Role of management and human resource factors on matrix support in secondary oral health care in Brazil.

OBJECTIVES: To investigate the association between health management and human resource factors on matrix support (MS) in a nationally representative sample of Dental Specialty Centres (DSCs) in Brazil. METHODS: This survey included 1042 DSCs (Response rate = 94.99%) in the second cycle of the National Program for the Improvement of the Quality and Access to the Dental Specialty Centres (PMAQ-CEO, in Portuguese) in 2018. Previously trained interviewers extracted information on MS, health management and human resources of the DSC by using a structured instrument. An MS score was created by adding the number of positive answers to the 10 MS questions. Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios (RR) and corresponding 95% confidence interval (CI). RESULTS: Of all the DSCs (n = 1042), 116 (11.1%) performed all 10 MS procedures. Those DSCs with a manager who had a higher education degree in the area of Public Health or Public Management (RR = 1.01, 95% CI, 1.01-1.02) and with human resources that received incentives, bonuses or financial awards for performance related to the PMAQ-CEO result (RR = 1.01 95% CI 1.01-1.02) are more likely to perform MS, when compared to the reference categories. The DSCs that are more likely to perform MS include those that developed actions as a result of periodic planning and evaluation with confirmatory documentation (RR = 1.06, 95% CI; 1.01-1.10); those that received support for planning and organizing the work scheme (RR = 1.03, 95% CI; 1.01-1.05); those that monitored and analysed the goals set for each specialty offered at the DSC, with (RR = 1.06, 95% CI; 1.01-1.10) or without confirmatory documentation (RR = 1.06, 95%CI; 1.02-1.11); those whose team periodically performed self-assessment processes, using the Ministry of Health's formal self-assessment (AMAQ in Portuguese) (RR = 1.04, 95% CI; 1.02-1.05); those who followed clinical guidelines (with confirmatory documentation) regarding the referral of patients from primary care to the DSC (RR = 1.02, 95% CI; 1.01-1.04). On the contrary, DSCs that did not use the results achieved in previous PMAQ cycles in the organization of the DSC's team work scheme proved to be less likely to perform MS (RR = 0.98, 95% CI; 0.96-0.99). CONCLUSIONS: Matrix support is associated with human resources and management factors in secondary oral health care in Brazil. Continuing professional development and some management characteristics are important for secondary dental care quality and could be considered in health policy initiatives.

COVID-19 Morbidity Among Oral Health Professionals in Brazil.

BACKGROUND: We evaluated and compared the cumulative incidence of confirmed COVID-19 cases between oral health professionals and the general population in Brazil. METHODS: Secondary data from notification of laboratory unconfirmed and confirmed cases of COVID-19 in the National data system for 41 epidemiological weeks were analysed and compared between oral health professionals (dentist + oral health technicians/assistants) and the general population. The cumulative incidences of COVID-19 were obtained by the ratio of the total number of confirmed cases to the total Brazilian population or the population of oral health professionals registered with the Federal Council of Dentistry and adjusted by age. The incidences were then compared. RESULTS: The age-standardised cumulative incidences were 18.70/1000 for oral health professionals and 17.71/1000 for the population, with a ratio of 1.05. The highest incidences were observed in the states of Roraima (67.05/1000), Tocantins (58.81/1000), and Amazonas (58.24/1000). In 14 states, the age-standardised cumulative incidences were higher among oral health professionals than in the general population. There was a decrease in the number of new cases between the 29th and 30th epidemiological weeks in both populations. CONCLUSIONS: COVID-19 infections among oral health professionals was similar to that of the general population. However, the cumulative incidence was 5% higher among oral health professionals, varying among Brazilian states. PRACTICAL IMPLICATIONS: Infection control practices might help lower the risk of contamination in dental settings.

User satisfaction with the secondary dental care services: Is there an association between structure and work process?

OBJECTIVE: To assess the association between user satisfaction in relation to secondary dental care services and the structure and process of Brazilian Dental Specialty Centers (CEO, in Portuguese). METHODS: This study used nationwide secondary data from two CEO evaluation cycles. Ten users from each CEO answered questions on the self-perception of healthcare quality and satisfaction with health services. Latent class analysis (LCA) was performed to identify subgroups of satisfied and dissatisfied users (outcome). The CEO structure included equipment, supplies, instruments, ambience and type of CEO (type I, II or III, according to the number of dental chairs and dental professionals). The work process referred to the planning/monitoring of actions, collaborative care, characteristics of the demand for medical care /the organization of scheduling, and continuing education for employees. Covariables concerned user profiles. A multilevel logistic regression model was used (p-value <.05). RESULTS: Seven thousand nine hundred and ninety-seven users in 794 CEOs, together with 10056 users in 911 CEOs, participated in the 1st and 2nd evaluation cycles, and satisfied users corresponded to 85.3% and 87.1%, respectively. In both cycles, the CEO's structural characteristics explained most of the variance in satisfaction. CEOs with more favourable structural characteristics showed higher satisfaction. Users from CEOs, type II and III, and those who received dental care where there was an interruption of services due to a lack of equipment or instruments reported a lower level of satisfaction. CEOs that organize their demand through referrals received from primary care dentists who have participated in continuing education actions for dental professionals presented a higher frequency of satisfied users. CONCLUSIONS: Characteristics of the process and structure were associated with user satisfaction, but a quality of care was perceived by users, mainly due to structural characteristics.

