Peer tutoring in a medical school: perceptions of tutors and tutees

Background: Peer tutoring has been described as “people from similar social groupings who are not professional teachers helping each other to learn and learning themselves by teaching”. Peer tutoring is well accepted as a source of support in many medical curricula, where participation and learning involve a process of socialisation.
Peer tutoring can ease the transition of the junior students from the university class environment to the hospital workplace. In this paper, we apply the Experienced Based Learning (ExBL) model to explore medical students’ perceptions of their experience of taking part in a newly established peer tutoring program at a hospital based
clinical school.
Methods: In 2014, all students at Sydney Medical School – Central, located at Royal Prince Alfred Hospital were invited to voluntarily participate in the peer tutoring program. Year 3 students (n = 46) were invited to act as tutors for Year 1 students (n = 50), and Year 4 students (n = 60) were invited to act as tutors for Year 2 students (n = 51). Similarly, the ‘tutees’ were invited to take part on a voluntary basis. Students were invited to attend focus groups, which were held at the end of the program. Framework analysis was used to code and categorise data into themes.
Results: In total, 108/207 (52 %) students participated in the program. A total of 42/106 (40 %) of Year 3 and 4 students took part as tutors; and of 66/101 (65 %) of Year 1 and 2 students took part as tutees. Five focus groups were held, with 50/108 (46 %) of students voluntarily participating. Senior students (tutors) valued the opportunity to practice and improve their medical knowledge and teaching skills. Junior students (tutees) valued the opportunity for additional practice and patient interaction, within a relaxed, small group learning environment.
Conclusion: Students perceived the peer tutoring program as affording opportunities not otherwise available within the curriculum. The peer teaching program provided a framework within the medical curriculum for senior students to practice and improve their medical knowledge and teaching skills. Concurrently, junior students were provided with a valuable learning experience that they reported as being qualitatively different to traditional teaching by faculty.

Interações físicas e psicossociais em mulheres com fibromialgia

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome of unknown etiology, with symptoms of diffuse musculoskeletal pain and presence of specific anatomic sites called tender points. The symptoms are often associated with fatigue, sleep disturbances, morning stiffness, alterations in pain perception, anxiety and depression. Fibromyalgia exhibits a correlation between physical and behavioral symptoms, which have a negative influence on the quality of life of patients. Emotional skills are important factors since they are related to subjective well-being, personal productivity, social interaction and interpersonal relationships. We aim to describe the physical and psychosocial interactions in women with FM, showing the association between perceived social support and affect with symptoms of pain, functionality and mood. We will also describe a body representation of pain in women with FM. Data were collected over 3 years and the sample size ranged between studies. This is an exploratory cross-sectional study conducted with a convenience sample of 63 women with FM and 42 healthy women as a control group (CT), aged 20-76 years, recruited through spontaneous demand at Onofre Lopes University Hospital (HUOL) and the Clinical School of Physiotherapy of Universidade Potiguar (UNP). The Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Social Support Scale (MOS), Hamilton Anxiety Scale and Scale of Positive and Negative Affect Schedule (PANAS), in addition to pressure algometry were used. For data analysis, we used parametric and non-parametric tests and a general linear model with adjustment variables and analysis of variance. A significant difference was found between pain threshold and tolerance, functionality, depression, anxiety, social support, and positive and negative affect between the groups. Affective states and social support were associated with anxiety, depression and functionality. A body was drawn representing pain with higher incidences in trapeze, supraspinatus and second ribs. The reason for studying sensory aspects, affective behavior and social support in FM patients opens perspectives for scientific and clinical research of this syndrome. Women with chronic pain such as FM appear to have altered mood states, less social support and affective dysfunctions, influencing the other symptoms of the syndrome

Intervenção fonoaudiológica na síndrome de kabuki: relato de caso

TEMA: este trabalho teve como objetivo descrever o processo de intervenção fonoaudiológica em um caso de síndrome de Kabuki, com ênfase na terapia de linguagem. PROCEDIMENTOS: trata-se de relato de caso de uma criança de seis anos e seis meses de idade, gênero feminino, com diagnóstico de síndrome de Kabuki, que realizou terapia fonoaudiológica durante três anos em uma clínica-escola. Foi realizada análise documental dos dados do prontuário relativos à anamnese, avaliação e relatórios terapêuticos fonoaudiológicos, exames e avaliações multidisciplinares. Aos três anos e cinco meses, a criança passou por avaliação fonoaudiológica e apresentou, como histórico, características típicas da síndrome de Kabuki: alteração cardíaca, episódios de pneumonia, otite média secretora recorrente, alterações ortopédicas e crises convulsivas. Na avaliação fonoaudiológica, apresentou tempo de atenção auditiva e visual reduzido, dificuldade de compreensão oral, comunicação por meio de poucos gestos e vocalizações e problemas de comportamento. RESULTADOS: o processo terapêutico teve como objetivo principal promover o desenvolvimento da linguagem com ênfase na interação social por meio de atividades lúdicas, orientação familiar e escolar. Foi observada melhora na compreensão e emissão oral, no contato social e manutenção da atenção. CONCLUSÃO: este estudo permitiu divulgar o percurso de atuação fonoaudiológica na síndrome de Kabuki, do processo diagnóstico à terapia de linguagem. Verificou-se que a terapia foi eficaz no que se refere às habilidades comunicativas e de interação social. Esses dados podem contribuir para elucidar lacunas existentes na literatura acerca da terapia fonoaudiológica na síndrome em questão e subsidiar intervenções clínicas nesses casos.

