COMPETENCIES OF HEALTH PROFESSIONALS TO IDENTIFY CHRONIC CONDITIONS IN THE TERRITORY: IMPACT ASSESSMENTABSTRACT
Objective: To evaluate the impact on the work process of healthcare professionals who graduated from the Specialization Course in Care for People with Chronic Non-Communicable Diseases, regarding their competence in identifying and contextualizing chronic conditions within the territory.
Method: Ex-post facto Course Impact Assessment. The analysis is based on the Experiential Learning Cycle, with an emphasis on the Concrete Experience dimension. The research followed the guidelines of Consolidated Criteria for Reporting Qualitative Research and was conducted from May 2023 to June 2024, with semi-structured interviews of 41 graduate professionals, after approval by the Ethics Committee. Thirty-one codes, four subcategories, and a central axis of analysis emerged.
Results: In light of the Experiential Learning Theory, the following subcategories stand out: Participation and Initial Impact, Materials and Methods, Interaction and Support, and Initial Challenges. The results indicate that concrete experience was fundamental for the development of skills in identifying and contextualizing chronic conditions in the territory.
Conclusion: The study highlights the importance of Concrete Experience in developing skills for managing chronic conditions and the need to integrate experiential learning theory into the training of healthcare professionals to improve the quality of care. Future studies could explore other stages of Kolb's Theory and conduct longitudinal investigations to assess its long-term impact.
DESCRIPTORS:
Professional competence; Health care; Continuing education; Non-communicable diseases; Chronic diseases
RESUMO
Objetivo: avaliar o impacto gerado no processo de trabalho dos profissionais da saúde egressos do Curso de Especialização em Atenção às Pessoas com Doenças Crônicas Não-Transmissíveis, no que tange a competência de identificar e contextualizar as condições crônicas no território.
Método: avaliação do impacto do tipo ex-post facto do Curso. A análise é fundamentada no Ciclo de Aprendizagem Experiencial, com ênfase na dimensão Experiência Concreta. A pesquisa seguiu as diretrizes do Consolidated Criteria for Reporting Qualitative Research e foi realizada de maio de 2023 a junho de 2024, com entrevistas semi-estruturadas de 41 profissionais egressos, após a aprovação no Comitê de Ética. Emergiram 31 códigos, 04 subcategorias e um eixo central de análise.
Resultados: à luz da Teoria da Aprendizagem Experiencial, destacam-se as subcategorias: Participação e Impacto Inicial, Material e Métodos, Interação e Suporte e, Desafios Iniciais. Os resultados indicam que a experiência concreta, foi fundamental para o desenvolvimento das competências de identificação e contextualização das condições crônicas no território.
Conclusão: o estudo destaca a importância da Experiência Concreta na formação de competências para o manejo de condições crônicas e a necessidade de integrar a Teoria da Aprendizagem Experiencial na formação de profissionais de saúde para melhorar a qualidade do atendimento. Futuros estudos poderiam explorar outros estágios da Teoria de Kolb e realizar investigações longitudinais para avaliar o impacto a longo prazo.
DESCRITORES:
Competência profissional; Atenção à saúde; Educação continuada; Doenças não transmissíveis; Doenças crônicas
RESUMEN
Objetivo: Evaluar el impacto en el proceso laboral de los profesionales sanitarios graduados del Curso de Especialización en Atención a Personas con Enfermedades Crónicas No Transmisibles, en lo que respecta a su competencia para identificar y contextualizar las enfermedades crónicas dentro de la comunidad.
Método: Evaluación de impacto del tipo ex post facto del Curso. El análisis se basa en el Ciclo de Aprendizaje Experiencial, con énfasis en la dimensión de la Experiencia Concreta. La investigación siguió las directrices de Consolidated Criteria for Reporting Qualitative Research y se llevó a cabo entre mayo de 2023 y junio de 2024, mediante entrevistas semiestructuradas a 41 profesionales recién graduados, tras la aprobación del Comité de Ética. Surgieron 31 códigos, 04 subcategorías y un eje central de análisis.
Resultados: A la luz de la Teoría del Aprendizaje Experiencial, destacan las siguientes subcategorías: Participación e impacto inicial, Materiales y Métodos, Interacción y apoyo, y Desafíos Iniciales. Los resultados indican que la experiencia concreta fue fundamental para el desarrollo de habilidades en la identificación y contextualización de las afecciones crónicas en el territorio.
