yes No	112 (47.7%) 123 (52.3%)	31 (40.8%) 45 (59.2%)	81 (50.9%) 78 (49.1%)	0.164
Colloquium/Symposium	Yes No	109 (46.4%) 126 (53.6%)	30 (39.5%) 46 (60.5%)	79 (49.7%) 80 (50.3%)	0.163
Congresses	Yes No	65 (27.7%) 170 (72.3%)	17 (22.4%) 59 (77.6%)	48 (30.2%) 111 (69.8%)	0.275

Mandatory Course – present in 21 (27.6%) medical courses
Period offered: 1st (6), 2nd (9), 3rd (9), 4th (9), 5th (9), 6th (4), 7th (3), 8th (3), 9th (3), 10th (3), 11th (5) and 12th (4)
Most common areas: Health management: 7, public health: 17, clinical areas: 7, health education: 9
Level of focus: Primary: 20, secondary: 5, tertiary: 0
Methods used: Traditional: 7, problem-posing education: 15, PBL: 3, TBL: 9, others: 3
Average number of students involved per semester: 161.6 (SD: 148.9)
Elective Course – present in 26 (34.2%) medical courses
Period offered: 1st (6), 2nd (6), 3rd (8), 4th (5), 5th (6), 6th (6), 7th (8), 8th (6), 9th (4), 10th (3), 11th (3) and 12th (3)
Most common areas: Health management: 7, public health: 17, clinical areas: 13, health education: 11
Level of focus: Primary: 24, secondary: 12, tertiary: 8
Methods used: Traditional: 16, problem-posing education: 17, PBL: 5, TBL: 11, others: 3
Average number of students involved per semester: 79.8 (SD: 110.8)
Mandatory Clerkship – present in 13 (17.1%) medical courses
Period offered: 1st (0), 2nd (0), 3rd (0), 4th (0), 5th (1), 6th (0), 7th (1), 8th (1), 9th (7), 10th (7), 11th (7) and 12th (7)
Most common areas: Health management: 5, public health: 10, clinical areas: 9, health education: 7
Level of focus: Primary: 13, secondary: 7, tertiary: 6
Average number of students involved per semester: 95.9 (SD: 94.5)
Elective Clerkship – present in 7 (9.2%) medical courses
Period offered: 1st (0), 2nd (1), 3rd (2), 4th (2), 5th (2), 6th (2), 7th (3), 8th (3), 9th (3), 10th (3), 11th (3) and 12th (2)
Most common areas: Health management: 2, public health: 6, clinical areas: 4, health education: 1
Level of focus: Primary: 6, secondary: 4, tertiary: 3
Average number of students involved per semester: 26.8 (SD: 20.6)
Other Initiatives – present in 50 (65.7%) medical courses
Extension project: 49/ Training project: 20 / IC Project: 31 / Colloquium/symposiums: 30 / Congresses: 17
Methods used: Traditional: 28, Problem-posing education: 31, PBL: 13, TBL: 18, others: 17

Mandatory Course – present in 72 (45.3%) physical therapy courses
Period offered: 1st (33), 2nd (35), 3rd (33), 4th (27), 5th (23), 6th (17), 7th (18), 8th (15), 9th (11), 10th (10)
Most common areas: Health management: 20, public health: 54, clinical areas: 23, health education: 42
Level of focus: Primary: 264, Secondary: 42, Tertiary: 37
Methods used: Traditional: 42, Problem-posing education: 45, PBL: 26, TBL: 22, Others: 15
Average number of students involved per semester: 84.3 (SD: 80.6)
Elective Course – present in 60 (37.7%) physical therapy courses
Period offered: 1st (9), 2nd (8), 3rd (15), 4th (11), 5th (13), 6th (17), 7th (12), 8th (11), 9th (8), 10th (9)
Most common areas: Health management: 15, public health: 32, clinical areas: 22, health education: 32
Level of focus: Primary: 50, Secondary: 33, Tertiary: 28
Methods used: Traditional: 32, Problem-posing education: 32, PBL: 23, TBL: 21, others: 10
Average number of students involved per semester: 45.2 (SD: 40.8)
Mandatory Clerkship – present in 67 (42.1%) physical therapy courses
Period offered: 1st (0), 2nd (0), 3rd (1), 4th (2), 5th (5), 6th (10), 7th (17), 8th (24), 9th (26), 10th (22)
Most common areas: Health management: 14, public Health: 52, clinical areas: 47, health education: 29
Level of focus: Primary: 50, secondary: 33, tertiary: 28
Average number of students involved per semester: 37.9 (SD: 30.7)
Elective Clerkship – present in 14 (8.8%) physical therapy courses
Period offered: 1st (0), 2nd (0), 3rd (0), 4th (0), 5th (0), 6th (3), 7th (5), 8th (6), 9th (6), 10th (5)
Most common areas: Health management: 1, public Health: 8, clinical areas: 13, health education: 6
Level of focus: Primary: 11, Secondary: 12, tertiary: 7
Average number of students involved per semester: 40.5 (SD: 31.1)
Other Initiatives – present in 122 (76.7%) physical therapy courses
Extension project: 116 Training project: 26 IC Project: 81 Colloquium/symposiums: 79 Congresses: 48
Methods used: Traditional: 80, Problem-posing education: 69, PBL: 41, TBL: 36, others: 21

