Interprofessional education and collaborative practice in Primary Health Care. / Educação interprofissional e prática colaborativa na Atenção Primária à Saúde.

Objective To understand the perceptions of professors, health care providers and students about the articulation of interprofessional education with health practices in Primary Health Care. Method To understand and interpret qualitative data collection, carried out between 2012 and 2013, through semi-structured interviews with 18 professors and four sessions of homogeneous focus groups with students, professors and health care providers of Primary Health Care. Results A triangulation of the results led to the construction of two categories: user-centered collaborative practice and barriers to interprofessional education. The first perspective indicates the need to change the model of care and training of health professionals, while the second reveals difficulties perceived by stakeholders regarding the implementation of interprofessional education. Conclusion The interprofessional education is incipient in the Brazil and the results of this analysis point out to possibilities of change toward collaborative practice, but require higher investments primarily in developing teaching-health services relationship.

The educational environment of the undergraduate nursing course from the student perspective. / O ambiente educacional do curso de Graduação em Enfermagem na perspectiva dos estudantes.

Objective Evaluate the educational environment of the School of Nursing at the University of São Paulo from the student perspective. Method Quantitative approach with exploratory design. The 176 students who participated in the study answered questions ona Likert scale from 1 to 5 to evaluate the educational environment. The data underwent an exploratory factor analysis and inferential statistical tests, while the reliability of the instrument was verified by Cronbach's Alpha. Results The dimensionality analysis established four factors: support for hands-on learning, with a mean score of 3.64; attitudes during learning, mean score of 2.92; learning atmosphere, mean 3.58; and learning weaknesses,mean 3.04. Conclusion The most favorable factor of the environment was support for learning. The attitudinal competencies received lower scores, suggesting the need to strengthen these aspects during the undergraduate course.

[Higher education in nursing: the faculty work process in different institutional contexts]. / Educação superior em enfermagem: o processo de trabalho docente em diferentes contextos instucionais.

OBJECTIVE: To analyze the characteristics of faculty work in nursing higher education. METHOD: An exploratory qualitative study with a theoretical-methodological framework of dialectical and historical materialism. The faculty work process was adopted as the analytical category, grounded on conceptions of work and professionalism. Semi-structured interviews were conducted with 24 faculty members from three higher education institutions in the city of São Paulo, classified according to the typology of institutional contexts. RESULTS: The faculty members at these higher education institutions are a heterogeneous group, under different working conditions. Intensification and precarious conditions of the faculty work is common to all three contexts, although there are important distinctions in the practices related to teaching, research and extension. CONCLUSION: Faculty professionalization can be the starting point for analyzing and coping with such a distinct reality of faculty work and practice.


Preceptorship contributions to the development of clinical and managerial skills in nursing residency.

OBJECTIVES: to analyze the experience of resident nurses with preceptorship contributions to the development of common clinical and managerial skills acquired in pedagogical projects. METHODS: exploratory qualitative research developed in two stages: document analysis of pedagogical projects and semi-structured interviews with residents. Content analysis was carried out based on the framework of the nurse's work process and skills. RESULTS: the pedagogical projects of the three programs foresee the development of common skills, mostly clinical and only two managerial skills. The 22 residents reported the contributions of preceptorship in the development of competences centered on clinical practice, focusing on technical procedures disjointed from clinical reasoning and the managerial dimension of the nurse's work. FINAL CONSIDERATIONS: it is necessary to train preceptors and involve all social actors linked to residency programs to expand preceptorship potential.

Telehealth use in primary healthcare collaborative interprofessional practice: protocol for a scoping review.

