Learning process of nursing: planning and insert into matrizes curriculum

Abstracts

Este trabalho objetiva analisar a abordagem do ensino do processo de enfermagem, a partir dos planos de curso das disciplinas que evidenciam as bases conceituais e metodológicas do processo de enfermagem em instituições de Ensino Superior, em uma capital do Nordeste brasileiro. Os resultados evidenciaram que as disciplinas têm natureza prevalentemente teórica, apresentam ementas e bases conceituais com ênfase no suporte teórico-filosófico do processo de enfermagem, bem como no estudo das fases que o compõe. Evidenciou-se ainda a expressão e prevalência dos objetivos de domínio cognitivo e psicomotor e a utilização da metodologia tradicional.

Ensino; Educação em enfermagem; Processos de enfermagem

ORIGINAL ARTICLE

Learning process of nursing: planning and insert into matrizes curriculum^*

Proceso de aprendizaje de la enfermería: planificación y insert into matrizes plan de estudios

Oriana Deyze Correia Paiva Leadebal^I; Wilma Dias de Fontes^II; César Cavalcanti da Silva^III

^IRN. MSc Faculty at Medical-Surgical Nursing and Administration Department, Health Sciences Center, Universidade Federal da Paraíba. João Pessoa, PB, Brazil. [e-mail]

^IIRN. PhD Faculty in Graduate Program, Master's level and at Medical-Surgical Nursing and Administration Department, Health Sciences Center, Universidade Federal da Paraíba. João Pessoa, PB, Brazil. [e-mail]

^IIIRN. Ph.D. Faculty at Medical-Surgical Nursing and Administration Department, Health Sciences Center, Universidade Federal da Paraíba. João Pessoa, PB, Brazil. [e-mail]

^{Correspondence addressed to}

ABSTRACT

The objective of this study was to analyze the approach used to teach the nursing process based on the class plans of courses that evidence the concept and method bases of the nursing process in superior education institutions in a state capital of Northeast Brazil. Results showed that the courses are mostly theoretical, with amendments and concept bases emphasizing the theoretical-philosophical support of the nursing process, as well as on the study of the phases comprising it. Furthermore, it was shown there was an expression and prevalence of cognitive and psychomotor objectives and the use of traditional methodology.

Key words: Teaching; Education, nursing; Nursing process.

RESUMEN

Este documento tiene por objeto examinar el enfoque del proceso de aprendizaje de la Enfermería a partir de los planes de carrera de las disciplinas que constituyen las bases conceptuales y metodológicas de la Enfermería en instituciones de Educación Superior en una capital del Noreste brasileño. Los resultados demostraron que las disciplinas tienen una naturaleza prevalentemente teórica y se constituyen en sumarios y bases conceptuales con énfasis en el respaldo teórico-filosófico del proceso de Enfermería, así como en el estudio de las fases que componen dicho proceso. Se evidenció asimismo la expresión y prevalencia de los objetivos de dominio cognitivo y psicomotor, y la utilización de la metodología tradicional.

Descriptores: Enseñanza; Educación en enfermería; Procesos de enfermería.

INTRODUCTION

Motivated to establish defined scientific foundations, Brazilian nursing started to set out its object of study and work methodology in the 1970s seeking autonomy in care practice and, thus, be freed from the dominating paradigm to which it was subject. The caring/care practice, taken as a central element of professional practice, has guided development in the practical work fields and oriented its teaching and research activities. However, taking caring/care practice as the object of Nursing work is not sufficient to achieve the development envisaged within the profession, since, over time, care practices were devalued as a consequence of the dichotomy between the intellectual and manual work⁽¹⁾.

Seeking to reflect on and re-construct the inter-relationship established between subjects involved in the caring/care process, the nursing process has presented itself as an alternative to re-approximate nurses to their clientele, as a methodological work tool. Such a method was acknowledged as an essential instrument for nursing, capable of promoting autonomy, independence and specificity within the profession. It is currently described as an instrument through which it is possible to identify, understand, describe and/or predict how clients will respond to health problems or to life's vital processes, and to determine which aspects of these responses require a professional nursing intervention^(1-2).

