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Rev. esc. enferm. USP vol.45 no.4 São Paulo Aug. 2011
Profile of students entering the nursing diploma program: University of São Paulo at Ribeirão Preto College of Nursing
Perfil de estudiantes ingresantes en licenciatura: Escuela de Enfermería de Ribeirão Preto, de la Universidad de São Paulo
Adriana Katia CorrêaI; Maria Conceição Bernardo de Mello e SouzaII; Ronildo Alves dos SantosIII; Maria José ClapisIV; Nilton César GranvileV
University of São Paulo at Ribeirão Preto, College of Nursing,
General and Specialized Nursing Department. Ribeirão Preto, SP, Brazil.
IIProfessor, University of São Paulo at Ribeirão Preto, College of Nursing, Psychiatric and Human Science Nursing. Ribeirão Preto, SP, Brazil. email@example.com
IIIProfessor, University of São Paulo at Ribeirão Preto, College of Nursing, Psychiatric and Human Science Nursing. Ribeirão Preto, SP, Brazil. firstname.lastname@example.org
IVAssociate Professor, University of São Paulo at Ribeirão Preto, College of Nursing, Maternal-Child and Public Health Nursing. Ribeirão Preto, SP, Brazil. email@example.com
VUndergraduate Student, Teaching degree Program in Nursing, University of São Paulo at Ribeirão Preto, College of Nursing. Scholarship provided by the Project Teaching with Research from the Graduate Prorectory, University of São Paulo at Ribeirão Preto. Ribeirão Preto, SP, Brazil.
The objective of this study is to describe the profile of the entering students as to gender, age, marital status, educational background (elementary and high school studies) and employment status of the first class of the Nursing Teaching Diploma Program in EERP/USP, in the year 2006, highlighting their implications for the teaching-learning process. This descriptive exploratory study used a questionnaire for data collection. Results are presented in a descriptive way, with absolute and percentage frequency. The age group of the students is diverse, varying from 19 to 46 years old, most (67.5%) of them comes from public schools (high school studies), 42% work, of those, 67% already work in the health area. These data can influence in the pedagogical practice of professors.
Descriptors: Education, nursing, baccalaureate; Students, nursing; Education, nursing
Se objetiva describir el perfil de ingresantes en cuanto a sexo, edad, estado civil, identidad escolar (enseñanza primaria y secundaria) y vínculo laboral del primer grupo del Curso de Licenciatura en Enfermería de la EERP/USP, en 2006, destacando sus implicaciones para el proceso de enseñanza-aprendizaje. Estudio de naturaleza descriptiva-exploratoria, que utiliza cuestionario como técnica de recolección de datos. Los resultados serán presentados de modo descriptivo, con frecuencia absoluta y porcentual. La faja etaria de estudiantes es diversa, variando entre 19 y 46 años, la mayoría (46%) proviene de escuela pública (enseñanza secundaria), existiendo 42 personas con vínculo laboral, actuando el 67% de ellos en el área de la salud. Estos datos podrían traer implicancias para la práctica pedagógica del profesor.
Descriptores: Bachillerato en enfermería; Estudiantes de enfermería; Educación en enfermería
While involved with the Teaching Degree Program in Nursing at the University of São Paulo at Ribeirão Preto, College of Nursing (EERP-USP), we faced the challenge of being professors and a student in a new undergraduate program that has certain peculiar characteristics: a) it educates nurses with a teaching degree to work in health services at different levels of care, as well as in basic and professional education, that is, linking the generalist education in nursing to the field of knowledge in education; b) courses are administered during afternoon and night; c) the program's pedagogical project is based on critical pedagogy; d) it values specific education for teaching in an academic context focused on research, though it is challenging to be a research program while qualified as an undergraduate program.
An essential element that may help to organize and monitor the implementation of a teaching program at EERP-USP is knowledge concerning the students as one of the subjects involved in the teaching-learning process: Who is the student who attends this program? What is his/her socio-economic, educational and professional context?
