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      Aprendizagem sobre teleconsulta: representações de um grupo de alunos de um curso de Medicina Translated title: Aprendizaje sobre teleconsulta: representaciones de un grupo de alumnos de un curso de Medicina Translated title: Learning about teleconsultation: representations of a group of Medical students

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          Abstract

          Com o avançar da tecnologia, passou a fazer parte da graduação médica atual o aprendizado em teleconsultas. Esta pesquisa apresenta as representações de um grupo de alunos de um curso de Medicina localizado na capital do estado de São Paulo sobre suas experiências com a realização de teleconsultas síncronas supervisionadas durante estágio realizado em um ambulatório-escola, durante o segundo semestre de 2021. Trata-se de pesquisa qualitativa que utilizou o software IRaMuTeQ® e “Análise do Conteúdo”. Esses educandos pontuam entraves para a utilização das teleconsultas, destacando preocupações com a humanização, segurança da pessoa atendida e qualidade da consulta, mas visualizam potencialidades tais como a facilidade de acesso e a comodidade. Reconhecem a importância da prática durante sua Graduação em um mundo cada vez mais tecnológico, mas trazem inquietações relacionadas à perda do exame físico e à mercantilização da Medicina.

          Translated abstract

          Con el avance de la tecnología, el aprendizaje en teleconsultas pasó a formar parte de la graduación médica actual. Esta investigación presenta las representaciones de un grupo de alumnos de un curso de medicina localizado en la capital del estado de São Paulo sobre sus experiencias con la realización de teleconsultas sincronizadas supervisadas durante una pasantía realizada en un ambulatorio escuela, durante el segundo trimestre de 2021. Se traba de una investigación cualitativa que utilizó el software IRaMuTeQ® y Análisis de Contenido. Estos alumnos puntúan obstáculos para la utilización de las teleconsultas, destacando preocupaciones con la humanización, seguridad de la persona atendida y calidad de la consulta, pero visualizan potencialidades tales como la facilidad de acceso y la comodidad. Reconocen la importancia de la práctica durante su graduación en un mundo cada vez más tecnológico, pero presentan inquietudes relacionadas a la pérdida del examen físico y a la mercantilización de la medicina.

          Translated abstract

          With the progress of technology, teleconsultation has become part of medical degree courses. This article presents the representations of a group of medical students from a university in the capital of the state of São Paulo regarding their experiences with supervised synchronous teleconsultations during an internship in a teaching clinic in the second semester of 2021. We conducted a qualitative study using the software IRaMuTeQ® and content analysis. The students highlighted barriers to the use of teleconsultation, emphasizing concerns with humanization, patient safety and consultation quality, but also perceived strengths such as ease of access and convenience. They recognize the importance of practice on the degree course in an ever more technological world, but raise concerns about the lack of physical examination and the commodification of medicine.

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          Medical education during pandemics: a UK perspective

