NURSI NG EDUCATI ON: CONTRADI CTI ONS AND CHALLENGES OF PEDAGOGI CAL PRACTI CE
1Joelm a Bat ist a Tebaldi Pint o2 Alda Muniz Pepe3
Pint o JBT, Pepe AM. Nur sing educat ion: cont radict ions and challenges of pedagogical pract ice. Rev Lat ino- am En fer m agem 2 0 0 7 j an eir o- fev er eir o; 1 5 ( 1 ) : 1 2 0 - 6 .
Th is st u d y d eals w it h t h e n u r sin g cu r r icu lu m , p ed agogical p r act ice an d ed u cat ion . Now ad ay s, t h is t hem e has t aken up considerable space in academ ic debat es. Thus, t his st udy aim ed t o get em pirical knowledge and provide an analyt ical descript ion of t he academ ic realit y of nursing educat ion at Sant a Cruz St at e Universit y in t he undergraduat e nursing course. This is a descript ive st udy, which m ay provide a new view of t he problem , w it h car eful obser v at ion, descr ipt ion, and ex plor at ion of t he sit uat ion aspect s, int er pr et ing t he r ealit y , w it hout int erfering in it and, consequent ly, being open t o new st udies. Descript ive st at ist ics w it h sim ple frequency and per cent age calculat ion w as applied. I n sum m ar y, r esult s indicat e t hat pr ofessor s and st udent s have difficult ies t o evaluat e t he cur r iculum . I n addit ion, t he cur r iculum under st udy is char act er ized as a collect ion cur r iculum , w it h a pedagogical pr act ice pr edom in an t ly dir ect ed at t h e t r adit ion al m odel. Hen ce, n u r sin g edu cat ion st ill show s feat ur es of t he biom edical- t echnical m odel.
DESCRI PTORS: cur r iculum ; facult y ; nur se’s r ole
LA FORMACI ON DEL ENFERMERO: CONTRADI CCI ONES
Y DESAFÍ OS DE LA PRÁCTI CA PEDAGÓGI CA
Est e est udio t r at a de la t em át ica cur r ículo, pr áct ica pedagógica y for m ación del enfer m er o, que en la act ualidad v iene t om ando espacio r elev ant e en el debat e académ ico. Así, buscam os conocer em pír icam ent e y describir analít icam ent e la realidad académ ica de la form ación del enferm ero en la carrera de Enferm ería de la UESC. Se trata de un estudio descriptivo que puede proporcionar una nueva visión del problem a, teniendo cuidado de obser v ar , descr ibir y ex plot ar aspect os de la sit uación, int er pr et ando la r ealidad, sin int er fer ir en ella par a m odificarla y, consecuent em ent e, abiert o a nuevos est udios. Para el análisis de los dat os, ut ilizam os la est adíst ica descriptiva con cálculo de frecuencia sim ple y porcentual. Sintéticam ente, los resultados señalaron que los profesores y los alum nos t ienen dificult ades para concept ualizar currículo. Y el currículo est udiado se caract eriza dent ro del t ipo colección , con u n a pr áct ica pedagógica v olcada, pr edom in an t em en t e h acia el m odelo t r adicion al y , en consecuencia, la form ación del enferm ero sigue t eniendo caract eríst icas del m odelo biom édico- t ecnicist a.
DESCRI PTORES: cur r ículo; docent es; r ol de la enfer m er a
A FORMAÇÃO DO ENFERMEI RO: CONTRADI ÇÕES E DESAFI OS À PRÁTI CA PEDAGÓGI CA
Est e est udo aborda a t em át ica currículo, prát ica pedagógica e form ação do enferm eiro que, na at ualidade, t em t om ado espaço r elev an t e n o debat e acadêm ico. Assim , bu scou - se con h ecer em pir icam en t e e descr ev er analit icam ent e a r ealidade acadêm ica da for m ação do enfer m eir o no Cur so de Gr aduação em Enfer m agem da Un iv er sidade Est adu al de San t a Cr u z. Tr at a- se de est u do descr it iv o, qu e pode pr opor cion ar n ov a v isão do p r ob lem a, t en d o t id o o cu id ad o d e ob ser v ar , d escr ev er e ex p lor ar asp ect os d a sit u ação, in t er p r et an d o a r ealidade, sem n ela in t er f er ir par a m odif icá- la, est an do, con seqü en t em en t e, aber t o a n ov os est u dos. Par a a n á l i se d o s d a d o s, u t i l i zo u - se e st a t íst i ca d e scr i t i v a co m cá l cu l o d e f r e q ü ê n ci a si m p l e s e p e r ce n t u a l . Sint et icam ent e, os r esult ados apont ar am que os pr ofessor es e alunos t êm dificuldade em conceit uar cur r ículo. E o cu r r ícu l o e st u d a d o se ca r a ct e r i z a co m o d o t i p o co l e çã o , co m u m a p r á t i ca p e d a g ó g i ca v o l t a d a , pr edom inant em ent e, par a o m odelo t r adicional e, em conseqüência, a for m ação do enfer m eir o cont inua t endo car act er íst icas do m odelo biom édico- t ecn icist a.
