824 resultados para Avaliação da Formação


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The Health Multiprofessional Residency Program of the Federal University of Rio Grande do Norte (PRMS/UFRN) adopts as guiding keystones the learning process of in-service teaching, the interdisciplinary multiprofessional work and the compliance with the principles and guidelines of the Brazilian Unified Health System (SUS). Although PRMS/UFRN have been idealized with a focus on hospital care, the training process in the insertion of residents in the Primary Health Care (PHC) has an important role because they need to experience all levels of care, taking into account that the educational process through work proposed by the Residence is based on the comprehensiveness of health care. In light of the foregoing, the present research has sought to elucidate the insertion of these residents in PHC services, through a qualitative approach of case study, where data collection was held in two different moments: firstly, a questionnaire was accomplished, through an semi-structured script, with the residents of PRMS/UFRN, Natal Campus; subsequently, the focus group technique was accomplished with a group of nine residents, and data were analyzed from the categorical thematic content analysis. From the process of empirical categorization, categories and subcategories were raised, among which, the positive aspects and potentialities of insertion of residents in PHC. We detected the articulation of actions for promoting, preventing and recovering health; training in comprehensiveness of health care, multiprofessional activities and activities aimed at doing the integration among teaching-service-community. Regarding the difficulties found in this experience, we dealt with the organization and planning of rotation activities, the preceptorship, the process of work found in the Basic Health Units (BHU), in addition to factors external to educational practice, such as the issue of safety within these communities. Accordingly, with this situational diagnosis, we became able to realize that residents have identified the importance of this rotation for their vocational training, since these are inserted in post-graduate programs in hospital care. As an immediate product of this study, we will present a report that will provide a space for discussion and assessment of this rotation by the coordination bodies of PRMS/UFRN, in order to seek organizational and pedagogical adaptations, besides the proposition of qualification courses for the actors involved with this process, aiming the implementation of improvements in the rotation of PHC toward the qualified training of professionals for SUS.

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Nos dias atuais, oferecer uma educação para o exercício da cidadania é função primordial das políticas públicas educacionais, conforme estabelece a constituição brasileira e a legislação de ensino. Essa função vem sendo defendida por muitos professores no Ensino Médio, atribuindo-se a disciplina de Química o papel de proporcionar um ensino crítico, participativo, reflexivo e humano. Segundo os documentos oficiais brasileiros para o Ensino de Química, o estudo do conceito de energia deve favorecer o desenvolvimento de competências para que o aluno compreenda a produção e o seu uso em diferentes fenômenos e possam interpretá-los de acordo com modelos explicativos, além de saber avaliar e julgar os benefícios e riscos da produção e do uso de diferentes formas de energia nos sistemas naturais construídos pelo homem, articulando com outras áreas de conhecimento na procura de promover a interdisciplinaridade. As unidades de ensino potencialmente significativas (UEPS), tomam como base um conjunto de teorias de aprendizagem que tem o intuito de promover um ensino com base na aprendizagem significativa e podem ajudar os estudantes nas diferentes relações que um conceito pode ter. Neste sentido, o estudo do conceito da energia a partir do trabalho com UEPS, pode ser uma importante proposta que favorece um ensino de Química na perspectiva construtivista. Assim, o objetivo deste trabalho é construir e avaliar uma proposta didática para o conteúdo de termoquímica na perspectiva das unidades de ensino potencialmente significativas de Moreira com alunos do Ensino Médio de uma escola pública do Município de Campina Grande-PB. Inicialmente a UEPS foi avaliada por 22 professores em formação inicial de duas instituições públicas de ensino superior. Em seguida, ela foi aplicada para 15 alunos do 2° ano da Escola Estadual de Ensino Médio Prof. Raul Córdula, localizada na cidade de Campina Grande-PB. A coleta dos dados para os professores em formação inicial teve como base um instrumento de validação de elaboração de unidades didáticas baseada na Engenharia Didática proposta por Artigue (1996 apud Guimarães e Giordan, 2011). Já para os alunos do ensino médio, os dados foram coletados no decorrer da UEPS e a avaliação final sobre a proposta didática ocorreu através de um questionário tomando como base a escala de Likert e o uso de mapas conceituais. Para a descrição dos dados, foram utilizados os pressupostos da análise de conteúdo de Bardin. Como produto educacional foi elaborado a Unidade de Ensino Potencialmente Significativa e um DVD contendo orientações de como trabalhar com a proposta. Os resultados deste trabalho apontam uma avaliação positiva quanto à proposta de ensino elaborada para a Educação Básica, onde se observa através do instrumento de validação aplicado, que a maioria das respostas atribuídas pelos professores, ficou entre os itens suficiente e mais que suficiente. Em relação aos momentos de aprendizagem dos alunos do Ensino Médio durante a aplicação da UEPS, foi possível observar que a proposta gerou motivação no processo de ensino e aprendizagem dos conceitos da termoquímica, como também se percebe que os mapas conceituais apresentados pelos alunos apresentaram mais proposições conceituais em uma segunda tentativa de elaboração, logo a proposta de ensino foi aprovada por mais de 90 % dos estudantes do nível médio. Portanto fica evidente que a proposta didática contribuiu no processo de ensino aprendizagem, despertando interesse e motivação nos estudantes pelo conteúdo de Termoquímica.

