Fatel Quécia H, Silva Flávia Gm, Avena Katia M, Menezes Rodrigo C, Andrade Bruno B, Quintanilha Luiz F
Salvador University (UNIFACS), Salvador, Brazil.
Clariens Educação, São Paulo, Brazil.
J Med Educ Curric Dev. 2025 Jul 30;12:23821205251360521. doi: 10.1177/23821205251360521. eCollection 2025 Jan-Dec.
Education holds transformative power in society, driving economic and social development. In medical education, training quality leads to well-prepared physicians and directly impacts patient care. In Brazil, a key measure of medical training quality is the National Student Performance Exam (Enade). This study aims to analyze the institutional, social, and economic determinants of the quality of medical education in Brazil through Enade scores.
An ecological study was conducted with all Brazilian higher education institutions participating in the Enade for the Medicine undergraduate course in the last 5 editions. Group comparisons and a multivariable logistic regression model were conducted to examine the associations between institutional, social, and economic aspects with the Enade score, categorizing institutions into high and low/medium score groups.
Considering all editions, the average Enade score of medical schools in Brazil was 2.8. Geographic location was a determining factor of Enade results. The highest proportion of high scores was observed in South (62.4%) and Central-West (57.3%) regions, and low scores in the North (76.4%), Southeast (64.1%), and Northeast (52.6%). The proportion of medical schools with high Enade scores increased over time ( < .001), and they demonstrated significantly higher performance in general knowledge tests (+10.6%; 64.4 vs 58.20) and specific knowledge tests (+16.0%; 65.4 vs 56.4). Institutional factors associated with better student performance in Enade included a well-rated didactic-pedagogical organization (odds ratio [OR]: 1.62 [confidence interval (CI): 1.10-2.40]), a more qualified faculty (OR: 1.81 [CI: 1.27-2.59]), and being publicly administered (OR: 5.74 [CI: 3.44-9.95]).
This study highlights significant variations in training quality among medical schools nationwide, with the Center-South region showing a higher proportion of institutions achieving high Enade scores compared to more socioeconomically vulnerable regions in Brazil. Institutional characteristics such as well-rated didactic-pedagogical organization, a highly qualified faculty, and public administration are associated with better exam performance.
教育在社会中具有变革力量，推动经济和社会发展。在医学教育中，培训质量造就准备充分的医生，并直接影响患者护理。在巴西，医学培训质量的一项关键衡量标准是全国学生成绩考试（Enade）。本研究旨在通过Enade分数分析巴西医学教育质量的机构、社会和经济决定因素。
对过去5届参加医学本科课程Enade考试的所有巴西高等教育机构进行了一项生态研究。进行了组间比较和多变量逻辑回归模型，以检验机构、社会和经济方面与Enade分数之间的关联，将机构分为高分和低分/中等分数组。
考虑所有年份，巴西医学院校的Enade平均分数为2.8。地理位置是Enade成绩的一个决定因素。在南部（62.4%）和中西部（57.3%）地区观察到高分比例最高，而在北部（76.4%）、东南部（64.1%）和东北部（52.6%）地区分数较低。Enade高分医学院校的比例随时间增加（<0.001），并且它们在常识测试（+10.6%；64.4对58.20）和专业知识测试（+16.0%；65.4对56.4）中表现明显更好。与学生在Enade考试中取得更好成绩相关的机构因素包括教学组织评价良好（优势比[OR]：1.62[置信区间(CI)：1.10 - 2.40]）、师资更合格（OR：1.81[CI：1.27 - 2.59]）以及由公立管理（OR：5.74[CI：3.44 - 9.95]）。
本研究突出了全国医学院校培训质量的显著差异，与巴西社会经济较脆弱地区相比，中南地区达到Enade高分的机构比例更高。教学组织评价良好、师资高素质和公立管理等机构特征与更好的考试成绩相关。
