Family Medicine from the First to the Sixth Year of Undergraduate Medical Training: Considerations on an Educational Proposal for School-Service Curricular Integration

Abstract

Medical training is current topic of discussion both on the national and international stage due to changes in contemporary society and the consequent health demands. In Brazil, insertion into the workplace of the Primary Health Care (PHC) student is recommended throughout the medical course. However, such insertion is hampered by inadequate practical scenarios, the lack of preceptors, insufficient training of general practitioners to receive students, teachers without adequate training in teaching in the area and resistance by teachers of traditional disciplines. This article describes and analyzes a model for insertion into PHC and Family and Community Medicine (FCM) of students from a medical course in São Paulo, the challenges of teaching-management integration and the actions that help to address these issues. The proposal is based on educational objectives aimed at developing competences (knowledge, skills and attitudes) so that the student can offer comprehensive care, understanding the individual in the context of family, social and environmental life. The program contents were developed to provide learning in an increasing degree of complexity, connecting previous knowledge to new knowledge. From this starting point, the development of the educational project has as innovative brand involving a combination of planning and educational management that adopts the following measures to improve the quality of the teaching-learning process: (1) insertion of students into Basic Health Units (BHU) from the first year to internship; (2) hiring family doctors as faculty staff; (3) integration of the contents of the Family Medicine and PHC modules with the contents of other disciplines, such as Epidemiology, Health Policies and Evidence-Based Medicine; (4) critically questioning teaching methodologies regarding their suitability for the topic addressed and the student and teacher profiles; (5) formative assessments; (6) pedagogical improvement for teachers and preceptors for the exercise of teaching in health; (7) practices that encourage students to work in interprofessional teams; (8) encouragement of national and international exchange programs for undergraduate and residency students in FCM; (9) promotion of the publication of books, articles and research in PHC. Among the facilitating factors for the good progress of this teaching proposal, it is highlighted that FCM and PHC are the axial foundations of the political-pedagogical project of the medical course and are developed in an institution that has a long history of assistance and teaching in the health area, contributing significantly to service-school integration. Dialogue is required for the execution of didactic activities in the practical settings, due to the proximity between local management, preceptors and teacher-managers. Another factor which strengthens the proposal is the investment in the preceptor team through training, participation in the construction and integration of content proposed in the FCM modules and a human resources policy that values them. Thus, it is considered that the presentation of this initiative could contribute to the debate on educational models for curricular insertion into FCM and PHC, and the related challenges and possibilities in contemporary medical education.

Integração ensino-serviço na implantação de um curso de medicina no Paraná

“…Isso reforça os preceitos da Política Nacional de Educação Permanente em Saúde, em que se tem, na inter-relação entre serviço e instituições de ensino, a cooperação para o desenvolvimento profissional. Ela traça o entendimento de que o trabalhador da saúde traz consigo conhecimento, sendo as experiências prévias no trabalho as fontes de conhecimento e aprendizagem 27 . Além disso, a própria prática dos estudantes e profissionais de saúde na APS se constituiu como processo formativo, possibilitando uma maior proximidade da realidade da população 28 .…”

A Área De Gestão Em Saúde Na Formação Do Médico: Resgatando a Literatura E a Aplicabilidade Em Ações Educativas Na Perspectiva Docente

“…Focalizando-se o subtema "gestão em saúde na parceria ensino-serviço-comunidade", a inserção precoce de estudantes das 14 graduações da área da saúde nos cenários de práticas do SUS é uma orientação prevista nas DCN de 2001 e reiterada pela Resolução n. 569, de 08 de dezembro de 2017 (BRASIL, 2001;2017). Para isso, indica-se a construção de PPP e de currículos na perspectiva da articulação com o SUS por meio da integração ensino-serviço e da valorização da realidade sociosanitária nas práticas de ensino e nos processos de trabalho em saúde (cuidar, administrar, ensinar, pesquisar e participar politicamente) (BRASIL, 2014; LIMA, J.; LIMA, R.; GOMES; LOPES; BEZERRA; NORO, 2020;PARMA;OLIVIERA;ALMEIDA, 2019;PEIXOTO et al, 2019;SILVA et al, 2018).…”

A inserção da Atenção Primária à Saúde no processo de ensino-aprendizagem: revisão integrativa

“…O treinamento e preparo de futuros profissionais da saúde tem prescrito a adoção de enfoque de novas habilidades, dentre elas as generalistas. O currículo institucional da graduação é reconhecido por apresentar determinantes para fortalecer a atuação na área, retratando-se como elemento condicionante para a reflexão quanto a formação e a afinidade com a realidade de saúde em tempos atuais (Khay-Guan, 2019;Lillevang, Henriksen, Brodersen, Lewandowska, & Kjaer, 2019;A. T. C. da Silva et al, 2018).…”