Conclusión: El estudio subraya la importancia de la Experiencia Concreta para desarrollar habilidades en el manejo de enfermedades crónicas y la necesidad de integrar la Teoría del Aprendizaje Experiencial en la formación de los profesionales de la salud para mejorar la calidad de la atención. Futuros estudios podrían explorar otras etapas de la Teoría de Kolb y realizar investigaciones longitudinales para evaluar su impacto a largo plazo.
DESCRIPTORES:
Competencia profesional; Atención de salud; Educación continua; Enfermedades no transmisibles; Enfermedades crónicas
INTRODUCTION
Globally, it is estimated that Non-Communicable Chronic Diseases (NCCDs) account for 41 million deaths annually, representing 70% of all deaths. In Brazil, the burden of NCCDs is similarly high, accounting for 76% of deaths. NCCDs overburden health systems and have serious consequences for individuals, families, and communities. This scenario increases costs for both public health systems and society, impacting the development of countries. Despite the seriousness of the situation, there is a clear gap in the training of healthcare professionals, since less than 15% of undergraduate programs address topics such as aging and geriatric health, areas directly related to the population most affected by NCCDs, which is the older population1-2.
Several initiatives in Brazil and around the world have been proposed for the prevention and control of NCCDs. The document “World Health Statistics 2024: Monitoring Health for the SDGs, Sustainable Development Goals” highlights the need to transform reactive systems into proactive ones, focused on keeping people healthier3. The “Strategic Action Plan for Addressing NCCDs and NCDs in Brazil 2021-2030” states that, for health promotion, it is necessary to develop and implement Continuing Health Education (CHE) initiatives4. Furthermore, the United Nations (UN) included goals for reducing NCCDs and their risk factors by 2030 in the Sustainable Development Goals (SDGs)5.
In this context, the Universidade Federal de Santa Catarina offered the “Specialization Course in Care for People with Chronic Non-Communicable Diseases,” with the objective of qualifying managers and professionals in Primary Health Care (PHC) to promote care for people with NCCDs, such as diabetes, hypertension, and obesity, in addition to addressing their risk factors, such as inadequate diet, smoking, and physical inactivity. This initiative was an interdisciplinary and multi-institutional demand, driven by the CNPq/MS/SAPS/DEPROS Call for Proposals No. 28/2020 and aligned with the UN Sustainable Development Goals5.
Developed collaboratively, the course aimed to foster the professional and interprofessional, strategic, and innovative skills of healthcare professionals in the areas of health promotion within the territory and in the prevention and care (pharmacological and non-pharmacological) of NCCDs, based on the identification of their determinants, situational analysis within the community, and guided by protocols, guidelines, and other instruments recommended by the Ministry of Health (MS), such as the “Strategic Action Plan for Addressing Chronic Diseases and Non-Communicable Diseases in Brazil 2021-2030”4, the “Indicators Notebook of the NCDs Plan 2021-2030”6 and the document “Language matters! Language update for diabetes, obesity, and other chronic health conditions”7.
A total of 337 students graduated from the Specialization program, in the Distance Learning (EaD) modality, with in-person meetings and the development of a Course Completion Work (TCC) in the form of an Intervention Project (PI). With a workload of 360 hours, the course combined asynchronous content through the Virtual Learning Environment (VLE), synchronous distance learning classes, and face-to-face meetings in six centers in the State of Santa Catarina (Blumenau, Chapecó, Criciúma, Florianópolis, Joinville, and Lages).
The NCCDs, such as diabetes, hypertension, and obesity, are currently one of the biggest challenges for global public health. These conditions have a high prevalence and a significant impact on individuals' quality of life, requiring continuous and effective management. The complexity of the care required for these conditions highlights the importance of healthcare professionals staying up-to-date to provide patient-centered care tailored to the specific needs of the territory in which they work6-7.
In the meantime, it becomes essential for health systems to orient their care models, integrating prevention, treatment, and rehabilitation in a sustainable and continuous manner8-9. Thus, this study aims to investigate: How does the Specialization Course in Care for People with Chronic Non-Communicable Diseases impact the work process of health professionals, specifically in the competence of identifying and contextualizing chronic conditions within the territory?
The objective is to evaluate the impact on the work process of healthcare professionals who got the “Graduate certificate on Care for People with Chronic Non-Communicable Diseases,” regarding their competence in identifying and contextualizing chronic conditions within their territory.
