Learning clinical skills during bedside teaching encounters in general practice: a video-observational study with insights from activity theory

Purpose – This paper aims to explore how opportunities for learning clinical skills are negotiated within bedside teaching encounters (BTEs). Bedside teaching, within the medical workplace, is considered essential for helping students develop their clinical skills. Design/methodology/approach – An audio and/or video observational study examining seven general practice BTEs was undertaken. Additionally, audio-recorded, semi-structured interviews were conducted with participants. All data were transcribed. Data analysis comprised Framework Analysis informed by Engeström’s Cultural Historical Activity Theory. Findings – BTEs can be seen to offer many learning opportunities for clinical skills. Learning opportunities are negotiated by the participants in each BTE, with patients, doctors and students playing different roles within and across the BTEs. Tensions emerged within and between nodes and across two activity systems. Research limitations/implications – Negotiation of clinical skills learning opportunities involved shifts in the use of artefacts, roles and rules of participation, which were tacit, dynamic and changing. That learning is constituted in the activity implies that students and teachers cannot be fully prepared for BTEs due to their emergent properties. Engaging doctors, students and patients in refecting on tensions experienced and the factors that infuence judgements in BTEs may be a useful frst step in helping them better manage the roles and responsibilities therein. Originality/value – The paper makes an original contribution to the literature by highlighting the tensions inherent in BTEs and how the negotiation of roles and division of labour whilst juggling two interacting activity systems create or inhibit opportunities for clinical skills learning. This has signifcant implications for how BTEs are conceptualised.

História da psicologia e psicologia histórica: seus critérios e suas diferenças

Este trabalho diferencia a História da Psicologia da Psicologia Histórica, mostrando que a História da Psicologia se ateve ao estudo da evolução de uma ciência e, assim sendo, operou a nível conceitual, tendo considerado importantes para melhor compreensão de seu objeto de estudo - o homem - conceitos referentes à leis fisiológicas e psicológicas. As raízes desses conceitos encontram-se em movimentos relacionados às ciências naturais - conceitos fisiológicos, principalmente sobre os reflexos e a localização cerebral, conceitos biológicos, como os de evolução e adaptação, interesse pela pesquisa, surgimento de laboratórios e uma abordagem do psiquismo - e à filosofia - empirismo crítico, associacionismo e materialismo científico. Fundamentalmente opera com o princípio da permanência, ou seja, com o princípio que sustenta a permanência da natureza humana ao longo da História. Influenciados pelos estudos da sociologia e da antropologia, os psicólogos começaram a rever seus conceitos e, dessa revisão, surgiu, então, uma nova visão do homem; uma compreensão de que ele é um ser cuja realidade é essencialmente histórica e cuja conduta produz e reflete mudanças no ambiente social em que ele vive. Surge, a partir dessa nova visão, a Psicologia Histórica, operando não a nível conceitual, como a História da Psicologia, mas a nivel factual. Trabalha não com uma natureza humana essencialmente estável, mas com um ser humano que se modifica ao longo da História, mostrando características novas e novas espécies de comportamento.

Sobre a constituição do sujeito: uma análise comparativa entre a psicologia sócio-sociologia do conhecimento de berger e luckmann