It is structured in five key stages presented by several contemporaneous theorists: data collection, nursing diagnosis, planning, implementation and evaluation. This work organization method helps nursing professionals develop care delivery with individual qualities and problem-solving capacities, provided these are based on conceptual models or Nursing Theories appropriate to each care situation, which in turn, demand technical, intellectual, cognitive and interpersonal skills from those who use them. Given the need for nurses to develop these capacities to carry out the nursing process, these are expected to be developed based on academic experience, especially in undergraduate nursing programs in the course of their theoretical-philosophical and practical training processes.

From this perspective, the teaching of undergraduate nursing programs has been transformed so as to follow advancements in the sphere of knowledge production and the speed with which information is disseminated, in addition to transformation in the social, political and ethical spheres experienced by those who practice the profession. The National Curricular Guidelines provided in Resolution CNE/SES Nº 3/2001 are highlighted in the current scenario. These guidelines provide necessary guidance for the development of pedagogical processes in universities that administer undergraduate nursing programs and which hold the encouragement to learn how to learn, to learn to know, to learn how to do, to learn to be, and to learn to live together as guiding principles⁽³⁾.

It is worth mentioning that reflection about educational practices responsive to the current paradigm permeates the awareness of the need for careful selection of teaching/learning methods that focus on the desire to stimulate dialog, the participation of students and the understanding of numerous aspects involved in a more liberating, creative, reflective, and constructive approach that questions content with a view to develop critical professionals capable of transforming their realities⁽⁴⁾.

The process of nurses' education requires attention to basic demands of professional practice, including teaching the method to be used by these professionals. Moreover, the nursing process is introduced in courses of undergraduate programs that administer basic components that seek to construct, together with students, knowledge to perform each phase and develop abilities and attitudes in the context of courses that address the professional component, which allows learning in theoretical and practical spheres.

However, despite the growing concern to integrate theory and practice, unbiased observation reveals that there is a gap between what is taught in theoretical classes and what is seen in supervised training, as an example of how nursing processes have been applied. It is worth pointing out that the participation of academia itself favors this fragmentation between knowing and doing, which initially allows the construction of knowledge within the boundaries of courses and then blocks the interaction between the content of different courses. In this way, there is a reproduction of the know-how-to-do model in the program's professional component, that is, it is divorced from critique, reflection and is not linked to content developed by the remaining curricular courses. From this perspective, driven by the interest in developing a critical, reflective and questioning awareness of nurses-to-be and considering the crucial role of the educational process to achieve this development, we ask: How is the process of teaching the methodological foundations of nursing processes in undergraduate institutions characterized in the field? In which level does the planning of courses fit into the current educational paradigm?

OBJECTIVE

To analyze the planning for the teaching of the methodological foundations of the nursing processes in the matrices of this program based on the National Curricular Guidelines proposed in the Resolution 03/2001.

METHOD

This exploratory and descriptive study with qualitative approach was carried out in three universities located in João Pessoa, PB, Brazil: one public and two private schools, where undergraduate nursing programs acknowledged by the Ministry of Education (MEC) are administered. The three schools met the following inclusion criterion: having had classes in the last curricular semester. They were identified by the letters A, B and C and formally agreed to collaborate with the research through Agreement Forms. The study was developed according to Resolution 196/96 of the National Health Council⁽⁵⁾ and approved by the Ethics Research Committee at the CCS/UFPB (protocol Nº 1004/07). Data collection was carried out in April 2007 when the plans of the course Methodology of Nursing Care were analyzed, which transmits the conceptual bases of nursing processes and competencies necessary to its implementation.

A structured form based on the theoretical references of Brazilian authors was used in the development of this study. It contained items regarding the course description, conceptual bases, number of credits, workload, objectives, teaching-learning strategies, didactic resources, strategies of evaluation and used references. The data collection technique consisted of direct extraction of the elements of interest from the course plans to the form^(6-7). The obtained material was analyzed according to the Content Analysis technique. This method provides codification of messages through selection and enumeration of thematic units (units of meaning), which were grouped using rules such as presence, frequency and co-occurrence, giving rise to categories and respective subcategories, which were discussed in light of Resolution Nº 3/2001 and literature pertinent to the theme⁽⁸⁾.