O grupo psicoterapêutico na abordagem lacaniana: um estudo da interpretação a partir da análise de uma prática

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Processamento auditivo em trabalhadores expostos a ruído e inseticida: testes de ordenação temporal e P300

Pós-graduação em Fonoaudiologia - FFC

Avaliação audiológica, metabólica e de qualidade de vida no indivíduo jovem com zumbido usuário de estéreo pessoal

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Triagem interventiva: a caracterização de uma demanda

This paper analyzes the process of sorting through the intervening demand survey that reaches the Center for Research and Applied Psychology (CPPA) “Dr. Betti Katzenstein” UNESP Assis. The objective was to better understand the reality of conflicts that people face and, therefore, to characterize the patients who seek help in CPPA. With greater understanding of demand, it is possible to trace more consistent referrals and tailor the service to the school clinic profile of clients that demand. Recalling that the actual attendance of screening is already a form of interventional care, because it provides patient care from first contact. This was a documentary research, which had collected their data sheets of the CPPA trials conducted in 2011. 394 screenings were performed. We present the distribution of the demand for sex, age and complaint that motivated the search for care. It can be concluded that the characterization allows a customer routing more efficient services offered at the institution, as it contributes to a better understanding delineated in each case and a reduced number of dropouts in the screening process.

The rural medicine rotation: Increasing rural recruitment through quality undergraduate rural experiences

TITLE: The Rural Medicine Rotation: Increasing Rural Recruitment through Quality Undergraduate Rural Experiences Eley Diann, University of Queensland, School of Medicine, Rural Clinical Division, Toowoomba 4350, Queensland Australia Baker Peter, University of Queensland, School of Medicine Rural, Clinical Division, Toowoomba 4350, Queensland Australia Chater Bruce, University of Queensland, Chair, Clinical School Management Committee, School of Medicine Rural Clinical Division, Queensland Australia CONTEXT: While rural background and rural exposure during medical training increases the likelihood of rural recruitment (Wilkinson, 2003), the quality and content of that exposure is the key to altering undergraduatesâ?? perceptions of rural practice. The Rural Clinical Division at University of Queensland (UQ) runs the Rural Medicine Rotation (RMR) within the School of Medicine. The RMR is one of five eight week clinical rotations in Year three and is compulsory for all students. The RMR provides the opportunity to learn from a wide range of health professionals and clinical exposure is not restricted to general practice but also includes remote area nursing, Indigenous health care, allied health professionals and medical specialists. Week 1 involves preparation for their rural placement with workshops and seminars and Week 8 consolidates their placement and includes case and project presentations and a summative assessment. Weeks 2-7 are spent living and working as part of the health team in different rural communities. SETTING: Rural communities in and around Queensland including locations such as Arnham Land, Thursday Island, Mt. Isa and Alice Springs METHOD: All aspects of the RMR are evaluated with surveys using both qualitative and quantitative free response questions, completed by all students at the end of the Week 8. RESULTS: Overall the RMR is evaluated highly and narratives offered by students show that the RMR provides a positive rural experience. The overall impact of the RMR for students in 2004 ranked 3.45 on a scale of 1 to 4 (1 = lowest and 4 = highest), and is exemplified by the following quote; â??I enjoyed my placement so much I am now considering rural medicine something I definitely had not considered beforeâ??. OUTCOME: The positive impact of the RMR on studentâ??s perceptions of rural medicine is encouraging and can help achieve the overall aim of increasing recruitment of the rural workforce in Australia.

Paracoccidioidomycosis: Survey and clinical aspects from the Department of Dermatology of the School of Medicine of Botucatu (Sao Paulo - Brazil)

Background - Paracoccidioidomycosis is the most frequent among the systemic mycoses in Brazil. Objective: To study the cases of paracoccidioidomycosis diagnosed from 1976 to 1996 at the Department of Dermatology of the School of Medicine of Botucatu. Methods - Descriptive study obtained from specific protocols comprising anamnesis, clinical- dermatological-laboratorial examination, treatment and follow-up of the patients. Results - Paracoccidioidomycosis was diagnosed in 1.04% of the dermatologic outpatients assisted from 1976 to 1996. In 315 cases, 89.8% were male, 61.9% were over forty and 53.7% were rural workers. The complaints were related more to oropharyngolaryngeal (53.6%) or cutaneous (23.8%) lesions or adenopathy (10.2%). Seventy patients had already been treated in other health services. The chronic multifocal clinical from was the most common: 80.6% of the cases, followed by the acute-subacute (juvenile type) 15.5%. The disease was pulmonary in 80.0%, oropharyngolaryngeal in 69.2% and cutaneous in 45.7%. Th treatment: Amphotericin B in 146 patients, Ketoconazole - 88, Itraconazole - 56, Sulfonamide derivatives - 146 and Terbinafine in 3. The lethality index resulting from the disease or its treatment was 2.0%. Conclusions - The high number of cases, showing the regional relevance of the disease and the high percentage of tegumentary complaints and the high number of relapsing are remarkable.

