As aproximações da educação e prática interprofissional colaborativa em Residências Multiprofissionais em Saúde
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Data
2022-02-24
Autores
Santos, Lucas Cardoso dos
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Universidade Estadual Paulista (Unesp)
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Introdução: nas últimas décadas, fez-se um grande esforço no âmbito dos cursos técnicos, de graduações e pós-graduações na área da saúde para reorientar a formação de modo a atender às necessidades do Sistema Único de Saúde. Influenciaram esse processo as Diretrizes Curriculares Nacionais e o relevante papel indutivo realizado pelos Ministérios da Saúde e Educação para alcançar uma formação mais humanizada e desenvolvida mediante um processo de ensino-aprendizagem que incluísse diferentes cenários e práticas interprofissionais. Nesse sentido, a educação e a interprofissionalidade têm sido apontadas como capazes de promover mudanças nos cenários de ensino e prática para o enfrentamento dos problemas sociais e de saúde e vem sendo gradativamente valorizadas devido seu potencial na formação de profissionais de saúde mais preparados para o trabalho em equipe, característica essencial para se alcançar um cuidado integral de indivíduos, famílias e comunidades. A Residência Multiprofissional em Saúde se apresenta como uma possibilidade e estratégia potente de formação com vistas a uma prática colaborativa interprofissional por estimular o desenvolvimento de ações de interação, comunicação e colaboração entre os diferentes atores. Esses programas têm como locus de atividades diferentes cenários reais da Rede de Atenção à Saúde e Psicossocial podendo contribuir com a revisão do modelo assistencial, pois busca-se um novo perfil do profissional de saúde, humanizado e preparado para responder às necessidades da população. Objetivos: analisar a incorporação dos marcos teórico-conceituais e metodológicos da educação interprofissional no contexto das Residências Multiprofissionais em Saúde para o fortalecimento das práticas colaborativas em saúde. E como objetivos específicos: identificar na literatura científica as ações de educação interprofissional desenvolvidas no Brasil no contexto dos Programas de Residência Multiprofissional em Saúde; avaliar a aproximação dos Projetos Políticos Pedagógicos das Residências Multiprofissionais em Saúde de uma instituição de ensino pública do interior de São Paulo em relação à educação interprofissional e prática interprofissional colaborativa; e conhecer a experiência dos residentes envolvidos nos programas de Residência Multiprofissional em Saúde em consideração ao referencial da educação interprofissional e prática interprofissional colaborativa. Método: realizou-se uma pesquisa exploratória, descritiva e analítica, de natureza qualitativa guiada pelo referencial da pesquisa-ação com a adoção de três etapas e instrumentos de coleta de dados: revisão integrativa da literatura, análise documental e intervenção-ação. A revisão integrativa da literatura voltou-se para a interface entre a formação profissional e o trabalho em saúde a partir da literatura científica acerca da educação interprofissional no contexto de formação profissional nos Programas de Residência Multiprofissional em Saúde no Brasil. Os Projetos Políticos Pedagógicos dos três Programas de Residência Multiprofissional em Saúde da Faculdade de Medicina de Botucatu – Saúde da Família, Saúde Mental, Saúde do Adulto e Idoso – foram submetidos à análise documental tanto à luz da educação interprofissional quanto dos eixos norteadores propostos aos Programas de Residência pelos Ministérios da Educação e Saúde. A intervenção-ação foi operacionalizada por meio de duas oficinas na modalidade de videoconferências com a participação de 18 residentes dos segundos anos dos Programas de Residência Multiprofissional da Saúde da Família e Saúde Mental da Faculdade de Medicina de Botucatu. Os dados produzidos pelas diferentes estratégias de coleta de dados foram analisados segundo o referencial metodológico da Análise de Conteúdo proposto por Graneheim e Lundman e o referencial teórico da interprofissionalidade. Resultados: a Revisão Integrativa de Literatura possibilitou conhecer as diferentes experiências da prática interprofissional colaborativa no contexto das Residências Multiprofissionais em Saúde no Brasil a partir de 16 estudos, publicados de 2014 a 2019, nos idiomas português e inglês, desenvolvidos sobretudo na região Sudeste do país e analisados a partir de quatro temas: As dimensões dos desafios para a consecução da educação interprofissional nos Programas de Residências Multiprofissionais em Saúde; Dissonância curricular no processo ensino-aprendizagem-trabalho; As estratégias utilizadas para a efetivação da educação e prática interprofissional; Os efeitos das tentativas de implementação da educação e prática interprofissional nos cenários de prática das residências multiprofissionais. A análise dos Projetos Políticos Pedagógicos dos três Programas de Residência Multiprofissional em Saúde elucidou as possibilidades para a realização de uma prática interprofissional colaborativa no contexto da residência, apesar de nenhum programa demonstrar de maneira explícita a intencionalidade de adoção dos marcos teórico-conceituais e metodológicos da educação interprofissional. Já os resultados emergidos das duas oficinas evidenciou, por meio das falas dos participantes quais as oportunidades identificadas como potentes e as oportunidades e desafios encontrados para a consecução de uma prática interprofissional, bem com as aprendizagens adquiridas por meio dessa prática. Considerações finais: identificou-se que o proposto nos PPP dos Programas de Residência Multiprofissional em Saúde analisados não acontece na prática como planejado demonstrando um distanciamento entre o currículo organizado e prescrito e o currículo em ação. E que a articulação entre o ensino, a aprendizagem e o trabalho acontece de forma fragmentada, reproduzindo o modelo tradicional de ensino e de saúde, não assegurando mudanças nos cenários de formação e prática como preconizado nos ideários desses programas.