Primary dental care evaluation in Brazil: an item response theory approach.

OBJECTIVES: Item response theory (IRT) is a method used to design, analyze, and score tests, questionnaires, and similar instruments measuring abilities, attitudes, or other variables. The aim of this study was to assess the psychometric properties of dental care questions in the "Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica-PMAQ-AB," Brazil, using IRT. METHODS: Dentists in primary health care units in Brazil (n = 12,403) were interviewed face-to-face using a structured questionnaire. The questions were primarily dichotomous, with a no answer/do not know option. The items about dental care from a Brazilian national evaluation survey were analyzed using the IRT model (20 items). Oral health teams (OHTs) received scores that varied from the lowest performance level to the highest performance level. Scores for the Brazilian states and the Federal District were calculated to evaluate the regional distribution of OHT performance. RESULTS: The questions about dental care exhibited higher discrimination power for OHTs with below average performance. In general, the teams, including those with low performance, performed the actions, and procedures included in the questionnaire. Actions such as making prostheses and tracking and monitoring oral cancer cases characterized the high-performing teams. The performance of the teams distributed throughout the Brazilian states indicated that OHTs in the south and southeast performed better than OHTs in the rest of the country. CONCLUSIONS: Although the analyzed items are insufficient to determine the performance of OHTs, the items related to prosthesis and oral cancer tend to discriminate high-performing OHTs from other OHTs.

O papel do preceptor na formação profissional em serviço de saúde / The role of the preceptor in professional training in health services

O estudo objetivou avaliar o papel do preceptor na formação do estudante de Odontologia na disciplina "Estágio Supervisionado em Odontologia" da Faculdade de Odontologia da UFMG. Foi utilizado um questionário com questões abertas e fechadas sobre as experiências e impressões dos estudantes, professores e preceptores de seis campos de estágio localizados em Belo Horizonte. Onze estudantes, dez preceptores e quatro professores participaram deste estudo. Todos os alunos e professores e 50% dos preceptores consideram que a preceptoria faz parte das atribuições do profissional de saúde. A maioria dos atores afirmou que o profissional de saúde se sente motivado e preparado para atuar como preceptor. Todos os atores consideraram importante a participação do estudante em estágios em serviços de saúde durante a formação profissional e afirmaram que o preceptor tem conhecimento sobre os objetivos da disciplina. Apenas 20% dos preceptores afirmaram que já participaram de curso de capacitação de preceptoria e 80% manifestaram interesse em participar. A percepção dos participantes sobre o papel do preceptor na formação do profissional de saúde foi positiva. Alguns preceptores não têm consciência de que a preceptoria faz parte de sua atribuição como profissional da saúde. São necessárias ações que busquem capacitar e conscientizar os preceptores do seu papel na formação dos futuros profissionais de saúde (AU).

The study aimed to evaluate the role of the preceptor in the training of dentistry students in the discipline "Supervised Internship in Dentistry" at the Faculty of Dentistry at UFMG.A questionnaire with open and closed questions about the experiences and impressions of students, teachers and tutors from six internship fields located in Belo Horizonte was used. Eleven students, ten preceptors and four professors participated in this study. All students and professors and 50% of preceptors consider that preceptorship is part of the health professional's attributions. Most actors stated that the health professional feels motivated and prepared to act as a preceptor. All actors consideredimportant the student's participation in internships in health services during professional training and stated that the preceptor knows about the discipline's objectives. Only 20% of preceptors said they had already participated in a preceptorship training course and 80% expressed interest in participating. The participants' perception of the role of the preceptor in the training of health professionals was positive. Some preceptors are not aware that preceptorship is part of their role as health professional. Actions that seek to train and make preceptors aware of their role in trainingfuture health professionals are needed (AU).

Relationship between Primary and Secondary Dental Care in Public Health Services in Brazil.

