Formação em saúde para o trabalho em equipe: a educação interprofissional no âmbito do Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde) e Programa de Educação pelo Trabalho para Saúde (PET-Saúde)
Data
2019-05-23
Autores
Medeiros, Nara Maria Holanda de 
Orientadores
Rossit, Rosana Aparecida Salvador
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
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Resumo
Esta pesquisa trata-se de cinco pesquisas que constituem o Estudo de Caso Avaliativo, exploratório e descritivo com abordagem qualitativa e quantitativa, cujos os objetivos foram avaliar o Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde) e o Programa de Educação pelo Trabalho para Saúde (PET-Saúde) nas perspectivas da Educação Interprofissional (EIP), da Prática Colaborativa (PC) e do Trabalho em Equipe Interprofissional (TEI), nas dimensões, do ensino, aprendizagem e avaliação das Instituições de Ensino Superior (IES) de São Paulo; construir, validar e aplicar instrumentos de avaliação; avaliar concepções, propostas e métodos de ensino/aprendizagem/avaliação por meio de análise documental e avaliar a relação de ensino/aprendizagem/avaliação nos Programas a partir da concepção dos ex-discentes. Os meios de investigação foram realizados mediante a realização de cinco pesquisas, Construção e Validação da Matriz de Análise com Termos Rastreadores; Pesquisa Documental; Construção e Validação da Escala Atitudinal de Avaliação da Interprofissionalidade, na perspectiva da EIP, PC e do TEI; Avaliação da Concepção dos Ex-Discentes dos Programas, no tocante à relação de ensino/aprendizagem/avaliação e o Estudo de Caso Avaliativo, de avaliação dos Programas, considerando os resultados dos cinco estudos. A Matriz de Análise com Termos Rastreadores foi validada para aplicação e análise dos Projetos das IES e possibilita sua utilização para análise de outras propostas de Reorientação da Formação relacionadas com a EIP, PC e TEI, no âmbito da Formação e de outras instâncias. Foi criado um novo percurso metodológico para Pesquisa Documental, uma adaptação do percurso metodológico de Bohomol (2013), apresentado como manual claro para realização de outras pesquisas desta natureza. A partir da Pesquisa Documental verificou-se que os cinco Projetos das IES apresentaram 1.572 núcleos de significados a partir de 122 Termos Rastreadores, evidenciando que todas as IES apresentaram arcabouço teórico/metodológico e mecanismos determinantes para compreensão e implementação da EIP, PC e do TEI. A Escala Atitudinal de Avaliação da Interprofissionalidade obteve ótima validação de conteúdo, com perda de quatro asserções num total de 30 (13,13%), enquanto a literatura considera aceitável perda de até 40% (até 12 asserções). A validação de confiabilidade foi de 0,96, denotando ótima consistência estatística ao instrumento aplicado. Essa Escala é pioneira no país, construída segundo evidências científicas do contexto das práticas nacionais de Atenção Primária à Saúde, nas perspectivas da EIP, PC e do TEI. A Pesquisa de Avaliação da Concepção Discente revelou que os Programas são terrenos férteis para o desenvolvimento de competências (colaborativas, complementares e comuns) para a EIP, as PC e o TEI através do reconhecimento das mesmas, dos princípios, conceitos, pressupostos e de ações conjuntas consistentes. A pesquisa Estudo de Caso Avaliativo evidenciou coerência entre as propostas do Ministério da Saúde e da Educação com as das IES e que impactaram positivamente no desenvolvimento das ações de saúde, conclusivo de que os Programas das cinco IES construíram suas identidades e implementaram as ações fundamentados na EIP, PC e no TEI, viabilizando reformas curriculares, fortalecendo a integração ensino-serviço; consolidando inovações dos métodos de ensino/aprendizagem/avaliação e agregando saberes e competências entre os profissionais e discentes.
