The Contribution of Simulated Patients to Undergraduate Medical Education: A Pathway to Educational Excellence

Paulo Oom

doi:10.20344/amp.22902

Autores

Paulo Oom Católica Medical School. Universidade Católica Portuguesa. Lisboa. Portugal.

DOI:

https://doi.org/10.20344/amp.22902

Palavras-chave:

Competência Clínica, Doentes Simulados, Educação de Graduação em Medicina/métodos

Resumo

Este artigo de revisão narrativa procura revelar o estado na arte do contributo dos doentes simulados para a educação médica e incentivar as escolas médicas a adotar esta metodologia como um pilar essencial da formação de excelência. A utilização de doentes no ensino médico pré-graduado é considerada fundamental. No entanto, a utilização de doentes reais é acompanhada por diversas dificuldades, como as relacionadas com a sua privacidade e a grande variedade de apresentações clínicas. Os doentes simulados são atualmente parte integrante do corpo docente das faculdades de medicina e devem ser encarados como sendo dos seus colaboradores mais valiosos. O seu espectro de atuação tem vindo progressivamente a alargar-se, assumindo novos desafios e responsabilidades. A sua utilização conduz de uma forma eficiente ao desenvolvimento de competência técnica no desempenho de procedimentos e na capacidade de tomar decisões sobre o diagnóstico ou tratamento. Igualmente são imprescindíveis no treino da capacidade de comunicar com os doentes e na capacidade de trabalhar em equipa. A utilização de doentes simulados para o ensino do exame físico, veio expandir enormemente a sua utilização, com destaque para o treino do exame ginecológico ou da mama na mulher ou do exame genital e rectal no homem. A possibilidade de o aluno receber feedback do doente simulado durante ou após a simulação representa uma oportunidade única de o aluno se aperceber do ponto de vista do ‘doente’ e de poder refletir sobre as suas limitações e oportunidades de melhoria. A utilização de doentes simulados na avaliação médica permite igualmente comparações adequadas de diversos alunos. Em determinados casos é o próprio doente simulado que desempenha o papel de avaliador, com uma fiabilidade idêntica à de avaliadores clínicos, de que resulta uma maior credibilidade do processo de avaliação. O desenvolvimento de cenários híbridos permite o uso combinado de doentes simulados e simuladores com o objetivo de aumentar o realismo do cenário de simulação. Do ponto de vista administrativo, a utilização de doentes simulados no ensino médico envolve múltiplas atividades sendo o maior desafio para a sua implementação os recursos financeiros necessários. [...]

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