Abstract

Introduction

Higher education, according to the Brazilian Law of Guidelines and Bases for the National Education (LDB), includes, among its purposes, encouraging research and scientific investigation work; promoting the dissemination of cultural, scientific, and technical knowledge; stimulating knowledge of contemporary issues – particularly, the national and regional ones; and promoting university outreach, open to the population’s participation. To serve these purposes, the law highlights the creation and transmission of culture; the development of the view on the human being and the environment in which she/he lives; the communication of knowledge; and the dissemination of the achievements and benefits resulting from cultural creation and scientific and technological research produced at the institution, in addition to the establishment of a reciprocal relationship with society (LDB, art. 43)¹1 Brasil. Presidência da República. Lei nº 9.394, de 20 de dezembro de 1996. Estabelece as diretrizes e bases da educação nacional. Diário Oficial da União. 23 Dez 1996.. Higher education includes, besides undergraduate and graduate education, plans; scientific research programs and projects; artistic works; and university outreach actions. Universities are responsible for programs, courses, and outreach actions open to candidates who meet the requirements established in each case by educational institutions. The university’s social responsibility, under the terms of the Brazilian Federal Constitution, is exercised according to the inseparability of teaching, research, and outreach²2 Brasil. Constituição (1988). Constituição da República Federativa do Brasil. Brasília, DF: Senado Federal; 1988. .

In the case of health, the Opinion issued by the Brazilian National Council of Education (CNE) that inaugurates the proposal of Brazilian National Curriculum Guidelines (DCN) recommends the connection between higher education and health, indicating common general competencies for the educational profiles that include health care within (national and international) contemporary references of professional practice in health, stipulating the strengthening of the connection between theory and practice; and appreciating individual and collective research, as well as internships and participation in outreach activities. The inaugural document was published in 2001 and it addresses the field named as “Health: concept, principle, guidelines and objectives.” Those later opinions, which included undergraduate courses in health, also reaffirmed the importance of the inseparability between teaching, research, and outreach and the need to safeguard this tripod in the structures of undergraduate courses³3 Brasil. Ministério da Educação. Parecer CNE/CES nº 1.133, de 07 de agosto de 2001. Estabelece as diretrizes curriculares nacionais dos cursos de graduação em enfermagem, medicina e nutrição. Diário Oficial da União. 03 Out 2001..

Regarding the interaction university-society, the ‘academic leagues’ (ALs) emerge as a possible space for teaching and learning, since they begin to resurface in the midst of university outreach activities. The ALs emerged in Brazil after the creation of the League to Fight Syphilis, in 1920, at the School of Medicine of the University of São Paulo – the name indicates the, above all, hygienist nature. The purpose of this AL was offering free medical care provided by students, who put into practice the knowledge acquired at the university and, in return, they gained experience and learned by having the reality of the services and the population as a basis⁴4 Burjato Jr D. História da liga de combate à sífilis e a evolução da sífilis na cidade de São Paulo (1920-1995) [dissertação]. São Paulo: Universidade de São Paulo; 1999.. The time when the ALs rose coincided with the period of the Brazilian Military Dictatorship⁵5 Silva JHS, Chiochetta LG, Oliveira LFT, Sousa VO. Implantação de uma liga acadêmica de anatomia: desafios e conquistas. Rev Bras Educ Med. 2015; 39(2):310-315., in which, if there were restricted university students’ knowledge and questioning, there was also great expectation towards the provision of community services with a clinical nature (serving the nation and serving science, focusing on the provision of technical and scientific actions regardless of the notions of health system, public policies, or citizenship in health).

Despite the origin and predominance of medical specialties, the ALs have been present in other courses in the health field and in other knowledge areas. However, despite almost 100 years since the first AL, the scientific literature on the subject is scarce, something which testifies in favor of an analysis of the instrumentality of its use and the prevalence of medical specialties, either due to affiliation with expert organizations or to the ‘altruistic’ provision of public health services. In an integrative review conducted by Cavalcante et al.⁶6 Cavalcante ASP, Vasconcelos MIO, Lira GV, Henriques RLM, Albuquerque INM, Maciel GP, et al. As ligas acadêmicas na área da saúde: lacunas do conhecimento na produção científica brasileira. Rev Bras Educ Med. 2018; 42(1):199-206., only 24 articles were found in the Brazilian databases, the majority of which belonging to medical specialties, such as surgery, orthopedics, anesthesiology, psychiatry, and intensive care medicine. Also, published articles addressing this topic did not reach a consensus on the definition and practices of ALs, stating, however, that they would aim at providing students with an opportunity for practical experience and the acquisition of skills in health care, according to the inseparability of care, research, and technical and scientific growth, covering the notion of convergence between teaching, research, and outreach, too. The ALs may introduce themselves as a ‘transformative space,’ fostering bonds between students, professors, and society, as well as building ties between diverse scenarios of practice and bringing students closer to population segments⁷7 Silva AS, Flores O. Ligas acadêmicas no processo de formação de estudantes. Rev Bras Educ Med. 2015; 39(3):410-425..