INTRODUCTION: Telehealth is a growing topic, with potential to improve access to primary healthcare. However, there is a lack of knowledge regarding how telehealth could facilitate interprofessional collaboration that is recommended to strengthen the comprehensive approach of primary healthcare. The objective is to identify the characteristics and applications of telehealth services related to the interprofessional collaborative practice of primary healthcare professionals. METHODS AND ANALYSIS: This review will cover studies including as target population those health professionals who work in telehealth services; as concept, telehealth in relation to collaborative interprofessional practice; and as context, primary healthcare. A scoping review will be carried out according to the Joanna Briggs Institute methodology. Databases to be searched include MEDLINE, CINAHL, Embase, Eric, Scopus, LILACS and Web of Science. All identified records will be grouped, duplicates will be removed, titles and abstracts will be selected by two independent reviewers, and the full text of selected articles will be evaluated in detail. A data extraction tool developed by the reviewers will be used for data extraction. The results will be presented in data map format in a logical way, in a diagram or in a tabular format, accompanied by a descriptive summary. ETHICS AND DISSEMINATION: No ethical approval is required for this study. A manuscript based on this scoping review will be submitted to a journal and we hope it will contribute to scientific knowledge on the interprofessional field and key research findings will be sent to key events on interprofessional practice and education. SYSTEMATIC REVIEW REGISTRATION: This scoping review was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/2BV8D).

Interprofessional education at a Brazilian public university: A document analysis.

Background: Interprofessional Education is considered a necessary approach to develop skills for collaborative work in the training of professionals in order to improve the quality of health care. The curricula are the guiding documents for training and should explain how Interprofessional Education is adopted in undergraduate health courses. Objective: To analyze curricula of undergraduate health courses, from the perspective of Interprofessional Education, in a Brazilian public university. Design: Qualitative study of document analysis. Settings: Undergraduate health courses at a Brazilian public university. Methods: 13 undergraduate health courses were analyzed. Data collection was conducted based on an adapted quality assessment script for Interprofessional Education. From the thematic content analysis, three analytical categories emerged. Results: In the category "Curriculum organization and interprofessionality", the courses do not make free periods available in the curriculum, and each of the courses provide space for elective subjects at different times. In the category "Training guided by social reality and health needs" the courses propose training based on the health needs of patients from the Brazilian public health system. In the category "Learning for interprofessional action", the term "multiprofessional" characterizes learning for teamwork, with a discrete number of interprofessional disciplines. Conclusions: The theoretical bases of IPE and organizational goals are necessary to establish training objectives, specific shared times, and mutual interests that are directed to interprofessionality. Interprofessional Education can be expanded from activities that already exist in the curricula of undergraduate courses.

Characterization of interprofessional education experiences in health education at the University of São Paulo.

OBJECTIVE: To map the experiences of Interprofessional Education (IPE) in Health at the São Paulo campus of the University of São Paulo. METHOD: This is a descriptive, exploratory study with a quantitative approach and data collection through an online questionnaire addressed to teachers from eight teaching units and 14 health courses. The data was analyzed using absolute and percentage frequencies. RESULTS: The majority of teachers do not take part in IPE experiences (70.4%). Most of the experiences are between six and ten years old, involving up to four teachers and small groups of students, mostly extracurricular or extension activities. The teaching and assessment strategies are diverse and open to students of all years. CONCLUSION: IPE experiences involve a small number of students and teachers and, although consolidated in terms of the time they have been offered, are limited to extracurricular spaces. Factors such as improvements in institutional support and teacher development are pointed out as important for making progress in strengthening IPE in the analyzed context.

Project-based learning in remote teaching for undergraduate nursing students.

OBJECTIVE: To report the experience of using the Project-Based Learning methodology, in emergency remote teaching, with undergraduate nursing students. METHOD: The study was carried out in the course "Educational Actions in Nursing Practice", developed remotely in 2020, during the pandemic caused by the new coronavirus, in the Bachelor's and Licanciate Degrees in Nursing at a public university in the state of São Paulo. The course used Project-Based Learning through the following phases: anchoring; driving question; investigation and research; creation and development; and presentation of the results as an active learning methodology, with the formation of small groups of students and tutors and process evaluation. RESULTS: The students developed educational projects in health through a virtual learning environment, platforms, and digital tools. CONCLUSION: The methodology adopted and the use of digital technologies allowed the achievement of the proposed objectives, the motivation and autonomy of the students throughout the remote teaching process, and the development of competences for the elaboration of projects in health education for nursing training.

Nursing education in Brazil: a historical perspective. / A formação superior de Enfermagem no Brasil: uma visão histórica.

