Estado do conhecimento: recuperação da aprendizagem e do reforço escolar na rede estadual paulista (1999 a 2009)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perspectivas e desafios da prática avaliativa de professores em uma escola da rede particular do ensino fundamental: um estudo de caso

Pós-graduação em Educação - FFC

Avaliação formativa e reflexão pedagógica de um grupo de professores de ensino fundamental II: pesquisa-ação

Pós-graduação em Educação - FFC

Avaliação de produções escritas em português para falantes de outras línguas em contexto teletandem: contribuições para a formação inicial de professores

Pós-graduação em Estudos Linguísticos - IBILCE

Intelligent tutoring system for distance education

This study aims to develop and implement a tool called intelligent tutoring system in an online course to help a formative evaluation in order to improve student learning. According to Bloom et al. (1971,117) formative evaluation is a systematic evaluation to improve the process of teaching and learning. The intelligent tutoring system may provide a timely and high quality feedback that not only informs the correctness of the solution to the problem, but also informs students about the accuracy of the response relative to their current knowledge about the solution. Constructive and supportive feedback should be given to students to reveal the right and wrong answers immediately after taking the test. Feedback about the right answers is a form to reinforce positive behaviors. Identifying possible errors and relating them to the instructional material may help student to strengthen the content under consideration. The remedial suggestion should be given in each answer with detaileddescription with regards the materials and instructional procedures before taking next step. The main idea is to inform students about what they have learned and what they still have to learn. The open-source LMS called Moodle was extended to accomplish the formative evaluation, high-quality feedback, and the communal knowledge presented here with a short online financial math course that is being offered at a large University in Brazil. The preliminary results shows that the intelligent tutoring system using high quality feedback helped students to improve their knowledge about the solution to the problems based on the errors of their past cohorts. The results and suggestion for future work are presented and discussed.

Quality Control for SP Performance Regarding Patient Portrayal in a High-Stakes OSCE

Introduction Since the quality of patient portrayal of standardized patients (SPs) during an Objective Structured Clinical Exam (OSCE) has a major impact on the reliability and validity of the exam, quality control should be initiated. Literature about quality control of SP’s performance focuses on feedback [1, 2] or completion of checklists [3, 4]. Since we did not find a published instrument meeting our needs for the assessment of patient portrayal, we developed such an instrument after being inspired by others [5] and used it in our high-stakes exam. Methods SP trainers from all five Swiss medical faculties collected and prioritized quality criteria for patient portrayal. Items were revised with the partners twice, based on experiences during OSCEs. The final instrument contains 14 criteria for acting (i.e. adequate verbal and non-verbal expression) and standardization (i.e. verbatim delivery of the first sentence). All partners used the instrument during a high-stakes OSCE. Both, SPs and trainers were introduced to the instrument. The tool was used in training (more than 100 observations) and during the exam (more than 250 observations). FAIR_OSCE The list of items to assess the quality of the simulation by SPs was primarily developed and used to provide formative feedback to the SPs in order to help them to improve their performance. It was therefore named “Feedbackstruckture for the Assessment of Interactive Role play in Objective Structured Clinical Exams (FAIR_OSCE). It was also used to assess the quality of patient portrayal during the exam. The results were calculated for each of the five faculties individually. Formative evaluation was given to the five faculties with individual feedback without revealing results of other faculties other than overall results. Results High quality of patient portrayal during the exam was documented. More than 90% of SP performances were rated to be completely correct or sufficient. An increase in quality of performance between training and exam was noted. In example the rate of completely correct reaction in medical tests increased from 88% to 95%. 95% completely correct reactions together with 4% sufficient reactions add up to 99% of the reactions meeting the requirements of the exam. SP educators using the instrument reported an augmentation of SPs performance induced by the use of the instrument. Disadvantages mentioned were high concentration needed to explicitly observe all criteria and cumbersome handling of the paper-based forms. Conclusion We were able to document a very high quality of SP performance in our exam. The data also indicate that our training is effective. We believe that the high concentration needed using the instrument is well invested, considering the observed augmentation of performance. The development of an iPad based application for the form is planned to address the cumbersome handling of the paper.