The answers to these questions can be valuable considering that the pedagogical proposal of the teaching degree program recognizes the important role of the student as an active subject in the teaching-learning process, who's experiences and previous knowledge need to be considered and re-signified in the construction of theoretical-practical knowledge in the fields of health and education. When these are in agreement, they allow a critical view and effective action within reality. The construction of these different types of knowledge is based on the critical pedagogical approach that emphasizes the political dimension of educational practice.
The critical pedagogical approach needs to be concretized in the ways the teaching-learning process is put into operation, involving the selection of teaching content, the relationship between professor and student and teaching methods distinct from the traditional approach. Hence, the point of departure for learning, democratic relations between educator and student and active teaching methods, in which the role of students is co-participation in the process of constructing knowledge, are considered essential aspects. From this perspective, we value experiences as the foundation of educational action and the idea of pedagogical self-management with an emphasis on the group teaching process(1).
THE TEACHING DEGREE PROGRAM IN NURSING AT EERP-USP
From 1994 to 2002 the EERP-USP offered a teaching degree program conceived as an optional educational process and an extension of the bachelor's degree in nursing. After internal evaluation from the faculty members and taking into consideration the changes established at the time in Brazilian educational legislation, this program was replaced by the Teaching Degree Program in Nursing. It was initiated in 2006 with 50 slots and administered in the afternoon and night. Such a replacement, as already mentioned, was intended to comply with the new guidelines established by the National Educational Bases and Guidelines Law for qualifying professors(2).
In 2002, the EERP-USP focused on the development of a new project - a teaching degree program in nursing - in a political moment in which the University was discussing the need to offer more slots, especially in night courses, to meet a demand related to its social commitment as a public university. In this context, we understand that the Teaching Nursing Program should not be considered a modality co-extensive with the bachelor's degree program, but an undergraduate program with specific matriculation process, management and political project, integrating the education of generalist nurses with training in education - a Teaching Degree. We note that while the pedagogical political project for the teaching degree was developed by the EERP-USP, curricular changes in the undergraduate nursing program were also in progress. These changes were based on an integrated competency-based curriculum, on a dialogical approach and on critical-reflective pedagogy. Such changes proposed at the time significantly influenced the project of the teaching degree program(3).
From a dialogical perspective, competence implies linking teaching in nursing oriented to the world of work (health and education), the everyday routine in which the student constructs his/her professional practice, develops attributes (knowledge, skills and attitudes) while facing real, complex and diverse situations. The development of such attributes implies a permanent reflexive process concerning professional practice, seen as a social reality that is constructed and can be transformed by the subjects within such a reality. The construction of this process requires the adoption of a methodological framework within a critical approach that values the problematization of reality, the autonomy of students, and professors as facilitators of a significant learning process.
There are three conceptual approaches concerning competence: one of them holds that competence is a personal attribute; another relates it to obtained results (performed tasks); the last approach, the dialogical, combines personal attributes with the performance of actions in specific contexts aiming to achieve certain results(4). In the last approach, on which the pedagogical project of the teaching degree program is based, personal attributes are posed in relation to distinct social constructions that legitimate them according to the history of society in distinct periods of time. This author also states that competence is not directly observed but can be inferred through performance. Groups of performance are areas of competence that complement themselves. Hence, over the course of the teaching degree program, the student develops competence in relation to the following fields: individual care, collective care, management and education.
In order to construct knowledge, skills and attitudes in an interconnected way from a theoretical-practical perspective and to develop actions that take into consideration the complexity of the health-disease continuum and education; different types of knowledge from the biological and human fields need to be connected. It is feasible through an integrated curriculum, which is considered essential for a generalist education, because it permits enlarging the student's understanding concerning the daily routine in health and education in its multiple facets: biological, psychological, social, political and ethical, constructing a learning process with a critical view and action committed to social reality. It implies acknowledging the complexity of such a reality.
