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Nursing training from the perspective of graduates

La educación en enfermería desde la perspectiva de los graduados

ABSTRACT

Objective:

To correlate the satisfaction of graduates with their training according to their professional characteristics and general competences.

Method:

Descriptive cross-sectional study with a sample of 192 Nursing graduates from a private higher education institution in the city of São Paulo. Data were collected between 2016 and 2017.

Results:

Graduates placed in the job market within one year (p=0.01) had nursing as their main source of income (p=0.011) and occupation (p=0.014); those who considered themselves professionally successful and those who would choose the profession again (p=<0.001), if they could choose, were more satisfied with their training. Satisfaction with training was linked to the competences acquired during graduates’ training, such as decision making (p=0.002), leadership (p=0.004) and continuing education (p=0.005).

Conclusion:

The study shows that most graduates consider their training satisfactory when analyzed with the study variables.

Descriptors:
Education, Nursing; Students, Nursing; Job Market; Teaching; Professional Competence

RESUMEN

Objetivo:

Correlacionar la satisfacción de los graduados con su formación según sus características profesionales y competencias generales.

Método:

Estudio descriptivo transversal con una muestra de 192 graduados de la carrera de Enfermería en una institución privada de educación superior de la ciudad de São Paulo. Los datos se recopilaron entre 2016 y 2017.

Resultados:

Los graduados colocados en el mercado laboral dentro de un año (p=0.01) tenían a la enfermería como su principal fuente de ingresos (p=0.011) y ocupación (p=0.014); los que se consideraban profesionales exitosos y los que, si pudieran elegir, volverían a elegir la profesión (p=<0,001) se mostraron más satisfechos con su formación. La satisfacción con la formación se vinculó con las competencias adquiridas durante la formación de los graduados, como la toma de decisiones (p=0,002), el liderazgo (p=0,004) y la formación continua (p=0,005).

Conclusión:

El estudio muestra que la mayoría de los graduados considera su formación satisfactoria cuando se analiza con las variables de estudio.

Descritores:
Educación en Enfermería; Estudiantes de Enfermería; Mercado de Trabajo; Competencia Profesional

RESUMO

Objetivo:

Correlacionar a satisfação do egresso com sua formação, segundo suas características profissionais e competências gerais.

Método:

Estudo descritivo de delineamento transversal com uma amostra de 192 egressos do curso de Enfermagem de uma instituição de ensino superior privada do município de São Paulo. Os dados foram coletados entre 2016 e 2017.

Resultados:

Os egressos que obtiveram colocação no mercado de trabalho em até um ano (p=0,01) tinham a enfermagem como principal fonte de renda (p=0,011) e ocupação (p=0,014); os que se consideraram bem-sucedidos profissionalmente e os que, se pudessem optar, escolheriam novamente a profissão (p=<0,001), estavam mais satisfeitos com sua formação. A satisfação com a formação foi atrelada às competências adquiridas na formação do egresso como, tomada de decisão (p=0.002), liderança (p=0.004) e educação permanente (p=0.005).

Conclusão:

O estudo mostrou que a maioria dos egressos considera sua formação satisfatória, quando analisada com as variáveis do estudo.

Descritores:
Educação em Enfermagem; Estudantes de Enfermagem; Mercado de Trabalho; Ensino; Competência Profissional

INTRODUCTION

The Political Pedagogical Projects (PPP) of undergraduate Nursing courses defines the graduate’s profile description based on the National Curriculum Guidelines (NCDs) established by the National Education Council.The instructions on the graduate’s profile indicate the skills and competencies based on healthcare, decision making, communication, leadership, administration, management, and continuing education(11 Ministério da Educação (BR). Conselho Nacional de Educação. Câmara de Educação Superior. Resolução CNE/CES 3/2001. Institui Diretrizes Curriculares Nacionais do curso de graduação em enfermagem [Internet]. Brasília; 2001 [cited 2017 Jun 26]. Available from: http://www.portal.mec.gov.br/cne/arquivos
http://www.portal.mec.gov.br/cne/arquivo...
).

This graduate profile is also analyzed by the National Higher Education Evaluation System, a proposal developed as an advance for higher education. One of its objectives is to control the quality of what is done in universities under three aspects: institution, courses and students(22 Ministério da Educação (BR). Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira. Diretoria de Avaliação da Educação Superior. Sistema Nacional de Avaliação da Educação Superior. Institui o Instrumento de Avaliação de Cursos de Graduação Presencial e a Distância [Internet]. Brasília; 2015 [cited 2017 Jun 26]. Available from: http://download.inep.gov.br/educacao_superior/avaliacao_cursos_graduacao/instrumentos/2015/instrumento_avaliacao_cursos_graduacao_presencial_distancia.pdf
http://download.inep.gov.br/educacao_sup...
).

