Activité et compétences professionnelles dans des espaces culturellement et linguistiquement hybrides: le cas des professionnels de santé à la frontière Uruguay-Brésil

Abstract

This research focuses on the study of health professionals who work on the border between Uruguay and Brazil. This area is characterized not only by a “culture of the borderlands”, but also by multilingualism because two standard languages (Spanish and Portuguese) as well as two local dialects (Portuguese Gaucho da Fronteira and Uruguayan-Portuguese - popularly called portuñol) are found in this territory. It is in this particular sense that we are trying to understand how healthcare professionals work in such a singular and complex area. The aim of this research is to study these workers’ professional activity and the competences they employ in their domain to better take care of the patients living in the border. We wonder which competences, other than technical, are necessary to these professionals to ensure a suitable and efficient care of the patients whose socio-economic, linguistic and cultural background may differ from theirs. We have chosen to work on this subject using a variety of techniques, which differ greatly but are all relevant in helping us achieve a holistic understanding of the topic we are studying. In this way, we will mention francophone ergonomics, the theory of conceptual fields developed by Gerard Vergnaud, the clinic of activity, and research from the domain of intercultural studies. More specifically using the historical-cultural theory of mind developed by the Russian school of psychology (in particular Vygotski and Leontiev’s work), we will study the professional activity and competences expressed through this activity. For this purpose, we have conducted this study with 208 Uruguayan and Brazilian professionals, using five methodological tools: ethnographic observations, a questionnaire, informal interviews, the so-called instruction to a double, and self-confrontation interviews. The results of this research show that the health professionals who work on that borderland seem to have developed a set of competences, other than technical, in order to provide more suitable and efficient care. Moreover, and in these quantitative and qualitative results, we have noticed that this culturally hybrid context is not an obstacle to their professional activity. On the contrary, in some cases, it is even likely to help them develop other skills and take initiatives that exceed what is demanded by technical requirements as well as their job's requirements.