Introduction: in recent decades, a great effort has been made within the scope of technical, undergraduate and postgraduate courses in the health area to reorient training in order to meet the needs of the Unified Health System. National and the relevant inductive role played by the Ministries of Health and Education to achieve a more humanized training and developed through a teaching-learning process that included different scenarios and interprofessional practices. In this sense, education and interprofessionality have been identified as capable of promoting changes in teaching and practice scenarios to face social and health problems and have been gradually valued due to their potential in training health professionals more prepared for work. as a team, an essential characteristic to achieve comprehensive care for individuals, families and communities. The Multiprofessional Residency in Health presents itself as a possibility and a powerful training strategy with a view to an interprofessional collaborative practice by stimulating the development of interaction, communication and collaboration actions between the different actors. These programs have as locus of activities different real scenarios of the Health and Psychosocial Care Network, which can contribute to the revision of the care model, as it seeks a new profile of the health professional, humanized and prepared to respond to the needs of the population. Objectives: to analyze the incorporation of theoretical-conceptual and methodological frameworks of interprofessional education in the context of Multiprofessional Residencies in Health to strengthen collaborative practices in health. And as specific objectives: to identify in the scientific literature the actions of interprofessional education developed in Brazil in the context of the Multiprofessional Residency Programs in Health; to evaluate the approach of the Political Pedagogical Projects of the Multiprofessional Residencies in Health of a public teaching institution in the interior of São Paulo in relation to interprofessional education and collaborative interprofessional practice; and to know the experience of the residents involved in the Multiprofessional Residency in Health programs in consideration of the reference of interprofessional education and collaborative interprofessional practice. Method: an exploratory, descriptive and analytical research was carried out, of a qualitative nature guided by the action research framework, with the adoption of three stages and data collection instruments: integrative literature review, document analysis and action-intervention. The integrative literature review focused on the interface between professional training and health work based on the scientific literature on interprofessional education in the context of professional training in Multiprofessional Health Residency Programs in Brazil. The Pedagogical Political Projects of the three Multiprofessional Residency Programs in Health at the Faculty of Medicine of Botucatu - Family Health, Mental Health, Adult and Elderly Health - were submitted to document analysis both in the light of interprofessional education and the guidelines proposed for the Programs of Residency by the Ministries of Education and Health. The intervention-action was implemented through two workshops in the form of videoconferences with the participation of 18 residents of the second years of the Multiprofessional Residency Programs for Family Health and Mental Health at the Faculty of Medicine of Botucatu. The data produced by the different data collection strategies were analyzed according to the methodological framework of Content Analysis proposed by Graneheim and Lundman and the theoretical framework of interprofessionality. Results: the Integrative Literature Review made it possible to know the different experiences of collaborative interprofessional practice in the context of Multiprofessional Residencies in Health in Brazil from 16 studies, published from 2014 to 2019, in Portuguese and English, developed mainly in the Southeast region of the country and analyzed from four themes: The dimensions of the challenges for the achievement of interprofessional education in the Multiprofessional Residency Programs in Health; Curricular dissonance in the teaching-learning-work process; The strategies used to carry out interprofessional education and practice; The effects of attempts to implement interprofessional education and practice in the practice scenarios of multiprofessional residencies. The analysis of the Pedagogical Political Projects of the three Multiprofessional Health Residency Programs elucidated the possibilities for carrying out a collaborative interprofessional practice in the context of the residency, although no program explicitly demonstrates the intention to adopt the theoretical-conceptual and methodological frameworks of the interprofessional education. The results that emerged from the two workshops showed, through the speeches of the participants, which opportunities were identified as potent and the opportunities and challenges encountered in achieving an interprofessional practice, as well as the learning acquired through this practice. Final considerations: it was identified that what was proposed in the Pedagogical Political Projects of the Multiprofessional Residency Programs in Health analyzed does not happen in practice as planned, demonstrating a gap between the organized and prescribed curriculum and the curriculum in action. And that the articulation between teaching, learning and work happens in a fragmented way, reproducing the old traditional model of teaching and health, not legitimizing changes in the training and practice scenarios as recommended in the ideas of these programs.
