Desenvolvimento do raciocínio clínico em estudantes de medicina do primeiro ao quinto ano

Abstract

INTRODUCTION: There is a partial understanding of the clinical reasoning development. The SCT usage is not common in Brazil. OBJECTIVES: We aimed to analyze the clinical reasoning development and the SCT application in a medical school of a brazilian university. METHODS: analytical, descriptive research, quantitative/qualitative with SCT and focus groups. The test had ten clinical cases in Internal Medicine, which has been accomplished with reference panel. The study has five focus groups, eight of each year, from first to fifth year. RESULTS: Participated 159/550 academics in the SCT. In SCT preclinical phase the average was 51.6% and clinical phase 63.4% of the maximum. We found significant difference (40%) of study items. Cronbach's Alpha of 0,64. Participated 40/159 academics in focus groups. The content of the speech was divided into clinical reasoning and knowledge of the basic disciplines. DISCUSSION: In the SCT senior performed better. The construction of SCT is not easy. The low reliability because: problems in construction, panel limitations and punctuation key. In preclinical phase reasoning is based on the basic disciplines and clinical phase pattern recognition. 80.6% perceived use of basic disciplines. CONCLUSION: In the pre-clinical phase, the reasoning is dependent on the basic disciplines and clinical phase pattern recognition. The SCT is a difficult application instrument.