Exploring preparation practices of nursing and midwifery educators for in situ simulation-based education: A qualitative study in a large healthcare service.

AIM: This study aimed to explore nursing and midwifery clinical educators' preparation practices related to in situ simulation-based education, at a tertiary health service in Australia. BACKGROUND: Simulation-based education is routinely used in healthcare education and training. A key mechanism to optimise simulation-based education is learner preparation. While diverse pre-simulation preparation approaches are described in the literature, these are predominantly focused on activities that are undertaken in either university and/or skills centre contexts. In contrast, the learner preparation practices for simulation-based education that is delivered insitu in healthcare facilities by clinical nurse and midwifery educators are underexplored. DESIGN: This study used an exploratory qualitative design. METHODS: Participants were recruited using purposive sampling from a potential study group of thirty. Twelve individuals from the nursing and midwifery education group met selection criteria and agreed to participate in the study. Each individual participated in a semi-structured interview. Interview data were then transcribed and analysed using qualitative descriptive methods. RESULTS: Data analysis resulted in the development of four themes related to the preparation of participants for insitu simulation-based education sessions. Each theme informs the choices of clinical nurse/midwifery educators' preparation practices: 1) responsivity to workplace and clinical priorities; 2) clinical educator objectives; 3) preparedness for learning and clinical practice; and 4) evolving educational expertise. CONCLUSION: This study explored the preparation practices of nurse and midwifery clinical educators engaged in the delivery of insitu simulation-based education. Findings indicate a depth of experiences and a willingness to share practice insights, suggesting that insitu simulation-based education is an integral part of the in service repertoire and a key component of departmental education strategies, designed to support practice and hone skills required to deliver quality patient care.

Developing effective In-Service Education for intensive care nurses: Exploring the views of clinical stakeholders in the Kingdom of Saudi Arabia.

BACKGROUND: Evidence-based in-service education (ISE) in the intensive care unit (ICU) is essential to maintaining nurse skill and competence in this complex clinical area. However, there has been limited research that has focused on developing and optimising the specialised training required by ICU nurses working in trauma care. OBJECTIVES: To explore the perspectives of ICU clinical stakeholders regarding their needs and preferences for ISE to inform the future development and implementation of effective educational interventions. DESIGN: A qualitative, multiple-case study supported by the "Empowering Education" theoretical framework, which emphasises the importance of stakeholder involvement in education development. SETTINGS: Adult ICUs in three major hospitals located in two geographical areas in Saudi Arabia. PARTICIPANTS: Forty clinical nurses, twelve nurse managers, nine nurse leaders and seven clinical educators participated. METHODS: Data were collected through semi-structured interviews followed by focus groups. Framework analysis was used for data analysis. FINDINGS: Stakeholders wanted ISE and training by subject experts characterised by: (i): relevant educational content; (ii): a range of educational techniques and (iii) flexible delivery and format. Nurses also identified factors that encouraged them to participate in ISE including adequate resources and a supportive work environment, whilst heavy workloads, cost and scheduling issues hindered engagement. CONCLUSION: This paper highlights the importance of considering staff needs and local context when developing in-service ICU education to support nurses' competence. Further recommendations and a proposed framework to develop future ISE in the ICU are provided. TWEETABLE ABSTRACT: The key to effective in-service education for ICU nurses is understanding stakeholders' needs and motivational drivers, whilst addressing barriers to successful implementation.

In-service education in trauma care for intensive care unit nurses: An exploratory multiple case study.

