RESUMENObjetivo: Identificar y analizar las competencias profesionales necesarias para la atención de ancianos en cuidados primarios de salud. Método: Estudio exploratorio descriptivo cuali-cuantitativo. Fue utilizada la Técnica Delphi en tres rondas, con la participación de profesionales de la red básica y un grupo multidisciplinario de expertos. El primer cuestionario solicitó que los participantes indicasen competencias necesarias para la atención de ancianos en cuidados primarios. Estas fueron compiladas en un listado que, añadido de una Escala de Likert (de 1 a 5), compuso el segundo y tercer cuestionarios. El criterio de consenso adoptado fue el 70%. Resultados: Veintiocho competencias alcanzaron el consenso, habiéndose clasificado en 12 áreas de dominio. Conclusión: Las competencias reflejan las políticas brasileñas de salud y constituyen una referencia para la práctica y la formación de los profesionales de salud para la atención al añoso en la atención primaria a la salud. DESCRIPTORES ABSTRACTObjective: to identify and analyze the necessary competencies in primary health care for attending to older adults. Methods: An exploratory, descriptive, and quali-quantitative study was developed. Three rounds of the Delphi Technique were conducted with participants from primary health care services and a multidisciplinary committee. The first questionnaire asked participants to indicate the competencies needed for attending to older adults in primary health care. They were compiled into a list and added to a Likert Scale (from 1 to 5) for the second and third questionnaires. A consensus criterion of 70% was adopted. Results: Twenty eight competencies were reached by consensus and were classified into twelve domains. Conclusions: the competencies reflect Brazilian health care policy and constitute a reference for professional health practice and education when caring for the older adult in primary health care.

The findings showed that preceptors were committed to the education of future health care professionals. The development of pedagogical skills was emphasized, as was the necessity of education before preceptorship. These competencies constitute a useful reference for continuing professional education.

Resumo A relevância e a complexidade do trabalho desenvolvido pelos preceptores nos cenários de formação do Sistema Único de Saúde vêm crescendo nos últimos anos. Ser preceptor é uma construção cotidiana que exige a mobilização de competências específicas, porém o processo de sua estruturação e as condições para que sejam apropriadas pelos preceptores precisam ser melhor estudados. Foi realizada uma investigação que objetivou compreender como são estruturadas competências para a prática da preceptoria na residência multiprofissional em saúde. A pesquisa é qualitativa, do tipo estudo de caso, com observações das atividades e entrevistas com preceptores de um Programa de Residência Multiprofissional em Saúde da Família e Comunidade no sul do Brasil. Para análise, foi realizada a triangulação dos dados e definição de categorias temáticas após verificação das observações, pela técnica de combinação de padrão, e das entrevistas, pela análise temática. Foram identificados três grupos de recursos: características pessoais, institucionais e programáticas; a trajetória acadêmica e profissional; as interações na residência e a colaboração da equipe multiprofissional. A elucidação desses elementos constitutivos da estruturação de competências contribui para que sejam explorados pelos preceptores na sua prática profissional, para as instituições de saúde, ao proporcionarem condições para o seu desenvolvimento, e para que sejam incorporados às políticas de formação em saúde.

A case study with the objective of identifying the insertion of EPHF in the curriculum of the nursing undergraduate course at Federal University of Rio Grande do Sul was developed. Keywords were defined from the definitions of the eleven EPHF. These were searched for in the class plans of the curriculum courses. Ten EPHF were identified, with major occurrence of the human health resources development and training in public health. Contemplating more intensively some of the EPHF, the curriculum under study should propitiate the education of nurses capable of contributing towards their performance. It is necessary to insert the other EPHF into the curriculum, contributing to the excellent performance of public health by the professionals educated in this institution.

Objectives: This study intended to evaluate the overuse of episiotomy as a routine practice at a public referral regional hospital and the changes promoted by the widespread concept of obstetric violence. Materials and Methods: This study was an analytic cross-sectional study with retrospective gathering of data through medical record analyses from women that gave birth from July 2012 and July 2015 at the Birth Center of Ceilândia Regional Hospital. Results: From a sample of 519 births, 47.4% were performed by resident physicians in training. The overall episiotomy rate considering both periods was 41.2% with a significant decrease on the rate between the periods (p < 0.01), with a 53.2% rate in 2012 vs. a 32.3% in 2015. There was no difference in the episiotomy rates amongst obstetricians (p = 0.263). However, in 2012 a 60.2% rate against a 24.6% rate in 2015 was observed among resident physicians (p < 0.001). There was no statistically significant difference among third-and fourth-degree tear rates in the two periods. Perineal integrity was observed in 26.78% of the patients. Conclusion: This study indicates that the referred center is currently facing a paradigm shift motivated by young physicians, with a drop in the episiotomy rates, but still with little reflex on the fully trained obstetricians' practices.