In the ALs, the importance and relevance of extracurricular teaching strategies are recognized, seeing that they address perspectives provided for by law and that meet the expectations of connecting the basic education with research and outreach. Considering the lack of information in the literature on the calling and management of ALs, especially when made available to several professional categories – also incorporating interprofessional practices –, it is worth exploring the definition with which professors and students work. To do this, a case study was taken in the health field, according to the experience in the countryside of the State of Ceará, Northeastern Brazil, where the ALs operate and are offered to undergraduate students in Medicine and Nursing. Thus, this study aimed to systematize a contemporary definition of ALs according to the experience of 8 ALs in 2 public universities, involving 2 of the main courses in the health field.

Paths followed

In view of the building of a contemporary definition of ALs, a case study has proven to be promising⁸8 Yin RK. Estudo de caso: planejamento e métodos. 3a ed. Porto Alegre: Bookman; 2015.. As a basis for conducting the study, a qualitative approach was used, by means of documentary analysis, semi-structured interviews, and field observation. The study scenario consisted in the Federal University of Ceará (UFC) and the Ceará State University ‘Vale do Acaraú’ (UVA), more precisely, the 4 ALs of the undergraduate courses in Nursing and the 4 ALs of the undergraduate course in Medicine.

The choice for these 2 courses was due to the fact that they are paradigmatic in health and the oldest ones in the study site. Thus, there was a random selection of 4 Medicine Leagues out of the 17 then active, and the 4 Nursing Leagues active within the data collection period were also included in this study (i.e., an equal number of ALs in each course).

The study participants were 8 professors and 16 students. The professors were the professors’ coordinators of the 4 Nursing Leagues and the 4 Medicine Leagues. The participants (‘league members’) needed to regularly perform activities in ALs for at least 3 months. The league members were undergraduate students, 2 from each league, one of whom was the student’s coordinator. To choose the other league members, a random draw was conducted. The data collection period was from August to November 2017.

For the analysis of documents, the internal rules, the project to create the respective leagues, and the most recent public notice of selection for each league were chosen. For the interviews, a semi-structured script was used, with guiding questions about the definition of ALs and their role in students’ education. The interviews were recorded and later transcribed. For the analysis of documents, a previously systematized guiding script was used. The observation strategy consisted of 3 meetings of each AL, with each observer using a script on the focus of attention to be registered. The data obtained underwent content analysis as proposed by Bardin⁹9 Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011., which consists of the identification of systematic information for building the inference. Relying on the aid of the software NVivo 11, the information from interviews, documents, and field observation was organized, making it possible to categorize data and the analyses.

To protect the participants’ identity, as well as their rights to participate in research involving human beings, the provisions of Resolution No. 466/2012, from the Brazilian National Health Council¹⁰10 Brasil. Ministério da Saúde. Resolução n° 466, de 12 de dezembro de 2012. Aprova diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União. 13 Jun 2013. were observed. The project was submitted to the Research Ethics Committee of the UVA, being granted the Favorable Opinion No. 2,102,883. All participants signed the Brazilian free and informed consent form (TCLE). All efforts needed were mobilized to minimize possible risks of embarrassment in the field or during the interviews. To safeguard the participants’ anonymity, codes relating only to the gathering of each belonging were used, followed by a sequential Roman number.

Characterization of academic leagues

The leagues participating in this study had different periods of existence. The medical ones were created in the years of 2003 – Trauma League –, 2007 – Family and Community Medicine League in Sobral –, 2012 – Academic League of Plastic Surgery in Sobral (LACIPS), and 2013 – Academic League of Otorhinolaryngology and Cervico-Facial Surgery (LOCCF). As for the nursing ones, these started in 2014 –Family Health Nursing League (LESF]) –, 2015 – Adolescent Health Promotion League (LIPSA) and Child Health Interdisciplinary League (LISCRI) –, and 2016 – Urgency and Emergency Nursing League (LENUE). As for the organization and operation, all the leagues had a statute, regulating the activities of their members, dealing with rights and duties, composition of the board or coordination, and the respective different positions. Regarding the objectives, most of them were related to one of the pillars of the educational tripod, others gathered 2 or 3 pillars. Objectives related to interdisciplinarity and social mobilization were also found.

