O ensino de endocrinologia e metabologia pela aprendizagem baseada em problemas: a experiência de 20 turmas de medicina

Abstract

Introduction: Problem-Based Learning (PBL) has been the preferred teachinglearning methodology among medical schools in Brazil in recent years. Thereby, there is an increasing number of Medicine courses getting experience in this method, such as the Centro Universitário do Estado do Pará (CESUPA), which the twentieth class of Medicine concluded teaching by PBL in 2020. In this context, it is relevant the analysis of how this teaching has been carried out and how it has evolved over the years, especially in areas that are interrelated with various organic systems and that involve very prevalent pathologies and that will be conducted by Primary Care Physicians, as the case of Endocrinology and Metabolism (E/M). Objectives: To describe how cognitive aspects related to E/M teaching were worked by the PBL methodology from the first to the twentieth class of CESUPA Medicine course, identifying the moments of the course in which they were studied, pointing out the changes that occurred over time and analyzing if there was a distribution of the contents so that the themes were reviewed with increasing levels of complexity. In addition, it aimed to develop, at the end, a teaching guide proposal of E/M related themes for medical courses that will use active methodologies. Methodology: A review of 360 manuals used by tutors from the first to the eighth semester of the course, in its first 20 classes, was carried out. In these manuals, there were problems to be developed, with their respective learning objectives, in addition to the objectives of the morphofunctional laboratory. Then, a critical and descriptive analysis of the E/M content present in these manuals was carried out, evaluating how the evolution of this teaching occurred over the years. Finally, the proposal for the aforementioned guide was constructed. Results: It was observed that the themes related to the Endocrinological System are distributed throughout each of the first eight semesters of the course. The initial focus is on anatomy, histology and physiology, however, from the very beginning there are citations of the pathologies that affect this system, which allows contextualization and meaningful learning. Subsequently, the subjects are revisited with progressive deepening in relation to the management of patients. Over the years, there have been significant changes, especially in the detailing and standardization of the manuals, beyond description of well-defined objectives to be achieved in the morphofunctional laboratory. Discussion: The most cited endocrine theme among the manuals is Diabetes Mellitus, which is explained for being a very prevalent pathology with high morbidity. On the other hand, obesity, which has been steadily increasing in prevalence, has also shown a progressive increase in citations in the manuals over the years. Rare pathologies were in fact not prioritized as topics for discussion, however it is suggested to expand the presence among the problems of some frequent pathologies such as thyroid nodules. Conclusion: The teaching of E/M was carried out in a well distributed way over the first four years of the CESUPA Medicine course and the way of doing it evolved significantly during its first 20 classes.