Análise da oferta da disciplina de Bioética nos cursos de graduação em Odontologia brasileiros / Análisis de la oferta de la disciplina de Bioética en los cursos brasileños de pregrado en Odontología / Analysis of the Bioethics subject offer in Brazilian undergraduate Dentistry courses

O objetivo deste estudo foi verificar a oferta da disciplina de Bioética nos currículos dos cursosde odontologia brasileiros.Para isso foi realizado a revisão de todas as matrizes curriculares disponíveis no site do Ministério de Educação, no período de fevereiro a abril de 2019. A busca foi realizada individualmente na matriz de cada curso buscando informações sobre: a presença da disciplina de Bioética, a carga horária da disciplina, o semestre e o regime (optativa ou obrigatória) de oferta na matriz curricular. No levantamento realizado encontrou-se 41 (17,67%) cursos que ofertavam a disciplina de Bioética de forma isolada e 36 (15,52%) na forma associada, totalizando 77 (33,19%) com oferta da disciplina. Concluiu-se que, no ano de 2019, a maioria dos cursos não disponibilizava a disciplina de Bioética, inferindo-se a necessidade de haver sua inclusão em todos os cursos como forma de cumprir as diretrizes curriculares nacionais existentes e proporcionar adequada formação humanística aos futuros profissionais (AU).

El objetivo de este estudio fue verificar la oferta de la asignatura de Bioética en los planes de estudio de los cursosde odontología brasileños. Para eso fue realizado una revisión de todas las matrices curriculares disponibles en el sitio del Ministerio de Educación de Brasil, de febrero a abril de 2019. La búsqueda fue realizada de forma individualizada en la matriz de cada curso buscando las informaciones sobre: presencia de la asignatura de Bioética, la carga horaria de la asignatura, el semestre y el régimen (obligatoria u optativa) que era ofertada. En la búsqueda encontramos que 41 (17,67%) cursos ofrecían la asignatura de Bioética de forma aislada y 36 (15,52%) en forma asociada, totalizando 77 (33,19%) con oferta de la asignatura. Se concluyó que, en 2019, la mayoría de los cursos no proporcionaban la asignatura de Bioética, infiriendo la necesidad de ser incluida en todos los cursos como una forma de cumplir con las directrices curriculares existentes y proporcionar capacitación humanística adecuada para los futuros profesionales (AU).

The aim of this study was to verify the offer of the Bioethics course in the curricular matrices of Brazilian dentistry schools. For this purpose, a review of all curricular matrices available on the Ministry of Education website was conducted from February to April 2019. The search was carried out individually in the matrix of each course, seeking information about the presence of the Bioethics course, the course load, the semester, and the regime (optional or mandatory) of the course offering in the curricular matrix. In the survey, 41 (17.67%) courses were found to offer the Bioethics course singly, and 36 (15.52%) offered it in the associated form, totaling 77 (33.19%) with an offer of the courses. It was concluded that, in 2019, the majority of courses did not provide the Bioethics subject, inferring the need for its inclusion in all courses as a way to comply withthe existing national curricular guidelines and provide adequate humanistic education to future professionals (AU).

Conhecimento e interesse em Odontologia Legal dos graduandos em Odontologia da Universidade Federal da Paraíba / Conocimiento e interés en Odontología Forense de estudiantes de graduación en Odontología de la Universidad Federal de Paraíba / Knowledge and interest in Forensic Dentistry among undergraduate dental students at the Universidade Federal da Paraíba

O estudo objetivou identificar o conhecimento e interesse em Odontologia Legal dos estudantes de Odontologia da Universidade Federal da Paraíba (UFPB) e comparar os resultados entre os graduandos que não haviam cursado as disciplinas de Odontologia Legal e Ética e Legislação e aqueles que já tivessem cursado. Trata-se de uma pesquisa de campo com abordagem indutiva e técnica de documentação direta e extensiva com procedimentos estatísticos descritivos do tipo correlacional. Foram analisadas as respostas aos questionários online acerca do conhecimento e do interesse na Odontologia Legal pelos estudantes que não cursaram as disciplinas de Ética e Legislação Odontológica e Odontologia Legal (G1; n=45) daqueles que cursaram tais disciplinas (G2; n=29). Os dados foram analisados descritivamente e pelo teste qui-quadrado (α=5%). Observou-se que dos estudantes do G1, 44,4% (n= 20) apontaram a Odontologia Legal como meio de identificação humana e investigação e o G2 teve 48,27% (n=14) relacionando ser "Voltada para identificação criminal". Na autoavaliação dos estudantes acerca do conhecimento, o G1 teve 44,4% (n=20) avaliando em "Muito Baixo" e o G2 apresentou "Muito Baixo", "Baixo" e "Médio" com mesma porcentagem 24,1% (n=7), havendo diferença estatisticamente significante (p=0,002). Quanto ao interesse na carreira profissional, 37,8% dos estudantes do G1 positivaram e do G2, 48,3%. Nas questões objetivas os índices de acerto não passaram de 51% no G1 e 56% no G2 e a área mais apontada como relacionada à Odontologia Legal foi "Identificação Humana" (97,7% e 100%) em ambos os grupos. Em relação ao interesse na área após aplicação do questionário, ambos os grupos apontaram "Muito Alto" em maior porcentagem. Constatou-se conhecimento mediano dos estudantes e grande interesse em Odontologia Legal, independentemente do grupo de estudantes. Verificou-se também que menos de 50% tem interesse em seguir carreira na área da Odontologia Legal (AU).

