TRENDS OF KNOWLEDGE PRODUCTION IN HEALTH EDUCATION IN BRAZIL

Disponible en castellano/Disponível em língua portuguesa SciELO Brasil www.scielo.br/rlae 1 RN, MS in Environmental Sciences and Health, Professor University Salgado de Oliveira, Brazil, e-mail: carolvila@ibest.com.br; 2 RN, PhD in Nursing, Assistant Professor I da Goiás Catholic University, Brazil Artigo de Revisão Rev Latino-am Enfermagem 2007 novembro-dezembro; 15(6):1177-83 www.eerp.usp.br/rlae


TENDENCIAS DE LA PRODUCCIÓN DEL CONOCIMIENTO EN LA EDUCACIÓN EN LA SALUD EN BRASIL
Se trata de una revisión de literatura cuyo objetivo fue identificar el concepto de Educación en Salud utilizado por investigadores en la Salud Colectiva; presentar las principales tendencias y referenciales pedagógicos discutidos en estas investigaciones y ejemplificar estudios construidos con el objetivo de promover la educación en salud a través de estrategias con la participación de la comunidad.Tras la lectura y análisis de 22 artículos encontrados en el Scientific Eletronic Library Online que atendían a los temas orientadores del estudio, han sido construidas las siguientes categorías de análisis: Educación en Salud en Brasil-aspectos conceptos conceptuales, prácticas pedagógicas en educación y salud; educación en salud aplicada a la práctica profesional.La educación es un campo imprescindible al desarrollo de una sociedad y las prácticas educativas son marcos de aplicación de los saberes destinados al crecimiento social.Se nota la importancia de las propuestas educacionales basadas en la reflexión, en la crítica, en el involucramiento y concientización, y la importancia de implantar nuevos programas educativos que atiendan a toda la población.
DESCRIPTORES: educación en salud; salud pública; enfermería groups and on the environment as activities" (1) .It consists in the "art and science of preventing diseases and disabilities, prolonging life and promoting physical and mental health in the face of the community's organized efforts (2-3)   .In Brazil, this field of knowledge is based on health promotion and prevention, aiming at a better quality of life to the population.Thus, the period defined for the search is related to the date of the periodical's first publication in the electronic library until 2005.Articles with the following key words were selected: education in health, collective health, education and health and education in nursing.Initially, 160 scientific articles were surveyed, as described in Table 1.From this initial search, the following inclusion criteria were defined: studies related to education in Collective Health, pedagogical trends used by health professionals, studies that denote pedagogical practices in Education and Health.From the reading of abstracts of these articles, 75 were selected for analysis of the full version, resulting in the final selection of 22 articles, which were the references guiding this study, as described in Table 2.

Table 2 -Scientific Production on Education in
Collective Health selected for the study, in the Scientific Electronic Library Online database in the period between 1986-2005   Education in health is understood as a means to exchange information and to develop a critical view of health problems and not as a limited process of information transformation (4) ; it can be perceived as a social fact that involves subjective factors and aspects; it can be considered a social practice, because it is attitude, performance, experience, something that happens at each instant.
Education in health aims to elicit the involvement of the community in health programs, include public policies, promote conceptual transformations in the understanding of health, relate liberating proposals, committed to the development of solidarity and citizenship, towards actions whose essence is the improvement of quality of life.
Educating is characterized by the need of the educator to master scientific, technical, pedagogic, investigative, interdisciplinary and cultural knowledge (7) .Practicing education in health is practicing socialization, because it is something produced for the social, for an action focused on the human activity.
In the nursing context, practicing education in health is to provide the individual with conditions so that s(he) (her)himself seeks, exposes, questions, lives, experiments, creates, contributes, rescues, acquires his(er) place in society, reaches objectives and ideals and makes dreams come true.It is to acknowledge man as a subject responsible for his own reality (5) .This is not a very easy task because it requires dedication, perseverance and desire by the educator and of learner, but it certainly is a very pleasurable task.
Nursing must be seen as a social practice directed to the communitarian and human side; a tie that interconnects individual-society-healthenvironment.The nurse is closely linked to the practice and educative interventions because s(he) is increasingly prepared to develop his/her role as an educator.