The organizational structure of the National Higher Education Evaluation System has ten dimensions for internal and external evaluation of Higher Education Institutions (HEIs), and Dimension 1 stands out among them. It evaluates the Didactic-Pedagogical Organization of HEIs, and one of its indicators is the evaluation the graduates’ profile, valuing the competences and planned and implemented curricular contents that provide the development of the upcoming professional(22 Ministério da Educação (BR). Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira. Diretoria de Avaliação da Educação Superior. Sistema Nacional de Avaliação da Educação Superior. Institui o Instrumento de Avaliação de Cursos de Graduação Presencial e a Distância [Internet]. Brasília; 2015 [cited 2017 Jun 26]. Available from: http://download.inep.gov.br/educacao_superior/avaliacao_cursos_graduacao/instrumentos/2015/instrumento_avaliacao_cursos_graduacao_presencial_distancia.pdf
http://download.inep.gov.br/educacao_sup...
).

Some studies(33 Andriola WB. Study of alumni from undergraduate courses: grants for institutional self-assessment and planning. Educ Rev [Internet]. 2014 [cited 2018 May 12];54:203-19. Available from: http://www.scielo.br/pdf/er/n54/a13n54.pdf
http://www.scielo.br/pdf/er/n54/a13n54.p...

4 Branquinho NCSS. Satisfação dos Egressos do Curso de Graduação em Enfermagem de uma Universidade Pública[Dissertação]. 2012. 103f. Goiânia: Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia; 2012.

5 Nassif AA, Pereira SC. Perfil dos egressos do curso de enfermagem de uma universidade do planalto norte catarinense. Braz J Develop [Internet]. 2019 [cited 2020 Jun 06];5(12):32996-33008. Available from: https://www.brazilianjournals.com/index.php/BRJD/article/view/5745/5185
https://www.brazilianjournals.com/index....
-66 Nunes EBLLP, Duarte MMSLT, Pereira ICA. Planejamento e avaliação institucional: um indicador do instrumento de avaliação do SINAES. Avaliação[Internet]. 2017 [cited 2021 Mar 18];22(2):373-84. Available from: https://www.scielo.br/pdf/aval/v22n2/1982-5765-aval-22-02-00373.pdf
https://www.scielo.br/pdf/aval/v22n2/198...
) corroborate this dimension with emphasis on: systematic monitoring of graduates by describing their opinions, attitudes and beliefs about the university and society; identification and assessment of the value added by the HEI, the strengths and weaknesses of the formation of new nurses regarding the demands of the health system; assessment of the opinion of employers and sectors of organized civil society about the adequacy and relevance of the professional and citizen formation of the graduates.

These informations allow the comprehension and reflection on issues related to Nursing higher education and permit the implementation of curricular changes and teaching strategies that bring the training of these professionals closer to the needs of the society and of the job market, such as the most considered areas of expertise, the greatest employment sector and if the actual occupation of these professionals is in their area of training(55 Nassif AA, Pereira SC. Perfil dos egressos do curso de enfermagem de uma universidade do planalto norte catarinense. Braz J Develop [Internet]. 2019 [cited 2020 Jun 06];5(12):32996-33008. Available from: https://www.brazilianjournals.com/index.php/BRJD/article/view/5745/5185
https://www.brazilianjournals.com/index....

6 Nunes EBLLP, Duarte MMSLT, Pereira ICA. Planejamento e avaliação institucional: um indicador do instrumento de avaliação do SINAES. Avaliação[Internet]. 2017 [cited 2021 Mar 18];22(2):373-84. Available from: https://www.scielo.br/pdf/aval/v22n2/1982-5765-aval-22-02-00373.pdf
https://www.scielo.br/pdf/aval/v22n2/198...
-77 Camelo SHH, Mishima SM, Pereira MCA, Laus AM, Porto HS. Developing a nursing graduate follow-up methodology for a higher education institution. Rev Eletr Enferm [Internet]. 2015 [cited 2018 May 19];17(2):247-56. Available from: https://www.fen.ufg.br/revista/v17/n2/pdf/v17n2a09.pdf
https://www.fen.ufg.br/revista/v17/n2/pd...
).

In a study(88 Meira MDD, Kurcgant P. Nursing education: training evaluation by graduates, employers and teachers. Rev Bras Enferm[Internet]. 2016 [cited 2018 Jun 2];69(1):16-22. Available from: http://www.scielo.br/pdf/reben/v69n1/0034-7167-reben-69-01-0016.pdf
http://www.scielo.br/pdf/reben/v69n1/003...
) involving graduates, teachers and employers, an action plan was prepared collectively containing proposals for changes considered essential, such as curriculum flexibility, content resizing, continuing education, insertion of active methodologies and appreciation of students’ practice and autonomy by providing concrete elements for curriculum improvement of the nursing course studied.