El objetivo del estudio fue identificar el conocimiento y el interés de los estudiantes de odontología de la Universidad Federal de Paraíba (UFPB) y comparar los resultados entre los estudiantes que no habían cursado las asignaturas de Odontología Forense y Ética y Legislación con los que ya habían cursado. Es una investigación de campo con enfoque inductivo y técnica de documentación directa y extensiva con procedimientos estadísticos descriptivos del tipo correlacional. Se evaluaron cuestionarios online sobre conocimientos e interés en Odontología Forense, de estudiantes que no cursaron Ética y Legislación en Odontología ni Odontología Forense (G1; n = 45), y de los que cursaron dichas asignaturas (G2; n = 29). Los datos se analizaron de forma descriptiva y mediante prueba de Chi-cuadrado (α =5%). De los estudiantes de G1, 44,4% (n = 20) señalóa la Odontología Forense como medio de identificación e investigación humana, y de los de G2, 48,27% (n = 14) la consideró"orientada a la identificación criminal". En la autoevaluación acerca de su grado de conocimiento, 44,4% (n=20) de G1 lo catalogó como "Muy bajo", al tiempo que, G2 presentó "Muy bajo", "Bajo" y "Medio", con el mismo porcentaje, 24,1% (n = 7), constatándose diferencia estadísticamente significativa (p = 0,002). Sobre el interés por la carrera profesional, 37,8% de G1 y 48,3% de G2 respondieron positivamente. En relación a las preguntas estructuradas, 51% de G1 y 56% de G2 fueron correctas, mencionando a la "Identificación Humana" como el área más Conhecimento e interesse em Odontologia Legal dos graduandos em Odontologia da Universidade Federal da Paraíba relacionada con la Odontología Forense(97,7% y 100%, respectivamente). Con respecto al interés por el área, el mayor porcentaje de ambos grupos, señaló "Muy Alto". Se verificó un grado "Medio" de conocimiento y "Alto" de interés, en ambos grupos. En contrapartida, menos del 50% pretende especializarse en Odontología Forense (AU).

This study aimed to identify the knowledge and interest in Forensic Dentistry among undergraduate dental students at the Universidade Federal da Paraíba (UFPB). Furthermore, we aimed to compare the results between undergraduate students who had not studied Forensic Dentistry and Ethics and Legislation and those who had. This study comprises field research with an inductive approach and a direct and extensive documentation technique with descriptive statistical procedures of the correlational type. We analyzed the responses to the online questionnaires regarding knowledge and interest in Forensic Dentistry by students who did not take Dental Ethics and Legislation and Forensic Dentistry (G1; n=45) and those who did (G2; n=29). Data analysis was descriptive and by chi-square test (α=5%). We observed that 44.4% (n=20) of G1 students pointed to Forensic Dentistry as a human identification and investigation method. Meanwhile, 48.27% (n=14) of G2 students said it was "Focused on criminal identification". In the students' self-evaluation regarding knowledge, 44.4% (n=20) of G1 students rated their knowledge as "Very Low". Whereas, G2 students rated "Very Low", "Low", and "Medium" at the same percentage of 24.1% (n=7). Statistical difference was significant (p=0.002). Regarding the interest in a professional career, 37.8% of the G1 students were positive, while 48.3% were positive in G2. In the objective questions, the success indexes did not exceed 51% in G1 and 56% in G2. Moreover, the area most indicated in both groups (97.7% and 100%) as related to Forensic Dentistry was "Human Identification". After applying the questionnaire, both groups indicated the interest in the area as "Very High" in a higher percentage. Students showed average knowledge and great interest in Forensic Dentistry, regardless of the student group. Furthermore, we found that less than 50% are interested in pursuing a career in Forensic Dentistry (AU).

Experiência de estudantes na divulgação da imagem de pacientes odontológicos / Student experience in the images' dissemination of dental patients

As implicações éticas do uso de redes sociais por profissionais da saúde têm ocupado espaço na agenda da Bioética quando se considera os direitos do paciente e o risco de exposição de sua imagem. Este estudo buscou conhecer a percepção de estudantesde Odontologia sobre a exposição da imagem de pacientes em redes sociais. Trata-se de estudo observacional transversal, quantitativo, com aplicação de questionário a estudantes de um curso de Odontologia. Os dados foram tabulados e analisados por meio de estatísticas descritivas. A taxa de resposta foi de 73,5% (n=247), todos utilizando redes sociais e 33,1% (n=82) declararam já ter realizado fotografia de paciente na clínica de ensino. Muitos estudantes ainda não têm clareza sobre as questões éticas que envolvem a divulgação de imagem de pacientes em rede social. Isso revela a importância de se ater a esse tópico nos cursos brasileiros de graduação em Odontologia (AU).