PEDAGOGICAL PRACTICES IN EDUCATION AND HEALTH
Regarding educative practices in health, researchers report that they are a space of production and implementation of knowledge destined to human development and must favor the teaching-learning process through the adoption of pedagogical reference * final result obtained from the reading of the 75 articles' full texts and selection according to inclusion and exclusion criteria Articles that did not address education in health in terms of the Collective Health reference framework were excluded.From the reading of these articles, the bibliographic analysis categories regarding knowledge production on Education in health were built as a reference framework for Collective Health.These categories are: education in health in Brazil -conceptual aspects; pedagogical practices in education and health; education in health applied to professional practice.These are presented and discussed below.

EDUCATION IN HEALTH IN BRAZIL -CONCEPTUAL ASPECTS
From the critical review of the surveyed studies, it was evidenced that education in health is understood as a multifocused field to which several conceptions converge, both in education and health, which reflect different understandings of the world, the human being and society.It is an instrument that allows individuals to understand what happens in society, broadening their view of the world they are inserted in.By stimulating education and health, it is possible to transform, develop ideas, create means and support the growth and development of a society (4-6)   .frameworks that promotes the subjects' critical and participative reflection (6) .
Among the pedagogical practices discussed in literature, the traditional or conditioned pedagogy and the critical or renewed pedagogy (6) are highlighted.In the traditional or conditioned pedagogy, actions are focused on the teacher's knowledge.The teacher assumes the function of surveilling the students, correcting tests and teaching the subject.
The teacher is seen as the maximum authority in the classroom, the only one conducting the process.In this pedagogical practice, the learner receives the knowledge passively, becoming the depository of information provided by the educator.This practice is also denominated "banker education".Educating for filing what is deposited, that is, "it is assumed that the more one gets, the more one knows" (8) .
Critical or renewed pedagogy, also known as "problematization pedagogy and/or pedagogy of freedom", has its origins in the popular education movements that occurred in the 1950s.It defines education as an activity in which teachers and students are mediated by the reality they learn and from which they extract the learning content, reach a level of awareness of this reality, which allows for social transformation.Liberating education questions the reality of the human being's relations with nature and with others towards transformation (4,(9)(10)(11) .
Problematizing education works with the construction of knowledge from experiences, based on learning by discovery processes, as opposed to those of reception (12)   .From self-knowledge and selfreflection, the individual becomes more aware of his(er) responsibility and acts, which certainly facilitates learning (5) (13) is highlighted.This study aimed to recall the history of Londrina State It is perceived that this work involved discussions on principles, values and beliefs that guide the nurse's education to meet demands of the work and job market, without losing the capacity to criticize, reflect and act (14) .
Other studies also discuss curricular issues that involve education of health professionals, using This study will contribute to elucidate the concept of Education in Health, as well as to identify the reference framework used by these studies, which can contribute to the planning and implementation of educative programs able to actually attend to the community's needs.METHODFirst, scientific production on Education in Collective Health was surveyed in periodicals indexed in the Scientific Electronic Library Online (SciELO), which comprehends the selected collection of Brazilian scientific journals.Through this bibliographic search, it was evidenced that, among the journals indexed in the database, the following stood out in terms of publications on this theme: Journal of Public Health; Reports in Public Health and Latin American Journal of Nursing.These periodicals were selected because they are nationally and internationally relevant, with classification A, B and C international by the Qualis system -Periodicals, Annals and Journals classification.The Qualis system is the result of the classification process of vehicles used by graduate programs for the dissemination of their faculty and students' intellectual production.This system was created by the Coordination for the Improvement of Personnel of Superior Level (Capes) to meet specific graduate evaluation needs.The scientific periodicals fit in categories that indicate quality -A, B and C and circulation scope (international, national or local).
1972, until the current one, implemented in 2000.The author reports that the nursing curriculum of this institution went through five changes across its implementation, all of them due to quality improvements in teaching and health care delivered to the population.The current curriculum is highlighted in the article characterized as "Integrated Curriculum", based on the critical-social conception and on the problematizing pedagogy.The author emphasizes that the adoption of this pedagogical reference came to break with traditional teaching, based on the reproduction of concepts, and met the need to form a new nurse profile with a holistic and not fragmented view of the human being, capable of acting in the care, management, teaching and research areas.As a result of this integrated change process, a new pedagogic proposal is highlighted, based on the certainty that the student is the active subject in the knowledge construction process, in which the teacher's role is to conduct the teaching and learning processes by continuously challenging the student's rationale, by integrating new knowledge to previous experiences.

Table 1 -
Scientific Production on Education in