This article describes the process of the expansion of higher education in Brazilian nursing, highlighting the diversity and heterogeneity of the system. It is observed that teaching in this area developed in a very fast and disorganized fashion, as of the nineties. This growth resulted in great diversity and variety of educational institutions, which are aspects that also affect the profile of the faculty, particularly their title and working arrangements, which vary according to their institutional placement. It is argued that these aspects will, eventually, affect the faculty, and, thus, in the early nursing training, in the qualification of nurses, and, therefore, in the nursing care offered to users of different health services. In conclusion, it is necessary to identify the professional profile and the particular working processes, contextualized in the current setting of the public policies for higher education in Brazil.

Expansion of undergraduate Nursing courses: distance education scenario, interests, and challenges. / A expansão dos cursos de graduação em Enfermagem: cenário, interesses e desafios do ensino a distância.

OBJECTIVE: To analyze the expansion of undergraduate Nursing courses in Brazil, especially those in the distance education modality. METHODS: Exploratory, descriptive, analytical, and documentary study that used the Statistical Overview of Higher Education - Undergraduate Courses, of the Brazilian National Institute for Educational Studies and Research "Anísio Teixeira", which is part of the Ministry of Education and Culture, as a source of secondary data for the period between 2009 and 2018. RESULTS: There was a growth in the number of undergraduate Nursing courses and new seats in the distance education modality. However, only 8.89% of these seats were occupied and 3.39% of the enrolled students completed the course, which accounted for 0.30% of the new seats. CONCLUSION: The expansion of undergraduate Nursing courses is aligned with the general trends in higher education. This scenario exposes the interests of capital in education, which emphasizes the need for collective development of strategies to guarantee the right to education that is public, free and has social quality.

[Integrality of healthcare as an educational competency of the nurse]. / Integralidade do cuidado à saúde como competência educativa do enfermeiro.

The objective of this study was to identify the meaning of comprehensiveness as found in the discourse of those involved in primary nursing education. The methodological framework employed was historic and dialectical materialism. Thirty subjects were interviewed: five professors, five students, ten nurses, two managers and eight patients from two healthcare teaching clinics. Discourse was analyzed using the discourse analysis method. Although comprehensiveness takes on different meanings in the discourse of the respondents, they are all associated with comprehensiveness know-how, where healthcare is based on a true commitment and a sense of trust between professionals and patients. In conclusion, promoting the comprehensiveness of healthcare is a fundamental competency that needs to be further developed in primary nursing education.

Expansion of the interprofessional clinical practice of Primary Care nurses.

OBJECTIVE: To analyze the clinical practice of nurses in the interprofessional context of the Family Health Strategy. METHOD: Case study in a basic health unit of the city of São Paulo with a professional team of the Family Health Strategy and of the Family Health Support Center. Direct observation and interviews with thematic analysis and triangulation were conducted. RESULTS: Four empirical categories were identified: interprofessional actions guided by the logic of the user's health needs; interprofessional actions guided by the logic of expediting service; interprofessional actions with a biomedical approach and interprofessional actions with an integral/holistic approach. Six interprofessional actions that indicated the expansion of the clinical practice of the Family Health Strategy's nurses were also identified. CONCLUSION: The results express the world trend of interprofessional practice and expansion of the scope of practice of different professions, particularly that of nurses, which requires consolidation based on the population's health needs.

Prevalence of sexually transmitted infections and bacterial vaginosis among lesbian women: systematic review and recommendations to improve care.

Our aim was to systematically review data about the risk of sexually transmitted infections (STI) and bacterial vaginosis among lesbian women and to suggest strategies to improve prevention, diagnosis and treatment. A search strategy for lesbian, STI and bacterial vaginosis was applied to PubMed, LILACS and BDENF databases. Of 387 unique references retrieved, 22 fulfilled the inclusion criteria (cross-sectional studies reporting prevalence for 8 STIs/bacterial vaginosis and history of a STI). The most frequent infection reported was bacterial vaginosis, and none study reported data on hepatitis B. A wide range of prevalence was observed for most infections. In terms of risk factors, the number of sexual partners, the past or current smoking, a history of forced sex and sexual stigma seem to increase the risk of STI and bacterial vaginosis. The findings of this review are discussed considering guidelines directly addressing the LGBT community's health and relevant studies investigating both safe sexual practices and the intricate relationship between LGBT people and their care providers. A set of recommendations to improve preventive care for lesbian women is proposed. Affirming that little is known about the extent of STIs and bacterial vaginosis transmission in female-to-female sexual activities or about the risk factors for STI and bacterial vaginosis among lesbian women is reasonable. In fact, the overall quality of the studies was low or very low with significant uncertainty around their findings. However, we consider that the available knowledge indicates some paths to be followed by care providers and policy decision-makers to improve their actions towards better sexual health of lesbian women.

