Canadian undergraduate nursing programs have incorporated global health concepts and experiences in their curricula as these are elements of Registered Nurses’ entry-level practice competencies. With their knowledge of global health concepts, nursing students are aware of local, national, and international populations’ health needs. While there are multiple ways of promoting such knowledge, many nursing programs include optional clinical experiences abroad. This dissertation explored nursing students’ reentry process following immersive global health clinical experiences in resource-limited international settings. Charmaz’s Constructivist Grounded Theory approach was used and led to the development of a substantive theory named Reentry Process Theory. Data was gathered through face-to-face in-depth interviews with 20 participants recruited for the study, including Level 4 nursing students, nursing alumni, and faculty from a School of Nursing in Ontario. Data analysis identified 4 conceptual categories that explain processes embedded in participants’ reentry experiences: adjusting to being back, seeking understanding, making meaningful connections, and discovering a new self. Findings revealed the importance of understanding experiences and factors that impact the lives of nursing students who have lived and studied in resource-limited international settings not only in their role as students but also as individuals and soon to become professional nurses. Recommendations are made for education, research, policy and for future undergraduate students pursuing a global health clinical experience. / Dissertation / Doctor of Philosophy (PhD) / Many Canadian undergraduate nursing programs include optional clinical experiences abroad as a way of fostering nursing students’ knowledge of global health concepts as well as local, national, and international populations’ health needs. This dissertation investigated factors that impact nursing students’ reentry process following immersive clinical experiences in resource-limited international settings. The study adopted Kathy Charmaz’s constructivist approach to Grounded Theory and constructed a Reentry Process Theory that addresses nursing students’ personal and professional development. Data was gathered through face-to-face in-depth interviews with 20 participants, including Level 4 nursing students, nursing alumni, and faculty from a School of Nursing in Ontario. Data analysis identified 4 conceptual categories that underpin participants’ reentry experiences: adjusting to being back, seeking understanding, making meaningful connections, and discovering a new self. Recommendations are made for education, research, policy and for future undergraduate nursing students involved in immersive clinical experiences abroad.

Made available in DSpace on 2016-06-02T20:45:42Z (GMT). No. of bitstreams: 1 6438.pdf: 2051384 bytes, checksum: 374efd43e4f0d0bfed75020a01b0d74f (MD5) Previous issue date: 2014-10-21 / The Permanent Education in Health (Educação Permanente em Saúde - EPS) is a pedagogical strategy recognized by the Pan American Health Organization in Latin America as a method to consolidate public healthcare systems around the world since regular educational activities in health alone are not capable of fulfill the needs of the population and increase the quality of the service. This study discuss the Permanent Education in Health in the city of São Carlos SP and aims to identify and problematize the limitations and potentialities pointed by the local healthcare workers and managers in other to contribute to the development of the strategy in the city. The study uses a qualitative research method through semi-structured interviews of nine actors directly related to the local EPS activities. The results show that the EPS in the city is weakened by different factors such as: fragmented actions in education; lack of knowledge or misunderstanding of the concept of EPS by the workers and mainly by the managers; and above all, rupture of project and political policies due to changes in the government political party. Despite the obstacles, the study also revels positive aspects of the EPS implementation in the city, like: good partnership between healthcare network and educational institutions; investment in activities of education in health; and involvement in governmental forums of EPS discussions and planning. The study conclude that EPS can evolve by increasing the articulation between the players involved in the public health system SUS (teaching, management, care, and social control), to guarantee the continuous consolidation the National Policy of Permanent Education in Health. / A Educação Permanente em Saúde (EPS) é uma estratégia pedagógica de educação em saúde reconhecida pela Organização Pan-Americana de Saúde (OPAS) em toda América Latina para solidificar os sistemas públicos de saúde, visto que as atividades educativas em saúde não têm sido efetivas para atender as necessidades de saúde da população e realizar mudanças na qualidade dos serviços de saúde. Este estudo busca analisar o processo da Educação Permanente em Saúde de acordo com as políticas e diretrizes no município de São Carlos, além de ponderar os impasses que dificultam o processo de Educação Permanente em Saúde e suas condições de realização e contribuir para o desenvolvimento e articulação do processo de EPS no município. A discussão está subsidiada na técnica qualitativa de pesquisa, especificamente, por meio de entrevista semiestruturada realizada com nove sujeitos que estão diretamente ligados à EPS nesse município. Os resultados demonstram que a EPS no município encontra-se fragilizada por diversos fatores como: ações de educação em saúde ocorrem de modo fragmentado, pela falta de conhecimento ou diferentes concepções dos sujeitos e principalmente pelos gestores acerca da EPS, e, sobretudo, pela ruptura de projetos e políticas devido à alternância de governos e de partidos, como ocorrido com a implementação da EPS no município de São Carlos. Apesar disso, a pesquisa evidenciou que o município possui também potenciais para a estruturação e efetivação da EPS, tal como a parceria rede-escola, recursos investidos em atividades de educação em saúde e representatividade nos colegiados de discussão e planejamento de EPS. Assim sendo, concluise que apesar de fragilizada, a EPS possui possibilidade de ascensão. Sugere-se, a partir dos resultados deste estudo, que a articulação dos atores que formam o quadrilátero do SUS (ensino, gestão, atenção e controle social) seja fortalecida de modo a garantir a continuidade e a consolidação da Política Nacional de Educação Permanente em Saúde.