This research consists of five studies that constitute the evaluative, exploratory and descriptive case study with qualitative and quantitative approach, whose objectives were to evaluate the National Program for Reorientation of Vocational Training in Health Care (Pró-Saúde) and the Program of Education for the Work in Health Care (PET-Saúde) in the perspectives of Interprofessional Education (EIP), Collaborative Practice (PC) and Interprofessional Teamwork (TEI), in the dimensions of teaching, learning and evaluation of Higher Education Institutions (HEI) from Sao Paulo; build, validate and apply assessment tools; evaluate conceptions, proposals and methods of teaching / learning / evaluation through documental analysis and evaluate the relationship of teaching / learning / evaluation in the Programs from the conception of alumni. The means of investigation were performed by conducting five studies: Building and Validation of the Analysis Matrix with Tracking Terms; Documentary research; Building and Validation of the Attitudinal Scale for the Evaluation of Interprofessionality, from the perspective of IPE, CP and TEI; Evaluation of the Conception of the Programs’ Alumni, regarding the teaching / learning / evaluation relationship and the Evaluative Case Study, of the Evaluation of the Programs, considering the results of the five studies. The Analysis Matrix with Tracking Terms was validated for application and analysis of HEI Projects and allows its use for analysis of other proposals of Training Reorientation related to the EIP, PC and TEI, within Training and other instances. A new methodological path was created for Documentary Research, an adaptation of Bohomol's methodological path (2013), presented as a clear manual for further research of this nature. From the Documentary Research it was found that the five HEI Projects presented 1,572 nuclei of meanings from 122 Tracking Terms, showing that all HEIs presented theoretical / methodological framework and determinant mechanisms for understanding and implementing the EIP, PC and TEI. The Attitudinal Interprofessionality Rating Scale obtained excellent content validation, with a loss of four assertions out of a total of 30 (13.13%), while the literature considers a loss of up to 40% (up to 12 assertions) acceptable. The reliability validation was 0.96, denoting excellent statistical consistency to the instrument applied. This Scale is a pioneer in the country, built according to scientific evidence from the context of national practices of Primary Health Care, from the perspectives of IPE, CP and TEI. The Student Conception Assessment Survey revealed that the Programs are fertile ground for the development of competencies (collaborative, complementary and common) for the IPE, the PC and the TEI through their recognition of the principles, concepts, assumptions and consistent joint actions. The Evaluative Case Study research showed coherence between the proposals of the Ministry of Health and Education with those of the HEIs that positively impacted the development of health actions, concluding that the programs of the five HEIs built their identities and implemented the actions based on EIP, PC and TEI, enabling curriculum reforms, strengthening teaching-service integration; consolidating innovations in teaching / learning / assessment methods and aggregating knowledge and skills among professionals and students.
This research consists of five studies that constitute the evaluative, exploratory and descriptive case study with qualitative and quantitative approach, whose objectives were to evaluate the National Program for Reorientation of Vocational Training in Health Care (Pró-Saúde) and the Program of Education for the Work in Health Care (PET-Saúde) in the perspectives of Interprofessional Education (EIP), Collaborative Practice (PC) and Interprofessional Teamwork (TEI), in the dimensions of teaching, learning and evaluation of Higher Education Institutions (HEI) from Sao Paulo; build, validate and apply assessment tools; evaluate conceptions, proposals and methods of teaching / learning / evaluation through documental analysis and evaluate the relationship of teaching / learning / evaluation in the Programs from the conception of alumni. The means of investigation were performed by conducting five studies: Building and Validation of the Analysis Matrix with Tracking Terms; Documentary research; Building and Validation of the Attitudinal Scale for the Evaluation of Interprofessionality, from the perspective of IPE, CP and TEI; Evaluation of the Conception of the Programs’ Alumni, regarding the teaching / learning / evaluation relationship and the Evaluative Case Study, of the Evaluation of the Programs, considering the results of the five studies. The Analysis Matrix with Tracking Terms was validated for application and analysis of HEI Projects and allows its use for analysis of other proposals of Training Reorientation related to the EIP, PC and TEI, within Training and other instances. A new methodological path was created for Documentary Research, an adaptation of Bohomol's methodological path (2013), presented as a clear manual for further research of this nature. From the Documentary Research it was found that the five HEI Projects presented 1,572 nuclei of meanings from 122 Tracking Terms, showing that all HEIs presented theoretical / methodological framework and determinant mechanisms for understanding and implementing the EIP, PC and TEI. The Attitudinal Interprofessionality Rating Scale obtained excellent content validation, with a loss of four assertions out of a total of 30 (13.13%), while the literature considers a loss of up to 40% (up to 12 assertions) acceptable. The reliability validation was 0.96, denoting excellent statistical consistency to the instrument applied. This Scale is a pioneer in the country, built according to scientific evidence from the context of national practices of Primary Health Care, from the perspectives of IPE, CP and TEI. The Student Conception Assessment Survey revealed that the Programs are fertile ground for the development of competencies (collaborative, complementary and common) for the IPE, the PC and the TEI through their recognition of the principles, concepts, assumptions and consistent joint actions. The Evaluative Case Study research showed coherence between the proposals of the Ministry of Health and Education with those of the HEIs that positively impacted the development of health actions, concluding that the programs of the five HEIs built their identities and implemented the actions based on EIP, PC and TEI, enabling curriculum reforms, strengthening teaching-service integration; consolidating innovations in teaching / learning / assessment methods and aggregating knowledge and skills among professionals and students.