Educação problematizadora e Sistema Único de Saúde: uma análise de contribuições da pedagogia de Paulo Freire em um programa de residência multiprofissional em saúde

Abstract

The Multi-professional Residences in Health (RMS) emerged in the 2000s, as a strategy of the health professionals´ training founded on the understanding of the political and humanistic relations that lead to the teaching-service-community interaction. However, even today, the Multi-professional Residences in Health are considered to be an innovative curricular modality in health education, because they present a pedagogical structure based on the problem-posing regarding the reality of public health services; furthermore, there are still few studies that address the philosophical and pedagogical foundations underlying these teachinglearning processes in health. Among the research topics about this subject, it is possible to identify the alignment of the RMS proposal with the Paulo Freire's pedagogy, although this association is not deepened and referenced in the normative documents of this modality of health education. From this conception, the following questions arise: what aspects are evidenced in the relation between the political-pedagogical presuppositions of Freire and the teaching proposal of RMS in the field of theory and practice? how are these aspects characterized in terms of contributions to the training of health professionals, in view of the principles and guidelines of health public system and their relationship with Paulo Freire's pedagogy?. Therefore, this current piece of research aimed o understand about the contributions of Paulo Freire's pedagogical proposal, in a Multiprofessional Residency Program in Health, to promoting advances in the professional practices of residents, which cooperate to the fulfillment of the National Health System (SUS). This is an evaluative, participatory research with a qualitative approach, of the case study type. The locus of the study was a Multiprofessional Residency Program in Mental Health, offered by the Federal University of Paraíba, whose syllabus is based on Paulo Freire´s methodology. Data were collected during the year 2017, through semi-structured individual interviews with tutors and preceptors, as well as focus group meetings with residents, and analyzed according to the Content Analysis. The study was submitted to the Research Ethics Committee of the Federal Institute of Education, Science and Tecnology of Paraíba and aproved in accordance with the opinion number 1.982.127. The pedagogical dynamics of action-reflection-action, led by the collective and multi-professional work, enabled the residents view the mental illness sufferer not only under the several biological knowledge, but understanding them in the complexity of their life reality and empowering them to overcome their own limits. Advances in coping with daily difficulties and challenges of the National Health System were also attributed to the Problem-solving Pedagogy through the insertion of both students and professors in different participation ways and health social control, as well as the construction of professional practices consistent with the individuals´ and collectivities´ real needs. Therefore, Freire´s pedagogical proposal, when truly experienced, tends towards transformations of both oneself and reality as consequences of the students´ mind enlargement by reading the world, which, in the health area, can mean infringement of the assistance model of care and management, strengthening the instituting principles of the National Health System with emphasis on equity, integrality and social participation.