Consenso sobre procedimentos técnicos para ensino baseado em simulação em urgências clínicas e cirúrgicas em adulto

Abstract

INTRODUCTION: Medical education was characterized as a traditional teaching model for a long time, with a rather questionable capacity to provide knowledge retainment. In recent years, medical courses have undergone structural changes in their curricula and pedagogical plans to modernize and increase the effectiveness of medical teaching using simulation-based teaching as a possible educational tool. JUSTIFICATION: In view of the need for changing the medical education model, the possibility of simulation-based teaching as an active educational strategy, and the existence of few studies in the literature on procedural training for medical students, the faculty of the Amazonas State University (UEA) developed a consensus on which technical procedures should be taught to students through clinical and surgical emergency simulations in adults. OBJECTIVES: To develop a consensus on technical procedures for medical students in clinical and surgical emergencies in adults, through a needs assessment based on the modified Delphi method. To reach a consensus on a prioritized list of technical procedures and produce a descriptive manual for professor about the first ten procedures chosen in the prioritized list. METHOD: The modified Delphi method was used for the consensus, in a process involving three series of questionnaires and having the UEA professors as participants. The initial questionnaire consisted of an open question in which the participant should mention at least twelve technical procedures in clinical and surgical emergencies in adults to be taught to undergraduate students. In the second round, the participating professor received a list with the 17 procedures chosen in questionnaire 1 and had to assess each of them using the modified Copenhagen Academy for Medical Education and Simulation - Needs Assessment Formula (CAMES-NAF). In the third round, the professor received the preliminary prioritized list of procedures according to the evaluation in the second questionnaire and used a Likert scale to inform their degree of agreement with the list of procedures presented so as to proceed with content validation by the Content Validity Index (CVI). RESULTS: A prioritized and validated list (CVI = 0.95) of 17 technical procedures to be taught to medical students through simulation was created using the modified Delphi methodology, with the participation of 22 UEA professors. The first five procedures with the highest scores by the CAMES-NAF formula were: endotracheal intubation, cardiopulmonary resuscitation, basic airway management, central venous access, and superficial sutures. Based on this list, a descriptive manual on the top ten procedures was produced for the professors. CONCLUSION: A consensus on technical procedures in clinical and surgical emergencies in adults to be taught to undergraduate students was created, based on the professors’ opinions. These procedures originated a prioritized list and, from this, a descriptive manual was produced. The results of this study may guide managers and professors in the inclusion of simulation in medical curricula as an educational strategy; and the descriptive manual will guide the practice of the procedures.