DOCTORAL EDUCATION IN NURSING IN BRAZIL

O objetivo do trabalho foi apresentar a trajetória da educação do doutorado em Enfermagem no Brasil de 1981 a 2004. Estudo descritivo, analítico que utilizou dados documentados pela Coordenação de Aperfeiçoamento de Nível Superior (CAPES/MEC), órgão responsável pelo reconhecimento, avaliação e coordenação de estudos de pós-graduação no Brasil. A análise dos dados evidenciou que há treze cursos de doutorado em Enfermagem, com concentração na região sudeste (69,2%), e que o ensino e a produção científica tem sido influenciados pela transição demográfica, epidemiológica e pelos movimentos históricos, sociais e políticos. A produção do conhecimento está relacionada à assistência de Enfermagem, Gestão e Práticas de Saúde e Fundamentos Teóricos do Cuidar. O programa de Doutorado tem preparado líderes em educação, pesquisa e desenvolvimento de políticas públicas, em instituições de saúde e órgãos governamentais.


INTRODUCTION
Graduate education is a basic condition to grant a higher education institution the college character that turns it into a science and cultureproducing center.Besides constructing the framework for research development, graduate education plays a social role, and its performance depends on the mobilization of the academic community and integration between the Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES) and the National Council for Scientific and Technological Development (CNPq).
In this country, the National Graduate Education System (SNPG), approved by the Federal Education Council through a document frequently referred to as the Sucupira Decree, was established by the University Reform of 1968.Its expansion started in the 1990's and involved all knowledge areas, which looked for answers that would indicate the need to train qualified teaching staff to attend to the country's higher education demands, as well as to broaden colleges' research capacity.This would only be possible by training new researchers (1) .
The SNPG is coordinated by the Ministry of Education (MEC) through CAPES.This foundation supports the MEC in the formulation of graduate policies and in the coordination and stimulation to concede fellowships, grants and other mechanisms directed at human resource formation for higher education and teaching.
The SNPG is being implemented on the basis of five National Graduate Education Plans (PNPG) (2) .
The I PNPG (1975-1979)   (2) .In this sense, the SNPG evidences three In its search for quality, the Brazilian system has elected scientific production as one of the main evaluation parameters for Master's and Doctoral Graduate Education Programs.
In evaluating the quality of these programs  The key component of doctoral education is the annual evaluation.The scientific community participates in the construction of the evaluation process, conducted by peers.For this purpose, the nursing area has adopted the same assessment criteria as other health areas, such as medicine, dentistry, pharmacy, physiotherapy, occupational therapy, physical education and public health, favoring its visibility and scientific nature.This evaluation model has made Brazilian graduate programs consolidate their doctoral courses.However, some items still need greater study before being consolidated, in view of the particularities of nursing as a knowledge area (5) .

GRADUATE NURSING EDUCATION -EMPHASIS ON DOCTORAL FORMATION
In 2001, nursing leaders at CAPES and graduate program coordinators elaborated the agenda of nursing doctoral education (Table 1).This work consisted in organizing priority research lines, defined as follows: "the professional category must be understood as comprising the sociopolitical space of the profession and includes studies concerning theoretical, philosophical, historical and ethical fundamentals, as well as the technological production in the area.The clinical category refers to the objective reality that can be perceived, thought about and represented.Hence, the care given to human beings during the health and disease process is considered in this category.Finally, the organizational category is related to the nursing profession in the context of service management, health and education practices, and participation in public policies" (6)   .

Theoretical-Philosophical Foundations of Health and
Nursing Care, in the professional area (7) .
The most frequent theme areas were: This articulation represents a strong tendency in the efforts to find solutions to predominant health problems, whether these are current or future, global or, at least, multinational or international (8) , displaying nursing as a profession of global importance.This reveals the relevant role of international articulations to improve doctoral education in Brazil and other countries.
In Europe, some countries are only starting doctoral education in nursing, while others have already reached high educational and research levels.In Europe, the study area of Nursing doctoral education depends on each university's program; in Finland, for example, research is more directed at the clinical area, followed by education and, finally, administration (8) .
A comparison between nursing doctoral education in Brazil and in Europe and North America reveals that the produced knowledge is founded on similar factors, and that there is also a need for greater interlocution among different universities and researchers with a view to international networking.Moreover, in these regions, variables like population ageing, health priorities (analysis of morbidity, disability and death causes), social and economic factors and health sector organization constitute essential themes for research development (8) .In North America, countries like the United States and Canada promote the expansion of nursing knowledge by emphasizing individual, family and community care, instead of focusing on disease.Nursing knowledge in North America has rapidly expanded due to the increase in research funds available for doctoral students and graduated researchers.Contextual factors influencing knowledge development in doctoral programs include social, economic, political and demographic indicators, as well as the context of the health system itself (8) .
As a result of the guidelines established for doctoral education in Brazil, universities and nurse researchers attempt to collaborate with international universities and researchers on a more consolidated base, with a view to implementing multicenter research with a wider range of alternative methodologies, including trials.Another relevant aspect is research funding in Brazilian nursing, which is affected by the limited number of agencies and the large number of competitors for these grants.
Special attention should also be given to the impact factors of research.This parameter should be followed and measured by researchers; the produced knowledge should be evaluated, measuring whether this knowledge has contributed to professional practice; strategies should be defined that allow

