Iniquidades sociais e os cenários de ensino-aprendizagem em um curso médico da Bahia.

Abstract

Professional training in health must be aligned with assumptions that correspond to society's expectations and needs, with equity as a structuring principle. The teaching-learning scenarios of medical courses are spaces capable of generating experiences that bring students closer to the health needs of the population or the reproduction of social inequities. As a general objective, we sought to analyze the contribution of scenarios and practices to the teaching-learning process in a medical course, taking into account the promotion of equity or inequities in health. For this, qualitative research was carried out, in which the stages of document analysis, semi-structured interviews and focus groups were integrated, contemplating the perspectives of teachers, preceptors and students in relation to the study theme. A medical course at a public university in the state of Bahia (BA) was chosen to participate in this research and the teaching-learning scenario selected was a teaching hospital linked to this institution. Regarding ethical aspects, this research is in accordance with Resolutions nº 466/2012 and nº 510/2016 of the Conselho Nacional de Saúde (CNS), which regulate the ethical principles of research with human beings, ensuring the rights and duties of researchers and participants, and was submitted to the Comitê de Ética em Pesquisa (CEP) of the Instituto de Saúde Coletiva of the Universidade Federal da Bahia, approved under opinion 5.790.707. As results and discussion, in the documentary analysis, pedagogical and normative aspects contained in documents such as the Pedagogical Project of the Course and the Syllabus were identified, observing an alignment with the Diretrizes Curriculares para o Curso de Medicina de 2014; the deepening regarding equity and inequities in health occurred through interviews with preceptors and teachers and the focus group with medical students, who carried out activities in the teaching-learning scenario chosen for the investigation. The analysis plan articulated theoretical categories and empirical results, supported by the content analysis strategy. At this stage, an active experience of practices in the teaching-learning scenario studied was initially identified, through the understanding of subcategories such as “activities carried out by students”, “development of skills and competencies”, “experience”, “training with quality”, “multidisciplinary work” and “autonomy”. Next, the main perceptions of the research participants regarding the promotion of equity or inequities in health were presented, based on the day-to-day experience in the teaching-learning scenario, being evidenced in the analysis categories called “the perception of needs of health”, “the perception of equity and inequities” and “the perception of quality-equity”. Given the centrality of the study participants in the training process, the main challenges experienced and overcoming strategies perceived in the teaching-learning scenarios were also presented. As final considerations, equity was perceived in multiple statements in a manner consistent with the theoretical framework adopted in this work. Despite this, students still live with practices that generate inequities in health and challenges persist in overcoming these practices, which reinforces the need for greater attention to medical training and confronting inequalities, so that they do not reproduce inequities.