This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients. The specialties with the highest frequencies were endodontics (68.4%), minor oral surgery (65.8%), periodontics (63.0%), radiology (46.8%), oral medicine (40.2%), orthodontics (20.5%) and implantology (6.2%). In all percentiles, the shortest wait time for secondary care was for radiology, followed by oral medicine and the other specialties. In the 50th percentile, the wait for endodontics, periodontics, minor oral surgery and orthodontics was 30 days, while for implantology, the wait was 60 days. Finally, in the 75th percentile, the wait for endodontics, orthodontics and implantology was 90 days or more. Two clusters, with different frequencies of OHT access to specialties, were identified. Cluster 1 (n = 7,913) included the OHTs with lower frequencies in all specialties except orthodontics and implantology compared with Cluster 2 (n = 4,474). Of the Brazilian regions, the South and Southeast regions had the highest frequencies for Cluster 2, with better rates for the relationship between primary and secondary care. This study suggests certain difficulties in the relationship between primary and secondary care in specific specialties in oral health, with a great number of OHTs with limited access to DSCs, in addition to different performance in terms of OHT access to DSCs across Brazilian regions.

Describing the primary care actions of oral health teams in Brazil.

OBJECTIVE: To describe the primary care actions performed by oral health teams (OHTs) that participated in a large national survey led by the Ministry of Health in 2012. METHODS: A total of 12,403 dentists from OHTs completed a set of survey questions (response rate = 85.01%) on the organization of care, basic dental procedures and oral health surveillance actions of OHTs. Descriptive and hierarchical cluster analyses were developed. RESULTS: The majority of OHTs (85.2%) reported that they performed "patient welcoming". The delivery of services was based on a patient's identified disease risk (83.1%), and continuity of care was ensured by 85.9% of OHTs. Individual preventive, restorative and surgical procedures were performed by the majority of the teams; however, screening for oral cancer and construction of dental prostheses/dentures occurred less frequently. Cluster 1 was composed of OHTs with the lowest proportion of oral healthcare actions related to oral cancer and dental prostheses/dentures, and the Southeastern and Southern regions had higher proportions of OHTs from cluster 2. CONCLUSIONS: OHTs adhere to some of the principles of primary care organizations; however, the teams perform fewer actions related to oral cancer treatment and rehabilitation with complete dentures. The geographical distribution of the clusters was unequal in Brazil.

Use and resolubility of the oral health public services offered to children in a large municipality / Uso e resolutividade de serviços públicos de saúde bucal ofertados a crianças em município de grande porte

ABSTRACT Objective: To evaluate the effect of caries severity and socioeconomic conditions on use of oral health services and treatment situations (completed treatment, evasion, referral) among children with dental treatment needs, using the Unified Health System. Methods: Cross sectional study performed among children up to six years old, with dental treatment needs, coming from public schools in Belo Horizonte, Brazil, examined by the Oral Health Teams in the annual survey of oral health, in 2014. Variables were collected by consulting the medical records and information systems. Services were used by children who had attended the dental appointment at least once. The severity of caries considered the number of cavitated teeth. The socioeconomic variables were: age, sex, skin color and family socioeconomic classification. Resolubility was assessed by the ratio between completed treatment and first appointment. Evasion was defined by absence in more than two consecutive unjustified appointments. Association was tested by chi-square test and Poisson regression. Results: The frequency of services use was 44.3% and there was greater use by children with treatment needs in 4 to 8 teeth (PR=1.48, 1.23-1.78) and in more than 9 teeth (PR=1.80, 1.32-2.46) and lower in those with very high socioeconomic risk (PR = 0.79, 0.63-0.99). The resolubility was of 49.6% and 5.2% abandoned the treatment. Children with lower socioeconomic status presented lower resolubility and greater avoidance. Conclusion: The results suggested a persistent iniquity, with less use and resolubility of oral health services among children presenting worse socioeconomic status.