The ethical implications of social networks use by health professionals have occupied space on the Bioethics' agenda, when considering the rights of patients and the risk of exposing their image. This study aimed to understand the perception of dentistry students about the exposure of patients image in social networks. This is a cross-sectional, quantitative, observational study, with the application of a questionnaire to students of a Dentistry course. It was used the descriptive statistics for tabulating and analyzing the data. The response rate was 73.5% (n=247), all using social networks, and 33.1% (n=82) reported having already taken a patient photograph at the training clinic. Many students are still unclear about the ethical issues surrounding the dissemination of patient images on social media. The ethical implications of social networks use by health professionals haveoccupied space on the Bioethics' agenda, when considering the rights of patients and the risk of exposing their image (AU).

Reconocimiento docente de los valores éticos y morales en la formación curricular de la carrera de odontología de la Universidad de Viña del Mar, Chile / Teaching recognition of ethical and moral values in the curriculum training of the dentistry career of the Universidad de Viña del Mar, Chile

El objetivo de esta investigación es determinar la coherencia entre lo declarado por los programas de estudios de pregrado en la carrera de Odontología de la Universidad de Viña del Mar, en relación a los valores éticos y morales y, cómo son reconocidos efectivamente por los docentes en los estudiantes. El diseño de investigación corresponde a un estudio descriptivo y transversal. Para esto se adaptaron dos instrumentos, el primero: "cuestionario sobre percepción en la categorización de valores" que busca determinar la importancia que le dan los docentes a los valores. Mientras que en el segundo: "Encuesta sobre valores en estudiantes de odontología" solicita que cada docente evalúe la frecuencia con que se manifiestan ciertos valores éticos y morales en sus estudiantes. Se consideraron los 28 académicos que constituyen la totalidad del universo de docentes clínicos de los cursos de 4to y 5to años de la carrera de odontología en el año 2019. Se discuten los resultados comparándolos con experiencias similares en otras instituciones. Los resultados muestran la percepción y el reconocimiento de los valores por parte del cuerpo docente en los estudiantes, donde se identificó que los valores incorporados de mejor manera son la dignidad, el trato humano y el dialogo; mientras que la autocrítica y el conocimiento fueron los menos incorporados, estos son clave para establecer reflexión y mejoras en los planes de estudio. Se marca el punto de inicio para la generación de futuras líneas de investigación que incorporen otros aspectos como la perspectiva de los pacientes, los estudiantes, así como también continuar recabando información para utilizar metodologías que puedan contribuir a la integración de valores y poner en debate la importancia de ellos en la formación de pregrado.

The aim of this article is to determine the coherence between what is declared by the undergraduate study programs in the Dentistry career at the University of Viña del Mar, in relation to ethical and moral values and how they are effectively recognized by teachers in the students. The research design corresponds to a descriptive and cross-sectional study. Two instruments were adapted for this, the first: "questionnaire on perception in the categorization of values" that seeks to determine the importance that teachers give to values. While in the second: "Survey on values in dentistry students" requests that each teacher evaluates the frequency of certain ethical and moral values which are manifested in their students. 28 academics constituting the entire universe of clinical teachers of the 4th and 5th year courses of dentistry career in 2019 were considered. The results were discussed, comparing them with similar experiences in other institutions. Results show the perception and recognition of the values by the teaching staff in the students. These values incorporated in the best way were dignity, humane treatment and dialogue; while self-criticism and knowledge were the least incorporated. These are key values to establish a reflection and subsequent improvements in the study plans. This article marks a starting point for the generation of future lines of research that incorporate other aspects such as the perspective of patients, students, as well as continuing to collect information to use methodologies that can contribute to the integration of values and put them into a debate about the importance of them in undergraduate training.

Assessing Moral Skills in General and Post-Graduate Dental Students in the Southeast of Iran: A Cross-Sectional Study

Abstract Objective: To assess the level of moral skills in dental students and residents. Material and Methods: This cross-sectional and descriptive-analytical study was conducted on dental students and residents of Kerman University of Medical Sciences, selected by census sampling. Data collection tools included a demographic information checklist (age, gender, marital status, educational level (before basic sciences, after basic sciences, residency), and moral skills inventory questionnaire. The data were analyzed using a T-test and multiple regression analysis at a confidence level of 95%. Results: The total score of the moral skills questionnaire was about 44 out of 80, and there was no difference between males and females in moral skills (p=0.79). However, there was a significant difference in moral sensitivity between married and single students (p=0.036). Residents gained significantly higher moral integrity scores than students (p=0.046). Conclusion: The study highlights that the level of professional moral skills in Kerman dental students and residents was acceptable. Single students got higher scores in the moral sensitivity domain, although residents got the highest scores in the moral integrity domain. There was no significant correlation between gender and the level of moral skills (AU).

