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Three Generations of educational reforms

First: Science based curriculum. Scientific foundation into the medical education.

Doubling of life span. Development of Medicine.

Second: Problem-based instructional innovations

Third: Systems-based to improve health systems performance

New Context, new Challenge: we are talking about the world health and the students life.

The actual and, principally, the new students will encounter a world with 2 basic

characteristics: 1st

: the innumerous gaps and inequities around the world and within our own

country. 2nd

: new health challenges are been present. New demands on health need to be

attended. The university has a important mission in provide those students and futureprofessionals, colleagues in profession, a health universe to practice medicine.

Its been no easy to act outside. Even more is been more difficult to practice medicine. Its a

role of the institutional, either before attend its own wishes, construct, maintain and take care

of the profession and allows the professionals formed by it a certain of good formation and no

doubts about competencies.

The new focus claims not to forget the evolution of medicine and the science below the

evolution. It ask for a new target objective in guarantee this certain of success in medicalpractice, which passes over the completing need for the 21

stcentury health professional and a

role well defined in the health system.

(Better conditions not only for the students, but for the medical teachers too!)

Gaps and inequities: need to share the dramatic health advances. Conditions of the past

century. Continuity of diseases a long time controlled in more affluent populations: infections,

malnutrition, maternity-related health risks.

New health challenge: new infections, environmental and behavioral risks, at a time of rapid

demographic and epidemiological transitions, threaten health security of all. Health systems

worldwide are struggling to keep up, as they become more complex and costly, placing

additional demands on health workers. Chronic diseases more proactive in health-seeking

behavior.

Unprecedented teamwork need for a actual patient management, coordinated across time

and space.

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Face of the health system: knowledge brokers, link people to technology, information and

knowledge. They are also caregivers, communicators, educators, team members, managers,

leaders and policy makers.

Needs: Technical competence, service orientation, driven by ethical commitment and social

accountability. Professional workers.

Lengthy period of education and substantial investment by both the student and society.

Importance of medical education.

Actual education reform is attempting to developed professional competences that are

responsive to changing health needs, overcome professional silos through interprofessional

education, harness information technology-empowered learning, enhance cognitive skills for

critical inquiry and strengthen professional identity and values for health leadership.

Many countries are attempting to extend essential services through the deployment of basic healthworkers, even as millions of people resort to providers without credentials, both traditional and modern.

Consequently, in many countries, postsecondary professional education is absent from thepolicy agenda and is overtaken by emergency or urgent action projects and is regarded as too

costly, irrelevant, or long term.

Education revolution

Alongside the explosive increase in total volume of information need for the 21st

health

professional, there is a equivalent increase in ease of access to it.

the role of universities and other educational institutions needs to be rethought.

Universities and educational institutions are broadening their traditional role as places where

people go to obtain information (eg, by consulting books in libraries or listening to expert

faculty members) to incorporate novel forms of learning that transcend the confines of the

classroom. The next generation of learners needs the capacity to discriminate vast amounts of

information and extract and synthesise knowledge that is necessary for clinical and population-

based decision making. These developments point toward new opportunities for the methods,

means, and meaning of education

Transformative learning -> instructional reform

Three successive levels

Three fundamentals shifts

Fact memorization -> searching, analysis and synthesis for decision making

Achieving core competencies

Creative adoption of global resources and educational models.

Interdependence -> institutional reform

Three fundamentals shifts

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Harmony between education and health systems

Networks of institution

Global preoccupations: flows of education content, teaching resources and

innovations.

Relevance of these thoughts

Improve of population health and quality of life

Role of FMUSP and Medicine in the 21st

century and Brazil politics

This revolution will happens. The FMUSP need to be a leader in this process.