Preparando farmacêuticos competentes para a prática clínica: percepção dos estudantes acerca do desenvolvimento de habilidades clínicas.

Abstract

Although medication is the primary tool in the treatment of diseases, within the current context of the medicalization of society, it represents a risk to the population. Pharmaceutical care, offered as a Medication Therapy Management service, aims to optimize medication use through a rational decision-making process. This study seeks to understand students' perceptions regarding the development of clinical skills for care, specifically anamnesis, the use of clinical reasoning for decision-making in pharmacotherapy, and the documentation of practice. For this study, a qualitative approach was chosen, using Grounded Theory. The research was conducted with students from the elective course "Advanced Clinical Skills I" in the Pharmacy program at UFMG, which utilizes realistic simulation and progressively more complex clinical case discussions as teaching-learning methods. Data collection, which took place from August 2022 to December 2023, included in-depth interviews and participant observation in the classroom over three consecutive semesters. The data were analyzed using NVivo. At the end of the analysis, a theoretical model was developed. Of the thirty-two students enrolled in the course during the research period, six were selected because they met the pre-/co-requisites and represented the full range of perspectives and viewpoints of the study object. They were interviewed, highlighting that the guiding strategy for the development of clinical skills was the use of standardized and adequately planned cases to enhance learning, combined with a set of sequential strategies and teaching-learning methodologies. The serial anamneses, conducted in the form of realistic simulations, allowed the evaluation of their own progress and fostered documentation. Regarding the documentation of practice, they noted that it was challenging but emphasized the importance of using a standardized document as a guide during consultations, which facilitated the development of both anamnesis and clinical reasoning. Case discussions, both during resolution among peers and in the classroom, were identified as a key strategy for improving the three skills outlined by the course. The students pointed to limited time for solving clinical cases and the short course load as negative aspects. The study’s limitations included memory bias and the elective nature of the course, which may have influenced the experiences reported by the students. The results revealed that the development of clinical skills by students is perceived through sequential clinical courses using active teaching-learning methodologies. This generates confidence and autonomy in students, bridging the gap between theory and practice, which is essential for providing person-centered care.