Curricular transformations in medical school: an exploration of the promotion of change in <scp>B</scp>razil

Alves, Cintia Aparecida; Belisário, Soraya Almeida; Abreu, Daisy Maria Xavier de; Lemos, José Maurício Carvalho; D'Ávila, Luciana Souza; Goulart, Lúcia Maria Horta Figueiredo

doi:10.1111/medu.12154

Cited by 10 publications

(10 citation statements)

References 17 publications

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“…Given that the universal Brazilian healthcare system emphasizes preventive medicine, the low interest of students in pursuing primary care specialties is a major national issue. This situation is aggravated by the lack of physicians (national mean of 1.8 professionals per 1000 habitants) and an unequal geographic distribution of this workforce [ 23 , 36 ]. Importantly, a survey of medical residents in the United States reported that internships significantly influence the choice of primary care [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…In New Zealand, general practice (i.e., family medicine) is the third most popular career choice in junior doctors [ 20 ]. In contrast, the situation in Brazil is marked by a low interest in general practice (including primary care), which impairs the medical needs for social programs from the universal Brazilian healthcare system [ 21 – 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors

et al. 2015

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BackgroundChoosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors.Methodology and FindingsA cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ2 = 107.2). The choice mainly occurred during the internship period in medical school (n = 466; 38.7%). An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%), which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3) and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2). With regard to influential factors in controllable lifestyle specialties, “financial reason” (mean score ± standard deviation: 2.8 ± 1.0; median = 3) and “personal time” (3.1 ± 1.3; median = 4) were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both), and higher scores were observed for “curricular internship” (3.2 ± 1.1, median = 4) and “social commitment” (2.6 ± 1.3, median = 3).ConclusionThe present findings provide important insights into developing strategies to stimulate interest in specialties based on the needs of the Brazilian healthcare system.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors

et al. 2015

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“…Este resultado reflete o movimento observado durante a realização do Promed em que muitos cursos de Medicina propuseram a inserção dos estudantes em cenários reais de prática desde o início dos cursos como uma das estratégias do vetor "mudança de cenários de prática" 10 .…”

Section: Resultsunclassified

“…Entretanto, na busca pela adequação da formação profissional, essas escolas se deparam com inúmeros obstáculos que as impedem de avançar nesse processo. Uma avaliação de desempenho do Promed nas 19 escolas participantes apontou dificuldades na integração ensino-serviço, baixa produção de conhecimentos voltadosàs necessidades do SUS e estrangulamentos na oferta de pós-graduação e educação permanente 10 . Esse estrangulamento do processo de mudanças pode ser reflexo da hegemonia de grupos tradicionais de pesquisa mais voltados para o desenvolvimento de linhas de estudo das especialidades médicas 11 .…”

Section: Introductionunclassified

Repercussões do Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) na Reforma Curricular de Escolas Médicas Participantes do Programa de Incentivos às Mudanças Curriculares dos Cursos de Medicina (Promed)

Alves

Belisário

Abreu

et al. 2015

Rev. bras. educ. med.