Encantada e enredada pela fabulosa história de Alice no País das Maravilhas, nesta tese se constroem três possibilidades de olhar para as Residências em Saúde. Uma primeira possibilidade é tecida com a experiência da autora, segundo suas memórias, sentimentos e afecções, registro produzido em seus “encontros” com a temática e sua pragmática. A segunda possibilidade sumariza elementos de pesquisa com base em teses e dissertações elaboradas no Brasil, no período de 1987 a 2012, sobre Residências em Área Profissional da Saúde e Médicas. A terceira possibilidade, a tecedura de um País das Maravilhas das Residências, resultado de uma pesquisa constituída por conversas. Conversas empreendidas com participantes dos Encontros – Gaúcho e Nacional – de Residências e também do X Congresso da Associação Brasileira de Saúde Coletiva, eventos ocorridos no ano de 2012. Esses participantes, os quais receberam os nomes dos habitantes do “País” de Lewis Carroll, foram conversando com este estudo sobre detalhes do País das Maravilhas das Residências. Esta pesquisa possibilitou também manifestações à provocação “como você expressaria uma experiência de aprendizagem na Residência em Saúde (imagem, som, narrativa, poesia...)?” A análise das conversas e das manifestações livres foi empreendida juntamente com a análise de regramentos emitidos pelas Comissões Nacionais de Residência Médica e Multiprofissional em Saúde. Na invenção do País das Maravilhas das Residências, o material empírico foi recortado, didaticamente, baseado em dois analisadores: a governamentalidade (a partir de Foucault) e os encontros de aprendizagem em saúde (tomando os signos, conforme Deleuze). Como resultados, estão apontadas a inseparabilidade desses dois conceitos e sua produção mútua, mas, também, os modos de liberdade e captura que vão aparecendo na fabricação deste “País das Residências”. A tarefa política, no interesse das aprendizagens ou do exercício da governamentalização, é de apostar nas singularizações, modos de ser profissional da saúde, de formar para o cuidado do outro e, neste sentido, possibilitar liberdade aos “encontros” para que não sejam constrangidos pela forma. Ao fim destes escritos, um reencontro com o Coelho Branco, como possibilidade de continuar despertando curiosidades de pesquisa, interrogações, instigantes, problemas de pensamento e movimento em relação ao tema, uma apropriação complexa do “trabalhar” em saúde, resultado dos encontros de aprendizagem. A governamentalidade, naquilo que parece ser o “império” da forma, enfraquece justamente esta apropriação. / Enchanted and entangled by the fabulous story of Alice in the Wonderland, three possibilities of looking at the Health Residencies are built in this dissertation. An initial possibility is woven with the author experience, according to her memories, feelings, and affections, a record produced in her “meetings” with the theme and its pragmatics. The second possibility summarizes elements of research based on theses and dissertations produced in Brazil, between 1987 and 2012, on Medical and Health Professional Area Residency Programs. The third possibility, the weaving of a Residency Programs Wonderland, resulted from a research composed of conversations. These conversations were undertaken with the participants of the National and State Meetings of Residency Programs, as well as the X Congress of the Brazilian Association of Collective Health, events that occurred in 2012. These participants, who received the names of the inhabitants of Lewis Carroll’s “Land,” dialogued with this study on details of the Residency Programs Wonderland. This research also made possible manifestations to the question “How would you express an experience of learning in the Health Residency Program (image, sound, narrative, poetry…)?” The analysis of the conversations and the free manifestations was undertaken together with the analysis of regulations issued by the National Commissions of Medical and Multiprofessional Health Residency Programs. In the invention of the Residency Programs Wonderland, the empirical material was didactically cut out, based on two analyzers: Foucault’s governmentality, and the learning meetings in health (taking the signs, according to Deleuze). As results, the inseparability of these two concepts and its mutual production, as well as the ways of freedom and capture that appear in the manufacturing of this “Residency Programs Land,” is indicated. The political task, in the interest of the learning or the exercise of governmentalization, is to bet in the singularization, ways of being a health professional, of educating for the care of the other, and, in this sense, to provide freedom to the “meetings”, so that they are not constrained by the form. At the end of these writings, a reunion with the White Rabbit, as a possibility to continue arousing research curiosity, exciting interrogations, problems of thought, and movement in relation to the theme, a complex appropriation of “to work” in health, resulting from the learning meetings. The governmentality of the learning meetings. The governmentality, in what seems to be the “empire” of the form, weakens exactly this appropriation. / Encantada y enredada por la fabulosa historia de Alicia en el País de las Maravillas, en esta tesis se construyen tres posibilidades de mirar hacia las residencias en salud. Una primera posibilidad es tejida con la experiencia de la autora, desde sus memorias, sentimientos y afecciones, registro producido en sus “encuentros” con la temática y su pragmática. La segunda posibilidad sumariza elementos de investigación con base en tesis y disertaciones elaboradas en Brasil sobre residencias médicas y en áreas profesionales de la salud, que comprende el período de 1987 a 2012. La tercera posibilidad, la tejedura de un País de las Maravillas de las residencias, resultado de una investigación constituida por diálogos. Éstos fueron emprendidos con participantes de