          Introduction As the coronavirus (COVID-19) pandemic becomes widespread, its impact on society is becoming more pervasive and is now threatening medical education. Numerous medical schools have suspended all clinical placements and classes with the hopes of mitigating viral transmission. The timing of this disruption is set to have profound consequences as universities, particularly in the UK, are now conducting assessments remotely, and some are considering deferring students due to the inability to carry out teaching and clinical placements. Here, we discuss the different modes of teaching that may be offered during this time. Over the last several years, some medical schools have shifted from traditional forms of ‘in-person’ lecture-based teaching to other modes, employing online, distance or electronic learning [1]. Whilst not ideal, teleteaching or the delivery of live teaching via online platforms may prove to be an apt solution to the cancellations that are currently taking place. Rather than leaving students to their own devices, online teaching guides student learning and places content within the overall context of their curriculum. Currently, universities utilise lecture capture technology. However, this is limited in its interactivity and ability for students to ask questions. Additionally, outside of the current crisis many are worried that it may lead to empty lecture halls and reduced participation, and often, the missed lectures are not caught up. Perhaps it is now time for universities to consider utilising other modes of facilitating learning such as live teleteaching video conference platforms whereby student engagement and interactivity can be preserved, whilst observing appropriate COVID-19 social distancing measures. Teleteaching and Telemedicine Whilst online platforms may be sufficient for students in their pre-clinical years, senior medical students who are placed in clinical environments require patient contact. Indeed, communication with and examination of patients is necessary for learning and building a diagnostic clinical thought process, for as William Osler proclaimed, ‘He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all’. As an alternative to clinical placements, students at Imperial College London are being given access to an online repository of patient interview recordings and cases. Many universities have released their clinical academics to work in the National Health Service (NHS), and the acute timescale for this event has meant that drastic reorganisation has needed to be done with little time for actual teaching. However, Imperial clinicians are still delivering teleteaching through computers on hospital sites, which have seen excellent student attendance and interaction. Nonetheless, student-patient engagement is still necessary, and teleteaching does not substitute actual patient contact. Patients have a multitude of pathologies and present with varying signs and symptoms. They come with differing educational backgrounds, each presenting with a unique challenge. By not being able to engage with patients, developing key clinical skills will be more difficult. Whilst this disruption may not affect senior students’ skills, younger years are more likely to be adversely affected, as it is at this stage that their clinical foundation is set. Rather than restricting student access to patients, telemedicine technologies may be utilised. One such approach uses tablet computers which can be cleaned between patients following appropriate infection control protocols. They can be used at sites with a high risk of COVID-19 transmission; patients can be given a tablet and isolated in an exam room. In turn, both students and physicians can communicate with these patients without risking exposure to the pathogen and wasting personal protective equipment [2]. Not only would this help clinical students to maintain and refine their diagnostic thought process but could also allow them to aid healthcare systems by reducing the burden of COVID-19 through the triage of patients. Healthcare provision through telemedicine will become the mainstream in the coming years. Indeed, studies have found that interaction with telemedicine technologies during undergraduate medical training contributes to improved core competencies, medical knowledge, overall learning and higher quality patient care [3]. Furthermore, examinations have suffered from cancellations. Students are examined regularly throughout the course, and performances in different exams often have a good correlation. In turn, examination disruptions in a single instance would not alter the predictive ability of previous exams in assessing the competency of students. As a compromise, some medical schools are turning to utilise tele-technologies in order to conduct remote assessments in an effort to ensure that final year medical students have met the required competencies before they begin to practise [4]. Looking to the future A key educational dilemma involves looking at the length of the epidemic. If indeed, as seems to be the case, it was set to last several months; this would lead to a substantial loss of learning time for students and probable depreciation in confidence, although the slight loss of clinical skills would likely be quickly rekindled once students are back in a clinical environment. Importantly, throughout this crisis, what will be ever-present is the use of textbooks. With the emergence of teleteaching platforms, both can be combined to fill in the gaps that would otherwise normally be learned from lecturers or clinicians on the wards. As a side note, learning should always be placed in the modern context, and great novels of the plague, such as Daniel Defoe’s Journal of the Plague Year, Manzoni’s The Betrothed, or Camus’s La Peste, can provide students with highly relevant perspectives to the current predicament we find ourselves in. This will not only illustrate why microbiologists have worried about ‘the big one’ for so long but may even motivate students to pursue a career in infectious disease and help in the prevention of futre outbreaks. Conclusion As healthcare systems are set to be further stretched with the increasing burden of COVID-19, disruptions in medical education are inevitable across the world. Arrangements need to be made whereby students can retain clinical skills and knowledge. Though not without its problems, teleteaching technologies have the potential to substitute in-person lecture and clinical-based teaching, particularly during this pandemic. Such approaches may not only be necessary for effectively tackling the medical education dilemma during this current crisis but will also serve to lay the foundation for teaching during future disasters and beyond.
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            Representações sociais: investigações em psicologia social

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              Telemedicine and Medical Education in the Age of COVID-19

              The COVID-19 pandemic has offered medical schools an opportunity to incorporate telemedicine training into the curricula in a timely and practical manner. Telemedicine has grown exponentially in the United States, and the shift toward remote care to align with social distancing guidelines is fueling this growth. Training medical students to deliver high-quality, secure, and personalized health care through telemedicine will prepare the next generation of physicians to conscientiously use these technologies and meet a growing need for telehealth services. Telemedicine-specific educational goals can be incorporated into curricula and integrated with existing clinical experiences to provide students with core telemedicine and clinical skills to prepare them for current and future pandemics. Medical educators could explore 5 major telemedicine domains: (1) access to care, (2) cost, (3) cost-effectiveness, (4) patient experience, and (5) clinician experience. Schools could use the following learning vehicles to help medical students explore these domains: (1) asynchronous lectures covering telehealth history; (2) discussions on applications, ethics, safety, etiquette, and patient considerations; (3) faculty-supervised standardized patient telehealth encounters; and (4) hands-on diagnostic or therapeutic procedures using telehealth equipment. Incorporating telemedicine into the medical school curriculum exposes students to the application of telemedicine across specialties as well as its limitations.
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                Author and article information

                Journal
                icse
                Interface - Comunicação, Saúde, Educação
                Interface (Botucatu)
                UNESP (Botucatu, SP, Brazil )
                1414-3283
                1807-5762
                2024
                : 28
                : e230001
                Affiliations
                [02] São Paulo orgnameCentro Universitário São Camilo orgdiv1curso de Medicina Brazil
                [01] São Paulo orgnameCentro Universitário São Camilo orgdiv1Curso de Medicina Brazil
                Article
                S1414-32832024000100905 S1414-3283(24)02800000905
                10.1590/interface.230001
                8e0866eb-80bd-4f1d-963c-a9e91160722d

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 12 January 2023
                : 01 December 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 0
                Product

                SciELO Brazil


                Consulta remota,Medical education,Curriculum,Telemedicine,Remote consulting,Educação médica,Currículo,Telemedicina,Educación médica

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