AIM: This study explores the perceptions of intensive care units (ICUs) nurses with different educational backgrounds regarding their abilities in trauma care and the in-service education they receive to support it. BACKGROUND: The advanced care of patients with traumatic injuries in ICU environments requires skilled and knowledgeable nurses, who need continuing and in-service education to provide the best care. Therefore, it is essential to understand the competencies and educational support these nurses may need in the ICUs to ensure safe and effective care delivery. DESIGN: An exploratory multiple case study design was used, comprising three hospitals located in two different regions of Saudi Arabia. METHODS: The study was conducted between October 2021 and March 2022. A total of forty ICU clinical staff, twelve managers, nine leaders and seven clinical educators participated in semi-structured interviews, which were complemented by a review of available documents on the trauma care in-service education syllabi, competencies and protocols. Interview data were analysed according to the Framework analysis approach, while documents were reviewed using qualitative content analysis. FINDINGS: The data analysis revealed two interrelated categories relevant to trauma care: (i) care practice and (ii) education practice. The trauma care practice category highlighted the limited competencies and education in trauma care, as well as the perceived challenges and educational needs of nurses. The education practice category described the staff learning behaviours, supervision practices and in-service education systems in the participants' settings. CONCLUSIONS: The study concludes that there is a lack of trauma care education at the examined sites. It suggests the need for further research to develop a theoretical foundation for trauma care education that can meet ICU nurses' educational needs while this being feasible to implement in the specific ICU context and practice.

Construction of learning objectives and content for newly graduated nurses in tertiary teaching hospitals: A Delphi study.

BACKGROUND: Transition education is a robust strategy to improve the core competency of newly graduated nurses and the quality of clinical nursing and ensure people's safety. Limited information about the learning objectives and educational content for newly graduated nurses in China was available. OBJECTIVE: Construct the learning objectives and educational content for newly graduated nurses based on defined core competencies. DESIGN: We used a literature review and the e-Delphi method to conduct this study. SETTINGS: Ten tertiary teaching hospitals and six nursing schools in Zhejiang Province, China, were selected. PARTICIPANTS: Experts (n = 21) were invited to the e-Delphi study. METHODS: Based on seven competencies from the literature review and the research group discussions, we formed an initial set of objectives and specific educational content for newly graduated nurses. Subsequently, experts provided supportive and modification advice on the competencies, objectives, and specific content in the two Delphi rounds. The consensus percentage and the weight of each first-level, second-level, and third-level item were calculated. RESULTS: Consensus was achieved on seven core competencies, 44 learning objectives, and 60 components of educational content. The positive coefficient of the two Delphi rounds was 100 %, the authority coefficient was 0.83 and 0.87, the proportion of experts who made suggestions was 71.40 %, the coefficient of variation (CV) was <0.25 (P < 0.05) except for two items and the Kendall coefficient (W) was 0.15-0.48 (P < 0.01). CONCLUSION: The developed objectives and content framework provide a reference for implementing systematic and standardized education for newly graduated nurses.

Research progress of humanistic nursing training for nurses / 中国实用护理杂志

This paper expounds the concept of humanistic nursing and humanistic nursing training, and summarizes the current situation of humanistic nursing training. Mainly includes training courses based on humanistic care nursing theory, training courses based on humanistic medical practice skill training, training courses based on training mode, training courses guided by promoting hospital development, humanistic training aimed at developing humanistic nursing discipline, etc. Through summarizing the existing research results, to provide reference for the construction of systematic training courses of humanistic nursing practice ability.

Entre nós: educação permanente em saúde como parte do processo de trabalho dos Núcleos Ampliados de Saúde da Família e Atenção Básica / Among us: permanent health education as part of the work process of the Extended Nuclei for Family Healthcare and Basic Care

Resumo O artigo apresenta uma pesquisa cujo objetivo foi analisar o processo de trabalho de um Núcleo Ampliado de Saúde da Família e Atenção Básica (NASF-AB), sob as perguntas de quem apoia o apoiador matricial e como esses profissionais aprendem/apreendem seu fazer. A pesquisa estudou o processo de trabalho com os próprios apoiadores de NASF-AB e, articulado às perspectivas da servidão e liberdade em Baruch Spinoza, problematizou como sentem e como agem, evocando o pensamento-afecção e o pensamento-ação. As escolhas metodológicas envolveram a cartografia e o pesquisar-com. Foi possível identificar um comportamento de equipe, promotor da educação permanente em saúde e do necessário coletivo de enunciação que o NASF-AB deve representar. Compreendeu-se que o "apoio aos apoiadores" objetivamente se expressa pelos processos de autoanálise (institucional), providências de educação permanente em saúde (entre pares) e esforço por exaurir medo e esperança para que os afetos apareçam genuínos e encontros vicejem (liberdade). A ação entre pares, no interior do próprio NASF-AB para aprender, apreender e exercer o matriciamento levou à compreensão de que se trata de algo que acontece como um "entre nós" (os próprios apoiadores), investida a perseverança da liberdade ante a servidão.