los encuentros de residencias, gaucho y nacional, y también del X Congreso de la Asociación Brasileña de Salud Colectiva, eventos ocurridos en 2012. Estos participantes, los cuales recibieron los nombres de los personajes del cuento de Lewis Carroll, conversaron, bajo ese estudio, sobre detalles del País de las Maravillas de las residencias. Esta investigación también hizo posible manifestaciones a la provocación de “como usted expresaría una experiencia de aprendizaje en la residencia en salud (imagen, son, narrativa, poesía…)?” El análisis de los diálogos y de las manifestaciones libres fue emprendido en conjunto con el análisis de reglamentos emitidos por las Comisiones Nacionales de Residencia Médica y Multiprofesional en Salud. Con relación a la invención del País de las Maravillas de las residencias, se hizo un recorte didáctico del material empírico basado en dos puntos de análisis: la gubernamentalidad (a partir de Foucault) y los encuentros de aprendizaje en salud (desde el concepto de signo de Deleuze). Como resultados se apuntan la inseparabilidad de esos dos conceptos y su producción mutua, además de los modos de libertad y captura que van apareciendo en la constitución de este “País de las Residencias”. La tarea política – desde el interés de los aprendizajes o del ejercicio de la gubernamentalización – es de apostar en las singularizaciones, modos de ser profesional de la salud, de formar para la asistencia al otro y, en este sentido, posibilitar libertad en los “encuentros” para que no sean constreñidos por la forma. Al fin de estos escritos, un reencuentro con el Conejo Blanco, como posibilidad de seguir despertando instigadoras curiosidades de investigación, interrogaciones y problemas de pensamiento y movimiento con relación al tema, una relación compleja del “trabajar” en salud y de los encuentros de aprendizaje. La gubernamentalidad, a partir de una concepción de lo que parece ser el “imperio” de la forma, debilita justamente esta apropiación.

Encantada e enredada pela fabulosa história de Alice no País das Maravilhas, nesta tese se constroem três possibilidades de olhar para as Residências em Saúde. Uma primeira possibilidade é tecida com a experiência da autora, segundo suas memórias, sentimentos e afecções, registro produzido em seus “encontros” com a temática e sua pragmática. A segunda possibilidade sumariza elementos de pesquisa com base em teses e dissertações elaboradas no Brasil, no período de 1987 a 2012, sobre Residências em Área Profissional da Saúde e Médicas. A terceira possibilidade, a tecedura de um País das Maravilhas das Residências, resultado de uma pesquisa constituída por conversas. Conversas empreendidas com participantes dos Encontros – Gaúcho e Nacional – de Residências e também do X Congresso da Associação Brasileira de Saúde Coletiva, eventos ocorridos no ano de 2012. Esses participantes, os quais receberam os nomes dos habitantes do “País” de Lewis Carroll, foram conversando com este estudo sobre detalhes do País das Maravilhas das Residências. Esta pesquisa possibilitou também manifestações à provocação “como você expressaria uma experiência de aprendizagem na Residência em Saúde (imagem, som, narrativa, poesia...)?” A análise das conversas e das manifestações livres foi empreendida juntamente com a análise de regramentos emitidos pelas Comissões Nacionais de Residência Médica e Multiprofissional em Saúde. Na invenção do País das Maravilhas das Residências, o material empírico foi recortado, didaticamente, baseado em dois analisadores: a governamentalidade (a partir de Foucault) e os encontros de aprendizagem em saúde (tomando os signos, conforme Deleuze). Como resultados, estão apontadas a inseparabilidade desses dois conceitos e sua produção mútua, mas, também, os modos de liberdade e captura que vão aparecendo na fabricação deste “País das Residências”. A tarefa política, no interesse das aprendizagens ou do exercício da governamentalização, é de apostar nas singularizações, modos de ser profissional da saúde, de formar para o cuidado do outro e, neste sentido, possibilitar liberdade aos “encontros” para que não sejam constrangidos pela forma. Ao fim destes escritos, um reencontro com o Coelho Branco, como possibilidade de continuar despertando curiosidades de pesquisa, interrogações, instigantes, problemas de pensamento e movimento em relação ao tema, uma apropriação complexa do “trabalhar” em saúde, resultado dos encontros de aprendizagem. A governamentalidade, naquilo que parece ser o “império” da forma, enfraquece justamente esta apropriação. / Enchanted and entangled by the fabulous story of Alice in the Wonderland, three possibilities of looking at the Health Residencies are built in this dissertation. An initial possibility is woven with the author experience, according to her memories, feelings, and affections, a record produced in her “meetings” with the theme and its pragmatics. The second possibility summarizes elements of research based on theses and dissertations produced in Brazil, between 1987 and 2012, on Medical and Health Professional Area Residency Programs. The third possibility, the weaving of a Residency Programs Wonderland, resulted from a research composed of conversations. These conversations were undertaken with the participants of the National and State Meetings of Residency Programs, as well as the X Congress of the Brazilian Association of Collective Health, events that occurred in 2012. These participants, who received the names of the inhabitants of Lewis Carroll’s “Land,” dialogued with this study on details of the Residency Programs Wonderland. This research also made possible manifestations to the question “How would you express an experience of learning in the Health Residency Program (image, sound, narrative, poetry…)?” The analysis of the conversations and the free manifestations was undertaken together with the analysis of regulations issued by the National Commissions of Medical and