A study(99 Colenci R, Berti HW. Formação profissional e inserção no mercado de trabalho: percepções de egressos de graduação em enfermagem. Rev Esc Enferm USP. 2012;46(1):158-66. https://doi.org/10.1590/S0080-62342012000100022
https://doi.org/10.1590/S0080-6234201200...
) of nursing graduates of a private HEI allowed the review of the PPPs, with emphasis on the need for teaching focused on the development of competences, that include the practice of nurses in management, care, education and research, that are the dimensions of the care process

In nursing courses, the evaluation indicator for the graduate’s profile is still little explored by the educational management of HEIs. The analysis of graduates’ perception about the contribution of their course is fundamental, as it promotes a dialogue between training and praxis. This approximation between educational strategies and the reality where one intends to act can support the reflection on changes to acquire the competences, skills and attitudes expected of the future nurse(1010 Higa EFR, Gomes R, Carvalho MHR, Guimarães APC, Taipeira EF, Carvalho SMR. Perceptions of nursing alumni regarding the course contribution in providing health care. Texto Contexto Enferm[Internet]. 2013 [cited 2018 Jun 10];22(1):97-105. Available from: http://www.scielo.br/pdf/tce/v22n1/pt_12.pdf
http://www.scielo.br/pdf/tce/v22n1/pt_12...
).

Other evaluative aspect to be explored is the graduates’ satisfaction, that is considered a quality indicator of the teaching-learning process and service provision(1111 Meira DDM, Oliveira GS, Silva MCH, Kurcgant P. Evaluation by graduates as a quality indicator in the graduation training process. Rev Cienc Gerenc [Internet]. 2018 [cited 2018 Jun 5];22(35):68-74. Available from: http://pgsskroton.com.br/seer//index.php/rcger/article/view/4399/4299
http://pgsskroton.com.br/seer//index.php...
), enables their reflection and the insertion in practice of what they best acquired during their construction of knowledge(44 Branquinho NCSS. Satisfação dos Egressos do Curso de Graduação em Enfermagem de uma Universidade Pública[Dissertação]. 2012. 103f. Goiânia: Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia; 2012.).

OBJECTIVE

To correlate the satisfaction of graduates with their training, according to their professional characteristics and general competences.

METHOD

Ethical aspects

The research was guided by the determinations of Resolution No. 466/2012 of the National Health Council(1212 Ministério da Saúde (BR). Conselho Nacional de Saúde. Resolução n. 466, de 12 de dezembro de 2012. Aprova diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos [Internet]. Brasília, Diário Oficial da União, 12 dez. 2012 [cited 2021 Mar 18]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html
https://bvsms.saude.gov.br/bvs/saudelegi...
). The Informed Consent Form was signed by the participants and the study was approved by the reference Research Ethics Committee.

Design, study location and period

This is a descriptive, cross-sectional, quantitative study in which the STROBE tool was adopted. The scenario included a Higher Education Institution in the city of São Paulo with focus on health courses. Data collection occurred electronically between November 2016 and January 2017.

Population, sample and inclusion and exclusion criteria

The study population consisted of 200 Nursing graduates of the HEI who concluded the course between years 2012 and 2016. They represented around 10% of the total graduates in the period, during the term of the PPP related to the four-year period matrixes.

Some steps were taken in the search of the study population: requesting a list of graduates from the last five years in the undergraduate dean’s office; search for e-mails and telephone numbers of graduates in files of the coordination of the Nursing course of the HEI studied and checking social media websites and nursing communities.

Of the 200 graduates in the indicated period, 197 (98.5%) responded to the data collection instrument. Of these, 192 (96%) answered all questions and were part of the study sample.

Study protocol

Data collection was performed through an adapted questionnaire authorized by the main researcher of the study that was applied to graduates(44 Branquinho NCSS. Satisfação dos Egressos do Curso de Graduação em Enfermagem de uma Universidade Pública[Dissertação]. 2012. 103f. Goiânia: Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia; 2012.). The referred instrument (without a validation process) is structured in five parts, namely: the first with seven items of characterization of graduates; the second with 12 items referring to the job market, such as time of insertion, employment contract, workload; the third with an item on the competences acquired during training, described in Resolution CNE/CES 3/2001 of the National Education Council(11 Ministério da Educação (BR). Conselho Nacional de Educação. Câmara de Educação Superior. Resolução CNE/CES 3/2001. Institui Diretrizes Curriculares Nacionais do curso de graduação em enfermagem [Internet]. Brasília; 2001 [cited 2017 Jun 26]. Available from: http://www.portal.mec.gov.br/cne/arquivos
http://www.portal.mec.gov.br/cne/arquivo...
); the fourth part with five items on the training process and satisfaction with the course completed; and the fifth and last part with three items on professional improvement. The questions regarding graduates’ satisfaction with the salary and training are included in the second and fifth part of the instrument in the form of Likert scales(1313 Marconi MA, Lakatos EM. Metodologia Científica. 6ª ed. São Paulo: Atlas; 2011.).

