The profile of nursing management graduates from the nursing programs in southern Brazil

Abstracts

Estudo exploratório-descritivo, em base documental, de natureza quantitativa com o objetivo de descrever o perfil dos egressos dos Programas de Pós-Graduação da Área de Enfermagem da Região Sul titulados nas linhas de pesquisa de gerenciamento de enfermagem, de 2006 a 2009. A coleta dos dados ocorreu mediante consulta aos Cadernos de Indicadores da CAPES e busca dos Currículos Lattes/CNPq dos egressos. Os Programas de Pós-Graduação em Enfermagem da Região Sul titularam 409 alunos, sendo 129 (31,5%) nas linhas de pesquisa de gestão/gerenciamento em enfermagem: 116 (89,9%) Mestres e 13 (10,1%) Doutores, que atuam majoritariamente na docência. Dos Mestres titulados, dois (1,7%) já são Doutores e 39 (33,6%) estão cursando o Doutorado. A produção intelectual após titulação soma um total 501 artigos científicos publicados, com uma média de 1,1 e 1,8 artigo/ano entre mestres e doutores, respectivamente. Apontam-se indicativos para a formação de mestres e doutores diferenciados para atuar na gestão/gerência em saúde e enfermagem.

Nursing research; Education higher; Education, Nursing, Graduate; Health management

ORIGINAL ARTICLE

The profile of nursing management graduates from the nursing programs in southern Brazil

Perfil de los egresados de gerenciamiento en enfermería de los programas del área de enfermería de la región Sur

Alacoque Lorenzini Erdmann^I; Selma Regina de Andrade^II; José Luís Guedes dos Santos^III; Roberta Juliane Tono de Oliveira^IV

^INurse. Ph.D. in Nursing Philosophy. Full Professor of the Department of Nursing and the Nursing Graduate Program, Federal University of Santa Catarina. CNPq Researcher 1A. Study and Research Group on Administration, Care Management and Education Administration in Nursing and Health (Grupo de Estudos e Pesquisas em Administração, Gerência do Cuidado e Gestão Educacional em Enfermagem e Saúde - GEPADES). Coordinator of the CAPES Nursing Area January 2008 to June 2011. Florianópolis, SC, Brazil. [e-mail]

^IINurse. Ph.D. in Nursing. Professor of the Department of Nursing and the Nursing Graduate Program. Vice-Leader of GEPADES. Federal University of Santa Catarina. Florianópolis, SC, Brazil. [e-mail]

^IIINurse. Doctorate Student of the Nursing Graduate Program, Federal University of Santa Catarina. Member of GEPADES. CAPES Fellow. Florianópolis, SC, Brazil. [e-mail].

^IVNursing undergraduate, Federal University of Santa Catarina. CNPq fellow (Scientific Initiation). Florianópolis, SC, Brazil. [e-mail]

^{Correspondence addressed to:}

ABSTRACT

This is an exploratory-descriptive study, performed on a documental basis and using a quantitative approach. The objective was to describe the profile of graduates from the Nursing Graduate Programs from Southern Brazil, from 2006 to 2009, which titles revealed they were in the lines of research regarding nursing management. The data was collected using The CAPES Indicator Books and searches on the graduates' Curriculum Lattes/CNPq. The Nursing Graduate Programs in Southern Brazil totaled 409 students, 129 (31.5%) of which worked in the lines of research associated with nursing management/administration: 116 (89.9%) Masters and 13 (10.1%) Doctorates. Most graduates currently work as faculty. Of those with a master degree, two (1.7%) have already obtained a doctorate degree, and 39 (33.6%) are currently in the doctorate program. The intellectual production after obtaining the degree adds up to 501 published scientific articles, with an average 1.1 and 1.8 article/year among masters and doctorates, respectively. The study presents indicatives for the preparation of differentiated masters and doctorates to work in nursing and health management/administration.

