Formação continuada em educação física e inclusão do deficiente no ensino regular sob a ótica de professores =: The ongoing graduation in physical education studies and the inclusion of disable people in regular schools under the teacher's perception

Pós-graduação em Ciências da Motricidade - IBRC

Development and evaluation of an integrated clinical learning model to inform continuing education for acute care nurses

Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

Early childhood education : the natural starting point for environmental education

Young children are most vulnerable to, and most at risk from, environmental and sustainability challenges. Early education investments aimed at addressing such issues, until recently however, have been neglected or under-rated. Fortunately, this is changing. A groundswell of practitioner interest in early childhood environmental education/ education for sustainability is emerging, in contrast to the ‘patches of green’ that have characterised previous decades. Indeed, an international coalition for early childhood education for sustainability (ECEfS) is beginning to develop, evidenced by The Gothenburg Recommendations on Education for Sustainable Development (2008) that identifies early childhood, within a framework of lifelong learning, as a ‘natural starting point’ for all ongoing education for sustainability. This document is important as it is the first international statement to explicitly identify ECEfS as contributing to education for sustainability. The next challenge for ECEfS is for practitioner mobilisation to be matched by research activity aimed at broadening and deepening practice-based responses. This is the next exciting frontier in the legitimisation of ECEfS.

An integrated educational model for continuing nurse education

Aim This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Background Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. Methods A quasi experimental pre test, post test non–equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. Findings The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. Conclusion The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

Job satisfaction, stress and burnout associated with haemodialysis nursing : a review of literature

Job dissatisfaction, stress and burnout are linked to high rates of nurses leaving the profession, poor morale and poor patient outcomes. Haemodialysis (HD) nursing is uniquely characterised by the intense-prolonged interaction with patients who require complex technological care. A review of nine papers found that factors affecting job satisfaction were aspects of nursing care, organisational factors and length of time that a nurse has been working in nephrology nursing. Factors affecting job stress and burnout were due to interpersonal relationships with physicians, patient care activities, violence and abuse from patients, organisational factors and a lack of access to ongoing education.

Treating skin tears in nursing home residents : a pilot study comparing four types of dressings

A pilot study was conducted to compare four types of dressings used to treat skin tears in nursing home residents. Wounds treated with a non-occlusive dressing healed more quickly than those dressed with occlusive dressings. The results suggest that ease of use and product wastage are important considerations when treating skin tears. The pilot study also highlights the need for further research into skin tear management and the need for ongoing education for nurses regarding skin integrity risk assessment and product information.

Specialist nursing training in Poland: Applications for neuroscience nursing

Background: Nurses have a pivotal role in providing, facilitating, advocating and promoting the best possible care and outcome for the client. To ensure decisions and actions are based on current standards of practice, nurses must be accountable for participation in ongoing education in their area of practice. Aim: To present a description of the current state of Polish nursing education and specialized model for neurological and neurosurgical nursing that can be utilized for both undergraduate and postgraduate continuing education in Poland. Data sources: The model of postgraduate training introduced in Poland in 2000 was taken into consideration in developing the framework for neuroscience nursing postgraduate continuing education presented here. The framework for neurological continuing education is also based on a review of the literature and is consistent with Poland’s legally binding professional nursing regulations (normative and implementing regulations). Conclusion: The model demonstrates the need for the content of pre- and post-undergraduate degree education in neurological nursing to be graduated, based on the frameworks for undergraduate education (acquiring the knowledge and basic skills for performing the work of nurses) and postgraduate education (acquiring knowledge and specialist skills necessary for providing advanced nursing care including medical acts on patients with nervous system diseases). Implications for nursing: New and advanced skills gained in specialization training can be applied to complex functions, roles and professional tasks undertaken by nurses in relation to care of patients with neurological dysfunctions.

Palliative care problem severity score: Reliability and acceptability in a national study

Background The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using a 4-point categorical scale (absent, mild, moderate, severe). Aim To test the reliability and acceptability of the Palliative Care Problem Severity Score. Design: Multi-centre, cross-sectional study involving pairs of clinicians independently rating problem severity using the tool. Setting/participants Clinicians from 10 Australian palliative care services: 9 inpatient units and 1 mixed inpatient/community-based service. Results A total of 102 clinicians participated, with almost 600 paired assessments completed for each domain, involving 420 patients. A total of 91% of paired assessments were undertaken within 2 h. Strength of agreement for three of the four domains was moderate: pain (Kappa = 0.42, 95% confidence interval = 0.36 to 0.49); psychological/spiritual (Kappa = 0.48, 95% confidence interval = 0.42 to 0.54); family/carer (Kappa = 0.45, 95% confidence interval = 0.40 to 0.52). Strength of agreement for the remaining domain (other symptoms) was fair (Kappa = 0.38, 95% confidence interval = 0.32 to 0.45). Conclusion The Palliative Care Problem Severity Score is an acceptable measure, with moderate reliability across three domains. Variability in inter-rater reliability across sites and participant feedback indicate that ongoing education is required to ensure that clinicians understand the purpose of the tool and each of its domains. Raters familiar with the patient they were assessing found it easier to assign problem severity, but this did not improve inter-rater reliability.