The ALs selected may be divided into the Healthcare Networks, such as those of urgency and emergency care and family health; into life cycles, such as those of child health and adolescent health; and into specialties, such as those of trauma, otolaryngology, and plastic surgery, specific to Medicine. All the ALs under study were linked to the universities’ outreach pro-rectorates, which are responsible for issuing the participation certificates¹¹11 Silva DP, Raimundo ACL, Santos IMR, Gomes NMC, Melo PDCR, Santo DS. Proposição, fundação, implantação e consolidação de uma liga acadêmica. Rev Enferm UFPE online. 2018; 12(5):1486-1492.. Also, regarding the length of stay, the ALs that were linked to the courses in Medicine did not have a final duration time, i.e. the students enter through a selection process and can remain until the end of their undergraduate course. In the ALs linked to the courses in Nursing, there was a predetermined time ranging from 6 months to 1 year, with no interruption of activities throughout the period. The selection processes in the Medicine Leagues take place according to the need to fill vacancies.

The definition of academic leagues

The fact that the ALs consist in university outreach projects was recurrent in the participants’ manifestations and a constant finding in the documents, all of them are linked to the respective outreach pro-rectorates. The ALs were regarded as outreach projects even when they carried out teaching and research activities and had an unlimited duration. University outreach was considered as its pillar of support, playing a role in teaching in terms of deepening both theoretical issues and practical skills; and it improves research, which is guided by development gaps in the theoretical or practical fields during regular teaching hours. The ALs in the health field were defined as outreach projects that stem from the needs of deepening and mastering a certain knowledge area in which, however, gaps in teaching supply or routine learning opportunities are observed, as shown in Figure 1.

The link to university outreach is put into question, however, by the statutes of several ALs¹²12 Universidade Federal de São Carlos. Guia das ligas acadêmicas do curso de medicina da USFCar. São Carlos: UFSCar; 2010.,¹³13 Universidade Federal de São João Del-Rei. Estatuto da liga acadêmica de medicina intensiva da Universidade Federal de São João Del-Rei. Divinópolis: UFSJ; 2009., since they show this link as a qualification program, not being limited to the notion of outreach activities, something which reveals the longitudinality and continuity of the experience in the ALs. The term ‘outreach groups’ would also not represent the ALs, since their link and organicity between discussion and action is strong. The document prepared by the Forum of Outreach Pro-Rectors of Brazilian Public Universities, which has advised the organization and systematization of university outreach, covers under the concept of outreach project the determination of duration terms, i.e. pre-established duration¹⁴14 Fórum de Pró-Reitores de Extensão das Universidades Públicas Brasileiras. Extensão universitária: organização e sistematização. Belo Horizonte: Coopmed; 2007.. The ALs, however, have unlimited duration, longitudinal qualification, and continuity of actions.

The main difference of the ALs is student protagonism. This characteristic has been expressed since its inception and it is one of the key elements for meaningful and autonomous learning¹⁵15 Santos MA, Reis GA, Barros FS, Gomes KR. Projeto VER-SUS/Brasil no estado do Tocantins: protagonismo estudantil em defesa do SUS, da democracia e dos direitos sociais. Expr Ext. 2017; 22(1):22-33.. The ALs’ emergence is marked by recognizing any gap in deepening or thickening deemed necessary by the students themselves. They mobilize around a common intervention objective and, from then on, begin the process of building an AL under the professor oversight.

Specialization was another characteristic found in ALs, something which must be observed by the professors who oversee them, since undergraduate education should provide a generalist qualification¹⁶16 Varela DSS, Carvalho MMB, Barbosa MUF, Silva IZF, Gadelha RRM, Machado MFAS. Diretrizes curriculares nacionais e a formação de profissionais para o SUS. Rev Bras Ens Super. 2016; 6(3):39-43. and demonstrate openness to the specialties needed by the world of work within the health system, and not the anticipation of specialties by the world of specialist corporations.

