O método clínico centrado na pessoa na formação médica como ferramenta de promoção de saúde: aplicação e dificuldades na utilização por estudantes de medicina

Abstract

In the context of public health policies in Brazil and in most part of the countries of the world, Health Promotion has a fundamental role that is useful as a theoretical basis for planning and execution of health actions. Among the essential aspects of practice for health promotion are building relationships, increasing individuals self knowledge, agreeing priorities and goals, the rational use of health resources, and experiencing the results. These aspects pervade all the principles of Patient Centered-Medicine, which, in addition to provide a theoretical framework, propose techniques that help health professionals - specially physicians - in clinical practice. The Patient-Centered Clinical Method (PCCM) proposes that the patient become protagonist of his own health and places it as a focus on the medical consultation and active participant in achieving priorities and decision making for care. However, there is still a gap in current medical training regarding PCCM and a challenge to incorporate its teaching in the curricula of undergraduate medical courses. This study aims to analyze the use of PCCM and its difficulties by undergraduate students in medicine, especially with regard to health promotion and propose a strategy for their inclusion in medical education. A research was conducted through descriptive qualitative methodology, following an interpretative paradigm, analyzing contents of audios recorded from videofeedback of medical appointment made by students. It was found that students have little prior knowledge about the method, and that after getting in touch with it, they point out that the main difficulty in its use is the lack of familiarity and practice. They also recognized the PCCM as a superior tool compared to the traditional clinical method, and had a perception that it should be explored throughout the medical school, and made suggestions for methodologies for its insertion, such as: an emphasis on practice, supervision of teachers in students' anamneses, content collection in the theoretical and practical formal evaluations, adoption of a personcentered anamnesis script, practice of role-plays and videofeedback of recorded consultations.