This study investigated how the process of the constitution of the subject is interpreted in the formulations of the founders of socio-historical psychology (Lev S. Vigotski, Alexei N. Leontiev and Alexander R. Luria) and in the sociology of knowledge of Peter Berger and Thomas Luckmann. These two theoretical perspectives, despite having different philosophical formulations as ontological and epistemological intentions (socio-historical psychology, historical dialectical materialism; the sociology of Berger and Luckmann and phenomenology) arrive, however, at the same basic conclusion about the social nature of the subject. The objective of the study, therefore, was that of identifying the differences and convergences between the two perspectives and then, try to determine the possibility of a theoretical synthesis between them in relation to the constitution of the subject. At the same time, we intended to analyse the implications of this possible synthesis in order to comprehend the manner in which the ideology functions in human societies as thought by Louis Althusser and Alípio de Sousa Filho. We arrived at the conclusion that, despite being incompatible from the ontological and epistemological points of view, a synthesis is possible between socio-historical psychology and the sociology of knowledge of Berger and Luckmann in relation to the conception of society and the comprehension of the process of the constitution of the subject. Starting from the philosophical intentions of socio-historical psychology, it is possible to incorporate, enriching points such as: Berger s and Luckmann sconception of society and the interpretation of the process of constitution of the subject. This possible synthesis, when interpreted in light of the reflections of Althusser and Sousa Filho on the phenomenon of ideology in human societies, is constituted in a real unveiling of the concrete provisos by which the ideology acts in human societies in order to transform biological examples of the human species in specific social subjects

Entre cristo e o diabo:o ideário do Colégio Americano Batista do Recife (1902-1942)

Due to lack of work on the history of Baptist schools in the Northeast region of Brazil, it is important to understand through a historical reconstruction of the Baptist Protestant education. We embarked on this venture as a chance to understand the presence of Protestant schools, and his ideas on Brazilian soil. Our goal is to promote a reflection which has the axial dimension of the Baptists Protestant education, in time, we will place the debate between 1902-1942. The temporal boundaries of 1902-1942 was because 1902 was when he started the American Baptist College of Recife in 1942 and that ends the cycle of managing directors of Americans. Understand the functionality of time a school is justified when we realize that the history of education is the story of a work of self and formation within a framework that has the school as the main support that can enable a reading of reality. We also intend to examine the school culture brought to Brazil by American missionaries and their applicability in the Brazilian cultural-historical context. And just to demonstrate the hypothesis that the educational contribution of Baptists added to the participation of other Protestants promoted advances in Brazilian society. Possibly taking for granted that the Baptists were in possession of the democratic ideals of religious freedom, taken by many representatives and religious version of the republican regime. In addition to promoting a model in Brazil to make different methodological schools, based on the ideals of new school and ethics of the Bible. Our proposed research aims at understanding how North American missionaries settled in Brazil and what were the purposes of adding to the efforts of evangelization to formal education, binomial that justified the establishment of schools. A vision of saving men for evangelization and education of the Devil attack victims over the ethics of Christ

Trilhas da inclusão escolar percorridas por uma aluna com paralisia cerebral na EJA: concepções e práticas

On this qualitative study, it has been discussed the school inclusion paths done by a student with cerebral palsy, who we call Liz, and who was also the reference and indirect subject for this study. For the representation of landscapes found, it follows throughout historical, political and pedagogical paths, getting through the case study method references on the current Brazilian educational context, analyzing, which concepts are attributed to the inclusion and which practices are developed by educational managers and teachers in a regular school of the City of Natal/RN. The theory which based this research is supported on Vygotsky's central ideas (1991, 1997, 2004) and his followers. Furthermore, it was essential to bring to this investigative journey a literature which could dialogue with the most relevant aspects of the cultural-historical approach, emphasizing the assumptions of a progressive education tendency, which promotes the subject involvement of his/her work in the world and for the world. This way, it was necessary to seek for theoretical support on assistive technology and on alternative communication, in order to show the importance of establishing other communications, which is, to break away from the conventional pattern established by the school. On this journey it was used procedures for the data construction, such as: observation, conducting semistructured interviews and questionnaires; and document analysis that supported and legitimized the inclusion, besides the permanent field diaries record. On the access paths to this landscape it entered in the Youth and Adults Education (Educação de Jovens e Adultos - EJA), seeking to establish a dialogue among Youth and Adult Education and Special Education. It was verified that, still, there are large gaps in these policies articulation. Among the results obtained it was raised discussions on new scenery, in which Youth and Adults Education (EJA) emerges as prominent mode of the established relationships throughout the school inclusion process. There were target reflections on: the planning and evaluation systematic, the pedagogical articulation among the Youth and Adults Education (EJA) teachers and the multifunctional resource room teacher's actions and the continuous training importance of the educators involved. It was considered, therefore, that the necessary mediations for school inclusion may be sustained if the walkers are involved in a permanent contact with the nature of a proposal from the Special Education inclusive perspective

