INTRODUCTION

In Brazil and worldwide, learning processes have developed into methods that promote critical-reflective professional training¹. The adopted strategies are based on the principles of active methods, in which students take on a leading role in the construction of knowledge, moving away from the passive approach of traditional methods. Among these strategies, Problem-Based Learning (PBL), problematization and the use of virtual strategies² stand out.

Active learning methods are capable of bringing students closer to the reality of professional practice and improving the integration between theory and practice, as they allow experiences to act as triggers for study. Moreover, most active methods are structured through work in small groups, so that they also stimulate the development of interpersonal communication and the ability to evaluate one’s own learning and that of the group, fostering critical thinking and making the student reflect on the learned content³.

Among the examples of institutions that stand out in curriculum integration and adoption of the active method is a Higher Education Institution located in the interior of the state of São Paulo, which offers undergraduate courses in Nursing and Medicine. The institution structures the curriculum based on competencies and, in its development, fully employs active teaching and learning methods^4),(5, as well as broadcasting the National Curricular Guidelines for the Undergraduate Course in Medicine⁶.

In this context, Nursing and Medicine students, in the first two years of the course, participate in theoretical and practical activities in an integrated manner, valuing interdisciplinarity, with both courses sharing activities and scenarios. The pedagogical content is introduced through Problem-Based Learning (PBL) and problematization^4),(5. However, problematization is used for activities in the real scenario that occur from the first year of the courses, based on action-reflection-action on the reality of the world of work, with creativity as its basic foundation, aiming to train participatory professionals with a critical understanding of reality, through joint mediation between the subjects involved in it^7),(8.

This proposal also highlights the possibility of exercising interprofessionality, considered an important strategy to be used when facing the complex problems imposed on health services, since it foresees professional practice in a team, with the articulation of different areas of knowledge, in favor of meeting the needs of people, families and the community⁹.

The institution in question develops practical activities in Family Health Units (USF, Unidades de Saúde da Família), with groups of 10 to 12 individuals. Thus, a group of students, aiming to improve curricular experiences, with the purpose of expanding topics related to learning scenarios, decided to address the National Policy for Comprehensive Child Health Care (PNAISC, Política Nacional de Atenção Integral à Saúde da Criança)¹⁰ to be presented in a plenary session, thus choosing to create a video in the ‘Draw my Life’ format.

This article aims to report the experience of a group of students from the Medicine and Nursing courses, when using the problematization method to understand the PNAISC.

EXPERIENCE REPORT

This is the experience report of a group of 13 students from a Higher Education Institution (HEI), whose curriculum is based on active teaching-learning methodologies^4),(5, during activities developed at the Professional Practice Unit (UPP, Unidade Prática Profissional), in August 2018, addressing the PNAISC⁶. The actions were carried out at the Family Health Unit (USF) where the group worked and at the HEI premises.

As part of the active methodology adopted by the HEI, students attending the 1^st and 2^nd years of the Medicine and Nursing courses are required to have common professional skills and, therefore, are organized into groups of 10 to 12 students in a 2:1 ratio (Medical students/Nursing students). These groups are coordinated by two facilitators, one of which is a teacher affiliated with the HEI and the other a professional from the USF itself. This organization aims to integrate the needs of the population living in the territory with the academic training of students, allowing practical work since the start of the undergraduate course, through actions at the USF itself and in the covered territory^4),(5. The students’ practical experience acts as a trigger for problematization¹.

The research was approved by the Research Ethics Committee, under CAAE number 75097623.6.0000.5413, and all students who participated in the experiment signed the Free and Informed Consent Form (TCLE), agreeing to participate in the research.

The experience report was developed in seven steps, as follows.

Step 4: Filming the creation of posters with the illustrations

A student from the group who was more skilled at drawing was responsible for creating the illustrations.

The group acquired simple materials, such as cardboard and colored pens, which were necessary to create the illustrations. The chosen recording location was a classroom at the HEI itself, and the camera used was from a cell phone belonging to one of the students. The camera was positioned with a top view of the cardboards, while the student created the posters, based on the developed script.

Source: the authors.

Figure 1 Process of creating the video using the ‘Draw My Life’ technique with drawings. 

Source: the authors.

Figure 2 Video creation process using the ‘Draw My Life’ technique, with texts and diagrams 

DISCUSSION

The proposed topic showed to be extremely relevant, allowing students to attain meaningful learning through reflection during the process, about how public health policies affect children’s health care, especially morbidity and mortality indicators, due to the greater vulnerability of this age group. Dependence on adults, challenges in the growth and development process, as well as intense changes in children’s lives require specific care at different moments¹⁵.

Public policies aimed at child health worldwide indicate that investments in child care are essential, requiring local and coordinated solutions, especially in low-income countries¹⁶. Furthermore, the use and implementation of neonatal and child health policies based on scientific evidence and that prioritize the axes of longitudinality and intersectorality are recommended^17),(18),(19.