The ALs should not materialize in spaces of early specialization, despite the fact that they are almost always related to a specialty, and not to an area of social intervention or to a coming together of university-society¹⁷17 Moreira LM, Mennin RHP, Lacaz FAC, Bellini VC. Ligas acadêmicas e formação médica: estudo exploratório numa tradicional escola de medicina. Rev Bras Educ Med. 2019; 43(1):115-125.. In Medicine, for instance, the ALs usually gather students due to the wish for early adherence to the desired specialty in medical residency and prospective specialized professional practice. It is necessary to prepare, during the undergraduate course, professionals aimed at the national health system, with a comprehensive view of the population’s social and regional health needs who can help the sector to provide systemic responses to global issues related to the health-disease-quality of life process.

Opportunities to stimulate students to think and do collaborate with their personal and professional growth, mobilize professional abilities for autonomy, communication, interpretation of reality, and decision-making. Students more engaged in social issues are more receptive to educational changes in higher education and crave strategies that break with the traditional teaching model. The call to action attracts students and entices them to participate in activities that break with the dichotomy theory versus practice¹⁸18 Debald BS, Golfeto NV. Protagonismo estudantil e metodologias ativas de aprendizagem em tempos de transformação na educação superior. Pleiade. 2016; 10(20):5-11.. Furthermore, according to the students, in the ALs they have an opportunity to exercise the idealized professional practice shown in the classroom, but having reduced contact with users and services.

This finding requires caution, since it can have a utilitarian or assistentialist view of the population. The intervention scenarios of ALs need to be taken as spaces for improved learning not only of the technique, but also of social reading, ethical growth, respect for the user, understanding of the system, appropriation of health policies, and building of critical interactions between university, society, and health system. Another major characteristic is that, in this research, what marked the ALs’ concept was their insertion in the reality of the future world of work: discussing reality allows us to learn in a more meaningful way. Also, the continued and engaged presence of students in services encourages professionals in the workplace to reflect on their own professional practices.

In the meetings that took place, usually once a week, it was observed that the subjects were directed to the planning or analysis of teaching, research, and outreach activities, in addition to a discussion about some action that the league members took in the scope of the various health services. Some meetings were related to theoretical alignment on a specific theme important for taking other actions in the ALs participating in this study. Moreover, there were bureaucratic meetings related to discussions about participants’ attendance, public notice of selection, internal rules, among other subjects.

ALs also allow the emergence of collective work: students begin to work in teams and along with various social actors; and they get in touch with students and professionals from different categories, with users and with managers of the services and/or territories in which they carry out their activities. This exercise, based on the encouragement of interprofessional education during the undergraduate course, encourages the adoption of collaborative practices (and praxis) in professional practice. Collaborative action among students allows the sharing of common and specific skills that are important for prospective professional practice¹⁹19 Lima AWS, Alves FAP, Linhares FMP, Costa MV, Coriolano-Marinus MWL, Lima LS. Percepção e manifestação de competências colaborativas em discentes da graduação em saúde. Rev Lat-Am Enfermagem. 2020; 28:e3240..

A major dimension related to ALs was the intersection between the education and professionalization processes in the search of solutions to real problems, as highlighted by Silva and Flores⁷7 Silva AS, Flores O. Ligas acadêmicas no processo de formação de estudantes. Rev Bras Educ Med. 2015; 39(3):410-425.. The ALs are characterized as complementary activities that allow flexible qualification and do not have a focus on a financial, service provision, or scholarship perspective: the objective has been to improve students’ education. The ALs correspond to contemporary models to the so-called active methodologies, such as project-based learning, team-based learning, situated training, in-service learning, learning communities, among others, being a thorough way to relate teaching, knowledge, and what and how to do, processing realities in action and activating creation through exchange²⁰20 Ceccim RB. Coletivos aprendentes e coletivos de prática: das mutações de cenário e das práticas educativas em educação na saúde. In: Santos AM, Bispo Junior JP, Prado NMBL. Caminhos da pesquisa em saúde coletiva no interior do Brasil. Salvador: EdUFBA; 2020. p. 117-135..

The inseparability of theory and practice, as well as between teaching, research, and outreach, is highlighted in the ALs’ proposal²¹21 Daniel E, Zétola PR, Sue CA, Amorim CS. Liga acadêmica de medicina do trabalho: a experiência da Universidade Federal do Paraná. Rev Bras Med Trab. 2018; 16(2):199-203. and it seems to be exemplified not only by the defense of the best professional qualification of undergraduate students, but also of civic education, starting from the implication and commitment to the realities and to the necessary educational changes in the health field. Nevertheless, this inseparability appears as a goal to be pursued in the actions taken by the ALs, in order not to be restricted to the statutes and internal rules, as a utopia to be reached.