DESCRI TORES: cur r ículo; docent es; papel do pr ofissional de enfer m agem
1
St udy ext ract ed from Doct oral Dissert at ion; 2 RN, PhD in Educat ion, Full Professor, Sant a Cruz St at e Universit y, e- m ail: j oelm at ebaldi@uol.com .br; 3 Faculty, Bahia Federal Universit y
I NTRODUCTI ON
T
he hist or y of Br azilian higher educat ion in n u r sin g is m ar k ed by fou r cu r r icu lar ch an ges, n on e of which prom ot ed significant changes in professionalpract ice( 1- 3). We believe t his is due t o t he fact t hat t he p ed ag og ical p r act ice of n u r sin g ed u cat or s h as n ot
accom panied t he int ended curricular changes in t erm s o f p h i l o s o p h i c a l - m e t h o d o l o g i c a l p r e m i s e s a n d
obj ect iv es, bu t h av e m ain t ain ed t h e ch ar act er ist ics of t r adit ion al pedagogical pr act ice( 4 - 6 ). Th is pr act ice
p er p et u a t es t h e b i o m ed i ca l - t ech n i ca l m o d el( 7 ), a s
o p p o se d t o t h e n u r si n g e d u ca t i o n d e m a n d e d b y con t em p or ar y r ealit y.
Now ad ay s, w e p er ceiv e Hu m an Car e( 8 - 9 ) in an o t h er d i m en si o n , w h i ch ev o l v ed t o b eco m e t h e
“ h ealt h act ’s p air ”. Th e lat t er is u n d er st ood as an e x ch a n g e b e t w e e n su b j e ct s, i n co m p l i a n ce w i t h
int egral care. However, unt il t he 1990’s, t his was not a sour ce of gr eat concer n. The w or d car e had lit t le
use, and t he m ost used t er m w as assist ance, w hich im plied deliv er ing nur sing assist ance, an act t hat , in
our opinion, w as per for m ed w it hout r eflect ing on it s m eaning t o w hoev er r eceiv ed or deliv er ed t he car e.
On t h e ot h er h an d , ed u cat ion w as alm ost
a l w a y s co n n e ct e d w i t h t e ch n i ca l a ct i v i t i e s. I t i s c o m m o n f o r p r o f e s s i o n a l c a r e t o b e d e l i v e r e d
m echanically, guided by t asks, in rigid com pliance wit h st andards and prescript ions. Personal relat ions, in t urn,
ar e alm ost alw ay s fr agile.
When t he new m inim al curriculum for nursing
courses in Brazil was approved t hrough Decree 1721/
9 4 by t he Minist r y of Educat ion and Cult ur e ( MEC) , t his per spect ive gave r ise t o our desir e t o w or k w it h
“ Cu r r icu lu m ” an d “ Ped ag og ical Pr act ice” in n u r sin g ed u cat ion .
We s t a r t f r o m t h e p r e m i s e o f a n in t er d ep en d en t r elat ion b et w een t h e cu r r icu lu m on
t he one hand, which represent s t he int ent ion, t he what
and how educat ion should be, and pedagogical pract ice
on t he ot her, which should put t his plan int o pract ice, t hat is, t he academ ic t r aining pr ocess.
I n a d d i t i o n , f u r t h e r st u d i e s a r e n e e d e d ,
l o o k i n g a t co n cr et e r ea l i t i es i n d a i l y p r o f essi o n a l pedagogical pr act ice.
Hence, w e int ended t o st udy t he r ealit y w e ex per ienced as facult y m em ber s and co- par t icipant s
in it s adm in ist r at ion , as w e h ad t h e oppor t u n it y t o experience it as a facult y m em ber, coordinat or of t he
Cou r se Cou n cil an d Dir ect or of t h e Healt h Scien ce
Dep ar t m en t .
I n t h i s s e n s e , w e p r e s e n t t h e r e s e a r c h
p r o b l e m a n d o b j e c t i v e , i n q u i r i n g w h e t h e r t h e
cu r r i cu l a r ch a n g e a l t e r e d t e a ch i n g p r a ct i ce a n d ,
consequent ly, m odified nur sing t raining, in t he belief
t h at , if t h is ch an ge ( in pedagogical pr act ice) is n ot
confir m ed, gr aduat es fr om t he UESC under gr aduat e
nur sing cour se w ill not hav e been t r ained accor ding
t o cu r r en t d em an d s, t h at i s, t h e n u r si n g t r ai n i n g
r equ ir ed by con t em por ar y r ealit y.
We want t o r eaffir m t hat t his st udy neit her
i n t en d ed t o p r esen t a r ead y - m ad e p r o p o sal f o r a
cu r r i cu l u m o r p ed a g o g i ca l p r a ct i ce m o d el , n o r t o
r ealize an in- dept h ex plor at ion of nur sing educat ion
or of t he facilit at ing elem ent s and difficult ies t hat were
im posed by t he changes caused by t he SENADEns
-Nat ional Sem inars of Guidelines for Nursing Educat ion
in Br azil.
I t s h o u l d a l s o b e e m p h a s i z e d t h a t w e
a t t e m p t e d t o l o o k a t t h e a c a d e m i c m o m e n t
e x p e r i e n c e d b y t h e c o u r s e u n d e r s t u d y i n t h e
co n t ex t o f t h e p u b l i cat i o n o f Reso l u t i o n CNS/ CES
N o 3 , i s s u e d i n 2 0 0 1 , w h i c h e s t a b l i s h e d t h e
c u r r i c u l a r g u i d e l i n e s f o r u n d e r g r a d u a t e n u r s i n g
co u r se s.
