Comparação de três métodos de ensino em ventilação mecânica na emergência para alunos de medicina do último ano de graduação.

• Ano de defesa: 2018
• Autor(a) principal: Tallo, Fernando Sabia [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Education medical; Artificial respiration; Simulation training; Educação médica; Respiração artificial; Treinamento por simulação
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6620776; https://repositorio.unifesp.br/handle/11600/52430

Introduction: Mechanical ventilation is an intervention of high morbidity and mortality, high cost and complexity, required in many hospital departments with physicians who are not specialists in its practice. There are few studies about mechanical ventilation teaching strategies and their impact on the competence acquisition for training physicians, or even for those who work in the emergency room. Objective: To evaluate the knowledge acquired on mechanical ventilation, and its retention in students of the last year of medical school, comparing three teaching methods. Methods: This is a multicenter controlled randomized trial with 334 sixthyear medical students, which assessed three teaching strategies: realistic simulation, casebased learning, and online tutorial method. The students were randomly assigned to three training groups: Simulation, Case, Tutorial, and a control. Afterwards, all the groups were evaluated by a validated questionnaire; after a 6month followup, knowledge retention was evaluated through the same questionnaire. Results: Of the total, 73.29% of the students were below 25% of the instrument knowledge score, and 83.3% declared they did not have any training in mechanical ventilation in their undergraduate curriculum. There was no difference in the pretest scores among the study groups. The posttest score was (15.13) in the Simulation Group, (14,62) in the Case Group, (3.57) in the Control Group, and (5.99) in the Tutorial Group. There were no statistically significant differences in postknowledge acquisition between the Simulationbased (95% CI 3.755.29) and Casebased Groups (95% CI 3.915.64). In the comparison of knowledge retention, the Simulation Group obtained (4.48, 95% CI, 3.775.33), and the Case Group (3,37; 95% CI 2.804.07, p<0.001) in relation to the pretest. Students who had ventilation courses at their undergraduate level had increases of 46% (95% CI 19% 52%) in the knowledge scores when compared to those who did not. Conclusion: The level of knowledge in mechanical ventilation among medical students evaluated by the questionnaire was low, and influenced by the presence of training programs in the undergraduate curriculum. The Casebased and Simulationbased groups did not show any difference in knowledge acquisition evaluated by the questionnaire; however, the simulation group showed higher retention.