The aim of this study is to present a strategy for the teaching practice and evaluation of cardiopulmonary semiology through an objective structured clinical examination. Practical lessons were developed with medical students. The students did anamnesis and physical exams to patients and later, each sign and symptom that was found was analyzed. At the end of practical lessons, a practical evaluation based on the objective structured clinical examination was applied. We have established a clinical situation in which the student had to do anamnesis, physical and cardiopulmonary exam and describe the results. Using computing software, cardiopulmonary sounds present in some diseases were shown to ask the students to identify them. An evaluation of the activity was done by means of a questionnaire applied to each student. Average mark in practical evaluation was 8, 93. The students' evaluation of the activity was very positive, with marks ranging from 3 to 5 in a scale from 0 to 5. Qualities of lessons and clinical histories have also been evaluated with an average mark of 4. The implementation of an objective structured clinical examination in Semiology has proved to be an efficient and useful tool in the evaluation of the medical student together with the practical lessons that made the students apt to recognize main signs and symptoms in cardiopulmonary diseases.

El objetivo de este estudio es presentar una estrategia para la práctica de la enseñanza y la evaluación de la semiología cardiopulmonar a través de un examen objetivo clínico estructurado. Las clases prácticas se llevaron a cabo con estudiantes de Medicina. Los estudiantes realizaron anamnesis y examen físico de los pacientes, y posteriormente fue discutido el significado de cada signo y síntoma encontrado. Al final de las clases prácticas se realizó una evaluación práctica basada en el examen objetivo clínico estructurado. Se estableció una situación clínica en la que el estudiante tuvo que realizar la anamnesis, examen físico cardiopulmonar y describir los resultados. Se mostró, por medio de programas de ordenador, sonidos cardiopulmonares de ciertas enfermedades para que el estudiante las identificara. Fue realizada una evaluación de la actividad, a través de un cuestionario aplicado a cada estudiante. La puntuación media de la evaluación práctica fue 8,93. La evaluación de la actividad por los alumnos fue muy positiva, con puntuaciones que van de 3 a 5 en una escala de 0 a 5. La calidad de las clases y las historias clínicas también han sido bien evaluadas, con un promedio de 4. La aplicación de un examen objetivo clínico estructurado en la semiología ha demostrado ser una herramienta útil y eficaz en la evaluación del estudiante de Medicina, junto con las clases prácticas, que hicieron a los estudiantes aptos para reconocer los signos y síntomas principales de enfermedades cardiopulmonares.

O currículo por competências deverá preparar o aluno para um saber-fazer crítico, reflexivo, ser parte ativa do contexto social, mobilizar recursos, que resolvam problemas surgidos no exercício profissional. Investigou-se, entre cirurgiões-dentistas do serviço público do Rio Grande do Norte, dificuldades em saúde coletiva, para estabelecer um perfil de competências no novo currículo. Coletaram-se os dados pelo teste de associação livre de palavras e entrevista, analisados pelo EVOC 2000 e análise de conteúdo. As dificuldades dos entrevistados foram trabalhar em equipe, falta de compromisso dos gestores com a continuidade das ações, despreparo profissional para enfrentar problemas coletivos, além da precarização do trabalho. Considerando o perfil profissional sugerido pelas novas diretrizes curriculares, os resultados sinalizam para mudanças no currículo, fundamentadas nas diretrizes, formando profissionais compatíveis com as exigências do mercado de trabalho, incluindo as competências saber, saber-fazer, saber-ser, com visão questionadora da própria prática. Quanto mais rápido os cursos de odontologia aderirem as mudanças, mais provavelmente os profissionais formados a partir delas estarão capacitados do ponto de vista de competências e habilidades para lidar com dificuldades surgidas.

A curriculum by skills should prepare the student for a critical and reflective know-how, so that he can feel as an active part of his social context, mobilizing resources to solve problems that appear in the professional exercise. It was investigated the difficulties faced by dentists from the public service of Rio Grande do Norte State about the public health in order to establish a profile of skills for the new vocational curriculum. Data were collected through a questionnaire with a test of free association of words and an interview analyzed by EVOC 2000 and Thematic Content Analysis. The main difficulties found were: working in teams, lack of commitment of managers with the continuity of the health actions, unprepared professionals to face the collective problems, and the precariousness of work. Considering the profile of the health professional suggested by the new curriculum guidelines, the results signal for a need for changes in the curriculum, to graduate professionals compatible with the requirements of the actual labour market, which includes knowledge, know-how and know-be, with a critic view. Thus, as soon as the courses of Dentistry adhere the changes in education, more likely the new graduated will be able from the view of competencies and skills to deal with possible difficulties.