Competencies for educational activities in nursing.

UNLABELLED: The focus of this study is the interface between nursing education and nursing care in its educative dimension. OBJECTIVE: To develop a profile of competencies for nursing care education from the perspective of the subjects involved. METHOD: Historical and dialectical materialism was used as the theoretical and methodological framework. Competence was addressed as the conceptual category, as defined by Perrenoud, based on healthcare concepts and on instrumental knowledge as advocated by Mendes-Gonçalves. RESULTS: the analysis of empirical material resulted in the creation of 10 core competencies for nursing education activities. CONCLUSION: The need to give a new meaning to education action from the perspective of Popular Education implies the development of pedagogical opportunities during their undergraduate studies in order to enable students to use their knowledge and skills to develop a dialogical attitude of recognition of the subjects of nursing care.

Competencies for educational actions of Family Health Strategy nurses.

OBJECTIVE: To create competencies for the educational actions of nurses in the care and management work processes at the Family Health Strategy. METHOD: This is an exploratory, descriptive research, with a qualitative approach, on nurses of the Family Health Strategy (FHS) from a municipality in the Greater São Paulo. It was performed through semi-structured interviews and workshops. RESULTS: There is a set of specific competencies for the educational actions of the nurse in care work, geared towards meeting the health needs of users/community; and for educational actions in management work, focused on work organization of the health team, indicating the importance of this work to FHS. Final considerations: Creating competencies proved to be significant to reflect on the educational actions of the FHS nurses and can be used as a strategy in permanent education processes.

Advanced practice nursing: a possibility for Primary Health Care?

OBJECTIVE: Reflect on the role of advanced practice nursing (APN) in the context of Brazilian primary health care. METHOD: analysis of the main scientific productions and of the discussion on the implementation of APN. RESULTS: there are favorable areas for the work of APN in primary health care, especially in the family health strategy. Professional master's degree and nurse residency programs constitute powerful training spaces. As a challenge, standardized definition of the roles of advanced practice nurses and of minimum training for work are necessary. FINAL CONSIDERATIONS: researches that contribute to understanding the perspectives, facilitators, and barriers for APN are necessary, as well as determining the population's health needs and expectations concerning the role of these professionals.

Preceptorship contributions to the development of clinical and managerial skills in nursing residency / Contribuciones de la preceptoría para el desarrollo de competencias clínicas y gerenciales en la residencia en enfermería / Contribuições da preceptoria para o desenvolvimento de competências clínicas e gerenciais na residência em enfermagem

ABSTRACT Objectives: to analyze the experience of resident nurses with preceptorship contributions to the development of common clinical and managerial skills acquired in pedagogical projects. Methods: exploratory qualitative research developed in two stages: document analysis of pedagogical projects and semi-structured interviews with residents. Content analysis was carried out based on the framework of the nurse's work process and skills. Results: the pedagogical projects of the three programs foresee the development of common skills, mostly clinical and only two managerial skills. The 22 residents reported the contributions of preceptorship in the development of competences centered on clinical practice, focusing on technical procedures disjointed from clinical reasoning and the managerial dimension of the nurse's work. Final Considerations: it is necessary to train preceptors and involve all social actors linked to residency programs to expand preceptorship potential.

RESUMEN Objetivos: analizar experiencia de enfermeros residentes con las contribuciones de la preceptoría para el desarrollo de las competencias clínicas y gerenciales comunes previstas en los proyectos pedagógicos. Métodos: investigación cualitativa exploratoria desarrollada en dos etapas: análisis documental de los proyectos pedagógicos y entrevista semiestructurada con residentes. Realizado análisis de contenido fundamentado en el referencial del proceso de trabajo del enfermero y de competencias. Resultados: los proyectos pedagógicos de los tres programas prevén el desarrollo de competencias comunes mayormente clínicas y solo dos competencias gerenciales. Los 22 residentes relataron las contribuciones de la preceptoría en el desarrollo de competencias centradas en la prática clínica, con enfoque en procedimientos técnicos separados del raciocinio clínico y de la dimensión gerencial del trabajo del enfermero. Consideraciones Finales: es necesaria la formación de los preceptores y el involucramiento de todos los actores sociales vinculados a programas de residencia para ampliar el potencial de la preceptoría.

