Beyond Traditional Health Training: Experience of Popular Education in Medical Training

ABSTRACT In recent years medical training has been at the heart of different discussions and policies. Despite the evolutionary process of Brazilian medical education, whether in its curricular or methodological aspects, there are still important gaps to be filled, in order to guarantee an comprehensive and humanistic education. It has become évident that transforming the methodologies and the curriculum does not go far enough; it is fundamental to introduce students into spaces of reflection, that can have a positive affect on their «existential worlds”. One possible tool for building such spaces would be university extension programs, understood as an interdisciplinary, educational, cultural, scientific and political process capable of fostering interaction between the University and the most diverse sectors of society, transforming them mutually. Thus, this article presents and analyzes the impacts of an extensionist action, based on Popular Health Education in a settlement in innerstate Bahia, on the training of medical students, according to their perceptions. Content analysis was applied to the field diaries and semi-structured interviews of ten medical students participating in the program «Social participation and the right to health: intersectoral planning, art, social mobilization and popular education in a settlement in Bahia». The results indicate that the traditional teaching of medicine often neglects the human being in all its potential, as well as its social, political and cultural context. The curriculum offers little possibility for real community-based practice; practical activities are often confined to the hospital setting; there are few opportunities for exchanges and dialogues with students from other undergraduate courses. Thus, it is concluded that university extension can favor important processes of transformation in medical education by enabling a broad understanding of individuals, their relationships and their ways of living in the world.摘要 近年来，医学培训始终是各类讨论与政策的核心议题。尽管巴西医学教育在课程与教学方法层面均经历了发展变革，但为保障全面且兼具人文性的医学教育，仍存在诸多亟需填补的重要空白。显而易见，仅变革教学方法与课程体系远远不够，引导学生进入反思空间至关重要——此类空间可对学生的「存在世界」产生积极影响。打造此类空间的可行工具之一为大学拓展项目（university extension programs），其被定义为一种跨学科的教育、文化、科学与政治实践过程，能够推动大学与社会最广泛的群体开展互动，并实现双方的共同变革。据此，本文基于参与项目的10名医学生的主观感知，呈现并分析了一项基于大众健康教育（Popular Health Education）、在巴伊亚州（Bahia）内陆地区某定居点开展的拓展实践活动对医学生培训产生的影响。研究采用内容分析法，对参与「社会参与与健康权：巴伊亚州（Bahia）某定居点的跨部门规划、艺术、社会动员与大众教育」项目的10名医学生的实地日记与半结构化访谈资料进行分析。研究结果显示，传统医学教育往往忽视了个体的全部潜能，以及其所处的社会、政治与文化语境；现有课程几乎无法提供真正的社区实践机会，实践活动常被局限于医院场景；同时，医学生与其他本科专业学生开展交流与对话的机会寥寥无几。综上，本研究得出结论：大学拓展项目可帮助学习者全面理解个体、个体间的关系以及个体的生存方式，从而推动医学教育实现重要变革。