How to Open Ways to Change Medical Teaching in Brasil

Abstract: The teaching of Medicine at the State University of Londrina has been changing significantly with introduction, in 1998, of a restructured curriculum based on problem-based, community-oriented, student-centered learning. This rewarding incorporation of innovations into the teaching and learning process has been experienced at the Health Sciences Center over recent years as the result of a prolonged, intense and democratic process of construction. lt is the fruit of many seeds sown in recent years with support from the UNI program, which has catalyzed the search for answers of the following, How to construct a proposal for transforming medical education? How to bring about the necessary changes? How to make them lasting? What are they? Who should participate in them? Resistance and opposition are natural and proper to change of this kind. It is hoped, however, that some of the important lessons learned can be shared by those who are participating in this ongoing - and thus necessarily imperfect and insufficient - process, and who nonetheless fortered opportunities to create strategies to implement these processes and to take them beyond simplifications.

摘要：隆德里纳州立大学（State University of Londrina）的医学教育自1998年引入基于问题式、面向社区、以学生为中心的重构课程体系以来，已发生显著变革。近年来，该校健康科学中心（Health Sciences Center）历经长期、深入且兼具民主性的建设历程，将多项创新成果融入教学与学习全流程，取得了斐然成效。此项改革乃是近年依托UNI项目（UNI Program）支持所结出的硕果，该项目推动了一系列核心议题的探索：如何构建医学教育改革方案？如何推动必要的变革落地？如何确保变革长效可持续？变革的核心内涵为何？哪些主体应当参与变革？此类变革遭遇阻力与反对实属正常且合理。尽管如此，我们仍希望参与这项仍在推进——因而必然存在不完善与不足——的改革进程的各方，能够共享我们从中汲取的宝贵经验；即便进程尚存局限，仍应把握机遇制定策略以推进改革，并避免将改革简化片面化。