Abstract The article presents a study aimed to analyze the work process of an Extended Nucleus of Family Health and Primary Care (NASF-AB), questioning: who are those that support the matrix supporter? and how these professionals learn/understand their work? The research studied the work process with the NASF-AB supporters and, articulated with the perspectives of servitude and freedom in Baruch Spinoza, problematized how they feel and how they act, evoking thought-affection and thought-action. Methodological choices involved cartography and research-with. It was possible to identify team behavior that promotes permanent education in the healthcare field and the necessary collective enunciation that the NASF-AB must represent. It can be understood that "support for supporters" is objectively expressed through the processes of self-analysis (institutional), measures of permanent health education (among peers) and efforts to allow fear and hope to be expressed so that affections appear genuine and encounters may thrive (freedom). The action among peers, within the NASF-AB to learn, get ownership and practice the matrix support led to the understanding that it is something that happens as "among us" (the supporters themselves), invested with the perseverance of freedom in the face of servitude.

Shared clinical decision-making experiences in nursing: a qualitative study.

BACKGROUND: Shared decision making (SDM) is a patient-centered nursing concept that emphasizes the autonomy of patients. SDM is a co-operative process that involves information exchange and communication between medical staff and patients for making treatment decisions. In this study, we explored the experiences of clinical nursing staff participating in SDM. METHODS: This study adopted a qualitative research design. Semistructured interviews were conducted with 21 nurses at a medical center in northern Taiwan. All interview recordings were transcribed verbatim. Content analysis was performed to analyze the data. RESULTS: The findings yielded the following three themes covering seven categories: knowledge regarding SDM, trigger discussion and coordination, and respect of sociocultural factors. CONCLUSIONS: The results of this study describe the experiences of clinical nursing staff participating in SDM and can be used as a reference for nursing education and nursing administrative supervisors wishing to plan and enhance professional nursing SDM in nursing education.

British and Finnish nurses' attitudes, practice, and knowledge on deteriorating patient in-service education: A study in two acute hospitals.

AIM: The aim was to assess both nurses' attitudes about in-service education, and the impact had by attending in-service education on nurses' management and knowledge of deteriorating patients. BACKGROUND: In-service education cannot reach its best potential outcomes without strong leadership. Nurse managers are in a position of adopting leadership styles and creating conditions for enhancing the in-service education outcomes. DESIGN: We conducted a comparative cross-sectional study between British and Finnish nurses (N = 180; United Kingdom: n = 86; Finland: n = 94). METHODS: A modified "Rapid Response Team Survey" was used in data collection. A sample of medical and surgical registered nurses were recruited from acute care hospitals. Self-reporting, self-reflection, and case-scenarios were used to assess nurses' attitudes, practice, and knowledge. Data were analyzed by Mann-Whitney-U and Chi-square tests. RESULTS: Nurses' views on education programs were positive; however, low confidence, delays caused by hospital culture, and fear of criticism remained barriers to post education management of deteriorating patients. Nurses' self-reflection on their management of deteriorating patients indicates that 20-25% of deteriorating patients are missed. CONCLUSION: Nurse managers should promote a no-blame culture, mitigate unnecessary hospital culture and routines, and facilitate in-service education focusing on identification and management of deteriorating patients, simultaneously improving nurses' confidence.

Perceptions of nurse managers and staff nurses regarding Technological Competency as Caring in Nursing theory in general hospitals in Japan.