RESULTS

The analysis of the courses' plans revealed that the courses are called Methodology of Nursing Care in the three institutions participating in the research, which are organized into a system of credits. This fact shows the specificity of these courses and their goal to develop the competency in know-how doing and being, both essential in the students' appropriation of the nursing process, which aims to put it into operation in the context of caring for clientele.

Following the methodological orientation of the content analysis technique, nine categories and respective subcategories were identified in the corpus of study composed of the courses' plans, which are presented below:

DISCUSSION

It was possible to identify the subcategory inclusion of basic components in the category What is included in the curricular matrix through the following thematic unit: ...third semester... extracted from the plan of course of the B institution, and the subcategory inclusion of professional component through the thematic unit: ... fourth semester... present in the plans of the B and C institutions.

Two important aspects are highlighted in the context of this analysis. These aspects are linked to the teaching of the conceptual foundations of the nursing process included in the curricular matrices organized into courses, which is the most common type of curricular matrix in the Brazilian educational system whose main characteristic is the fragmentation of knowledge construction. The first aspect refers to the inclusion of the course in semesters emphasizing the basic component, the teaching-learning context that hinders the concomitant development of the competencies know, do and be, all crucial in the care process, which provides little motivation to students in terms of content learning due to the lack of meaning of these in the context in analysis, resulting in a passive teaching that understands students as empty containers in which teachers deposit content/knowledge. The teachers value the quantity of transmitted information more than the previous knowledge each person has in a given subject, what might be called bank education⁽⁹⁾.

The second aspect consists of the professional component, a space suitable for linking the competencies already mentioned, which contribute to the optimization of learning linked to the nursing process, since the courses of this component are the foundation, whether for theoretical understanding and/or practical implementation. In the context of the category Characterization of workload, the analysis allowed the construction of the subcategory eminently theoretical, through the thematic unit ...theoretical credits..., evident in Institutions A and B; and the subcategory theoretical-practical through the unit ...theoretical-practical credits..., identified in the plan of the course of institution C.

The occurrence of an eminently theoretical approach in the nursing process is the most common in the routine of universities. Not linking the first with a practical approach, however, has hindered students' perceptions regarding the application of this basic nursing tool and its viability in the routine of the caring/care process in the field.

We highlight that the 5^th article of the Resolution Nº 3/2001 do CNE/CES, which presents the nurses' competencies and specific abilities to be developed in undergraduate students, reveals in items IV, XV, XIX and XXIX, competencies that are directly related to the application of all phases of the nursing process. Hence, we infer that competencies and abilities can be developed through the application of the nursing process. We therefore conclude that teaching this basic instrument in the undergraduate program is extremely important for training competent nurses. Their learning permeates experiences of theoretical and practical learning so that knowledge and abilities and behaviors are truly developed.

The category Descriptive dimension of the course's description indicates a teaching process that seeks to establish Nursing as a profession with defined scientific bases as well as delimitating and characterizing the caring/care process as the objective of the care practice in this profession, in order to reconstruct nurses' autonomy, freeing them from the dominating paradigm, which has historically characterized nursing as an auxiliary profession of health practices.

Three subcategories emerged from the analysis of the thematic units regarding this category: Study of the theoretical-philosophical foundations of the nursing process (e.g.: ... study of nursing theories.../focuses... conceptual and philosophical aspects of nursing.../the construction of nursing knowledge...), Study of the stages that compose the nursing process (e.g. ...study... planning of care/ focuses... the systematization of nursing care to the individual, family and community) and Study of the ethical-legal foundations of the nursing process (e.g. Focuses... statutes of the professional exercise...) only in institution B. The absence of ethical-legal foundations in institutions A and C is highlighted.

Although Resolution Nº 3/2001 does not have a determinative character and provides flexibility and aids organization of the curricular matrices of universities, we have to consider that the inclusion of some aspects, e.g. ethical-legal aspects of the nursing process, is essential to the development of the descriptions of the studied courses. The rationale is that legal aspects, provided in Law 7.498/86 of professional exercise and in Resolution 272/2002 of the systematization of nursing process, explicitly and implicitly express considerations about the application of the nursing process, whose competencies should be developed in the course of the process of education of professionals in the field, because they are extremely important to the integration of the competencies know-how-to-do and be^(10-11).