The curriculum does not include this perspective of integrated education. Education in the health field is still organized in isolated courses that overlap and are classified into scientific courses contained in the basic cycle and applied courses that belong to the professional cycle. Additionally, the courses focus on general theories of sciences so that later practical situations are addressed. It is then expected that students apply the knowledge acquired through the course in practical situations(5).
Based on the previous discussion, adopting the theoretical framework of the teaching degree program implies going beyond the functionalist perspective of competence, as well as beyond the disciplinary organization of knowledge and traditional focus of the teaching-learning process that is centered on the transmission of previously defined knowledge without effectively linking theory and practice. The search for new frameworks and ways of putting the teaching-learning process into operation is significant considering the goal to educate teacher-nurses who will teach in basic and vocational education.
To describe the profile of the students concerning gender, age, marital status, academic background (primary and secondary schools) and work contract of the first class of the Teaching Degree Program in Nursing of EERP-USP in 2006, highlighting its implications for the teaching-learning process.
This exploratory descriptive study uses a questionnaire to collect data. The questionnaire was composed of open and closed questions containing data of personal, professional, school and cultural identification. This questionnaire was based on instruments used to delineate the profile of first year students from the University of São Paulo at Ribeirão Preto in 2006 and on the questionnaires used by the Brazilian Institute of Geography and Statistics(6). It was applied to all the students enrolled in 2006 in the Teaching Degree Program in Nursing.
Participation was voluntary and confidential in order to avoid any potential conflict. The study's objective and contributions were presented at the time of data collection and the participants signed free and informed consent forms. The data collection instrument had been previously tested with students attending the Undergraduate Nursing Program at EERP-USP. Data collection was initiated only after approval from the Research Ethics Committee at EERP-USP was obtained (Protocol nº0730/2006). Data obtained from closed questions are descriptively presented using absolute and percentage frequencies.
RESULTS AND DISCUSSION
Of the total of 50 freshmen from the teaching degree program, 43 answered the questionnaire. Most of the students (30/70%) were women while 13 (30%) were men, aged between 18 and 46 years old. A total of 29 students (67.4%) were between 19 and 25 years old; 12 (27.9%) were between 26 and 46 years old, one (2.3%) student was 18 years old and another did not report his/her age. The great majority (35/81.5%) were single, seven were married (16%); and one (2.5%) was separated.
Other studies reporting the profile of nursing students also show that most are women. In a study conducted in 1987 in two schools, one public and one private, in the city of São Paulo, SP, Brazil 98.04% of the participants were women(7). Another study from 1995 whose objective was to describe the profile of nursing students from public and private schools from Minas Gerais, Brazil reported that 88% of the participants were also women(8). In 2004, 92% of the students who responded to data collection in a private school in the city of São Paulo were also women(9).
A study conducted in 2005 to compare the socio-economic profile and factors affecting the choice for nursing in two schools (one public and one private) in the city of Rio de Janeiro, RJ, Brazil revealed that 85.5% and 89.1% of the students respectively were women(10).
Therefore, these studies conducted in different locations, different years and in both public and private schools confirm a very well known fact: students in undergraduate nursing programs are predominately women, given the historical-social constitution of the profession. Even though most of the students in this study are women, if we compare its data (70% are women and 30% are men) with data from other studies, we verify there is a larger number of male students in the teaching degree program offered by EERP-USP in 2006.
In the University of São Paulo at Ribeirão Preto to which the EERP belongs, the programs in which there were a larger number of female students were speech and language therapy (100%), nutrition and metabolism (100%), occupational therapy (93%), the bachelor's degree program in nursing (91%), pedagogy (81%), teaching degree in nursing (76%), and psychology (72%)(11). These data indicate there are many other programs with a significant predominance of women and that the numbers of women enrolled in the bachelor's degree program and in the teaching degree program are very distinct from one another.
Students most frequently enroll into university between 18 and 24 years of age(12). A study in the nursing field indicates that the most common age of first-year students is between 20 and 22 years old(7). Other studies report changes in the profile of students from a public school in the city of São Paulo revealing a decrease in the students' age when data collected from the period between 1973 and 1982 are compared to data from 1988, in which most students were between the ages of 20 and 21 years old(13).
