Group practices for teaching the state of the art with multiprofessional residents in health

Abstract

OBJECTIVE

Describing the development of group practices with multiprofissional residents in health with a view to teaching the state of the art.

METHODS

Experience reports of the group practices World Café and Tree of Knowledge dynamics, the creative-sensitive method, for teaching the state of the the art, an essential stage in the construction of the end of course paper in the Multiprofessional Residency in Women's Health.

RESULTS

The activities are an important strategy for learning the stages of implementation of the state of the art. Furthermore, they favor a reflection on the extent of the application of the state of the art, including teaching, assistance, research, and extension.

CONCLUSIONS

The experience showed that group practices provide a dynamic moment of learning and strengthen the interactions among multiprofissional residents.

Keywords:
Methods; Qualitative research; Patient care team; Teaching; Creativity

Resumo

OBJETIVO

descrever o desenvolvimento de práticas grupais com residentes multiprofissionais em saúde para o ensino do estado da Arte.

MÉTODOS

Relato de experiência do uso das práticas grupais World Café e Árvore do conhecimento- Método criativo sensível, para o ensino do estado da arte, etapa fundamental para a construção do trabalho de conclusão de curso da Residência Multiprofissional em Saúde da Mulher.

RESULTADOS

as atividades destacam-se como uma importante estratégia de fixação das etapas de realização do estado do estado da arte. Além disso, favorece uma reflexão sobre a amplitude de aplicação do estado arte, incluindo o ensino, assistência, pesquisa e a extensão.

CONCLUSÕES

A experiência demonstrou que as práticas grupais proporcionam um momento dinâmico de aprendizado e fortalece as interações entre eles.

Palavras-chave:
Métodos; Pesquisa qualitativa; Equipe de atenção ao paciente; Ensino; Criatividade

Resumen

OBJETIVO

Describir el desarrollo de prácticas grupales con residentes multiprofesionales en salud con el objetivo de enseñar el estado del arte.

MÉTODOS

Relatos de experiencias del uso de prácticas grupales World Café y dinámica del árbol del conocimiento, el método creativo - sensible, para enseñar el estado del arte, etapa fundamental de la construcción del trabajo de finalización del curso en Residencia Multiprofesional em Salud de la Mujer.

RESULTADOS

Las actividades constituyen una estrategia importante para aprender las etapas de implementación del estado del arte. Además, favorecen una reflexión sobre el alcance de la aplicación del estado del arte, incluida la enseñanza, la assistência, la investigación y la extensión.

CONCLUSIONES

La experiencia demostró que las prácticas grupales brindan un momento dinámico de aprendizaje y fortalecen las interacciones entre los residentes multiprofesionales.

Palabras-clave:
Métodos; Investigación cualitativa; Grupo de atención al paciente; Enseñanza; Criatividad

Introduction

The multiprofessional residency in health was created by Law n° 11.129, from 2005, follow the principles and directives of the Unified Health System (SUS), considering local and regional necessities and contexts¹. This Lato Sensu post-graduation is characterized by teaching during service. The residents have practical, theoretical, and practical-theoretical classes, at the end of which they leave, as their scientific contribution, an end of course paper². The meetings of members of the residency take place through internal and field seminaries, sections with a preceptor, theoretical classes, and field activities, which build relationships and interactions among them³.

The State of the Art is an essential stage to build a scientific research. This type of research is bibliographic, since it aims to present what has already been discovered on a given theme without wasting time with any unnecessary investigations. It also helps improving and developing new studies⁴.

Since the students' educational process requires methodological changes, focused on active teaching-learning methodologies, the use of teaching-learning strategies is recommended⁵. Therefore, this study aims to describe the development of group practices, carried out with multiprofessional residents in women's health, to teach the State of the Art.

Methodology

This is an experience report regarding the use of the group practices World Café and Tree of Knowledge - the creative-sensitive method for the state of the art, which is an essential stage in building the end course paper for members of the Multiprofessional Women's Health Residency course from a teaching hospital at Rio de Janeiro.