METHOD
Impact assessment research, with a qualitative approach, which investigates the effects of an intervention after its implementation, without directly manipulating the variables10. The qualitative approach to impact assessment does not rely on counterfactual evidence to arrive at causal inferences. Instead, the aim is to establish a causal relationship between the actions of the Course and changes in the participants’ behaviors, attitudes, or actions11. In this study, the ex-post facto type of evaluation is adopted, which aims to reconstruct the elements necessary to estimate the impact through document analysis and interviews with those involved in the process12.
The theoretical and methodological framework adopted in this study was Kolb’s Experiential Learning Theory (ELT)13, which involves four stages in the cyclical learning process: Concrete Experience, Reflective Observation, Abstract Conceptualization, Active Experimentation. For the present study, the analysis focused on the Concrete Experience (CE) dimension. This dimension involves actions such as identifying, contextualizing, recognizing, diagnosing, mapping, describing, detecting gaps, and characterizing chronic conditions in the territory. Therefore, it is understood that ELT allows the training of critical professionals, capable of fully understanding the determinants of health and developing contextualized and territorially adapted care practices.
The design and presentation of this research were guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines14. During the preparation of this article, no artificial intelligence was used in the methodology stage, nor in the collection or analysis of primary data, which were conducted entirely by the researchers. The course was held from May 2022 to July 2023. From a universe of 337 graduating professionals, 41 participated in the semi-structured interview (12%), where theoretical saturation was achieved. The sample was intentional and non-probabilistic, ensuring the necessary representativeness for an in-depth analysis of the skills developed. The inclusion criterion was having completed the course.
Data collection took place from June to September 2023 and included sending invitations in advance, scheduling and conducting online interviews with a semi-structured script, as well as transcription and validation. Each interview lasted an average of 40 minutes, was conducted by a trained researcher - a doctoral student, with this material coming from his dissertation, and who was involved with the dynamics of the course. The 206 pages of material were manually analyzed between June 2023 and June 2024 using content analysis15. Thirty-one codes emerged, resulting in four subcategories and a central axis of analysis: the CE dimension.
All participants were informed about the objectives, risks, and benefits, and gave their consent to participate in the research. The study received approval from the Ethics Committee and complies with Resolutions No. 466/2012 and 510/2016 of the National Research Ethics Committee. The information collected was stored securely and anonymized, and participation was voluntary, with the option to withdraw until the publication of the findings. To preserve the participants’ identities, pseudonyms were adopted according to profession and sequential number, such as P1 (Psychologist 1).
RESULTS
The analysis revealed that CE was fundamental in developing the competence to identify and contextualize chronic conditions in the territory, involving actions such as: identifying, contextualizing, recognizing, diagnosing, mapping, describing, detecting gaps, and characterizing chronic conditions in the territory. Participants were encouraged to revisit their experiences in the course, providing reflections on the development of skills to identify and contextualize chronic conditions in the territory. Thus, 31 codes emerged, which supported four subcategories: (i) Participation and Initial Impact, (ii) Material and Methods, (iii) Interaction and Support, and (iv) Initial Challenges (Chart 1).
Participation and initial impact
Participation in the course was perceived as a transformative experience, with professionals highlighting the active methodology and the clarity of the material. The reports underscored the immediate impact on clinical practice, with participants emphasizing their satisfaction in learning and applying new knowledge in a simple and directly applicable way in their daily professional lives.
My experience with the course was really great. It is an active methodology. [...] You need to study, do your homework. [...] I was happy I was able to dedicate myself, learn, and put it into practice! (E11) I found the material, the text, very clear, with simple language that everyone can understand and that we can actually use in our daily lives (E15).
The first module, with its interactive smoking map, was highlighted as fundamental, allowing professionals to visualize the health reality of the territory in an organized way. Despite the initial challenges of balancing the course with professional responsibilities, participants quickly recognized the value of the skills acquired, experiencing a learning CE directly connected to their work reality.
That first module, which I found super interesting and fundamental to part of my research on smoking, was an interactive map that allowed me to visualize the number of smokers related to consultations in a specific area. So, for me, it was very beneficial (E14). Initially, it was challenging to balance the course with my work responsibilities, but I soon realized the importance of the skills I was acquiring (S2).
Participants highlighted the positive experience, emphasizing how the live sessions and forum discussions enriched their practical knowledge. The course was evaluated as beneficial and well-organized, redirecting the search for qualified information on non-communicable chronic diseases, directly impacting professional experiences and actions.
