The production of critical-reflexive narratives and their effect on nursing students' portfolios

Abstracts

Esta investigação visou analisar o processo de construção das narrativas reflexivas em portfólios de estudantes de enfermagem. Trata-se de um estudo qualitativo, que analisou os portfólios da disciplina Promoção da Saúde na Educação Básica, ministrada no quarto semestre do curso de Licenciatura em Enfermagem. Os resultados indicaram a predominância inicial de registros descritivos, com a incipiente abordagem de aspectos teóricos articulados aos aspectos vivenciais. Com o transcorrer das discussões em grupo e das vivências foram apresentadas narrativas com elementos mais críticos e reflexivos, com justificativas das ações descritas e relações com aspectos teórico-práticos estudados na disciplina e no curso. O estudo conclui que há um processo de produção das narrativas crítico-reflexivas em portfólios que pode incluir descrição sintética, senso comum, idealização, e que, de modo singular, possibilita a inclusão do outro, das diferenças e de revisão teórica.

Educação em enfermagem; Bacharelato em enfermagem; Aprendizagem; Narração

ARTIGO ORIGINAL

The production of critical-reflexive narratives and their effect on nursing students' portfolios^*

La producción de narraciones crítico-reflexivas en los portafolios de estudiantes de enfermería

Cinira Magali Fortuna^I; Marlene Fagundes Carvalho Gonçalves^II; Marta Angélica Iossi Silva^III; Ronildo Alves dos Santos^IV

^IRN. PhD in nursing. Professor, University of São Paulo at Ribeirão Preto, College of Nursing. Ribeirão Preto, SP, Brazil. [e-mail]

^IIBacharel in Pedagogy. PhD in Education. Professor, University of São Paulo at Ribeirão Preto, College of Nursing. Ribeirão Preto, SP, Brazil. [e-mail]

^IIIRN. PhD in Nursing. Professor, University of São Paulo at Ribeirão Preto, College of Nursing. Ribeirão Preto, SP, Brazil. [e-mail]

^IVPhilosopher. PhD in Philosophy. Professor, University of São Paulo at Ribeirão Preto, College of Nursing. Ribeirão Preto, SP, Brazil. [e-mail]

Correspondence addressed

ABSTRACT

The objective of this study is to analyze the process of producing reflexive narratives on nursing students' portfolios. This qualitative study performed an analysis of the portfolios of the class discipline Health Promotion in Primary Education, taught in the fourth semester of the Nursing Licensure Course. Results showed an initial predominance of descriptive records, with the incipient approach of theoretical aspects associated with the aspects regarding their experience. Further, in the group and experience discussions, there were narratives containing more critical and reflexive elements, with justifications for the described actions and the relationships with the theoretical-practical aspects studied in the class and in the course. In conclusion, there is a process of producing critical-reflexive narratives in portfolios that could include a summarized description, using common sense and idealization which allows for including the differences and the theoretical review.

Descriptors: Education, nursing; Education, nursing, baccalaureate, Learning; Narration

RESUMEN

Esta investigación objetiva analizar el proceso de construcción de las narraciones reflexivas en portafolios de estudiantes de enfermería. Estudio cualitativo que analizó los portafolios de la disciplina Promoción de la Salud en Educación Básica, dictada en el cuarto semestre del curso de Licenciatura en Enfermería. Los resultados indicaron la predominancia inicial de registros descriptivos, con el incipiente abordaje de aspectos teóricos relacionados a los aspectos vivenciales. Con el transcurrir de las discusiones grupales y de las vivencias, fueron presentándose narraciones con elementos más críticos y reflexivos, con justificaciones de las acciones descriptas y relaciones con aspectos teórico-prácticos estudiados en la disciplina y en el curso. El estudio concluye en que existe un proceso de producción de narraciones crítico-reflexivas en portafolios, que puede incluir descripción sintética, sentido común, idealización, y que, de modo singular, posibilitan la inclusión del otro, de las diferencias y de la revisión teórica.