The World Café is a good and simple process to gather people around important issues. It seeks, in a laid-back and good-natured environment, including snacks and a certain amount of irreverence and pressure, to jump-start the creativity of participants, leading to a structured and creative process of idea generation, based on the collaboration between individuals⁶. The groups are made up by a host and knowledge disseminators, who, as they gather around a table not different from a breakfast table, eat snacks as they discuss the trigger issue. In the right moment, the groups are replaced. Only the host stays in his place, since they will receive the other knowledge disseminators and present the records discussed earlier. The other participants, that is, the knowledge disseminators, expose the ideas generated in the first group to the other groups, building new knowledge. As soon as all groups have participated, the results are summarized and presented by the host.

The Creative-sensitive Method is an alternative for researches in health. The Knowledge Tree dynamic stands out in this method as an instrument that privileges group discussions through the metaphor of a tree and its three main components: root, trunk, and treetop⁷. The creativity and sensibility dynamic of the Knowledge Tree was performed, so that the path of the state of the art could be presented to the multiprofessional residents in women's health.

The first stage of this path corresponds to the root of the tree; the second, to the trunk; and the third, to the treetop.

Group practices were performed from 2016 to 2017. Considering that the class on the state of the art is given to classes in the first year of residency, two classes participated in this activity.

Results

The use of the World Café technique to reflect on the importance of the state of the art

The activity was carried out in the auditorium of the institution. Cakes and juices helped creating an informal environment and a large table was prepared to welcome 12 residents.

The residents were asked to form two groups, with six in each. The professional categories present in both groups were Nursing, Psychology, and Social Service. They answered to the following question: How important is the state of the art for researches, assistance, and teaching? Each group determined who would have the role of host, since this person would be making notes, and would stay there throughout the activity to receive the new group in the moment of exchange. The other five participants would be the knowledge disseminators and should change groups at the right moment.

For ten minutes, the residents would eat snacks while discussing and answering the questions in a cardboard sheet. After that, the group was replaced. Only the host remained from group one, to welcome the knowledge disseminators from group two. During the ten-minute stay of this new group, the host could hear the other disseminators, present the records left by the previous group, and encourage reflection and the growth of knowledge. After this round finished, since there were no other groups, the hosts presented the cardboard sheets in which the knowledge built with the disseminators had beem recorded.

For the residents, the state of the art increases knowledge, qualifies assistance by articulating current theories and practices, identifies gaps in knowledge, produces new knowledge, and integrates teaching, research, assistance, and extension. This dynamic could be developed with other types of group and could be used to discuss other types of content.

State of the art using the creative-sensitive research method - Tree of Knowledge

This group meeting also took place in the auditorium of the institution. Eight residents participated, representing the following categories: nursing, social services, and psychology. Initially, the group was guided regarding the creative-sensitive method, and about how the Tree of Knowledge, as built by the residents, would be a dynamic that would work in the discussion of the state of the art. Later, the person applying the dynamic would teach a class via direct instruction, aided by audiovisual resources. Finally, they would go back to the drawing of the tree, so they could potentially deconstruct and reconstruct their knowledge. After that, each resident would follow the steps to build the state of the art of their respective researches.

After the dynamic was presented, a cardboard sheet with the drawing of a tree was presented. It had the following question to trigger debate: what do I need to know to create the state of the art? The class had 25 minutes do discuss in which part of the tree (root, trunk, or treetop) the following words and their corresponding definitions should be placed: "State of the art", "Descriptors in health sciences", "Boolean operator", "Inclusion criteria", "Exclusion criteria", "Bibliographic research guiding question", "Databases", "AND", "OR", and "Virtual Health Library (BVS)". A box was on the table, containing pens, colored paper, the essential stages to perform the state of the art and their definitions, white glue, and adhesive tape.