Background: Nurses as primary healthcare providers demonstrate quality nursing care through competencies with healthcare technologies, while nurse managers assume the primacy of managing quality healthcare in their respective care settings. However, little is known about perceptions of the influence of care technologies on their nursing practice. Objective: This study aimed to determine managers' and staff nurses' perceptions regarding the Technological Competency as Caring in Nursing (TCCN) theory in general hospitals in Japan. Methods: This study employed a cross-sectional survey design, with 421 participants selected using a stratified sampling method. Technological Competency as Caring in Nursing Instrument-Revised (TCCNI-R) was used for online data collection using Survey Monkey©. Data were analyzed using Welch's t-test and ANOVA. Results: Nurses with years of experience within the range of 20 to less than 30 years showed the highest TCCNI-R scores among the two groups. Nurses who had received education on caring in nursing showed significant differences for Factor 2 (Technological Competency as Caring), that of expressing Technological Competency as Caring. Three other factors showed no significant difference, namely in Factor 1 (Nursing Expression as Caring), Factor 3 (Technology and Caring), and Factor 4 (Technological Knowing). However, the average scores of these factors were high, which reflect high professional ethics and occupational discipline and increased awareness of caring in nursing. It was also found that the nurse managers were more aware of the TCCN than were the staff nurses. The nurse managers were also more aware of providing care using technology, recognizing the need-to-know patient needs through technology and providing care to the ever-changing patient's condition. Conclusion: The study discovered that continuing education is needed regarding the practice of nursing based on theory, enabling appropriate and accurate understanding of practicing knowing persons as caring in nursing.

Effects of a cultural competence education programme on clinical nurses: A randomised controlled trial.

BACKGROUND: The cultural competence education programme for health professionals aimed to ensure that all people receive effective health care, particularly those from culturally diverse backgrounds. OBJECTIVES: The purpose of this study was to investigate the effect of a cultural competence educational course on nurses' self-assessment of their cultural competence. DESIGN: A single-blind, randomised control trial design was employed. PARTICIPANTS AND SETTINGS: Eligible nurses were recruited from a northern Taiwan medical centre with 2089 beds. METHODS: A permuted block of four was used to randomly assign participants to the experimental (n = 47) and control groups (n = 50). The educational course comprised four units and was conducted once weekly for four weeks, with each session lasting 3 h. RESULTS: A significant group-time interaction was identified regarding self-learning cultural ability, verifying the education intervention's effect on self-learning cultural ability after a two-month intervention. In addition, a significant main effect over time was discovered for total cultural competence; there was no significant interaction effect. CONCLUSIONS: The study provided evidence that an educational programme effectively improved cultural competence in clinical nurses. The results provide a reference for health care providers to design in-service cultural competence education for improving quality of care.

Teaching Careers: Exploring Links Between Well-Being, Burnout, Self-Efficacy and Praxis Shock.

Burnout and attrition are issues facing many professions. In a bid to better understand this phenomenon and ways to address it, this paper explores experiences of praxis shock, well-being, burnout, and self-efficacy during teachers' careers. Regression and mediation analyses of 836 responses to a questionnaire reveal that praxis shock may occur at multiple points in a music teachers' career. Findings reveal that praxis shock predicts patterns of reported burnout, well-being and self-efficacy. This impacts on the development of productive professional identities, career satisfaction and success. Evidence is presented regarding praxis shock and its impact across a teaching career.

[Using the Cognitive Behavioral Therapy to Improve the Mental Health of Women With Breast Cancer].

Previous studies have shown that patients with breast cancer may suffer from symptoms of psychological distress, such as: depression, anxiety, insomnia, and chronic fatigue. Nurses are expected to offer physical and mental support to these patients. Cognitive behavior therapy (CBT) is commonly used in psychiatry as well as in the treatment of patients with breast cancer. CBT is believed to reduce mental distress in patients by changing their negative cognitive schema. The present article discusses the mental problems of patients with breast cancer and introduces the effects of using CBT on patients with breast cancer. Successful examples of training clinical nurses to apply CBT to the patients are introduced in order to facilitate the design of effective CBT training programs for nurses that improve professional knowledge and skills in dealing with the mental health problems of these patients and further enhance the quality of nursing care.