Adherence to HIV /AIDS therapies among low -literacy populations: The ALP project

Adherence to HIV/AIDS therapies has been an important health problem since the early 1980s when AZT was first prescribed as a therapy for HIV/AIDS. It became particularly important between 1995 and 1997 with the advent of protease inhibitors (Chesney, Ickovics, Hecht, Sikipa, & Rabkin J., 1999) and became even more significant as persons with HIV/AIDS began to develop resistance to medications. Low-literacy populations have poorer health (Brez & Taylor, 1997) and higher AIDS rates (Simon, Hu, Diaz, & Kerndt, 1995), than their higher literacy counterparts due to delayed treatment (Baker, Parker, Williams, Clark, & Nurss, 1997), shame of literacy skills (Parikh, 1996), and poor access to care (Williams, et al., 1995). Poorer health and higher AIDS rates can also be attributed to poor patient-provider relationships (Crespo-Fierro, 1997; Eldred, Wu, Chaisson, & Moore, 1998) to a poorer understanding of medical protocols (Murphy, 1997), and inadequate patient education (Ungvarski, 1997; Davis, Michielutte, Askov, Williams, & Weiss, 1998, Doak, Doak, & Root, 1996). ^ The ALP intervention was developed for HIV positive low-literacy populations of African American women in Houston, Texas. The intervention was based on a needs assessment, using the PRECEDE model, an innovative process referred to as Intervention Mapping, and validated using formative evaluation methods with 54 individuals. The needs assessment resulted in a list of behavioral, environmental, predisposing, enabling, and reinforcing determinants of adherence. The Intervention Mapping framework was used to refine these determinants and develop a list of objectives describing what must be learned or changed to for the target population to adhere to HIV/AIDS therapies. Methods and strategies, were developed using theoretical constructs from the Health Belief Model (Rosenstock, 1974) and Social Cognitive Theory (Bandura, 1986). These theories, empirical evidence, and information from the target population indicated that perceived susceptibility, perceived severity, outcome expectations, and self-efficacy were important and changeable determinants of adherence to HIV/AIDS therapies for this population. ^ These components were brought together in the form of a theory-based color cartoon book and 10-minute cassette tape. The book was developed for people with 2.9 years of U.S. education as measured with the Flesch-Kincaid Grade Level method and the script was recorded onto a cassette tape to make it suitable for populations with even lower-literacy skills. A formative evaluation was conducted to ensure that the content and structure were accurate, clear, realistic, readable, appropriate, and likely to be used as intended. ^

Aprendizaje colaborativo en enseñanza a distancia: entorno genérico para configurar, realizar y analizar actividades en grupo