Another component of great importance in the planning of the entire educational program consists of the determination of objectives, which should express the results that students will achieve at the end of the course⁽⁶⁾. The analysis of the objectives expressed by the plans of the studied courses surprisingly revealed that institution B did not present teaching objectives. This finding is important because the absence of objectives in the teaching-learning process compromises the plan of the course in terms of efficiency of organization of methods to develop professional competencies.

On the other hand, institutions A and C expressed educational objectives that helped determine the next category of analysis, based on Bloom's and his colleagues' taxonomy, entitled Learning domains⁽⁸⁾. The thematic units, expressed in the subcategory cognitive domain (e.g. ... qualify students to provide systematized and individualized nursing care.../ ...promote... reflections regarding the care process in nursing...), justifies the predominantly theoretical nature of the course, which works the conceptual basis of the nursing process in the institutions, confirming that the primary objectives of this course permeate the development of students' competency knowledge and intellectual skills. We highlight, however, that, as already stated, an opportunity of practical and meaningful learning is necessary to even construct knowledge.

Another focus of analysis, regarding the subcategory psychomotor domain (e.g. ... implement... (the) nursing process based on different theoretical nursing structures/ ...promote strategies... to deliver a systematized care...), reveals that in the plans of the courses in institutions A and C, the expressed objectives are consistent with know-how-to-do or motor skills. We note that the distinction of boundaries in this domain meet didactic objectives but in practice the use of a skill involves the mobilization of knowledge for the efficient performance of a practical task.

We call attention to the fact that the plan of the course of institution A characterizes the course as eminently theoretical, which again poses an important question: How can we meet objectives that envision psychomotor skills if the course only has a theoretical workload? It is important to reflect on the fact that due to the theoretical predominance of these courses, which require the development of knowledge, skills that involve cognitive, psychomotor and affective aspects are compromised since the synergy of competencies are established in practical situations. Otherwise theory might become blah blah blah and practice, activism⁽⁹⁾.

Through a category called Descriptive dimension of conceptual bases, we verified the meaning of the selected and worked content. Four subcategories were identified: theoretical-philosophical foundations of the nursing process (e.g. Development of nursing knowledge.../ Science and theory.../...Nursing theories...), identified in the plans of the three institutions; ethical-legal foundations of the nursing process (e.g. ... the nursing process and the ethical-legal issues) identified from thematic units found in institution B; the subcategory basic instruments linked to the care process (e.g. ... basic instruments for nursing care/observation.../creativity.../teamwork.../manual dexterity.../scientific principle..), identified in institutions A and B and finally, the identification of the subcategory didactic division of the nursing process (e.g. ...data collection.../nursing diagnosis.../care planning.../evaluation.../stages of the nursing process and their relations) found in the plans of the courses of the three institutions.

We understand that the identification of the subcategory theoretical-philosophical foundations of the nursing process expresses the valorization of the scientific and philosophical aspect of making sense, rationale to the application of the methodological structure of the nursing process. This is an important aspect, considering that the process consists of an instrument to implement thinking supported by the scientific method with a view to aid the practical implementation of conceptual models and theories linked to nursing care. The latter is a phenomenon that goes beyond the requirements of scientific understanding and demands philosophical reflection, without which nurses' actions are mere procedures, not linked to the essence of care⁽¹²⁾.

We highlight of thematic units related to the subcategory ethical-legal foundations of the nursing process are identified only in the course plan in institution B, according to the course description of this institution. We believe that the content related to this subcategory meets the practical-theoretical elements demanded in the job market. Such content should be considered in the plans of the remaining institutions because they also permeate the construction of ethical competence required in nursing practice. As stated earlier, the Systematization of the Nursing Care is a requirement of the profession's Federal Council, regulated through Resolution 272/2002 in accordance to Law 7.498/86, which regulates the exercise of the profession^(10-11).

