Permanent and continuing education: a principle of medical education


Permanent and continuing education: a principle of medical education

La formación permanente y continuada: principio de la educación médica



Norberto Valcárcel Izquierdo1*
Antonio Suárez Cabrera2
Guillermo José López Espinosa3
Elvis Pérez Bada3


1 Havana University of Medical Sciences. Cuba.
2 Havana University of Medical Sciences. Girón Faculty Albarrán Headquarters. Cuba.
3 Villa Clara University of Medical Sciences. Academic Vice-rectorate. Cuba.


* Author for correspondence. E-mail:




Scientific and technological development has resulted in the formation of human resources in all labor and training contexts, with respect to the health branch is an element that is stabilized as a principle of the medical education science. The authors intend to socialize them as support, by offering a scientific essay about the permanent and continuous nature of the training of human resources, which seeks to promote reflection on the process of building sciences, via to acquire competencies in medical care, teaching and researching services; for this reason it is necessary its adequate implementation as a strategy, in the Cuban medical universities.

MeSH: health postgraduate programs; health resources; staff development; education, medical.


El desarrollo científico y tecnológico ha traído como consecuencia la formación de los recursos humanos en todos los contextos laborales y formativos, respecto al sector de la salud constituye un elemento que se estabiliza como principio de la ciencia de la educación médica. Los autores pretenden socializarlos como sustento, al ofrecer un ensayo científico acerca del carácter permanente y continuado de la formación de los recursos humanos, que persigue promover la reflexión en torno al proceso de construcción de las ciencias, vía para la adquisición de competencias en los servicios asistenciales, docentes e investigativos; por ello se hace necesario su adecuada ejecución como estrategia, en las universidades médicas cubanas.

DeSC: programas de posgrado en salud; recursos en salud; desarrollo de personal; educación médica.



Submitted: 03/04/2019
Accepted: 02/09/2019



Since its inception the social sciences: pedagogy, psychology, sociology, education, among others, have faced the need to train man for life, in a process of construction and development of its personality; for that reason Comenius, referenced by Mendoza Rodríguez,(1) meant the importance of how to organize learning, schooled or not; but with a permanent and continuous character.

This education, recognized as a set of experiences that follow the initial training, allows the health worker to maintain, increase and improve its competence so that it is relevant to the development of its responsibility; for that reason it ´s recognized as one of the principles of medical sciences, stable over time, regulated by regulations and laws of higher education in Cuba.

The stability of the permanent and continuous training of human resources in health, resulting from the practice through professionalization, it´s raised in four levels: skilled worker, middle level technician, higher level technician and bachelor´s degree in undergraduate education; then it is completed in postgraduate education, from professional development and / or training, to academic training (master´s courses, specialties and doctorates); its results are revealed in institutional projects, theses, publications and scientific events, where the felt needs of labor resources are socialized to continue preparing for life.(2)

Within the epistemic confusions of the debate on this formation, there are differences between the features that make it permanent and continuous.(3) For a better understanding, attention is focused on education in its broad sense, according to Chávez Soler,(4) as well as its extension from programs that pay a basic preparation to those that certify a specialization in labor resources.

On the importance of education, Lemus Lago et al.(5) assure that: "... historically, education has been a process of intentional action, mainly on the youngest, with the purpose of developing their personality, training them for work and prepare them for social life...".

Returning to education, it is interesting to remember that in 1990, in Jomtien, at the World Conference on Education for All, important commitments were assumed with the goals that aim at the concretization of basic learning needs. At the 2000 World Education Forum in Dakar, education was considered as: "... a fundamental human right and constitutes the key to sustainable development, as well as to ensure peace and stability within each country...".(6)

Santos Graca et al.(7) express that the permanent and continuous formation is marked by the following four paradigms:

  • Deficiency: the labor resource presents training gaps due to the outdated initial training and the lack of practical skills. The permanent and continuous training emerges as an action of completion of knowledge and skills or responses to needs recognized as a priority, more by the administration than by labor resources. The determination of priority areas (imposed on workers) and the (predetermined) typology of training are some of the particularities of this paradigm in which the logic of administration prevails.
  • Growth: the permanent and continuous training of the work resource is based on the logic of personal experience and a purpose of professional development. Value is given to the experience of the subjects who assume an active role in their work.
  • Change: training is perspective, as a process of negotiation and collaboration within an open space (centers of production and services, and those in which it was formed), based on the need to reorient knowledge and skills towards the labor market.
  • Problem solving: it starts from the principle that the work context is a space where problems that are linked to the performance of work resources constantly emerge, which will be better solved when there is a diagnosis of those difficulties and potentialities, as they are the participants that directly intervene in work situations.

Analyzing the previous paradigms, the professional competences constitute a common denominator in them, with the preoccupation always focused on the improvement of the labor and educational services, that is, the work related or professional improvement of each resource, among them teachers, facilitators and trainers, which leads to a process of change adjusted to the training needs of society.

From these paradigms, the authors highlight the links that exist between the temporal and cognitive dimensions in the formation of human resources, they are converted into a need and right of every human being, it´s seen in its conformation as a bio-psycho-social entity; in this sense the permanent means that it begins its construction from birth and only ends with death.

On the other hand, the cognitive dimension is meant in the continuum of training; while the contents addressed in the actions related to the ways of updating, methodological work, self-improvement, innovation, research, among others, it highlights this training as a process of knowledge construction that occurs in every formal or informal educational process. Its contents must express the continuity that is offered in plans and programs for the development of human capital, from basic to specialized training, including free self-improvement that occurs from the personal needs of each subject, in favor of the satisfaction of the labor, professional, institutional, technological and/or social goals, in correspondence with the continuous development of sciences.(8)

This conception for permanent and continuing education is shown through the following ideas:

  • It is adjusted to the profiles of each level of professionalization of human resources, based on the requirements of training and the quality of services from knowledge management, to contribute to the development of professional performance and enhance the improvement of your competences.
  • The development of competences goes through the construction of knowledge from the in-service training for the development of the clinical, epidemiological and social method, related to the links that arise from the substantive processes: academic, medical care, research and social.
  • The components of personal, deontological and sociocultural training from the professional dimension are manifested in the research process plus development, achieving sustainable results.(9)

To integrate the permanent and the continuous in the formation of human resources in medical education sciences is to value its principle character from and for the in-service training, it´s to evaluate the manifestation of the relations among science, technology and society, which does not take place if the triad of research, development and innovation is not present, reflecting the dialectical space-time and content-form pairs, which favor the construction of an epistemology of sciences.

Permanent and continuous training as a principle of medical education sciences is manifested in two dimensions: the temporal where the trait associated with the permanent education for life is revealed, while in the cognitive is reflected the continuity that It is achieved from basic training, to specialized training at different levels of professionalization.(10)

The authors expressed in this systematization, as continuous and permanent education is the way for the acquisition of competences in the medical care, teaching and researching services; therefore, its proper implementation, as a strategy, in Cuban medical universities is necessary.



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Declaration of interests

The authors declare no conflict of interest.



Contribution of the authors

All the authors managed the information, reviewed the manuscript and approved the version finally submitted.



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