Teaching-Community Integration as an Educational Strategy in Brazilian Primary Health Care

Abstract Background In Brazil's public health system, “territorialization” assigns specific areas to health teams, enabling actions tailored to local social determinants. The Teaching-Community Integration (Integração Ensino-Comunidade - IEC) course places medical students in Primary Health Care (PHC) territories, fostering health promotion and exposing them to socioeconomic realities. Objectives To present a Public Health educational strategy based on student-community interaction within PHC settings. Methods Offered during the first four years of medical school, the IEC course alternates weekly between theory and practice. Theoretical classes cover core Public Health concepts. In practice, students work in small groups, supervised by PHC professionals. Each group is assigned a territory and begins territorialization through home visits or medical consultations to identify families and health conditions. These findings support the development of “Curricular Extension Actions” (Ações Curriculares de Extensão - ACEx), implemented after planning and discussion. At the semester's end, students present their reports to an evaluation panel. The written reports served as the primary data source for this study. The Net Promoter Score (NPS) assessed satisfaction. Results Over two years, 226 reports were produced across 11 health themes, mainly women's, child, and elderly care. Most actions occurred in PHC units and schools. Low-cost materials, like brochures and posters, were commonly used. About 12,450 people were reached. NPS showed high team engagement, with most items above 90%. Communication skills scored highest (98.2). The course's average NPS was 94.2. Conclusions The IEC course is an innovative and effective model that connects Public Health theory to real-world PHC practice. Its focus on community engagement and social determinants prepares students for ethical, collaborative work in diverse contexts, making it highly adaptable and internationally replicable. Key messages • The IEC course strengthens the bond between medical students and the community, promoting health in PHC with a focus on social determinants and ethical, humanized training. • Over two years, the actions reached 12,450 people with high satisfaction (NPS 94.2), demonstrating social impact and potential for replication in national and international contexts.