The identification of the subcategory basic instruments linked to the care process in the thematic analysis of the courses' plans reiterates the construction of the course Methodology of the Nursing Care in the development of competencies specific to the profession, since the basic instruments involve a set of knowledge and skills essential to its exercise. Such instruments include observation, communication, teamwork, planning, evaluation, manual dexterity and psychomotor skill, scientific principles and scientific method, which when applied with responsibility confer organizational quality to nursing care. The latter, in turn, is considered one of the objectives of the use of the nursing process, a scientific method to solve problems that require the remaining basic instruments to be accomplished⁽¹³⁾.

The subcategory didactic division of the nursing process permits inferring that the construction of competencies necessary to put each phase of the process into operation in a specific way is valued with a view to qualify students for the methodological development of the process.

It is necessary to understand that learning these conceptual bases reflects on the students' construction of conceptions and the materialization of these through their behaviors. It is also necessary to acknowledge that for such an accomplishment one has to go beyond the discernment of the construction of learning objectives and important and meaningful conceptual bases, and visualize the synergy necessary to these two elements through the selection of methods or procedures of appropriate teaching to such learning, which led to the development of the next category of analysis, Nature of methodological teaching strategies.

Two methods characterize the teaching process of the studied course in the three teaching institutions. The first originated the subcategory professors' methods of exposing contents (e.g. expository classes.../oral exposure of content/ reading of texts, articles, periodicals...) and denotes the importance of the professors' work in determining the direction of the teaching process in the course Methodology of Care. This method is characterized by the evidence of the professors' work in view of a situation in which students show receptivity, a term whose meaning differs from that of passivity⁽⁶⁾.

Considering the specificity of the course and the potential novelty with which students are exposed to the conceptual bases, the employment of strategies of methods of exposing content may be considered appropriate. It is worthy mentioning that these should not be used with a view to transmit or pass knowledge, a characteristic of the bank education method, whose philosophy is contrary to the current didactic and pedagogical conceptions, including the recommendations of the Curricular Guidelines for the Undergraduate Nursing Programs that point to an educational process in which critical, creative, reflective professionals with political commitment and the capability to cope with real problems in the interim of their complexities are trained. The expected education assumes the autonomy of subjects of this process, through the use of active teaching-learning methodologies that allow students to acknowledge their role in the construction of their own knowledge⁽¹⁴⁾.

The second subcategory methods of jointly or group elaboration (e.g. group tasks and discussions.../ double panel.../seminary...) denotes that students are valued in the process of teaching construction in the Methodology of Nursing care, including the interaction of students with professors and among students. The strategies that helped the identification of this method contribute to the employment of conversation, which has a great didactic value as it develops in students the ability to express opinions, which, in turn, tend to demand increasingly complex constructions necessary to the verbalization of personal experiences and development of arguments to refute others' opinions. Conversations also develop abilities related to learning to listen, describe and interpret facts, among other important abilities necessary to the education of nurses⁽⁶⁾, required in the modern world.

The strategies identified in the corpus of study tend to value concrete reality and the need to go beyond the content and technical issues. Its values focus on the opportunity to work with emotions and in interpersonal relationships from the discussion and construction of values and attitudes, inherent to learning to live together and learn to be, essential competencies given that care delivery is performed by individuals loaded with values, cultures and ideologies that permeate their professional practice⁽¹⁴⁾.

From this perspective, we highlight the importance of employing teaching strategies compatible with the described method in the course Methodology of Nursing Care, the objectives of which permeate the construction of competencies essential to the exercise of a systematized care, which requires much more than individuals capable of memorizing content, going through the use of rationale, critique, interpretation and competencies related to teamwork, since nurses are subject to two teams, the health team and the nursing team, whose complexity goes beyond the sum of individual attitudes.

Acknowledging the importance of developing competencies linked to the ability to criticize, to autonomy and interpersonal relationships in the academic education, Resolution Nº 03/2001 emphasizes the importance of selecting teaching strategies that permit the development of such competencies in its article 14, items VI and VII. It is therefore important to stress that the selection of strategies appropriate to good learning requires the choice of didactic-pedagogical resources appropriate to the teaching method previously selected, as well to the learning objectives, to the conceptual bases to be worked, to students and to the environment in which teaching occurs. In this perspective, we highlight the absence of these resources in the plan of the course of the institution B, which might have undervalued this component in the course's plan⁽³⁾.

