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：巴西隆德里纳州立大学的医学教育自1998年引入基于问题式学习、面向社区、以学生为中心的重构型课程体系以来，已发生显著变革。近年来，该校健康科学中心历经长期、深入且民主的构建进程，将此类创新成果深度融入教与学的全过程，取得了良好的实践成效。该成果乃是近年依托UNI项目支持所付出诸多努力的结晶，该项目推动了如下核心议题的探索：如何构建医学教育改革方案？如何推动必要变革？如何保障变革长效推进？变革的核心内涵是什么？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，我们仍期望参与这一持续推进——因而必然存在不完善与不足——进程的各方，能够共享从中汲取的宝贵经验，并把握机遇制定策略落实相关改革，同时避免将改革简单化、片面化。