Lots of positive things. [...] The live sessions and forum discussions enriched my knowledge and practice (P1). For me, the course was very beneficial, very well organized, and provided a lot of knowledge that we can apply in practice (E13). In the world of chronic non-communicable diseases, there is a lot of information in many places. The course redirected me to where I can find this information and with greater quality, thus impacting our experiences and our actions (E22).
The motivation for participating in the course varied among the professionals, but many highlighted the need to improve specific skills, perceiving it as an essential opportunity for continuing education. Professionals recognized it as a “game-changer,” fundamental for understanding the possibilities of working in primary care and maintaining a continuous process of learning.
My main motivation for participating in the course was the need to improve my skills in managing chronic conditions, something essential for my professional practice (Fi2). I saw it as an excellent opportunity to improve my knowledge in this area, especially because those of us in healthcare can never stop improving; we have to be in a continuous process of learning. Taking the course was a turning point, because I saw how much we can do for people with chronic diseases from the perspective of primary care (E23).
Early in the course, diaries and forums proved to be a valuable component, as evidenced by one participant: The interaction and study spaces were an excellent opportunity to practice specific skills and discuss real cases with colleagues and tutors (Ed1). This feedback illustrates the importance of practical activities and interaction with other professionals for the development of skills.
Healthcare professionals actively participated in the course, highlighting the importance of discussion forums for understanding the realities of different territories and identifying common problems. So, for me, forums are interesting because you get to know everyone's reality. And then, you can identify that your problem is common to everyone (E16).
MATERIALS AND METHODS
Participants rated the course as comprehensive and up-to-date. They underscored that the teaching material was of high quality, with accessible language applicable to clinical practice, encouraging the search for more information.
The course content was comprehensive and up-to-date, covering all important aspects of caring for patients with chronic conditions (E7). The material was clear, with simple language that everyone can understand and use in their daily lives (E19). It was very enlightening, because if you read the material on Moodle and watched the live stream, you understood it perfectly (Fi2).
The teaching material was of high quality, well-structured, and directly applicable to clinical practice (E16). The material available on the platform was very rich, with links and references that encouraged the search for more information (E17).
The diaries were recognized as a fundamental tool for bringing municipal reality to light, allowing for reflection on existing practices and possibilities for improvement. The course went beyond theoretical knowledge, enabling participants to apply that knowledge to the concrete context of their professional experiences.
Diaries are tools that help us bring the reality of the municipality closer, making us reflect on what we already practice and what can even be improved (Fi3).
Case studies and diaries were highlighted as important elements for learning, allowing participants to describe their reality and experiences. These activities enabled the effective application of theoretical knowledge, which is important for developing skills in identifying and contextualizing chronic conditions in the territory.
The diaries, the clinical cases there, describing my reality, what I experience, it was all worthwhile (E13).
The teaching methods, including discussion forums and integration sessions, were positively evaluated by the participants. However, there were some specific criticisms regarding the lack of detail about medications in diabetes care guidelines. This approach provided an opportunity for a critical analysis contextualized to the reality of primary care and specialized attention.
I think the method was very valid (E19).
I personally really liked the methodology used (E8).
I noticed something was missing - in the content about diabetes care pathways - where are the medications? Where is the section on medications? And I don't just want basic care medication, I want specialized component medication too! [...] If it's a line of care, the municipality needs to know, the professional needs to know that this medication exists and how to access it! The user needs to know about this medication (Fa2).
The course was considered important for professional development, with varied and comprehensive teaching resources. The materials, including books with research links, asynchronous content on VLE, synchronous sessions, assessment and reflection activities in diaries and forums, and feedback, were designed to promote the development of practical and theoretical skills.
It was important to have up-to-date information. (M1). It was very well done, from the PDFs and the topics, to the diaries and clinical cases that describe my reality, what I experience. It was all valuable and useful; the materials were very good. You could see that there were dedicated professionals behind it, concerned with providing quality materials (Ed1).
PDF files were highly valued, and live sessions provided rich interactions with tutors, similar to a traditional classroom. The recorded classes offered flexibility for review and adaptation to different learning paces, making it easier to reconcile schedules and enhance knowledge.