Descriptores: Educación en enfermería; Bachillerato en enfermería; Aprendizaje; Narración

INTRODUCTION

The sanitary reform movement in Brazil took place during the 1970s and 1980s and achieved health as a right for all and a duty of the State. There was a concern since law 8080/1990 covered the training of health workers so that they would be able to ensure the principles and guidelines of the Single Health System (SUS): integrality, equity, universality, participation and social control, hierarchy, decentralization, accessibility, and inter-sector cooperation, among others⁽¹⁾. The current challenge is for the system to meet the health needs of the population in an integral manner with quality and problem-solving capacity, which certainly requires the qualification of workers both in terms of college education and continuing education. Programs in the health and nursing fields are implementing curricular changes to integrate practice and teaching during the educational process in order to meet the SUS guidelines^(2-6).

The Political Pedagogical Process in the nursing teaching program to which this study refers is based on the National Guidelines for Nursing Undergraduate Programs⁽⁷⁾ and on the National Curricular Guidelines for the Education of Primary Education Teachers⁽⁸⁾ at the college level. It is based on the following principles: integrated and competency-based curriculum; academic education linked to practice in real contexts; pedagogical references: critical-reflective education, significant learning. It requires faculty members, students, health service workers and workers in the field of education to constantly analyze and evaluate their learning-teaching process.

The integrated curriculum, partially adopted in this program, implies that pedagogical processes promote the immersion of students within small groups in the professional environment for which they are being prepared⁽²⁾. In this approach, undergraduate students construct their knowledge based on reflections, questioning, and relationships established in their own practice, which are recorded in a portfolio. Hence, students are no longer limited to rigid structures of unrelated courses; rather they find theoretical aspects to be necessary as they experience practice in the professional environment with the support of professors, who participate in the process, encouraging them to question and reflect upon the process, suggesting new relationships, indicating alternatives.

The educational practice developed in this proposition takes place in pedagogical cycles. Each cycle is composed of five distinct stages: 1) Immersion in real contexts – a time when the student performs tasks in the professional environment based on his/her experiences; 2) Provisory synthesis – reading and discussion of each student report concerning the immersion in real contexts take place within groups to identify problems related to tasks, which then lead to the formulation of a learning question; 3) Individual search for information/knowledge – students search varied sources that subdivide an answer to the learning question; 4) New synthesis – a time of reflection within groups concerning the information/knowledge collected by the students in order to understand the identified problems and reconstruct professional practice; 5) Evaluation – at the end of each activity students perform a self-evaluation, while the group and the professor/facilitator are also evaluated.

In this context, learning through social relations is highlighted in the process of human development as the most important historical-cultural approach. The role of social interaction in the process of appropriating knowledge developed by humanity is in evidence. Social relations enable cultural aspects of the social group to be appropriated from an activity constituting the subject him/herself⁽⁹⁾.

One of the strategies used to monitor and evaluate learning is the analysis of narratives that compose the portfolio. These narratives are a portrait of the students' experiences compared to relevant theoretical aspects. Through them one can reconstruct the learning trajectory and its records, individually redacted by each student and by the group and, in this way, identify advancements and limitations in the intense process of writing/reflecting/learning^(9-11).

The portfolios are therefore a synthesis of the process experienced by students while constructing knowledge as well as an instrument to systematically reflect on individual and shared experiences in a critical and theoretically grounded manner^(10-11).

Hence, the guiding questions of this study are: How are the student narratives presented? and How are critical and reflective narratives developed? This study is intended to analyze the development of critical-reflective narratives in the portfolios of nursing students.

METHOD

This is a qualitative exploratory descriptive study. Qualitative studies in the education and sociological fields are appropriate given the nature of the object to be studied, which is configured in social relations. Qualitative studies emphasize the process more than the product and are concerned with the perspective of the participants⁽¹²⁾ .

The portfolios of two students, developed during the course Health Promotion in Primary Education administered in the fourth semester of the Teaching Diploma Program in Nursing at a public university in the state of São Paulo, Brazil were analyzed. The development of narratives is part of the pedagogical process and has a purpose within the curriculum and course. The course Health Promotion in Primary Education is administered at the beginning of the program and introduces the practice of nurses at schools, with which students are not familiar, since many still have imprecise conceptions concerning the profession and are not aware of such practices. It is still an almost nonexistent practice when we consider the assumptions of courses in primary and middle schools; the role of registered nurses in training nursing auxiliaries and technicians and their practice in health services is more widely known.

