Perceptions of teachers on their corporeality in nursing education: a phenomenological study
Dolores Ferreira de Melo Lopes1, Miriam Aparecida Barbosa Merighi2, Maria Cristina Pinto de jesus3, Mara Lúcia Garanhani1, Alexandrina Aparecida Maciel Cardeli1, Maria Elisa Wotzasek Cestari1
1State University of Londrina
2University of São Paulo
3Federal University of Juiz de Fora
The topic of corporeality is a significant attribute in nursing education, as it deals with human care education. Objective: To understand how a nursing teacher perceives his body in professional acting. Method: This research involves a qualitative study based on the philosophical work of Merleau-Ponty, it was undertaken in 2009 with ten teachers of nursing within a public university in the state of Paraná. Result: The nursing faculty demonstrate an awareness of the body in pedagogical practice in addition to the biological aspects. They assign meanings to the body as a facilitator of interpersonal relationships and as a teaching tool, which reflect on both theoretical and practical learning. At the same time, they are aware of the impact of the work process on their lives and bodies. Conclusion: Recognizing oneself as corporeality and understanding one’s professional relationship will enable a good standard of pedagogical work, providing better teacher-student, teacher-teacher and teacher-health staff interactions, as well as facilitating self-knowledge and interpersonal relationships in professional activities.
Keywords: Education, Nursing; Faculty; Qualitative Research.
The body is the vehicle of being in the world. This body perceives and is perceived and, through this perception, it turns to the world and knows it, coexists with and relates to other bodies, assigns meanings to the phenomena experienced, and has a mutual perception of others in a constant movement of communication(1).
Corporeality refers to how the body is involved in the world, and relates to creatures and things. It is a living process that is not confined to its physical limits, but is open to the world as a whole(2). In all existential situations, corporeality is present. Even in the face of different concepts and ways of seeing the body, from the point of view of several cultures and social segments, the human being continues using it to coexist with himself, with the world and with other people(3).
The educational act is an event that takes place in bodies permeated by desires and needs, which cannot be controlled by the curricular subject, and is part of the relationship in teaching and learning(4). The body communicates through its posture, eyes, tone of voice and facial expressions, that is, it uses all the sensory dimensions of interpersonal relations(1).
In the health area, education with regard to corporeality on the part of faculty is essential(5). However, in the area of nursing the themes body and corporeality are significant attributes in training at the undergraduate level, since it concerns the teaching of how to take care of human beings. Undergraduate nursing teachers experience diverse contexts related to teaching issues and the process of caring for patients, using their entire corporeal dimension. They communicate through their bodies in expressing their knowledge related to nursing. Teaching does not always brings joy and fulfillment. The involvement with teaching and learning issues may generate positive feelings, as well as suffering and physical and mental exhaustion(6).
In terms of the context under consideration in this study, the following questions have guided this study: is the nursing teacher aware of his body in the development of his professional activities? Does he give meaning to his body in the performance of his work? How does the teacher perceive his body in nursing education?
These concerns led to the development of this study with the aim of understanding how the nursing teacher perceives his body during his professional performance.
The results of this research may stimulate critical thinking and promote theoretical and practical reflection with regard to the dimensions of teaching, research and nursing care.
METHOD
A qualitative research approach was adopted using the phenomenological existential approach and the philosophical conceptions of Maurice Merleau-Ponty(1) This approach addresses concepts such as lived space (spatiality), lived body (corporeality), lived time (temporality) and lived human relationships (relatedness) that jointly make up the existential field and the fundamental structure by which all human beings experience the world(7).
The phenomenological approach allows researchers to move beyond the question of objectivity by considering the emotional and psychic world. It allows the investigation of everyday life in order to understand the concrete reality. It describes the overall structure of the lived experience and how individuals perceive themselves in these experiments(8).
The present study includes teachers who are part of the Undergraduate Program in Nursing of a public university in the state of Paraná who, during the data collection period, had worked in the job for at least five years, which is a period of time that presupposes a substantial amount of teaching experience.
Data collection was conducted with 10 female teachers in the months of May and June, 2009, through recorded interviews lasting about 40 minutes, in a place chosen by the teachers. The testimonies were identified with the word "teacher" and were numbered 1 to 10 to ensure anonymity.
After clarification of the research and acceptance by the interviewee, the signature of the Instrument of Consent was requested and the following guiding question was used: how do you perceive your body posture when teaching nurses?
For the analysis of the testimonies we used the phenomenological framework of Josgriberg(9): reading and rereading the testimonies in order to detect the meaning of units and the grouping of similar units (convergence) that culminated in the theme "corporeality and the practice of teaching." The discussion of the results was based on the theoretical framework of Merleau Ponty(1) and references on the subject.