I printed all the PDFs and I'm going to have them bound because I want to keep them for myself (E14). The live sessions allowed for rich interactions with tutors and other participants, which was essential for learning (E13). It was very similar to a classroom, with interaction with tutors, lectures, videos, and live sessions (Fa3). The recorded classes were a valuable resource, allowing me to review the content as needed (E23).
The IPs were highlighted as a distinguishing feature of the course, allowing for the practical application of acquired knowledge. The participants, as in the example of the creation of a group for people with hypertension and diabetes, were able to consolidate skills and demonstrate the relevance of the learning in the real-world context of chronic health conditions.
I am developing my IP [...] I created a group for people with hypertension and diabetes - my project was initially focused on people with diabetes, but it ended up encompassing both - and I've already started, I've had two meetings with them, using an approach I learned in the course (E11).
Interaction and support
Graduates express a positive view of the interaction with colleagues from different regions and professional areas, through forums and synchronous meetings. The exchange of experiences among professionals from different backgrounds allowed for a broader and more enriching understanding, which was essential for contextualizing chronic conditions in the territory and identifying common problems.
You read what other people write. Each person has a different reality from ours. [...] A dentist, which is a different field from mine, or a doctor, or a nurse. These are completely different areas; I learned a lot from what they posted on the forum, from the way they handled things. So, this exchange of experiences between one health unit and another, I thought it was really cool. I learned a lot. Group sessions and forum discussions were fundamental for contextualizing chronic conditions in the territory and for identifying common problems (Fa3).
Group sessions and forum discussions were fundamental to collaborative learning, facilitating the exchange of experiences and the deepening of knowledge. These spaces allowed for the clarification of doubts and the development of interprofessional skills in identification and contextualization, promoting a broader understanding of health conditions.
The group sessions facilitated collaborative learning and the exchange of experiences (Fi3).
The forum discussions were an excellent platform for clarifying doubts and enhancing knowledge (E9).
Tutoring in distance learning courses has proven essential in creating a welcoming and supportive environment, facilitating the learning process and making participants feel truly supported.
Positive [...] When we talk about a distance learning course that has this level of involvement of the tutors. It's precisely to make things easier [...] The person on the other side of the screen feels truly embraced (E10).
The tutors' support was characterized by its availability and efficiency, allowing participants to resolve doubts and develop skills. Contrary to initial expectations, the tutors proved to be proactive, providing assistance in the chats, closely monitoring the activities, and creating a supportive environment. This approach mitigated difficulties and deepened the professionals’ understanding, facilitating their study routine and the performance of their tasks.
All the teachers I needed to message received a very quick response, because you get a little apprehensive about having to do it on the platform; it seems like if it’s not through WhatsApp the person won't respond, but no, it was in a timely manner, I liked it a lot (Fi3).
I think we have a lot of support in the chats. The tutors ended up calling you, talking to you, and providing assistance. I found that quite interesting, because it's not just one thing scattered around. There was someone asking if you needed any help with the activities or genuinely offering their assistance. I thought it was really cool, very different (N2).
Initial challenges
Participants faced initial challenges in the contextualized application of knowledge, especially in the IP and group work. They reflected that adversity also presented opportunities for meaningful learning.
It’s a project that can be implemented. We have a reduced team, so we have a lot of work to do [...] but it's a project that can easily be conceived, studied, and implemented here at the Health Unit (Fa3).
The results indicate that the diversity and quality of teaching materials, combined with interactive teaching methods and continuous support from tutors, were fundamental to the development of the health professionals' skills. The clarity and applicability of the content, along with the reflection promoted in the discussion forums, contributed to the training and dynamism capable of improving professional practice and the quality of care for patients with chronic conditions. This challenge helped professionals adapt and apply their knowledge effectively. This account highlights the importance of teamwork and collaboration for successful learning.
Applying knowledge in a contextualized way within the work environment was challenging, but very rewarding (Fa2).
This multi-professional exchange is very important. Those of us who come from residency programs see how important this is. It's wonderful! We no longer have just the perspective of a pharmacist or a nurse. We see the patient and immediately think: “Wow, I think a physiotherapist would be helpful,” or “Ah, I think we could do an oral assessment,” and that's when we start evaluating the patient as a whole. We don't just see our profession anymore, we don't live only in our bubble anymore. We begin to broaden our perspective. It is very good (Fa4).
Initial challenges also included adapting to the distance learning format and integrating the course with the work routine.
It was quite challenging because we had to balance work and studies. Sometimes it got really tight (S2).