RESUMO Objetivo: Avaliar o efeito da gravidade da cárie e das condições socioeconômicas no uso dos serviços de saúde bucal e nas situações de atendimento (tratamento concluído, evasão, encaminhamento) entre crianças com necessidade de tratamento odontológico usuárias do Sistema Único de Saúde. Métodos: Estudo transversal entre crianças de até 6 anos de escolas públicas infantis, de Belo Horizonte, examinadas pelas Equipes de Saúde Bucal no levantamento anual de necessidades em saúde bucal de 2014. Foram incluídas as crianças com necessidade de tratamento odontológico. Variáveis foram coletadas por consulta ao prontuário e sistemas de informação. Usaram os serviços as crianças que compareceram pelo menos uma vez, em 2014, à consulta odontológica. A gravidade da cárie considerou o número de dentes cavitados e as variáveis socioeconômicas foram: idade, sexo, cor da pele e classificação socioeconômica da família. Resolutividade foi avaliada pela razão entre tratamento concluído e primeira consulta. Evasão foi definida pela ausência por > 2 consultas consecutivas sem justificativa. Associação foi testada por teste chi-quadrado e Regressão de Poisson. Resultados: A frequência de uso de serviços foi 44,3% e houve maior uso nas crianças com necessidade de tratamento em 4 a 8 dentes (RP=1,48; 1,23-1,78) e em > 9 dentes (RP=1,80; 1,32-2,46) e menor naquelas com muito elevado risco socioeconômico (RP=0,79; 0,63-0,99). A resolutividade foi de 49,6% e 5,2% evadiram. Crianças com pior nível socioeconômico apresentaram menor resolutividade e maior evasão. Conclusão: Sugere-se uma iniquidade persistente, com menor uso e resolutividade dos serviços de saúde bucal entre crianças com pior condição socioeconômica.

Organization of oral health actions in primary care from the perspective of dental managers and dentists: process of work, planning and social control / Organização de ações de saúde bucal na atenção básica a partir da perspectiva de gestores em saúde bucal e cirurgiões dentistas: processo de trabalho, planejamento e controle social

ABSTRACT Objective: The aim of this study was to evaluate both the managers' and dental surgeons' perception about the organization of oral health actions in primary care, regarding the work process, planning and social control, in a health micro region. Methods: Qualitative study case with the performance of interviews with oral health managers and focal group with dental surgeons. The content analysis proposed by Bardin was used. Results: The management of the planning and work process is characterized by isolated actions, low institutional support and verticalized authoritarian processes. In the scope of primary care, there is no integrality nor intersectoriality. The managers and dental surgeons have little access to the fundamental indicators and parameters to the initial diagnosis of the planning. Conclusion: The National Program of Improvement to the Access and Quality in Primary Care allowed a possible breakthrough in the current model, with the implementation of new ways of work organization and production, record information, planning and action implementation. There is hardly any social control.

RESUMO Objetivo: Avaliar a percepção de gestores e cirurgiões dentistas acerca das principais dificuldades de organização das ações de Saúde Bucal na atenção básica, na microrregião de Ituiutaba (MG), referentes ao processo de trabalho, integralidade, gestão, planejamento e controle social. Métodos: Estudo de caso de natureza qualitativa, com realização de entrevistas com os gestores de saúde bucal de cada município e Grupo Focal com cirurgiões dentistas. Análise dos resultados realizada com o emprego do método de análise de conteúdo proposta por Bardin. Resultados: A gestão do planejamento e do processo de trabalho dos serviços de Saúde Bucal caracteriza-se por ações isoladas, baixo apoio institucional e processos autoritários verticalizados. No âmbito da atenção básica, não há integralidade e intersetorialidade. Os gestores e os cirurgiões dentistas têm pouco acesso aos indicadores e parâmetros que são fundamentais aos diagnósticos iniciais do planejamento. Ainda predomina o modelo de atenção baseado na demanda espontânea. Conclusão: O Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica significou o momento de maior possibilidade de superação do atual modelo, com a instauração de novas formas de organizar o trabalho, de produzir, registrar informações, de planejar e implantar as ações. O controle social praticamente inexiste.

Hospital Dental Treatment for Special Health Care Needs Patients in Minas Gerais state, Brazil: A Cluster Analysis

Objective: To describe and group some demographic and healthcare characteristics of hospital dental care for the special health care needs population. Material and Methods: Cross-sectional census survey with a total of 1,063 visits with special health care need patients under general anesthesia or sedation at the Brazilian Health System Minas Gerais, Brazil, over 12 months. Clinical diagnosis was divided into "mental and behavioral disorders and diseases of the nervous system" and "others". Age group, gender, clinical diagnosis and care by a general dentist were submitted to descriptive and multivariate cluster analysis. The analysis was performed using the software SPSS version 19.0. Results: Cluster 1 (N=173) had no ICD codes for nervous system (NS) diseases and mental and behavioral disorders. Clusters 2 (N=564) and 3 (N=326) are quite similar except for gender distribution. Cluster 1 was 3.5 times more frequent among non-host cities than HER host cities. Dental treatment was mostly performed on males diagnosed with mental and behavioral disorders and diseases of the NS who were over the age of 25 years and were seen by general dentists. The clusters were distributed unevenly between EHR host and non-host cities. Conclusion: Non-host performed more frequently treatment for patients with no mental and behavioral disorders and diseases of the NS than EHR host cities.

