Consenso docente sobre competências em saúde bucal coletiva a serem desenvolvidas na graduação em instituições de ensino superior brasileiras

Abstract

The training in Dentistry, historically, proved to be technicist, fragmented, focused on the disease, under the strong influence of the Flexinerian teaching model. The National Curriculum Guidelines (NCG) for the undergraduate course in Dentistry brought the proposal of a critical, reflective, generalist training, with a focus on comprehensive health care, in addition to teaching by competences. The curricular structure must contemplate the ethical, humanistic and social dimensions, directed to citizenship and human rights, characteristics that insert the area of Collective Health as a longitudinal axis of the teaching-learning process. This study has a descriptive, cross-sectional character, with a quantitative approach and aims to identify the competencies to be developed in undergraduate courses in the area of Collective Oral Health (COH), in the view of professors from Brazilian Higher Education Institutions (HEI). The participants were professors from 49 HEI (37 public and 12 private) with grade four or five in the National Student Performance Exam in 2019, in an initial sample of 236 professors. The Delphi technique was used, developed in three rounds. The degree of agreement was set at 70% or more. In the first stage, an instrument was developed to collect data on knowledge, skills and attitudes based on data from previous qualitative research with professors and preceptors at the Federal University of Goiás (UFG). A fourpoint Likert scale and an open question were used for teachers' suggestions about each competence. This stage presented 71 respondents. In the second stage, with 49 respondents, a questionnaire with closed questions was used, composed of the skills already presented in the first stage, plus the suggestions most cited by the participants, using the four-point Likert scale. In the third stage, with 24 participants, professors were asked to express their opinion of maintaining or excluding the analyzed question, in addition to requesting suggestions for the improvement of a competence matrix. The relative frequencies of each answer were calculated to verify if the consensus was reached in each step and the internal consistency was measured by Cronbach's Alpha. Among the most cited knowledge, there are social determinants of health and health promotion. Regarding skills, teamwork and recognizing local vulnerabilities are mentioned. Among the most cited attitudes, there is autonomy and exercising leadership in the health team. The competencies identified relate the Unified Health System (SUS) as an integral part of the training process and stimulate understanding of the health-disease process and social health needs. The contribution of practices in Collective Health to training in Dentistry reveals new ways of training and educating in health, with the consideration of social determinants in health and new teaching paradigms beyond the technicist. It is concluded that, by the teaching consensus, it was possible to establish knowledge, skills and attitudes that must be developed in the undergraduate course by the SBC area and that these are aligned with the proposals of the NCG and the principles and guidelines of the SUS. The competencies identified reflected the prevailing view of professors from public HEI, Institutions that represent the smallest part of the Brazilian HEI that offer the undergraduate course in Dentistry, highlighting the need for more studies on the subject, which include strategies for joining the research of more professors from private HEI. As a technical product, this study presents a proposal for a competency matrix to collaborate in improving the conduction of the discipline within the scope of HEI.