OBJECTI VES
Gen er al Ob j ect iv e
- Descr ibe an d ex plain t each in g pr act ice in
t h e n u r si n g co u r se o f f e r e d a t Sa n t a Cr u z St a t e
Un iv er sit y ( UESC) in coh er en ce w it h t h e p r in cip les
and int ensions of t he current curriculum ( MEC Decree
1721/ 94 MEC) .
Specif ic Obj ect iv es
- Ch ar act er i ze t h e p ed ag o g i cal p r act i ce o f f acu l t y
m em bers in t he undergraduat e nursing course offered
at UESC.
- Analy ze if t his pr act ice is com pat ible w it h/ com plies
w it h t h e ph ilosoph ical- m et h odological an d scien t if ic
int ensions of t he Br azilian cur r icular pr oposal.
- Analyze t he curricular proposal of t he undergraduat e
nur sing cour se at UESC, w it h r espect t o:
- philosophical- m et hodological concept ions ( pr em ises
an d obj ect iv es) ;
- char act er ist ics/ pr ofile of educat ion pr ofessionals;
METHODS
Th i s d escr i p t i v e st u d y w a s ca r r i ed o u t a t
Sant a Cr uz St at e Univer sit y, locat ed in I lhéus, a cit y
in t he Sout h of Bahia, Brazil, and in hospit al and healt h
unit s ( pract ice and supervised t raining inst it ut ions for
under gr aduat e nur sing st udent s fr om UESC) , locat ed
in I t abuna, an area influenced by t he UESC. The st udy
p o p u l a t i o n i n c l u d e d UESC f a c u l t y m e m b e r s a n d
st u den t s.
Th e f o l l o w i n g i n c l u s i o n c r i t e r i a w e r e
co n si d er ed t o sel ect t h e st u d y sa m p l e: b ei n g a n
effect iv e or su bst it u t e facu lt y m em ber w h o t each es
or t au g h t in t h e u n d er g r ad u at e n u r sin g cou r se at
UESC, and being a st udent in t he eight sem est er of
t his cour se. The r esear ch populat ion consist ed of 72
f a c u l t y m e m b e r s a n d 4 1 s t u d e n t s . Fr o m t h i s
popu lat ion , w e select ed t h ose st u den t s an d f acu lt y
m em ber s w h o at t en ded t h e places of st u dy on t h e
day s w hen dat a w er e collect ed, bet w een Mar ch and
June 2001. Thus, t he sam ple consist ed of 45 facult y
m em bers and 37 st udent s, t hat is, 82 subj ect s.
D a t a co l l e ct i o n i n st r u m e n t s i n cl u d e d o n e
q u e s t i o n n a i r e f o r f a c u l t y m e m b e r s a n d o n e f o r
st udent s, bot h w it h open and closed quest ions; and
dir ect obser v at ion scr ipt s for t he w r it t en r egist r y of
facu lt y m em ber s’ an d st u den t s’ t h eor et ical- pr act ical
act ivit ies during classes, m eet ings at t he UESC Healt h
Sci e n ce D e p a r t m e n t a n d Un d e r g r a d u a t e Nu r si n g
Co u r se Co u n ci l a n d d a i l y co u r se r e a l i t y ; b e si d e s
d ocu m en t ar y an aly sis.
Qu a n t i t a t i v e d a t a w e r e a n a l y ze d t h r o u g h
d e s c r i p t i v e s t a t i s t i c s ( m e a n s , p e r c e n t a g e s a n d
fr equ en cies) . Qu alit at iv e dat a w er e collect ed du r in g
d ir ect ob ser v at ion s of t h eor et ical- p r act ical classes,
f a c u l t y a n d s t u d e n t a c t i v i t i e s , H e a l t h S c i e n c e
D e p a r t m e n t m e e t i n g s a n d d a i l y c o u r s e r e a l i t y ;
i n t e r v i e w s w i t h d e p a r t m e n t h e a d s a n d c o u n c i l
m e m b e r s a n d d o c u m e n t a r y a n a l y s i s , a n d
com plem ent ed st at ist ical dat a, clar ify ing, suppor t ing
and/ or br oadening t he possibilit y of analy zing t hese
t ables, discussing r esult s and r eaching conclusions.
We an aly zed d at a ab ou t h ow t h ese f acu lt y
m em bers and st udent s underst ood curriculum, in t he
l i g h t o f t h e c o n c e p t a d d r e s s e d i n t h e s u b j e c t
Curriculum of t he Mast er’s Course in Educat ion - UESC/
UFBA ( 1 9 9 5 ) ; w it h r espect t o cur r iculum t y pes, t h e
r efer ence fr am ew or k w as based on t w o ex per t s( 10- 11)
w ho w or k w it h Cur r iculum Ty pology ; for appr oaches
t o t h e t e a c h i n g - l e a r n i n g p r o c e s s a n d t e a c h i n g
p r a ct i ce s, w e e l a b o r a t e d a r e f e r e n ce f r a m e w o r k
based on aut hors( 4,12) who work wit h t his t hem e. Anot her
r ef er en ce sou r ce w as b ased on d ocu m en t s b y t h e
Br azilian Nur sing Associat ion, called: New cur r iculum
proposal for nursing courses: nursing educat ion( 13) and
Na t i o n a l Cu r r i cu l a r Gu i d e l i n e s f o r Un d e r g r a d u a t e
Nur sing Cour ses( 14).