The project was favorably evaluated by the Ethics Committee in Research of the School of Nursing, of the University of São Paulo (Opinion No. 767/2008).
The teachers of the Undergraduate Nursing Course show that thinking about the body and corporeality is not a common routine in everyday academic life:
] Actually [...] we do not stop to think about [...] how I use my body as a teacher. (Teacher 5)
When reflecting on the body, the first feature is the physical body. The concern with the development of cognitive skills overlaps the perception of its corporeality and how this corporeality is used in professional life:
] I don't know if it's because, in Nursing, we greatly appreciate the technical part [...]. When we think about the body, the first thing that comes to mind is its physical aspect. (Teacher 4)
This teacher pointed out that nursing as a profession is one which asks a lot of the nurse's physical body and this may be the reason it was highlighted at the time of reflection on the lived body in its entirety. However she states that, in terms of academic performance, either in the classroom or in the training environment, the teacher uses not only her physical body, but also the lived body that makes up the scenario within which she teaches. Both aspects are a whole when it comes to meaning and responsibilities:
] I don't think about the body only in terms of a woman's body, I see it as a physical body, but that is also my framework when it comes to supporting the mental, physical and spiritual aspects. (Teacher 1)
The body is evidenced as the owner of meanings that expresses feelings, ideas, values and beliefs:
] The body carries the significance of who you are; [...] It’s your own meaning. Sometimes you express how you feel, what you believe. So the body is an expression of your beliefs and values. (Teacher 8)
The lived body was thought of as a facilitator of interpersonal relationships that comprises teaching and learning:
] My body is my communication with others, with the patient and with my students. Then I see how fundamental it is. (Teacher 7)
The nursing teacher moves and communicates through her corporeality, using her body schema. One teacher reported that she uses several features of the body when performing teaching activities:
] Do you realize how your voice is an instrument? In the classroom I perceive the whole body. (Teacher 10)
] When you know the student a little more, you achieve body communication, non-verbal communication [...] that appears to you. (Teacher 2)
The body is remembered as a teaching tool that allows students to observe the behaviors and the attitudes of the teacher while teaching:
] My body is an instrument in my profession, in teaching, in the way I address the patient, the person that I'm taking care of; the way I deal with them, touch them; the care I perform. I think this is how I teach my students. (Teacher 7)
When reflecting on her corporeality in nursing education, the teacher refers to her career in performing this activity. The beginning of teaching activities has proved to be surrounded by fears, insecurities and difficulties, considering the teacher’s lack of experience of teaching and his unpreparedness for the job:
] I had no training to be a teacher. (Teacher 6)
] At the beginning of professional life we have limitations, due to our own inexperience. (Teacher 3)
The first contact with the students, taking responsibility for their learning and the difficulty in dealing with the corporeality were reasons that generated emotional stress on the part of the nursing teachers:
] At the beginning, when I started teaching. The physical body aspect was strange. I didn't know where he put my hands [...] My body basically showed insecurity. [...] Am I going to handle the responsibility of transmitting scientific knowledge? And the relationship with my students. At the beginning, the body wanted to stay behind a little, leaving the other aspects to go ahead. (Teacher 8)
Learning how to deal with the corporeality, in an academic environment, was a construction that occurred as time passed, and the teacher assumed her role as an educator. Becoming a teacher was permeated by suffering:
] I also think that the student can’t afford to wait for a graduate to develop as a teacher, because he wants to learn, but in the beginning we suffer a lot. (Teacher 8)
Despite all the initial difficulties of a teaching career, the teacher shows that there was growth in the teaching profession and that this is an ongoing process:
] When I got here it was like I knew nothing, but, slowly I learned it. (Teacher 4)
She also mentions that the experience of the various functions that are part of work at the university brings difficulties:
] There is the administrative part that always leaves us overwhelmed; it's in this context that we live, because we are submitted to a great deal of exhaustion due to a heavy workload and responsibilities. (Teacher 8)
The intellectual output of the teacher, the demand as to the realization of the need ot undertake research and engage in continuing education are considered stressful aspects:
] Because in the end you have to show to the university some kind of production. But to achieve this production you must have quality and, to have quality, you have to start much earlier; you must have time and dedication. There is also the need for the training of teachers; [...] a doctorate must be done; you must handle all the activities; [...] a PhD is essential at the university, after all we are the teachers. (Teacher 6)
She realizes the impact of the work process on her life and body:
] The physical and mental fatigue is intense. [...] Because last year I discovered that I had high cholesterol and triglycerides, and I had to do some physical activity. I already did it, but it was not enough to account for the balance, but all this because of the stress of everyday life. (Teacher 6)
The teacher experiences a situation of ambiguity regarding her everyday professional activities:
