de Carvalho Filho Marco Antonio, Hafferty Frederic William
Wenckebach Institute for Education and Training (WIOO), LEARN - Lifelong Education and Assessment Research Network, University Medical Centre Groningen, University of Groningen, Netherlands.
Center for Professionalism and the Future of Medicine, Accreditation Council for Graduate Medical Education, Chicago, Illinois, USA.
Med Educ. 2025 Jan;59(1):37-45. doi: 10.1111/medu.15486. Epub 2024 Aug 1.
In this article, we propose developing a "pedagogy of connection" based on the history and evolution of medical education in Brazil. This pedagogy emerged from the intersection of the healthcare and higher educational systems, both dedicated to the principles of social justice and universal access, in response to the country's efforts to address the enduring impacts of slavery and social inequality. Following the "Sanitary Reformation" movement-a foundational moment for Brazil's healthcare and medical education systems-Brazil established the Unified Public Healthcare System (Sistema Único de Saúde - SUS). SUS is founded on principles of universality, integrality, equity, community participation, political and administrative decentralisation, hierarchisation and regionalisation. Aligned with these core principles and inspired by critical pedagogy, Brazilian medical education has evolved with a profound commitment to social justice, critical consciousness, professional presence and compassion. This evolution has given rise to a "pedagogy of connection," which imbues medical education with a sense of purpose and joy, preparing future medical professionals to address the challenges of our ever-evolving society and healthcare systems. The connections fostered by this pedagogy occur in complementary dimensions: (a) healthcare system and society, (b) community, (c) profession, (d) patients, and (e) ourselves. This innovative pedagogy enhances medical education discourse and practice by emphasising the development of a professional identity grounded in social justice and patient-centred care, which remain challenges for current medical education systems. As the global medical education community embraces decolonisation, this pedagogy offers a framework that can be adapted and enriched in various contexts worldwide, fostering opportunities for mutual learning from diverse educational systems in a dialogical and democratic manner.
在本文中，我们提议基于巴西医学教育的历史与演变来发展一种“连接式教学法”。这种教学法源自医疗保健系统与高等教育系统的交叉融合，这两个系统都致力于社会正义和普遍可及性原则，以回应该国应对奴隶制和社会不平等的持久影响所做的努力。继“卫生改革”运动（巴西医疗保健和医学教育系统的一个奠基时刻）之后，巴西建立了统一的公共医疗保健系统（Sistema Único de Saúde - SUS）。SUS 基于普遍性、整体性、公平性、社区参与、政治和行政分权、层级化和区域化原则建立。与这些核心原则相一致，并受批判教育学的启发，巴西医学教育在对社会正义、批判意识、专业素养和同情心的深刻承诺中不断发展。这种演变催生了一种“连接式教学法”，它赋予医学教育一种使命感和愉悦感，使未来的医学专业人员能够应对不断发展的社会和医疗保健系统所面临的挑战。这种教学法所促进的连接存在于互补的维度：（a）医疗保健系统与社会，（b）社区，（c）专业，（d）患者，以及（e）我们自身。这种创新的教学法通过强调以社会正义和以患者为中心的护理为基础发展专业身份，提升了医学教育的话语和实践，而这仍然是当前医学教育系统面临的挑战。随着全球医学教育界接受去殖民化，这种教学法提供了一个框架，可在全球各种背景下进行调整和丰富，以对话和民主的方式促进从不同教育系统相互学习的机会。
