Utilização de mapas conceituais como ferramenta de ensino para o desenvolvimento do raciocínio clínico no curso de medicina da Universidade Federal do Rio Grande do Norte

BACKGROUND: Among the wide range of skills displayed by a medical doctor is undoubtedly the need to use cohesive and well grounded clinical reasoning in order for medical care to be indeed effective. It is in this respect that conceptual maps emerge; these are a methodological innovation that allows a comprehensive, panoramic and associative outlook of theoretical content, making it more practical and applicable to the reality of clinical observation. Promoting learning, learning resources and a feedback system between professor and students, as well as assessing and monitoring the performance of students during their academic training, are the main features of this tool. OBJETIVE: Assess the use of conceptual maps as a teaching-learning tool in the training of undergraduate medical students at Universidade Federal do Rio Grande do Norte (UFRN). METHODOLOGY: Interventional, randomized, cross-sectional study conducted with students from the 3rd and 5th periods of the medical course at UFRN, during the second semester of 2014, totaling 86 participants, divided into two groups: GI (intervention – clinical case resolution with a conceptual map) and GII (control – clinical case resolution without a conceptual map) in each period. RESULTS: The use of conceptual maps to teach liver failure syndrome resulted in a statistically significant cognitive gain for G1 students from the 5th period (GI: 6.8±1.6 and 8.0±1.5, p = 0.024; GII: 7.2±2.1 and 8.0±1.7, p = 0.125, pre and post-intermediate means, respectively), a result not observed in the period 3rd (GI: 7.7±1.3 and 8.0±1.4, p = 0.501; GII: 6.7±1.8 and 7.8±1.8; p=0.068, pre and post-intermediate means, respectively). Students in the 3 rd period gave better responses to the first clinical case, with a larger number of suitable concepts and crosslinks, when they used conceptual maps (GI: 91.3±13.15 and GII: 64.84±22.84, p=0,002). Students in the 5th period exhibited better clinical reasoning and more complete responses using the tool (p=0,01). Most of the students were not aware of the tool (53.8% from the 3rd period and 65.3% from the 5th period). Among those who knew about conceptual maps, most (59.3%) had only used them during high school, 14.8% had never used them and only seven students (25.9%) used them during the medical course. Analysis of open responses, obtained in process assessment showed clear satisfaction and enthusiasm with learning about the new tool, and frequent suggestions to use it at other moments in the course. Assessment of learning profile, using the VARK questionnaire, showed that most students from both periods exhibited a multimodal style. CONCLUSION: Despite their scant knowledge regarding the tool, good acceptability and understanding was observed in the study participants. The conceptual maps allowed cognitive gains, better responses and clinical reasoning in teaching liver failure syndrome to 5th period students.

Prevalence of refractive errors in students in Northeastern Brazil

To determine the prevalence of refractive errors in the public and private school system in the city of Natal, Northeastern Brazil. Methods: Refractometry was performed on both eyes of 1,024 randomly selected students, enrolled in the 2001 school year and the data were evaluated by the SPSS Data Editor 10.0. Ametropia was divided into: 1- from 0.1 to 0.99 diopter (D); 2- 1.0 to 2.99D; 3- 3.00 to 5.99D and 4- 6D or greater. Astigmatism was regrouped in: I- with-the-rule (axis from 0 to 30 and 150 to 180 degrees), II- against-the-rule (axis between 60 and 120 degrees) and III- oblique (axis between > 30 and < 60 and >120 and <150 degrees). The age groups were categorized as follows, in: 1- 5 to 10 years, 2- 11 to 15 years, 3- 16 to 20 years, 4- over 21 years. Results: Among refractive errors, hyperopia was the most common with 71%, followed by astigmatism (34%) and myopia (13.3%). Of the students with myopia and hyperopia, 48.5% and 34.1% had astigmatism, respectively. With respect to diopters, 58.1% of myopic students were in group 1, and 39% distributed between groups 2 and 3. Hyperopia were mostly found in group 1 (61.7%) as well as astigmatism (70.6%). The association of the astigmatism axes of both eyes showed 92.5% with axis with-the-rule in both eyes, while the percentage for those with axis againstthe- rule was 82.1% and even lower for the oblique axis (50%). Conclusion: The results found differed from those of most international studies, mainly from the Orient, which pointed to myopia as the most common refractive error, and corroborates the national ones, with the majority being hyperopia

O ensaio jornalístico na revista Veja: uma análise multidimensional

This work has as objective generality to make a multidimensional analysis in the genre journalistic assay, communicative genre that, beyond complex and multimodal, presents hybrid characteristics. Specifically, with the intention to propose defining criteria of the cited genre, this research looks for to establish differences and similarities between the assay and other genres of the same sphere, from the description and interpretation of used multimodal resources. The analysis of the formal, schematical and rhetorical resources identified in the formatting of the journalistic assay sample that the analyses are supported in the socio-semiotic and socio-rhetorical approaches. In the formal dimension, we contemplate elements that constitute design of the text, including the forms of representation from the typography, the colors, images, as well as the aspects communicative-linguistics: the modalization indices, the communicative operators and the category time; in the schematical dimension, we present the organizational structure, considering the rhetorical movements postulates for Swales (1990) and in the rhetorical dimension we observe the categories: who writes, for who it writes, on what it writes and where writes. The adopted methodologicals postulates are of qualitative nature and the procedure is documentary, data that in we are valid them written texts of this genre as analysis object. Corpus it is constituted by a composed sample for 14 extracted texts of a set of 173 propagated journalistic assays weekly for the magazine Veja, in the period between August of 2004 and January of 2008. The analysis of the data showed that the journalistic assay, object of this study, materializes through multiple symbolic representations and multiple subjects that turn since a small episode of the daily facts of great social relevance in the present time, of historical and cultural nature, nationwide or international. Used for the first time by Montaigne in 1580, to assign, in saying of the proper author, written fast on its life and historical events, which could nor be remembered later , the term `assay' was enriched with other specifications, of form to enclose the one that if they call scientific assay today, academic assay, journalistic assay and other types of specific assays. These denominations have to see with the enrollment of the members of diverse of practices communities, in virtue of the multiplicity of activities carried through in these spheres. The conclusions the one that we arrive had been the following ones: 1. the discursive genre is not a pure entity, in virtue of the multiplicity of situations where the sorts if insert in the social actions; 2. the institutions define the configuration of one definitive genre, also its proper assignment, since for backwards of all discursive genre a voice exists to discipline - institutional voice, and in the case of the assays for analyzed us, the institutional voice if it presents, really, as a defining trace; 3. the journalistic assay, for its multiple symbolic representations, multiple subjects and for passing explicit or implicit opinions of its author, resembles it other genres, being able, therefore, to be inserted in a colony of opinionatives genres