Assault experiences: Lessons learned from mental health nurses in Taiwan.

Mental health nurse are frequently subjected to patients' violent and aggressive behaviour. These assault experiences have given rise to mental health nurses' physical and psychological trauma, and negatively impact the quality of patient care. The purpose of the present qualitative study was to understand mental health nurses' experiences of being assaulted, the influences on their patient care, and their perspectives of the effectiveness of in-service, violence-prevention education. Ten mental health nurses from two different inpatient mental health facilities were interviewed using a semistructured interview guide. Thematic analysis of interview data found six themes: (i) violence is unpredictable; (ii) violence is normal; (iii) lasting psychological trauma; (iv) limited support from peers and the administrator; (v) violence prevention requires team cooperation; and (vi) doubting the effectiveness of in-service education on violence prevention. Psychiatric ward administrators should assess nurses' learning and skill needs to determine whether these needs are met by existing in-service training programmes. A culture of safety should also be promoted by building a warm and supportive ward climate for both staff and patients, which would include team cooperation and support for colleagues who suffer a violent incident.

Resources-tasks imbalance: Experiences of nurses from factors influencing workload to increase.

BACKGROUND: While nursing workload is a worldwide challenge, less attention has been given to the determining factors. Understanding these factors is important and could help nursing managers to provide suitable working environment and to manage the adverse outcomes of nursing workload. The aim of this study was to discover nurses' experiences of determinant factors of their workload. MATERIALS AND METHODS: In this qualitative study, the participants included 15 nurses working in two hospitals in Tehran, Iran. The data were collected through 26 unstructured interviews and were analyzed using conventional content analysis. The rigor has been guaranteed with prolonged engagement, maximum variance sampling, member check, and audit trail. RESULTS: Resource-task imbalance was the main theme of nurses' experiences. It means that there was an imbalance between necessary elements to meet patients' needs in comparison with expectation and responsibility. Resource-task imbalance included lack of resource, assignment without preparation, assigning non-care tasks, and patients' and families' needs/expectations. CONCLUSIONS: A deep and comprehensive imbalance between recourses and tasks and expectations has been perceived by the participants to be the main source of work overload. Paying more attention to resource allocation, education of quality workforce, and job description by managers is necessary.

Another way to teach family: family nursing game / Um modo de ensinar família: jogo para enfermagem de família

Current paper describes the application of an innovative strategy to teach family, within a hospital context, by sensitizing nurses on the family subject through the use of a game. Given the hospitalization of a relative, the family faces changes in its dynamics caused by the crisis it is exposed to. It is the relevance for including the family within the care process. Since nurses are expected to assume a key role for which they need specific competence to intervene in families when experiencing an eventual crisis. The in-service education becomes a strategy of generating new skills and enhances human capital to improve the quality of nursing care. Considering the importance of including family in the care context, a playful tool called Family Nursing Game has been invented for teaching the family, especially by passing a model of family intervention. The strategy is based on the belief of the existence of relationship between game and learning.

Artigo descreve aplicação de uma estratégia inovadora para ensinar família em contexto hospitalar, sensibilizando os enfermeiros sobre família através de um jogo. Perante a hospitalização de um de seus membros, a família é confrontada com alterações em sua dinâmica com o paciente, daí a relevância da inclusão da família no processo de atendimento e cuidados. O enfermeiro assume neste nível um papel preponderante de competência específica para intervir junto a família de pacientes por ocasião de vivência de possível crise acidental. A educação em serviço, torna-se estratégia geradora de inovadas competências e potencializa o capital humano para a melhoria da qualidade na assistência em enfermagem. Da importância de inclusão da família no contexto de cuidados, criou-se um instrumento lúdico denominado Family Nursing Game com o intuito de ensinar família, nomeadamente divulgando um modelo de avaliação e intervenção familiar. Tal estratégia fundamenta-se na convicção da existência de relação entre o jogo e a aprendizagem.