In this study, the sub-items referring to the regional description of the nursing course and the minimum wage value that appear, respectively, in the first and second part of the instrument, were adapted. The item on competences acquired during graduates’ training was also added.

The instrument was inserted in the LimeSurvey 1.9(1414 Limesurvey.org [Internet]. United State of American: GPL; 2009. [cited 2017 Nov 25]. Available from: https://www.limesurvey.org/pt/
Limesurvey.org...
) software and encoded for the confidentiality of participant’s identity. Messages by e-mail and social network were sent to graduates with the invitation to participate in the study and a link to the LimeSurvey 1.9 software for access to the IC and the instrument.

Analysis of results and statistics

The data were analyzed using the statistical software R 3.4.2(1515 R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. Vienna [Internet]. 2017 [cited 2017 Nov 25]. Available from: http://www.R-project.org/
http://www.R-project.org/...
). For hypothesis tests, a significance level of 5% was considered. The tables built to answer the questions were described using absolute and relative frequencies. The measure of satisfaction was considered continuously (1– Very unsatisfactory to 5– Very satisfactory) and values of mean and standard deviation for each category were presented. Comparisons of mean values between groups were tested using Kruskal-Wallis and Mann-Whitney non-parametric tests(1616 Lehmann EL, D'abrera HJM. Nonparametrics statistical methods based on ranks. Nova Iorque: Springer; 2006.).

After analysis of data generated from each item in the questionnaire, variables were crossed as follows: satisfaction with nursing training with the professional characteristics of graduates; and satisfaction with nursing training with the acquisition of general National Curriculum Guidelines competences in order to broaden the understanding of the scope of this study.

RESULTS

Most graduates participating in this research were between 20 and 30 years old (76.6%), single (63.5%), had no children (79.2%), attended high school in a public institution (62%), had a postgraduate degree/specialization (72.1%) or residency (8.4%). Most were employed (76.6%), had no difficulty entering the job market in the first 12 months after completing the course (77.6%), with a significant amount entering the market in the first six months (54.7%).

Graduates indicated the income of up to five minimum wages (46.3%), up to 40 working hours per week (51.5%), and there was a significant number of graduates with total work hours over 40 hours per week.

Most graduates worked in private services (81.1%), were dissatisfied with their salary (42.2%), and indicated that nursing work was their main income and occupation (91.8% and 98.1% respectively).

The percentage of nurses performing care duties was quite high (89.2%) and 60.4% considered themselves successful in the profession. Although 83.4% of graduates considered the profession stressful, 63% indicated they would choose Nursing, were they given the opportunity to choose the profession again.

From data collected, it was possible to analyze the predominance of factors combined to the satisfaction of the graduate with their professional training, profession, income and employment related to the job market in nursing.

In Table 1, differences in the distribution scales of the variable of interest satisfaction with training were identified, with p-values below 5% (0.05). Graduates placed in the job market in up to one year, in general, were more satisfied with their training (p=0.01). The result is also reflected in the issue of difficulty in entering the job market. Graduates who indicated this difficulty had a mean satisfaction of 3.79 points, against 4.43 of those who did not (p=< 0.001). Satisfaction with training was also evaluated in relation to the formal work situation (p=0.001), that is, even unemployed graduates who worked in other areas, considered their training satisfactory.

Table 1
Evaluation of satisfaction with nursing education according to professional characteristics of Nursing graduates at the Higher Education Institutions (n = 192) who graduated between 2012 and 2016, São Paulo, São Paulo, Brazil, 2020.

Significance (p=0.047) was found between the correlation of graduates’ salary and satisfaction with training. Graduates who earned up to nine minimum wages or more were more satisfied with their training, had nursing as their main source of income (p=0.011) and occupation (p=0.014) and were also more satisfied with their training. Graduates who considered themselves professionally successful and those that would choose the profession again, if they had the chance, were the most satisfied with their training (p=<0.001).

Table 2 shows satisfaction with training linked to the general competences described in the National Curriculum Guidelines and acquired during graduates’ training, such as: decision making (p=0.002), leadership (p=0.004) and continuing education (p=0.005).

