A Paradigm Shift in Predoctoral Dental Curricula in Brazil: Evaluating the Process of Change

Abstract

In 2002, the Brazilian Ministry of Education approved the oficial curricular guidelines for undergraduate courses in Brazil to be adopted by the nation's 188 dental schools. In 2005-06, the Brazilian Dental Education Association (BDEA) promoted workshops in forty-eight of the schools to verify the degree of transformation of the curriculum based on these guidelines. Among the areas analyzed were course philosophy (variables were v1: knowledge production based on the needs of the Brazilian Public Health System [BPHS]; v2: health determinants; and v3: postgraduate studies and permanent education); pedagogical skills (v4: curricular structure; v5: changes in pedagogic and didactic skills; and v6: course program orientation); and dental practice scenarios (v7: diversity of the scenarios for training/learning; v8: academic health care centers opened to the BPHS; and v9: participation of students in health care delivery for the population). The subjects consisted of faculty members (n=711), students (n=228), and employees (n=14). The results showed an incipient degree of curriculum transformation. The degree of innovation was statistically different depending on the type of university (public or private) for variables 1, 2, 4, 5, 6, and 7. Private schools reported a higher level of innovation than public institutions. Resistance to transforming the dental curriculum according to the oficial guidelines may be linked to an ideological conception that supports the private practice model, continues to have faculty members direct all classroom activities, and prevents students from developing an understanding of professional practice as targeted towards the oral health needs of all segments of society.

A functional natural dentition for all – and for life? The oral healthcare system needs revision

“…Dentists are not cost‐effective for oral disease control, and they hold a ‘competence’ profile that is out of proportion with the oral healthcare needs of major sections of our populations. The problems that will emerge if we maintain the current oral healthcare structure in which ‘only the dentist is the competent and responsible leader of the dental team’ and ‘fully trained dentists [……] retain full responsibility for diagnosis, treatment planning and treatment’ have been identified by some , but are, for obvious reasons, quite likely to be largely disregarded by the dental profession itself.…”

“…This development inevitably sparked a move within each of these subdisciplines to create special postgraduate ‘specialties’ in order to demonstrate the importance of these subdisciplines for an ‘optimal’ dental healthcare service provision to individual patients. This somewhat haphazard subdiscipline, and specialty budding has resulted in a profession with ineffective interdisciplinary communication and weak relations to other healthcare professionals, whether in practice or in public institutions .…”

“…Many before us have reflected in depth on the need for action from responsible dental educators and academic leaders on the different components of oral healthcare provision. While most have discussed a need for adjustments of the dental curriculum in response to rapidly changing oral disease patterns , or a perceived need for expansion of the dental specialist training , few have addressed the structure and organisation of the oral healthcare system as a major obstacle for achieving a functional natural dentition for life for all. Tomar and Cohen emphasised the urgent need to integrate oral health care into general health care, and we think that their ‘diagnosis’ of the problem in the USA covers much broader scenarios.…”

Formação em Odontologia e os estágios supervisionados em serviços públicos de saúde: percepções e vivências de estudantes

“…As IES em saúde devem pensar na formação profissional voltada para os princípios e diretrizes do SUS, a partir da humanização das práticas em saúde, com a integração de conhecimentos gerais e específicos, habilidades teóricas e práticas, atitudes e valores éticos. Para isto, é necessário repensar a inserção desse profissional na sociedade e construir sua participação partindo do cotidiano, da reflexão e da formulação de propostas fundamentadas nos problemas enfrentados na rede de atenção à saúde [7][8][9][10][11][12] .…”

“…Na Odontologia, tradicionalmente, o ensino tem se baseado na transmissão de conhecimento e no desenvolvimento de habilidades psicomotoras, com foco nas doenças bucais e na clínica privada 9 3,7,17 .…”