Aspectos ético-legais que envolvem a manipulação de dentes humanos extraídos: o olhar de cirurgiões-dentistas / Ethical and legal aspects involving the manipulation of extracted human teeth: the dental surgeons' viewpoint

Investigou-se o conhecimento de cirurgiões-dentistas acerca dos aspectos ético-legais envolvidos na manipulação e descarte de elementos dentários humanos extraídos. Utilizou-se um questionário semiestruturado, enviado eletronicamente para cirurgiões-dentistas. Asperguntas objetivas foram analisadas pela estatística descritiva e as subjetivas peloDiscurso do Sujeito Coletivo. Dos 208 cirurgiões-dentistasrespondentes, 78,4% reconheceram o elemento dentário como órgão, 98,6% afirmaram ter utilizadodentes humanos para treinamento laboratoriale pesquisa na graduaçãoe pós-graduação, 42,4% obtiveramesses dentesem unidades de saúde, 28,3% em consultórios odontológicos, 22% na instituição de ensino e 2,4% através de compra. Sinalizou-se a doação por unidades de saúdee consultórios odontológicos como forma ideal para aquisição dos dentes (72,11%). Apesar de 75,5% afirmarem conhecer a regulamentação específica, issonão se refletiu nas demais questõesavaliadas. Quanto ao risco biológico na manipulação dos dentes, 88,9% consideraram existir e a análise qualitativa das respostas gerou as categorias "contaminação" e "infecção cruzada". Já sobre a finalidade do Banco de Dentes, 59,6% declararam conhecê-las, emergindo categorias como "ensino e pesquisa" e "comércio ilegal". A despeito desse conhecimento, apenas 43,3% indicaram estar totalmente dispostos a se vinculara um Banco de Dentes para doação.Conclui-se que existe pouco conhecimento quanto aos aspectos ético-legais envolvidos na manipulaçãoe descarte de dentes humanos extraídose que essa insciência se reflete na baixa intenção em se vincular às atividades de um futuro Banco de Dentes instalado no município pesquisado (AU).

It was intended to investigate the knowledge of dental surgeons about the ethical and legal aspects involved in the handling and disposal of extracted human teeth. A semi-structured questionnaire was used, sent electronically to dental surgeons. The objective questions were analyzed by descriptive statistics and the subjective ones by Collective Subject Discourse. Of the 208 dental surgeons who answered the questionnaire, 78.4% recognized the dental element as an organ, 98.6% stated that they used human teeth for laboratory training and research during graduation and post-graduation, 42.4% obtained these teeth in health units, 28.3% in dental offices, 22% in teaching institution and 2.4% through purchase. Donation by health units and dental offices was signaled as the ideal way to acquire the teeth (72.11%). Although 75.5% claimed to know the specific regulation, this was not reflected in the other questions evaluated. As for the biological risk in handling teeth, 88.9% considered it existed and the qualitative analysis of the answers generated the categories "contamination" and "cross infection". As for the purpose of the Tooth Bank, 59.6% said they knew it, and categories such as "teaching and research" and "illegal trade" emerged. Despite this knowledge, only 43.3% indicated that they were totally willing to join a tooth bank for donation. It is concluded that there is little knowledge about the ethical-legal aspects involvedin the handling and disposal of extracted human teeth and that this unawareness is reflected in the low intention of joining the activities of a future Tooth Bank installed in the researched municipality (AU).

Conhecimento e utilização do Biobanco de Dentes Humanos pela comunidade acadêmica do curso de Odontologia da UFPR / Knowledge and use of the Human Teeth Biobank by the academic community of the UFPR Dentistry course

Oobjetivo desteestudofoianalisaro perfil dos usuários do Biobanco de Dentes Humanos da Universidade Federal do Paraná (BDH-UFPR), os serviços mais procurados, se háutilização de dentes obtidos externamentee o grau de satisfaçãodos usuários.Para isso,foi aplicado um questionário eletrônico semiestruturado à comunidade interna do curso de Odontologia daUFPR, entre agosto edezembro de 2019. Um total de 300 questionários foram respondidos, sendo263 por estudantes degraduação, 4 por pós-graduandos, 24 por professores e 9 por servidores técnico-administrativos.A maioria dos estudantes erado sexo feminino entre 17e 22 anos, enquantopara osservidores (professores e técnicos) houve uma distribuição semelhante entre os sexosna faixa etária entre 40e 59 anos. Embora 80,99% dos discentes afirmaram conhecer oBDH-UFPR, apenas 50,19%usaram seus serviçose59,32% relataram játerembuscadodentesexternamente.O serviço mais utilizado foi o empréstimo de dentes para atividades de ensino, porém apenas 42,15% os devolveram após ouso.Os dentes obtidos externamente foram provenientes,principalmente, deconsultórios particulares e apenas 56,33% dos alunosrelataram sempre ter submetido-os à desinfecção/esterilização, sendo a autoclave o método mais indicado. Todos os servidores conheciam o BDH-UFPR e,dentre os professores,a maioria realizoutanto empréstimos quanto doações. Os empréstimostiveram como principal finalidade a pesquisae 63,6% relataramterem devolvido os dentes.Quanto à satisfação, a comunidade acadêmica mostrou-se predominantemente totalmente satisfeita.Por fim, ressalta-se a necessidade de ampliar as ações de conscientização para a comunidade acadêmica quanto aos aspectos éticos, legais e de biossegurança na aquisição e manipulação de dentes humanos (AU).