The effect of in-service English education on medical professionals' language proficiency.

BACKGROUND: Despite its inevitable significance, the effect of in-service English education on medical professionals has rarely been studied longitudinally. The reason can be issues such as physicians' heavy workload, commuting problems, inappropriate class times, and inexperienced teaching staff. MATERIALS AND METHODS: A needs assessment worksheet was administered to faculty members of Shahid Beheshti University of Medical Sciences in Tehran and the responses were analyzed. A project for the promotion of faculty members' English proficiency was formulated. Then, following a placement test, 235 applicants from the university colleges and hospitals were classified into 28 homogeneous groups. After four terms of instruction, the participants' scores on the pre- and post- assessments were analyzed. RESULTS: There was significant improvement in participants' total scores on different communicative skills (P<0.001). Regarding individual skills also, they achieved meaningful gains on listening (P<0.001), writing (P = 0.038), and grammar (P<0.001), but failed to progress significantly on reading comprehension (P = 0.523). CONCLUSION: The administration of in-service education for skill-oriented courses, over a long period, can be quite encouraging and should be further strengthened. Regular instructions on each individual skill on the one hand and on their combination on the other are essential for success in such education.

Integralidade, construção e socialização de conhecimentos no contexto da educação permanente e atuação de profissionais da área da saúde / Comprehensive health care, construction and socialization of knowledge in the context of permanent education and actions of health professionals / Integralidad, construcción y socialización de conocimientos en el contexto de la educación permanente y actuación de profesionales del área de la salud

O texto discute a fragmentação entre práticas desenvolvidas em serviços de saúde e saberes produzidos no contexto acadêmico, elaborando uma reflexão sobre o tema, enquanto fenômeno relacionado às concepções da ciência moderna, pautada pelo paradigma cartesiano. Discute a relevância de se estabelecerem novas concepções sobre a construção de conhecimentos, valorizando saberes desenvolvidos no cotidiano dos serviços e estabelecendo nova abordagem sobre o tema no âmbito dos cursos de graduação, pós-graduação e demais atividades realizadas dentro das propostas de educação permanente. Nesta perspectiva, é descrita uma experiência de realização de oficinas de elaboração de textos voltadas para profissionais que frequentam cursos de especialização na área da saúde, visando à sistematização e socialização de suas experiências. A atividade vem se mostrando um importante espaço de construção de saberes, permitindo que textos no formato de relatos de experiência sejam produzidos e divulgados nos meios científicos.

The paper discusses the fragmentation between practices developed in healthcare services and knowledge generated in the academic context, proposing a reflection on the subject as a phenomenon related to the concepts of modern science, guided by Cartesian paradigm. It discusses the relevance of establishing new conceptions of building knowledge, valuing those elaborated in routine services and proposing a new approach about this subject in undergraduate and graduate courses, and also other activities within inservice education proposals. From this perspective it describes an experience in conducting workshops of texts elaboration, focused for professionals who are performing specialization courses in health area, aiming the systematization and socialization of experiences developed in their fields of professional activities. This activity allowed an important place in building knowledge and the elaboration of texts in the form of experience reports, published in scientific journals.

El texto discute la fragmentación entre las prácticas desarrolladas en los servicios de salud y saberes que se producen en el contexto académico, proponiendo una reflexión sobre el tema, como un fenómeno relacionado con los conceptos de la ciencia moderna, cartesiana. En este sentido, discute la importancia de establecer nuevas concepciones acerca de la construcción de conocimientos, valorando saberes elaborados en los servicios cotidianos y estableciendo nuevos planteamientos sobre el tema en los cursos de graduación, pos-graduación y actividades de educación permanente. Se describe una experiencia con talleres de elaboración de textos destinados a los profesionales que realizan cursos de especialización en salud, a fin de sistematizar y socializar sus experiencias. La actividad se viene mostrando un importante espacio de construcción de saberes, lo cual permite que textos científicos, en forma de relatos de experiencia, se produzcan y se divulguen.