University outreach as a key pillar of academic leagues

Based on research, it may be said that the ALs could be one of the strategies to implement the university’s social responsibility²²22 Sobrinho JD. Responsabilidade social da universidade em questão. Avaliação. 2018; 23(3):586-589., according to the dialogue between outreach, teaching, and research; and relying on the potential to be managed by students and for students, in line with the documents issue by the Family Health Nursing League and the Urgency and Emergency Nursing League:

According to the manifestation of students and professors from the Nursing and Medicine Leagues:

The interesting thing about the ALs is that students are driven by the disquiet of problems that they face when they are inserted in the reality of health services and the populations with which they are taking their actions. Studies must be carried out to learn more about this reality or to propose solutions to problems identified in situ. Teaching is an opportunity to improve knowledge on a specific theme of the AL, which has a close relationship with the population or network of services in which they will act as practitioners.

If, on the one hand, many students do not know what university outreach really means, insisting on an assistentialist view¹⁷17 Moreira LM, Mennin RHP, Lacaz FAC, Bellini VC. Ligas acadêmicas e formação médica: estudo exploratório numa tradicional escola de medicina. Rev Bras Educ Med. 2019; 43(1):115-125., on the other hand, they learn through questioning reality, social criticism, problematization and, mainly, contact with the Brazilian National Health System (Sistema Único de Saúde [SUS]), and the population. They recognize that health services are teaching and learning territories and that it is necessary to break with the concept of university outreach as a mere space for dissemination of knowledge and diffusion of cultural events or assistentialism and/or service provision²³23 Ribeiro MA, Cavalcante ASP, Albuquerque IMN, Vasconcelos MIO. A extensão universitária na perspectiva de estudantes de cursos de graduação da área da saúde. Interagir. 2016; 21:55-69.:

In order to overcome the utilitarian view of the population, research can play a major role in expanding education to meet actual social needs. In this sense, it is worth mentioning that students and professors must appreciate the population’s knowledge, recognizing and considering them in health care. Popular education, inserted in the qualification of health professionals, allows us to recognize the previous knowledge both of students and the very population that these students will provide with care later, in a dynamics of appreciating the knowledge and interests of students and the population²⁴24 Vasconcelos EM, Cruz PJSC, Prado EV. A contribuição da Educação Popular para a formação profissional em saúde. Interface (Botucatu). 2016; 20(59):835-838. doi: https://doi.org/10.1590/1807-57622016.0767.
https://doi.org/10.1590/1807-57622016.07... .

The history of the ALs recognizes them as potential spaces for deploying university outreach¹⁷17 Moreira LM, Mennin RHP, Lacaz FAC, Bellini VC. Ligas acadêmicas e formação médica: estudo exploratório numa tradicional escola de medicina. Rev Bras Educ Med. 2019; 43(1):115-125. and it is in line with the Brazilian National Education Plan (Plano Nacional de Educação [PNE]), which requires that at least 10% of the undergraduate curricular credits are allocated to outreach²⁵25 Brasil. Presidência da República. Lei nº 13.005, de 25 de junho de 2014. Aprova o Plano Nacional de Educação (PNE) e dá outras providências. Diário Oficial da União. 26 Jun 2014..

The challenging role of professors as learning mediators in the academic leagues and student protagonism on the scene

Professors’ role in ALs consists in facilitating/mediating learning. A professor must provide practical, theoretical, and pedagogical support in the ALs; mobilize students; and encourage them to learn through their practical and social insertion:

The ethico-political commitment of professors contributes to build a more meaningful learning¹⁸18 Debald BS, Golfeto NV. Protagonismo estudantil e metodologias ativas de aprendizagem em tempos de transformação na educação superior. Pleiade. 2016; 10(20):5-11.,²⁶26 Rios GM, Ghelli KGM, Silveira LM. Qualidades de um professor universitário: perfil e concepções de prática educativa. Ensino Rev. 2016; 23(1):135-154., as well as their ability to connect theory and practice, ethics and technique, and their competence and ability to relate contribute to charm and raise awareness among students. They must serve, then, as a set in which one relates dialogically with the other so that co-responsibility exists in teaching and learning processes.

