Educação Médica para controle do câncer: avaliação de egressos de um curso de Medicina e a contribuição das ligas acadêmicas como mais uma estratégia de ensino

Abstract

Cancer is increasingly widespread as a public health problem. In order to reduce the morbidity and mortality associated, several strategies are being implemented. When it comes to control it, the role of health professionals, particularly the physician, is of paramount importance. However, deficiencies are observed in the medical schools' (MS) curricula, especially with regard to teaching activities developed in primary health care. In Brazil, projects generically called academic leagues (AL) have been gaining attention, as extracurricular activities proposals for education, through student initiative. This work aims to: (1) evaluate the training of medical students in knowledge and practices for prevention, screening and early diagnosis of the main malignancies in Brazil and (2) evaluate the impact of the proposals of AL as supplementary teaching. Data were obtained from students in the last year at a public university in Rio de Janeiro through a self-administered questionnaire conducted in American studies, previously subjected to a cross-cultural adaptation. Seventy- eight students were considered eligible and 74 participated in the study. Of these, 87% consider that cancer studies of medical school curriculum is insufficient. Only 4% were able to correctly inform the recommended protocol for cancer screening in Brazil. Similarly, our results show that skill training for cancer control is weak: on the advice of patients, 30% received training to guide to smoking cessation and an even smaller percentage (15%) reach the end of the course without having been trained to assess the nutritional history of patients. In according to physical examination, almost 60% have never been trained to perform the clinical examination of the skin, 50% end up graduating without having executed a preventive gynecological examination and almost 20% without performing the clinical breast exam. With regard to self-perception, students feel more prepared to advise patients about cancer prevention habits. Other variables (gender, quotas for university access and family/friends with cancer) did not affect the performance of students in the dimensions evaluated (training, practice and self-perception). In order to evaluate the effect of graduation, a control group of first year students (n=77) was used. There was a significant gain in training and practice dimension comparing the two groups, and in a lower proportion, self-perception dimension. To evaluate the AL, a survey involving all MS registered in Brazil, which started academic activities before 2010 was undertaken. Despite that, we can only truly understand the real impact and the potential of these projects by undertaking qualitative analysis of their activities. It is observed that in AL, students are encouraged to develop skills not addressed in traditional curricula, such as management, leadership, entrepreneurship, innovation, health education and construction of citizenship.