Corpo e saúde: reflexões sobre o quadro "Medida Certa"

The present scenario is permeated by different comprehensions about the body and health. These are the result of a historical process experienced by men in different times and social contexts through which were being built. Faced this scenario, we emphasize the media as a powerful means of information and training ideas regarding the body and health of theses. The media also as a means of mediating information we present characteristics of the social scenario where is inserted. In our research we bring reflects about the comprehensions, knowledge and practices propagated by the way the body and health under "Medida Certa" of the program Fantastico the broadcaster Globo Telecommunications, in order to identify how Physical Education, has contributed the construction of knowledge disseminated. Therefore, we focus our analysis to the table "Medida Certa" exhibited by Fantastico in the months of April, May and June of 2011.The data for analysis were collected through the videos shown live in Fantastic and the information provided in the blog that table. Thus, we had 14 videos shown live, 16 videos posted on the blog, 97 posts in blog. As technique of analysis of the datas used of content analysis of the Bardin (2011). About body obtained as analytical categories: body as operating system; biological body; fragmented body exterior to the subject; body trailer quantified to patterns; subject body. How to health we analyze the categories of health existential: health existential based in biological indices of normality; health existential associated with weight loss and aesthetic patterns; health existential associated with physical activity and nutritional control; and finally we propose a comprehension of health existential. Therefore, from the analysis of the data evidenced a predominance of comprehensions, knowledge and practices about the body and health guided the biological constituents of the body, quantification and classification in medium and normal patterns on pervasive forms of care, in the linear association among physical activity and nutritional control with health, evidenced that Physical Education has contributed to these constructions, through some of his discourses with emphasis on biological aspects. Thus, in our study we advocate an understanding of not only the body as object, but also as a subject clipped by organic, cultural, historical and social elements, a living body, feeling, desire and above all expresses itself, and health viewed as something body, interlaced through the biological, cultural, historical and emotional aspects of this body that coexist in this society

Intervenção reflexiva: instrumento de formação continuada do educador especial

O presente artigo busca demonstrar a ocorrência de mudanças na prática pedagógica de uma professora, durante o período em que se fez a reflexão teórico-metodológica sobre essa prática, à luz de proposições da Psicologia sócio-histórica. Foram realizados 20 encontros reflexivos com uma professora da Educação Especial, a partir da análise de gravações das situações ocorridas em sala de aula. As discussões promovidas compreendiam aspectos relacionados ao processo de ensino e de aprendizagem na atividade docente. Foram examinadas as locuções verbais da professora e observaram-se indícios de mudança no que se refere ao foco de atenção, quando ela analisa seus problemas pedagógicos, na consideração da multideterminação dos problemas de ensino e aprendizagem, na concepção de aluno, no método de ensino, no estabelecimento e valorização da relação professor-aluno e da interação de alunos. Os resultados obtidos sinalizaram que a interação reflexiva mostrou-se um instrumento útil para a formação continuada de professores.