Desafios para a oferta de prótese dentária na rede de saúde pública / Challenges related to dental prosthesis offer in the public health system

Objetivo: Conhecer os desafios enfrentados pelos municípios na implantação e manutenção dos Laboratórios Regionais de Próteses Dentárias (LRPD), além de identificar o perfil dos municípios com LRPD implantados. Método: Estudo exploratório, transversal, baseado em um questionário aplicado a 317 gestores municipais de saúde, no ano de 2014-2015, e em informações extraídas dos bancos oficiais. Para análise dos dados secundários, foi realizado o teste do Qui-quadrado, tendo como variável dependente a presença do LRPD credenciado e, como covariáveis, a Cobertura de Equipe de Saúde Bucal (ESB), o Contingente populacional, o Índice de Desenvolvimento Humano (IDH), o Fator de Alocação (FA) e os dados relativos aos Gestores Municipais de Saúde. Resultado: A baixa oferta do Técnico de Prótese Dentária (TPD) foi o maior desafio para a implantação dos LRPD e, para a manutenção dos LRPD, o baixo financiamento foi o fator limitante. Os municípios com população maior que dez mil habitantes tiveram mais chance de possuir um LRPD credenciado (RP = 2,42). Conclusão: Os desafios enfrentados pelos municípios para a oferta de prótese dentária na rede de saúde pública demandam ações que extrapolam a esfera municipal, sendo necessário o envolvimento das instituições de ensino, a fim de garantir a capacitação dos recursos humanos e dos demais entes da federação na criação de estratégias de regionalização que minimizem os custos e ampliem o acesso dos municípios de menor porte populacional aos LRPD.

Objective: To describe the challenges faced by local health managers during the implementation and maintenance of Regional Laboratories Dental Prosthetics (RLDP), and identify the profile of the cities with RLDP. Method: A cross-sectional study using a questionnaire that was replied by 317 local health managers between 2014 and 2015 and information extracted from official database. A chi-square test was used to analyze secondary data, with the existence of credentialed RLDP as a dependent variable and the coverage of Dental Health Team (DHT), local population, Human Development Indices (HDI), Allocation Factor (AF) and data about local health managers being the co-variables. Result: The low number of dental prosthetic technician was the main challenge regarding the implementation of the RLDP and low funding was the main one related to maintenance. Cities a population of less than 10,000 inhabitants were more likely to have a credentialed RLDP (rate = 2.42). Conclusion: To meet the challenges faced by cities in offering dental prosthesis in the public health, the system demands actions that go beyond the local public sphere. The educational institutions' involvement is needed in order to meet human-resources training requirements and state and federal levels involvement is required to promote strategies that reduce costs and increase access to RLDP by small cities.

Utilização dos serviços de atendimento odontológico hospitalar sob sedação e/ou anestesia geral por pessoas com necessidades especiais no SUS-MG, Brasil / Availability of hospital dental care services under sedation or general anesthesia for individuals with special needs in the Unified Health System for the State of Minas Gerais (SUS-MG), Brazil

O presente estudo identificou as características demográficas dos indivíduos e assistenciais do tratamento odontológico sob sedação e/ou anestesia geral em ambiente hospitalar no SUS-MG. Foram avaliadas todas as Autorizações de Internações Hospitalares (AIH) para o procedimento Tratamento Odontológico para Pacientes com Necessidades Especiais, de julho de 2011 a junho de 2012. Foram mensuradas variáveis demográficas e assistenciais dos atendimentos. Foram calculadas as taxas de internações por 10.000 habitantes e a cobertura assistencial realizada no estado de Minas Gerais e em cada uma das Regiões Ampliadas de Saúde. A análise descritiva das variáveis foi feita por meio de cálculo da frequência e medidas de tendência central e variabilidade. Foram avaliadas todas as 1.063 AIH pagas no período estudado, que representaram uma taxa de 0,54 internações por 10.000 habitantes. A maioria dos indivíduos era adulta, do sexo masculino, com diagnóstico de transtornos mentais ou comportamentais e residente em 27,7% dos municípios de Minas Gerais. Os procedimentos foram realizados em 39 municípios e a cobertura assistencial foi igual a 1,58%. O estudo revelou um perfil clássico do paciente atendido. Dificuldades em se estabelecer uma rede de atenção à saúde bucal foram identificadas.