Thisstudy aimed toanalyze the profile of users of the Human Teeth Biobank at the Federal University of Paraná (HTB-UFPR), the most sought-after services, whether externally obtained teeth are used and the degree of user satisfaction. For this, a semi-structured electronic questionnaire was applied to the internal community of the Dentistry course at UFPR, between August and December 2019. A total of 300 questionnaires were answered, 263 by undergraduate students, 4 by graduate students, 24 by professors and 9 by technical-administrative employees. Most students were female between 17 and 22 years old, while for employees(teachers and technicians) there was a similar distribution between the sexes in the age group between 40 and 59 years old. Although 80.99% of the students claimed to know the HTB-UFPR, only 50.19% used its services and 59.32% reported having already looked for teeth externally. The most used service was the withdrawalfor teaching activities, but only 42.15% returned them after use. The teeth obtained externally came mainly from private offices and only 56.33% of the students reported having always submitted them to disinfection/sterilization, with the autoclave being the most indicated method. All employees knew the HTB-UFPR and, among the teachers, most made both withdrawaland donations. The main purpose of the withdrawals was the research and 63.6% reported having returned their teeth. As for satisfaction, the academic community was predominantly fully satisfied. Finally, it emphasizes the need to expand awareness actions for the academic community regarding ethical, legal and biosafety aspects in the acquisition and manipulation of human teeth (AU).

Bioética do cuidado na clínica de ensino: aprendendo com pacientes / Bioethicsof the care in the teaching clinic: learning with patients

O estudo buscou compreender práticas de acolhimento de pacientes em uma clínica de ensino odontológico.Trata-se de um estudo de caso único e holístico, com abordagem qualitativa. Foram realizadas entrevistas abertas com 20 pacientes, guiadas por um roteiro com temas problematizadores que procuram ligar princípios bioéticos a dispositivos subjetivos do cuidado: conceito ampliado de saúde e doença, intersubjetividade, corresponsabilidade e qualidade de vida. As práticas discursivas analisadas mostraram que o vínculo entre estudantes e pacientes da clínica de ensino se estabelece em uma construção mediada pelo longo tempo da formação. A corresponsabilidade está relacionada às construções intersubjetivasnocuidado e tem como atores do processo osestudantes e os pacientes. Ao afirmarem sentirem-se livres para opinar sobre seus tratamento também expressam uma postura de reduzida autonomia, pois consideramque não sejanecessário fazê-lo. Como reflexo da fragmentação do cuidado nas clínicas de ensino, muitos silenciamentos emergem destas relações de poder e cuidado. Acredita-se que é clara a importância de práticas que se desvinculem de funções estritamente técnicas e invistam nos processos de fala e escuta, incansavelmente buscando empatia e vínculo como as tecnologias de saúde mais potentes para o tratamento, pois reafirmam a autonomia das pessoas na construção de seus itinerários de cuidado e a dignidade humana como valor central da prática de saúde (AU).

The study aimed to understand welcoming patients practices in a dentistry teaching clinic.It is a holistic single-case study with a qualitative approach.Twenty patients were interviewed following anopen-ended script containing problematizing topics trying to connect bioethical principles tosubjective devices of care: expandedconcept of health and illness, intersubjectivity, co-responsibility, and quality of life.The discursive practices analyzed showed that the bond between students and patients of the teaching clinic is established in a construction mediated by the long training time.Co-responsibility is related with the intersubjective constructions in the care, being the actors of the process both the students and the patients.When claiming to feelfree to give an opinion on their treatment, they also express a position of reduced autonomy, as they consider that it is not necessary to give it.As a reflection of the fragmentation of the care in the teaching clinics, much silencing emerges from these relations of power and care.It is believed that that the importance of practices that unlinkthemselvesfrom strictly technical functions and invest in the speaking and listening processes is clear. In an untiring search for empathy and bond as the mostpowerful health technologies for the treatment, they reaffirm the autonomy of the people in the construction of their itineraries of care and human dignity as a core value of the practice of health (AU).

Exploring Dental Student Performance in Moral Reasoning Using the Defining Issues Test 2.