Descriptors: Nursing research; Education higher; Education, Nursing, Graduate; Health management

RESUMEN

Estudio exploratorio descriptivo, basado en documentos, de naturaleza cuantitativa, objetivando describir el perfil de egresados del Programa de Posgraduación del Área de Enfermería de Región Sur, recibidos en las líneas de investigación de enfermería, entre 2006 y 2009. Recolecta de datos efectuada mediante consulta de Cuadernos de Indicadores de CAPES y búsqueda de Currículos Lattes/CNPq de los egresados. Los programas de Posgraduación en Enfermería de la Región Sur graduaron 409 alumnos, 129 (31,5%) en las líneas investigativas de gestión/gerenciamiento en enfermería: 116 (89,9%) Maestros y 13 (10,1%) Doctores, con actuación mayoritaria en docencia. Dos (1,7%) de los maestros graduados son ya Doctores, 39 (33,6%) cursan el Doctorado. La producción documental de posgraduación suma 501 artículos científicos publicados, con promedio 1,1 y 1,8 artículo/año entre Maestros y Doctores, respectivamente. Se apuntan indicaciones para la formación de Maestros y Doctores especializados para actuar en gestión/gerenciamiento de salud y enfermería.

Descriptores: Investigación en enfermería; Educación superior; Educación de Postgrado en Enfermería; Gestión en salud

INTRODUCTION

The National Graduate Plan (Plano Nacional de Pós-Graduação - PNPG) established for 2011-2020 by the Brazilian Ministry of Education presents the evolution of the number of graduate programs in activity since 1976. The expansion occurred in all areas, but the health area stood out in terms of the number of master and doctorate degrees for every 100,000 people. The data show that from 2004 to 2009, the number of graduate programs in activity increased 38.1% (a 35.9% growth for academic masters, 104.2% for professional masters, and 34.4% for doctorate programs). Although this is an expressive development, it represents a slight increase in degrees per 100,000 people. The number of degrees in Brazil increased from 16.04 masters and 5.05 doctorates in 2006 to 18.64 and 5.94 in 2009, respectively⁽¹⁾.

The estimated economic growth for Brazil in the next 10 years will require highly qualified personnel. The PNPG presented a challenge to reach, by 2020, a number of doctorates that would level Brazil to come first-world countries⁽¹⁾. In this context, nursing science is demanded to increment the preparation of masters and doctorates, with the purpose of consolidation and expanding its scientific, technologic, and innovation fields by means of the knowledge it produces particularly in graduate programs.

Nursing research is key for the advancement and consolidation of the profession's science and technology and to contribute with the search for excellence in healthcare. Graduate Programs in Brazil are structured according to areas of concentration, lines of research, study projects, and research groups/centers registered with the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq). This structure permits to prepare masters and doctorates with investigative competencies in practical nursing experiences, in different settings, contemplating the diversity of different knowledge areas and practices⁽²⁾.

The nursing area with the Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES) has grown in terms of the number of graduate programs and courses, preparing masters since the 1970s and doctorates sing the 1980s^(2-3). Today, in 2011, there are 54 stricto sensu Nursing Graduate Programs accredited by CAPES, comprising a total of 76 courses, 24 of which are nursing doctorate courses, 42 academic master programs, and another 10 professional nursing masters. One of these programs, established in 21010, has Nursing Management as its area of concentration.

Despite the referred growth and the implementation of governmental policies that promote graduate studies in Brazil, some regions remain without programs and nursing doctorates, while other have very few programs compared to the number of undergraduate courses, and this ratio also occurs in other health areas⁽²⁾.

There is also a growing production of scientific and technological knowledge published in high impact journals, which contributes for Nursing to become gradually consolidated in its specificities and diversities, associated with the knowledge of other sectors determining of the life and health of society. Between 2007 and 2009, the scientific production of Nursing in Brazil, registered by the 35 graduate courses on the CAPES evaluation system, corresponded to 5,194 articles published in 595 journals. In the triennium, 1,517 master dissertations and 377 doctorate theses were defended^(4-5).

