ACADEMIC-PROFESSIONAL MOBILITY AND INTERNATIONALIZATION OF NURSING: CONTRIBUTIONS OF THE BOLOGNA PROCESS

MOVILIDAD ACADÉMICO-PROFESIONAL E INTERNACIONALIZACIÓN DE LA ENFERMERÍA: APORTES DEL PROCESO DE BOLONIA

ABSTRACT

Objective:

to understand the contributions of the Bologna Process to academic-professional mobility of Nursing.

Method:

a descriptive exploratory qualitative research. Open interviews were conducted with six PhD nurses, nursing professors, with more than 20 years of experience and who experienced the changes that occurred in higher education in post-Bologna nursing. The interviews took place in the Health or Nursing Schools of the north, center and south regions of Portugal, between January and March 2019, until saturation occurred by repetition. Content analysis was performed.

Results:

three perspectives are presented: 1) Mobility and internationalization as presuppositions to the strengthening of the economic bloc; 2) Mobility and internationalization contribute to the consolidation of a European identity; and 3) Diploma Supplement: fundamental aspect of academic-professional mobility.

Conclusion:

education proved to be a valid instrument for the construction of a common professional identity, considered indispensable for the strengthening of the block, with regard to the production of knowledge. The guidelines for the harmonization of university systems and the Diploma Supplement promoted scientific and cultural exchange through academic-professional mobility and intensified the dialogue between nations, which reverberate in social practices.

DESCRIPTORS:
Nursing education; Teaching; European Union; International Educational Exchange; Freedom of movement; Nursing.

RESUMEN

Objetivo:

comprender las contribuciones del Proceso de Bolonia a la movilidad académico-profesional de Enfermería.

Método:

investigación cualitativa exploratoria descriptiva. Se realizaron entrevistas abiertas a seis enfermeros doctores, docentes de enfermería, con más de 20 años de experiencia y que vivieron los cambios que ocurrieron en la educación superior en la enfermería post Bolonia. Las entrevistas se realizaron en las Escuelas de Salud o Enfermería de las regiones norte, centro y sur de Portugal, entre enero y marzo de 2019, hasta que se produjo la saturación por repetición. Se realizó análisis de contenido.

Resultados:

se presentan tres perspectivas: 1) Movilidad e internacionalización como presupuestos para el fortalecimiento del bloque económico; 2) La movilidad y la internacionalización contribuyen a la consolidación de una identidad europea; y 3) Suplemento al Título: aspecto fundamental de la movilidad académico-profesional.

Conclusión:

la educación demostró ser un instrumento válido para la construcción de una identidad profesional común, considerada indispensable para el fortalecimiento del bloque, en lo que respecta a la producción de conocimiento. Los lineamientos para la armonización de los sistemas universitarios y el Suplemento al Título promovieron el intercambio científico y cultural a través de la movilidad académico-profesional e intensificaron el diálogo entre las naciones, que repercute en las prácticas sociales.

DESCRIPTORES:
Educación en enfermería; Enseñando; Unión Europea; Intercambio Educativo Internacional; Libertad de movimiento; Enfermería.

RESUMO

Objetivo:

compreender as contribuições do Processo de Bolonha para a mobilidade acadêmico-profissional de Enfermagem.

Método:

pesquisa descritiva, exploratória e de natureza qualitativa. Realizou-se entrevistas abertas com seis enfermeiros doutores, docentes de Enfermagem, com mais de 20 anos de atuação e que vivenciaram as mudanças ocorridas na formação superior em Enfermagem pós-Bolonha. As entrevistas ocorreram nas Escolas de Saúde ou de Enfermagem das regiões norte, centro e sul de Portugal, entre janeiro e março de 2019, até a saturação por repetição. Realizou-se análise de conteúdo.

Resultados:

apresentam-se três perspectivas: 1) A mobilidade e a internacionalização como pressupostos ao fortalecimento do bloco econômico; 2) A mobilidade e a internacionalização colaboram para a consolidação de uma identidade europeia; e 3) Suplemento ao Diploma: aspecto fundamental à mobilidade acadêmico-profissional.