RESUMO Objetivos: analisar a experiência de enfermeiros residentes com as contribuições da preceptoria para o desenvolvimento das competências clínicas e gerenciais comuns previstas nos projetos pedagógicos. Métodos: pesquisa qualitativa exploratória desenvolvida em duas etapas: análise documental dos projetos pedagógicos e entrevista semiestruturada com residentes. Realizou-se análise de conteúdo fundamentada no referencial do processo de trabalho do enfermeiro e de competências. Resultados: os projetos pedagógicos dos três programas preveem o desenvolvimento de competências comuns majoritariamente clínicas e apenas duas competências gerenciais. Os 22 residentes relataram as contribuições da preceptoria no desenvolvimento de competências centradas na prática clínica, com foco em procedimentos técnicos separados do raciocínio clínico e da dimensão gerencial do trabalho do enfermeiro. Considerações Finais: faz-se necessária a formação dos preceptores e o envolvimento de todos os atores sociais vinculados aos programas de residência para ampliar o potencial da preceptoria.

Residências em saúde em hospital universitário: cenário potente de formação para a prática colaborativa interprofissional / Health residency programs in a university hospital: a potent training setting for interprofessional collaborative practice / Residencias sanitarias en un hospital universitario: un potente escenario de formación para la práctica colaborativa interprofesional

Resumo Este estudo tem por objetivo compreender a experiência de residentes sobre a Prática Colaborativa Interprofissional (PCI) em um hospital universitário (HU) do estado de São Paulo. É uma pesquisa qualitativa realizada por meio de entrevistas semiestruturadas com base na Técnica do Incidente Crítico, com 14 residentes de programas de residência uni e multiprofissionais, analisadas pela análise temática de Bardin. O HU mostrou-se potente para efetivação da PCI por proporcionar interações entre profissionais de diferentes áreas e níveis de formação. A qualidade das interações entre trabalhadores, residentes, usuários e família foi determinante para o desenvolvimento da PCI. Foram identificadas barreiras como ausência de estruturação organizacional, sobrecarga dos profissionais, fragilidade na oferta de Educação Permanente relacionada à educação interprofissional e predomínio do modelo biomédico de Atenção à Saúde. As ações colaborativas mediadas pela comunicação informal constituem o dispositivo mais utilizado para os atendimentos compartilhados.(AU)

Abstract The aim of this study was to explore residents' experiences of interprofessional collaborative practice (ICP) in a university hospital (UH) in São Paulo. We conducted a qualitative study with 14 residents undertaking uniprofessional and multiprofessional residency programs. The data were collected using critical incident technique-based semi-structured interviews and analyzed using thematic analysis as proposed by Bardin. The UH was shown to be a potent training setting for ICP, promoting interactions between professionals from a range of areas and with varying levels of qualification. The quality of interactions between workers, residents and patients and their families was a determining factor for the development of ICP. Barriers to ICP included lack of organizational structure, excessive workload, weaknesses in the provision of permanent training in ICP and the predominance of the biomedical model of health care. Collaborative actions mediated by informal communication were the most common mechanism used for providing shared consultations.(AU)

Resumen Este estudio reta comprender la experiencia de los residentes sobre la Práctica Colaborativa Interprofesional (PCI) en un hospital universitario (HU) en el estado de São Paulo. Investigación cualitativa a través de entrevistas semiestructuradas basadas en la Técnica del Incidente Crítico con 14 residentes de programas de residencia uni y multiprofesionales, analizadas por análisis temático de Bardin. El HU demostró ser potente para la implementación de la PCI al propiciar interacciones entre profesionales de diferentes áreas y niveles de formación. La calidad de las interacciones entre trabajadores, residentes, usuarios y familiares fue crucial para el desarrollo de la PCI. Se identificaron barreras como falta de estructura organizacional, sobrecarga de profesionales, debilidad en la provisión de educación permanente interprofesional y predominio del modelo biomédico de atención. Las acciones colaborativas mediadas por comunicación informal son el dispositivo más utilizado para el cuidado compartido.(AU)