After that, there was a class about how to carry out bibliographic surveys, where to find descriptors, how to use boolean operators, which databases to consult, and what are the possible criteria for article selection. Later, we went back to the drawing of the tree, to break it down and rebuild it. The activity ended with after the residents carried out the state of the art of their respective subjects.

Building knowledge as a group, in a dynamic, dialogic, and interactive way, led to the codification of the problem situation, and later, to the decoding and recoding of subjects. During the recoding, after the class, the residents found that defining what to search was the starting point for carrying out the state of the art. That meant having a guiding Question for the research and knowing the Virtual Health Library, and therefore, these words were placed in the root of the tree. In the trunk, the second stage in the state of the art, the terms placed were: Descriptors in health sciences, Boolean operator, Inclusion criteria, Exclusion criteria, AND, OR. The treetop, which represented the last stage of the process, would be the place for the articles, theses, etc., and also for the State of the Art itself, as shown in Image 1.

Image 1:
Tree of knowledge about the state of the art

Discussion

Using innovative strategies for traditional teaching methods brings about many challenges. When the audience of this study is considered, the efforts needed for the teaching process are not to be taken lightly, since these are health professionals from different fields.

The main difficulty of teaching institutions has been breaking apart ingrained structures and traditional teaching methods, to form health professionals whose competence allows them to recover the essential dimensions of care. Such a demand leads to a growing trend in the search for innovative methods, that allows for an ethical, critical, reflexive, and transformational practice, going beyond the limits of a purely technical training, to effectively form the students⁸.

Adopting group practices to teach the state of the art with multiprofessional residents makes the teaching process richer and easier. The exchange of ideas and the moments of discussion stimulate a critical and permanent acquisition of knowledge, since the content has been giving new meaning for the members of the group.

The World Café is a different technique, whose creative process aims to generate and encourage a dialogue between individuals, leading to a lively network of collaborative dialogue that accesses and takes advantage of the collective intelligence to answer important questions⁹. In the case discussed here, understanding that the state of the art is not merely a stage of scholarly work was in itself a satisfactory result, as was the promotion of a broader look at its function, the encouragement of the connection between theory and practice, and acquiring updated knowledge - all of which were abilities developed by the groups during the group practice.

Creativity and sensibility dynamics, such as the Tree of knowledge, encourage people to intrinsically participate by expressing feelings, such as affection, solidarity, emotion, understanding, and listening, when the themes being discussed are of common interest, and allow for collective construction. During group activities, participants have a chance of perceiving and listening to others. In addition, their senses are broadened, so they can go beyond what was previously believed to be truth¹⁰.

Therefore, the multiprofessional residents intensified their interaction, discussed the stages of the state of the art, and made decisions about in which part of the tree the content should be placed. Communication between the different categories was exercised to develop teamwork, aiming to encourage complementary and non-exclusive interpersonal relations and multiprofessional formations.

The innovative teaching-learning methods show a change from teaching to learning, eschewing the focus on the professor to focus on the students, who become co-responsible for their own learning. In addition, learning to learn and developing individual autonomy and communication skills are also valued by this method⁸.

Conclusions

The World Café technique is useful to generate ideas in the suggested context. In addition, applying the technique allowed for a dynamic moment of learning. An improvement in the amount of ideas was noticed, according to the perception of students. The tree of knowledge dynamic, in its turn, was an important strategy for making permanent the knowledge on the stages of the state of the art. The critical-sensitive method also offered the possibility of other expressions, such as affection, solidarity, understanding, and listening, during the collective and individual parts of the activity, since participants could expose their ideas, dialogue, and make decisions that will strengthen their interpersonal relations in their professional path.

Learning the essential stages of developing the state of the art, and understanding that it is not merely a requirement to build scientific research for the multiprofessional residency, since it can be reproduced in the Stricto Sensu post-graduation, were the qualities found in the use of group practices in teaching.

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Publication Dates

• Publication in this collection
  29 July 2019
• Date of issue
  2019

History

• Received
  12 July 2018
• Accepted
  16 Apr 2019