Conclusão:

a educação provou ser um instrumento válido para a construção de uma identidade profissional comum, considerada indispensável para o fortalecimento do bloco, no que tange a produção de conhecimentos. As diretrizes para a harmonização dos sistemas universitários e o Suplemento ao Diploma promoveram o intercâmbio científico-cultural por meio da mobilidade acadêmico-profissional e intensificaram o diálogo entre as nações, que reverberam em práticas sociais.

DESCRITORES:
Educação em enfermagem; Ensino; União Europeia; Intercâmbio Educacional Internacional; Liberdade de circulação; Enfermagem

INTRODUCTION

The propulsion of European higher education towards internationalization necessarily involves the success of the mobility of academics and professionals between the different European Union (EU) countries. The Post-Bologna Declaration scenario in Europe gained global prominence because it is a political-educational movement in favor of a knowledge society, in which the workforce aligns itself with the prospects of economic growth, with efforts that have been seen in the different world economic blocs, including Mercosur. Regarding nursing, internationalization promoted by academic and professional mobility has significant impacts on the profession, with emphasis on the technical-scientific, financial, social and cultural aspects of the training area.1

Nursing does not stand out as an area that strongly adhered to mobility from the beginning, and even now, in post-Bologna, it continues gradually in the process. Although the health reality of the European population is considered a source of concern, mainly due to the inversion of the age pyramid and increased life expectancy, highlighting nursing as a necessary profession for health care, the different views about the nurse training may be impacting the choice of academic mobility. In some EU countries, nursing is configured as vocational education, as well as aspects in technical, technological, polytechnic and higher education, which makes it difficult to adapt exchanges, especially because it is a formative area of health, with important implications regarding the disciplinary responsibilities to be assumed. 2

In the scope of professional mobility, the European Directives have dealt with the subject since 1977, when the European Commission regulated the minimum conditions for the free movement of professionals whose area of activity is regulated, nursing entered the list. More specifically, Directive 2005/36/EC, establishes rules for the mutual recognition of professional qualifications, minimum time in years of study, training hours and learning content for nurses, allowing professionals who have what is required, to enjoy mobility.3

With regard to higher education in nursing, with the signing of the Bologna Declaration in 1999, mobility gained momentum. The proposed objectives seek to strengthen internationalization, as it proposes actions, such as: adoption of the system of transferable academic credits, in which the period of study is measured by learning outcomes; the adjustment of the curriculum of the courses in study cycles comparable between the different nations; and the establishment of the diploma supplement, which is a bilingual document that recognizes degrees and/or completed studies, reducing bureaucracy in document validation and facilitating the retention of talents in the economic bloc. 4^-5

For nursing, both academically and professionally, the Bologna Process was opportune to strengthen the area in Europe. In Brazil, actions to encourage internal and external mobility are still isolated, but they are growing, and Mercosur shows itself inclined to changes in higher education in the economic bloc, which was more strongly signaled with the signing of the Agreement on Revalidation of Higher Education Titles or Diplomas at Undergraduate Level in Mercosur in 2018 which aims to facilitate academic and professional mobility between the countries of the bloc.6

Pedagogical practice permeated by mobility and internationalization will demand procedures aimed at the act of knowing, and not receiving ready-made knowledge. In this practice, the active, inquiring, transforming character is observed, since education as a mere transfer of knowledge is restricted to the pure description of a reality, blocking critical awareness in the student and reinforcing alienation. By exchanging, it is possible to create opportunities for the intertwining of technical-scientific knowledge with the development of critical-reflective thinking, a necessary condition for the exercise of citizenship and strengthening of a cultural identity.7

Teaching is globalized, it is a source of knowledge for the development of innovation and technology and has been the focus of attention of the different economic blocs. Thus, it is important to understand how the process of academic-professional internationalization has been occurring in contexts that are ahead of Brazil in this trajectory. The EU has been on this path for more than 20 years since the Bologna Declaration, and it has a lot to teach about its experience in the period. Thus, the question is: what are the contributions of the Bologna Process to academic-professional mobility of Nursing? The study aimed to understand the contributions of the Bologna Process to academic-professional mobility of Nursing.