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This study analyzed the Worker’s Healthy Eating Program in Rio Grande do Norte state (RN) to assess its possible impact on the nutritional status of the workers benefitted. To that end, we conducted a cross-sectional observational prospective study based on a multistage stratified random sample comparing 26 small and medium-sized companies from the Manufacturing Sector (textiles, food and beverages, and nonmetallic minerals) of RN, divided into two equal groups (WFP and Non WFP). Interviews were conducted at each company by trained interviewers from Tuesday to Saturday between September and December 2014. Data were collected on the company (characterization and information regarding the program’s desired results) and workers (personal and professional information, anthropometrics, health, lifestyle and food consumed the previous day). Population estimates were calculated for RN on the characteristics of workers and the study variables. The main variable was BMI. The secondary variables were waist circumference (WC), nutritional diagnosis, calorie intake, blood pressure, metabolic variables and lifestyle indicators. The statistical method used was hierarchical mixed effects linear regression for interval variables and hierarchical mixed effects logistic regression for binary variables. The variables measured in ordinal scales were analyzed by ordinal logistic regression adjusted for correlated variables, adopting robust standard errors. The results for interval variables are presented as point estimates and their 95% confidence intervals; and as odds-ratios and their 95% confidence intervals for binary variables. The Fisher’s exact and Student’s t-tests were used for simple comparisons between proportions and means, respectively. Differences were considered statistically significant at p<0.05. A total of 1069 workers were interviewed, of which 541 were from the WFP group and 528 from the Non WFP group. Subjects were predominantly males and average age was 34.5 years. Significant intergroup differences were observed for schooling level, income above 1 MW (minimum wage) and specific training for their position at the company. The results indicated a significant difference between the BMI of workers benefitted, which was on average 0.989 kg/m2 higher than the BMI of workers from the Non WFP group (p=0.002); and between the WC, with the waist circumference of WFP group workers an average of 1.528 cm larger (p<0.05). Higher prevalence of overweight and obesity (p<0.001) and cardiovascular risk (p=0.038) were recorded in the WFP group. Tests on the possible effect of the WFP on health (blood pressure and metabolic indicators) and lifestyle indicators (smoking, alcohol consumption and exercise) were not significant. With respect to worker’s diets, differences were significant for consumption of saturated fat (lunch and daily intake), salt (lunch, other meals and daily intake) and proteins (other meals and daily intake), with higher consumption of these nutrients in the WFP group. The study showed a possible positive impact of the WFP on nutritional status (BMI and WC) among the workers benefitted. No possible effects of the program were observed for the lifestyle indicators studied. Workers benefitted consumed less salt, saturated fat and protein. The relevance of the WFP is recognized for this portion of society and it is understood that, if the program can reach and impact those involved, the development of educational initiatives aimed at nutritional and food safety may also exert a positive influence.