This study identified the demographic characteristics of individuals and dental treatment care under sedation/general anesthesia in a hospital environment in the Unified Health System in the State of Minas Gerais (SUS-MG). All Hospitalization Authorizations (AIHs) for Dental Treatment for Patients with Special Needs procedures were evaluated between July 2011 and June 2012. Demographic and health care variables for treatment were also assessed. Hospitalization rates per 10,000 inhabitants, and health care coverage provided in the state of Minas Gerais and in each of the Broader Health Regions were calculated. Descriptive analysis of data was carried out by calculating the central trend and variability frequency and measurements. All 1,063 AIHs paid during the study period were evaluated, which is equivalent to a rate of 0.54 hospitalizations per 10,000 individuals. The majority of the patients were adult, male, diagnosed with mental or behavioral disorders and resident in 27.7% of the municipalities in Minas Gerais. The procedures were performed in 39 municipalities and the care coverage was equal to 1.58%. The study reveals a classic demographic and clinical profile of patient attendance. Difficulties in establishing a network of dental care were identified.

O Pró-Saúde e o incentivo à inclusão de espaços diferenciados de aprendizagem nos cursos de odontologia no Brasil / The national reorientation of vocational healthcare training (Pro-Saúde) and encouragement of inclusion of differentiated learning scenarios within dentistry courses in Brazil / El Pro-Salud y el fomento de la inclusión de diferentes áreas de aprendizaje em los cursos de odontología en Brasil

Este estudo objetivou conhecer a situação dos cursos de Odontologia no Brasil envolvidos com o Programa Nacional de Reorientação da Formação Profissional em Saúde - Pró-Saúde, em relação aos diferentes espaços de aprendizagem. Foi realizada análise documental dos relatórios dos cursos contemplados com o Pró-Saúde I. O item "atividade de ensino na rede de serviços" e a carga horária (CH) de estágio foram os critérios de inclusão, e, dos vinte relatórios, 18 foram incluídos. Verificou-se uma diversidade entre as CH das Instituições de Ensino Superior (IES) destinadas ao estágio nos serviços da rede básica, embora todas apresentassem alunos neste cenário, cinco cursos incluíssem, ainda, os Hospitais/CEO (Centro de Especialidades Odontológicas), e 11 agregassem os projetos comunitários. A incorporação dos serviços de saúde como cenário diversificado de aprendizagem varia, refletindo as diferentes interpretações dadas a sua importância, com consenso na expectativa gerada pelo incentivo do Pró-Saúde.

This study had the aim of ascertaining the situation regarding dentistry courses in Brazil that are involved in the National Reorientation of Vocational Healthcare Training (Pro-Saúde), in relation to different learning spaces. Document analysis was performed on the reports on the courses included in Pro-Saúde I. The item "teaching activity within the service network" and the timetabled workload of the course were the inclusion criteria. Out of 20 reports, 18 were included. There was diversity among the timetabled workloads of the higher education institutions for the primary care course, although all the institutions had students within this scenario. Five courses also included hospitals and specialized dentistry centers, and 11 included community projects. The incorporation of healthcare services as diversified learning scenarios varied, reflecting the different interpretations given regarding its importance, with consensus regarding the expectations generated by the Pro-Health stimulus.

El objetivo de este estudio es el de conocer la situación de los cursos de odontología en Brasil relacionados al Programa Nacional de Re-orientación de la Formación Profesional en Salud, Pro-Salud, en relación a los diferentes espacios de aprendizaje. Se ha realizado un análisis documental de los informes de los cursos contemplados en el Pro-Salud I. La "actividad de enseñanza en la red de servicios" y la "carga horaria" (CH) correspondiente han sido los criterios de inclusión; de los 20 informes, 18 fueron incluidos. Se verificó una diversidad entre las CH de las Instituciones de la Enseñanza Superior (IES) destinadas al período de práctica en los servicios de la red básica; aunque todas presentasen alumnos en este cuadro, cinco cursos incluyesen también los hospitales del Centro de Especialidades Odontológicas (CEO) i 11 agregasen los proyectos comunitarios . La incorporación de los servicios de salud reflejando las diferentes interpretaciones dadas a su importancia como consenso en la expectativa por el fomento del Pro-Salud.

Inserção do aluno de odontologia no SUS: contribuições do Pró-Saúde / Participation by dentistry students in the Unified National Health Service: contributions from the Educational Program for Health Work

O objetivo deste trabalho é descrever a experiência da disciplina Ciências Sociais Aplicadas à Saúde (CSAS) da Faculdade de Odontologia da Universidade Federal de Minas Gerais (FO-UFMG). Em resposta às recomendações das Diretrizes Curriculares Nacionais para os cursos de graduação em Odontologia e do Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde), desde 2004, a FO-UFMG tem-se mobilizado para mudar seu currí­culo, dando atenção especial à diversificação dos cenários de aprendizagem. Em 2007, a disciplina de CSAS foi reformulada, permitindo a inserção dos discentes no Sistema Único de Saúde (SUS) no iní­cio de sua formação profissional, quando a realidade e a prática do SUS são os objetos de ensino. Esse movimento reforçou as expectativas de que essa inserção é viável. Espera-se que as mudanças na disciplina funcionem como um projeto piloto, subsidiando outras iniciativas que destinem a uma maior aproximação dos estudantes com a prática profissional, e que sirva de parâmetro na organização e planejamento de outros conteúdos vinculados à saúde coletiva a serem incluí­dos na formação profissional.