En esta tesis se ha profundizado en el estudio y desarrollo de modelos de soporte para el aprendizaje colaborativo a distancia, que ha permitido proponer una arquitectura fundamentada en los principios del paradigma CSCL (Computer Supported Collaborative Learning). La arquitectura propuesta aborda un tipo de problema concreto que requiere el uso de técnicas derivadas del Trabajo Colaborativo, la Inteligencia Artificial, Interfaces de Usuario así como ideas tomadas de la Pedagogía y la Psicología. Se ha diseñado una solución completa, abierta y genérica. La arquitectura aprovecha las nuevas tecnologías para lograr un sistema efectivo de apoyo a la educación a distancia. Está organizada en cuatro niveles: el de Configuración, el de Experiencia, el de Organización y el de Análisis. A partir de ella se ha implementado un sistema llamado DEGREE. En DEGREE, cada uno de los niveles de la arquitectura da lugar a un subsistema independiente pero relacionado con los otros. La aplicación saca partido del uso de espacios de trabajo estructurados. El subsistema Configurador de Experiencias permite definir los elementos de un espacio de trabajo y una experiencia y adaptarlos a cada tipo de usuario. El subsistema Manejador de Experiencias recoge las contribuciones de los usuarios para construir una solución conjunta de un problema. Las intervenciones de los alumnos se estructuran basándose en un grafo conversacional genérico. Además, se registran todas las acciones de los usuarios para representar explícitamente el proceso completo que lleva a la solución. Estos datos también se almacenan en una memoria común que constituye el subsistema llamado Memoria Organizativa de Experiencias. El subsistema Analizador estudia las intervenciones de los usuarios. Este análisis permite inferir conclusiones sobre la forma en que trabajan los grupos y sus actitudes frente a la colaboración, teniendo en cuenta además el conocimiento subjetivo del observador. El proceso de desarrollo en paralelo de la arquitectura y el sistema ha seguido un ciclo de refinamiento en cinco fases con sucesivas etapas de prototipado y evaluación formativa. Cada fase de este proceso se ha realizado con usuarios reales y se han considerado las opiniones de los usuarios para mejorar las funcionalidades de la arquitectura así como la interfaz del sistema. Esta aproximación ha permitido, además, comprobar la utilidad práctica y la validez de las propuestas que sustentan este trabajo.---ABSTRACT---In this thesis, we have studied in depth the development of support models for distance collaborative learning and subsequently devised an architecture based on the Computer Supported Collaborative Learning paradigm principles. The proposed architecture addresses a specific problem: coordinating groups of students to perform collaborative distance learning activities. Our approach uses Cooperative Work, Artificial Intelligence and Human-Computer Interaction techniques as well as some ideas from the fields of Pedagogy and Psychology. We have designed a complete, open and generic solution. Our architecture exploits the new information technologies to achieve an effective system for education purposes. It is organised into four levels: Configuration, Experience, Organisation and Reflection. This model has been implemented into a system called DEGREE. In DEGREE, each level of the architecture gives rise to an independent subsystem related to the other ones. The application benefits from the use of shared structured workspaces. The configuration subsystem allows customising the elements that define an experience and a workspace. The experience subsystem gathers the users' contributions to build joint solutions to a given problem. The students' interventions build up a structure based on a generic conversation graph. Moreover, all user actions are registered in order to represent explicitly the complete process for reaching the group solution. Those data are also stored into a common memory, which constitutes the organisation subsystem. The user interventions are studied by the reflection subsystem. This analysis allows us inferring conclusions about the way in which the group works and its attitudes towards collaboration. The inference process takes into account the observer's subjective knowledge. The process of developing both the architecture and the system in parallel has run through a five-pass cycle involving successive stages of prototyping and formative evaluation. At each stage of that process, we have considered the users' feedback for improving the architecture's functionalities as well as the system interface. This approach has allowed us to prove the usability and validity of our proposal.

The development of an online neonatal intensive care unit family education

Background: British Columbia’s Fraser Health Authority (FHA) neonatal intensive care units (NICUs) value family centered care (FCC). Nevertheless, there is limited evidence that FCC is actually incorporated into practice, as well as some concern that FHA NICU education is inaccessible, inconsistent, or disorganized. Purpose: The mission of this project is to support the principles of FCC throughout the development of an FHA online NICU family education guide by reflecting upon the needs of families throughout their NICU journey. Methods: A needs assessment was initially completed and included literature reviews, consultations, and an environmental scan. This data informed development of an online NICU family education guide which plots current education materials along key stages of the NICU journey: prenatal, admission, early days, growing and developing, discharge and at home. For the purposes of this practicum, only the prenatal stage was fully developed and will serve as a template for other stages following a formative evaluation. A pamphlet and revised FHA Neonatal Checkpoint will also be developed to augment teaching by health care professionals. Implementation and evaluation plans were adapted from the Center for Disease Control Framework for Program Evaluation in Public Health. Results: The needs assessment validates and directs the development, implementation, and evaluation of the online guide illustrating an FCC approach. The online guide centralizes and organizes education by selecting education topics that relate to each stage of the NICU journey. This family-directed design enables families’ access to consistent and reliable information and offers them an opportunity to learn at their own pace. Conclusion: The process of creating, implementing, and evaluating an online family education program for FHA NICUs elucidates the intricacies and the advantages of integrating FCC into NICU practice.

D5.5 – First Version Scenario Arrangement Document – round 1

This deliverable outlines the implementation plan for each of the first-round studies of the RAGE pilots. The main goal of these pilots is to perform a small-scale test of the RAGE games with end-users and intermediary stakeholders in five different non-leisure domains to guide the further development of the games for the final validation studies. At the same time the pilots implement the pre-testing of the research instruments and methodology for answering the main evaluation questions in the five areas of investigation identified in D8.1: 1) usability, 2) game experience, 3) learning effectiveness, 4) transfer effect and 5) pedagogical costs and benefits. Finally, the pilots are aimed at collecting preliminary results for a first formative evaluation of the games and game technologies, with the goal of feeding back useful information to development for the final versions of games and assets. The results of the first pilot will be compared with the results of the final evaluation studies to demonstrate improvements of the game and game effects from first to final version. A revision of the deliverable will be done in the next few months to produce the final arrangement document (D5.1, due at M21).

