Leprosy remains neglected in Brazilian medical training, perpetuating delayed diagnoses and preventable disabilities. Despite the WHO elimination target, the high proportion of cases presenting with grade 2 disability at diagnosis highlights systematic failures in early detection. This study aimed to evaluate medical students’ knowledge about leprosy using Bloom’s Taxonomy as a theoretical framework, investigating how curricular deficiencies compromise essential diagnostic competencies. Cross-sectional study with 405 medical students from 13 universities in Santa Catarina. A structured questionnaire based on Bloom’s Taxonomy was applied, assessing five cognitive domains (remember, understand, apply, analyze, evaluate) through 15 questions stratified by complexity. Questions addressed three thematic axes: clinical aspects, prevention, and epidemiology. Statistical analysis used non-parametric tests (Kruskal-Wallis, Mann-Whitney) to compare groups, considering prior clinical experience and the presence of specialized outpatient clinics. A progressive decline in performance was identified as cognitive complexity increased: “remember” (59%), “evaluate” (65%), “understand” (25%), “apply” (21%), and “analyze” (46%). Questions classified as easy had 69% correct answers, while moderate and complex questions reached only 25% and 40%, respectively. Operational classification of leprosy showed the worst performance (8.2% correct). Students with prior clinical experience performed better in “analyze” (p=0.013) and “apply” (p=0.043). Universities with specialized outpatient clinics improved “understand” (p=0.016) and “remember” (p=0.031), but did not ensure superior diagnostic competencies. The study reveals a critical structural gap in medical education: students show adequate conceptual memorization but fail in practical application. The discrepancy between basic and higher cognitive domains indicates fragmented teaching centered on passive information transmission. Even specialized infrastructure proved insufficient to develop effective clinical competencies. Urgent curricular reforms should prioritize supervised exposure to real cases, transforming medical training from memorization to practical application.
Vitiritti et al. (Sun,) studied this question.