Characterization of interprofessional education experiences in health education at the University of São Paulo / Caracterización de las experiencias de educación interprofesional en formación en salud en la Universidad de São Paulo / Caracterização das experiências de educação interprofissional na formação em saúde na Universidade de São Paulo

ABSTRACT Objective: To map the experiences of Interprofessional Education (IPE) in Health at the São Paulo campus of the University of São Paulo. Method: This is a descriptive, exploratory study with a quantitative approach and data collection through an online questionnaire addressed to teachers from eight teaching units and 14 health courses. The data was analyzed using absolute and percentage frequencies. Results: The majority of teachers do not take part in IPE experiences (70.4%). Most of the experiences are between six and ten years old, involving up to four teachers and small groups of students, mostly extracurricular or extension activities. The teaching and assessment strategies are diverse and open to students of all years. Conclusion: IPE experiences involve a small number of students and teachers and, although consolidated in terms of the time they have been offered, are limited to extracurricular spaces. Factors such as improvements in institutional support and teacher development are pointed out as important for making progress in strengthening IPE in the analyzed context.

RESUMEN Objetivo: Mapear las experiencias de Educación Interprofesional (EIP) en Salud en el campus de São Paulo de la Universidad de São Paulo. Método: Se trata de un estudio descriptivo, exploratorio, con abordaje cuantitativo y recolección de datos por medio de cuestionario online dirigido a profesores de ocho unidades de enseñanza y 14 cursos de salud. Los datos se analizaron mediante frecuencias absolutas y porcentuales. Resultados: La mayoría de los profesores no participa en experiencias de EIP (70,4%). La mayoría de las experiencias tienen entre seis y diez años de antigüedad, involucran hasta cuatro profesores y pequeños grupos de estudiantes, en su mayoría actividades extracurriculares o de extensión. Las estrategias de enseñanza y evaluación son diversas y están abiertas a estudiantes de todos los cursos. Conclusión: Las experiencias de EIP involucran a un número reducido de estudiantes y profesores y, aunque consolidadas en términos de oferta de tiempo, se limitan a espacios extracurriculares. Factores como la mejora del apoyo institucional y el desarrollo de las docentes se señalan como importantes para avanzar en el fortalecimiento de la EIP en el contexto analizado.

RESUMO Objetivo: Mapear as experiências de Educação Interprofissional (EIP) em Saúde no campus São Paulo da Universidade de São Paulo. Método: Pesquisa descritiva, exploratória, com abordagem quantitativa e coleta de dados por meio de um questionário online, direcionado aos docentes de oito unidades de ensino e 14 cursos da área de saúde. Os dados foram analisados por meio de frequências absolutas e percentuais. Resultados: A maior parte dos docentes não participa de experiências de EIP (70,4%). Em sua maioria, as experiências têm de seis a dez anos de existência, com envolvimento de até quatro docentes e em pequenos grupos de estudantes, majoritariamente extracurriculares ou atividades de extensão. As estratégias de ensino e avaliação são diversificadas e abertas aos estudantes de todos os anos. Conclusão: As experiências de EIP envolvem um número pequeno de estudantes e professores e, embora consolidadas em relação ao tempo de oferta, são limitadas aos espaços extracurriculares. Fatores como melhorias no apoio institucional e desenvolvimento docente são apontados como importantes para avançar no fortalecimento da EIP no contexto analisado.

[Building skills for the nurse's educational actions in primary health care]. / Construindo competências para ação educativa da enfermeira na atenção básica.

This is a study to review the methodological process developed to built a profile of competencies required for nurse's educational actions. It was a qualitative research, in the historical and dialectical materialism, that used competence as the conceptual category, anchored in the conceptions of work in health and operating knowledge. The subjects were teachers and students of the School of Nursing of University of Sao Paulo (USP), Brazil; nurses, managers and patients of health services connected to USP. The speech analysis technique was used to analyze the speeches. All groups addressed contained similarities related to knowledge, skills and attitudes required to the development of more dialogical and participative educational practices. The methodological approach described enable the construction of a profile of competencies related to nurse's educational actions, in a collective perspective, closer to the population's health needs.