Guia do exame físico mamário para estudantes de medicina

Abstract

The aim of the present study, approved by the Onofre Lopes University Hospital's Ethics and Research Committee, under number 2,841,025, was to systematize a "Guide Model for Physical Mammary Examination" at the Clinical Skills Laboratory of the Federal University of Rio Grande do Norte. The target public consisted of 41 students regularly enrolled in the curricular component of clinical oncology, of the medical course of the same university. It was an action research, where the intervention is thought from the diagnosis of the situation and had the following steps: (1) Application of the diagnostic questionnaire; (2) Systematic and interactive theoretical and practical guidance on how to perform the physical examination; (3) Practical guidance for performing the mammary examination on the manikin; (4) Application of the evaluation questionnaire after class; (5) Discussion and evaluation of the activity with students; (6) Evaluation of the questionnaires and (7) Analysis of the results. The mean score of the pre-intervention questionnaire was 4.1 (± 2.06), with the lowest grade being equal to zero and the highest grade 8. After class, the average grade was 8.71 (± 1 , 3). The lowest score was 6 and the highest was 10. A difference between the means of 4.6 points was identified (T-test, paired p <0.0001). Considering the evaluation criteria, it was verified that the palpation of the breast was the most accomplished procedure among the students (87.8%), while the conversation with the patient (9.8%) and the dynamic inspection (4, 9%) were the least accomplished items. After the class all the students described the palpation of the breast and the static and dynamic inspection as procedures of the examination, while the conversation with the patient continued being the less accomplished item, but with a rise from 9.8% to 42.7% in pre-intervention evaluation. It is concluded that the systematization of a guide for the physical examination of the breast allowed a better performance of the students in the practical accomplishment of this examination, being a theoretical and practical tool that could be developed and replicated in the other health areas that perform the physical examination.