Exame físico de tireoide entre pares com guia digital: uma proposta para a educação médica

Abstract

Introduction: The thyroid physical examination is an essential clinical skill often taught in a non-systematized way through theoretical and practical classes with real patients. This approach can compromise the uniformity of teaching due to the limited number of patients per student, the need for repetition and the risk of causing discomfort or exposure to the patients themselves. Aim: To assess whether a structured teaching strategy, based on the use of a digital guide and the Peer Physical Examination (PPE) technique, improves medical students’ performance in this skill, compared to the traditional teaching model. Methodology: Firstly, a systematized model was designed for teaching the thyroid physical examination, resulting in a digital guide and an assessment checklist validated by specialists. Subsequently, a quantitative study was conducted with 32 medical students, divided into two groups: the Training Group (n=14), composed of third-semester students who used the digital guide and practiced with peers; and the Comparison Group (n=18), with fifth-semester students who received traditional teaching. The assessment took place using a checklist applied to both groups, including the following steps: preparation for the examination, inspection, palpation of the thyroid and lymph nodes, auscultation, Pemberton’s maneuver, and recording of the findings in the medical charts. Statistical analysis used Fisher’s exact test and the chi-square test, with a significance level of p< 0.05. Results: The Training Group performed better in all the domains assessed, with p<0.05. The items related to preparation for the examination stood out, with all the criteria showing significance. During the inspection, two of the six items showed significant differences. In palpation, there were differences in the patient’s positioning, identification of vascular fremitus and mention of lymph nodes. Furthermore, the Training Group stood out by emphasizing the need to auscultate the thyroid and perform the Pemberton’s maneuver. The groups were similar in medical chart recordings, except for two items. Conclusion: Systematizing the teaching of thyroid physical examination through the use of a digital guide and the PPE technique proved to be effective and feasible in developing this skill in medical education.