METHOD

This is a descriptive, exploratory and qualitative research, in which open interviews were adopted as a data source. The use of open interviews in data collection allowed us to compare and corroborate findings from different points of view, which present similarities, differences and particularities in their responses, enriching the results of the study. The interviews took place with six 'key people', nurses who are professors of the higher education course in nursing in Portugal with more than 20 years of experience in the area, and who have experienced the curricular reform of European higher education and the changes that have taken place in higher education in Nursing post Bologna, having occupied decision-making spaces (coordinators, study group leaders, positions in the Order of Nurses and/or in Nursing Federations).

Each interview lasted about 1h30m-2h, resulting in more than 10 hours in total and 100 pages of transcripts. The first interviewee was chosen by a member of the European Federation Educators in Nursing Science (FINE), a board that acts strongly in the context of the study. The participant selection for the interviews followed the snowball technique, in which the first participant interviewed recommended the second according to the relevance of the content and, then, until data saturation.8 The interviews were guided by a guiding question, designed for the answers to reach the theme and objective of the study: to what extent did the Bologna Process contribute to nursing education? The collected information was recorded, fully transcribed and validated by the participant prior to the analysis. When the researcher realized that the statements corroborated each other and showed similarities, the interviews were ended.

Data collection occurred by prior e-mail scheduling, in which the researcher presented herself, described the research project, forwarded the Informed Consent Form and invited the person to participate in the research. The interviews took place in the Health or Nursing Schools of the north, central and southern regions of Portugal, between January and March 2019, and were finished when data repetition occurred.

The interviews were recorded, fully transcribed and validated by the participants prior to data analysis. Content analysis was used, whose steps included pre-analysis of the material, the selection of meaning units, the coding process of the units of analysis, the construction of non-aprioristic categories and data interpretation. 9 To collaborate with the systematization of the analysis, the Atlas.ti™ software was adopted, which provides visualization tools to assist in the encoding of primary data. Three units of analysis emerged from the data, which are presented in the results. Paulo Freire's Theory of Knowledge was adopted as a reference framework.1

The study was approved by the ethics committee for research with human beings. Thus, the acronyms P for participants was used followed by a number in the representation of the textual clippings of the interviews.

RESULTS

Mobility and internationalization as prerequisites for strengthening the economic bloc

The Bologna Process has given a new dimension to academic mobility, an undoubted and permanent progress. This statement is evidenced in all the interviews conducted and is present in academic publications and in other scenarios (congresses, meetings, conferences, among others). Academic mobility is very relevant and has gained a new dimension with Bologna. The number of students who leave due to mobility is significant, there was a great demand. It is widespread in almost all courses, students seek the opportunity to go to Europe [exchange between countries] to do a semester. And the contact I had with students who came from mobility experiences was very interesting: the way they talk about their experiences in other countries, how they open horizons, so it is fundamental (P1).

There was a need for the EU to adopt strategies to strengthen the economic bloc through supranational education reform that would bring it to competitive levels in relation to other nations. They realized [EU countries] that education in Europe needed to be competitive, especially with regard to the United States; and on the other hand they realized that there was no competition without quality and without mutual recognition. This alone could facilitate the mobility of students in Europe. The purposes [of the Bologna Process] were clearly mobility, employability and competitiveness, establishing the basis of the movement. A student studying nursing in Portugal can work all over Europe. And to have that recognized is very important. It really is good (P2).

The relevance of internationalization for economic development and scientific-technological advancement is emphasized. This intention is mediated by the exchange of knowledge and mobility between students, professionals and scientific society who dialogue and elevate teaching, research, extension, social practices in various areas, social development, expanding opportunities for multicentric experiences, interdisciplinary work, cultural exchanges and job creation. Understanding the social dynamics of other nations, their obstacles, inserted in their social contexts - and thinking together about solutions - favors the formation of people who are more prepared to deal with adversities, with complex social problems, and who have greater aptitude and capacity for leadership. We don't want everything to be the same, because that makes innovation impossible. Development is made of the possibility of doing different things and finding and experiencing better things. If we're all doing the same, it's impossible. We need diversity and training for contexts that are also diverse; and students with open minds, with the ability to think outside the box, make decisions, and be leaders. None of this is compatible with closed structures (P2).