In Brazil, with the implementation of the Unified Health System (SUS, Sistema Único de Saúde), there was a significant expansion of social rights and the guarantee of the right to health, providing continuous progress in the implementation of public policies for child health care, favoring access to health services and contributing to improving children’s living conditions²⁰.

The PNAISC¹⁰, created in 2015, is one of the initiatives focused on children, of which origins date back to the need to provide resources to vulnerable populations, such as riverside children, quilombolas, children with disabilities and rare diseases. This policy also seeks to address inequalities regarding access to treated water and basic sanitation, in addition to responding to the challenges related to new infectious agents and the resurgence of diseases previously considered to be eradicated. The high rate of Caesarean sections, preterm births and the challenges of reducing neonatal mortality were also determining factors for its implementation¹².

It is important to highlight that the PNAISC¹⁰ emerged as a means of strengthening, in practice, the assurance of the universal right to health provided for in the Federal Constitution of 1988, on the occasion of the establishment of the Unified Health System, SUS²¹, as well as promoting the comprehensive protection of children, in accordance with the principles established by the Statute of Children and Adolescents (ECA, Estatuto da Criança e do Adolescente)²².

The PNAISC¹⁰, guided by eight principles that include the right to life and health, universal access to health and comprehensive care, aims to articulate health actions and services at different levels and in the Health Care Networks (RAS), aiming to overcome the fragmentation of the existing care¹⁴. Structured into seven strategic axes, it aims to fully meet the needs of children, covering everything from pregnancy to adolescence^10),(23.

In the Federal District, the implementation of the PNAISC contributed to the construction of the Comprehensive Child Health Care Network, developing and improving local care by strengthening Primary Health Care as a care provider, integrating health services, connecting the dots through agreed flows and the construction of lines of care at different levels of care²³.

Furthermore, during the implementation of SUS and its policies, there was an urgent need to adopt new care models, in which health professionals are “more involved in the dynamics of the system, sensitized to teamwork and contextualized with the social reality, in search for a professional practice based on humanized relationships that are close to the population”²⁴. In this context, active learning methodologies emerge as crucial elements, since, in addition to training professionals qualified from a technical-theoretical point of view, it is imperative that they are prepared to face the challenges and difficulties inherent to the reality of health services²⁵.

When considering the relevance of the topic and using the active teaching methodology as a tool in the search for knowledge, it was observed that, during the video preparation, the students were challenged to improve several skills, such as the active search for information, the critical analysis of the obtained data and the restructuring of these data to adapt it to the proposed presentation model. Thus, doing it in accordance with the National Curricular Guidelines for undergraduate Medicine courses⁶.

In this direction, a study that compared the learning disparities between a group of students who completed two semesters of the course using an active method, together with a lecture-based classroom, and a group that was submitted to traditional teaching only, showed that students exposed to the active method showed significant improvement in their ability to learn, analyze and solve problems, in addition to increased confidence when dealing with patients²⁶.

Regarding interprofessionality, it can be considered that the educational method used in this report, as found in another study, facilitated the development of collaborative learning, the promotion of mutual involvement, the stimulation of a sense of leadership and the awareness of the importance of teamwork on the part of students²⁷.

Additionally, it is important to highlight the importance of the virtual strategies employed in the development of the final project on the PNAISC. When shared on social networks to expand the reach and relevance, the pertinence of these approaches is highlighted, especially considering the current era of Information Technologies (IT). In this context, the produced educational videos can be accessed at any time, through notebooks, smartphones and tablets, allowing frequent playback and facilitating access to information and knowledge. The use of IT in medical education gives students a perception of more creative learning, a feeling of constant updating and the capacity to extend their studies beyond the limitations of the classroom²⁸.

Finally, throughout this educational process, in which students played the role of protagonists, the question arises about the effectiveness of meaningful learning about the PNAISC. Meaningful learning manifests itself through the cognitive interaction between prior knowledge and new information, in a non-arbitrary and non-linear manner. The learner’s predisposition and the quality of the learning materials play crucial roles in this context, elements that are present in this specific experience²⁹. Therefore, when evaluating the teaching-learning methods implemented in the design of this project, the perspective of the medical and nursing students involved in it and the definition of the abovementioned meaningful learning, it is possible to state that this educational process culminated in meaningful learning about the PNAISC.

FINAL CONSIDERATIONS

This study showed that the use of problematization in the learning process gives students greater autonomy in the search for information, stimulating their interest, creativity and curiosity, which makes learning more meaningful and enjoyable and, consequently, facilitates the understanding of the covered content.

It was observed that understanding public health policies is of the utmost importance for both students and professionals in the health area, since these policies guide practices, aiming to ensure comprehensive care for the population and society in general, which need to be aware of their own rights and responsibilities to exercise autonomy and co-accountability.

Therefore, the proposal to encourage the study of public health policies and promote the active search for knowledge, aiming to improve the teaching-learning process in a more meaningful way for the student, achieved its objectives and proved to be an innovative practice to strengthen and value interprofessional education, also meeting the curricular guidelines for health area courses.