Percepção de docentes e de estudantes sobre a presença dos determinantes sociais de saúde no currículo de uma escola de medicina.

Abstract

In an increasingly socially unequal and inequitable context, considering health as an essential right and pursuing the idealized physical, mental and social welfare involve governmental, institutional and communal decisions, and the community is directly influenced by Social Determinants of Health (SDH). Considering the role of higher education institutions and the doctor education process, its complexity requires several strategies so that these professionals can further address the population’s health needs. In order to do so, there is an attempt to intervene in several levels, regarding both legislation, through the adaptation of the curricula to the National Curriculum Guidelines, and new learning pedagogical methods, which make a theoretical-practical approach through problematization. Students then have the opportunity to learn about the social determinants of health, emerging from a purely biomedical education into a critical, reflective perspective, connected with social responsibility. Curricular experiences can bring enriching answers consistent with the health ideal proposed. This work was developed at Escola Superior de Ciências da Saúde (ESCS), an institution located in Brasília and whose teaching background is centered on the primary care, developed on the Education-Service-Community Interaction (IESC) level, and its objective was to understand the perception on the theme of social determinants of health held by medicine students and professors from the aforementioned institution. A qualitative research was developed with the documental analysis of the institution’s political-pedagogical Project and IESC’s guidebooks, in addition to content analysis of semi-structured interviews focused on students’ and professors’ perception. In view of curricular experiences that intend to address the institution’s development of social responsibilities, as well as the inclusion of the theme of social determinants of health, a need for a deeper theoretical development and a better correlation between theory and practice in the activities was observed in the documents. After analyzing the perceptions of students and professors, the primary care setting and its complexity as an ideal to broaden knowledge on SDH were identified as strong points. The diversity of settings offers a significant learning experience that goes beyond purely biomedical contents, developing empathy and a more integrated and broader perspective on the role of doctors and the need for interprofessionality in order to provide high-quality healthcare. The following elements were identified as improvement points: the need for a better correlation between theory and practice throughout the curriculum and other levels, a better teacher training and the exploration of correlated themes such as violence and inequality, experienced in home visits, although it still needs systematization and uniformity to qualify the learning and the medical education. The study also suggests the inclusion of the community’s and other healthcare professionals’ perception in a future approach. This essay aims to contribute to a social responsibility driven medical curriculum development.