Likert (% of those who agree or strongly agree)	Total (n=235)	Medicine (n=76)	Physical Therapy (n=159)	p
Do you consider Interprofessional Education activity to be important for training professionals in the area of health?	233 (99.1%)	75 (98.7%)	158 (99.4%)	0.543
Do you agree that students should be prepared to act interprofessionally while still in undergraduate school?	233 (99.1%)	74 (97.4%)	159 (100.0%)	0.104
Do you agree that your institution manages to produce undergraduate curriculum for healthcare courses in an integrative and collaborative manner?	140 (59.6%)	32 (42.1%)	108 (67.9%)	<0.001
Do you agree that both institutional and academic institutional support interferes with the development of interprofessional activities in undergraduate health courses?	218 (92.8%)	73 (96.1%)	145 (91.2%)	0.281
Do you agree that undergraduate health courses in Brasil have paid adequate attention to interprofessional work?	38 (16.2%)	9 (11.8%)	29 (18.2%)	0.258
Do you agree that the Brazilian Health System has paid adequate attention to interprofessional work?	55 (23.4%)	23 (30.3%)	32 (20.1%)	0.100
My institution does NOT support interprofessionalism ACADEMICALLY.	28 (11.9%)	13 (17.1%)	15 (9.4%)	0.130
My institution does NOT support interprofessionalism FINANCIALLY.	55 (23.4%)	20 (26.3%)	35 (22.0%)	0.511
Undergraduate course curriculum at my institution is heterogenous, which makes the interaction between students and faculty difficult.	82 (34.9%)	43 (56.6%)	39 (24.5%)	<0.001
My institution does not offer “green zones” ( shared free time, without activities) in course schedules, thus making the interaction between students and faculty difficult.	86 (36.6%)	19 (25.0%)	67 (42.1%)	0.014
There are difficulties in communication between courses at my institution.	66 (28.1%)	22 (28.9%)	44 (27.7%)	0.877
There are difficulties in time management between courses at my institution.	109 (46.4%)	40 (52.6%)	69 (43.4%)	0.209

Likert (1 strongly disagree to 5 strongly agree)	Total (235)	Medicine (76)	Physical Therapy (159)	p
Do you consider Interprofessional Education activity to be important for training professionals in the area of health?	4.74 (0.50)	4.67 (0.61)	4.77 (0.43)	0.170
Do you agree that students should be prepared to act interprofessionally while still in undergraduate school?	4.78 (0.49)	4.69 (0.67)	4.83 (0.37)	0.112
Do you agree that your institution manages to produce undergraduate curriculum for healthcare courses in an integrative and collaborative manner?	3.53 (1.10)	3.17 (1.12)	3.70 (1.05)	<0.001
Do you agree that both institutional and academic institutional support interferes with the development of interprofessional activities in undergraduate health courses?	4.38 (0.72)	4.39 (0.67)	4.38 (0.74)	0.913
Do you agree that undergraduate health courses in Brasil have paid adequate attention to interprofessional work?	2.45 (0.91)	2.34 (0.84)	2.51 (0.94)	0.157
Do you agree that the Brasilian Health System has paid adequate attention to interprofessional work?	2.64 (0.94)	2.76 (0.93)	2.59 (0.94)	0.191
My institution does NOT support interprofessionalism ACADEMICALLY.	2.15 (1.00)	2.28 (1.05)	2.09 (0.97)	0.163
My institution does NOT support interprofessionalism FINANCIALLY.	2.54 (1.09)	2.59 (1.07)	2.52 (1.10)	0.646
Undergraduate course curriculum at my institution is heterogenous, which makes interaction between students and faculty difficult.	2.80 (1.17)	3.27 (1.09)	2.57 (1.14)	<0.001
My institution does not offer “green zones” ( common free time, without activities) in course schedules, thus making interaction between students and faculty difficult.	2.82 (1.30)	2.51 (1.24)	2.98 (1.30)	0.010
There are difficulties in communication between courses at my institution.	2.63 (1.16)	2.72 (1.11)	2.59 (1.18)	0.437
There are difficulties in time management between courses at my institution.	3.12 (1.10)	3.39 (0.99)	2.99 (1.13)	0.006

IP activities^a
	OR	Lower	Upper	p
Integrated Curriculum	2.68	1.35	5.30	0.005
Not Supported Academically	0.64	0.46	0.89	0.008
Mandatory IP course ^b
	OR	Lower	Upper	p
Integrated Curriculum	1.52	1.13	2.04	0.005
Not Supported Financially	0.73	0.54	0.97	0.034
Mandatory IP clerkship ^c
	OR	Lower	Upper	p
Physical Therapy School	2.98	1.46	6.05	0.002
Integrated Curriculum	1.45	1.04	2.02	0.025
Not Supported Academically	0.63	0.43	0.91	0.015

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDING AUTHOR: Giancarlo Lucchetti Department of Medical Education - School of Medicine, Federal University of Juiz de Fora Av Eugênio do Nascimento s/n – Juiz de Fora, MG, Brasil – Phone +55 32 2102-6841 E-mail: g.lucchetti@yahoo.com.br