Table 2
Evaluation of satisfaction with nursing education according to the general competences of the National Curriculum Guidelines of Nursing graduates at the Higher Education Institutions (n=192) who graduated between 2012 and 2016, São Paulo, São Paulo, Brazil, 2020

Graduates who had these competences were more satisfied with their training, but even those who declared not having acquired them, considered themselves satisfied or very satisfied with their training.

DISCUSSION

Most of the surveyed graduates indicated early insertion in the job market, acting as nurses. This information is in line with the study conducted at a private HEI(1717 Cambiriba TFC, Ferronato AF, Fontes KB. Perceptions of nursing graduates in face of the insertion in the market. Arq Ciênc Saúde [Internet]. 2014 [cited 2018 Jun 5];18(1):27-32. Available from: http://revistas.unipar.br/index.php/saude/article/view/5155/2981
http://revistas.unipar.br/index.php/saud...
), in which 93.3% of graduates were employed until the third month after graduation, and a study(1818 Barbosa ACS, Luiz FS, Friedrich DBC, Püschel VAA, Farah BF, Carbogim FC. Profile of nursing graduates: competencies and professional insertion. Rev Latino-Am Enfermagem. [Internet]. 2019 [cited 2020 Jan 20];27:e3205. Available from: http://www.scielo.br/pdf/rlae/v27/pt_0104-1169-rlae-27-e3205.pdf
http://www.scielo.br/pdf/rlae/v27/pt_010...
) in which 48% of graduates started their activities in up to six months after graduation, and most (67%) got their first job within a year after graduation. Thus, the conclusion that despite the recent economic crisis in Brazil, with a high unemployment rate and the limitations encountered by graduates in seeking entry into the job market(88 Meira MDD, Kurcgant P. Nursing education: training evaluation by graduates, employers and teachers. Rev Bras Enferm[Internet]. 2016 [cited 2018 Jun 2];69(1):16-22. Available from: http://www.scielo.br/pdf/reben/v69n1/0034-7167-reben-69-01-0016.pdf
http://www.scielo.br/pdf/reben/v69n1/003...
), the surveyed graduates managed to maintain employability. Despite the economic and financial difficulties, nurses have been gaining respect and credibility and revealing nursing as a promising profession with guarantee of prestige and social success(1919 Sampaio MRFB, Franco CS. Mercado de trabalho: aspectos gerais. Enferm Foco [Internet]. 2016 [cited 2018 Jun 5];7(ESP):35-62. Available from: http://revista.cofen.gov.br/index.php/enfermagem/article/view/691/301
http://revista.cofen.gov.br/index.php/en...
).

With regard to salary, a study conducted in Ceará(2020 Oliveira FMM, Vasconcelos MIO, Vieira IPGF, Ferreira AGN, Cavalcante ASP, Teófilo FS. Insertion nursing school graduates in the labor market. Sanare [Internet]. 2014 [cited 2018 Jun 5];13(1):92-98. Available from: https://sanare.emnuvens.com.br/sanare/article/view/439/293
https://sanare.emnuvens.com.br/sanare/ar...
), indicated that most graduates working in the public service earn three to four minimum wages and 44.4% work more than 40 hours a week. In this study, the majority indicated having a workload between 30 and 40 hours a week.

The satisfaction with the professional training of the graduates of this research is linked to their social status and income, that can be obtained through employment, career and salary

During the phase of knowledge acquisition, in nursing education, when the student can have identification with the profession, there is a structuring of the learning process, joined by an adequate degree of satisfaction by the graduate(44 Branquinho NCSS. Satisfação dos Egressos do Curso de Graduação em Enfermagem de uma Universidade Pública[Dissertação]. 2012. 103f. Goiânia: Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia; 2012.). It was evidenced the probability that the graduates satisfied with their education, also showed satisfaction with their income and, therefore, considered themselves to be successful professionals.

Regarding satisfaction with nursing training, considering the general competences described in the National Curriculum Guidelines and in the identification of graduates’ profile described in the Pedagogical Political Project of the studied institution, this study showed competences, skills and attitudes related to the following: coordination of nursing care planning; motivation and technical-scientific updating of your team; conducting clinical reasoning and assessing the performance of nursing in different settings, with a scientific basis for their interventions, enabling autonomy in decision-making in care; attention to social health needs based on the National Health Service (Brazilian SUS), on the population’s epidemiological profile and professional legislation, ensuring comprehensive and humanized care; management through the planning, organization, direction and evaluation of nursing care and services.