This study aims to describe the experience in the course on Social Sciences Applied to Health at the Dentistry School of the Federal University in Minas Gerais (FO-UFMG). In response to the recommendations in the National Curriculum guidelines for undergraduate dentistry courses and the National Program for the Reorientation of Professional Training in Health (Pró-Saúde), since 2004 the FO-UFMG has taken steps to change its curri­culum, with special attention on the diversification of learning settings. In 2007, the course on Social Sciences Applied to Health was reformatted, allowing participation by students in the Unified National Health System since the beginning of their professional training, whereby the reality and practices of the National Health System become objects of learning. This movement reinforced the expectations that such participation is feasible. The changes in the course are expected to serve as a pilot project, backing initiatives towards closer ties between students and professional practice, serving as a benchmark for the organization and planning of other public health course contents to be included in the professional training.

Inserção do aluno de odontologia no SUS: contribuições do Pró-Saúde / Insertion of the dental student in the SUS: contributions of the Pro-Health program

O objetivo deste trabalho é descrever a experiência da disciplina Ciências Sociais Aplicadas à Saúde (CSAS) da Faculdade de Odontologia da Universidade Federal de Minas Gerais (FO-UFMG). Em resposta às recomendações das Diretrizes Curriculares Nacionais para os cursos de graduação em Odontologia e do Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde), desde 2004, a FO-UFMG tem se mobilizado para mudar seu currículo, dando atenção especial à diversificação dos cenários de aprendizagem. Em 2007, a Disciplina de CSAS foi reformulada, permitindo a inserção dos discentes no Sistema Único de Saúde (SUS) no início de sua formação profissional, quando a realidade e a prática do SUS são os objetos do ensino. Esse movimento reforçou as expectativas de que essa inserção é viável. Espera-se que as mudanças na disciplina funcionem como um projeto piloto, subsidiando outras iniciativas que visem uma maior aproximação dos estudantes à prática profissional, e que sirva de parâmetro na organização e planejamento de outros conteúdos vinculados à saúde coletiva a serem incluídos na formação profissional (AU).

The aim of this study was to describe the experience of the Social Sciences Applied to Health (CSAS) discipline of the Dental School of the Federal University of Minas Gerais (FO-UFMG). In response to the National Curriculum Guidelines for the dental undergraduate course and the National Program of Reorientation of Health Professional Training (Pró-Saúde), the FO-UFMG has been undergoing curriculum reform since 2004. Special attention has been given to the range of scenarios in the teaching process. In 2007, the CSAS discipline was changed, allowing the insertion of the students into the Unified Health System (SUS) as of the beginning of their training, when reality and SUS practice are the teaching subjects. This movement reinforced the expectation that this insertion is viable. It is hoped that the changes in the discipline will be used as a pilot project, supporting other initiatives that aim at putting students closer to professional practice and and that serve as a model in the organization and planning of other subjects related to public health, to be ultimately included in professional training (AU).

Avaliação do currículo do curso de Odontologia da Universidade Federal de Minas Gerais tendo em visto a percepção de egressos / Evaluation of the curriculum of the course of dentistry at the Federal University of Minas Gerais taking seen the perception of graduates

