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Universidad Nacional Autónoma de México

Indexada en:

Imbiomed, Periódica, SciELO, Latindex, ScienceDirect, Redalyc e Iresie.
Inv Ed Med 2017;6:e35 - DOI: 10.1016/j.riem.2017.01.086
Clinical Procedures Skills: The effectiveness of training of insertion of intrauterine devices by residents
Olivan Queiroz, Ana Carolina Barbosa, Priscila Coutinho, Gabriella Mattar, Monique Dias, Camilla Kaczan
Residência de Medicina de Família da Secretaria de Saúde do Rio de Janeiro

Description of the problem: Clinical procedures skills in primary health care are competencies to be developed with residents of family medicine. Expanding this menu of services, with quality in training, is a daily challenge. Insertion and evaluation of an Intrauterine Device (IUD) is one of these fundamental procedure, which is often no longer offered due to professional disqualification.

Method: In a family clinic with teaching duties, preceptors, residents, attending physicians (including from other clinics) and students were trained for procedures. Among these procedures, IUD insertion was one of the most accomplished. With all those in training were respected steps: (1) theoretical support and simulation; (2) observation of the preceptor as a model; (3) performing the procedure under the supervision of the preceptor; (4) performing the procedure without supervision. Peer education can also be included as strategies used by residents. Data were counted and presented descriptive results of the accomplishment of this procedure.

Results: Between January and October 2016, 126 IUDs were inserted in patients between 12 and 45 years of age. Of these, 42 devices were inserted by preceptors, 45 were by first year residents and 21 by second year residents. In addition, 15 IUDs were inserted by physicians from other teams, in continuing medical education, and 3 were inserted by undergraduate seniors. Of the total IUDs inserted, 26 (20.6%) were removed for three main reasons: malposition (18 cases), bleeding (7 cases), and pelvic inflammatory disease (1 case). Of these devices removed 20 devices had been inserted by residents and 06 by preceptors.

Conclusion: Developing skills in performing clinical procedures is imperative for residents of family medicine. Insertion and evaluation of IUDs is part of these procedures and is fundamental among the services offered to the population.

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