In the social sphere, the internationalization that is promoted through different fronts - mainly, mobility - rescues the magnitude of the dialogue. Problems can be collectivized and overcome jointly, such as the ongoing pandemic, in which several nations have joined forces in multicenter studies, research funding, exchanges of the most different types with a common goal. This is one of the great advantages that mobility and its consequent internationalization brings. 'We can move through Europe' is an opening of horizons, employability, knowledge transfer, new future perspectives at all levels; and this mobility is not only for students, but also for professors. I [professor] have already done mobility and it is always enriching. So there's always an exchange here, a sharing of learning. What we often think are our difficulties are the difficulties of others; and sometimes others have gone through the same process and their learning helps us to overcome our difficulties more easily (P5).

In turn, Scientific development and innovation have been driven by mobility and internationalization. What we want is, for example, to do research initiatives, to do things together, because perhaps the mobility of teachers and students is the most elementary level of internationalization. It's the most elementary level - we go there and they come here, but this is only the first level (P3). From the perspective of the participants it is necessary to advance in the levels of internationalization, however, the support already exists - facilitating mobility.

As for the mobility of professionals, the relevance of this concern for many areas of knowledge, especially nursing, is relevant. Respondents emphasize how much the EU's population aging indicators have expanded - associated with a low birth rate, resulting in a significant demand for health care. Thus, with the Bologna Process, professional mobility was facilitated, in addition to the possibility of knowing other realities, experiencing other cultures that also improved employability. After experiencing mobility, many students do not return. Not just for wage reasons. They do not return because the recognition of the profession [Nursing] in some societies is different. Because they're better paid there, they pay them to do the next training, they pay for their qualification. Some did not return and it is not only because of the standard of living (P3).

Mobility and internationalization contribute to the consolidation of a European cultural identity

Mobility contributes to the consolidation of a European cultural identity and also to the strengthening of the feeling of bonding and belonging. The exchange of ideas, practices, knowledge and cultural expressions favored by mobility represent a great advance for the internationalization of educational and research institutions, favoring scientific and technological development. The student mobility planned by Bologna was seated in a backdrop that was the construction of a European identity. I mean, we feel connected, we feel that we are European (P4). Mobility is not only an academic mobility, but social and cultural. Europe is not only a round-up of countries with a common philosophy, it is far from that, but ideologically it would like to be. Students will know other cultures, study in other universities in another language and relate to other people (P6). The mobility process also aims at the apprehension of the culture of that country, which is also in Europe (P4).

The interviewees consider that student exchange in the context of Bologna exceeds the mere objective of professionalization, advancing beyond technical capacities. This situation is evident in nursing. Students who do mobility do not go to learn nursing techniques. They broaden horizons from a multicultural point of view, they perceive how other people and systems work, other institutions are organized, and therefore there is an added gain from mobility for their understanding and for Europeanization - not to say globalization - of the learning process, and being truly able to integrate with respect for differences and with an expanded understanding of what can be the role of nurses in cultural and political and economic contexts (P3).

For another interviewee, student mobility is more than demarcating bases in a certain area of knowledge, as it necessarily permeates the cultural context and European identity: it consists of this addition, cultural baggage of ease of dialogue with other cultures, but equally European. He understands the notion that this is our space, the Europe space. It will join the single currency, the inexistence of borders, all this will make it easier. This is student mobility (P4).

With regard to the competencies developed by students during academic mobility, spending a period experiencing another reality, in another country, adds value to training and life. Individual competence is composed of a set of behaviors that integrate, mobilize, transfer knowledge, skills, judgments and attitudes that, connected, attribute value to institutions, society and the person who owns it. Thus, each one weaves the competence from its innate characteristics and acquired by the historical-cultural environment, in which mobility has remarkable value. The possibility of spending six months away [students], in another reality, is very significant at all levels of global and effective skills development. These young people are forced to manage their own daily lives: washing their clothes, taking care of their food, deciding what they buy, seeing if money arrives or if it is not enough, making choices they are not used to making, making decisions, choosing where to stay, with whom to stay, choosing to invest in this or that. There is a whole set of personal growth that favors the fact of being a nurse. I don't know if they [students] learn exactly the procedure that we [teachers] would like to have taught, but they learn to understand another way of seeing, of being in the world, of relating and that is very enriching. They usually come back with their eyes wide open, after all 'there is more to the world than I had thought' (P1).