Education and self-regulation of learning for gifted pupils: Systemic design and development.

Gifted pupils differ from their age-mates with respect to development potential, actual competencies, self-regulatory capabilities, and learning styles in one or more domains of competence. The question is how to design and develop education that fits and further supports such characteristics and competencies of gifted pupils. Analysis of various types of educational interventions for gifted pupils reflects positive cognitive or intellectual effects and differentiated social comparison or group-related effects on these pupils. Systemic preventive combination of such interventions could make these more effective and sustainable. The systemic design is characterised by three conditional dimensions: differentiation of learning materials and procedures, integration by and use of ICT support, and strategies to improve development and learning. The relationships to diagnostic, instructional, managerial, and systemic learning aspects are expressed in guidelines to develop or transform education. The guidelines imply the facilitation of learning arrangements that provide flexible self-regulation for gifted pupils. A three-year pilot in Dutch nursery and primary school is conducted to develop and implement the design in collaboration with teachers. The results constitute prototypes of structured competence domains and supportive software. These support the screening of entry characteristics of all four-year old pupils and assignment of adequate play and learning processes and activities throughout the school career. Gifted and other pupils are supported to work at their actual achievement or competency levels since their start in nursery school, in self-regulated learning arrangements either in or out of class. Each pupil can choose other pupils to collaborate with in small groups, at self-chosen tasks or activities, while being coached by the teacher. Formative evaluation of the school development process shows that the systemic prevention guidelines seem to improve learning and social progress of gifted pupils, including their self-regulation. Further development and implementation steps are discussed.

