Analysis of physical therapy education in Brazil during the COVID-19 pandemic

Introduction: The COVID-19 pandemic brought the need for social distancing as a strategy to control the disease, prompting most countries to te.,mporarily suspend educational activities at all levels. Objective: To analyze the status of physical therapy education in Brazilian public and private institutions during the COVID-19 pandemic. Methods: A cross-sectional study with professors from physical therapy courses in Brazil. The study was conducted using an electronic form distributed via a social media application, containing questions on the characteristics of the professor, educational institution and work process. Associations were analyzed by the chi-squared test at 5% significance. Results: A total of 313 professors from 22 Brazilian states participated, with 62.94% from private institutions and 73.80% reporting that activities were conducted via emergency remote teaching (ERT). Among the professors who shifted to ERT, 63.20% did so with no prior planning and 28.13% had received no training for this this teaching format. An association was observed between the type of institution (public or private) and professors’ age (p < 0.001), sex (p < 0.001), teaching experience (p < 0.001) and adopting ERT (p < 0.001). Conclusion: In Brazil, the COVID-19 pandemic prompted most institutions to switch to ERT, more prevalent at private facilities, with no prior planning for the transition from in-person to remote teaching.


Introduction
In December 2019, the World Health Organization COVID-19 brought the need for social distancing as a strategy to flatten the pandemic curve, ensure sustainable health care and, primarily, reduce the disease incidence and mortality rates. [5][6][7] As a result, most countries temporarily suspended educational activities at all levels, affecting approximately 8.5 million higher education students in Brazil. 7 Following the enactment of a National Public Health  With respect to the students, 73.59% of the professors indicated that they were ac-cepting of remote teaching and 74.45% believed they were partially developing the expected skills. In terms of their own work process, 63.20% of the professors reported that they were unable to maintain the desired level of quality (Table 2).  based on democratic principles and shared decisions, which may explain their resistance to abruptly switching to ERT, given its impact on higher education. By contrast, most private institutions in Brazil are large educational conglomerates governed by market logic and the pursuit of profit, which may justify their decision to maintain teaching activities, in order to ensure the payment of tuition, limit dropout rates and prevent financial losses.

Discussion
Although MEC Ordinance 544/2020 12 clearly stipulates that practical activities and internships should follow course NCG, some institutions have not complied, further weakening the teaching-learning process during the pandemic. This demonstrates the need for discussion as well as better assessment and reassessment procedures for courses post-pandemic, in order to ensure that standards and recommendations aimed at quality education are strictly adhered to.
Replacing classroom-based activities with remote teaching has always been a cause for concern in healthcare education because of the unique and complex aspects involved in developing the essential knowledge, skills and attitudes to equip these professionals to meet the needs of the population in an ethical, competent and The fact that professors feel they are unable to maintain the desired level of quality seems to be a natural part of the transition they are currently experiencing.
These feelings may also be related to lack of experience, planning and familiarity with digital technology, as well as concerns inherent to teaching, such as recognizing that social inequalities directly impact student access and, consequently, the fair and equal provision of education. 26

Conclusion
The results indicate that in the first semester of 2020, most Brazilian higher education institutions implemented emergency remote teaching during the pandemic, which was more prevalent among private facilities. However, there was no planning period before tran-sitioning from classroom-based to online activities.
Although institutional decisions were largely not the result of joint discussions among all stakeholders, most participants felt that the HEI had adopted the best strategy, albeit to the detriment of skills development.
The transition from in-person teaching to ERT is a critical time when both students and professors have to reshape their practices and reconcile different activities, which may have contributed to the high number of participants who felt they were unable to maintain the desired level of quality.
This study is an important reference in that it portrays the status of physical therapy education during a unique global health crisis and provides a theoretical foundation to dis-cuss teaching in this field in Brazil, since no national studies were identified in the literature that describe the profile of graduate physiotherapy professors in the country.
However, it should be noted that the research method used (opinion poll) has certain limitations, such as the inability to obtain more detailed information on certain aspects when the identity of participants is unknown.
It is also important to underscore that, given the study objective, no specific questions were asked regarding the professors' work process.
As such, there is a need for primary studies that, in addition to describing the scenar-io of physical therapy education in the country, aim to analyze and understand the work pro-cess of professors in these programs.