We emphasize the importance of appropriately valuing the selection of resources that are consistent with the uniqueness of students in regard to different means of the assimilation and appropriation of knowledge, as we conceive learning as a dynamic process that involves a necessary interaction between professors and students. Since there is not a classification of resources universally accepted or accepted without critiques, we opted to analyze the material extracted from the plans of the courses of institutions A and C aiming to identify the Consistency of didactic-pedagogic resources with the teaching methods.

The resources, which include white board, pens, overheads, slides, slide projector, data show, texts, poster, chalk, and books among others, contribute to identifying the subcategory consistent with professors' methods of conveying content because they constitute auxiliary resources of the work of professors in expository or demonstrative classes. Posters, texts and books are material resources, through which it is possible to work the professor/students interaction and also work certain themes collectively, which helped the identification of the subcategory consistent with methods of group elaboration.

When referring to the use of resources during the teaching process, we highlight that the utility of these elements reflects on their capacity to provide stimulus for learning, in presenting with clarity and precision the teaching content, favoring the individualized acquisition of knowledge. We also note the importance of the combined use of resources in teaching so as to promote collective learning⁽⁷⁾.

We emphasize the importance of resources being appropriate/up-to-date with technological development and with the means in which they will be used, to continuously propose motivating ways of teaching. It is also worthy noting that no resource by itself can be successful in the teaching process. These resources need to be linked to a method previously selected based on the content (conceptual bases) and already established teaching goals⁽¹⁵⁾.

The following category focused on the references used in the context of courses which were analyzed according to their topicality, giving origin to the category Contemporaneity of references, which includes two subcategories, namely: contemporaneous references (e.g. ALFARO-LEFEVRE... Application of the nursing process... 2005/ HORTA... Nursing Process... 1979/ IYER; TAPTICH; BERNOCCHI-LOSEY... Diagnostic Process in Nursing... 1993/ CIANCIARULLO... Basic Instruments for Care... 2004) and non-contemporaneous references (e.g.: ALFARO LEFEVRE ... 2000/ CARPENITO...Nursing Diagnosis: application to the clinical practice... 1997/ Nursing Diagnosis NANDA.... 2000/ NIELSEN; MORTENSEN... International Classification of Nursing practices of the International Council of Nurses: version alpha... 1997/ CAMPENDELLI...Nursing Process in practice...1989). It is important to stress that references were considered contemporaneous when their year of publication was less than five years old, those considered basic or essential when the nursing process teaching is considered, regardless of year of publication and those that did not present more recent issues.

The large number of thematic units that contributed to the identification of the subcategory non-contemporaneous references is disturbing since in recent decades we have experience an intense investment in studies about the systematization of nursing care, which includes the nursing process and related instruments. Such aspects, associated to the rapidity with which information is disseminated in the modern world, require professionals to continuously study and update, showing the need for professors in the studied course to continuously seek recent sources in grounding their work on conceptual bases.

In a paradigmatic context in which the main objective is active and conscious learning of content in view of educating active individuals capable of transforming their realities, one cannot proceed with a teaching analysis without taking into account the modes of evaluation used by the professor to validate learning. With this in mind, the category Modalities of evaluative methods is presented.

We stress that the objective of this study is not to analyze the evaluative methods used in the course because we would need to use a material that satisfied such a purpose. Nevertheless, we attempted to identify in the context of the studied course, the perspective under which evaluation was being carried out in view of the teaching-learning process in light of three important attributions: Verification; Qualification and Qualitative Appreciation based on performance standards⁽⁶⁾.

The analysis of the three course's plans helped to infer that the evaluative methods used aim to verify the students' learning predominantly using: written tests, theoretical-practical activities and exercises. The results of these instruments are oriented by the attribution of grades, which was evident in the following thematic units: tests... 0 to 10, summed evaluation, activity... from 0 to 10, and exercises worth 10,0. Therefore, we identified in the context of the modalities of evaluative methods only one subcategory, summative evaluation.