Teaching down or learning up

Résumé : L'élément important que cette thèse sous-tend est que l'enseignement efficace n'est pas seulement constitué de techniques et de méthodologie, mais plutôt d'attitude et d'approche envers l'enseignement. Ceci ne veut pas nécessairement dire que plusieurs méthodes d'enseignement reçues dans un cours avec l'intention d'optimaliser les mécanismes de transmission et d'assimilation de la matière sont inappropriées. Cependant, l'absence de ce que nous pourrions définir comme un ton pédagogique est essentiel, c'est-à-dire, qu'une attitude positive à la productivité autant vis-à-vis de la matière à transmettre que vis-à-vis de l'individu impliqué dans "l'acte" de réception versus la découverte, aura davantage de succès. Toute autre méthode sera complètement inefficace, inaccessible, voire même inutile. D'emblée, dans l'hypothèse de départ, l'argument principal présente une attitude générale d'enseignement à divers échelons ; soit au niveau secondaire ou collégial qui est inappropriée, incomplète ou négative. En d'autres mots, cette approche thérapeutise l'éducation. Dans l'exercice de cette approche, l'enseignant ou l'enseignante adopte plutôt le rôle d'un thérapeute que celui d'un éducateur. De ce fait, le professeur en situation a une approche plutôt de thérapeute que celle de maître-précepteur et que la matière présentée est souvent diluée, et réduite à des niveaux d'apprentissage accompagnés de carences notoires et d'échecs académiques. Les attentes d'une performance dans le milieu académique sont souvent des plus modestes. Cette même tendance d'une éducation à la baisse est évidente aussi dans le processus d'évaluation. Il est certain que dans les disciplines non scientifiques, l'évaluation formative a grandement suivi l'évaluation normative conduisant le précepteur, tour à tour, dans une évaluation dormative dans laquelle l'effort et l'intention remplacent les aptitudes et les habilitées réelles. Si l'approche pédagogique est vraiment l'élément crucial de l'éducation, il Importe que l'approche générale influence le climat de l'éducation contemporaine, de fait, devienne un palliatif contre-productif souvent réhabilitant. De plus, cette pseudo-thérapie d'où d'écoule une attitude exigeante envers l'enseignant et l'apprenant dont le fondement est la reconnaissance des impératifs culturels qui en sont le reflet et le corps doit-être affirmé et transposé dans la réalité. Cette dernière comprend des attentes très poussées en ce qui concerne la performance en classe et aussi le respect de la matière qui contient la présentation routinière et fondamentale; renouveau intense du processus d'évaluation qui fournira des standards communs et des objectifs externes dans l'évaluation du travail de l'étudiant. Cette connaissance et domestication empirique que nous présente Vygotsky dans un climat contemporain qu'il a expliqué ces termes comme "des zones de développement proximales" basées sur la doctrine suivante que le bon apprentissage précède le développement et que conséquemment s'ensuit une pédagogie d'apprentissage plutôt qu'une pédagogie centrée sur l'apprenant. L'application significative de ces derniers principes ou de ces épistémologiques s'imbriquent dans une situation d'apprentissage ascentionnel dont la structure est détaillée et considérée par différentes perspectives de la recherche qui suit.||Abstract : The central tenet of this thesis is that effective teaching is not only and perhaps not primarily a matter of technique and methodology but of attitude and approach. This is not to say that diverse methods of classroom instruction intended to optimize the mechanics of transmission and the assimilation of data are inappropriate but that in the absence of what we might denominate as a certain pedagogical tone. that is, a productive attitude toward both the material to be conveyed and the individuel engaged in the 'act' of reception-and-discovery, even the most powerful methods will be differentially unavailing or, at best, inefficient. Given this initial assumption, the argument proceeds that the general attitude toward instruction currently in place at the secondary echelons, that is, on the high school and college levels, may be popularly represented as a 'teaching down' approach, in other words, as one which seeks to therapeuticize education. In practice this means that the teacher tends to manifest in situ more as a therapist than as a preceptor, that the material to be presented is frequently diluted or scaled down to perceived levels of cognitive (dis)ability (as is also the case with the rate of instruction), and that performance expectations in the current pedagogical milieu are commonly quite modest. The same downward trend is evident in assessment protocols as well. Certainly in the nonscientific disciplines, normative evaluation has been widely succeeded by formative evaluation, leading in turn to a peculiar kind of dormative evaluation in which intangibles such as effort and intention may deputize for realized ability. If pedagogical approach is indeed the crucial element in instruction, and if the general approach that pervades the contemporary climate of instruction is indeed counter-productively remedial or rehabilitory, that is, therapeutic, then it should follow that a more demanding attitude toward teaching and learning founded on the recognition of the culturel imperative which teaching both reflects and embodies needs to be re-affirmed and translated into practice. This latter would entail the maintenance of high expectations with regard to classroom performance, a respect for the material which precludes its routine mitigation or debasement, a renewed insistance on grading protocols that provide an external, 'objective' or communal standard against which the student's work can be measured, the empirical acknowledgment or domestication of what Vygotsky has termed "the zone of proximal development," based on the doctrine that good learning proceeds in advance of development, and conséquently, a learning-centered rather than learner-centered pedagogy. The meaningful application of this latter set of principles or epistemological gradients comprises the 'learning up' situation whose structure is excunined in some détail and considered from various perspectives in the ensuing.

Conceções sobre avaliação formativa de professores do 2.ºCEB: um estudo comparativo

Relatório de estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e do 2.º Ciclo do Ensino Básico

Prática de ensino supervisionada em educação pré-escolar e ensino do 1º ciclo do ensino básico: tornando-se educadora/professora