The authors of the analyzed portfolios are identified by fictitious names of Brazilian writers: Cora Coralina (Cora) and Lygia Fagundes Telles (Lygia) to keep their identities confidential according to ethical principles. We note the extension of the empirical material given the presentation of two portfolios to monitor the process of transformation of descriptive narratives into critical narratives.

The texts of the portfolios were submitted to the analysis of utterances⁽¹³⁾ intended to grasp the senses and meanings attributed to the experiences as well as the individuals' motivations, apparent in the mode of the utterances.

Such senses and meanings can be grasped from the alignment and dynamics of the report, styles, atypical elements and rhetorical figures used in the text production such as recurrences, lapses, illogical elements, or common places. For the author, the style reveals that the expression and thought progresses side by side (...) the confusing, redundant style is a significant lack of mastery over the discourse; on the contrary, a controlled style, a succession of logical propositions generally indicate one is recovering such mastery ⁽¹³⁾. Rhetorical figures in turn are indications of elements that, even though are presented, are not explicit, as occurs with lapses.

The steps recommended for the analysis of utterances were followed: a) preparation of material – typing, preserving information such as misspellings, indications of deletions, etc.; b) different stages of analysis – level of sequences, propositions, atypical elements. The interpretation presented is a result of the comparison of these indicators. We note the importance of analyzing each text— in this case the portfolios—as an organized and unique whole.

The study complied with ethical standards set out by Resolution No. 196/96, Brazilian Council of Health that regulate ethical principles of studies conducted with human subjects and was approved by the Ethical Research Committee at the institution of origin (Process No. 0994/2009). Free and informed consent forms were signed by the subjects after grading at the end of the course in which they developed the portfolios. Confidentiality and the right to refuse to participate or withdraw from the study at any time were ensured to the participants. After the participants' consent, their portfolios and self-evaluation were copied.

RESULTS

The analysis of the portfolios led to the identification of two types of narratives: descriptive and critical-reflective narratives.

Descriptive narratives and their characteristics

Descriptive narratives present different characteristics in each phase of the pedagogical cycle. When they refer to the presentation of their peers, professors and the course, their narratives tend to be synthetic and reflection expresses general expectations the student believes to be relevant: (...) We participate in an activity in which we exposed our expectations in relation to the course (...) Similarly to many students my expectations refer to the role of nurses in primary education and at schools, expectations in passing on acquired knowledge and also learning how to behave in front of students (...) I have a big expectation in relation to the activities at schools because I know these will be different from those performed in primary care when we take the integral health care course. I hope to improve the way I behave in front of a classroom and know how to guide students and be able to clarify their doubts (Cora 8/4 – introduction of the course).

In relation to the Immersion stage, the descriptive narratives are poor in terms of the details they experienced, omitting relevant activities and aspects, as observed in the following excerpt: (...) We went to the teachers' room and we heard a bomb when we got there, it was really scary, and later we learned that it was a student who would possibly be expelled from school. (...) The school has many clearly designated classrooms with the number of the grade on the door of each classroom. It has a video room, library, large patio, a sports court (...) I became a little scared with the bomb, I know that at this phase they want to get attention but I do not know if it can be considered normal, he might have hurt someone, on the other hand, I am not sure expelling him is the right thing to do since it will push the problem off and it might not be ever solved (...). (Cora 8/15 – Immersion).

Lygia did not participate in this event and did not record it in her portfolio. Omitting a report communicates different aspects such as: the idea that participation is only implied by being present, lack of involvement with the remaining participants and with the task, among others.

Concerning the Provisory Synthesis, the descriptive narratives do not mention the names of classmates; rather narratives are focused on the students themselves and their impressions, describing facts and explaining them through common sense. (...) The class was initiated with the discussion of the student who detonated the bomb and opinions varied. Some believe that it is normal for boys this age to do this nowadays, others do not think this is normal. Some said he did it because he lives in a needy area and does not have information and is becoming a delinquent (...) We cannot judge the student based on the place he lives or on his socioeconomic status, as professionals we should respect the values of another, but not forget our own (...) (Cora 8/18 –Provisory synthesis).