This evaluation consists of a process of description and judgment with a view to classify students at the end of a unit, semester or course. This modality seeks to verify how much knowledge students acquired, which are expressed through grades or letter grades⁽⁷⁾.

It is worth mentioning that the National Curricular Guidelines for the Undergraduate Nursing Programs emphasize that: The evaluations of students should be based on competencies, abilities and developed curricular content... From this perspective, we have to know whether the identified evaluative modality associated with the predominantly theoretical character of the studied course permits students to achieve what is recommended by the Guidelines, especially taking into account the competencies required in the implementation of the nursing process. To evaluate competencies means to observe students' capacity to think and effectively act in a given situation; consists of accompanying them in their search for solutions to cope with complex situations based on knowledge but not limited to it^(3,16). We stress however, that the evaluative aspect of the studied course requires an analysis that goes beyond the course itself and corroborates the gap between the advancements in the critical-reflective conception about the education of contemporaneous professionals and the conservative educational praxis.

CONCLUSIONS

Given these considerations, the faculty members of the studied institutions need to develop teaching strategies that permit linking theoretical bases with practice in the course Methodology of Nursing Care, whose richness of specificities should be experienced in the professional education process itself, given that the teaching processes are justified by their results and learning is verified though the acquisition of the competencies know-how-to-do and be.

We emphasize that the ideology that underlies the current guidelines for higher education requires that strategies and teaching methods are linked so as to improve the education of better qualified professionals, whose potential goes beyond cognitive abilities, as we deem this will be the main objective of schools. We therefore experience the valorization of the education of professionals with competencies that permeate the construction of knowledge based on the reality that surround them, the construction of abilities based on the constructed knowledge and on the development of behavior that meets the complex demands of the work context.

It is convenient to add that this scenario will only be possible as investments that include ideological and normative revolutions beyond mere reformism or occasional adjustments in the educational process are implemented. There is no point in creating a new institution with old practices such as: curricula fragmented and disconnected from the reality of schools, no relation between theory and practice, education by content and illuminist conception of knowledge⁽¹⁷⁾.

Regarding the normative aspects, we believe that the first step was the establishment of the National Curricular Guidelines and the consequent autonomy of universities in the development of curricular matrices of their undergraduate courses. Therefore, these institutions should dare to take the next steps towards liberating themselves from the positivist model through pedagogical practices consistent with the assumptions of integrality(^a) and interdisciplinarity in professional education⁽¹⁸⁾, capable of respecting all the subjects in the educational process.

In this context we note that the modern world calls for the adoption of methods to assess learning that demand much more than the control and classification of students based on a grade or a letter grade. It demands an evaluative modality that values the qualitative aspect coupled with learning and, above all, transforms evaluative activities into another opportunity to learn, that is, to confer a dialogical relation on the evaluative method.

REFERENCES

Received: 09/23/2008

Approved: 03/11/2009

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• 16. Perrenoud P. Construir competências desde a escola. Porto alegre: Artmed; 1999.
• 17. Gadotti M. Perspectivas atuais da educação. Porto Alegre: [s.n.]; 2000.
• 18. Silva KL, Sena RR. Integralidade do cuidado na saúde: indicações a partir da formação do enfermeiro. Rev Esc Enferm USP [periódico na Internet]. 2008 [citado 2008 nov. 20];42(1):[cerca 9 p.]. Disponível em: http://www.scielo.br/pdf/reeusp/v42n1/07.pdf

Correspondence addressed to:

Oriana Deyze Correia Paiva Leadebal

Rua Luiz de França Pontes, 48, Jardim Oceania

CEP 58037-730 - João Pessoa, PB, Brazil

*

Part of the thesis "Ensino do processo de enfermagem nos Cursos de Graduação: aproximações e distanciamentos frente ás diretrizes curriculares nacionais", Universidade Federal da Paraíba, 2007.

(a

) Integrality refers to the idea that individuals are historical, social and political subjects and should be considered as a whole during the care delivery process. It also assumes that health care actions should be combined and focused on health promotion, prevention and healing.

Publication Dates

• Publication in this collection
  22 Mar 2010
• Date of issue
  Mar 2010

History

• Accepted
  11 Mar 2009
• Received
  23 Sept 2008