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The object of this study was motivated by the need to know the possible causes of differences in results achieved in the implementation of a Computerised Management System (CMS) in a Federal University Hospital, located in northeastern Brazil, to understand the factors that influenced the results in different groups when was used the same systems implementation methodologies. Considering the implication of managers, health professionals, other professionals involved and the existing organizational structure in the period when implantation occurred, aimed to know the perception of these people about the development of CMS in the deployment process in your group or sector and also in the organization.The methodology used in this study was the content analysis which provides a rich set of methodological tools for evaluating speeches,enabling us to discourse from the unknown analysis and subjectivity, but with scientific rigor, allowing, at the end, to understand the disparity in results in the implementation of CMS.It was used as a research tool, a semi-structured interview, which exploits a qualitative approach, as suggested by the authors. It was used the approach of the episodic interview, to be more narrative about the experiences of the interview participants in their practical experience along the CMS deployment process in the hospital.Were interviewed three groups of professional and a group of managers, all with higher education in their professions and who participated in the entire implementation process from the beginning.It followed the Bardin's methodology (2009) in all the phases of treatment and interpretation of data, where emerged three categories: the "Thought and Knowledge"; the "Practices and Changes"; the "Obtained Results". From the category "Thought and Knowledge"emerged three subcategories: the "Administrative", the "Institutional" and the "IT Knowledge". From the category "Practices and Changes" emerged three subcategories: "Reality Prior to CMS"; "The IT Project and the implementation of CMS" and "Impacts of the CMS Implementation". From the category "Results Obtained" emerged three subcategories: "Benefits Promoted by CMS", "Dissatisfaction Observed" and "Level of Use and Understanding CMS ". It was observed that the lack of integration of the sectors was a determinant problem in the implementation of CMS. The CMS implementation project was not well dimensioned and divulged in the institution. Different models of leaderships and of objectives of the sectors influenced in the course of the CMS implementation process. We can mention that an CMS should be a consolidation of organizational practices tool already institutionalized and of integration amongthe sectors and not supporting to isolated practices and personalistsfrom sectors of the institution.

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The generation of industrial wastes has been increased more and more in recent decades, motivating studies about a correct sustainable allocation and that also represents advantages for their generators. In this context, are included two companies of cleaning products niche, located in São José do Mipibu/RN, that produces industrial sludge at a sewage treatment plant, and that is the main approach of this research. Given this, it was studied the incorporation potentiality of this sludge as a mineral addition in cement matrix for concrete production due it high capacity of wastes immobilization inside this material, which are subsequently used in the company for making precast articles. Were added different sludge concentrations (5, 10, 15 and 20%) in a common trait (1: 2: 3), and evaluated their techniques and microstructural implications via workability test in fresh state and compressive strength, full porosity and scanning electron microscopy (SEM) in the hardened state. The results demonstrated the feasibility of the process both from a technical and environmental view as economical. All concretes produced with residue showed an increase of workability given the nature of the waste that had surfactants substances capable of adsorbing tiny particles of air into the batter. However, for all concentrations were obtained lower compressive resistances than standard concrete, with a reduction of 39% for samples with 20% of sludge. This are attributed mainly to an increase of porosity in the transition zone of these material, resulting from increased formation of ettringite at the detriment to the formation of other compounds, but which still allows the use of these for the manufacture of concrete articles with non-structural nature, such as precast floor. In addition, the water absorption and void ratio increased slightly for all samples, except the concrete with 20% of waste that has a reduction for the last parameter. Given this context, the recommended maximum level is 20%, constituting a significant proportion and able to allocate sustainably all waste generated in the industry.

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The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.

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The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.

