Pediatrics teaching in primary heath care: between the boundaries of the biomedical model and the perspective of integrality of care - a case study


Alice Yamashita Prearo

Tese (Doutorado), setembro de 2007, Programa de Pós-Graduação do Departamento de Pediatria, área de concentração Pediatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (FMBUnesp) <>



Key Words:Medical education. Pediatrics. Primary health care. Case study.



The present work was a study about medical education, focusing on the experience of Pediatrics teaching in primary heath care, and had the objective of analyzing the contribution of the discipline Social and Community Pediatrics in the 4º year of Medicine course at Botucatu Medical School (Faculdade de Medicina de Botucatu FMB) to the teaching that aims at the integrality of care. The quantitative research methodology was used, having the case study as strategy. The analysis method used in this work was grounded on the theorical framework of the social-historical approach, subsidized by Vigotski's studies. The relevance of the study is justified by the effort of the discipline Social and Community Pediatrics has been developing to contribute to the diversification of teaching-learning scenarios, playing its role as representative of the innovation of the Pediatrics course at FMB. The present work allowed analyzing what discipline formulator teachers, discipline supervisor doctors and the fourth-year undergraduate students consider to be relevant learning for the professional in health, which could only have been reached by its insertion into the services of primary care; identify the supervisor doctors' contribution to seek answers to questions that come from pediatric assistance in primary care; identify the supervisor doctors' contribution to the mediation process so that students can reach a learning level which they could not reach by themselves; and, furthermore, identify the importance of the students' role in their relation with the other members of the team. The interviews with the teachers and the doctors, written down and analyzed, and the analysis of the written tests taken by the students reveal signification kernels which are common to all these actors: the importance of the diversification of teaching-learning scenarios, of learning the main health problems, of learning about the possibility of multi professional group work, of the integrality in childcare, with emphasis on the bond and on the experience in the community as an opportunity to learn about prevention and health promotion. This analysis allowed realizing that the challenge created by the curricular directives of the Medicine course, for the formation of a professional that's able to work in the Unified Health System (Sistema Único de Saúde SUS), requires integration of disciplines in a political pedagogical project, to be continuously reviewed. Social Pediatrics can contribute to this process and, above all, that the integration with the community and the teaching of primary care must constitute a transversal axis of the course.



Recebido em 23/10/07. Aprovado em 25/10/07.

UNESP Botucatu - SP - Brazil