Este estudo teve como objetivo avaliar o currículo de graduação do Curso de Odontologia da Universidade Federal de Minas Gerais (UFMG) e sistematizar princípios que orientem a avaliação e a formulação de uma nova proposta curricular, tendo em vista o contexto da crise da universidade pública, os processos de avaliação institucional e da graduação, as Diretrizes Curriculares Nacionais para a área da saúde e a contribuição dos egressos do curso. O estudo está dividido em duas partes. Na primeira foi feita uma pesquisa documental da legislação mais recente que trata da avaliação do ensino superior e da bibliografia disponível sobre o tema. A discussão foi feita trazendo para o debate o modelo da avaliação de caráter regulatório e os princípios da avaliação educativa. A contextualização dos motivos e desdobramentos da avaliação teve como pano de fundo a crise da universidade pública e a grande dívida social com a saúde. Foram delimitados sete princípios que são propostos como ponto de partida para a avaliação e a mudança do ensino de graduação. A sistematização desses elementos foi feita com base na recente experiência de discussão do currículo do curso, na bibliografia sobre os movimentos de mudança do ensino superior, da área da educação, da saúde e nas Diretrizes Curriculares Nacionais. A segunda parte do trabalho reuniu depoimentos de egressos do Curso de Odontologia formados pelo currículo implantado em 1992. Foi realizado um survey para uma amostra de 151 egressos por meio de um questionário aplicado por telefone. Os resultados reforçam a tendência de feminilização da profissão. Foi identificada uma participação reduzida dos egressos na pós-graduação lato sensu, e a preferência pela área da Ortodontia. A maioria da amostra se declara com uma prática profissional autônoma atendendo a convênios. O número de profissionais empregados no setor público é maior que no privado. Os profissionais, mesmo acreditando que a profissão perdeu prestígio, relatam um razoável nível de satisfação profissional. A discussão dos resultados quanto a avaliação do curso foi feita de forma a relativizar o caráter absoluto que, a princípio, poderia se atribuir aos dados em uma primeira leitura. Os graduados, de forma geral, relataram satisfação com o curso e com o currículo; com a atuação dos professores; com a formação recebida no Instituto de Ciências Biológicas da UFMG; com a capacitação técnica oferecida na graduação; e com o Estágio Supervisionado. Os itens pior avaliados foram: instalações físicas e equipamentos; relação escola/mercado de trabalho e formação em áreas conexas à Odontologia. As escolhas feitas pelos sujeitos no questionário sugerem a necessidade de se investigar qual o entendimento dos egressos sobre o conjunto da formação profissional, e sua relação com o currículo. Os campos de interesse dos estudantes e dos profissionais precisam ser considerados nos estudos com egressos. Este trabalho identificou uma vasta bibliografia sobre a avaliação institucional e uma pequena produção sobre avaliação de cursos de graduação e estudos com egressos. Faz-se necessário associar vários elementos na avaliação dos cursos de graduação. Dois deles foram apresentados neste trabalho. Conclui-se também que outros estudos deverão ser realizados como o intuito de aperfeiçoar os processos de avaliação do ensino superior, principalmente levando-se em conta a necessidade de oportunizar a avaliação educativa

The aim of this study was to evaluate the résumé of the graduation course of Dentistry of the Federal University of Minas Gerais and systemize principles to guide the evaluation and formulation of a new curricular proposal, according to the context of the crisis in the public university, the processes of institutional and graduation evaluation, the National Curricular Lines for the health area and the contribution of the graduates of the course. This study was divided in two parts. In the first one, a documentary research was made of the more recent legislation that deals with the evaluation of the superior education and the available bibliography on the subject. The discussion was made bringing for debate the model of the evaluation of the regulation character and the principles of the educative evaluation. The contextualization of the reasons and unfolding of the evaluation had as background the crisis of the public university and the great social debt with health. Seven principles that are considered as starting point for the evaluation and the change of the graduation education were delimited. The systematization of these elements were made on the basis of the recent experience of the discussion of the résumé of the course, in the bibliography about the movements to modify the superior education, of the area of education, the health and in the National Curricular Lines. The second part of this work congregated depositions of egresses of the Course of Dentistry graduated by the résumé implanted in 1992. A survey was carried through for a sample of 151 egresses by means of a questionnaire applied by telephone. The results strengthen the trend of females in the profession. It was identified a small participation of the egresses in the post-graduation and the preference for the area of Orthodontics. The majority of the sample declares itself as an independent professional working with health plans. A lesser number works with and without health plans. The number of professionals employed in the public sector is greater than in the private one. The professionals, even believing that the profession lost prestige, relate a reasonable level of professional satisfaction. The discussion of the results about the evaluation of the course was made in a way to relative the absolute character that, in the principle, could be attributed to the data in a first reading. The graduates, in general, related satisfaction with the course and with the résumé; with the performance of the professors; with the formation received in the ICB; with the technique qualification offered in the graduation and with the Supervised Practical Training. The worst items evaluated were: the physical installations and equipment; the relation school/job market and formation in connected areas to Dentistry. The choices made by the graduates in the questionnaire suggest a necessity to investigate which is the agreement of the egresses about the set of the professional formation, and its relation with the résumé. The fields of interest of the students and the professionals need to be considered in studies with graduates. This work identified an extensive bibliography about the institutional evaluation and a small production about the evaluation of graduation courses and studies with egresses. It is necessary to associate several elements in the evaluation of the graduation courses and two were presented in this work. It is also concluded that other studies should be carried through as purpose to improve the processes of evaluation of the superior education, mainly taking in account the necessity of an opportunity of an educative evaluation