Transformative Education
for Health Professionals

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Integrating the social determinants of health into health workforce education and training

Simone Tetu Moysés, Samuel Jorge Moysés

To develop professional skills to tackle inequalities in oral health has been a major educational challenge in the world and in Brazil.

The literature emphasizes that it is critical to oral health promotion and equity a competent workforce, which means having the knowledge and abilities to recognize and to address the social underlying determinants of oral health. As such, it includes translating policies, theories and research into innovative and effective action (1).

Full project description: 

The Brazilian Ministry of Education established in 2002 a comprehensive framework that led the National Guidelines for Undergraduate Courses as a whole (BRAZIL 2002). In the health field, such Guidelines pointed out the need for professionals trained in the “real-world”, that is to say the health-working environment. In this context, the training should refer to the Brazilian National Unified Health System (SUS) as a priority setting for learning and practice.

The SUS is structured as a universal and equitable health system that articulates a network of complex services and programs developed by multidisciplinary teams, with priority to Primary Health Care and Family Health, thus providing opportunities for training in a critical and thoughtful perspective; it links theory and practice, taking into account the social determinants of oral health and disease.

Therefore, the students can understand their social responsibility and commitment to health and equity. The Guidelines also propose the use of active and participatory learning approaches, which requires teachers with a comprehensive public health training that allows guiding the students on population health issues and equity promotion strategies (ABENO 2016).

Integrating professional education and health determinants

As part of the Dental School Educational Project at the Pontifical Catholic University of Parana (PUCPR), located in the city of Curitiba, in Southern Brazil, and following the above-mentioned National Guidelines, students must meet the curricular internship activities in the Public Health disciplines. Since the year 2000, PUCPR established a partnership with the Primary Health Care (PHC) services of the City Hall of Curitiba, assuring that this internship occurs in the PHC Health Units network in the city. Its goal is to support the professional training in local communities, adopting multidisciplinary and cross-sector collaboration, addressing priority care for vulnerable groups at the community level.

The pedagogical approach stimulates creative and innovative responses, with effective, evidence-based interventions grounded in the local realities of social exclusion and economic dependence. Students have a shared supervision by university professors and local dental public health professionals for the achievements of their educational objectives as well as of some epidemiological population needs.

Objectives of the internship activities

1. To establish the relationship between the principles of Primary Health Care and Family Health for a comprehensive dental professionals’ education.

2. To recognize structural determinants and inequalities in oral health, including the identification of social vulnerabilities and resources available in the community.

3. To recognize the links between the living conditions of the diverse population groups and their health problems.

4. To establish the relationship between population group epidemiological profile and subjective health needs for the study of familial cases.

5. To systematize local health data and relevant social circumstances, as well as the scientific evidence of effectiveness of actions to promote / protect the oral health of families.

6. To build up an action plan that faces local challenges related to oral health care for families, encompassing social determinants of health, common risk factors for health/disease in a sustainable way.

Educational approach

The educational approach used is the Challenge Based Learning. It creates opportunities for the learning of professional skills through critical thinking, communication, and real problem solving in the course of collaborative work both with cross-sector teams working in the target neighborhood and with the local Health Units teams.

1. (BRAZIL 2002; IUHPE 2007; BARRY 2008; BATTEL-KIRK et al. 2009; WHO 2010; DEPSEY et al. 2011; ABENO 2016)


Simone Moysés and Samuel Moysés, Catholic Universtiy of Parana, School of Life Sciences, Curitiba, Brazil



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