The aim of this study was to assess the initial levels of moral reasoning among four cohorts of dental students in the first semester of their first year of study. All 332 students at one U.S. dental school were invited to take the Defining Issues Test 2 (DIT2) during the first semester of their first year while enrolled in a mandatory ethics course in 2015-18. Students' mean scores on the DIT2 subscales were compared to their gender, underrepresented minority (URM) status, citizenship, English as primary language, and single status. The four subscales were personal interests (PI), in which self-motivated interests are the main focus; maintaining norms (MN), which takes into consideration what is expected from society; post-conventional (PC), which upholds ethical principles that promote the good of society; and N2 index, which indicates one's ability to discriminate between lower stage and higher stage items. A total of 245 students participated (74% response rate). The results showed no differences between gender, URM status, citizenship, or English as primary language and any of the DIT2 subscales. Single participants scored significantly higher on the PC and N2 subscales and significantly lower on the MN subscale. There was a significant correlation between humanitarian liberalism (HL) and all four subscales. Religious (Christian) orthodoxy (RO) was significantly correlated with MN, PC, and N2. The DIT2 subscale scores were not impacted by various exploratory variables, with the exception of relationship status, which had significantly higher MN and N2 scores. Participants with higher scores on HL and RO had higher moral reasoning scores, and females had higher levels of moral reasoning than males on their PC and N2 scores. These findings have implications for implementing educational activities that may help develop students' moral reasoning abilities over the course of dental school.

Percepção clínica, ética e legal de acadêmicos de Odontologia sobre gerenciamento de resíduos de serviços de saúde / Dental Students' Clinical, Ethical, and Legal Perception on Healthcare Waste Management

O objetivo desse estudo foi analisar a percepção clínica, ética e legal de acadêmicos do curso de Odontologia sobre o gerenciamento de Resíduos em Serviços de Saúde (RSS). O estudo foi do tipo observacional transversal, com amostragem censitária de acadêmicos do 8º(n=23) e 9º(n=18) períodos. No questionário aplicado abordou-se o processo de produção, manuseio e descarte dos RSS, no que concerne ao gerenciamento, legislação e questões éticas. Os dados foram organizados em planilhas e interpretados por meio de análise descritiva. Sobre as normas vigentes para o gerenciamento de RSS, 82,9% e 95,1% dos estudantes afirmaram desconhecer o tratamento/disposição final e regulamento técnico para o gerenciamento de RSS, respectivamente. Em relação ao Plano de Gerenciamento de Resíduos de Serviços de Saúde (PGRSS), 85,4% não conhecem o Código Penal e 87,8% não estão familiarizados com o Código Civil. Além de disso, a maioria dos entrevistados desconhecem as Normas da Associação Brasileira de Normas Técnicas (75,6%) e as Resoluções do Conselho Nacional do Meio Ambiente (82,9%) e da Agência Nacional de Vigilância Sanitária (95,1%). Por outro lado, 73,2% afirmam conhecer os direitos e deveres do cirurgião-dentista, presentes no Código de Ética Odontológica. Quanto à classificação dos resíduos produzidos em ambiente odontológico, 95,1% responderam corretamente sobre o hipoclorito de sódio e 97,6% sobre os roletes de algodão e gaze com sangue. Portanto, foi possível concluir que existe conhecimento satisfatório sobre os aspectos clínicos e éticos, entretanto insuficiente quanto às legislações vigentes no Brasil (AU).

The aim of this study was to analyze the dental students' clinical, ethical and legal perception on the management of health services waste (HSW). This was a cross-sectional observational study, with census sampling of students from the 8th (n=23) and 9th (n=18) terms. The applied questionnaire addressed the process of production, handling and disposal of HSW, regarding management, legislation and ethical issues. Data were organized in spreadsheets and interpreted by descriptive analysis. Regarding the current rules for the management of WHS, 82.9% and 95.1% of the students stated that they did not know the final treatment/disposition and technical regulation for HSW management, respectively. Regarding the Health Services Waste Management Plan (HSWMP), 85.4% did not know the Criminal Code and 87.8% were not familiar with the Civil Code. In addition, most respondents were unaware of the principles of the Brazilian Association of Technical Standards (75.6%) and the Resolutions of the National Environmental Council (82.9%) and the National Health Surveillance Agency (95.1%). On the other hand, 73.2% claimed to know the rights and duties of the dental surgeon, present in the Code of Dental Ethics. Regarding the classification of residues produced in a dental environment, 95.1% answered correctly about sodium hypochlorite and 97.6% about cotton and blood gauze rollers. Therefore, it was possible to conclude that there is satisfactory knowledge about the clinical and ethical aspects, however insufficient regarding the current legislation in Brazil (AU).

Formação x educação, Deontologia x ética: repensando conceitos, reposicionando docentes / Training x education, Deontology x ethics: rethinking concepts and repositioning professors

Partindo de inquietações e reflexões docentes, buscamos problematizar alguns conceitos frequentemente tomados como sinônimos no contexto da educação de profissionais de saúde, descortinando concepções alternativas para um fazer pedagógico eticamente comprometido. A análise se centra na ideia hegemônica da ética que conforma certo sentido para a expressão "ética na formação", em contraposição ao que se poderia denominar de uma "dimensão ética da educação". Por meio de uma escrita dialógica sobre temas comuns a todo (a) professor (a), quer-se provocar o (a) leitor (a) para o exame de sua práxis acadêmica e para o questionamento sobre o que temos realizado na universidade: formação profissional ou educação superior? Os argumentos expressos neste ensaio almejam fomentar o (auto)questionamento para que cada um(a) responda, a sua maneira, e depois coletivamente, à pergunta essencial que a ética nos faz: "que devo(devemos) fazer"? (AU).