The learning question elaborated in the first cycle was: "What are the responsibilities of nurses within the context of primary education with an emphasis on health education?" The following excerpt shows how Cora describes it: (...) We did not know for sure what our learning question would be and we went back to read the responsibilities provided in the course, a doubt about what should be an initial priority is related to the role of nurses in primary education, a doubt we had since the first day (...) (Cora 8/18 – Provisory Synthesis).

The descriptive narratives related to the Search may contain both a simple annexation of a text, which is sometimes underlined, and a copy of paragraphs of texts without a proper citation, a mere reproduction of somebody else's text within their own texts. The following example cites an excerpt of a paper⁽¹⁴⁾ used in the portfolio of Cora without proper reference. In the nursing context, practicing health education is to enable individuals to make their own search, to expose, question, live, experience, create, contribute, recover, find their place in society, achieve their objectives and ideals and make their dreams come true; it is to recognize someone as the subject responsible for his/her own reality. (...) Nursing should be seen as a social practice focused on the communitarian and human aspects; a link interconnecting individuals society, health and the environment (Cora 8/19 – Search).

We note these are phrases describing an ideal nursing practice that get closer to the imagination of students at this point of the learning process. (...) For health education to take place the individual needs to be aware of the actions required for it (...) (Lygia 8/19 - Search).

The idea that individuals are the only ones responsible for their own health or disease is common and appears in Lygia's records. (...) The author put her feelings in relation to the nurse educator, where the professional "devotes him/herself expecting an answer that is priceless, s/he promotes education and expects it to have results but we see that devotion is something more historical in our profession, where religious women would provide care for the sick (Lygia 8/19 – Search).

After the literature search, the group reunites for the New Synthesis stage. There is a certain commotion, inherent to the learning process, when positions of other classmates, based on each one's material, are compared.

The professor's role at this point would be to create uncertainty wherever these are rooted, generate discomfort, unbalance. (...) the texts read show historical facts, governmental measures (...) education directed to adolescents, prevent disease, promote health, sensitize, professional/social practice and others, at the end of the readings and comments we decided that each one would elaborate his/her own answer, in the face of so much information I got confused about what and how to write for the answer to be right, but I understood that: Nursing became involved with education at a time of school failure, where health needed to go to the school environment, failure was due to the evasion (sic) of people to education, which in the past was available to few; with Capitalism, school became necessary for all who work and today education is mandatory for all, the medicalization of society occurs through standards established for the greater good (...) (Lygia 8/22 – New Synthesis).

(...) Prevention is different from promotion because prevention uses specific measures while promotion uses deeper measures, actions intended to improve life habits so health is achieved, and nurses are the most obvious professional for implementing it, developing educational actions in primary education (where the individual is being educated) sensitizing them, that is, emphasizing the importance of good habits (...) (Lygia 8/22 New Synthesis).

Cora describes the new synthesis as: (...) Nurses had to act in schools only when there were pathologies or parasites such as lice and scabies and that situation has changed. Nurses are working more on prevention and health promotion. (...) Nurses have the role to sensitize, inform, educate and guide these adolescents, clarify about diseases, and other issues that promote health. The school is the ideal place for implementing health education (...) (Cora 8/22 – New Synthesis).

The next step in the pedagogical experience was the Laboratory of Pedagogical Practices for acquiring knowledge, analyzing and reflecting on the Statute of the Child and Adolescent. The descriptive narratives concerning this stage are poor in detail and theoretical aspects. They often present confusing concepts or even a lack of them. (...) A social worker came to the class today (...) she talked about the Statute of the Child and Adolescent. There were not social policies up to the beginning of the 20^th century and needy people depended on charity and were sent to be cared for by the Catholic Church. The Statute of the Child and Adolescent introduced significant changes in the 1990s in relation to the previous law, the so-called Minor Code, established in 1979 (...) Considerations: there are still many barriers to overcome so that all children and adolescents have their rights really ensured (...) (Cora 8/25 – Laboratory of Pedagogical Practice).

The expression there are still appears in the record in a session separated from the first part called Considerations. Lygia writes a report at this point that is closer to a critical and reflective narrative. This is how this narrative is characterized.