Exploração sexual comercial de crianças e adolescentes : o estado da arte nas produções acadêmicas em psicologia

The Commercial Sexual Exploitation of Children and Adolescents (ESCCA) is a phenomenon that has been given priority in public policy agenda of many democratic governments of Western countries and civil sectors of society, besides the object of studies in different fields of knowledge. Psychology is among these areas and is considered one of the references in the construction of knowledge and actions to confront the phenomenon. However, the epistemological foundations of psychological science are quite different, and so, several are his speeches, knowledge produced and ways of conceiving man and the world. This is evident in the publications of psychology on ESCCA. This work aims to achieve a state of the art of psychology publication in Brazil (in the post-graduation - through theses and dissertations - and journals) on the Commercial Sexual Exploitation of Children and Adolescents. More specifically try to evidence (a) what conceptions of commercial sexual exploitation of children and adolescents the authors lists, (b) what are aimed at research and publications, (c) how the research and issues are justified, and (d) that theoretical approaches the authors are affiliated and methodological possibilities are applied to range the aim proposed in their work. In order to do so, a survey was conducted in the major index sites (eg, BVS-Psi, Capes, theses and dissertations database of university libraries) of the material, covering the period 1990 to 2007. Through research on these sites, we built a database, including information relating to the work sought from specific descriptors for studies in the area of victimization of children and adolescents, with reference to a list provided by Faleiros (2000). After reading the summary of the work, the number of recovered 25 productions was reached - including theses, dissertations and articles. For analysis of the material used in the analysis of thematic content. Two axes themes were established in order to guide the analysis: conceptual elements of commercial sexual exploitation, and theoretical and methodological strategies employed. The axes have as reference for analysis a chapter built on the concept of commercial sexual exploitation, so that all analysis is anchored on it. The analysis points to the existence, still strong, conceptual and terminological confusion about ESCCA. Few studies have not demonstrated this confusion, maintaining a consistent theoretical approach. In relation to the theoretical and methodological strategies, there is a great diversity of approaches in psychology surrounding the phenomenon of ESCCA, enriching levels of understanding and action. This diversity reflects a constitutive heterogeneity of psychological science. We emphasize the perspective of socio-historical psychology, most frequently among the publications. It is hoped that this research will help advance the qualitative approach to ESCCA, especially in the field of psychology, as well as contribute to new research in the area and construction of new means of addressing this human rights violation

Formação do indivíduo, consciência e alienação: o ser humano na psicologia de A. N. Leontiev

Neste artigo são analisados três aspectos da psicologia de A. N. Leontiev e suas implicações para a reflexão sobre a educação na atualidade: a diferença entre a formação do indivíduo humano e a ontogênese animal; a relação entre a estrutura da consciência e a estrutura da atividade; e, por fim, a questão da alienação como um fenômeno social e histórico.

O desenvolvimento do psiquismo na vida cotidiana: aproximações entre a psicologia de Alexis N. Leontiev e a teoria da vida cotidiana de Agnes Heller

Este trabalho pretende apontar algumas aproximações entre a psicologia de Leontiev e a teoria da vida cotidiana de Agnes Heller, mais precisamente aquilo que a filósofa húngara denomina como formas de pensamento, sentimento e ação típicas da cotidianidade. Nossa hipótese é a de que esse estudo pode trazer contribuições para a psicologia sócio-histórica, especialmente no que se refere à compreensão das características do psiquismo humano numa sociedade marcada por processos de alienação, isto é, quando a estrutura da vida cotidiana cerceia o desenvolvimento intelectual, afetivo e moral dos indivíduos. Pretendemos, assim, contribuir para o entendimento daquilo que denominamos de psiquismo cotidiano.

O cuidado de pessoas com transtornos mentais no cotidiano de seus familiares: investigando o papel da internação psiquiátrica

As atribuições da família no cuidado de seus membros portadores de transtornos mentais têm passado por profundas transformações nos últimos anos. A presente pesquisa investigou as modificações no cotidiano de familiares de pessoas que passaram por internação psiquiátrica e os significados implicados neste processo. Foram realizadas entrevistas semi-estruturadas com cinco familiares, cujo conteúdo foi submetido à análise temática e interpretado em perspectiva sócio-histórica. Dentre outras questões, observa-se que: (1) a concepção de cura está relacionada à recuperação da capacidade produtiva, restrita a partir do surgimento dos sintomas; (2) os recursos informais são complementares, principalmente quando os recursos públicos não são suficientes ou satisfatórios; (3) a religiosidade está presente na compreensão metafísica das causas do sofrimento psíquico; (4) a igreja, na figura dos correligionários, consiste em um grupo de suporte para o usuário e para a sua família e (5) a insuficiência de políticas adequadas de atenção à família na rede substitutiva.