The numbers of production advert towards the need to problematize the social utility of Nursing knowledge and the commitment to transforming it into the wellbeing of people, groups, and communities⁽⁵⁾. There have been reports of concerns regarding the scientific production in Nursing, mainly when addressing ethical-epistemological aspects, i.e., requirements that define the quality of the knowledge produced and the defining features of scientific maturity. In addition, there are also reflections of a more operational nature, regarding the production resulting from research, including publication and dissemination. Other resulting products work as sources of evaluation of the scientific capacity of Nursing, particularly by institutions that evaluate and fund the scientific-technological system⁽⁶⁾.

More specifically, regarding the area of nursing administration/management, 36 research groups are registered with the CNPq. These groups perform research on the theme using several approaches, thus comprising a broad collection of ideas and new technology in the nursing and health administration domain. The theory model referred to as Research Groups on Nursing Administration and Management: arrangements and interactions in the Nursing Care system (Grupos de Pesquisa de Administração e Gestão em Enfermagem: arranjos e interações no sistema de Cuidado em Enfermagem) results from the convergence and interrelation of several domains in which these groups work, which interact, work, and yield results based on concepts and contexts, aiming at making study proposals and innovations in this field ⁽⁷⁾.

The priority lines of research in nursing management involve themes regarding the elements and conceptions of nursing management in the different practice settings; nurses' managerial competencies; nursing in the social commitment networks; nursing in comprehensive care; public healthcare policies; nurse and health planning; organization culture; healthcare humanization; health technologies, economy and costs in health and nursing; safety and the occupational risks in nursing; the quantity and quality of nursing workers according to the expected standard healthcare quality; the quality of health and nursing care; informatics in nursing and health; better healthcare management practices; nursing in health promotion and models of nursing management, among many others⁽⁸⁾.

Based on the development and applicability of the results obtained from this line of research, it is expected that the production of science in nursing reach the expectation of society in terms of receiving high quality and state of the art nursing care. On the other hand, when these expectations are met, we hope nurses are acknowledged for their leadership potential and their mastering of nursing knowledge, be that in the international, national, or regional level.

Based on the panorama reported herein, a question is made: what is the profile of students from Nursing Graduate Programs in Southern Brazil, in the lines of research related to nursing administration/management?

OBJECTIVE

The study aimed at describing the profile of the students of Nursing Graduate Programs in Southern Brazil, related to the lines of research of health and nursing administration/management.

METHOD

This is an exploratory-descriptive, documental study, performed using a quantitative approach.

Data collection was performed from July to September 2011, and was divided into two stages. First, a survey was performed on the CAPES Book of Indicators⁽⁹⁾, which consist of the reports used in graduate programs evaluation processes, with the purpose of identifying the number of theses and dissertations that were defended in each Nursing Graduate Program in Southern Brazil, and the students whose studies were registered under the lines of research related to Nursing Administration/Management.

Next, the students' Curriculum Lattes (CNPs) were reviewed with the purpose of collect the variables regarding their professional occupation, scientific production after obtaining the degree, and, for master graduates, pursuing the doctorate degree. In order to quantify the scientific production after obtaining the degree, only full articles published in journals were considered. Students where excluded form the study if their Curriculum Lattes was out of date for over two years.

Data analysis was performed using descriptive statistics, using absolute and relative data. Results were grouped and presented as charts and tables.

This study was not submitted to the Research Ethics Committee because it is a documental study using content that is considered to be of public access. Nevertheless, all ethical recommendations were complied with while processing, analyzing and disseminating the research data.

RESULTS

There are eight Nursing Graduate Programs in Southern Brazil: three in the state of Paraná: State University of Maringá (Universidade Estadual de Maringá - UEM), Federal University of Paraná (Universidade Federal do Paraná - UFPR), and State University of Londrina (Universidade Estadual de Londrina - UEL). The state of Santa Catarina has only one program at Federal University of Santa Catarina (Universidade Federal de Santa Catarina - UFSC). In Rio Grande do Sul, there are four programs, in the following institutions: Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul - UFRGS), Federal University of Santa Maria (Universidade Federal de Santa Maria - UFSM), Federal University of Rio Grande (Universidade Federal de Rio Grande - FURG), and Federal University of Pelotas (Universidade Federal de Pelotas - UFPEL). All these programs have research lines related to nursing administration/management, as shown in Chart 1.