This r esear ch follow ed t he et hical fr am ew or k
det er m ined in Resolut ion No 196/ 96 by t he Nat ional
Healt h Council ( CNS) , about research involving hum an
bein gs ( Appr ov al by t h e Et h ics Com m it t ee an d t h e
I t abuna Sant a Casa de Miser icór dia) . All par t icipant s
signed t he Fr ee and I nfor m ed Consent Ter m .
RESULT ANALYSI S AND DI SCUSSI ON
Before m oving on t o t he result s, we highlight
t he not iceable lack of st udies about t he pedagogical
pr act ice of u n der gr adu at e n u r sin g f acu lt y m em ber s
an d u n d er g r ad u at e n u r sin g cou r se cu r r icu la. Th ese
a s p e c t s h a v e n o t b e e n i n v e s t i g a t e d f o r t h e
under gr aduat e nur sing cour se at UESC.
As t o sam p le ch ar act er ist ics, m ost f acu lt y
m em ber s w er e w om en ( 82.2% ) , bet w een 31 and 50
y ear s; liv ed in I t abu n a ( 9 3 . 4 % ) an d w er e ef f ect iv e
faculty at the UESC Health Science Departm ent ( HSD) ;
worked 40 hours per week and graduat ed from UESC.
At t he t im e of dat a collect ion, m ost of t hese facult y
m em bers w ere t aking st rict o sensu t raining in form al
con t act w it h a Pedagogical Tr ain in g cou r se/ su bj ect .
Alm ost half of t he sam ple had w or k ed at t he UESC
bet ween 6 and 15 years and m ost of t hem had earlier
t eaching experience, adm inist ering pre- professional and
professional subj ects in nursing technician and auxiliary
training courses. Most of the sam ple m em bers involved
in technical activities at the tim e of data collection worked
in hospit als or in healt h service adm inist rat ion. Hence,
this was an ideal sam ple for this research, as participants
had cont act wit h nursing work pract ice and were also
act ive in nursing t raining.
Wit h respect t o t he year of course conclusion,
m ost par t icipant s gr aduat ed fr om UESC bet w een t he
1980’s and 2000, t hat is, in t he last t wo decades. This
m eans t hat a m aj or it y ( 80% ) gr aduat ed in t he “ old”
curriculum , which was used bet ween 1972 and 1997,
a n d sh o u l d t h e r e f o r e , i n t h e o r y, k n o w a b o u t t h e
We a l s o w o r k e d w i t h a s a m p l e o f l a s t
-sem est er n u r sin g st u d en t s, m ost ly w om en ( 8 1 % ) ,
bet ween 22 and 33 years old, wit h a m ean age of 23
y ear s. I n ot h er w or ds, a gr ou p of y ou n g gr adu at es
t h at con f ir m s n u r sin g as a p r ep on d er an t ly f em ale
p r of ession .
Tab les 1 an d 2 illu st r at e t h e r esu lt s ab ou t
f acu lt y m em b er s’ an d st u d en t s’ con cep t ion s of t h e
cur r iculum , show ing how close t heir concept ions ar e.
This allows us t o conclude t hat m ost facult y m em bers
and, consequent ly, st udent s do not seem t o be able
t o for m a concept about cur r iculum .
Table 1 - Dist ribut ion of nursing undergraduat e facult y
sa m p l e f r o m UESC, a cco r d i n g t o t h e i r cu r r i cu l a r
c o n c e p t i o n i n l i n e w i t h t h e a d o p t e d t h e o r e t i c a l
fr am ew or k . I lhéus, BA. 2001
m en t i o n w h a t w er e t h e m a i n ch a n g es t h e “ New ”
Curriculum caused in t he UESC undergraduat e Nursing
cou r se.
A com parison bet w een t he hour loads of t he
“ old” and t he “ new” curriculum showed t hat about 41%
of t he t ot al hour load of t he course, corresponding t o
3 , 8 2 5 h ou r s t od ay, is d est in ed at h osp it al- r elat ed
su b j ect s, w h ile on ly 2 1 % is occu p ied b y collect iv e
healt h disciplines. These dat a are coherent wit h earlier
research result s, which showed t hat , in a t ot al course
of 2,970 hours, 44.4% was dest ined at hospit al- relat ed
subj ect s and only 13.1% at public healt h subj ect s( 15).
