Medical rationalities: evaluation of optional component in medical training

Abstract: Introduction: Overcoming the global crisis of the biomedical paradigm has promoted the insertion of Traditional Medicine in public health systems in many countries. Brazil is at the forefront of this movement, and since the launch of the National Policy on Integrative and Complementary Practices in 2006, it has officially included practices in the health care offered by the SUS. However, low qualification in this area of the professionals who work for the SUS, has hindered the levels of resolution in these services. One of the major challenges is training professionals who would be sensitive to health practices from other cultures and follow a vitalist paradigm. The study hypothesis is that the inclusion of socio-historical-epistemological content of Medical Rationalities during professional training can introduce an effective articulation between different medicines, promoting integrated knowledge. Objective: To assess the interest of academics in the topic, which carries little recognition in medical courses in Brazil but has been increasingly valued and incorporated into medical education in many countries. Method: This is a mixed-approach study. The qualitative analysis was organized by exploring the data collected with open-ended questions applied to students on the first day of classes and at the end of the course. The cross-sectional analysis was performed using information collected in a closed questionnaire applied to students. Result: Considering the questions presented to students at the beginning and the end of the component, expectations were exceeded, with very high assessment levels achieved at the end. The study participants showed interest in new knowledge in the training period. The analyses allow us to assert that including this theme sharpens critical reflection on the paradigms, even though it is presented vertically, punctually, and with an informative character, in the context of the course. There was great interest from participants in disciplines that addressed this scientific field. Conclusion: There are good prospects for the integration and complementarity of new knowledge and health practices in medical education in the reality of the studied course.

摘要：
背景：克服生物医学范式带来的全球危机，推动传统医学被纳入多国公共卫生体系。巴西在此进程中居于前沿，自2006年《整合与补充实践国家政策》发布以来，该国已通过巴西统一健康体系（SUS）正式将相关实践纳入官方医疗服务范畴。然而，巴西统一健康体系在职从业人员在该领域的专业资质不足，制约了相关服务的诊疗效能。当前核心挑战之一，是培养能够兼容异质文化健康实践、秉持生机论范式的专业医疗人才。本研究提出假说：在专业人才培养阶段融入医学理性的社会-历史-认识论内容，可有效实现不同医学体系间的有机衔接，推动整合式知识体系的构建。

研究目的：评估医学专业师生对该主题的关注度。该主题在巴西医学课程中认可度较低，但在全球多国的医学教育中已愈发受到重视并得到广泛融入。

研究方法：本研究采用混合研究范式。质性分析环节通过开放式问卷采集数据，分别于该课程单元首日与课程结束时对学生开展调研；横断面分析则基于封闭式问卷收集的学生信息完成。

研究结果：对比该课程单元首日与课程结束时向学生提出的调研问题，本次教学的实际效果超出预期，课程结束时学生的评价评分极高。参与本研究的学员在培训周期内展现出对新知识的浓厚兴趣。分析结果表明，尽管本课程中该主题的讲授方式为垂直式、单点式且以信息传递为主，但纳入该主题仍可强化学员对不同医学范式的批判性反思。此外，学员对涉及该科学领域的相关课程表现出极高的学习兴趣。

研究结论：在本次研究覆盖的医学教育场景中，新知识与健康实践的整合与互补具备良好的发展前景。