O presente relatório da Prática de Ensino Supervisionada (PES) resulta da observação e participação no contexto da PES em Educação Pré-Escolar realizado em Florianópolis, Santa Catarina (Brasil), através do programa Luso-Brasileiro, no Núcleo de Educação Infantil Colónia Z-11 e da PES em 1º Ciclo do Ensino Básico na Escola EB1 da Quinta da Vista Alegre, pertencente ao Agrupamento Manuel Ferreira Patrício de Évora. O relatório centra-se no meu percurso e aprendizagens como futura educadora/professora: ir aprendendo a profissão em contexto, indo ao encontro de quem somos e em quem nos vamos tornando, dando enfase ao papel das crianças nos processos de aprendizagem que experimentámos. Na conceção da ação educativa, tornada prática pedagógica em contexto, a avaliação, formativa e transformadora, assim como a reflexão acerca da prática foram fundamentais para o melhoramento da intervenção e, por tal, influências positivas na aprendizagem das crianças e na minha aprendizagem profissional. A problemática deste relatório teve como base o querer compreender relações entre uma reflexão sistemática, por escrito, sobre o desenvolvimento do meu projeto de formação em contexto, considerando que a avaliação formativa deveria nortear e monitorizar o nosso trabalho, as relações e aprendizagens, na ação docente que ia desenvolvendo, quer em Educação Pré-Escolar quer no 1º Ciclo. Neste percurso, entrelaçando a ação e a investigação, procurei respostas para as seguintes questões: o que sabia acerca da docência que se pauta por uma avaliação formativa e formadora no trabalho com crianças? O que fiz para aprendermos em conjunto, tendo em conta uma função reguladora que a avaliação poderia tomar? Como o fiz? Em que momentos e com quem? Para quê, com que finalidade? O que aprendi no decorrer deste processo de aprendizagem profissional, onde a investigação-ação teve um papel relevante?; Supervised Teaching Practice’s Report to obtain a Master’s Degree in Preschool and Primary school: Abstract: The present report of Supervised Teaching Practice (STP) is a result of the observation and participation in context of STP in pre-school that took place in Florianópolis, Santa Catarina (Brazil), through the Luso-Brazilian program, in Núcleo de Educação Infantil Colónia Z-11 and through STP in Primary School of Ensino Básico in Escola EB1 da Quinta da Vista Alegre, which belongs to the Manuel Ferreira de Évora Group. The report focuses on my journey and learnings as a future teacher: learning the profession in it’s actual context, trying to find who we are and what we can become, and emphasizing the children’s role in these learning processes. In the conception of the education activities, which became possible by pedagogical practice in context, the evaluation, formative and transformative, as well as the reflection about the practice were vital to improve the intervention and, consequently, to have a positive influence in the children’s learning process and in my own professional experience. The main focus of this report is to understand the relation between a systematic reflection, in writing, about the development of my teaching in context project, considering that the formative evaluation should guide and monitor our work, the relationships and learnings, in the educational process that I developed, either in pre-school or primary school. In this journey, by combining action and investigation, the main intention was to answer the following questions: What did I know about teaching characterized by a formative assessment when working with children? What did I do so we could learn together, bearing in mind a regulative function that evaluation could take? How did I do it? In what moments and whom with? What for, and what was the purpose? What did I learn throughout this professional learning process, where the investigation-action played a major role?

Idoneidade formativa dos campos de prática clínica - caso particular de uma unidade de saúde personalizada

A Ordem dos Enfermeiros (OE) aprovou em Assembleia Geral de 2007 uma proposta de alteração estatutária em termos de regulação e desenvolvimento profissional. Surge assim o Modelo de Desenvolvimento Profissional (MDP) que traz uma nova dimensão à certificação de competências de enfermeiro e enfermeiro especialista. Se até aqui a OE certificava estas competências a partir dos documentos académicos apresentados, a partir desta alteração a certificação passa por uma prática tutelada de exercício profissional e só depois de dará a atribuição do título profissional. O Exercício Profissional Tutelado (EPT) só poderá ocorrer em serviços de saúde com idoneidade formativa acreditada pela OE. Para determinar esta idoneidade formativa dos contextos de prática clínica de enfermagem, é construído um referencial, que parte do documento “Padrões de Qualidade dos Cuidados de Enfermagem”, tendo como eixo organizador o enunciado descritivo sobre “A organização dos cuidados de enfermagem”. Este trabalho reflete o estágio realizado num contexto de prática clínica (Unidade de Cuidados de Saúde Personalizados) onde foi feita uma avaliação em termos de idoneidade formativa. De Abril a Junho de 2011 foi feita observação documental e da prática de enfermagem, aplicada uma grelha de avaliação de idoneidade formativa e entrevistado o enfermeiro chefe. Os resultados apresentados são de não evidência de idoneidade formativa, após o que se tentou estabelecer um Plano de Acção, para cumprimento dos critérios estabelecidos para a certificação. Com base no mesmo enunciado, a organização dos cuidados de enfermagem, foram delineadas algumas intervenções que, a seu tempo, poderão certificar esta unidade para a prática do exercício profissional tutelado. Destacamos o necessário envolvimento de todos os elementos de enfermagem, com uma condução de liderança forte e motivadora, no sentido criar um contexto de prática clínica congruente com as orientações da OE para a certificação e, em simultâneo, melhorar a qualidade dos cuidados de enfermagem prestados.