Wit h respect t o t he curriculum t ype, according
t o t h e pr oposed t y pology( 1 0 - 1 1 ), m ost of t h e f acu lt y
m em b er s’ a n sw er s sh o w t h a t t h ey co n cei v ed t h e
c u r r e n t c u r r i c u l u m a s a c o l l e c t i o n c u r r i c u l u m ,
char act er ized by or ganizat iv e, disint egr at ed, isolat ed
an d r ig id p r in cip les. I n t h is cu r r icu lu m , k n ow led g e
( con t en t s) is h ier ar ch ically ar r an g ed . Con t en t s ar e
obligat ory and separat ed from each ot her; knowledge/
c o n t e n t i s d i s c i p l i n a r y / c l o s e d, s p e c i a l i z e d ; a n d
considered as t he sacred propert y of few people. The
r elat ion b et w een su b j ect s is closed , w it h con t en t s
d elim it ed in a v er t ical r elat ion . Con t en t is h eld b y
w h oev er t each es an d assesses it . Facu lt y m em ber s
can act t heir own way wit hin prescribed lim it s.Subj ect s
ar e isolat ed by in div idu alized t ask s. As t o t each in g
a s s e s s m e n t , t h i s c u r r i c u l u m v a l u e s s t u d e n t s ’
su b ser v ien ce an d p assiv en ess t ow ar d s k n ow led g e,
pr om ot ing indiv idualism and int r oducing t he logic of
m ar k et r elat ions int o t he t eaching sy st em ( qu an t it y
p r ev ails).
W i t h r e s p e c t t o t h e i r c o n c e p t i o n o f
Pedagogical Pr act ice, r esult s allow us t o affir m t hat
m ost facu lt y m em ber s’ idea of pedagogical pr act ice
approaches or coincides wit h t he t radit ional concept ion,
as p r o p o sed( 1 0 ), r ev eal ed b y t ech n i cal - m ech an i cal
act ions, t o t he det r im ent of t he hum anist ic appr oach
an d act ion s r ecom m en ded by t h e cu r r icu lar r efor m .
These dat a w er e confir m ed by t he st udent s’ opinion
and are shown in Tables 3 and 4.
Pe d a g o g i c a l Pr a c t i c e c o n c e p t i o n s w e r e
classif ied as Tr ad it ion al ( TC) , Hu m an ist ic ( HC) an d
Vagu e/ Con f u sin g/ I m pr ecise ( VCI C) , con sider in g t h e
crit erion of “ being close or not ” t o Pedagogical Pract ice
co n ce p t s( 1 0 ) ( TC a n d H C) , co n st r u ct e d / d e scr i b e d
accor ding t o 11 it em s: t eaching, m an, w or ld, societ y
cu lt u r e, k n ow ledge, edu cat ion , sch ool, t each in g
-l e a r n i n g , t e a c h e r - s t u d e n t , m e t h o d o -l o g y a n d
assessm en t .
n o i t p e c n o C r a l u c i r r u
C No %
y l n o k r o w e m a r f m u l u c i r r u c s a d e z il a u t p e c n o
C 21 46.6
) g n i s u f n o c , e u g a v ( t p e c n o c e h t h ti w e d i c n i o c t o n s e o
D 9 20.0
t p e c n o c e h t h t i w s e d i c n i o c y ll a it r a
P 7 15.5
" e a t i v m u l u c i r r u c " h t i w p u d e x i
M 5 11.1
t p e c n o c a e t a l u m r o f o t e g a n a m t o n d i
D 2 4.4
t p e c n o c e h t h t i w s e d i c n i o c y li r o t c a f s it a
S 1 2.2
l a t o
T 45 100
Table 2 - Dist r ibu t ion of t h e n u r sin g u n der gr adu at e
s t u d e n t s a m p l e f r o m U ES C, a c c o r d i n g t o t h e i r
c u r r i c u l a r c o n c e p t i o n i n l i n e w i t h t h e a d o p t e d
t heor et ical fr am ew or k . I lhéus, BA. 2001
n o i t p e c n o C r a l u c i r r u
C No %
y l n o k r o w e m a r f m u l u c i r r u c s a d e z il a u t p e c n o
C 21 58.8
" e a t i v m u l u c i r r u c " h t i w p u d e x i
M 12 32.4
t p e c n o c e h t h t i w s e d i c n i o c y ll a it r a
P 2 5.4
) g n i s u f n o c , e u g a v ( t p e c n o c e h t h ti w e d i c n i o c t o n s e o
D 1 2.7
d e r e w s n a t o
N 1 2.7
t p e c n o c e h t h t i w s e d i c n i o c y ll u
F 0 0.0
l a t o
T 37 100
Alt hough t hey affir m ed t hat t hey k new w hy
ABEn - t he Brazilian Nursing Associat ion( 13) proposed a
reform of the Nursing Undergraduate Course Curriculum
- 1 9 7 2 ( Old Cu r r icu lu m ) , w h en t h ey w er e ask ed t o
explain t hese reasons, m ost facult y m em bers ( 62.3% )
did not m anage t o give any j ust ificat ion t hat got near
t he act ual reasons. Moreover, alt hough m ost of t hese
su b j ect s i n f o r m ed t h ey k n ew w h a t ch a n g es w er e
int ended for t he UESC undergraduat e nursing course,
w hen t hey w er e ask ed t o quot e t hese changes, t hey
did not m anage t o giv e any answ er s t hat coher ent ly
coincided wit h t he int ended curricular reform .
Besid es t h eir d if f icu lt ies t o con cep t u alized
Tab le 3 - Nu m er ical an d p er cen t ag e d ist r ib u t ion of
t he undergraduat e nursing facult y sam ple from UESC
according t o t heir concept ion of pedagogical pract ice.
I lhéus, BA. 2001
c o g n i t i v e , a f f e c t i v e a n d p s y c h o m o t o r d o m a i n s .
