Tempo do Brasil traduzir para a prática o currículo Médico Baseado em Competência por meio de Atividades Profissionais Confiáveis (APCs)

Abstract

As competências médicas apresentadas pelas Diretrizes Curriculares Nacionais (DCN) e as políticas de incentivo à formação de mais médicos popularizaram temas como aprendizado ativo e competência. Distorções na implementação curricular resultaram em abordagens fragmentadas e reprodutivas das práticas com distanciamento do processo de trabalho. Vários países ocidentais, ao buscarem o aprimoramento da Educação Médica Baseada em Competência, adotaram as Atividades Profissionais Confiáveis (APCs) na tradução bem-sucedida desse referencial para a prática clínica. Este estudo perspectivo apresenta as APCs no âmbito da educação médica brasileira como possível solução para a melhor efetivação do Currículo Médico Baseado em Competência (CMBC). O estudo descreve as APCs, de seu conceito à realização; provê subsídios para seu entendimento e análise de sua capacidade em mediar uma formação médica mais qualificada e responsiva às necessidades de saúde locais; e contribui com a literatura brasileira na área.

Perfil da rede de saúde no extremo sul de Santa Catarina: potencialidades e desafios na implantação de um curso de Medicina

“…Considerando as mudanças globais do ensino médico, o Brasil tem demonstrado esforços para alcançar os níveis de qualidade destacados nos principais documentos internacionais, os quais estabelecem diretrizes e critérios para nortear a formação médica, como o Global Standards in Medical Education, o Canadian Medical Education Directions for Specialists (CanMEDS), a Association for Medical Education in Europe (AMEE), entre outros (Frank, Snell & Sherbino, 2015;Word Federation for Medical Education [WFME], 2003;Francischetti et al, 2020). Entretanto, devido às diferenças regionais no Brasil, alguns locais apresentam maior fragilidade em relação ao sistema de saúde, em detrimento a outros mais desenvolvidos.…”

Commitment to Care for the Community and COVID-19: teaching-learning approach to medical education in primary health care in Brazil

“…This should be approached on the best evidence considering principles of Evidence-Based Medical Education (EBME) and using Competence-Based Medical Education (CBME) as a framework to convey the needed competencies 7 . The highlight at CBME is that the proximity between classroom education and service-based vocational training is a differential that could ensure dynamism, integration between disciplines, professions, and emphasizes the longitudinal and permanent knowledge building aspect 8 .…”

Entrustable Professional Activities (EPAs) for the residency program in vascular surgery

“…The same process has taken place in parallel in the rest of the Western world, seeking to develop medical education that is more compatible with social reality and founded on the twin pillars of safety and efficacy. [1][2][3][4] According to Ten Cate, 5 safety is a critical point in medical education, especially so at conclusion of training, when medical activities should be carried out with confidence and free from uncertainty. 5 In turn, the same author considers that efficacy is directly linked residents' professionalism and competencies, which originate from their medical experience.…”

“…5 Competencies are a set of characteristics needed to deliver good medical practice and are not limited to acquisition of content and knowledge. 3,4 The Royal College of Physicians and Surgeons of Canada is a regulator comprising an association of Canadian doctors concerned with defining standards and protocols for competency-based medical education and has gained major acceptance in the global medical community. The College has identified seven essential competencies needed to complete medical residency training, thereby making a counterpoint to and extending the idea of competencies as acquisition of content and knowledge, namely: 1) communication; 2) collaboration; 3) leadership; 4) representativeness in the community; 5) commitment to lifelong learning; and 6) ethical professionalism.…”

“…Commonly, in the field of education, this term has been reconceived as a personal characteristic, trait, or attribute, a behavior or an activity, that draws our attention to extra-personal skills, rather than simply taking into account acquisition of content and knowledge, but also valuing the intrinsic aspects. [2][3][4] Several societies of medical specialties in Brazil, such as the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO), have already joined efforts to guide their training and accredited services to consider, validate and use the expansion of these competencies, since the assessment of skills, attitudes and other domains can be achieved in many ways and using reliable protocols. 2 One current tool that has been widely accepted and disseminated and which deciphers, identifies, and translates the competencies needed to exercise postgraduate medical activity is the concept of Entrustable Professional Activities (EPAs).…”