For the interviewees, mobility is greater than the sum of its parts. It surpasses technical knowledge and contributes to the recognition of peers in the European environment, strengthening cultural identity. Mobility is good for the student as a person, culturally, for the understanding of the world, the perception that the reality of formation is not exhausted in this reality of ours. Mobility opens horizons (P3).

Diploma Supplement: facilitating aspect of academic-professional mobility

Professional mobility is ensured in the European context even before Bologna. The mobility of workers is something that was already guaranteed. And workers can mobilize from country to country. There is a group of professions, in which nurses are included (P4). However, with the Bologna Process, mobility has been facilitated. In order for students and professionals to work in different countries, something was needed that would allow harmonizing, comparing, standardizing with an elementary guideline that was common to different countries, while respecting the peculiarities of the educational structures of each nation and/or stipulating deadlines and possibilities for curricular adjustments. As explained: Bologna is important because it allows comparability and recognition in different areas and this is very important for dialogue. (...) But we need to have a minimum common denominator, which allows for legibility of the different formations (P2).

Thus, the relevance of the Diploma Supplement emerged in the speeches of all participants: Bologna stimulated mobility among students by recognition, because then they receive the "Diploma Supplement", which is an official document of the bilingual institution, which allows the student to present in any EU country. It is a unique document, showing your academic career. The employer in Spain, France, can see the level of training... (P4). What does Bologna bring? A system of easily readable and comparable grades across Europe, together with a Diploma Supplement (P2).

The student can perform part of the studies in one country and validate such studies in another country, in other words, Bologna enables equivalence between different institutions. This notion is welcomed by the interviewees, since mobility expands the possibilities of learning/creation through scientific-cultural plurality. As illustrated in the statement: when performing the curricular units there, I consider that it was carried out here. So I'm saying that they are equivalent and what this student did not learn because mine had a specificity, certainly learned something else that I did not teach in mine (P4).

As for professional performance, the Diploma Supplement has singular relevance to make these activities viable, while mobility gave students the opportunity to get to know other realities and, if desired, opt for migration - a posteriori - in other countries. Such circumstances were emphasized: Regarding the movement of workers: [assuming] it is evident that the fact that I [student] go to Spain, I saw the work contexts and therefore I may have been interested, with some desire to go, I thought that Spain is an interesting place, I liked it, I decided to go to work there. Therefore, student mobility, in the background, stimulates professional mobility afterwards (P4).

Europe has had the Erasmus mobility project for over 30 years, but its adhesion took place with greater force after the Bologna Process. Erasmus had a mobility project, but it did not effectively have great support because students could do a period of study outside the country, but it was not recognized. And, if their studies were not recognized, the students felt at a loss. And it is not by chance that the Erasmus project only gained support after the implementation of Bologna, which consolidates mobility (P2).

The participants also stressed that international mobility is programmed and addressed the importance of this planning. Made possible by the Diploma Supplement, the institution that welcomes the exchange student will enable training that assigns the same equivalence credits to the institution of origin. It even carries out the evaluation. The student curriculum, in addition to having grades, has curricular units and how many ECTS [credits] a Diploma Supplement has (P6). It is clarified that the Diploma Supplement, a written document, always and necessarily accompanies the diploma and says what the student did throughout his school career. It continues: a student can do an activity outside the EU and then the scientific committee of the school of origin can analyze the award of credits. Going to another culture, with different or new learning experiences, can be considered extremely enriching (P6).