Training in and assessment of the procedural skills required to perform peripheral nerve blockade

The training and ongoing education of medical practitioners has undergone major changes in an incremental fashion over the past 15 years. These changes have been driven by patient safety, educational, economic and legislative/regulatory factors. In the near future, training in procedural skills will undergo a paradigm shift to proficiency based progression with associated requirements for competence-based programmes, valid, reliable assessment tools and simulation technology. Before training begins, the learning outcomes require clear definition; any form of assessment applied should include measurement of these outcomes. Currently training in a procedural skill often takes place on an ad hoc basis. The number of attempts necessary to attain a defined degree of proficiency varies from procedure to procedure. Convincing evidence exists that simulation training helps trainees to acquire skills more efficiently rather than relying on opportunities in their clinical practice. Simulation provides a safe, stress free environment for trainees for skill acquisition, generalization and transfer via deliberate practice. The work described in this thesis contributes to a greater understanding of how medical procedures can be performed more safely and effectively through education. The effect of feedback, provided to novices in a standardized setting on a bench model, based on knowledge of performance was associated with an increase in the speed of skill acquisition and a decrease in error rate during initial learning. The timing of feedback was also associated with effective learning of skill. A marked attrition of skills (independent of the type of feedback provided) was demonstrable 24 hrs after they have first been learned. Using the principles of feedback as described above, when studying the effect of an intense training program on novices of varied years of experience in anaesthesia (i.e. the present training programmes / courses of an intense training day for one or more procedures). There was a marked attrition of skill at 24 hours with a significant correlation with increasing years of experience; there also appeared to be an inverse relationship between years of experience in anaesthesia and performance. The greater the number of years of practice experience, the longer it required a learner to acquire a new skill. The findings of the studies described in this thesis may have important implications for the trainers, trainees and training bodies in the design and implementation of training courses and the formats of delivery of changing curricula. Both curricula and training modalities will need to take account of characteristics of individual learners and the dynamic nature of procedural healthcare.

Factors affecting the successful implementation and sustainability of the Liverpool Care Pathway for dying patients – a realist evaluation

Objectives: The Liverpool Care Pathway for the dying patient (LCP) was designed to improve end-of-life care in generalist health care settings. Controversy has led to its withdrawal in some jurisdictions. The main objective of this research was to identify the influences that facilitated or hindered successful LCP implementation.

Method: An organisational case study using realist evaluation in one health and social care trust in Northern Ireland. Two rounds of semi-structured interviews were conducted with two policy makers and twenty two participants with experience and/or involvement in management of the LCP during 2011 and 2012.

Results: Key resource inputs included facilitation with a view to maintaining LCP ‘visibility’, reducing anxiety among nurses and increasing their confidence regarding the delivery of end-of-life care; and nurse and medical education designed to increase professional self-efficacy and reduce misuse and misunderstanding of the LCP. Key enabling contexts were consistent senior management support; ongoing education and training tailored to the needs of each professional group; and an organisational cultural change in the hospital setting that encompassed end-of-life care.

Conclusion: There is a need to appreciate the organizationally complex nature of intervening to improve end-of-life care. Successful implementation of evidence-based interventions for end-of-life care requires commitment to planning, training and ongoing review that takes account of different perspectives, institutional hierarchies and relationships and the educational needs of professional disciplines. There is a need also to recognise that medical consultants require particular support in their role as gatekeepers and as a lead communication channel with patients and their relatives.

FORMAÇÃO DE PROFESSORES EM SERVIÇO: UMA EXPERIÊNCIA DA REDE MUNICIPAL DE EDUCAÇÃO DE SÃO PAULO INICIADA NO GOVERNO ERUNDINA

Este trabalho de pesquisa trata da política voltada para a formação continuada em serviço docente cujo período de implantação aconteceu entre 1989 e 1992 na cidade de São Paulo, durante a administração da prefeita Luíza Erundina, que teve à frente da Secretaria Municipal de Educação, nos anos iniciais de sua gestão, o professor Paulo Freire. Tal política marcou o início do processo de consolidação de conquistas, como resultado de longa luta de muitos educadores brasileiros por mudanças na educação. Erundina e Freire representaram a possibilidade da concretização de transformações estruturais na educação em um período de grande efervescência política da sociedade brasileira. A conquista de um espaço para formação na escola, de forma democrática e com a participação dos docentes representava uma das grandes bandeiras desta luta. Para melhor compreensão do processo de implantação desta política de formação docente em serviço, optamos por realizar uma pesquisa qualitativa a partir de documentos e estudo bibliográfico seguida de uma pesquisa de campo a partir de um pequeno roteiro de questões que serviram como ponto de partida para a realização de um círculo epistemológico, envolvendo educadores que de alguma forma participaram desta política; buscando compor, dessa maneira, um panorama das concepções que deram sustentação a esta política pública possibilitando uma análise das ações que foram desenvolvidas.