The critical-reflective narratives and their characteristics

Critical-reflective narratives have as a general characteristic a more detailed description that questions the routine and certainties in students. There is a dialog of the student with herself/himself, with the group, professors and other authors. Another interesting aspect is recalling previously narrated facts, and their relationship with other experiences and courses.

Such narratives also present characteristics according to the cycle and course. (...) We received a visit from a social worker in this laboratory (...) [name] showed us issues established in the statute of the child and adolescent, the most recent one (1990). (...) (Lygia 8/25 – Laboratory of Professional Pedagogical Practice).

The report proceeds for more three handwritten pages including details and facts told by the professional and was finished with the following: (...) At the end the professor [name] asked us to evaluate this LPP and I mentioned that I learned today that children were not considered individuals and it scared me because we know they need greater care to become healthy and good citizens, (...) It is a good thing I had a family who took care of me. Those who were abandoned, how did they manage to survive without rights? Other students reflected on the issue related to the proposition to decrease the age considered majority for legal purposes, who so far did not have the measure of this problem and who now oppose it. [The social worker] left a message that made us reflect that our expectations for actions should be active, that we start to do our share, each one to form a whole: The dehumanization that results from an unfair order should not be a reason to lose hope, on the contrary, it should be another reason to desire even more, to seek without rest, to restore humanity overwhelmed by injustice. (...) Hope does not mean, however, to sit back and wait. I move on the hope while I fight and if I fight with hope, I wait – Paulo Freire (Lygia 8/25 – Laboratory of Professional Pedagogical Practice).

Due to extensive critical-reflective narratives, we present smaller excerpts concerning the end of the semester that show the emergence of a school without limits, with authoritative practices, but with possibilities, with participant-students and professors who care. This experience and reflection encouraged students to propose as the final activity the organization of simultaneous workshops with many classes and themes based on the students' demand, cross-sectional themes and active leaning and teaching methodologies. (...) We arrived at the School (...) at 12:40pm because we would attend the HTPC (Time of Collective pedagogical work), which included the presence of some teachers and coordinators. The secondary school coordinator [name] suggested a soccer championship to be held on Fridays to improve attendance on these days, that is, students enrolled in the championship would have to behave because occurrences would be noted in a book and each will have a certain number of scores, which summed up, may result in the disqualification of the student from the championship, and if the student maintains disruptive behavior the entire class may be declassified (...) (Cora 10/21^st – Immersion).

The report proceeds with details of what was discussed among coordinators and teachers; there is a disagreement on how to implement the activity. (...) We left the room where the HTPC took place since the teachers would prepare the questions for the SARESP simulation (School Performance Assessment of the State of São Paulo), and we met Professor [name] who divided us into pairs for some activities, while [name of the classmate] and I were initially responsible for verifying the vaccination cards, I still have many doubts about the vaccination scheme. However, with the help of Professor [name] I could understand a little more about how to interpret the vaccination card. Then [name of the classmate] and I went to talk with a teacher [from the school] since one of the objectives of the course is to recognize the social relationships among the subjects working in the school. For that, we asked her whether she knew about the existence of students with special needs in the school and she said there were some students but she did not have much contact with them (Cora 10/21^st – Immersion).

Cora used to present poor descriptive reports, in which she would not name others and made few references to herself or her difficulties. The previous report indicates there were changes, because in addition to reporting the set of activities with more detail, she also established the objectives of such activities.

This report proceeds and at the end she comments: (...) After this activity we got together to discuss the activity we will have at the school and we had the idea of organizing workshops concerning more relevant subjects and which students prefer more and also organize some activity with the teachers (Cora 10/21^st – Immersion).

The separated text – Considerations – proceeds with the following: (...) At first the coordinator's suggestion seems valid but this championship is not proposed to encourage interaction among students, from my standpoint it is a form of repression, because only the well-behaved students will participate in the activity; those who do not behave well occasionally will not have the opportunity and if disqualified they will learn nothing and will remain disruptive and perhaps will become even worse. In relation to [name of the coordinator], I think he could use his authority better, not saying to the teachers they should tell the students to shut up, but he should rather instruct the teachers to use other methods to improve the behavior of students and no treating them without respect. The teachers were going to prepare questions for the SARESP simulation after the HTPC but I developed some doubts in regard to this subject, because I do not know for sure what SARESP is so I did a little search that follows attached. I also did a little search concerning the vaccination schedule. I was touched by the affection professor [name] feels not only for the special students but also for all her students. (Cora 10/21^st – Immersion).