In a study conducted at a public HEI of Minas Gerais(1818 Barbosa ACS, Luiz FS, Friedrich DBC, Püschel VAA, Farah BF, Carbogim FC. Profile of nursing graduates: competencies and professional insertion. Rev Latino-Am Enfermagem. [Internet]. 2019 [cited 2020 Jan 20];27:e3205. Available from: http://www.scielo.br/pdf/rlae/v27/pt_0104-1169-rlae-27-e3205.pdf
http://www.scielo.br/pdf/rlae/v27/pt_010...
), the competences recommended for a comprehensive training of professional nurses were listed, with emphasis on those described in the National Curriculum Guidelines and principles of the Brazilian SUS, especially the performance in comprehensive care programs; about ethical, technical and scientific issues for nursing practice; planning and production of scientific knowledge; health education; teamwork and conflict management; social role in political and health planning activities; coordination of nursing team activities and health management.

The aforementioned competences are evidenced in the results of this study and consistent with it(1818 Barbosa ACS, Luiz FS, Friedrich DBC, Püschel VAA, Farah BF, Carbogim FC. Profile of nursing graduates: competencies and professional insertion. Rev Latino-Am Enfermagem. [Internet]. 2019 [cited 2020 Jan 20];27:e3205. Available from: http://www.scielo.br/pdf/rlae/v27/pt_0104-1169-rlae-27-e3205.pdf
http://www.scielo.br/pdf/rlae/v27/pt_010...
), since the graduates expressed their preparation to act as social agents in political, health planning and Nursing activities. In a survey conducted in the FAMEMA Nursing course(99 Colenci R, Berti HW. Formação profissional e inserção no mercado de trabalho: percepções de egressos de graduação em enfermagem. Rev Esc Enferm USP. 2012;46(1):158-66. https://doi.org/10.1590/S0080-62342012000100022
https://doi.org/10.1590/S0080-6234201200...
), the graduates signaled that changes made in the institution contributed significantly to the practice of humanized and scientifically based care, giving them the professional competence required in the job world, of greater autonomy.

A study conducted with nursing graduates from a public HEI(2121 Souza NVDO, Correia LM, Cunha LS, Eccard J, Patrício RA, Antunes TCS. The FENF/UERJ nursing graduate in the working world. Rev Esc Enferm USP[Internet]. 2011 [cited 2018 Jun 9];45(1):250-7. Available from: http://www.scielo.br/pdf/reeusp/v45n1/en_35.pdf
http://www.scielo.br/pdf/reeusp/v45n1/en...
) demonstrated that the exercise of autonomy must be fostered in nurses’ training in order to mobilize their ability to adapt and create, to decide the best care to be provided, as well as the social approval of their performance, since the competence to make assertive and cost-effective decisions, based on scientific evidence, which allows for the evaluation, systematization and decision on the conduct related to human and technological resources and qualified assistance are other aspects that underlie the performance of health professionals(11 Ministério da Educação (BR). Conselho Nacional de Educação. Câmara de Educação Superior. Resolução CNE/CES 3/2001. Institui Diretrizes Curriculares Nacionais do curso de graduação em enfermagem [Internet]. Brasília; 2001 [cited 2017 Jun 26]. Available from: http://www.portal.mec.gov.br/cne/arquivos
http://www.portal.mec.gov.br/cne/arquivo...
).

These data on autonomy and decision making corroborate what was evidenced in this study about graduates’ satisfaction with their training linked to the acquisition of decision making and leadership skills.

In a study(2222 Almeida ML, Peres AM. Knowledge, skills, and attitudes towards management of nursing graduates of a Brazilian public university. Invest Educ Enferm [Internet]. 2012 [cited 2018 Jun 15];30(1):66-76. Available from: http://www.scielo.org.co/pdf/iee/v30n1/v30n1a08.pdf
http://www.scielo.org.co/pdf/iee/v30n1/v...
) conducted with recent graduates of the nursing course, leadership was identified as a challenge for nurses.The authors aimed at discussing the expected profile of the leader, but due to the changes observed in the world of work, these characteristics now show instability and dynamism.

In a study(2323 Ávila VC, Amestoy SC, Porto AR, Thofehrn MB, Trindade LL, Figueira AB. The view of nursing students on the training of nurse-leaders. Cogitare Enferm [Internet]. 2012 [cited 2018 Jun 10];17(4):621-7. Available from: https://revistas.ufpr.br/cogitare/article/view/30357/19635
https://revistas.ufpr.br/cogitare/articl...
) investigating the view of teachers on the training of nurse leaders, the following personal characteristics of the leader were indicated: responsibility, commitment, motivation and good mood. It is important that leadership strategies are identified in the current context of nursing, and it is the professors’ role to facilitate the development of this professional competence with appreciation for the transversal teaching of leadership(2424 Ciampone MHT, Kurcgant P. Gerenciamento de Conflitos e Negociação. In: Kurcgant P. coordenadora. Gerenciamento em Enfermagem. Rio de Janeiro: Guanabara Koogan; 2010. p. 51-62.).

