Os movimentos macropolíticos e micropolíticos: no ensino de graduação em Enfermagem

Abstract

This study deals with higher education in the field of nursing in the light of the Brazilian National Curriculum Guidelines, adaptation of professional education to the needs of the Brasilian Health System, and construction of care practices for comprehensive healthcare. This reflection is undertaken within the scope of university pedagogy relating to education for any of the professions regulated in Brazil regarding their orientation towards care. Care is seen as production of comprehensive healthcare; identification with the users of professional healthcare; understanding of the health system as a network response to social health needs; and education as a bold process of subjectivation that challenges autonomy that invents itself and the world.Keywords: Higher education. University pedagogy. Nursing education. Curriculum guidelines on nursing.Health care. IntroductionThis essay derives from a reflection on nursing education. Its point-of-departure are the micropolitical forces, seen as having potential for change in undergraduate programs, in opposition to the macropolitical forms, which establish "parameters" and determine "paths" for proposals of undergraduate teaching projects aiming to change care practices in the field of health and nursing.This text is part of a doctoral research in which I aim to understand the potential of micropolitical intermediation -what we live, on a daily basis, in the encounters promoted by educational processes.Brazilian education in the area of health has advanced, over time, in order to comply with the political guidelines of the health sector, mainly if we think of the needs imposed by the implementation of the Sistema Único de Saúde (SUS -Brazil's National Health System). However, the political imposition, even though derived from social movements that have strongly marked the field of public policies in the sector, does not guarantee the movement of changes in education.When we propose an undergraduate program in the area of health, we assume that its orientation, provided that rules, norms and protocols are obeyed, guarantees the education of COMUNICAÇÃO SAÚDE EDUCAÇÃO 2014; 18(49): professionals to meet the sector's needs. The imposed forms are its macropolitics and, generally speaking, they govern the pedagogical propositions. The fact is that the forces that compose this proposition of an undergraduate health program operate in another dimension, which contains forces with other flows and connections, components of micropolitics that cross, intersect, traverse macropolitics. Theoretical framework Macropolitics: government of the formsIn the field of public health policies, the movement of the Sanitary Reform, which in the middle of the 1980s held the 8 th National Health Conference (1986), delimited an important political moment in the sector, as the rupture of the thought that people's health is affected by political and social relations was joined to the urgency of our entering into another political moment (democratic) that inaugurated a participatory phase of soc...

Vocational Training In Nursing: Advances Curriculum And Innovations In Educational Projects

“…Brazilian training in health, over time, progresses towards meeting the political guidelines of the health sector, especially if we think of the requirements imposed by the implementation of the Unified Health System (SUS). However, the political imposition, even though arising from social movements, which have shaped the field of public policies in the sector, does not guarantee the change movement in training [16].…”

“…Thinking about the teaching management in health exposed to all health sector needs suggests, as necessary, the analysis of what has been proposed in the academic scene and also what has been possible to carry on the work and social participation of the sector. When it specifically comes to the health care process, it is expected that this training learns to take into account the other, the scientific knowledge serve mainly to account for the uniqueness of the moment of encounter caregiver assumes (recognizing that clinical act on health reflects a therapy that is effective in meeting the individuals) [16].…”

“…The education sector has gone through many crises, expressed, above all, because of the contrast between the hegemonic conceptions, which have a pedagogy of transmission of content or criticalsocial content, and constructive-interactionist conceptions sustained: the reality of questioning, the joint theory and practice, interdisciplinarity, the active student participation in the process of teaching and learning, an appreciation of cultural diversity, the individual historicity and its integration into everyday life [16].…”

O potencial da avaliação formativa nos processos de mudança da formação dos profissionais da saúde

“…Dada a complexidade que afeta os processos de mudança paradigmática no ensino da saúde, podemos antever que não faz sentido desperdiçar nenhuma oportunidade para esclarecer os sentidos inequívocos das mudanças em curso e em disputa. Para tal, o uso político da avaliação não pode ser desprezado, em especial, por seu forte poder indutor, pois como nos aponta Chaves 19 :…”

“…Estes abarcam um processo avaliativo na perspectiva de se avançar na produção de práticas de cuidado abrangentes e que possam "adequar-se à realidade de cada usuário de saúde e seu contexto social" 20 (p. 253), de cada território, de cada cidade, de cada região. Um encontro que contribua para a produção de serviços de saúde que ultrapassem o anunciado, o delineado, o prescrito 19 , na complexa relação e integração entre IES e serviços, que necessita da rede de saúde 4 , do trabalho interprofissional, em grupo e intersetorial, para abranger o cuidado integral, universal e igualitário preconizado pelo SUS.…”