As an example of critical-reflective narrative we highlight two excerpts of Lygia's report: (...) This day was reserved for preparing activities in the school where workshops would be developed; I did not attend because of a family appointment that was previously scheduled but I learned that I would organize a workshop addressing first aid with [name of classmate]. I liked the topic because it includes pedagogical knowledge acquired this semester and we will have to use knowledge acquired in the past semester when we attended CIS (Integral Health Care) (...) (Lygia 11/14^th – Preparation of activities).

This is the same student who missed classes at the beginning and did not record activities in her portfolio. Now, even though she did not attend the activity, she makes the record, comments on what she was told, seeks information from classmates, which indicates the construction of affective and significant relationships, possible in social interactions⁽¹¹⁾. (...) The workshop that [classmate] and I organized concerning first aid, there was intense interaction among the students, reports of their experiences and through it we talked about what was correct to do in some situations such as burns and drowning. One of the classes (...) wanted practical classes but we explained that is was a more technical part they would find in specific courses such as in training of firefighters and in the health field (nursing, medicine and others). The workshops in general were well evaluated by the students (...). The activities of the workshops in general were well helpful, some of the activities did not work as planned, but they were updated and altered as necessary as they were implemented. At the end of this class, the pictures of the activities were handed on and it left an atmosphere of nostalgia, synthetizing what we have learned and was put into practice. (Lygia 11/19^th – Reflection on activities).

The last words at the end of class are short; they may have been shortened given the nature of feelings that arose from missing that environment that seemed so scary at the beginning.

DISCUSSION

The analysis indicates a process in which critical-reflective narratives develop, over the course of the students' learning process, from descriptive narratives. The report of Cora (8/4^th – beginning of the course) shows that the student's pedagogical conceptions are close to banking educationª and traditional practices⁽¹⁴⁾ and the conception of an ideal nurse who knows and "passes information" that clarifies doubts. The narrative shows astonishment with the experience because it questions whether the student at the school is normal or not, expressing a fear in relation to him and the others, as opposed to the passivity and obedience expected from students. The bomb to which she refers was a firecracker, a fact that was highlighted among the other aspects that occurred in those four hours of activity in which we talked about the school, the structure of the primary and secondary school, among so many other aspects. Yet in another report from Cora (8/15^th – Immersion), the structure of the text implies she considers the student who set off the firecracker equivalent to a problem to be solved, which should not be passed on. It gives a hint of pre-conceptions and the need to re-signify adolescence and how the school deals with it, expelling, excluding, and hindering access.

This report also shows there is a differentiation between their and our values, a distinction she makes between herself and the population, cultural values and social classes. We verify in the group discussion that most students from the Teaching Program come from public schools

Cora's text (8/18^th – Provisory Synthesis) confirms the way the student understands the teaching/learning process: the course provides. There is also an implicit complaint concerning the role of professors who at the time of the cycle should cause uncertainties, questioning and seeking to destabilize the certainties of the participants in order to elaborate the learning question. Professors should not indicate the question but support the group while elaborating the question, which certainly can generate anguish.

It is thought that educators can guide themselves based on three big concerns for their pedagogical practice: mobilizing for knowledge, constructing knowledge and developing a synthesis of knowledge⁽¹⁶⁾. In relation to the mobilization of knowledge, we highlight that interest in the theme needs to be incited with questions and listening to the students' discussions and actions.

Lygia's report (8/19^th – Search) shows that the work of nurses at that point was translated as an act of self-giving, a hope for a reward for the noble work of educating. There seems to be a contradiction in this narrative that announces itself with the expression but. Considering nursing as work requires covering it with its historical and social becoming, acknowledging that it emerged from the capitalist mode of production that founded modern nursing, primarily performed by women, who in addition to being poorly paid had strong religious roots that justify the continuity of donations and bounties⁽¹⁵⁾.