Consequent ly, t hey do not at t end t o t he int egral form
of h u m an ized car e r eq u ir ed b y t h e h ealt h act . We
need t o under st and t hat hum anizing t he healt h car e
p r o c e s s r e q u i r e s a f f e c t i v e a n d p s y c h o m o t o r
c o m p e t e n c i e s , b e s i d e s r e c o r d s a n d c o g n i t i v e
com p et en cies.
Alt hough t he facult y m em ber s consider t hat
t he course subj ect s are int egrat ed, t his int egrat ion is
ch ar act er ized as t r adit ion al, w it h st r on gly iden t if ied
p r er eq u i si t es an d w el l d el i m i t ed co n t en t s i n each
disciplin e. I n t h is case, w e believ e t h at t h e f acu lt y
m e m b e r s h a v e n o t y e t c o n s i d e r e d o r n o t e v e n
el a b o r a t ed t h e co n cep t s o f i n t er d i sci p l i n a r i t y a n d
m ult idisciplinarit y. This expresses a lack of int egrat ion
in t he nur sing t r aining pr ocess.
Th u s , i f c o n t e m p o r a r y r e a l i t y r e q u i r e s /
dem ands nur sing pr ofessionals w it h a specific pr ofile,
guar ant eed by t r aining, w hich allow s t hem t o dev elop
gen er al com pet en cies an d sk ills, dir ect ed at h ealt h
car e; decision m ak in g; com m u n icat ion ; leader sh ip;
a d m i n i s t r a t i o n a n d p e r m a n e n t e d u c a t i o n, a s
est ablished by t he Nat ional Cur r icular Guidelines for
Under gr aduat e Nur sing Cour ses( 14), t his allow s us t o
under st and t hat t her e is no m or e r oom for t he “ old”
f or m of r elat in g t o k n ow ledge in t h is n ew con t ex t .
Th i s i s a l so t r u e b e ca u se t h e i d e a o f a Su b j e ct
Pr ogr am “ k ept in t he file” com plet ely loses any v alue
i n a w o r l d w h er e n ew i n f o r m at i o n em er g es at an
i n t e n s e p a c e a n d w h e r e t h e s t u d e n t n o l o n g e r
depends on t he t eacher as t he only sour ce of access
t o t his infor m at ion. Hence, t eacher s should lose t he
f ear of in n ov at ion an d “ in v it e” st u den t s t o becom e
par t of t he k now ledge- seek ing effor t , not only in t he
“ old” condit ion of passiv e st udent s but as par t ner s,
w h o sh ou ld b eh av e as su b j ect s of t h e p ed ag og ical
p a i r a n d p a r t i c i p a n t s i n t h e t e a c h i n g - l e a r n i n g
p r o ce ss.
Thus, in principle, in order t o com ply wit h t he
Cu r r icu lar Gu id elin es, w e b eliev e t h at w e n eed t o
con cer n ou r selv es w it h n u r sin g edu cat ion , n ot on ly
using m ut ually disconnect ed, rich cont ent s and skills,
b u t a l so a d d r e ssi n g co m p e t e n ce ca t e g o r i e s l i k e :
u n d er st a n d i n g a n d o p er a t i n g m u l t i p l e l a n g u a g es;
u n d e r s t a n d i n g b i o p s y c h o s o c i a l p h e n o m e n a t h a t
con dit ion h ealt h ; m ak in g decision s t h at in clu de an d
r e s p o n d t o w h a t n o r m a l h a p p e n s a n d i s d o n e ;
underst anding and or responding t o t he unedit ed and/
or unusual; const r uct ing ar gum ent s and int er v ening
in realit y, being aware of t he fact t hat realit y changes.
n o i t p e c n o
C No %
l a n o it i d a r
T 18 40.0
c it s i n a m u
H 10 22.2
e s i c e r p m
I 14 31.2
r e w s n a o
N 3 6.6
l a t o
T 45 100
Tab le 4 - Nu m er ical an d p er cen t ag e d ist r ib u t ion of
t he undergraduat e nursing st udent sam ple from UESC
according t o t heir concept ion of pedagogical pract ice.
I lhéus, BA. 2001
n o i t p e c n o
C No %
l a n o it i d a r
T 26 70.3
c it s i n a m u
H 0 0.0
g n i s u f n o c , e u g a
V 6 16.2
w o n k t' n o d
I 3 8.1
r e w s n a o
N 2 5.4
l a t o
T 37 100
I n f o r m a t i o n b y a l m o s t 8 0 % o f f a c u l t y
m e m b e r s c o r r o b o r a t e s o u r c o n c l u s i o n t h a t t h e
cu r r i cu l a r ch a n g e d i d n o t d e t e r m i n e a ch a n g e i n
Pe d a g o g i c a l Pr a c t i c e i n f u n c t i o n o f t h e “ n e w ”
Cur r iculum . Dat a obt ained t hr ough an int er v iew w it h
t h e Healt h Scien ce Dep ar t m en t h ead r ev ealed t h e
sam e, affir m ing t hat .
Yes, a change occur r ed, but ver y sm all. And
t he changes t hat occurred were due t o t eacher t raining
and t he im plant at ion of t he m edical course, using t he
PBL m odel. And t he subst it ut e facult y who always bring
a m ore open proposal. I don’t t hink t hat t he curricular
r e f o r m co n t r i b u t e d t o t h e ch a n g e i n p e d a g o g i ca l
p r act ice.