Multiprofessional Health Residency Programs. In the invention of the Residency Programs Wonderland, the empirical material was didactically cut out, based on two analyzers: Foucault’s governmentality, and the learning meetings in health (taking the signs, according to Deleuze). As results, the inseparability of these two concepts and its mutual production, as well as the ways of freedom and capture that appear in the manufacturing of this “Residency Programs Land,” is indicated. The political task, in the interest of the learning or the exercise of governmentalization, is to bet in the singularization, ways of being a health professional, of educating for the care of the other, and, in this sense, to provide freedom to the “meetings”, so that they are not constrained by the form. At the end of these writings, a reunion with the White Rabbit, as a possibility to continue arousing research curiosity, exciting interrogations, problems of thought, and movement in relation to the theme, a complex appropriation of “to work” in health, resulting from the learning meetings. The governmentality of the learning meetings. The governmentality, in what seems to be the “empire” of the form, weakens exactly this appropriation. / Encantada y enredada por la fabulosa historia de Alicia en el País de las Maravillas, en esta tesis se construyen tres posibilidades de mirar hacia las residencias en salud. Una primera posibilidad es tejida con la experiencia de la autora, desde sus memorias, sentimientos y afecciones, registro producido en sus “encuentros” con la temática y su pragmática. La segunda posibilidad sumariza elementos de investigación con base en tesis y disertaciones elaboradas en Brasil sobre residencias médicas y en áreas profesionales de la salud, que comprende el período de 1987 a 2012. La tercera posibilidad, la tejedura de un País de las Maravillas de las residencias, resultado de una investigación constituida por diálogos. Éstos fueron emprendidos con participantes de los encuentros de residencias, gaucho y nacional, y también del X Congreso de la Asociación Brasileña de Salud Colectiva, eventos ocurridos en 2012. Estos participantes, los cuales recibieron los nombres de los personajes del cuento de Lewis Carroll, conversaron, bajo ese estudio, sobre detalles del País de las Maravillas de las residencias. Esta investigación también hizo posible manifestaciones a la provocación de “como usted expresaría una experiencia de aprendizaje en la residencia en salud (imagen, son, narrativa, poesía…)?” El análisis de los diálogos y de las manifestaciones libres fue emprendido en conjunto con el análisis de reglamentos emitidos por las Comisiones Nacionales de Residencia Médica y Multiprofesional en Salud. Con relación a la invención del País de las Maravillas de las residencias, se hizo un recorte didáctico del material empírico basado en dos puntos de análisis: la gubernamentalidad (a partir de Foucault) y los encuentros de aprendizaje en salud (desde el concepto de signo de Deleuze). Como resultados se apuntan la inseparabilidad de esos dos conceptos y su producción mutua, además de los modos de libertad y captura que van apareciendo en la constitución de este “País de las Residencias”. La tarea política – desde el interés de los aprendizajes o del ejercicio de la gubernamentalización – es de apostar en las singularizaciones, modos de ser profesional de la salud, de formar para la asistencia al otro y, en este sentido, posibilitar libertad en los “encuentros” para que no sean constreñidos por la forma. Al fin de estos escritos, un reencuentro con el Conejo Blanco, como posibilidad de seguir despertando instigadoras curiosidades de investigación, interrogaciones y problemas de pensamiento y movimiento con relación al tema, una relación compleja del “trabajar” en salud y de los encuentros de aprendizaje. La gubernamentalidad, a partir de una concepción de lo que parece ser el “imperio” de la forma, debilita justamente esta apropiación.

Encantada e enredada pela fabulosa história de Alice no País das Maravilhas, nesta tese se constroem três possibilidades de olhar para as Residências em Saúde. Uma primeira possibilidade é tecida com a experiência da autora, segundo suas memórias, sentimentos e afecções, registro produzido em seus “encontros” com a temática e sua pragmática. A segunda possibilidade sumariza elementos de pesquisa com base em teses e dissertações elaboradas no Brasil, no período de 1987 a 2012, sobre Residências em Área Profissional da Saúde e Médicas. A terceira possibilidade, a tecedura de um País das Maravilhas das Residências, resultado de uma pesquisa constituída por conversas. Conversas empreendidas com participantes dos Encontros – Gaúcho e Nacional – de Residências e também do X Congresso da Associação Brasileira de Saúde Coletiva, eventos ocorridos no ano de 2012. Esses participantes, os quais receberam os nomes dos habitantes do “País” de Lewis Carroll, foram conversando com este estudo sobre detalhes do País das Maravilhas das Residências. Esta pesquisa possibilitou também manifestações à provocação “como você expressaria uma experiência de aprendizagem na Residência em Saúde (imagem, som, narrativa, poesia...)