UFSC and UFPR also offer Professional Masters in Nursing course, which were established in 2010 and 2011, respectively, and, therefore, no theses or dissertations have been defended to this date. The academic masters program at UEM was also established in 2010, therefore, it was not considered in the present analysis.

In the studied period (2006-2009), a total of 409 students completed their studies in Nursing Graduate Programs in Southern Brazil, 129 (31.5%) of which were involved in lines of research related to nursing administration/management. Of all students, four were not from the nursing area: two psychologists, one physical educator, and one nutritionist. Table 1 presents the distribution of students according to their institution and the year they obtained their degree.

Of all students who obtained their degree in the lines of research related to nursing administration/management, 116 (89.9%) were master graduates and 13 (10.1%) were doctorates. Of all master graduates, two (1.7%) have also obtained a doctorate degree, and 39 (33.6%) were attending the doctorate program. Master and doctorate graduates both work mostly as faculty. Regarding the production after obtaining the degree, together, the graduates published 501 scientific articles, as shown in Table 2.

DISCUSSION

The fact that all Graduate Programs in Nursing in Southern Brazil include lines of research related to nursing administration/management is evidence of the importance of this area as a dimension of nursing practice.

Regarding the students' distribution among the Graduate Programs, the most recent programs showed a smaller number of lines of research compared to consolidated programs, as they focus their production in the lines of nursing administration/management. In older programs, as that of UFSC, production in nursing administration/management appears apart reduced among the group of publications, despite having an expressive number.

From 2006 to 2009, there was a constant number of master/doctorate graduates, despite the increase in the number of programs: one began in 2007 (UFSM), another in 2008 (UFPEL) and, yet, a third program (UEL) began in 2010, but no students had completed the course yet.

The number of master graduates who have not yet enrolled in the doctorate program (64.7%) is a disturbing indicator, because stricto sensu education is made effective and complete with the doctorate degree. There is a clear need to prepare nursing doctorates to work in undergraduate and graduate programs, not only considering the growing number of undergraduate nursing courses authorized by MEC, but also due to the importance of establishing a career plan, investing in professional qualification, and in incrementing science, technology and innovation in Nursing.

On the other hand, Brazil has a well-defined and known policy regarding nursing education, which recommends the faculty should develop new practices, with a broad and deep domain in specific contents, organized into lines or themes considered priority in research. Their guidelines aim at contribution with the excellence of nursing education in order to strengthen both multiprofessional and interdisciplinary fields of knowledge.

Furthermore, the impact of the graduates' professional occupation on the improvement of nursing care quality needs to be evaluated. Because there are few graduates working directly with healthcare administration/management, it is a challenge to lever that education to increase the number of master and doctorate degrees in this specific field of knowledge.

Nursing in Brazil has developed presence and potential for making research and preparing researchers as it counts with 54 Graduate Programs, totaling 76 courses (24 doctorates, 42 academic master, and 10 professional master courses in nursing), 164 researcher holding CNPq fellowships, and 448 research groups⁽⁴⁾, 36 of which are in the area of nursing administration/management⁽⁷⁾. Today there are approximately 1.550 million nursing workers, accounting for about 50% of all health professionals, in the national health system (Sistema Único de Saúde - SUS), proving to be effective and contributive in providing healthcare to the population of almost 191 million people. This development and consolidation trajectory culminates with four programs receiving a score six from CAPES/MEC⁽⁴⁾, thus allowing to increase this specific field of knowledge, i.e., nursing and health administration/management.

In Brazil, the search for excellence in nursing is the path to answer the society about the great importance and meaning of the nursing profession. The production of knowledge, per se, about nursing graduates is a great challenge. To focus on the education of master and doctorate graduates in nursing on competencies, potentials or aptitudes requires knowing the profile necessary to achieve the necessary qualification and the respective professional status or impact on the health of the population, as constructors and catalysts of health policies and social development.

As to the scientific production after obtaining the degree, it was found that the average number of articles published by masters and doctorates was, respectively, 4.4 (1.1 article/year) and 7.5 (1.8 article/year) in the studied period. These indexes are more expressive compared to previous findings^(10-11). The identified increment in scientific production reflects the advancement produced by nursing. The distribution of the publications in nursing in Brazil, compared to that of other countries reveals that, from 2000 to 2008, it moved from the 25^th position to the 5^th in the world rank, which is evidence of a substantial growth⁽¹²⁾.