The ALs allow for a break with the traditional teaching model and with the characteristic hierarchy between students and professors. A professor has no ascending place over students and he becomes the member who, despite having more experience, learns along with the student. The latter is encouraged to increase her/his autonomy by having her/his proactivity as a basis. Here, the imagery of the professor as “owner of the specialist chair” and the students as “disciples of the specialist chair” vanish.

Students organize their activities based on the learning needs they encounter when faced with the reality in which they are inserted:

The improvement of skills is important so that students sharpen their creativity when building solutions to real problems. It was found that students become decision makers, in addition to exercising teamwork, something which provides experience in dealing with conflicts of pedagogical relevance. The professors’ role, however, is not always effective, and this can weaken the operation and effectiveness of the ALs²⁷27 Silva SA. As perspectivas das ligas acadêmicas no processo de formação dos estudantes de saúde na Universidade de Brasília [dissertação]. Brasília: Instituto de Psicologia da Universidade de Brasília; 2013.. In the ALs under study, there were cases in which the advising professors were not present, being only a means to reach the ALs’ registration at the educational institution, with no participation in the organization and meetings:

Professors need to self-assess their role and their commitment to students. A professor’s self-assessment enables the improvement of pedagogical practices and, consequently, of the teaching-learning process²⁸28 Ferreira CA, Oliveira C. Auto-avaliação docente e melhoria das práticas pedagógicas: percepções de professores portugueses. Estud Avaliação Educ. 2015; 26(63):806-836.. When she/he accepts to coordinate an AL, a professor also accepts the responsibility for carrying out its activities, especially that of supporting student learning. The professors recalled that they did not experience this format of activity during their undergraduate courses and that they often learn about the operation and management of the ALs along with the demanding students:

Professors and students learn and work together. They learn to operate and experience the AL collectively. The professors’ lack of preparation also reveals the university’s weakness when it comes to outreach, a lack of preparation that may reflect detachment from the need to update the ways of teaching and investigating at the university.

Conclusion

Based on the study, belonging to 2 public universities regarded as important – 1 federal and 1 state institutions –, both with campuses in the countryside of the State of Ceará, a region where social and regional needs are apparent, a characteristic of Northeastern Brazil, these ALs may be defined as undergraduate student groups organized under direct and indirect professor oversight as a regular longitudinal university outreach program, with intellectual and practical support from the university and the service network; and being driven by learning and scientific, technological, and political development of a specific theme contained in the respective alumni profile provided for and documented in the DCN.

The ALs, which prioritize the knowledge and professional domains that the world of work need and/or the performance in a specific profession aimed at meeting social needs, represent complementary teaching activities and are consistent with the Brazilian higher education legislation. Also, the ALs are aligned to the national proposal for university outreach and they offer opportunities for applied research, engagement in university research groups, in groups aimed at research, development, and innovation regarding methodologies, and in social action groups. The ALs, in the health field, connect the university and society, as well as the local, regional, and national health systems.

Despite being often configured as particular outreach projects, specific intervention projects of certain research groups or exceptional teaching loci – as a scenario for practice, internship, curricular internship, or undergraduate experience – the ALs are a face of university social responsibility and co-responsibility between professors and students, belonging to a theme, interconnecting teaching, research, and outreach; connecting theories and practices; enabling the sharing of knowledge and skills; and bridging the learning gaps in strategic fields regarding the provision of personnel in the health system, either under the aspects of clinical care, management, assessment, or continued health education.

The definition of AL extracted from this study allows students and professors to propose, conduct, or deploy such an initiative; and ask for resources, covenants, and partnerships not only in Medicine, but also in the other undergraduate courses in health sciences and in interprofessional education projects. Such a definition can also contribute to the regulation and control of ALs; to the emergence of policies encouraging their creation, remodeling, or extinction; to the preparation of leaders; and to prospect innovations in university-society interactions, bringing limited or fragmented modalities to an end.

Acknowledgments

To the Laboratory of Social Research, Transformative Education, and Collective Health (Laboratório de Pesquisa Social, Educação Transformadora e Saúde Coletiva [LABSUS]) of the Ceará State University ‘Vale do Acaraú’ (UVA); to the Brazilian Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [CAPES]) for the granting of a Master’s and Ph.D. scholarship to Ana Suelen Pedroza Cavalcante; to the Brazilian National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico [CNPq]) for the granting of a scientific initiation scholarship to Gabriel Pereira Maciel.

References

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