The heart challenge: The effect of regular aerobic exercise on body fat distribution in third and fourth grade school children: A randomized clinical trial

The pattern of body fat distribution known as "centralized", and characterized by a predominance of subcutaneous fat on the trunk and a "pot belly", has been associated with an increased risk of chronic disease. These patterns of fat distribution, as well as the lifestyle habit variables associated with adult fatness and chronic morbidity clearly begin to develop during childhood, indicating the need for intervention and primary prevention of obesity, particularly the centralized form, during childhood or adolescence. The purpose of this study was to determine whether regular aerobic exercise could beneficially alter the distribution of body fat in 8 and 9 year old children. One hundred and eighty-eight participants were randomized into either a regular aerobic exercise treatment group or a standard physical education program control group. A variety of aerobic activities was used for intervention 5 days per week during physical education class for a period of 12 weeks. Fat distribution was measured by a number of the most commonly used indices, including ratios of body circumferences and skinfolds and indices derived from a principal components analysis. Change over time in average pulse rate was used to determine if intervention actually occurred. Approximately 10% of the students were remeasured, allowing the calculation of intra- and interexaminer measurement reliability estimates for all indices.^ This study group was comparable to the U.S. population, though the study children were slightly larger for certain measures. No effect of the exercise intervention was found. The most likely explanation for this was inadequacy of the intervention, as indicated by the lack of any change in average pulse rate with treatment. The results of the measurement reliability analysis are reported and indicate that body circumference ratios are more precise than skinfold ratios, particularly when multiple observers are used. Reliability estimates for the principal component indices were also high.^ It remains unclear whether the distribution of body fat can be altered with exercise. It is likely that this issue will remain undecided until one highly reliable, valid, and sensitive measure of fat distribution can be found. ^

Evaluating a web-based clinical decision support system for language disorders screening in a nursery school

Background: Early and effective identification of developmental disorders during childhood remains a critical task for the international community. The second highest prevalence of common developmental disorders in children are language delays, which are frequently the first symptoms of a possible disorder. Objective: This paper evaluates a Web-based Clinical Decision Support System (CDSS) whose aim is to enhance the screening of language disorders at a nursery school. The common lack of early diagnosis of language disorders led us to deploy an easy-to-use CDSS in order to evaluate its accuracy in early detection of language pathologies. This CDSS can be used by pediatricians to support the screening of language disorders in primary care. Methods: This paper details the evaluation results of the ?Gades? CDSS at a nursery school with 146 children, 12 educators, and 1 language therapist. The methodology embraces two consecutive phases. The first stage involves the observation of each child?s language abilities, carried out by the educators, to facilitate the evaluation of language acquisition level performed by a language therapist. Next, the same language therapist evaluates the reliability of the observed results. Results: The Gades CDSS was integrated to provide the language therapist with the required clinical information. The validation process showed a global 83.6% (122/146) success rate in language evaluation and a 7% (7/94) rate of non-accepted system decisions within the range of children from 0 to 3 years old. The system helped language therapists to identify new children with potential disorders who required further evaluation. This process will revalidate the CDSS output and allow the enhancement of early detection of language disorders in children. The system does need minor refinement, since the therapists disagreed with some questions from the CDSS knowledge base (KB) and suggested adding a few questions about speech production and pragmatic abilities. The refinement of the KB will address these issues and include the requested improvements, with the support of the experts who took part in the original KB development. Conclusions: This research demonstrated the benefit of a Web-based CDSS to monitor children?s neurodevelopment via the early detection of language delays at a nursery school. Current next steps focus on the design of a model that includes pseudo auto-learning capacity, supervised by experts.

Clinical supervision in school counselling and career counselling: Is it time to develop a new story?

Supervision provides benefits for school counsellors and career counsellors such as support, an opportunity to gain new ideas and strategies, and personal and professional development. Despite this, studies have also shown that school counsellors perceive that the amount of time they participate in supervision is inadequate. In career counselling, there is little evidence that supervision has even been established as a mainstream professional practice. The reasons for this curious situation, whereby little time is spent on a potentially beneficial activity, are uncertain. The present study investigated the supervisory experiences of a group of school counsellors and career counsellors for a six month period following their completion of an intensive supervision training program. Participants recorded their supervisory experiences in a structured diary. Even though the participants were well informed about supervision, the findings of the present study are consistent with those of previous studies. This history of repeatedly similar findings suggests that it may be timely to ask some fundamental questions about supervision in these two professions. Such questions in turn suggest possible new research directions.