Integration Between Basic and Clinical Sciences as viewed by the Medical Students at UFPR

ABSTRACT

Traditional medical education is historically rooted in French positivism and the Flexner Report, which is currently reflected in the undergraduate division of the clinical and basic science sections. This division has been the object of constant debate over the last decades, making way for other models of medical education to be proposed and developed. There are many aspects of traditional medical education that are criticized, for example that it is excessively mechanistic, biologically and individual-oriented, hospital-centered and that it is geared towards precocious specialization. The disarticulation between the clinical and basic science sections, among these, is often highlighted. This disconnect prevents the content of the basic cycle from being transmitted in such a way as to remain applicable in the clinical section or future medical performance. This research intends to evaluate the integration between these two parts of medical training at the Federal University of Parana (UFPR) from the unique standpoint of the medical student, and assesses its influence on the quality of the education offered. A questionnaire developed by the authors, consisting of questions related to basic science teaching and tables that allow correlations to be made between basic science and clinical science, was applied to students in the last semester of the clinical setting. The tables correlate the disciplines in both individual and group terms in the semesters of the basic science section. Students were also asked to evaluate possible proposals that would increase the articulation between these sections. The main findings were as follows: 63% of students considered that the basic science portion is of key importance to medical pratice; 77°% report dissatisfaction with the teaching; 94% considered that they had assimilated less than 60% of the content taught during the basic science section, and 65% of the students evaluated this assimilated content as not very useful; 52% have thought about quitting medical school, half of them during the basic science period, and, of those, 44% correlate this intention to a lack of integration between the sections. The overall analysis of the connection between the tables demonstrated an insignificant level of integration between 59% of the disciplines. The individualized analysis of the tables, on the other hand, showed that the disciplines of Physiology, for example, were assessed as having an insignificant level of articulation by up to 70% of the students, and when compared to the related clinical disciplines, that same evaluation corresponded to the opinion of up to 44% of the students. Therefore, the basic science seems unable to transmit a suitable learning content that is appropriate for the clinical training. The result of the research reaffirms, through objective and quantitative data, the fragmentation present in the most traditional medicine schools. This paper revises the subject in the national and international setting, demonstrating its breadth, as well as inquiring and proposing approaches that can help in the integration between the sections, reviving key discussions that address the problems related to comprehensive medical education.

KEYWORDS:
Medical Education; Medical Students; Educational Measurement