However, it is necessary to ask and reflect: have the undergraduate and graduate courses provided nurses with a clear explanation of their social responsibility in view of their degree? Have the nurses' search for graduate courses and the dissemination of the produced knowledge in scientific journals made an impact in terms of improving healthcare/management/administration practices in nursing? What are the criteria used to evaluate the graduate students in term of their impact? How can their work be evaluated qualitatively and quantitatively? Are they any better than today's professionals? And, regarding us, professors, for instance, how long will it take for us to achieve the desired or necessary quantity and quality?

We reaffirm the need for Nursing Graduate Programs to make efforts towards preparing masters and doctorates capable of producing relevant knowledge and establishing practice that truly absorbs the knowledge produced in journals. The search for knowledge should contribute, most of all, to mobilize the general human attitude to propose and solve problems⁽¹³⁾.

In the USA, the Doctor of Nursing Science Programs can be referred as examples of the search to associate practice, theory, and knowledge production in nursing. These courses aim at preparing professionals who specialize in advanced nursing practices through performing research with results that can be converted into innovating practices/care, based on the best scientific evidence available⁽¹⁴⁾.

According to the Nursing Evaluation Report for the 2007 - 2009 triennium⁽¹⁵⁾:

The Nursing are in the CAPES has focused on the education of its researchers/scientists guided by a Profile of Nursing Doctorates, created with the purpose of achieving excellence, motivated following by the international profile of doctorate in nursing programs, of which major competences/aptitudes/domains include: - mastering the state of the art of its theme/area of study, with the capacity to communicate at an international level, be able to argument and support their ideas among their peers and other fields of knowledge in the scientific community aiming at establishing partnerships and networks for knowledge production; - mastering the specificity of the nursing area, broadly and in depth, in a specific area or regarding the interfaces with that area, so as to contribute with the advancement of the area, incorporating new knowledge and practices in interdisciplinary care; - identify and promote new pathways in nursing knowledge, focusing on its scientific and technologic differentiation and inclusion in society, to consolidate and strengthen the identity of the area; - perceive and interpret the opportunities of developing new knowledge, evaluating its importance for the theoretical and practical fields of the area, based on the impact of various knowledge; - skills/competences for research, team coordination and the use of knowledge with associated skills to manage research projects and prospecting research opportunities; - expert in scientific methods and/or developer of new methods and technologies for the process of developing advanced knowledge, as well as mastering the instrument and process of dissemination/socialization of knowledge in highly qualified journals; - practicing the educational process, collaborating with the education of new thinkers/professionals for competences/aptitudes in nursing knowledge or of related areas, with a critical-reflexive, constructive, and collaborative view; - capacity to develop their scientific career project, considering their leadership, insertion, academic acknowledgement, in addition to the time of professional life, interest, will, needs, or personal conditions.

Nursing is a specific field of knowledge and a social profession that has advanced at a fast pace, consolidating, expanding, and gaining strength as a science, technology, and innovation across continents⁽¹⁵⁾. New pathways have been developed, with new concepts, constructs, and explanations towards the production of new healthcare practices to answer the manifestations or health conditions of populations living in different contexts and with different social policies. It invests in the construction of knowledge that contributes to the promotion of a better being/living with better health regarding the phenomenon of human care.

In human health, nursing care is an object of study and work whose relevance for society is acknowledged and not much explored in the field of knowledge production in nursing. Human care is a value, a social asset indispensible to promote the vitality of living, having and maintaining life and a better dying; it is the product of knowledge, attitudes, aptitudes and potentials of human interaction, regarding the nature of life and the dynamics of vital functions controlled by science and the art of nursing⁽¹⁵⁾.