Starting from teachers' concerns and reflections, we seek to problematize some concepts often taken as synonyms in the context of professionals' health education, revealing alternative conceptions of ethical and pedagogical doing. The analysis focuses on ethics hegemonic idea that forms a particular meaning for the expression "ethics in training," in opposition to what could be called an "ethical dimension of education." Through a dialogical writing about common topics to every professor, the rationale is to provoke the reader to his/her academic praxis examination and to question what are we doing in universities: developing vocational training or higher education? The arguments expressed in this essay seek to encourage the (self) questioning so that each one responds, in his or her way, and then collectively, to the essential question regarding ethics: "What should we do"? (AU).

Reflections on the encouragement of altruism in dental education.

Dental ethics and professionalism are often relegated to being taught on the coat-tails of other disciplines, if they are taught at all. The assumption that students develop professionalism as a by-product of other learned competencies in dentistry is well documented to be false, and yet, little has been done in many institutions to deal with this. This article seeks to propose that altruism should be championed in dental education and that traditional learning through the preaching of professional codes is not the appropriate way to achieve this. The environment of dental schools needs to be challenged and reformed so that altruism is promoted. If we fail to address declines in altruism in the dental profession, then damage to the professional status of dentistry is inevitable and the ability to fulfil the profession's social contract with society will be inhibited.

The use of virtual patient scenarios as a vehicle for teaching professionalism.

OBJECTIVES: This study aimed to measure students' perceptions of virtual patient scenarios (VPs) for developing ethical reasoning skills and to explore features in VP design that are necessary to promote professionalism. METHODS: Sixty-five dental students participated in learning sessions that involved collaborative practice with five VPs (four high fidelity and one low fidelity), followed by reflection sessions. Students' perceptions towards the use of VPs in developing ethical reasoning skills were assessed using a questionnaire that involved 10 closed and three open-ended questions. RESULTS: High-fidelity VPs were perceived as significantly better for developing ethical reasoning skills than low-fidelity VPs. Analyses of answers to open-ended questions revealed two new features that are specific for VPs intended for teaching professionalism, which are VP dramatic structure and how it should end. CONCLUSION: VPs intended for teaching professionalism need to have high fidelity, follow a specific dramatic structure and should include multiple plausible endings. The use of VPs as part of a collaborative activity that is followed by a reflection session is perceived as an effective tool for the development of ethical reasoning skills in dental education.

A review of teaching ethics in the dental curriculum: challenges and future developments.

This study considers the role and status of the teaching of ethics on the dental undergraduate curriculum. The study reviews current developments in the delivery of dental ethics education and in particular focuses on the development of new pedagogies and curricula content. The study then critically considers the consequences of a squeezed curricula and the consequent reliance on professional regulation as shorthand for the ethical development of students. The study concludes that, although great strides have been made in improving the teaching of ethics in dental education, further dialogue is needed to better include patient views and develop a more theoretically robust approach to self-reflection.

La formación bioética del futuro profesional de estomatología en la universidad médica cubana / The bioethical formation of the future professional of dentistry in the Cuban medical university

En el contexto social cubano, la actividad laboral les plantea a los profesionales de la estomatología requisitos morales elevados. El currículo docente de dicha carrera dota a este profesional de la salud de las herramientas teóricas y prácticas; no obstante, resulta necesario potenciar el desarrollo de buenas prácticas de atención estomatológica en vínculo con una elevada sensibilidad humana, lo cual demanda de un proceso formativo comprometido y responsable enfocado en este sentido desde el punto de vista bioético. La presente investigación, tuvo como propósito describir los posicionamientos teóricos sobre la formación bioética del futuro profesional de estomatología en la universidad médica cubana. Desde una lógica integradora que señala a la bioética como un componente medular en la formación del futuro profesional de estomatología, se concluye que aún resulta insuficiente el componente bioético en la formación de los futuros profesionales de estomatología, cuestión de vital trascendencia en la solución de problemas del complejo buco-facial, razón que argumenta la incuestionabilidad de su enseñanza y aprendizaje dentro de la estomatología(AU)

In the Cuban social context, the work activity poses to the professionals of the stomatology high moral requirements. The teaching curriculum of this career gives this health professional the theoretical and practical tools; however, it is necessary to promote the development of good practices of stomatological attention in connection with a high human sensitivity, which demands a committed and responsible formative process focused in this sense from the bioethical point of view. The present research aimed to describe the theoretical positions on the bioethical formation of the future professional of stomatology in the Cuban medical university. From an integrative logic that points to bioethics as a core component in the future professional development of stomatology, it is concluded that the bioethical component in the training of future stomatology professionals is still insufficient, a matter of vital importance in solving problems of the complex buco-facial, reason that argues the unquestionability of its teaching and learning within the stomatology(EU)

The Role of Self- and Peer Assessment in Dental Students' Reflective Practice Using Standardized Patient Encounters.