We co n cl u d e t h a t , a s a p a r t o f t e a ch i n g
pr act ice, Planning Pr act ices ar e char act er ized neit her
as int egrat ed act ions nor part icipat ion, reaffirm ing t hat
t he inst it ut e’s cur r iculum is a collect ion curriculum(
10-1 10-1 ) .
Th i s a l so r e i n f o r ce s t e a ch i n g i n a t r a d i t i o n a l
a p p r o a ch, t h a t i s, “ i n a l l o f i t s f o r m s, t e a ch e r
-cent er ed”, and st udent s ar e consider ed as “ inser t ed
i n t h e w o r l d t h e y w i l l g e t t o k n o w t h r o u g h t h e
in f or m at ion t h ey w ill r eceiv e an d abou t w h ich t h ey
will decide whet her it is im port ant and useful t o t hem ”.
As t o t he lear ning dom ains addr essed in t he
subj ect s, we conclude t hat m ost facult y m em bers only
ex er cise aspect s in t he cognit iv e dom ain, dedicat ing
l e ss a t t e n t i o n t o t h e a f f e ct i v e a n d p sy ch o m o t o r
Un t il t h e t im e of dat a collect ion , t h e UESC
Nursing Undergraduat e Course followed t he t radit ional
p ed ag og ical m od el an d f acu lt y m em b er s w er e n ot
alert t o t he discordance bet ween t his t ype of approach
and t he obj ect ive of current nursing educat ion, in line
w i t h t h e Cu r r i c u l a r Gu i d e l i n e s a n d t h e a u t h o r s
con su lt ed an d r ef er r ed t o in t h is st u d y. Hen ce, w e
consider t hat , t hr ough t his t y pe of appr oach, w e ar e
losing t he prim ary role of nursing out of sight , which
w e believe is t he int egr alit y of hum an car e.
Th e s e r e s e a r c h f i n d i n g s r e v e a l a w e a k
at t em pt t o est ablish prerequisit es as t he only form of
i n t e r d i sci p l i n a r i t y. An d f a cu l t y m e m b e r s n e i t h e r
u n der st an d n or see t o t h ese pr er equ isit es, becau se
t hey do not t reat t he subj ect s as int erdependent and
m ut ually com plem ent ary. I t seem s t o us t hat t his fact
can explain, at least part ially, difficult ies t o guarant ee
int egral care, hum an care t o t he subj ect as a w hole.
Accor ding t o dat a pr ov ided by t he st udent s,
t eacher s m ost fr equent ly used t he follow ing t eaching
m e t h o d s: e x p o si t i v e cl a sse s, se m i n a r s a n d w o r k
g r o u p s . Th e s e r e s u l t s c o i n c i d e w i t h t h e f a c u l t y
m e m b e r s ’ i n f o r m a t i o n , r e i n f o r c e d b y f i e l d
observat ions, w hich show ed exposit ive classes as t he
pr edom in an t , con t en t - cen t er ed act iv it y.
As t o t each er s’ an d st u d en t s’ p er cep t i o n s
about t he st udent - t eacher relat ion, we can affirm t hat
b o t h g r o u p s d e f i n i t e l y e x p e r i e n ce d d i f f i cu l t i e s t o
ch ar act er ize t h e t y p e of r elat ion t h at u n it es t h em .
Alt hough t hey affir m ed t hat t hey w er e int er locut or s,
t hey faced difficult ies t o specify charact erist ics of t he
desired st udent profile, t hat is, what t he t eacher want s
and w hat t he st udent believes t he t eacher w ant s, as
t he it em s facult y m em bers m ent ioned in t he at t em pt
t o char act er ize t he desir ed st udent w er e pulv er ized,
w it hout any consensus.
Con sider in g dat a abou t t h e st u den t - t each er
relat ion, and com paring t hem wit h previously analyzed
dat a about planning pract ices, plan execut ion pract ices
and learning assessm ent pract ices, w e conclude t hat ,
alt h ou gh som e facu lt y m em ber s m en t ion ed bein g a
cr eat ive, par t icipat ive, cr it ical, et hical, inquisit ive and
i n t e r a ct i v e ci t i ze n a n d p r o f e ssi o n a l a s d e si r a b l e
st u d e n t ch a r a ct e r i st i cs, t h e p e d a g o g i ca l p r a ct i ce
d e v e l o p e d i n t h e t r a d i t i o n a l t e a c h i n g a p p r o a c h
co m p l i cat es o r ev en i m p ed es t h e d ev el o p m en t o f
t hese t rait s. I n t he t radit ional approach, t he t
eacher-st u d en t r el a t i o n i s v er t i ca l . On e o f t h e ex t r em es
( t each er ) h olds t h e pow er t o m ak e decision s abou t
m e t h o d o l o g y, co n t e n t s, a sse ssm e n t a n d f o r m o f
int eract ion, am ong ot hers. On t he ot her end, st udent s
are expect ed t o subm it t o t his power. Facult y m em bers
ar e r esp on sib le f or in f or m in g an d con d u ct in g t h eir
st udent s t owards obj ect ives t hat are ext ernal t o t hem ,
because t hey w er e chosen by t he school and/ or t he
societ y t hey liv e in and because t he subj ect s of t he
p r o cess, i . e. t h e st u d en t s, h av e n o t i n t er n al i zed /
assu m ed t h em .
