O ensino de epidemiologia nos cursos de graduação em Enfermagem do Brasil

Abstract

Introduction: Epidemiology constitutes an essential foundational component in the education of nurses. However, significant gaps remain in the knowledge regarding the provision of this discipline within undergraduate Nursing programs at Brazilian higher education institutions. Objective: To analyze the teaching of Epidemiology in the pedagogical projects of undergraduate Nursing programs at public higher education institutions in Brazil. Methods: This was a cross-sectional, document-based study employing a qualitative-quantitative approach. Data was collected from the Pedagogical Projects of Undergraduate Nursing Programs at public higher education institutions in Brazil. A total of 124 programs from 87 higher education institutions were included. Eligible institutions were officially accredited and registered in the e-MEC system, had a score equal to or higher than 3 in the 2023 National Student Performance Examination (ENADE), and had their pedagogical project publicly available. Quantitative data were analyzed using descriptive statistics with support from Microsoft Excel and RStudio software. Qualitative analysis was conducted using Bardin’s content analysis framework, supported by IRaMuTeQ software for data coding, categorization, and thematic class generation. Results: Epidemiology was identified in all programs analyzed. However, substantial variability was observed in its curriculares organization. In most institutions (72.2%), epidemiology was offered as a standalone discipline, whereas in others (27.8%), it was integrated into thematic axes related to Public Health, Biostatistics, and Health Surveillance. Additional variations were identified in course workload, year of offering, and types of bibliographic references adopted. Content analysis revealed three thematic classes. Terms related to epidemiological indicators, measures, and analytical methods predominated (49%), followed by content addressing the application of Epidemiology to health planning, management, and practice (38.6%). Expressions associated with health conditions and determinants of the health–disease process in Public Health appeared less frequently (12.4%). Statistically significant regional differences were observed among thematic classes (p-value = 0.012). The theoretical-descriptive dimension of the discipline was the most prevalent nationwide (73.0%), particularly in programs located in the North and Northeast regions. Approaches emphasizing health planning and management, either independently or integrated with the quantitative applicability of the discipline, were more predominant in the Midwest, Southeast, and South regions. Only five programs nationwide included all thematic classes within their course syllabi. Conclusion: The study demonstrates heterogeneity in the teaching of Epidemiology in public undergraduate Nursing programs in Brazil. Although the discipline is present in all analyzed programs, there is variability in curricular organization and a predominance of a conceptual and technical-operational approach in course syllabi, to the detriment of discussions addressing public health conditions and determinants. This scenario may pose challenges to the comprehensive education of nurses. The incorporation and integration of thematic classes, longitudinal distribution of the discipline throughout the curriculum, and strengthening of its critical-analytical depth across different stages of training emerge as strategies to reinforce a comprehensive perspective of Epidemiology and to reduce fragmentation in undergraduate Nursing education in Brazil.