Regarding competences of continuing education and decision making, the professional qualification of graduates who decided to invest in their training was identified as a differential for professional nurses. In this study, most participants sought improvement in specializations (72.1%), residency (8.4%) and master’s (1.6%). Corroborating these results, a study conducted with graduates from the School of Nursing at the University of São Paulo identified that 63.7% had attended specialization and/or residency(2525 Püschel AAV, Costa D, Patrício Reis P, Oliveira LB, Carbogim FC. Nurses in the labor market: professional insertion, competencies and skills. Rev Bras Enferm [Internet]. 2017 [cited 2018 May 28];70(6):1288-95. Available from: http://www.scielo.br/pdf/reben/v70n6/0034-7167-reben-70-06-1220.pdf
http://www.scielo.br/pdf/reben/v70n6/003...
).

In this study, the analysis of graduates’ satisfaction with nursing training linked to the competence of continuing education was characterized by participation in scientific events or improvement courses. Most graduates underwent continuing education that although in undesired amount (51.9%), did not negatively impact on the satisfaction with their training.

In this study, satisfaction with nursing training linked to continuing education was identified through graduates’ participation in scientific events or improvement courses. Most graduates who attended continuing education, although not to the extent they would like (51.9%), were satisfied with their training, though without statistical significance.

The reasons that made participation in scientific activities difficult were the high cost of scientific events (p=0.014), books and journals (p=0.046), although they had no negative impact on the satisfaction with training. These data indicate that even though graduates have difficulty in attending continuing education, this did not interfere with their concept of satisfaction and great satisfaction with their training.

Continuing education must be considered in the training of future nurses. It provides opportunities within teaching-service interaction and enables the adaptation of teaching to the real conditions in the job world. The investment and commitment of the two sectors, teaching and service, provide the effectiveness of continuing education by establishing intersubjective interactions in which the actors involved consider human beings in their entirety(2323 Ávila VC, Amestoy SC, Porto AR, Thofehrn MB, Trindade LL, Figueira AB. The view of nursing students on the training of nurse-leaders. Cogitare Enferm [Internet]. 2012 [cited 2018 Jun 10];17(4):621-7. Available from: https://revistas.ufpr.br/cogitare/article/view/30357/19635
https://revistas.ufpr.br/cogitare/articl...
,2626 Jesus BH, Prado ML, Gomes DC, Canever BP, Spillere LBB. Job market placement: professional trajectory of nursing graduates. Esc Anna Nery [Internet]. 2013 [cited 2018 May 20];17(2):336-345. Available from: http://www.scielo.br/pdf/ean/v17n2/v17n2a19.pdf
http://www.scielo.br/pdf/ean/v17n2/v17n2...
).

Professionals, aware of their responsibility as nurses, must recognize the importance of building and improving their knowledge and from that, consider permanent education in the daily context of professional performance and assume an attitude of criticality and reflection in the face of their learning(2727 Fater KH, Ready R. An education-service partnership to achieve safety and quality improvement competencies in nursing. J Nurs Educ [Internet]. 2011 [cited 2018 May 12];50(12):693-6. Available from: http://www.healio.com/nursing/journals/jne/2011-12-50-12/%7Bec373f45-0fff-46b8-bbeb-79c9268b15d8%7D/an-education-servicepartnership-to-achieve-safety-and-quality-improvementcompetencies-in-nursing.pdf
http://www.healio.com/nursing/journals/j...
-2828 Lima AF, Lopes LCS, Soane AMNC, Fortes AF. Nursing graduates: potentialities in the professional education process to promote the insertion in the labor market. Indag Didact. [Internet]. 2017 [cited 2018 May 20];9(4):65-80. Available from: http://revistas.ua.pt/index.php/ID/article/view/6104/4694
http://revistas.ua.pt/index.php/ID/artic...
). A study(1515 R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. Vienna [Internet]. 2017 [cited 2017 Nov 25]. Available from: http://www.R-project.org/
http://www.R-project.org/...
) also carried out with graduates, showed that the majority recognizes that they were instrumentalized in the planning, implementation and participation of continuing education actions in the service.

