Avaliação da grade curricular e conhecimentos de residentes em pediatria sobre vigilância do desenvolvimento.
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2007-05-31Autor
Barba, Patrícia Carla de Souza Della
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Studies have shown that developmental surveillance is an important task to be performed by
the pediatrician and its objective is to precociously identify children who may need more
complex evaluation as well as provide information about their development and not only their
physical health. It also makes possible a definite diagnosis and the elaboration of an
interdisciplinary plan of care for children in order to undergo early intervention. Other studies
indicate that the pediatricians´ knowledge regarding developmental surveillance and their use of
instruments to accomplish this practice is defective. Despite the fact that just a few perform
developmental surveillance, they consider this issue important and demonstrate interest in
updating themselves. According to these studies, the pediatricians should update their
knowledge concerning development aspects and risk factors, use sorting techniques and lead
the child presenting development delay to early stimulation programs. The general objective of
this work is to analyze the knowledge related to health promotion, developmental surveillance
and pediatric residents´ perception of babies´ delays in the state of São Paulo by analyzing the
curriculum description and the performance in questionnaires. The curriculum guidelines from
MEC (Brazilian Education Ministry) for pediatric residence teaching, the relation of vacancies for
this specialty and the curriculum of seven medical pediatric residence courses in the state of
São Paulo were analyzed, with the objective of identify elements concerning developmental
surveillance in pediatric teaching (first stage). In the second stage of this study, the data
regarding developmental surveillance practices and the knowledge about children s
development were collected and correlated. It was carried out by the replication of two
questionnaires, which were answered by 65 first and second-year pediatric residents of five
specialization courses in the state of São Paulo. According to the analysis of MEC´s curriculum
guidelines in relation to the subjects to be studied about developmental surveillance, it is
possible to assert that they are general and non-specific, and the curriculums are superficial
and not clear enough to make the identification of the practices related to developmental
surveillance possible. Only one course of this research has the necessary requirements that
allow the identification of elements related to this topic. The results of the second stage has
shown that the majority of pediatric residents has different attitudes compared to the ones
performed by doctors who are dealing with children s health for longer time. These different
attitudes may reduce the efficacy of the developmental surveillance carried out by pediatricians.
The correlation between the pediatric teaching and the residents´ knowledge about
developmental surveillance has shown that the courses which have higher average in the
questionnaires also have better developmental surveillance s contents described in their
curriculums. The residents who justified why they ask or not the mothers about development
and the ones who confirmed the use of evaluation scales had higher scores in the
questionnaire. This study proposes further investigation related to the continuous professional
development for pediatric residents, distance learning, the use of Moodle tools and topics such
as: Promotion of health concept and developmental surveillance, non-identified precocious
delays consequences, protocols about developmental surveillance, guidelines for normal infant
development to the pediatricians, identification of development delays, and quick and easy
measures to be used during practice and inserted in institutional dynamics. Using these results
as a basis, a contribution to the pediatrician s mobilization regarding the importance of
developmental surveillance and precocious identification of children with development delay is
expected.