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Fucoidan is a term used to define heteropolysaccharides that are composed of less than 90% L-fucose. The exception to this rule is the homofucoidan obtained from the seaweed Fucus vesiculosus. This fucoidan can be purchased from SIGMA Co. and have been used in various research for evaluation of their pharmacological activities. However, it is not a pure molecule. In fact, it is a mix of several fucoidan molecules. In this work, were obtained, from acetone precipitation, and biochemically characterized, four fucoidan molecules from SIGMA-ALDRICH Co. fucoidan to evaluate their anticoagulant, antioxidant, antiadipogenic, immunomodulatory and antiurolithiatic activities. In anticoagulant activity, evaluated by aPTT assay, fucoidans F0.9, F1.1 and F2.0 increased eightfold the coagulation time, compared to the control, when a mass of 10 μg was used. To PT test, only fucoidan F0.9 was capable of increase the coagulation time, compared to control. In the total antioxidant capacity assay (TAC), the fucoidan F2.0 showed 400 ascorbic acid equivalents, while fucoidan F0.5, the lest effective, 38 equivalents. In respect to the effect on pre-adipocyte cell lines (3T3-L1) adipogenesis, was observed that fucoidan F1.1 and F2.0 reduced the adipogenesis and this effect was associated to the reduction in the expression of regulatoy proteins C/EBPα, C/EBPβ and PPARγ. On the other hand, fucoidans F0.5 and F0.9 induced increased expression of these regulatory proteins. Furthermore, fucoidan F2.0 induced hydrolysis of triglycerides present in the interior of adipocytes. The immunomodulatory effect was evaluated and observed that the presence of fucoidans F0.5 , F1.1 and F2.0 significantly reduced the production of nitric oxide by activated macrophages with LPS specially fucoidan F2.0 that in 100 μg/mL, reduced about 55% the effect caused by LPS. Relative to the effect upon the formation of calcium oxalate crystals, fucoidan F0.5 was more effective in reduce the aggregation of the crystals and this effect it was not significantly different regarding the effect caused by the crude. Besides, fucoidan F0.5 only promoted the formation of COD type crystals, while fucoidans F1.1 and F2.0 did not influence the formation of crystals compared with the control. The results described in this study indicate that the commercial crude fucoidan of Fucus vesiculosus it’s a mix of several fucoidan which, in turn, have different chemical compositions besides having different pharmacological activities. The use of these fucoidans it´s indicated according the pharmacological activity to be evaluated.

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Fucoidan is a term used to define heteropolysaccharides that are composed of less than 90% L-fucose. The exception to this rule is the homofucoidan obtained from the seaweed Fucus vesiculosus. This fucoidan can be purchased from SIGMA Co. and have been used in various research for evaluation of their pharmacological activities. However, it is not a pure molecule. In fact, it is a mix of several fucoidan molecules. In this work, were obtained, from acetone precipitation, and biochemically characterized, four fucoidan molecules from SIGMA-ALDRICH Co. fucoidan to evaluate their anticoagulant, antioxidant, antiadipogenic, immunomodulatory and antiurolithiatic activities. In anticoagulant activity, evaluated by aPTT assay, fucoidans F0.9, F1.1 and F2.0 increased eightfold the coagulation time, compared to the control, when a mass of 10 μg was used. To PT test, only fucoidan F0.9 was capable of increase the coagulation time, compared to control. In the total antioxidant capacity assay (TAC), the fucoidan F2.0 showed 400 ascorbic acid equivalents, while fucoidan F0.5, the lest effective, 38 equivalents. In respect to the effect on pre-adipocyte cell lines (3T3-L1) adipogenesis, was observed that fucoidan F1.1 and F2.0 reduced the adipogenesis and this effect was associated to the reduction in the expression of regulatoy proteins C/EBPα, C/EBPβ and PPARγ. On the other hand, fucoidans F0.5 and F0.9 induced increased expression of these regulatory proteins. Furthermore, fucoidan F2.0 induced hydrolysis of triglycerides present in the interior of adipocytes. The immunomodulatory effect was evaluated and observed that the presence of fucoidans F0.5 , F1.1 and F2.0 significantly reduced the production of nitric oxide by activated macrophages with LPS specially fucoidan F2.0 that in 100 μg/mL, reduced about 55% the effect caused by LPS. Relative to the effect upon the formation of calcium oxalate crystals, fucoidan F0.5 was more effective in reduce the aggregation of the crystals and this effect it was not significantly different regarding the effect caused by the crude. Besides, fucoidan F0.5 only promoted the formation of COD type crystals, while fucoidans F1.1 and F2.0 did not influence the formation of crystals compared with the control. The results described in this study indicate that the commercial crude fucoidan of Fucus vesiculosus it’s a mix of several fucoidan which, in turn, have different chemical compositions besides having different pharmacological activities. The use of these fucoidans it´s indicated according the pharmacological activity to be evaluated.