A study(99 Colenci R, Berti HW. Formação profissional e inserção no mercado de trabalho: percepções de egressos de graduação em enfermagem. Rev Esc Enferm USP. 2012;46(1):158-66. https://doi.org/10.1590/S0080-62342012000100022
https://doi.org/10.1590/S0080-6234201200...
) on the insertion of nurses in the job market showed that the competences described in the graduate’s profile and acquired during the undergraduate course, prepared them for professional practice in part, and did not guarantee enough experiences within health sectors and understanding on the different functions taken over by nurses in the health field. This lack of full development of the competences of future nurses is in line with the analysis performed in the study(2929 Guareschi APDF, Kurcgant P. Influence of lecturer training on the profile of the graduate of the undergraduate course in nursing. Cogitare Enferm[Internet]. 2014 [cited 2018 May 20];19(1):101-8. Available from: https://revistas.ufpr.br/cogitare/article/view/35965/22419
https://revistas.ufpr.br/cogitare/articl...
) regarding the influence of teachers’ training on the profile and competences of nursing graduates. The teaching-learning process of future nurses needs to be constantly reframed by teachers and HEIs in order to achieve the profile of competences established by the National Curriculum Guidelines.

In order to collaborate with studies that may be conducted with graduates, an instrument has been developed and is already validated for the evaluation of graduates from nursing courses(3030 Vieira MA, Ohara CVS, Domenico EBL. The construction and validation of an instrument for the assessment of graduates of undergraduate nursing courses. Rev Latino-Am Enfermagem. [Internet]. 2016 [cited 2019 Sep 4];24:e2710 Available from: http://www.scielo.br/pdf/rlae/v24/pt_0104-1169-rlae-24-02710.pdf
http://www.scielo.br/pdf/rlae/v24/pt_010...
). As it was based on curricular guidelines, it can be used throughout the country and contribute to the process of regulating the quality of undergraduate nursing courses.

The professional nurse has several skills that are expected and those that are effectively performed in the day-to-day work, which lead to questioning what are the exact skills of this professional,their adaptation and performance in work settings, and the responsibility of education in the integration of theoretical and practical teachings at an earlier stage in the search for training professionals who can act and transform their practice(3131 Vieira MA, Souto LES, Souza SM, Lima CA, Ohara CVS, Domenico EBL. National Curriculum Guidelines for the nursing area: the role of the skills in the nursing education. Rev N Min Enferm [Internet]. 2016 [cited 2018 May 20];5(1):105-21. Available from: http://www.renome.unimontes.br/index.php/renome/article/view/102/148
http://www.renome.unimontes.br/index.php...

32 Souza NVDO, Pires AS, Gonçalves FGA, Tavares KA, Baptista ATP, Bastos TMG. Formação em enfermagem e mundo do trabalho: percepções de egressos de enfermagem. Aquichán[Internet]. 2017 [cited 2020 Jan 20];17(2):204-16. Available from:https://www.redalyc.org/jatsRepo/741/74153575009/74153575009.pdf
https://www.redalyc.org/jatsRepo/741/741...
-3333 Moreira LR, Siqueira AT, Sanos PT, Ladislau VN. Percepção do enfermeiro acerca da formação acadêmica para o exercício profissional. Enferm Rev [Internet]. 2018 [cited 2020 Mar 15];21(1):34-50. Available from:http://periodicos.pucminas.br/index.php/enfermagemrevista/article/view/17896
http://periodicos.pucminas.br/index.php/...
).

Study limitation

The conduction of this study was limited to a private educational institution and there was no qualitative analysis to identify the senses and meanings of the development of skills, as well as the profissional’s entry into the job market.

Contributions to the nursing field

Studies with graduates are of great value for training institutions, especially as they reveal a “picture” of students’ training.

This study directly contributed to the understanding of nurses’ training process, the acquisition of competences proposed for these professionals, and the discussion about their insertion in the job market. It also enabled, from the National Curriculum Guidelines, a reflection on the PPPs guiding undergraduate nursing courses.

CONCLUSION

Most graduates rated their training as satisfactory when analyzed with the study variables. We highlight the satisfaction with nursing training with the variables: interval between completion of the course and insertion in the job market, formal work situation, difficulty in finding a job in nursing, salary, nursing as the main source of income and occupation, considering oneself professionally successful and would choose that profession again.

With regard to competences described in the National Curriculum Guidelines, nursing graduates were more satisfied with their training in the acquisition of decision making, leadership and continuing education skills.

The satisfaction with graduates’ training related to continuing education was significant in the reasons that hinder participation in scientific activities, such as the high cost of scientific events, books and journals. However, this did not exert impact on graduates’ satisfaction with the training received.

ACKNOWLEDGMENT

Centro Universitário São Camilo.

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Edited by

EDITOR IN CHIEF: Dulce Barbosa
ASSOCIATE EDITOR: Margarida Vieira

Publication Dates

  • Publication in this collection
    24 May 2021
  • Date of issue
    2021

History

  • Received
    22 July 2020
  • Accepted
    09 Jan 2021
Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br