A Study on Nutrition Knowledge, Dietary Attitudes and Nutrition Education Needs among Child-Care Teachers / 대한지역사회영양학회지

This study was conducted on 175 child-care teachers, who participated in in-service education, to research the methods to improve child-care teacher's nutrition management capability for infants and children. Investigated results of child-care teachers' nutrition knowledge, dietary attitude status, and needs on nutrition education in child-care centers are as follows: The score of child-care teachers' nutrition knowledge was 10.83 points out of 15, which is about 72%. Total score increased as teachers' age but not significantly different from their career duration, since teachers who have a child-care career less than 5 years acquired 10.91 points, which is higher than 10.64 points of teachers having more than 5 years of child-care career. Teachers' average recognition to the nutrition knowledge was 90.6%, increased significantly by the older they are, and decreased according to the accumulation of their career. The average accuracy of the nutrition knowledge was 79.7%, increased in proportion to the teachers' age. The marks of child-care teachers' dietary attitude were 41.3 points (possible score range 5-50) and 83%, older teachers tended to have more desirable dietary attitude. As indicated by the increment of child-care career, the score of emotional attitude tended to be increased but which of cognitive and behavioral attitude showed a declining tendency. Nutrition information which child-care teachers were mainly interested in were correct selection of food (58.1%), obesity and weight management (52.7%), and nutrient content of food (44.9%). Nutrition education contents which child-care teachers needed were 'nutritious food and menu for child' (72.2%), 'health management of child' (69.2%) and meal management of child (40.2%). Nutrition education methods, which child-care teachers considered as of desirable ones, were cooking class of small scale (31.8%), visiting class at child-care center (26.5%). In consequence, the nutrition knowledge and dietary attitude of child-care teachers were not good and showed different issues by age and career duration. Therefore, it is requisite to intensify nutrition management courses in child-care teachers' qualification and in-service education courses which has actual necessity and suitability based on teachers' age, career, and the type of child-care center, and to disseminate these through public health centers and child-care & education information centers to pursue the efficient balance of nutrition education programs.

Atividades educativas de trabalhadores na atenção primária: concepções de educação permanente e de educação continuada em saúde presentes no cotidiano de Unidades Básicas de Saúde em São Paulo / Actividades educativas de trabajadores en la atención primaria: concepciones de educación permanente y de educación continuada en salud presentes en el quehacer cotidiano de Unidades Básicas de Salud en Sao Paulo, Brasil / Educational activities for primary healthcare workers: permanent education and inservice healthcare education concepts in the daily life of primary healthcare units in São Paulo

Esta pesquisa tem o objetivo de analisar a prática de atividades educativas de trabalhadores da saúde em Unidade Básica de Saúde (UBS) segundo as concepções de educação permanente em saúde (EPS) e de educação continuada (EC), processo de trabalho em saúde e enfermagem, trabalho em equipe e integralidade. Estudo do tipo transversal, realizado em dez UBS do Município de São Paulo, por meio de entrevista dirigida com 110 informantes-chave, representantes de todas as categorias profissionais e equipes das UBS, sobre as atividades educativas desenvolvidas em 2005. As informações foram classificadas segundo categorias operacionais para cada variável de estudo, com base no referencial teórico. Os trabalhadores relataram 396 atividades educativas, que revelam a complementaridade das concepções de EPS e EC. De acordo com a perspectiva do Sistema Único de Saúde (SUS) e da transformação das práticas de saúde, coloca-se a necessidade de ampliação do debate em torno da EPS como política pública.

