Teaching pediatrics and child care in medical courses: discussing practical scenarios

Abstract

Introduction: Comprehensive child health care is a guideline in pediatric teaching, and it is essential to develop practical activities considering all levels of health care in the Unified Health System. Objectives: To describe the hours involved, practice scenarios and preceptorship in pediatric and childcare teaching in medical schools. Method: A cross-sectional study using a questionnaire with 43 objectives and two open questions, sent by electronic forms to medical schools across the country that had already graduated at least one class in 2019. Results: 37 (14.97%) medical schools with at least one graduated class answered the questionnaire (16 public and 21 private schools) from 14 states in the five regions of the country. A median of 940.5 hours was found for the teaching of pediatrics, equivalent to 11% of the total medical course; 13 schools included child health topics since the first year and the majority (75.8%) from the third year onwards. Practical activities predominated in the internship: 87.5% (5th year) and 88.8% (6th year). The used settings include primary health care, general and specialty pediatric outpatient clinics, inpatient units, neonatology units, emergency services and simulation laboratories. It was reported that childcare teaching is carried out in general pediatric outpatient clinics (32 schools) and basic community health units (32 schools), with an emphasis on primary care as the essential setting for teaching childcare. Pediatric teachers provide preceptorship in all practice settings; non-teaching pediatricians from the medical institution or the local health system are more present in inpatient units (70.3% and 54.0%, respectively) and specialty outpatient clinics (54.0% and 35.1%, respectively). Conclusions: With the participation of 37 medical schools, this study has limitations for the generalizations about teaching in the country. Pediatric teaching is carried out in practice environments at all levels of care, demonstrating the importance of comprehensive child and adolescent health care, with an average of 11% of the course total workload allocated to this teaching. The predominant participation of pediatricians as teachers was observed. The learning of childcare has remained a relevant component of pediatric training and its development is significant in primary care, although there are challenges to preserving this practice setting.