SUMMARY OF THESES AND DISSERTATIONS

The development of competencies for nursing preceptorship in the primary health care environment: a descriptive-exploratory study

Fabiana Silva Marins Nazareno Cosme¹, Geilsa Soraia Cavalcanti Valente¹

¹Fluminense Federal University

ABSTRACT
This is a descriptive-exploratory study using a qualitative approach.
Aims: To describe the activities of nurse preceptors in the primary care environment and their role in the training of nursing students; to identify the competencies that those preceptors must develop in order to support nursing student training; to analyze the strategies that lead to the development of such competencies; and to use educational technology to support didactic-pedagogic strategies and competencies.
Method: This study has been carried out in three Primary Care Units in Rio de Janeiro city using semi-structured interviews. Participants include eleven nurse preceptors.
Results: Data have been divided into two categories: The role of the nurse preceptor in the training of nursing students and the challenges faced by the nurse preceptor in the primary care environment in terms of the needs and competencies required on the part of the nurse preceptor. 
Conclusion: The results have pointed to the need for a more proactive approach on the part of nurse preceptors concerning their own practice. Also, they have shown that the preceptors are provided with no precepting training. This results in a lack of planning skills on the part of the nurse preceptors when it comes to engaging in an efficient teaching-learning process.
Descriptors: Preceptorship; Competency-Based Education; Primary Health Care.

Dissertation Defense Date: August 9th, 2013.
Examination board: Prof. Ph.D Geilsa Soraia Cavalcanti Valente (Head of The Examination Board); Prof. Ph.D Ligia de Oliveira Viana – EEAN/UFRJ; Prof. Ph.D Vera Maria Sabóia – EEAAC/UFF; Prof. Ph.D Neiva Maria Picinini Santos - EEAN/UFRJ and Prof. Ph.D Donizete Vago Daher - EEAAC/UFF.
Reference: Cosme, FSMN. Preceptoria de Enfermagem na Atenção Básica: Uma construção de Competências na Prática. Niterói. Dissertação (Mestrado em enfermagem) - Universidade Federal Fluminense; 2013.

INTRODUCTION

Currently, the Primary Health Care approach is no longer regarded simply as an approach to the Brazilian healthcare system. Nowadays, it is considered crucial to the (re) organization of collective and individual practices, and to the alignment of the Unified Health System (SUS)⁽¹⁾. These philosophical, methodological and organization-based concepts have brought forth new challenges for health education, since they have triggered a paradigm shift and therefore the development of new practices. This shift has been reaffirmed by Law 9394/96/MEC which prescribed the creation of the National Curricular Guidelines (DCN) for Nursing Graduation Courses in 2001. In this context, nurse preceptors play an important role in the teaching-learning process involving nursing students⁽²⁾. In addition, preceptors must comply with legal and social demands in order to provide an efficient support for nursing students.

AIMS

To describe the activities of the nurse preceptors in the primary care environment and their role in the training of nursing students; to identify the competencies nurse preceptors must develop in order to support nursing student training; to analyze the strategies that lead to the development of such competencies; and to develop educational technology to support didactic-pedagogic strategies and competencies.

METHOD

This is a descriptive-exploratory study using a qualitative approach that has been carried out in three Primary Care Units in Rio de Janeiro. Participants include eleven nurse preceptors. The inclusion criteria are: nurses who have worked as preceptors for at least two months. The exclusion criteria are: those nurses who did not agree to participate in the study. Data collection has been undertaken through the use of semi-structured interviews. This study has been based on the Reflectivity Cycle theory developed by Valente (2009), who deals with the concept of Reflectivity in nurse-professor’s practice, based on the action-reflect-action movement⁽³⁾. This is a permanent movement that culminates in assessment and decision in a retrospective way.

This research has been approved by the IRB of the City of Rio de Janeiro, under protocol no. 69A/2013; and also by IRB of Antonio Pedro University Hospital, under protocol no. 31643/2012.

RESULTS

The data have been analyzed using the Thematic Analysis technique proposed by Minayo and this has resulted in the identification of two categories: The role of the nurse preceptor in the training of nursing students and the challenges faced by the nurse preceptor in the primary care environment in terms of the needs and competencies required on the part of the nurse preceptor. The analysis was undertaken in a cyclic fashion and was based on Reflectivity Cycle theory. The participants have shown a positivist view of their own practice. They have described a nurse preceptor as a professional who passes on knowledge, teaches techniques, shows the daily routine to the nurse students, and complements the nursing program. Regarding the identification of competencies and strategies, the study has shown that the preceptors are unable to manage their own training.  In addition, they lack the ability to plan such training, which prevents theory-practice integration. Concerning educational technology, a practice-based course has been designed to support the nurse preceptors’ practice, using the problematization methodology.

DISCUSSION

This study has shown that the current precepting training must be reconsidered, since some participants are attached to a positivist view of their own practice. After analyzing the categories, we conclude that the preceptors do not regard themselves as agents of social change. Furthermore, it is important that the preceptors develop competencies based on retrospective reflection of their own practice in order to develop a more proactive approach. Also, it is important to find a means to provide the preceptor with some training that will enable them to promote an effective teaching-learning process.

CONCLUSION

The research participants must realize the importance of their role in the education of nursing students. Also, they must understand their practice as being part of a cyclical movement, in which each cycle culminates in decisions that may maintain or change their practice methods. A reflective practice not only sets a good example for the students, but also contributes to the improvement of the SUS.

REFERENCES

1. Trajman A, Assunção N, Venturi M, Tobias D, Toschi W, Brant V. A preceptoria na rede básica da Secretaria Municipal de Saúde do Rio de Janeiro: opinião dos profissionais de saúde. Rev bras educ méd  [ Internet ]. 2009 [ Cited 2012 Nov 10 ] 33(1): 24-32. Available from: http://www.scielo.br/pdf/rbem/v33n1/04.pdf

2. Ministério da Saúde (Brasil). Política Nacional de Educação Permanente em Saúde. Brasília: MS; 2009.

3. Valente GSC. A Reflexividade na Prática docente da Graduação em Enfermagem: Nexos com a Formação Permanente do Enfermeiro Professor. Rio de Janeiro. Tese (Doutorado em Enfermagem) - Universidade Federal do Rio de janeiro; 2009.

Researcher’s mentor: Geilsa Soraia Cavalcanti Valente. Ph.D in Nursing. Professor at the Health Education Master’s Course, Nursing School, Fluminense Federal University. Rio de Janeiro, Brazil.

Received: 02/09/2013
Revised: 06/09/2013
Approved: 07/09/2013