FINAL CONSIDERATIONS
The education system, as one of the strategic points in Brazil's socioeconomic and cultural development process, has shown that nursing doctoral education provides an important contribution to the construction of social knowledge in health.In this perspective, many of the predominant current and future health problems will be global, or at least multinational or international (9) .

aspects: 1 -
adoption of evaluation criteria by the scientific and academic community, under the coordination of CAPES; 2-expansion of research development funding by CAPES, CNPq and State Foundations; 3-permanent participation of scientific community in the evaluation and reevaluation process of Brazilian graduate education.
Women's Health, Nursing and Health Management, Collective Health and Child Health, among others.This predominance may be due to the fact that the first research lines, adopted in graduate programs created in the 1970's, referred to Women's Health, Child Health, Collective Health / Public Health and Administration / Management.The large number of studies on women's health and service management reveals that, in Brazil, women's health is one of the main social and political challenges.In terms of research lines and methods, study or research type, most studies were either exploratory with a qualitative approach or studies that sought knowledge about reality or understanding of social phenomena, indicating a paradigm change in the nursing knowledge construction process, which evidences a tendency towards qualitative studies.In this sense, phenomenological-hermeneutical, ethnographic, historic and social studies, among others, revealed possibilities to obtain a deeper knowledge or understanding about the social phenomena that permeate nursing practice.The use of different methods and theoretical approaches has required contents and theoretical foundations from other areas, offering a wider chance of knowledge construction and professional improvement from a scientific and cultural point of view.Our analysis has clearly shown an increase in the number of courses and doctoral graduates.Moreover, communication vehicles are allowing for a more intense and agile information exchange among researchers, favoring the development of research and Nursing itself.The scientific production originated by the theses considered here indicates the legitimacy of the research lines defined by the nursing area at CAPES in terms of range, making it possible to accompany nursing research tendencies as well as their consolidation and consistency.The consolidation of nursing research lines and joint research initiatives in partnership with research groups from different regions in Brazil as well as abroad offers possibilities to identify research priorities and produce less fragmented knowledge.These factors favor greater articulation and integration in multidisciplinary knowledge.The range of subjects from diverse areas involved in interdisciplinary training and the above mentioned partnerships point towards a tendency aimed at improving nursing education.On the other hand, the increase in nursing knowledge all over the world has contributed to improve doctoral education, influencing both doctoral education programs (research development) and professional practice.With a view to achieving excellence, doctoral teaching staff has been mobilizedto exchange knowledge with international researchers, whether through postdoctoral courses or collaborative research, closing inter-institutional agreements or presenting research at international congresses, with a view to promoting advances in teaching models.
This indicates the possibility of establishing a collaborative network among different European universities, through the European Academy of Nursing and the Nordic Academy for Advanced Study.
organizations to implant research results and establish consortia among universities, researchers and nursing professionals.These and other issues are essential for the consolidation of Brazilian nursing research, in view of the results presented by Erdmann et al. (2005).
Both the number of doctoral graduates and scientific production have experienced a steep growth, although studies on interventions in professional practice and technological development are still limited.The greatest challenge ahead is the need for nurses to develop experimental research, containing proposals to change health practices.Studies demonstrate a rising tendency in this sense, but also point towards the need for researchers to carry out interventionist studies directed at professional practice.The most used strategies are the preparation of students within the interventionist research line and articulations with national and international researchers, through 'sandwich' and postdoctoral programs.Current programs already offer instruments for this new education mode, aimed at expanding this area.Thus, there is an urgent need to understand individual differences between researchers, as well as the context of universities and the organization of Brazilian agencies and culture, with a view to making nursing doctoral education into a feasible challenge in the preparation of new generations of nursing leaderships.

Table 1 -
Description of Research Lines in Graduate Nursing Programs /CAPES -Florianópolis, 2001