Background Most of medical schools in Brazil still maintain a traditional discipline-based curriculum. In this context, a recent survey of medical students at clerkship in the UFRN, Natal, RN, Brazil, showed that current training is insufficient to meet the increasing educational demands for diagnosis and treatment in rheumatology.
Objectives To develop a multidisciplinary longitudinal curriculum in rheumatology since the early undergraduate years, with progressive levels of complexity and integrating biomedical to clinical related contents.
Methods During the last five years we started to insert “Rheumatology” as a longitudinal subject through our undergraduatecurriculum, with gradual levels of complexity. A faculty development program has been implemented for planning of insertion of rheumatology biomedical and clinical knowledge and skills in curriculum. The first contact with medical students is at the 1st year, when studentsare learning musculoskeletal anatomy/physiology and are introduced to clinical correlations focused in “soft tissue rheumatism”, as a way of basic-to-clinical integration. In the subsequent 2 years, learning activities are focused in development of semiological skills, including history-taking, physical examination and clinical reasoning. During the 4th year, students are introduced to most prevalent Rheumatology diseasesthrough theoretical and practical activities. Finally, in the medical clerkship (5th and 6th year), we have been the opportunity to discuss primary clinicalcases during the rotation of “Community Health” at a rural context. Additionally, inpatient and outpatient practices of connective tissue diseasesare experienced by students at the tertiary hospital setting.
Results Overall, on the view of students, it is clear that these practices have contributed to their learning, giving meaning to the previously studied biomedical knowledge on musculoskeletal system. Internal institutional evaluation of rheumatology course pointed that students highly rated the faculty performance and their skills achievement. An external institutional evaluation performed by the Brazilian Ministry of Education also rated the UFRN medical course at maximum score (5,0). From the student view the main factors that facilitate learning in rheumatology were: basic-to-clinical integration (82.0%), small group discussions (66.7%), integration with community health (73.5%), carrying out practical activities (61.7%) and diversification of practice scenarios (44.4%), use of OSCE assessment in clerkship (76.2%).
Conclusions Understanding the basic-to-clinical integration and promoting rheumatology learning in a diversity of scenarios are important strategies for the current medical education. Our experience with this teaching strategy has been effective and constitutes the basis for systematic and adequatetraining of students in musculoskeletal diseases.
Vilar M, Bezerra EM, Diniz RZ, Azevedo GD. Medical students’ self-assessed confidence in rheumatic diseases Ann Rheum Dis 2010; (Suppl3): 485.
Monrad SU, Zeller JL,Craig CL, Di Ponio LA. Musculoskeletal education in US medical schools:lessons from the past and suggestions for the future. Curr Rev Musculoskelet Med 2011; 4:91–98.
Disclosure of Interest None Declared
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