] I love teaching. This, of course, is something I'm happy to do. But, on the other hand, I get very exhausted; it's a huge physical and mental exhaustion. (Teacher 6)
On terms of the set of activities, responsibilities and functions, the nursing teacher values the educational work done with the student, and identifies their perception regarding their attitudes:
] they really observe how I treat the patient, even my posture, and the tone of voice, the reception, how I take care of them, how I take care of myself [...]. (Teacher 9)
She seeks to develop her role as an educator in the best possible way and places the student as the core of what she aims to do:
] we try to help the student as much as we can in order to guide her to be a good professional; [...] to make her understand the role of nursing in society. (Teacher 4)
In terms of her relations with students she is aware that, in her teaching practice, it is necessary to perform care actions that contribute to the professional development of the student:
] I think about what my contribution is in her life (Teacher 1). So, in this relationship of taking care of the student, [...] her needs, [...] I think that the teacher, in a way, takes care of her. It's a relationship of care. (Teacher 9)
The intention of caring for the student becomes an attitude that helps the teacher to prepare herself to be a carer for other individuals in the health world. To carry out the care actions in relation to the student, the teacher highlights the need for proximity, for creating links and the search for this proximity:
] And one thing that, for me, is very important and I appreciate; it's when you create a human relationship with the student. (Teacher 1)
In these inter-relationships with the student, the nursing teacher perceives the way the profession makes demands on her corporeality. In addition, she perceives herself as an individual in need of self-care in order to look after the student:
] I do everything you can imagine to try to keep myself healthy. [...] As a teacher, what I need [...] is to steady myself. (Teacher 8)
She assigns great value to the body in its entirety when reflecting on teaching and nursing:
] Our profession requires a lot from human beings, and it requires all the dimensions that make up this body. (Teacher 7)
In her everyday life, the teacher is concerned with transmitting, through her corporeality, examples that contribute to the professional development of the student, because she knows that she is observed and that the students learn her way of being:
] you must be an example for those who are learning with you [...] then the way you use your body is going to help them learn how to use theirs. (Teacher 8)
DISCUSSION
The discussion of the body is essential to the training of professionals in the health field. A plurality of perspectives that influence the construction of meanings about the image of the body is inter- and trans-disciplinary, and involves psychic, individual, collective, cultural, social, symbolic, institutional, religious and other aspects(5).
In this study, the physical aspect of the body was highlighted in terms of nursing, both with regard to teaching and in service. The appreciation of the body by the nursing teacher as a physical structure, is supported by western culture(10).
The use a man makes of his body transcends the biological dimension(1). This statement reflects the lived experience of a nursing teacher, who can transcend the biological body, and act in a particular time and space in search of the living body in its entirety. This finding requires a reframing of the movement of one’s body in space and time in terms of one’s existence as an educator.
The body is defined by its existence and the subject needs firstly to have a world or to be in the world. By this we mean, the subject needs to keep around himself a system of meanings of which correspondences, relationships and interests need not explicitly be used. He enters the object based on perception, assimilates its structure and, through his body, directly regulates its movement(11).
When entering the existential space of nursing education, the teacher, as a perceptive being, observes aspects related to herself, the inclusion in the pedagogical practice and the relationship with the student. Perception is the background on which all acts stand out, being presupposed by the students(1).
The physical body of the nurse is seen as a teaching tool for care procedures, yet other dimensions of corporeality are emphasized as is the exercise of teaching that creates, in the act of caring, an existential moment among the human beings involved in nursing education. We communicate through body movements, speech and gestures, emitting existential meaning to the world and allowing bodies to interact and know each other(1). By using her body schema, the nursing teacher also uses her motricity - body movements towards the world, objects, or even towards people - and these movements are accompanied by meanings and intentions. Having a body means, for the living being, joining a defined medium, getting confused with certain projects, and engaging continuously with them(1).
The body is engaged in the world with a project that is developed as it is executed, with the ability of improvisation, creativity and adaptation in the face of diverse life situations(11).
Proximity movements are performed by the body and have the potential to strengthen interpersonal relationships, allowing the teacher and the student to interact in various learning situations. Human knowledge is structured in the relations that the individual establishes with himself, with others and with the world in an exchange system, from relational and reflective perspectives arising from life and from experiences(12). The understanding of nursing education, in addition to the technical aspects, is also based on the interpretation of the meaning of educational activities in terms of the teacher-student relationship(13).