?” A análise das conversas e das manifestações livres foi empreendida juntamente com a análise de regramentos emitidos pelas Comissões Nacionais de Residência Médica e Multiprofissional em Saúde. Na invenção do País das Maravilhas das Residências, o material empírico foi recortado, didaticamente, baseado em dois analisadores: a governamentalidade (a partir de Foucault) e os encontros de aprendizagem em saúde (tomando os signos, conforme Deleuze). Como resultados, estão apontadas a inseparabilidade desses dois conceitos e sua produção mútua, mas, também, os modos de liberdade e captura que vão aparecendo na fabricação deste “País das Residências”. A tarefa política, no interesse das aprendizagens ou do exercício da governamentalização, é de apostar nas singularizações, modos de ser profissional da saúde, de formar para o cuidado do outro e, neste sentido, possibilitar liberdade aos “encontros” para que não sejam constrangidos pela forma. Ao fim destes escritos, um reencontro com o Coelho Branco, como possibilidade de continuar despertando curiosidades de pesquisa, interrogações, instigantes, problemas de pensamento e movimento em relação ao tema, uma apropriação complexa do “trabalhar” em saúde, resultado dos encontros de aprendizagem. A governamentalidade, naquilo que parece ser o “império” da forma, enfraquece justamente esta apropriação. / Enchanted and entangled by the fabulous story of Alice in the Wonderland, three possibilities of looking at the Health Residencies are built in this dissertation. An initial possibility is woven with the author experience, according to her memories, feelings, and affections, a record produced in her “meetings” with the theme and its pragmatics. The second possibility summarizes elements of research based on theses and dissertations produced in Brazil, between 1987 and 2012, on Medical and Health Professional Area Residency Programs. The third possibility, the weaving of a Residency Programs Wonderland, resulted from a research composed of conversations. These conversations were undertaken with the participants of the National and State Meetings of Residency Programs, as well as the X Congress of the Brazilian Association of Collective Health, events that occurred in 2012. These participants, who received the names of the inhabitants of Lewis Carroll’s “Land,” dialogued with this study on details of the Residency Programs Wonderland. This research also made possible manifestations to the question “How would you express an experience of learning in the Health Residency Program (image, sound, narrative, poetry…)?” The analysis of the conversations and the free manifestations was undertaken together with the analysis of regulations issued by the National Commissions of Medical and Multiprofessional Health Residency Programs. In the invention of the Residency Programs Wonderland, the empirical material was didactically cut out, based on two analyzers: Foucault’s governmentality, and the learning meetings in health (taking the signs, according to Deleuze). As results, the inseparability of these two concepts and its mutual production, as well as the ways of freedom and capture that appear in the manufacturing of this “Residency Programs Land,” is indicated. The political task, in the interest of the learning or the exercise of governmentalization, is to bet in the singularization, ways of being a health professional, of educating for the care of the other, and, in this sense, to provide freedom to the “meetings”, so that they are not constrained by the form. At the end of these writings, a reunion with the White Rabbit, as a possibility to continue arousing research curiosity, exciting interrogations, problems of thought, and movement in relation to the theme, a complex appropriation of “to work” in health, resulting from the learning meetings. The governmentality of the learning meetings. The governmentality, in what seems to be the “empire” of the form, weakens exactly this appropriation. / Encantada y enredada por la fabulosa historia de Alicia en el País de las Maravillas, en esta tesis se construyen tres posibilidades de mirar hacia las residencias en salud. Una primera posibilidad es tejida con la experiencia de la autora, desde sus memorias, sentimientos y afecciones, registro producido en sus “encuentros” con la temática y su pragmática. La segunda posibilidad sumariza elementos de investigación con base en tesis y disertaciones elaboradas en Brasil sobre residencias médicas y en áreas profesionales de la salud, que comprende el período de 1987 a 2012. La tercera posibilidad, la tejedura de un País de las Maravillas de las residencias, resultado de una investigación constituida por diálogos. Éstos fueron emprendidos con participantes de los encuentros de residencias, gaucho y nacional, y también del X Congreso de la Asociación Brasileña de Salud Colectiva, eventos ocurridos en 2012. Estos participantes, los cuales recibieron los nombres de los personajes del cuento de Lewis Carroll, conversaron, bajo ese estudio, sobre detalles del País de las Maravillas de las residencias. Esta investigación también hizo posible manifestaciones a la provocación de “como usted expresaría una experiencia de aprendizaje en la residencia en salud (imagen, son, narrativa, poesía…)?” El análisis de los diálogos y de las manifestaciones libres fue emprendido en conjunto con el análisis de reglamentos emitidos por las Comisiones Nacionales de Residencia Médica y Multiprofesional en Salud. Con relación a la invención del País de las Maravillas de las residencias, se hizo un recorte didáctico del material empírico basado en dos puntos de análisis: la gubernamentalidad (a partir de Foucault) y los encuentros de aprendizaje en salud (desde el concepto de signo de Deleuze). Como resultados se apuntan la inseparabilidad de esos dos conceptos y su producción mutua, además de los modos de libertad y captura que van apareciendo en la constitución de este “País de las Residencias”. La tarea política – desde el interés de los aprendizajes o del ejercicio de la gubernamentalización – es de apostar en las singularizaciones, modos de ser profesional de la salud, de formar para la asistencia al otro y, en este sentido, posibilitar libertad en los “encuentros” para que no sean constreñidos por la forma. Al fin de estos escritos, un reencuentro con el Conejo Blanco, como posibilidad de seguir despertando instigadoras curiosidades de investigación, interrogaciones y problemas de pensamiento y movimiento con relación al tema, una relación compleja del “trabajar” en salud y de los encuentros de aprendizaje. La gubernamentalidad, a partir de una concepción de lo que parece ser el “imperio” de la forma, debilita justamente esta apropiación.