FI NAL CONSI DERATI ONS
I n view of t he dat a discussed above, we can
co n si d e r t h a t a p e d a g o g i ca l p r o j e ct n e e d s t o b e
collect ively const ruct ed for t he course under analysis,
w h ich h eed s t o a h u m an ist ic f or m at ion an d t o t h e
biopsy ch osocial h u m an ph en om en a t h at can appear
as indiv idual as w ell as collect iv e social needs.
Figure 1 is an analogical m odel which, in our
opinion, represent s t he realit y of t he current curriculum
adopt ed in t he undergraduat e nursing course at UESC.
Figur e 1 - Cur r ent r ealit y of Under gr aduat e Nur sing
Cour se Cur r iculum at UESC - 2002
Th is m od el an alog ically in t en d s t o ex p r ess
t h e r elat ion am on g sig n if ican t elem en t s t o f or m a
concept of curriculum , in t his case charact erized as a
collect ion cu r r icu lu m , w it h ou t ar t icu lat ion w it h t h e
r e a l i t y i t i s s u p p o s e d t o s e r v e , a n d w i t h o u t a
co n n ect i o n b et w een p ed ag o g i cal p r act i ce an d t h e
int ent ions declared in t he curriculum proposal. I n t he
a n a l y z e d c o u r s e , t w o f a c t s a r e e v i d e n c e d : t h e
Cu r r i cu l u m , w h i ch f a cu l t y m em b er s a n d st u d en t s
u n der st an d as t h e cu r r icu lu m f r am ew or k , an d each
f acu l t y m em b er ’s Ped ag o g i cal Pr act i ce sep ar at el y,
w i t h o u t co m m o n o b j e ct i v e s, l e t t i n g e a ch f a cu l t y
m em ber act according t o his/ her part icular concept ion
o f p ed a g o g i ca l p r a ct i ce. I n t h i s m o d el , Rea l i t y i s
4'#.
%744+%7.7/ 4'#.+6;
r epr esen t ed by t h e r egion al h ealt h con t ex t an d, as w e o b ser v ed , h av e n o t b een u sed as a r ef er en ce p a r a m e t e r f o r t h e c o u r s e . I n o t h e r w o r d s , t h e
Cu r r i cu l u m a n d t h e Pe d a g o g i ca l Pr a ct i ce a r e n o t
consider ing t he r egional healt h cont ex t .
I n t his perspect ive, w e believe t hat t he dat a w e o b t a i n e d f r o m r e a l i t y c a n s u p p o r t t h e ( r e ) c o n s i d e r a t i o n a n d / o r ( r e ) o r g a n i z a t i o n o f a
pedagogical pr oj ect , as w ell as t he ( r e) dim ensioning o f p e d a g o g i c a l a c t i o n s b y UES C u n d e r g r a d u a t e n u r sin g f acu lt y m em b er s, g u id ed b y an an alog ical m odel w hich w e believ e is ideal or close t o ideal, as
pr esent ed in Figur e 2.
Fig u r e 2 is an an alog ical m od el, w h ich w e believ e is ideal or close t o ideal and m or e coher ent w i t h Re a l i t y. I n t h i s c o n c e p t i o n , Cu r r i c u l u m , Pe d a g o g i ca l Pr a ct i ce a n d Re a l i t y a r e i n t e g r a t e d ,
at t ending t o com m on needs. This w ould r esult in an
in t egr at ion cu r r icu lu m , in pedagogical pr act ice w it h h u m an ist ic act ion s, w h er e Realit y (r eg ion al h ealt h con t ex t ) in clu d es all su b j ect s, r eceiv in g p r ior it y in
c u r r i c u l a r o r g a n i z a t i o n , s t i m u l a t i n g c o n s t a n t a s s e s s m e n t s o f p e r t i n e n c e a n d a n y n e c e s s a r y cor r ect ion s/ ad ap t at ion s.
We are referring t o academ ic t raining t hrough
int egr at ed act ions ( Figur e 2) , pr epar ing pr ofessionals w h o a r e d i r e c t e d a t u n d e r s t a n d i n g a n d m a k i n g p ossib le act ion s of t h e “ Healt h Act ’s Pair ” - w h ich con sist s of t h e h ealt h p r of ession al an d t h e su b j ect
seek ing help fr om healt h ser v ices. This pr esupposes cooper at ion bet w een peer s, bet w een t he par t ner s in t h ese coop er at iv e act ion s, as t h ese p eop le j oin t o r e a l i ze a co m m o n t a sk w i t h t h e sa m e o b j e ct i v e ,
perform ing t he cooperat ive act ions needed t o m aint ain an d/ or r ecov er h ealt h .
ACKNOW LEDGEMENTS
To Mar idalva Pent eado, for her collaborat ion
in t he elaborat ion of t his art icle. Figur e 2 - Under gr aduat e Nur sing Cour se Cur r iculum
a t U ES C, t o b e c o n s t r u c t e d a s a n i n t e g r a t i o n
cu r r icu lu m
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Recebido em : 28.9.2005 Aprovado em : 3.7.2006
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