Introduction: in recent decades, a great effort has been made within the scope of technical, undergraduate and postgraduate courses in the health area to reorient training in order to meet the needs of the Unified Health System. National and the relevant inductive role played by the Ministries of Health and Education to achieve a more humanized training and developed through a teaching-learning process that included different scenarios and interprofessional practices. In this sense, education and interprofessionality have been identified as capable of promoting changes in teaching and practice scenarios to face social and health problems and have been gradually valued due to their potential in training health professionals more prepared for work. as a team, an essential characteristic to achieve comprehensive care for individuals, families and communities. The Multiprofessional Residency in Health presents itself as a possibility and a powerful training strategy with a view to an interprofessional collaborative practice by stimulating the development of interaction, communication and collaboration actions between the different actors. These programs have as locus of activities different real scenarios of the Health and Psychosocial Care Network, which can contribute to the revision of the care model, as it seeks a new profile of the health professional, humanized and prepared to respond to the needs of the population. Objectives: to analyze the incorporation of theoretical-conceptual and methodological frameworks of interprofessional education in the context of Multiprofessional Residencies in Health to strengthen collaborative practices in health. And as specific objectives: to identify in the scientific literature the actions of interprofessional education developed in Brazil in the context of the Multiprofessional Residency Programs in Health; to evaluate the approach of the Political Pedagogical Projects of the Multiprofessional Residencies in Health of a public teaching institution in the interior of São Paulo in relation to interprofessional education and collaborative interprofessional practice; and to know the experience of the residents involved in the Multiprofessional Residency in Health programs in consideration of the reference of interprofessional education and collaborative interprofessional practice. Method: an exploratory, descriptive and analytical research was carried out, of a qualitative nature guided by the action research framework, with the adoption of three stages and data collection instruments: integrative literature review, document analysis and action-intervention. The integrative literature review focused on the interface between professional training and health work based on the scientific literature on interprofessional education in the context of professional training in Multiprofessional Health Residency Programs in Brazil. The Pedagogical Political Projects of the three Multiprofessional Residency Programs in Health at the Faculty of Medicine of Botucatu - Family Health, Mental Health, Adult and Elderly Health - were submitted to document analysis both in the light of interprofessional education and the guidelines proposed for the Programs of Residency by the Ministries of Education and Health. The intervention-action was implemented through two workshops in the form of videoconferences with the participation of 18 residents of the second years of the Multiprofessional Residency Programs for Family Health and Mental Health at the Faculty of Medicine of Botucatu. The data produced by the different data collection strategies were analyzed according to the methodological framework of Content Analysis proposed by Graneheim and Lundman and the theoretical framework of interprofessionality. Results: the Integrative Literature Review made it possible to know the different experiences of collaborative interprofessional practice in the context of Multiprofessional Residencies in Health in Brazil from 16 studies, published from 2014 to 2019, in Portuguese and English, developed mainly in the Southeast region of the country and analyzed from four themes: The dimensions of the challenges for the achievement of interprofessional education in the Multiprofessional Residency Programs in Health; Curricular dissonance in the teaching-learning-work process; The strategies used to carry out interprofessional education and practice; The effects of attempts to implement interprofessional education and practice in the practice scenarios of multiprofessional residencies. The analysis of the Pedagogical Political Projects of the three Multiprofessional Health Residency Programs elucidated the possibilities for carrying out a collaborative interprofessional practice in the context of the residency, although no program explicitly demonstrates the intention to adopt the theoretical-conceptual and methodological frameworks of the interprofessional education. The results that emerged from the two workshops showed, through the speeches of the participants, which opportunities were identified as potent and the opportunities and challenges encountered in achieving an interprofessional practice, as well as the learning acquired through this practice. Final considerations: it was identified that what was proposed in the Pedagogical Political Projects of the Multiprofessional Residency Programs in Health analyzed does not happen in practice as planned, demonstrating a gap between the organized and prescribed curriculum and the curriculum in action. And that the articulation between teaching, learning and work happens in a fragmented way, reproducing the old traditional model of teaching and health, not legitimizing changes in the training and practice scenarios as recommended in the ideas of these programs.
Descrição
Palavras-chave
Relações interprofissionais, Educação interprofissional, Equipes de saúde, Educação, Interprofessional relations, Patient care team, Education