A equipe de saúde como mediadora no desenvolvimento psicossocial da criança hospitalizada

Num primeiro momento a criança se apropria do conhecimento por mediações externas, nas quais um objeto externo a ela, que pode ser um adulto, faz uma mediação entre ela e o conteúdo a ser adquirido. Assim, a hospitalização pode tornar-se um fator de risco no desenvolvimento psicológico da criança, tanto no âmbito cognitivo quanto no afetivo, caso suas potencialidades não sejam mediadas pela equipe de saúde, pois esta tem grande contato com a criança durante a internação. Foi investigado, como objetivo do estudo, o conhecimento do processo de desenvolvimento infantil por parte dos profissionais da saúde envolvidos no cuidado com crianças hospitalizadas, em um hospital-escola público do Estado de São Paulo. Participaram da pesquisa onze profissionais, entre técnicas e auxiliares de enfermagem, e os resultados indicam que estas consideram importantes alguns aspectos no cuidado com a criança, tais como estimulação da linguagem, atenção, brincadeira, vinculação, contato físico, porém não reconhecem estes aspectos como importantes para o desenvolvimento, e elegem profissionais específicos para tratarem de aspectos relacionados ao desenvolvimento infantil na internação, não se percebendo como mediadoras no processo de desenvolvimento psicossocial da criança hospitalizada.

(Em defesa dos) Cuidados Paliativos na Atenção Primária à Saúde

One of the basic principles of the Brazilian Public Health System (SUS) is integral assistance, which considers the integrality of the individual, of service and care, which should necessarily include end of life care. Our aim was to analyze the work process of health professionals at the Family Health Strategy / Primary Care that already cared for people in the dying process to propose viable contributions to the Public Health area as regards the implementation of Palliative Care in Primary Care. We present data referring to the following themes: Singular Therapeutic Project (PTS); death quality as PTS goal (work purpose); the team's ways of doing (bonding as a pact condition). Eleven health professionals (four nurses and seven physicians) linked to the Family Health Strategy (ESF) of Campinas (São Paulo) participated on this research. From the interviews, data analysis followed the Socio-Historical Psychology theoretical and methodological approach. The professionals' activity was analyzed in articulation with the specificities of caring for people in the dying process. We found that action planning in health is oriented by the Singular Therapeutic Project (PTS), with an emphasis in social diagnosis and the need of a bond for attaining a pact. It is understood that the purpose of health professionals' activity is to promote dignity and life quality in the dying process, but integral care should include not only individual and family care, but also the defence of full human development during all phases of life.

Softwares educativos para alunos com deficiência intelectual: Estratégias utilizadas

The computer is present in everyday school life and using it with educational software must be mediated and planned in order for this resource to contribute to student learning, including those with intellectual disabilities (ID). Therefore, the aim was to propose specific computer activities for students with ID using educational software, and to quantify and analyze the technical and pedagogical strategies used. The participants were six students with ID enrolled in two public schools. To collect information we used observation protocols and a field journal. Data were analyzed quantitatively and qualitatively, based on the concepts of mediation and the zone of proximal development of cultural-historical theory. The results indicated that when the content developed in the computer classes were compatible with the proposed activities in the classroom, students with ID had opportunities to experience different activities that enable them to be successful. We noted that what enabled them to understand and correctly perform the proposed activities were the teaching strategies. Thus, we consider that technical knowledge about educational software and pedagogical knowledge about content that is being worked on, are insufficient to ensure that the proposed activity will contribute to the development of students with ID.

O produto de moda para o portador de deficiência física: análise de desconforto

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)