DISCUSSION

Academic and professional mobility in the European context has been debated since the creation of the European Economic Community in 1957, when discussions emerged for the development of the spirit of a European culture. It resulted in programs to support academic mobility, among them: Comett, Leonardo da Vinci, Socrates, Grundtvig and Erasmus, the last being the most outstanding of which was the most prominent, created in 1987. In January 2014, the EU decided to merge mobility programs as an integral part of the actions of the European Education Area, creating Erasmus+. It is noteworthy that the role of the program is to provide opportunities for funding and optimize exchanges, however, it is not a sine qua non condition for academic mobility.10^-12

The intention of the Bologna Process, originally, presupposes the elevation of the European economic scenario to competitive levels at the international level, based on the expansion of knowledge and the promotion of science and technology. In this context, it is emphasized that higher education in nursing is not only associated with obtaining clinical knowledge, but also with the need to develop cultural identity and moral values. The transformations that emerge in the face of mobility and its consequent internationalization contribute to making nursing a discipline with identity and autonomy. This new structure, in view of the Bologna Process for higher education, reinforces the competitiveness of nursing and promotes the influence of nurses on the health status of people, families and communities.13^-14

It is necessary to rethink the paths that market logic finds to influence the educational process. Neoliberal ethics is market ethics. In education it can provoke individualism, competitiveness and material success.15 People's freedom must be at the forefront of capitalism, for when the opposite occurs, alienation is the result.16

The European Higher Education Area aims to train professionals who produce new knowledge, technologies and innovation, provoking responses to society's needs, transforming it. The proposition seems to be a viable path through education, since it is an instrument for transforming reality.17

Thus, it is observed that the consolidation of internationalization has been supported by the opportunity for mobility and that is among the main objectives of the Bologna Process, planned with the intention of promoting the international movement of students, professionals, professors, researchers and administrative personnel. The Leuven/Louvain-la-Neuve Communiqué that took place in Belgium in 2009 stated in advance that by 2020, at least 20% of graduates in the field of European higher education should have had a period of study or training at the abroad.18

With regard to the consolidation of a European cultural identity, recognition and respect for cultural identity are absolutely important in professional training and it is from this perspective that comes the challenge of thinking about the importance of the cultural issue for the process of educational construction of a nation or economic bloc. In the EU's educational reform proposal, academic and professional mobility is one of the main pillars of the process, envisioning the search for a new cultural identity, a Europeanization, through a Europe of Knowledge. Thus, the transformations of the educational process in a multiple cultural context such as that presented, causes problems and challenges characterized by the uniqueness of each country to rethink professional training in Nursing within its own perspectives, with repercussions on the nursing care offered.

The learning of the nursing care process needs to be equipped with a cultural framework so that the student learns the sharing of knowledge and care practices taking into account cultural differences. It is also pointed out that, in addition to the personal cultural differences of nurses and clients, there is a meeting of cultural differences between professional knowledge in nursing, coming from technical-scientific knowledge and the personal knowledge of nurses, which need to be considered in the educational process. When analyzing this macro cultural educational context, with such considerable socio-political-economic differences, it is essential to act with caution so that the values of the individual cultural identity of each nation are maintained, without disregarding the diverse individual cultural values in which they are found.

It is essential to recognize what is essential for each culture in order not to lose its own historical meaning in the face of a new cultural context, but it is also necessary to be careful not to restrict its culture as the only existing truth, as this makes it impossible to integrate cultures for the construction of a new common context, especially in the transnational context. The overcoming of cultural boundaries that prevent the full appropriation of a common professional training, in a transnational context, is directly related to overcoming the conditions of a multicultural education for the search for a cross-cultural education in nursing.19

The foundation of international mobility was the creation of a system of transferable credits to enable exchanges, transfers and progression of students between universities with the use of learning content between them. The scope is inserted in a document called a diploma supplement, which facilitates the interpretation of the movement of students to different institutions, promoting employability by professional recognition of graduates in EU countries, i.e. an EU citizen with the required qualifications can automatically practice his profession in another Member State. Studies report positive experiences, but there are still many challenges that need to be overcome.

In the case of academic mobility, if on the one hand the experience gained in different Universities will help students develop a competent intercultural vision, on the other hand, the didactic incorporation of internationalization as an educational objective can be somewhat distant, making mobility only academic tourism, even if it has its learning value. It is necessary to take care not to see internationalization only from an organizational perspective, linked to economics and politics, but rather, it should be experienced from an educational perspective above all. The discussion is based on the view that the internationalization of higher education envisaged by Bologna concerns the teaching-learning activity, but clear measures are not being taken to indicate whether the educational core has been achieved.