The objective of this study was to analyze the educational activity practices among healthcare workers in primary healthcare units (PHUs) according to the concepts of permanent healthcare education (EPS) and continuing education (CE), healthcare and nursing work processes, teamwork and comprehensiveness. This was a cross-sectional study conducted in 10 PHUs in the municipality of São Paulo, through structured interviews with 110 key informants who represented all professional categories and teams at the PHUs. The interviews covered educational activities developed in 2005. The information was classified according to operational categories for each study variable, based on the theoretical framework. The workers reported 396 educational activities that demonstrated the complementary nature of the concepts of CFHE and CE. In accordance with the perspectives of the Brazilian Unified Health System (SUS) and the transformation of healthcare practices, there is a need to expand the debate relating to CFHE as public policy.

Investigación con el objeto de analizar la práctica de actividades educativas de trabajadores de salud en Unidad Básica de Salud (UBS) según las concepciones de educación permanente en salud (EPS) y de educación continuada (EC), proceso de trabajo en salud y enfermería, trabajo en equipo e atención integral. Estudio del tipo transversal realizado en diez UBS del municipio de São Paulo, por medio de entrevista dirigida con 110 informantes clave representantes de todas las categorías profesionales y equipos de las UBS, sobre las actividades educativas desarrolladas en 2005. Las informaciones se clasificaron según categorías operacionales para cada variable de estudio con base en el referencial teórico. Los trabajadores relataron 396 actividades educativas que revelan la complementariedad de las concepciones de EPS y EC. De acuerdo con la perspectiva del Sistema Unico de Salud (SUS) y de la transformación de las prácticas de salud se plantea la necesidad de ampliación en el debate en torno de la EPS como política pública.

Aprendizagens de professoras da educação infantil: possibilidades a partir da exploração-investigação em geometria / Pre-school teachers' learning: possibilities from an exploration-investigation in Geometry

Esta pesquisa investigou os conhecimentos revelados por professoras de Educação Infantil que participaram de um curso de formação continuada, no qual tais professoras envolveram-se em atividades exploratório-investigativas com conteúdos geométricos, refletiram sobre sua prática, bem como desenvolveram atividades com seus alunos. Trata-se de uma pesquisa de abordagem qualitativa, cujos dados empíricos são constituídos de videogravações, do diário de campo da pesquisadora, cuja atuação constituiu-se pela observação participante e dos registros escritos das quatro professoras participantes. O repensar da prática pedagógica em decorrência das atividades desenvolvidas e dos momentos formativos de reflexão compartilhada possibilitaram ressignificações sobre como a geometria é entendida no início da Educação Básica e reelaborações do conhecimento pedagógico do conteúdo, indicando possibilidades da exploração-investigação matemática no ensino de Matemática para crianças de seis anos. Tais evidências apontam para mudanças nas atitudes do professor ao assumir uma postura instigadora e questionadora, levando, dessa forma, as crianças a também questionarem e justificarem suas hipóteses, em uma atividade conjunta entre professor e alunos. As ações desenvolvidas na sala de aula pelas professoras participantes confirmaram essas possibilidades, bem como revelaram novas formas de entender as finalidades dos registros das crianças sobre as brincadeiras que realizam(AU)

This research studied the knowledge revealed by Pre-school teachers in a continuing professional training course, in which those teachers were involved in investigation activities based on mathematics geometric contents, reflected on their own teaching practices and as well as developed activities with their students. In this qualitative research the data were collected through video recordings, observation and note taking done by the researcher on a diary and associated with the written registers of the four participant's notes. The researcher also acted as a trainer. In this case, the observation conducted was a participant observation. The reconsideration of the pedagogical practice - as a result of the activities experienced and the moments of sharing reflections - gave birth to the development of new viewpoints as to how geometry is conceived at the outset of primary school. Moreover, such reconsideration resulted in new elaborations of the pedagogical content knowledge, which indicates possibilities for mathematical exploration-investigation in the math teaching for six-year-olds. Such evidences also showed changes in teachers' attitudes when adopting an inquiry and critical posture, which can also lead to more critical and inquiring students, who will ask and justify their hypothesis in an integrated activity with their teacher. The actions developed by the participant teachers in the classroom confirmed such possibilities, and brought new perspectives to understand the purpose in the children's writing and attitudes when playing in the room(AU)