The technical-scientific competence of caring for citizens in their health-disease process and in its social context of human living requires the mastering of advanced knowledge of biological, social-critical, humanist and social natures, with aspects in several fields of knowledge, in the wide field that characterizes (applied) nursing science or the discipline particular of nursing and the interdependence with other fields of knowledge, particularly those in health, education and the administration/management in public social policies, i.e., of practicing multi, inter and cross-disciplinary production and practice⁽¹⁵⁾.

It is believed that society expects to receive excellent, state of the art nursing care that ensures a healthier life or living with better health, performed by highly qualified or competent nurses, acknowledge for mastering the nursing knowledge in the international, national, and regional levels, recognizing that health is every citizen's right.

The educational policies of different countries support that nurses should be prepared focusing on competences or aptitudes to work in different social contexts, mastering the production and use of new knowledge or skills, different technologies, have political and managerial potentials, articulate well, have an integrating, vitalizing and analytical attitude, be professionally and socially involved, socio-humanistic, ethical care, promote citizenship, establish relationships, be a social entrepreneur with a broad micro and macrosocial view, have a potential of leadership and of developing health promotion policies.

The education of highly capacitated nursing professionals is a great challenge: nurses, specialists, masters and doctorate with differentiated profiles and differentiated administrators. Perspectives point to a qualitative and quantitative growth followed by new configurations in the distribution of professionals: a greater number, more qualified, performing differentiated actions, seeking better sustainability on scientific and technological bases, continually developing new practices that are differentiated and more qualified considering the reality and resolvability of healthcare practice. Investments in healthcare are higher, better services are offered, and better professionals are sought.

Nursing education assumes a new direction by focusing on the process of learning centered on the practice of the profession or of nursing care, i.e., of learning through the continuous exercise of developing new practices that require mastering the state of the art and potentials of practicing new aptitudes. The processes of learning through research and continuously innovating are complementary and vital in the quality of teaching centered on nursing care practice.

Nursing has improved the integration of thinking and collaborative and constructive practice in the profession. It is necessary to graduate students capable of promoting innovation, resulting from the production of healthcare technologies, the advancement of nursing science and a new teaching-learning pedagogy. Masters and doctorates, experts in nursing administration/management, are able to make the expected difference.

CONCLUSION

There are eight Nursing Graduate Programs in Southern Brazil. Between 2006 and 2009, seven of those courses graduated 409 students, 129 (31.5%) of which were in a line of research related to nursing administration/management. Of all graduates, 116 (89.9%) obtained a master degree, and 13 (10.1%) a doctorate degree, and most of them currently work as faculty. Of all master graduates, two (1.7%) have already obtained a doctorate degree, and 39 (33.6%) are currently in the doctorate course. The intellectual production after obtaining the degree corresponded to 501 published scientific articles, with an average of 4.4 (1.1 article/year) among master graduates, and 7.5 (1.8 article/year) among doctorates.

The Nursing Graduate Programs have contributed with the consolidation of scientific, technological and innovation knowledge in Nursing as well as in the specific field of nursing administration/management by developing exceptional human resources at the academic master, professional master, and doctorate levels, with positive repercussions in the national and international settings, as well as in the organization of healthcare healthcare services, and in nursing care and practices. Over the last three years, there has been a significant increase in the presence, vitality, strength/power and acknowledgment of Nursing Graduate Studies in Brazil.

Despite the limitations inherent to documental research, this study, by outlining the profile of these graduates, points to indications of the advancement in the education of masters and doctorates centered on the profile established by the Nursing Document/CAPES/2009. By planning the development of a professional that works in nursing and health administration/management, with superior and differentiated education, competent, visionary, innovative, creator of public policies, Nursing Graduate Programs are giving a firm and accurate step towards the changes that are expected by society.

REFERENCES

Received: 11/01/2011

Approved: 11/08/2011

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Correspondence addressed to:

Alacoque Lorenzini Erdmann

Univ. Fed. de Santa Catarina, Centro de Ciências da Saúde,

Departamento de Enfermagem - Trindade

CEP 88040-900 - Florianópolis, SC, Brazil.

Publication Dates

• Publication in this collection
  17 Apr 2012
• Date of issue
  Dec 2011

History

• Received
  01 Nov 2011
• Accepted
  08 Nov 2011