According to Freire, behind education there is always an educational policy that leads it, establishing its objectives.20 Since its conception, The Bologna Process has been presented as a major supranational university educational policy. To this end, it implied changes driven by the EU to be adopted in member countries, through legal mechanisms granted by the Ministers of Education in each country. Based on the Freirean perspective, understanding the conjuncture that involves professional nursing education in the EU is a sine qua non condition for (re)knowing the political-educational dialectics of that formative context. Asking for whom and what, therefore against whom and against what, we make education and for whom and what, therefore, against whom and against what, we develop political activity, is part of Paulo Freire's legacy: questioning the world, dialoguing, understanding, reflecting and exercising praxis; what is fundamental in the face of the reality studied here.21^-22

Studies say that there is a lack of curricular foundations for students in academic mobility, and content should be offered that promotes learning of international conditions and relations, rather than simply focusing learning on the natural condition of 'exchange student', hoping that the experience alone will be sufficient. Few investigations have been carried out on the experience of internationalization with regard to learning content. Students express changes in their perceptions of other cultures through immersion, contact with another language and better understanding of nursing care in another reality, but there is no evidence of pedagogical intentions.23

Other obstacles mentioned in the studies concern the impositions of European directives, whose requirements confront the homogeneity of nursing education, but because it is a supranational legislative act, must be met. The fact that there are countries that have not yet adhered to the reform also causes obstacles, because without harmonization there are difficulties with comparability, hindering mobility. The low proficiency for the language of the host country was also cited as an significant barrier to mobility and internationalization.24^-25

Among the future challenges highlighted, there is a need to help European countries to progress with the harmonization of nursing education, taking into account different cultures, health needs of the European population, context and migration situation, promoting the highest level of studies, i.e., in the university environment. In addition, it is important to ensure an excellent level of PhD nurses, recruiting high-level candidates to carry out doctoral studies, so that they learn to investigate and promote scientific evidence that contributes to the development of nursing care. Furthermore, the teacher preparation for the development of the formation of the beginner researcher is relevant.26^-27

This main limitation of this study is the debate about a reality - the European - without theoretical and effective deepening with other initiatives carried out in the world, such as the ARCO-SUR developed in the Mercosur framework. Future studies that perform effective counterpoint are suggested, since it is from history and its paths that objectives and educational strategies appropriate to each situation and context are outlined.

CONCLUSION

Academic and professional mobility and internationalization are strategic goals in the EU political debate and clear contributions from the Bologna Process. Education proved to be a valid instrument for the construction of a common professional identity, therefore considered indispensable for the strengthening of the bloc, with regard to the production of knowledge.

The guidelines for the harmonization of university systems with a view to the premises of increasing Europe's competitiveness, serving the labor market and promoting internal and external mobility, lead nursing to a major change in its academic configuration and spectrum of action at the international level. The Diploma Supplement is a fundamental document that, through a system of transferable credits, equivalences and readable degrees in different countries, promoted scientific-cultural exchange through academic-professional mobility and intensified the dialogue between nations, which reverberate in social practices.

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NOTES

• ORIGIN OF THE ARTICLE

  Article extracted from the thesis - Nursing Training Post-Declaration of Bologna in Europe, presented to the Graduate Program in Nursing at the da Universidade Federal de Santa Catarina, in 2021.

• FUNDING INFORMATION

  This article was carried out with the support of the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) - Financing Code 001.

• APPROVAL OF ETHICS COMMITTEE IN RESEARCH

  Approved by the Ethics Committee in Research of the Universidade Federal de Santa Catarina, opinion no. 2,675,941, Certificate of Presentation for Ethical Appreciation 84512418.1.0000.0121.

Edited by

EDITORS

Associated Editors: Leticia de Lima Trindade, Monica Motta Lino. Editor-in-chief: Roberta Costa.

Publication Dates

• Publication in this collection
  22 June 2022
• Date of issue
  2022

History

• Received
  21 July 2021
• Accepted
  25 Feb 2022