Analysis of professional training in Multiprofessional Health Residency Programs in Brazil from the perspective of residents

Abstract The aim of this study was to analyze professional training in multiprofessional health residency programs (MHRPs) in primary care from the perspective of residents from 20 programs who had completed residency in the period 2015-2019. We undertook a cross-sectional study analyzing criteria in the dimensions Pedagogical Approach and In-Service Education Settings responded using a 10-point Likert scale. The study sample consisted of 365 graduates from MHRPs in 12 Brazilian states. The highest-scoring criteria in the dimension Pedagogical Approach (Cronbach’s α=0.94) were broad concept of care and professional training oriented towards comprehensive care (P50=10). The lowest scoring criteria were those involving preceptorship (P50=7). With regard to the In-Service Education Settings dimension (Cronbach’s α=0.90), the main strength was group educational activities (P50=9) and the main weaknesses were adequacy of the physical structure of health facilities (P50=6), participation of residents in local health committees (P50=6), and coordination with medical residency programs (P50=5). The findings show that professional training in MHRPs is aligned with the principles and guidelines underpinning Brazil’s public health system, with emphasis on comprehensiveness and prevention. However, efforts are needed to improve preceptor training and address weaknesses in practice settings.

摘要 本研究旨在从2015-2019年完成住院医师培训的20个基层医疗多专业健康住院医师项目（Multiprofessional Health Residency Programs, MHRPs）的毕业生视角，分析该类项目的职业培训情况。本研究为横断面研究，采用10点李克特量表（Likert scale）对"教学方法"与"在职教育环境"两个维度的指标进行评估。研究样本涵盖巴西12个州的365名多专业健康住院医师项目毕业生。在教学方法维度（克朗巴赫α系数（Cronbach’s α）=0.94）中，得分最高的指标为"宽泛的照护理念"与"以全面照护为导向的职业培训"（P50=10），得分最低的指标涉及临床带教（P50=7）。就在职教育环境维度（克朗巴赫α系数（Cronbach’s α）=0.90）而言，其主要优势为小组教学活动（P50=9），主要短板则包括卫生机构物理设施适配性不足（P50=6）、住院医师参与地方卫生委员会的情况欠佳（P50=6），以及与医学住院医师项目的协调不畅（P50=5）。研究结果表明，基层医疗多专业健康住院医师项目的职业培训符合巴西公共卫生体系的核心原则与指导方针，重点强调全面性与预防照护。然而，仍需加强带教培训，并针对性改善实践环境中的各类短板。