More recent studies show that the profile of students has changed in terms of age. Most of the students participating in a study carried out in a private school in 2006 were between 21 and 30 years of age (64%)(9); 48% of the students in a study conducted in 2008 were between 17 and 19 years old followed by 36% between 20 and 22 years in a public school, while 40% of the students in a private school were 25 years old or older(10). In this same direction, a study carried out in 1997 indicate that 80% of the students in public schools were between 20 and 23 years of age and 70.3% of those in private schools were older(8). Other studies indicate that 57% of the students enrolling in the bachelor's degree program in nursing between 1999 and 20003 were between 18 and 19 years old, 1.1% were between 24 and 25 years old and 1.3% were older than 26 years of age(14). This study's data related to the teaching degree program show that at the same time there is a predominance of young individuals as indicated by some studies, there are also older individuals (27.9% between 26 and 46 years of age), as is the case in private schools and was indicated by the previously mentioned studies.
Data from 2006 concerning the freshmen of all the programs offered by the University of São Paulo at Ribeirão Preto indicate that the teaching degree program in nursing is second in the number of individuals older than 24 years of age (34%), the first is Music; 25 programs are offered on this campus(11). A possible explanation for a significant number of freshmen being older than the usual age that individuals enter college is related to the fact it was a new program, with an entrance exam that did not pose a great obstacle, which enabled many workers already active in the technical field of health and who finished secondary school many years ago to enter the program.
In relation to primary school, it is worth noting that 38 students (88%) came from public schools, three (7%) came from private schools, one (2.5%) studied both in private and public schools and another (2.5%) did not answer the question. In relation to secondary school, 29 (67.5%) were from public schools, seven (16%) from private schools, five (12%) from public and private schools, and two (4.5%) did not answer this question. Hence, most of the students attended public schools while an increase is observed among students who attended primary education in private schools (7%) and those who attended secondary education in private schools (16%). Such a fact may be explained by a search for preparation for entrance exams, upon which private schools more effectively focus.
We note that the number of students who attended public schools during secondary education is expressive - 67.5%. Another study conducted in 2006 also points in this direction, though it addresses an undergraduate nursing program offered by a private school: 56% of the freshmen attended public schools while 8% attended private schools(9). Hence, the profile concerning secondary school of students entering the teaching degree program at EERP-USP is similar to that of students entering an undergraduate nursing program in a private school in the city of São Paulo.
If we compare the number of first-year students (67%) in the teaching degree program at EERP-USP who attended public schools with the number of those (75%) in the bachelor's degree program in the same school in 2006 who attended private schools we can infer that there was even less competition in the entrance exam considering it was a new program that was initiated exactly in 2006.
It is worth noting that a study developed in 2007 indicates an increase in the percentage of freshmen in the bachelor's degree in nursing at EERP-USP who finished secondary education in private schools from 1999 to 2003: 28.07% in 1999, 37.34% in 2000, 36.36% in 2001, 40.25% in 2002 and 33.73% in 2003. The comparison of data from 2003 (33.73%) with previous information from 2006(14) that indicates that 75% of the students in the bachelor's degree program attended secondary education in private schools reveals there was a considerable increase in students who attended private schools. These data point to a significant difference in the profiles of the two programs - bachelor's degree and teaching degree - offered by EERP-USP in this specific year.