The aim of this study was to gain insight into the nature of the role played by self- and peer assessment in the development of dental students' reflective practice skills and the value gained through structured encounters with standardized patients. Four standardized patient encounters in an objective structured clinical exam (OSCE) format served as a learning experience for students to demonstrate decision making and communication skills in complex scenarios regarding issues of ethics. Self- and peer assessment and peer-to-peer discourse were used to enhance student reflection. A sample of 16 peer pairs was randomly selected from the population of 108 fourth-year students who participated in the 2014 Clinical Dental Ethics OSCE. Data were collected from self- and peer assessment forms. Five overall performance themes (personal affect, verbal communication, professional demeanor, relationship-building, and patient management) and three student learning themes (application and knowledge, ways to change, and impressed with peer/increased confidence in self) were identified. The results showed that peer assessment ratings were consistently higher than those in the self-assessments, but overall the students deemed both their peers' and their own decision making and communication skills to be quite good. These students rated their experience with the OSCE and self- and peer assessments as positive, appreciating the importance of reflection and learning from their peers. These results provide support for the continued formative use of standardized patient OSCEs and self- and peer assessment to help students develop skills in decision making, communication, professionalism, and reflection.

Conversation Salons: A Flexible Format for Open Discourse in Dental Education.

A series of conversation salons was created at the University of Minnesota School of Dentistry as an innovative format with the objective of engaging students, faculty, staff, and practitioners in discussion to promote reflection. The aim of this study was to explore the nature of students' abilities in the salons to connect experiences through reflection and apply what they learned to practice. Reflective essays (written during the summer and fall semesters of 2014) from 108 fourth-year dental students (all members of the Class of 2015) were read and assessed for the nature of reflection, number of connections, references to the past, applications to the future, and use of examples. For analysis, the theoretical works of Schön and Mezirow provided a useful framework. Overall, the results showed that the participants found the salon experience to be positive, and student participation was strong. When asked about learning, the most frequent responses were topic-related. At this stage of dental education, the students were largely focused on their future practice and found it easier to connect to an imagined future than a past experience. In terms of student abilities to reflect, the majority were skilled at simple reflection, based on these essays since only 18% were non-reflective and 15% showed strong critical reflection skills. The open and respectful environment of the salons enabled discussion and promoted reflection. These results suggest that more opportunities for collegial conversations and instruction in reflective practice earlier in the dental curriculum may be beneficial.

Medición de los valores éticos y morales enseñados en la carrera de Odontología de la Pontificia Universidad Católica de Chile, desde la apreciación docente / Measurement about the ethical and moral values taught in the career of dentistry at the Pontifical Catholic University of Chile, on teacher appreciation

Introducción: La formación universitaria debe entregar ciudadanos competentes al servicio de la sociedad; la dimensión moral de la docencia superior es intrínseca a su quehacer. Objetivo: Realizar un estudio cuantitativo y descriptivo para determinar la coherencia de la formación de pregrado en la carrera de Odontología de la Pontificia Universidad Católica de Chile (PUC), en relación con los valores éticos y morales declarados y los reconocidos efectivamente en los estudiantes, según la visión de los docentes clínicos que la imparten. Sujetos y métodos: Se revisaron los valores éticos y morales fundamentales en la formación de un odontólogo de la PUC; con este material se construyó una encuesta estructurada que se aplicó a los 68 docentes clínicos de la carrera. Respondieron 46 docentes (68%) manifestando si reconocían los valores éticos y morales indicados, su grado de cumplimiento y si habían advertido situaciones en las que algún valor fuese vulnerado por sus estudiantes. Resultados: Se reveló que los programas de los cursos incluyen escasos objetivos relacionados con valores éticos y morales, que los valores éticos y morales menos observados son el respeto por el medio ambiente y la responsabilidad, y los más observados la justicia y el respeto por las personas. Las situaciones donde se observó una mayor vulneración de valores éticos y morales se produjeron en la relación del estudiante con su paciente. Conclusiones: El material obtenido aportó información acerca de la situación actual de la docencia de valores en la carrera de Odontología de la PUC, lo que servirá para realizar investigaciones en profundidad sobre el tema, para su corrección e implantación en los programas docentes

Introduction: University education must provide competent citizens in the service of society. The moral dimension of teaching in higher education is intrinsic to its work. Aim: To perform a quantitative and descriptive study to help determine the coherence in the undergraduate training at the Dentistry School in Pontificia Universidad Católica (PUC) between the established values and those effectively recognized by the students, from the point of the view of the school’s clinical teaching staff. Subjects and methods: The fundamental values in the formation of PUC dentist were revised. Then, using these materials a structured survey was constructed and applied to the school’s 68 clinical teachers. Of those, 46 answered the survey (68%) stating whether they acknowledged the indicated values and whether they had noticed any situations in which any value was infringed by their students. Results: It was revealed that the course programs include few value-related goals, that the ethics and moral values less observed where the respect to the environment and the responsibility and the most observed values were justice and the respect of others. The most infringements to ethics and moral values were yielded by student-patient relationship situations. Conclusion: The obtained material provided insight about the current situation in the teaching of values in the school of Dentistry in PUC and will assist for further research regarding this topic, for correction and implementation in educational programs