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-11-11T15:12:26Z No. of bitstreams: 1 Eluana Borges Leitão de Figueiredo.pdf: 1539244 bytes, checksum: 3b27d7a2edf9d325db4008e42d368bee (MD5) / Made available in DSpace on 2015-11-11T15:12:26Z (GMT). No. of bitstreams: 1 Eluana Borges Leitão de Figueiredo.pdf: 1539244 bytes, checksum: 3b27d7a2edf9d325db4008e42d368bee (MD5) Previous issue date: 2014 / Mestrado Profissional em Ensino na Saúde / A Educação Permanente em Saúde (EPS) e sua expressão nas práticas locais é o objeto deste estudo. Buscou-se conhecer tal expressão em um município da região Médio Paraíba, interior do estado do Rio de Janeiro, considerando os movimentos institucionais e inventivos sob o referencial teórico de Paulo Freire e Adolfo Sanchez Vásquez em simbiose com a poesia de Manoel de Barros. Três questões nortearam o estudo: Quais concepções pedagógicas municipais predominam nas propostas e ações institucionais de formação? Como os trabalhadores da gestão e da atenção básica concebem e praticam a EPS no município sob as perspectivas institucional e inventiva? Como produzir, com os sujeitos participantes, dinâmicas sociais inventivas? Como metodologia de trabalho, utilizou-se a pesquisa de campo com abordagem qualitativa do tipo pesquisa ação, após aprovação pelo Comitê de Ética e Pesquisa do Hospital Universitário Antônio Pedro e autorização da secretaria de saúde do município em questão. Os dados foram coletados a partir de documentos oficiais do município, entrevistas semiestruturadas com trabalhadores da gestão e da estratégia saúde da família e observação participante em duas unidades de atenção básica. Os sujeitos participantes foram gestores/responsáveis pela condução de processos institucionais de EPS na região/município e profissionais da estratégia de saúde da família. Os documentos pesquisados foram o Plano Municipal de Saúde, período 2011-2013, a Ata da VIII Conferência Municipal de Saúde (2013) e os registros das atividades institucionais para profissionais de saúde. Observou-se que, embora os documentos relativos ao Plano Municipal de Saúde e a VIII Conferência Municipal de Saúde tenham mencionado a necessidade de formação dos profissionais de saúde, a EPS foi pouco abordada no movimento institucional, sendo a capacitação predominante. Os dados referentes às entrevistas apresentaram a EPS na perspectiva da construção de espaços formais de cursos, palestras ou reuniões. Em contrapartida, a observação participante apresentou a EPS com outro formato: sem nome, horário definido e como expressão da inventividade dos trabalhadores. A analise dos dados das entrevistas possibilitou a elaboração de duas categorias que refletem tanto a expressão da EPS no município, quanto as potencialidades e dificuldades na construção de espaços de EPS. O estudo conclui apontando para a criação de um espaço de EPS [Grupo EPensando], capaz de abarcar tanto os movimentos institucionais, como a riqueza criadora e inventiva de encontros potentes entre os trabalhadores da atenção, gestores e usuários dos serviços de saúde / The Permanent Education in Health (EPS) and its expression in local practices is the subject of this study. This research aimed to study such expression in a part of Middle Paraíba region, in State of Rio de Janeiro, taking into account the institutional and inventive movements under the theoretical framework of Paulo Freire and Adolfo Sanchez Vasquez and linked with the poetry of Manoel de Barros. Three questions guided the study: Which municipal pedagogical conceptions predominate in proposals and institutional training activities; how the workers and the management of primary health care conceive and practice the EPS in city, under the institutional and inventive perspectives; and how to produce inventive social dynamics with participating subjects. As a working methodology, we used field research with qualitative research approach and an action-type study, after the approval by the Research Ethics Committee of the Antonio Pedro University Hospital and authorization of the health department of the city in question. Data were collected from official documents of the city, semi-structured interviews with workers or managers of Family Health Strategy program and participant observation in two primary care units. Participants were managers and part of the staff in charge for conducting EPS institutional processes in the region/city and professionals from Family Health Strategy. The Municipal Health Plan from 2011 to2013, the Minutes of the Eighth Municipal Health Conference (2013) and records of institutional activities for health professionals were the documents studied. We observed that although the documents relating to the Municipal Health Plan and the 8th Municipal Health Conference have mentioned the need for training of health professionals, EPS has been little addressed in the institutional movement, being the predominant training.The data relating to interviews presented the EPS into the perspective of building formal spaces for courses, lectures or meetings; however, participant observation presented another format of EPS: with no name or time defined as an expression of workers’ creativity. The analysis of the interview data allowed the creation of two categories that reflect the expression of EPS in the municipality, and the potential and difficulties in building EPS spaces. The study concludes by pointing to the creation of an area of EPS [EPensando Group] that could encompass both institutional movements as creative and inventive wealth of the powerful encounters between the health care professionals, managers and users of the services.