O currículo por competências deverá preparar o aluno para um saber-fazer crítico, reflexivo, ser parte ativa do contexto social, mobilizar recursos, que resolvam problemas surgidos no exercício profissional. Investigou-se, entre cirurgiões-dentistas do serviço público do Rio Grande do Norte, dificuldades em saúde coletiva, para estabelecer um perfil de competências no novo currículo. Coletaram-se os dados pelo teste de associação livre de palavras e entrevista, analisados pelo EVOC 2000 e análise de conteúdo. As dificuldades dos entrevistados foram trabalhar em equipe, falta de compromisso dos gestores com a continuidade das ações, despreparo profissional para enfrentar problemas coletivos, além da precarização do trabalho. Considerando o perfil profissional sugerido pelas novas diretrizes curriculares, os resultados sinalizam para mudanças no currículo, fundamentadas nas diretrizes, formando profissionais compatíveis com as exigências do mercado de trabalho, incluindo as competências saber, saber-fazer, saber-ser, com visão questionadora da própria prática. Quanto mais rápido os cursos de odontologia aderirem as mudanças, mais provavelmente os profissionais formados a partir delas estarão capacitados do ponto de vista de competências e habilidades para lidar com dificuldades surgidas.

A curriculum by skills should prepare the student for a critical and reflective know-how, so that he can feel as an active part of his social context, mobilizing resources to solve problems that appear in the professional exercise. It was investigated the difficulties faced by dentists from the public service of Rio Grande do Norte State about the public health in order to establish a profile of skills for the new vocational curriculum. Data were collected through a questionnaire with a test of free association of words and an interview analyzed by EVOC 2000 and Thematic Content Analysis. The main difficulties found were: working in teams, lack of commitment of managers with the continuity of the health actions, unprepared professionals to face the collective problems, and the precariousness of work. Considering the profile of the health professional suggested by the new curriculum guidelines, the results signal for a need for changes in the curriculum, to graduate professionals compatible with the requirements of the actual labour market, which includes knowledge, know-how and know-be, with a critic view. Thus, as soon as the courses of Dentistry adhere the changes in education, more likely the new graduated will be able from the view of competencies and skills to deal with possible difficulties.

OBJETIVO: verificar a quantidade de células CD68+ no estroma das vilosidades coriônicas na placenta de gestações submetidas ou não ao trabalho de parto. MÉTODOS: estudo transversal, com gestantes saudáveis a termo, das quais 31 placentas foram examinadas pela técnica de imunoistoquímica. Vinte placentas foram obtidas após partos vaginais (GVAG) e 11 obtidas em cesarianas eletivas (GCES). Lâminas foram preparadas com amostras de vilosidades coriônicas e submetidas à marcação com anticorpo anti-CD68, específico para macrófagos. Foram contadas as células marcadas e as não marcadas dentro das vilosidades. Testes estatísticos não-paramétricos foram utilizados para a análise. RESULTADOS: entre 6.424 células contadas no estroma das vilosidades das 31 placentas, 1.135 células (17,6%) foram marcadas pelo CD68+. Em cada amostra placentária, a média de células coradas pelo anticorpo anti-CD68 foi de 22±18 para o grupo GVAG e de 20±16 para o grupo GCES. CONCLUSÕES: não houve diferenças significantes no percentual de macrófagos (CD68+) em associação com o trabalho de parto.

PURPOSE: to verify the amount of CD68+ cells in chorionic villosities in placentae from gestations submitted or not to labor. METHODS: transversal study with healthy near-term pregnant women, among whose placentae, 31 have been examined by immunohistochemical technique. Twenty placentae were obtained after vaginal delivery (VAGG) and eleven after elective cesarean sections (CESG). Slides were prepared with chorionic villosities samples and labeled with anti-CD68 antibody, specific for macrophages. Labeled and nonlabeled cells were counted inside the villosities. Non-parametric statistical tests were used for the analysis. RESULTS: among the 6,424 cells counted in the villosities' stroma from the 31 placentae, 1,135 cells (17.6%) were stained by the CD68+. The mean of cells labeled by the anti-CD68 was 22±18 for the VAGG group and 20±16 for the CESG, in each placentary sample. CONCLUSIONS: there were no significant differences in the percentage of macrophages (CD68+) in association with labor.