Social dimension in medical education: the context life in problem based learning

Abstract This study characterizes the social dimension in the contexts represented in problem situations in a São Paulo state medical course that uses Problem-Based Learning. A total of 69 problem situations were analyzed, triggering the learning process from the first to the fourth grade and their respective tutor guides. To read the material, the Social Dimension Analysis Guide was used, developed by the researchers based on related documents and literature. For analysis, the discursive textual analysis method was adopted. The comparison between the learning objectives presented in the problem situations and in the guides showed disagreements and dichotomies. The characterization of the explored contexts did not portray the real territory: social equipment was scarcely addressed, but the areas of competence of individual, collective and management care placed a satisfactory emphasis on public policies. The analyzes of areas of risk, diversity and vulnerable groups were superficial and the intersectoral approach was little used. It is hoped, with these results, to provoke reflections about the construction of problem situations in problem-based learning, because the deepening of the description, such as the expansion of its approach, may favor the theoretical-practical articulation, the extended learning and the training medical care focused on comprehensive care.

摘要 本研究针对某采用基于问题的学习（Problem-Based Learning）模式的圣保罗州医学课程中的问题情境所承载的背景，对其社会维度展开特征分析。本研究共分析了69个用于启动一至四年级学习进程的问题情境及其对应的导师指导手册。本研究采用由研究者基于相关文献与官方文件开发的《社会维度分析指南》对研究材料进行解读分析，并采用话语文本分析法开展分析。通过对比问题情境与指导手册中呈现的学习目标，发现二者存在分歧与二元对立现象。本研究对所探索背景的特征刻画未能如实反映真实的现实场景：社会服务设施几乎未被涉及，但个体照护、集体照护与管理式医疗照护的能力范畴对公共政策的重视程度尚属令人满意。针对风险领域、多样性与弱势群体的分析较为浅显，跨部门协作模式也极少被采用。本研究期望通过上述结果，引发学界对基于问题的学习模式中问题情境构建的反思——因为深化情境描述、拓展研究路径，将有助于实现理论与实践的有机衔接、开展延伸式学习，以及培养以全面照护为核心的医疗人才。