The main difficulties encountered were related to internet access and time management to attend live classes. These challenges highlight the need for adequate infrastructure and time management for successful distance learning.
If we decide to take a course, we have to have time for it (E24).
I wish I'd had more time to dedicate to it, to read more. So, for some modules we kind of did a summary (S2).
I had a little difficulty with the platform (E7).
The virtual learning environment was found to be well-structured, offering resources and tools suitable for the educational process. However, participants highlighted a significant gap: the limitation of face-to-face interaction. The reports emphasized the need to balance virtual and in-person learning modalities, recognizing that while the digital environment offers flexibility and reach, face-to-face interaction has a unique and enriching value for the learning process.
If it were an in-person format, I think the exchange - even though we exchanged ideas in the forums and read some of our colleagues' comments - would be much richer (E11).
Continuous professional development was essential to update practices and improve the quality of patient care. This continuous updating ensured that professionals were always up-to-date with best practices.
Look, for me, it was good, it was a good experience, it was important for improvement (M1).
This activity allowed professionals to offer more contextualized and appropriate care to the specific needs of their communities.
Mapping the territory was a fundamental activity for understanding the particularities of each region and adapting care practices. Studying about Brusque, Santa Catarina [...] It was really cool, it was priceless (E6).
DISCUSSION
Participation in the course had a transformative impact for many professionals. Concrete Experience, as described in Kolb’s ELT, emphasizes that learning occurs through involvement and experience in an activity. Kolb’s Experiential Learning Cycle is essential for the internalization of knowledge, as it allows individuals to transform CEs into meaningful learning through reflection and practical application13. Integrating CE into educational programs can significantly increase the ability of healthcare professionals to apply theoretical knowledge in practical contexts16. This was reflected in the reports from the study participants, who indicated the immediate application of the acquired knowledge in clinical practice.
Course graduates frequently mentioned that participation provided a deeper understanding of the needs of people with chronic conditions. Direct experience with real clinical cases facilitates the acquisition of critical clinical skills17. Through practical and interactive activities, professionals were able to experiment and reflect on their actions, which is central to the Kolb Cycle.
The perception of immediate impact is a key aspect of the effectiveness of health education programs; programs that allow for the immediate application of new knowledge and skills tend to have higher success rates in changing clinical practices18. This is corroborated by reports from course participants, who felt an immediate improvement in the quality of care provided to patients with chronic conditions.
The training and continuous development of healthcare workers are fundamental to the sustainability and effectiveness of the Brazilian Public Health System (SUS). The National Policy for Continuing Education in Health (PNEPS), established by Ordinance GM/MS No. 198/2004, promotes a pedagogical model that integrates teaching, service, instruction, and health19. This model is essential for professional development, sector management, and social control, as evidenced by the Specialization Course at the Universidade Federal de Santa Catarina. Focused on addressing NCCDs, the course provides healthcare professionals with the necessary tools to face challenges such as diabetes, hypertension, and obesity. The participants' motivation to improve their skills highlights the importance of continuous professional development.
The interdisciplinary and multi-institutional nature of the course, aligned with the UN SDGs, reinforces CHE as a participatory and transformative management strategy5. Thus, CHE meets the needs of the population and promotes a meaningful learning environment, guiding professional development and changes in health practices, consolidating the “training quadrilateral” that involves educational institutions, workers, managers, and users19.
Workshops and practical sessions were mentioned as valuable components of the course. Practical activities such as workshops are essential for consolidating theoretical knowledge, as they allow participants to apply what they have learned in a controlled environment before transferring it to clinical practice20.
The development of practical skills was one of the main benefits mentioned by the participants. Recent literature emphasizes that the quality of teaching materials and teaching methodology are fundamental to the effectiveness of experiential learning. Experiential learning is an effective pedagogical approach that promotes active learning by offering hands-on experiences, allowing students to interact with and critically analyze course content and become deeply involved with the subject matter21. The use of innovative teaching methods, such as case studies and practical simulations, is effective in developing skills in clinical settings22. Course participants confirmed that the teaching methods used were innovative and facilitated the understanding and application of the concepts.
The integration of educational technologies, such as virtual learning platforms, has been identified as a key element in facilitating experiential learning. The use of virtual learning environments not only increases student engagement but also offers flexible access to a wide range of educational resources, enriching the learning experience23. Participants in this study reported that the provided PDFs and recorded lectures were valuable resources for reviewing and consolidating the learned content.