To safeguard the health and well-being of faculty, students, staff, and the community is of moral imperative for higher education institutions. Likewise, protecting the environment is a socially sound practice. Furthermore, building and maintaining a positive safety culture is believed to contribute to productive environmental health and safety (EH&S) outcomes. Higher education EH&S leaders are at the center of universities’ efforts in maintaining a positive safety culture. The purpose of this inquiry was to study higher education EH&S leaders’ perspectives on safety culture and contribute to closing the academic literature gap in the higher education setting. Interviews and a survey were the data collection techniques. EH&S leaders of U.S. higher education institutions participated in the study. I used Cooper’s (2000, 2016) reciprocal safety culture model as a theoretical framework and a mixed methods research design to find answers to the research questions. The survey results revealed how EH&S leaders viewed different aspects of their operations, and findings from the interviews revealed the leaders’ lived experiences. For example, the quantitative study showed 100% of the participants strongly agree or agree that shaping the safety culture of their campus is part of their role. In addition, the qualitative data identified distinct strategies employed by leaders to shape the safety culture of their campuses. Four major themes were identified in the qualitative data. In the first theme, The Higher Education Safety Culture, the EH&S leaders reflected on their lived experiences and the importance of positive safety culture in accomplishing their goals. They mobilize their campus communities in a collective effort to achieve a healthy and safe working environment, minimize the impact on the environment, and remain compliant with regulatory requirements. The second theme, Higher Education Environmental Health and Safety Programs, stressed the plans and procedures the leaders and their departments engage in their daily operations. The third theme, Higher Education Management’s Role in Environmental Health and Safety Operations, manifested the leaders’ equivocal voice on the necessity of the higher education leadership and upper management support to fulfill their missions. The last theme, Modus Operandi of Higher Education Environmental Health and Safety Leaders, is about a range of strategies and tactics the EH&S leaders employed to succeed in a structured, bureaucratic, and challenging environment. The findings have direct implications for both higher education EH&S professionals and higher education senior leadership. The study findings implied EH&S leaders should focus their effort where it generates the best outcome, namely: (a) orchestrate the campus community toward a positive safety; (b) build and implement effective EH&S programs; (c) bring upper management and leadership aboard; (d) apply effective communication; (e) build trust; (f) define their role as a consultant; (g) stand out; and (h) create a brand, motto, and slogan where possible. For higher education senior leadership, participants emphasized the necessity of upper management and leadership support to build and maintain a positive safety culture on the campus, agreeing with Cooper (2000, 2016). This work helps contribute to making higher education senior leadership and upper management understand their role in their campuses’ safety culture and provide due support and actively participate. This study served as an initial exploration in understanding higher education EH&S leaders’ perspectives on safety culture and contributing to closing the literature gap. It also opened a door for future research. Broadening the audience to students, faculty, and staff are reasonable candidates for further research for a more comprehensive understanding of the safety culture in higher education. In addition, expanding the survey to include more EH&S leaders of higher education will elaborate on the EH&S operations, challenges, and sentiment.

Syfte och frågeställningar Studiens syfte var att undersöka hur lärare i idrott och hälsa på gymnasiet förhåller sig till läroplanen med avseende på bollspel och bollekar. Vidare var studiens syfte att analysera och diskutera resultaten utifrån läroplansteori som teoretiskt ramverk. För att uppfylla syftet utformades följande frågeställningar: Hur arbetar lärarna med bollspel och bollekar i undervisningen? Vilka motiv uppger lärarna till att de använder bollspel och bollekar i undervisningen? Metod En kvalitativ metod användes för att besvara studiens syfte och frågeställningar och intervjuer genomfördes med sex gymnasielärare i idrott och hälsa som uppfyllde studiens kriterier. Urvalet skedde enligt bekvämlighetsprincipen. Resultat Samtliga lärare berättade att de använde sig av bollspel och bollekar i undervisningen och de uppskattade att 12 till 25 procent av tiden ägnades åt dessa aktiviteter. De vanligaste bollaktiviteterna var fotboll, badminton, basket, softboll, volleyboll och lacrosse. Lärarna använde mindre vanliga spel och lekar för att jämna ut nivåskillnader mellan elever. De använde olika bollaktiviteter för att eleverna genom dessa skulle vara fysiskt aktiva senare i livet. Lärarna berättade att de valde bollspel och bollekar efter sina egna kunskaper och färdigheter samt efter lokaler och materiel. Alla lärare använde bollspel och bollekar som en metod för att utveckla eller lära ut någonting annat än själva spelet eller leken. Samtliga lärare kopplade bollspel och bollekar till ämnesplanens centrala innehåll och de ansåg att elever kunde uppnå flera kunskapskrav genom undervisningen. Slutsats Slutsatser i studien var att bollspel och bollekar förekom i undervisningen i ämneskursen idrott och hälsa 1 men i mindre utsträckning än vad tidigare forskning har visat. Formuleringen av den nya läroplanen har haft stor del i att bollspel och bollekar har minskat. Alla lärare hade ett tydligt syfte med att använda bollspel och bollekar och kopplade dessa till ämnesplanens centrala innehåll och kunskapskrav. Det fanns likheter i lärarnas tolkningar av ämnesplanen vilket visade på att ämnets klassifikation stärkts. Lärarnas val av styrgrupp medförde att en del elever missgynnades. Lärarna måste väga för- och nackdelar mellan vanliga och mindre vanliga bollspel och bollekar mot varandra. Utifrån detta måste lärarna sedan besluta vilken aktivitet som uppfyller det tänkta syftet på bästa sätt. / Aim The purpose of the study was to examine how teachers in physical education and health on a high school level relate to the curriculum with a focus on ball games and ball exercises. Furthermore the study’s purpose was to analyze and discuss the results from curriculum theory as the theoretical framework. To fulfill this purpose the following research questions were established: How do teachers use ball games and ball exercises in their teaching? What motives do the teachers present while choosing to use ball games and ball exercises in their teaching? Method A qualitative method was used to answer the study’s purpose and research questions and interviews were conducted with six high school teachers in physical education and health that fulfilled the study’s criteria. The selection was founded on the comfort principle. Results All teachers confirmed to be using ball games or ball exercises in their teaching and they estimated that 12 to 25 percent of the curriculum were used for these specific exercises. The most common ball games were football, badminton, basketball, softball, volleyball and lacrosse. The teachers conducted less common games and exercises to even out the performance levels of different students. They varied their ball activities so that students through these exercises would be physically active later in life. The teachers told that they chose ball games and ball exercises based on their personal knowledge and access to facilities and material. All teachers used ball games and ball exercises as a method to develop or teach something other than the actual game itself. All teachers linked ball games and ball exercises to the curriculums core content and they believed that students could achieve several of the knowledge requirements through the education. Conclusion The conclusions of this study were that ball games and ball exercises were present in the education of the course physical education and health 1 but in less quantity than what earlier research has proven. The formulation of the new curriculum have had a major impact on the fact that ball games and ball exercises has decreased. All teachers had a clear purpose for using ball games and ball exercises and connected these to the curriculums core content and knowledge requirements. There were similarities between teachers interpretation of the curriculum which showed a strengthening of the subjects classification. The teacher’s selection of steering groups result in some students having a disadvantage. The teachers must weigh advantages and disadvantages between common and less common ball games and ball exercises against each other. Based on these observations the teachers must then choose which activities are best suited to successfully fulfill their purpose.