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The objective of this study was to analyze the repercussions of PET-Saúdein the curricular reform of medicine schools which participated in the PROMED.This qualitative research used focus groups with PET--Saúde coordinators from 12 medical schools. It was shownthat the PET-Saúde reinforced the curriculum development, contributing especially to the promotion of Primary Health Care as a priorityenvironment for teaching-learning practices. The most significant contributions of the PET-Saúde were related to the production of knowledge geared toward the needs of the SUS and strengthening of teaching-service integration, both of which aspects were considered main difficulties in the context of PROMED. As PET-Saúde also involved health professionals, it contributed to improving these services by training, empowering and raising the profile of these professionals. The program's role has been given less emphasis in graduate and permanent education. Offering educational opportunities which closely bound to the SUS remains a challenge for policies concerned with the training of health professionals. INTROdUçãONo Brasil, a implantação do Sistema Único de Saúde (SUS) marcou o início de uma era de profundas mudanças nas escolas médicas. Ao criar novas demandas na organização da atenção à saúde, provocou, consequentemente, a discussão sobre a formação de recursos humanos no País. Nesse sentido, as Diretrizes Curriculares Nacionais do Curso de Graduação em Medicina 1 , promulgadas em 2001 pelo Ministério da Educação, tornaram-se um referencial tanto para a reorganização dos currículos, visando à adequação do perfil profissional a essa nova realidade, como para o direcionamento das políticas públicas de incentivo às mudanças curriculares nessas instituições.Inaugurando uma série de políticas dessa natureza, o Programa de Incentivo às Mudanças Curriculares nas Escolas Médicas -Promed -foi a primeira iniciativa conjunta dos ministérios da Saúde e da Educação com este propósito. Com o lema "Uma nova escola médica para um novo sistema de saúde", teve início em 2002 e contou com a participação de 19 escolas de Medicina de todo o País 2,3 . O Promed representou um importante apoio à implantação e consolidação das reformas curriculares nas escolas contempladas, tendo enfatizado dimensões relacionadas às necessidades da sociedade e do setor saúde, em consonância com as diretrizes curriculares nacionais. Além disso, como política pioneira de incentivo a mudanças curriculares, propiciou terreno para o surgimento de programas subsequentes, com a ampliação da proposta para outros cursos da área da saúde, consubstanciados no Programa Nacional de Reorientação da Formação Profissional em Saúde -Pró-Saúde I e II . Em 2010, o programa ampliou sua atuação para todas as áreas estraté-gicas para o SUS, subdividindo-se em três versões: Saúde da Família, Vigilância em Saúde e Saúde Mental. Estes programas compartilham os seguintes pressupostos: educação pelo trabalho; qualificação em serviço dos profissionais de saúde; iniciação ao trabalho ...

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“…Even though universities spend a great amount of resources planning and implementing educational programs, a major issue is the intricate problem of evaluating the impact of curricula in students' academic performance [3][4][5]. It is not straightforward to identify the individual components of a major curricular change and their effects on the plethora of outcome variables, indicators of teacher performance and student learning, since there are many interlinked variables that can influence the main outcomes [3,4,6].…”

Section: Introductionmentioning

confidence: 99%

Curricular change in a medical school: a new method for analysis of students’ academic pathways

Sánchez

Godínez²,

Salinas³

et al. 2020

Preprint

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Background. Curricular changes in medical schools occur due to advances in medical sciences, but its evaluation is limited and fragmented, with scant data of students' success as they progress through the program. Longitudinal follow-up can be "natural experiments" to explore innovative methodologies. Objective. To propose a method for analyzing students' academic pathways, and identify changes associated with a medical school curricular reform. Methods. We analyzed the academic pathways of students throughout the program in two different curricula (1993 and 2010), at the National Autonomous University of Mexico (UNAM) Faculty of Medicine. Advancement of each student in the program was calculated with the "academic trajectory" using the accumulated credits in a defined time period, and the percentage of students that completed the credits for each stage of the curriculum. The theoretical framework is based on the "life course" approach, applying concepts of trajectory, transition and state. Data was analyzed with R software and TraMineR algorithm. Results. Five student cohorts of the older curriculum were studied (classes of 1994, 1995, 1996, 2004 and 2005), and two cohorts of the new curriculum (2011, 2012), a population of 6829 students. Students in the newer curriculum had a faster, more timely and efficient advancement in academic pathways, than cohorts in the older one. There was a higher percentage of students with "regular" trajectory (without failed courses) in the newer curriculum. Regularity is a straightforward metric that allows identification of complex curricular changes' associated effects. Conclusions. Analysis of students' academic pathways offers valuable information to evaluate curricular changes, which is difficult to obtain with traditional cross-sectional studies. The study does not provide proof of causality regarding the educational impact of different programs, although it can be useful to complement the array of program evaluation strategies in higher education.

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Curricular transformations in medical school: an exploration of the promotion of change in Brazil

Cited by 10 publications

References 17 publications

Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors

Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors

Repercussões do Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) na Reforma Curricular de Escolas Médicas Participantes do Programa de Incentivos às Mudanças Curriculares dos Cursos de Medicina (Promed)

Curricular change in a medical school: a new method for analysis of students’ academic pathways

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