Intervention projects were an important part of the course, allowing for the practical application of acquired knowledge. Practical projects and interventions are effective for testing and implementing new skills in a real-world context, promoting deeper and more sustained learning24.
According to the participants, interaction with colleagues and tutors was a critical aspect for the success of the course. The ELT suggests that learning should be enhanced through social interaction and constructive feedback. Collaborative learning improves the retention of knowledge and skills. Group learning allows participants to share experiences, discuss common challenges, and learn from each other, creating a supportive environment that facilitates learning25. The participants in this study valued forum discussions and group sessions as opportunities to deepen their knowledge and reflect on their practices.
Feedback related to tutor performance was recognized as constructive and guiding, playing an essential role in the experiential learning cycle by offering students insights into their performance and areas for improvement. The support provided by the tutors throughout the course was consistently described as available and efficient, which is an important factor in the success of distance education programs. The active presence of tutors and their promptness in answering students' questions not only increase satisfaction but also enhance the effectiveness of the learning process26.
The initial challenges reported by participants, such as adapting to the distance learning format and integrating the course with their work routine, are common in distance education programs. Flexibility and the availability of support resources are essential to overcoming these challenges. The literature suggests that adapting to new teaching methods and effective time management are critical skills for success in distance learning environments27. The ability to manage time efficiently and adapt to new teaching methods is a fundamental skill for professionals participating in continuing education programs and working with topics relevant to the context of public health, such as chronic conditions28.
Furthermore, continuous professional development was mentioned as an activity to improve clinical practice. Continuing education and regular knowledge updates are essential for evidence-based practice and maintenance of high standards of patient care29. Mapping the territory, a fundamental activity of the course, allowed professionals to better understand the particularities of each region and adapt their care practices. Understanding the local context is essential for the effective implementation of health interventions, ensuring that care strategies are tailored to the specific needs of the communities served30.
The results indicate that CE played a key role in developing skills to identify and contextualize chronic conditions in the territory. The practical application of the knowledge acquired in the course resulted in significant improvements in professional practice and in the quality of care provided to patients with chronic conditions. The integration of ELT into the training of healthcare professionals has shown promise for the effectiveness of training and the improvement of healthcare services.
Ex-post facto impact research may present limitations related to the participants' memory. Although this bias exists, this study sought to collect data at the end of the course.
The study's findings are consistent with recent literature, which emphasizes the importance of experiential learning and the use of innovative teaching methods for developing professional skills. Future studies could explore other stages of Kolb's Theory and conduct longitudinal investigations to assess the long-term impact of the skills developed in the course. Moreover, they could expand the application of Kolb's Theory, with subsequent impact assessment for other specialization courses in other regions and for a wider range of professionals.
Despite its limitations, the study provides important insights into professional training in healthcare, but caution is needed when generalizing the results.
CONCLUSION
This study highlights the relevance of Concrete Experience in developing skills to identify and contextualize chronic conditions in the territory, according to ELT. The results show that the course impacted healthcare professionals who immediately applied the knowledge acquired, improving the quality of care for patients with chronic conditions. Innovative teaching methods and continuous tutor support were fundamental in overcoming the initial challenges of distance learning and promoting the development of skills in identifying and contextualizing within the scenario of NCCDs. Continuous professional development and adaption of practices to local needs contribute to providing quality service. This study reinforces the importance of continuing education in improving health services and promoting the populations’ health.
ACKNOWLEDGEMENT
To the LITES/CNPq Group - Interdisciplinary Laboratory of Educational Technologies in Health.
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NOTES
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ORIGIN OF THE ARTICLE
Extracted from the thesis entitled “Development of Competencies in Health Professionals: An Analysis of the Application of Kolb's Experiential Learning Theory in the Management of Chronic Conditions” presented to the Postgraduate Program in Nursing, Universidade Federal de Santa Catarina, 2025.
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FUNDING INFORMATION
MML is a CNPq Research Productivity Fellow.
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APPROVAL OF ETHICS COMMITTEE IN RESEARCH
Approved by the Research Ethics Committee of the Universidade Federal de Santa Catarina, opinion no. 6,078,402, CAAE: 66635322.0.0000.0121.
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TRANSLATED BY
Denise Costa Rodrigues.
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DATA AVAILABILITY
All the data supporting the results of this study were published in the article itself.
Edited by
All the data supporting the results of this study were published in the article itself.