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A Saúde do Trabalhador (ST) refere-se a um campo do saber que compreende as relações entre o trabalho e o processo saúde/doença de modo articulado a um corpo de práticas teóricas interdisciplinares. No contexto das possibilidades para se efetivar a ST na amplitude que exige este conceito, diferentes iniciativas de Educação Popular em Saúde se articulam com demandas do Controle Social em Saúde, permitindo novas abordagens para configurar a formação crítica e ativa de trabalhadores de saúde e movimentos sociais no mosaico das políticas de ST. Nessa direção, os projetos de extensão universitária orientados pela Educação Popular têm desvelado caminhos metodológicos e novas possibilidades teóricas de pensar a Atenção à Saúde do Trabalhador, de forma articulada com a necessidade de re-significar o processo de formação dos profissionais da saúde, com ênfase no cuidado integral na atenção à saúde. O estudo promovido por ocasião do Doutoramento em Ciências da Saúde propiciou a avaliação do impacto e da potência das ações destes projetos na reorientação do cuidado guiado pela educação popular no campo da saúde do trabalhador. A sistematização foi utilizada como principal estratégia metodológica para a produção dos dados analisados, além de estratégias de pesquisa qualitativa como constituintes da fase exploratória do estudo, tendo como técnica central, nesse sentido, o grupo focal. Os resultados mostraram mudanças significativas no processo do cuidar em saúde guiado pela educação popular, A reorientação de práticas e saberes, coadunadas aos princípios fundamentais do Sistema Único de Saúde, foi observada nos sujeitos que participaram da experiência. A sistematização da experiência permitiu ainda concluir que estratégias de diálogo, organização político-social e troca de experiências de vida se apresentam como cenário significativo no compartilhamento de cultura e saúde do trabalhador, oportunizando crescimento coletivo e melhor qualidade de vida.

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A residência médica é uma modalidade de ensino de pós-graduação destinada a médicos, funciona em instituições de saúde, sob a orientação de profissionais médicos de elevada qualificação ética e profissional, sendo considerada o “padrão ouro” para a formação do especialista. A utilização do método de avaliação 360 graus na residência médica visa a avaliação integral dos médicos residentes, preenchendo lacunas que a avaliação cognitiva isolada deixa, quando utilizada como método único. Essa avaliação proporciona uma avaliação mais global do médico residente, já que inclui sua autoavaliação, avaliação pelos pares, pacientes e equipe de saúde. O objetivo deste estudo foi definir instrumentos de avaliação para implementar a avaliação 360 graus no programa de residência médica em cardiologia da UFRN e capacitar os docentes e preceptores do citado programa para avaliação de desempenho clínico do residente. Trata-se de estudo exploratório, prospectivo e descritivo, envolvendo quatro médicos residentes do programa de residência médica de cardiologia e 20 de clínica médica, esses durante o rodízio de cardiologia do programa de residência médica (PRM) em Cardiologia do Hospital Universitário Onofre Lopes (HUOL), além de 13 preceptores/docentes do PRM em Cardiologia do HUOL. Para implementação do novo modelo avaliativo na residência médica foram programadas três etapas, sendo a primeira a elaboração dos instrumentos de avaliação para a avaliação 360 grus; a segunda, o planejamento e a capacitação dos preceptores do PRM em Cardiologia do HUOL; e a terceira, o início das avaliações 360 graus dos residentes do PRM em Cardiologia e Clínica Médica, durante o período de janeiro de 2014 a março de 2015. Foram avaliados, no total, 24 residentes até o momento, sendo quatro residentes da cardiologia (três residentes do primeiro ano e um residente do segundo ano) e vinte residentes da clínica médica (sendo doze residentes do primeiro ano e oito residentes do segundo ano). Foram realizadas autoavaliações por oito residentes, sendo essas consideradas difíceis pela maioria dos residentes. A avaliação por pares foi realizada por 6 residentes, sendo o desempenho dos pares considerado acima do esperado em todos os itens da avaliação. A avaliação pela equipe de preceptores e equipe multiprofissional com feedback ao final das avaliações mostrou que os residentes de clínica médica do primeiro ano apresentam desempenho acima do esperado em relação ao humanismo, ética e profissionalismo, enquanto os do segundo ano apresentaram desempenho abaixo do esperado no item referente ao exame físico. Quanto aos demais domínios da avaliação todos estiveram dentro do esperado. Dez pacientes avaliaram os oito residentes, sendo tais avaliações positivas no sentido da qualidade da assistência prestada e das informações fornecidas pelos residentes. O método de avaliação 360 graus foi implementado na residência de cardiologia do Hospital Universitário Onofre Lopes da UFRN, tendo sido realizada em quatro residentes. A maioria dos preceptores e equipe multiprofissional da residência estão capacitados para utilização do método de avaliação.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Relatório de Estágio apresentado para a obtenção do grau de Mestre em Psicologia do Desporto e do Exercício