The reflection on corporeality in nursing education sends the teacher back to the beginning of her career and makes her remember the difficulties that are characteristic of the beginnings of academic life. The preparation for the exercise of educational activities minimizes the initial difficulties faced by the teacher. The training and development of nurses, from their undergraduate course, to the teaching function is important, since continuing education is one of their professional skills and teaching is an important curriculum content in nursing education. In this sense, teaching skills are built along both personal and professional trajectories, in daily work, expanding beyond the technical area of training and invading social spaces involving interpersonal relationships, both in society and in educational institutions(14).
All the teachers involved had experience of teaching nursing. The amount of experience is an important factor in the construction and mobilization of knowledge. It is also combined with the practice of collective and collaborative work that permeates the installation of a permanent state of reflection on and in daily practice(15). The exploration of life experiences in teaching aids the understanding of how to be a nursing educator and such explicit meanings can support changes in teaching practice(16). It is from existential experiences that have occurred in the past, which occur at present and which will occur in the future, that the subject understands himself and grows(1).
The workload and responsibilities involving herself and others makes the teacher express feelings of physical, mental and emotional exhaustion, and other perceptions of the work role. The women surveyed have had their lives and their health influenced by the many hours of work that they demand of themselves in today's society(17). As biopsychosocial and cultural beings, the teachers experience various roles, and bring all these dimensions with them to academia, since it is about a single body that experiences the corporeality in different spheres of everyday life; roles which, at times, are intertwined, making up the woman as an educator in nursing. The teacher engages herself in a network of interactions with the participants of an educational action in a context in which the human element is determinant and dominant(15).
Teaching activities go beyond the activities in the classroom; therefore the job of the educator becomes intense, because, in addition to the usual functions that are required of her, others are incorporated into her workday, such as the coordination of research, university extension, the writing of scientific articles, as well as technical and administrative activities. Work overload is a constantly observed aspect in the lives of university professors. The activities tend to be diversified and fragmented. An increase in the demands placed on these professionals has also been observed. They are increasingly under pressure concerning the progression of their teaching career, in addition to the need for self-empowerment and the constant updating of curriculum content(15,18).
Considering her working process, the teacher highlights the importance of keeping herself healthy, emphasizing the need to care for her body, which will reflect on her professional performance. To become a person who takes care of oneself, one needs to understand one’s chronic condition, and have self-motivation to engage in healthy behaviors and to be proactive(19).
The nursing faculty shows an attitude of care and respect for the capacity of the development of others. They highlight the meaning of education as a project for developing different possibilities that can open up learning to students. Therefore they make themselves available which makes student learning easier(20).
When there are two beings, the other is no longer a simple behavior in one’s transcendental field. Individuals are connected to one another in a perfect reciprocity. The perspective of one slides into that of the other, and they coexist in the same world(5).
Good teaching leads the nursing teacher to encourage a sense of responsibility and commitment to learning, as she finds the influence of her corporeality in the work of the student nurses(20). The movement of the body plays a role in the significance of the world. If it has a purpose in this world, it is necessary to have the world around it, not as part of a system of inert and meaningless objects, but as a set of objectives towards which we are heading(1).
Thus, the teacher emphasizes the body as a vehicle of care in teaching practice and sees the possibility of continuous reflections on the role of her corporeality in the development of nursing students.
CONCLUSION
This study allowed us to understand how the teacher perceives her body in undergraduate education in the field of nursing. The nursing teacher demonstrates an awareness of the body in pedagogical practice, besides the biological aspects. She assigns meanings to the body as the facilitator of interpersonal relationships and as a teaching tool, which reflects on both theoretical and practical learning, while they perceive the impact of the work process on her life and body.
The results of this study raise an interest in deepening our knowledge about the importance of the body and of corporeality with regard to the role of the nursing educator in the field of education and in the profession generally. It offers the possibility of reflecting on how to be a teacher and allows the understanding that, in everyday life, even when involved in so many diverse activities, the teacher needs to be aware of her corporeality.
It highlights the fact that the body is present in the relation to teaching in a way which transcend the physical aspects. Therefore it enables one to reflect on the subjectivity inscribed in the educational activity having, as a central element, the corporeality of the teacher.
It also considers the humanistic elements of learning in healthcare, which involve the student, the teacher and the act of caring.
Recognizing herself in terms of corporeality and the understanding of her relationship in the professional environment will probably allow nursing teachers to develop a pedagogical practice that will provide a better teacher-student, teacher-healthcare team and teacher-teacher interaction, which may facilitate her self-knowledge and her relationships in terms of professional activities.
The information derived from this study cannot be generalized, but it will certainly contribute to enhancing our knowledge relating to nursing.
The relevance of this topic will hopefully encourage further research from other perspectives, focusing on the importance of corporeality in nursing education.
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Received: 04/01/2012
Approved: 01/08/2012