Nurse training in health in different regions in Brazil

Abstract Objectives: to identify on the one hand whether there has been any changes in the nurse training in Brazil and on the other if regionalizing health incurred interference in this process. Methods: an exploratory research of a multiple case study in a qualitative approach developed between November 2015 and March 2017, in seven regions in Brazil. The data were collected by in-depth interviews with 16 administrators of the undergraduate courses in nursing and by documentary analysis of the Projetos Políticos Pedagógicos (Political Pedagogical Projects). Content analysis was undertaken by having the theoretical references of the Diretrizes Curriculares Nacionais (National Curriculum Guidelines). Results: varied profiles of undergraduates were observed with higher tendency for the basic level in health practice or for hospital level with competencies in health care that is still fragmented and not interdisciplinary. The curricular structure of the courses focuses on isolated disciplines with little or no interdisciplinary integration and the pedagogical model is based on traditional teaching-learning strategies and additional evaluation process. There were no differences in health among the regions. Conclusions: it is necessary in concomitance with the changes that are required in the field of training to undertake efforts in the development of health units and training institutions, which has already proven to be a factor of professional retention and regional development.

摘要
研究目的：一方面明确巴西的护士培训是否发生了变化，另一方面探究卫生保健区域化是否对该培训进程产生干预影响。
研究方法：本研究采用质性研究范式下的探索性多案例研究设计，于2015年11月至2017年3月间在巴西七个地区开展。数据收集方式包括：对16名护理学本科课程负责人开展深度访谈（in-depth interviews），以及对《教学政治项目（Projetos Políticos Pedagógicos）》进行文献分析（documentary analysis）。本研究以《国家课程指南（Diretrizes Curriculares Nacionais）》的理论框架为基础开展内容分析（content analysis）。
研究结果：研究观察到多样化的本科护理培养模式，其中多数倾向于卫生实践基础层级或医院护理层级的人才培养，但当前护理人才的卫生保健相关能力仍呈现碎片化特征，且未实现跨学科整合（interdisciplinary integration）。各课程的课程结构以孤立的学科教学为主，几乎不存在或完全缺乏跨学科整合；其教学模式（pedagogical model）以传统教与学策略（traditional teaching-learning strategies）及附加评价流程为核心。不同地区间的卫生保健培训情况未发现显著差异。
研究结论：伴随护理培训领域亟需推进的变革，亟需同步加强卫生保健机构与培训院校的建设——这一举措已被证实是促进专业人才留存与区域发展的关键因素。