University of São Paulo: USP project trains future health professionals for humanized care

Every week, on Wednesdays, around seven in the evening, students of medicine, physiotherapy, speech therapy, nutrition, nursing and other health areas gather in a room at the Faculty of Medicine (FM) of USP to learn how to tell stories. and how to become good clowns. They participate in the MadAlegria project, an extension activity of the faculty focused on the humanization of interpersonal relationships in the hospital environment. Its objective is to assist in the training of professionals who value empathy, welcoming and symmetry in the relationship with the patient.

“We have very shy students, who feel a lot of pressure when they become undergraduates in relation to the study and work journey”, says Professor Elizabeth Gonçalves Ferreira, coordinator of MadAlegria. “We also have extroverts, who if they’re too extroverted, need help focusing that energy,” she says.

Created in 2010, the project opens vacancies for new members once a year, when a short presentation course is held for interested parties. Then the participants decide whether to try to go the hospital clown or storyteller path. Only then do they go through the selection process, which consists of a letter or video introduction followed by an interview.

It is a voluntary work that prepares students to attend weekly, for at least one year, at Hospital das Clínicas (HC) and at the Cancer Institute of the State of São Paulo (Icesp).

“MadAlegria has a format that tries, within the Humanization strategy, to make the student experience concepts, instead of just talking about them”, says the coordinator. She emphasizes that, in order not to become a term devoid of meaning, humanization must be carried out in practice, putting the human being at the center of decision-making by medical professionals.

“The feeling of omnipotence is very dangerous in the health area because it induces errors and places the professional in an asymmetry with the patient”, he explains. “By becoming sensitive to the sick, it is possible to better see their universe and realize the responsibility that one has with life.”

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During hospital visits, patients always have the option of denying the presence of volunteers, who must learn to deal with this rejection. When the connection between the two is established, however, it can end in a transformative experience.

Elizabeth, who also attended the MadAlegria training course, remembers a service carried out together with a student at ICESP. During the meeting with a woman who was unconscious and was accompanied by her family, the two decided to sing a song. Quietly, respecting the energy of the place, they harmonized when, to everyone’s surprise, the patient’s newly awakened voice joined the chorus. “That stays with the student for life,” she says.

Within the hospital environment, where physical behaviors, dress codes and conduct can become so rigid, the project seeks to foster new means of interaction between patients, family members, professionals and medical staff. Classes include training in body command, speech, gaze, empathy, line of reasoning and improvisation and are taught by professionals in the arts and humanities.

MadAlegria prioritizes USP and health students, but also accepts people from other courses and institutions, as well as those who no longer study or have never attended university. “Many arrive with ideals of altruism, of doing good to others and giving of themselves”, says Elizabeth. “But over time, they realize that they were the ones who received the project, the patients and the care.”


Humanization in practice

The humanization of Medicine represents a paradigm shift in the provision of medical care in order to offer more complete care to patients. Its practice involves the education and training of health professionals, as well as interventions that make the hospitalization experience more pleasant for the patient.

“The concept of humanization is closely linked to the care of the patient as a unique being who needs to be heard and treated in an ethical and respectful way, taking into account all their psychic, emotional, physical, cultural, spiritual and social dimensions”, says Maria Helena Sponton, humanization coordinator at ICESP.

ICESP’s inpatient rooms usually receive students from MadAlegria on a weekly basis, making the atmosphere more serene, interesting and cheerful, in addition to serving as a bridge for socialization. “Employees also feel welcomed, learning new stories and playful strategies”, says Maria Helena. For her, humanized training contributes to deepening the patient’s experience as the center of care. “The project makes its future professionals more human and empathetic, knowing how to listen and talk to patients in their difficult moments of pain, anguish and fear”, she evaluates.

Impact on the hospital and classroom

According to internal data from the Technical and Scientific Humanization Nucleus (NTH), which works at FM and HC, in 2021, the Hospital developed 619 actions outside the work routine involving aspects such as education, reception, art and popular culture, promotion of of self-care, among others, reaching almost 2 million people between patients and employees.

At the Faculty of Medicine, Professor Izabel Cristina Rios, coordinator of the NTH, assesses that “investment in the area became more effective from 2017 onwards, when the Executive Board and the Chief of Staff created the Humanização FM Axis”. The initiative added activities in the field of medical education, health research, university extension and management of higher education services related to the topic.

Another important action, according to the coordinator, was the framing of humanization as one of the strategic bases defined in the pedagogical project of the medical course, along with integration, internationalization, excellence in teaching and research, sustainability and innovation, thus guiding all educational actions carried out. at the College.

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