Of the total of students participating in this study, 23 (53.4%) finished secondary school one to five years ago; nine (20.9%) from seven to ten years; four (9.3%) from 11 to 18 years and seven (16.2%) did not answer this question. These findings differ from the results of other studies: a study carried out in 1996 revealed that 62.8% of the students of the undergraduate program at the State University of Ceará, Brazil entered college immediately after finishing secondary school and 26% entered one year after finishing secondary school(15). Another study from 2006, which was developed in a private university in São Paulo, SP, Brazil, reports that 32% of the students entered college immediately after secondary school, 16% one year later and 4% after six months(9). According to a study conducted in 2007 that investigated the period between 1999 and 2003, 24.93% of the students entered the bachelor's program in the EERP-USP in the year immediately after secondary school, 38.46% entered the program after one year they finished secondary school, 22.28% entered two years later, 6.89% after three years and 5.57% in a period from four to 26 years after finishing secondary school(14). Considering data from the teaching program under study, we question whether the fact students entered the program after a more extensive period of time after they left secondary school is somehow related to the fact this new program is offered in the afternoon and night.
Eighteen (42%) of the students worked and 25 (58%) did not; 12 (67%) of those already working were in the health field. Other studies also report a relevant number of students who work: 62.5% of students from private schools have a paid job since the nursing program is part time, while 92% of students in public schools, which offer full-time programs, do not work(10). Data from another study also conducted in a public school offering a full-time nursing program reveal that only 12 (3.2%) students work(15). Another study addressing a private school indicates that 56% of the students are also workers(9).
Considering the period between 1999 and 2003 in the bachelor's degree program at EERP-USP, only 4.5% of the freshmen had a paid job, while 41.17% of these worked as nursing technicians or auxiliaries(14). In 2006, the percentage of freshmen in the bachelor's degree program in EERP-USP who worked was only 1%. Hence, despite the fact that most (58%) students from the teaching program do not work, the percentage (42%) of individuals who work is significant, especially if we consider the profile of public schools and compare the two programs - bachelor's degree and teaching degree at EERP-USP. It is worth noting that the enrollment of nursing technicians and auxiliaries was observed in previous years in the bachelor's degree program and the number of these individuals increased with the teaching degree program.
The profile of students entering the teaching degree program in nursing in the EERP-USP in 2006 present some demands for the professors' pedagogical practice given some aspects discussed below:
Even though most of the freshmen are young, 29 (67.4%) students were between 19 and 25 years of age, 12 (27.9%) between 26 and 46 years of age, it requires professors to deal with a diversity of individuals of varied ages. Another significant piece of data for the context of a program from a public school is that most students (67%) attended public schools during secondary education. These students differ substantially from those in the bachelor's degree program from the same school; 75% of the students from the bachelor's degree program in 2006 attended private schools. Such a fact lead us to reflect on the need to monitor the academic performance of students and verify whether their educational background influences their teaching-learning process and consequently the professors' pedagogical practice. Additionally, there were students who finished secondary school many years ago: 23 (53.4%) one to five years ago; nine (20.9%) students from seven to ten years ago; four (9.3%) from 11 to 18 years ago. This fact coupled with the students' background requires pedagogical monitoring. Therefore, how does being a student from a public school and having finished secondary school many years ago affects the teaching-learning process? Are there gaps that need to be filled in? What is the professor's preparedness and institutional support required to provide pedagogical support, if necessary? These issues are relevant if we also consider that the program's proposal is to develop a problematizing methodology that requires one to be included in the contexts of health and education. The teaching practice is a proposal aimed to develop students' critical-reflexive thinking and autonomy, which is different from the traditional teaching practices probably already experienced by most of the students. The diverse age range, background and years since secondary school can be worked in favor of learning as values, experiences, and perceptions of students are expressed, known and moreover, are respected among them.
Most (58%) of the students in the teaching degree program who entered the program in 2006 do not work, the percentage of individuals who work (42%) is significant if we take into account the context of a public school. It is worth noting that in 2006 only 1% of the students entering the bachelor's degree program worked. The student who works often brings to the context of classes interesting experiences since many already work in the health field. However, reconciling professional and academic lives is a challenge imposed on students and professors. Additionally, we have observed in our experience that students who already work in the health field find it a challenge to realize that the undergraduate proposal goes beyond simply deepening technical knowledge. Data presented here reveal how important it is to identify the profile of students with a view to devise strategies to enhance learning.
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