Hälsa är ett begrepp som har avsaknad av en bestämd definition. Det finns flertalet erkända definitioner såsom WHO:s men det finns även de definitioner som skapats av den enskilda individen. De flesta definitioner som finns kring och om hälsa har sitt ursprung i den fysiska aktivitetens värld, än dock menar flera personer att om hälsa enbart skall ses som god utifrån den fysiska aktiviteten så blir begreppet hälsa inte särskilt innehållsrikt. Syftet med studien var att undersöka hur lärarna ser på begreppet hälsa. Enligt bakgrund och tidigare forskning så är hälsa ett personligt och svårdefinierat begrepp, vilket de sex lärare som intervjuades i denna kvalitativa studie bekräftade. Lärarnas kunskap om hälsa har inhämtats från tidigare idrottsliga erfarenheter och utbildning. Resultatet i denna studie visar att hälsoundervisningen stundtals blir personlig då lärarna utgår från sina tidigare idrottsliga erfarenheter när de talar och undervisar om hälsa. Resultatet har analyserats utifrån två hälsomodeller, kontinuummodellen samt den kliniska modellen. Resultatet som framkommer är att hälsa många gånger ses ur ett kontinuumperspektiv och sällan ur ett dikotomt perspektiv. Sammanfattat så handlar denna studie om hur lärarna ser på begreppet hälsa och hur de önskade att hälsoundervisningen skulle kunna se ut. / Health defines a person’s general condition, both mind and body. Being healthy or have “good health” is something that people, on a daily basis, can read about in the newspaper or on the internet, but what is health or being healthy? Health is often taken for granted and is also often associated with training, but many claim that health is not only about being fit or train hard. There are different definitions of health; world health organization (WHO) has one that has been acknowledged for many years: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This definition has been controversy because it says that a person only can have good health if the person is free from illness, injury or pain which can seems quite possible to achieve. WHO:s definition about health, is not the only one, there are  many more definitions that has been created by dissimilar people. The aim with this study was to see how teachers look at health (and health studies) and where they got their knowledge about health. If you look at previous studies it says that health is a personal thing, each individual has their own opinion what health is, something that the teacher in this study agreed about. This is a qualitative study and sex teachers were interviewed. The result has been analyzed by two health models, the continuum model and the clinic model. The result showed that the teachers look at health from a continuum perspective and the teachers also said that their athletic background were the main reason for there value of health and how they look at health overall.

This dissertation deals with the didactic consequences of assessment for learning (AfL) in the subject of physical education and health (PEH) at three upper secondary schools in Sweden. The purpose of the study is to investigate how assessment for learning is realised in PEH and what triadic relations between the teacher, student and subject content are established in the formative assessment practice. The empirical material consists of group reflections within a Teacher Learning Community (TLC) as well as field studies, including lesson observations and semi structured interviews with both students and teachers. In the first step of the analysis the material is categorized by means of the five key strategies (Wiliam, 2010a), in order to identify different ways of working with AfL in upper secondary PEH. The second step is a combination of a governmentality (Foucault, 1978/1991b), a performativity (Ball, 2003) and a didactic (Hudson, 2002) analysis, which illuminates what triadic relations are established under different conditions of governance. The findings highlight five fabrications of AfL in PEH, named after their most prominent features or functions, AfL as: i) Empowerment, ii) Physical Activation, iii) Grade Generation, iv) Constructive Alignment, v) Negotiation. ”Among the products of discursive practices are the very persons who engage in them” (Davies & Harré, 2001, p. 263). Accordingly, different teacher and student subjects as well as characteristics of the subject content are constituted in each of these fabrications. Moreover, the so called ‘backwash effect’ (Torrance, 2012) implies that the contrasting versions of AfL promote different kinds of learning, such as: i) increased autonomy, ii) participation in a community of practice, iii) criteria compliance, iv) acquisition of prescribed abilities, v) group development. However, the big idea of AfL is to adapt the teaching to the students and not the students to the knowledge requirements. Hence, this dissertation could serve as a basis for discussion on possible didactic implications of AfL in PEH.