A CONTRIBUIÇÃO DA FORMAÇÃO CONTINUADA PARA AS PROFESSORAS DE EDUCAÇÃO INFANTIL DO MUNICÍPIO DE SÃO PAULO

Esta pesquisa aborda a formação continuada das educadoras da Educação Infantil da rede pública municipal de São Paulo. A questão central a ser investigada refere-se à proposta de formação continuada oferecida pela Secretaria Municipal de Educação de São Paulo SMESP buscando pesquisar quais são as contribuições desse projeto para essas educadoras. O estudo foi desenvolvido a partir da percepção da importância da formação continuada como um caminho de ressignificação da identidade docente e um exercício reflexivo para as professoras desse segmento da educação considerando todo o seu processo de construção histórica. Tal segmento foi escolhido para esta pesquisa, pois estudos contemporâneos realizados por diversos autores tais como: Beatriz Cerisara, Patricia Prado, Zeila Demartini, Júlia Formosinho e João Oliveira-Formosinho, entre outros, consideram que essa é uma fase essencial, na qual está sempre presente a necessidade de se discutir a dicotomia entre o cuidar e o educar, e de se ressignificar a identidade das professoras enquanto profissionais de Educação Infantil. Nesse sentido, a pesquisa apresenta uma discussão teórica acerca da formação das professoras da Educação Infantil no Brasil finalizando com uma pesquisa de campo que avalia o Projeto Estratégico de Ação PEA -, como uma das propostas de formação continuada das professoras de Educação Infantil, por meio de entrevistas semiestruturadas realizadas com nove professoras da Educação Infantil dessa rede municipal. A pesquisa possibilitou observar a relevância do PEA para as professoras entrevistadas, no que diz respeito à formação continuada. O estudo constatou também que este projeto vem sendo alterado de forma positiva e significativa, a partir de ações direcionadas às necessidades específicas da Educação Infantil, com uma concepção sobre a criança como um sujeito de direito à voz e dotado de competências. Nesta pesquisa, como possibilidade de formação, observou-se ainda a contribuição do PEA, que em momentos coletivos, permite a troca entre os pares e a reflexão sobre suas práticas, tornando-as professoras mais autônomas em seu papel enquanto parte do processo de construção de aprendizagem pela criança.

Waking the sleeping giant: Beliefs of Brazilian and *American teachers concerning liberation curriculum

The school curriculum is a matter mandated by the educational system rather than determined by the school stakeholders of a community, as Freire (1993) suggests. At the present time, one significant vision of school is challenging the current order of curriculum practice. It focuses on school as a liberating agency grounded on the belief that the abilities to access information and to think critically about it will educate an individual capable of making independent decisions. This dissertation investigates teacher's beliefs concerning curriculum. It was assumed that there is a discrepancy between what has been the position proposed by critical theorists including Freire (1998a, 1993); Apple (1979); Giroux (1998), and the position on curriculum which school systems are typically advancing. ^ There were four purposes of this study. The major purpose of this study was to determine whether or not Brazilian and American Teachers believe that a school curriculum based on Freirean principles could be implemented in the schools in which they worked. Also, this study sought to determine the differences found between teachers' beliefs in the Brazilian and American contexts. Another purpose was to determine how Brazilian and American teachers justify their beliefs and actions when these may represent conflicting values. Finally, this study sought to determine if these teachers believe that the curriculum is in need of change or if they accept the current curriculum as adequate. This study consisted of quantitative and qualitative data collection through multiple methods involving surveys and interviews. The study involved 171 teachers (88 Brazilian and 83 American) from multiple settings with the majority working for public systems. Overall, it seems that Brazilian and American teachers believe that a curriculum based on Freirean principles of education can be implemented in their schools, if ongoing education is provided. The majority of Brazilian teachers believe a curriculum change is necessary while half of the American teachers believe a curriculum change is needed and the other half seems to believe curriculum is adequate. Teachers explain that it is hard to implement a curriculum they believe to be most appropriate for students because the current curriculum is mandated by the school system or by national guidelines. The majority of Brazilian teachers and those American teachers who believed a curriculum change is necessary explained their rationale for change in terms of social justice, problem-solving, collective work, student-centered and context-based curriculum. American teachers, who believed that the curriculum is adequate, explained that they are satisfied with their student's achievements. They stated that their students are doing well on tests and are learning what is required. ^

Bilingualism, literacy and NAPLAN : ongoing challenges for EAL/D education [Editorial]

Advocacy is integral to the work of many TESOL specialists. For several decades, ACTA and the state TESOL associations, along with other professional associations, and individual teachers, researchers and administrators have all engaged with conversations about EAL/D education in public forums. These advocates have drawn attention to implications of policy developments for EAL/D students; they have proffered alternative forms of curriculum, pedagogy and assessment to better account for the particularity of EAL/D learning pathways; they have argued the necessity of specialist EAL/D teaching. In response to the Australian Language and Literacy Policy of the early 1990s, for example, there was “a frenzy of writing responses… a conference… and attempts to publicise what was going on through the press and television” (Moore, 1995, p. 6). It is in this spirit that this double issue of TESOL in Context has been compiled...