This view is still present in the nursing field and also in students and professors. Among the various aspects to be elected, the student brings it up not by chance, because she updates it in her contradiction, the dilemma of the profession. The report by Cora, even though with a different style, also indicates a role idealized for nurses, who do not question the corporate behavior and history as a sequence of dates and spontaneous facts.

The use of the word evasion in Lygia's excerpt (8/22^nd – New synthesis), when she actually meant inclusion, was observed. What meanings can support this lapse? The school as a way out? The difficulty in constructing knowledge is also apparent while questioning the syncretic view of nursing as a profession apart from historical movements and depending on the goodwill of professionals to become consolidated and recognized. Hence, a confusing narrative does not always denote superficiality, but may record that there was dis-order, which is required in learning.

When Lygia distinguishes promotion from prevention in her record (8/22^nd –New Synthesis) she shows an attachment to corporate positions of nurses as the professional most indicated for the task. This excerpt contains a notion of sensitization with the expression "that is"; it is equivalent to the compliance with precepts of good living: the incorporation of good habits.

Cora (8/25^th – Laboratory of Professional Pedagogical Practice) separates a session called consideration. The title and place of this session in the text indicates for the student a split between the description and reflection. What is the meaning of consideration? Is consideration associated with emotions? We observe, however, that the records say little about the student. She says it as it should be, as something external to her.

There is also in this report an apparent re-signification of what the media presents concerning legal majority. And a potential adherence to the aspect that calls for action and making a fight represented in the phrase of the educator Paulo Freire for active waiting is also highlighted.

In relation to the reflective narratives, we highlight in Cora's report (10/21^st – Immersion) the possibility of the emergence of the inadequacy of a teacher and adequacy of another. At this point, the student shows herself to be active in the search for knowledge and shows her feelings in relation to a professor, probably that professor who desires she expresses herself in her practice, manifesting through a constructive contradiction, advancement in her reflection.

Lygia (11/19^th – Reflection concerning activities) claimed responsibility for the workshop without excluding her partner, a feat that at the beginning of the semester was feared, cloudy, and loaded with re-significations of common knowledge. Another aspect to be noted is the recognition of the student from the school, who can now be encouraged to proceed studying because as the students themselves, they have the ability and potential to attend a nursing or a medicine program or become a firefighter.

The fact that the workshops were well evaluated by the school's students gained a special meaning for Lygia. It denotes recognition that the method and the theme were appropriate and confirms the theoretical aspects studied, that it may make a difference in the participation and meaning for the students, constituting significant learning.

Another aspect is the presence of a changing reality for which we can and should plan, but which requires adaptations and in the words of Lygia: have been updating and altered as necessary. She uses the verb in the present perfect have been which has a connotation of process and movement. It may indicate integration among experience, meaning, affection and learning.

CONCLUSION

The conclusion is that systematized records help the students to organize their thought, experience and theoretical search. An attentive reading of the portfolio made by the professor and discussions are essential to constructing critical-reflective narratives.

In the beginning, the narratives are only descriptive and briefly present experiences and in general, do not portray intellectual work in the search for meanings, estrangement of experiences and the possibility to intervene in reality. It was a syncretic description. Students were encouraged to go beyond this perspective to develop critical-reflective reports to express an interpretation of reality, at the same time questioning and comparing existent knowledge.

We note that the process of transforming descriptive narratives into critical-reflective narratives goes through idealization and common knowledge, the identification of negative aspects in practices as external to oneself and with a single possible meaning. The descriptive records and their authors, in processes of reflection, interrogation, embracement, and systematic monitoring can go toward the emergence of a multi-facet reality that includes criticism, mistakes, and also strength, the non-exclusive difference, opening up to possibilities to visualize interventions and moving the student to an active utopia. This teaching-learning strategy can contribute to the education of nurses, making them apt to meet the demands of SUS and professional routine in nursing care practice, teaching and research.

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• ¹
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Publication Dates

• Publication in this collection
  07 May 2012
• Date of issue
  Apr 2012

History

• Received
  18 Nov 2010
• Accepted
  18 Aug 2011