INTERPROFESSIONAL COLLABORATION IN THE EBSERH MULTIPROFESSIONAL HEALTH RESIDENCE PROGRAMS : FROM THEORY TO PRACTICE
interprofessional education, interprofessional collaboration, multiprofessional residencies in health, teamwork, federal university hospitals, Ebserh.
Interprofessional education (EIP, in the acronym in Portuguese) aims to foster health area interprofessional collaboration (CIP, in the acronym in Portuguese) culture, among professionals from different categories, with the aim of improving teamwork and improving the services provided to patients. CIP brings professionals from different backgrounds together to share knowledge and skills. Interprofessional teamwork (TIP, in the acronym in Portuguese) is one of CIP’s components. TIP is a conceptual-theoretical model that allows an understanding of teamwork complexity, and support interprofessional interventions realated to its four factors: relational, procedural, organizational and contextual. The Multiprofessional Health Residency Programs (PRMS, in the acronym in Portuguese) represent a governmental action aimed at training together in and through work. The general objective of the thesis was to investigate the interprofessional collaboration within the scope of the PRMS offered by the Federal University Hospitals (HUF, in the acronym in Portuguese) managed by the Brazilian Company of Hospital Services (Ebserh, in the acronym in Portuguese). This is a national, cross-sectional, descriptive and exploratory study with a mixed approach and convergent design. The thesis was organized in the form of five articles, related to their specific objectives and which respond to the general objective of the thesis. The first article presents an exploratory and descriptive literature review, carried out with the objective of identifying the facilitators and barriers of interprofessional education and collaboration to classify its components, according to the four TIP factors. The results showed 24 facilitators and 20 barriers to IPE; and 36 facilitators and 35 barriers to CIP, which were classified according to four TIP factors. The conclusion was that the identification and organization of EIP and CIP facilitators and barriers can contribute to a better understanding of the theme in the PRMS context, as well as subsidize future interprofessional interventions that promote the improvement of teamwork. The second article refers to a qualitative, documental and exploratory study, with textual discourse analysis by lexicometry. Were analyzed 43 pedagogical political projects (PPP, in the acronym in Portuguese) of PRMSs from Rede Ebserh managed HUFs. Data analysis showed two central nuclei, "team" and "training", which showed greater connection between the components associated with PIC. As for the central ideas the textual corpus wanted to convey, three classes whose components were associated with the EIP were identified: Characteristics for residents' training process; Egress final profile and Guidelines for resident's work during training. The analyzes by Brazilian region, in relation to the teaching-work-learning process, showed elements associated with the EIP and CIP precepts. It was found that the analyzed PPP have components associated with the EIP and the CIP, which indicates the convergence of the PRMS for interprofessional training for a collaborative culture through teamwork. The third article analyzed the perception of residents regarding the characteristics of PRMS. A cross-sectional, descriptive and exploratory study with a quantitative approach was carried out, using lexicometric analysis, with 178 residents. The results organized into three classes explained the resident's motivation to attend the PRMS: Benefits for the professional career; Benefits offered by PRMS; Knowledge of care practice scenarios. The results also showed the residents' satisfaction both in terms of the characteristics of the teaching and learning process and in relation to the fact that the PRMS are offered by reference institutions. The conclusion was that the PRMS are capable of training professionals able to deal with the complexity involved in health care through teamwork in and for the service. The fourth cross-sectional, descriptive and exploratory study article measured interprofessional collaboration using the Interprofessional Team Collaboration Assessment Scale II (AITCS II-BR). The sample had 178 residents. The results showed a greater propensity for PIC associated with males and in the PRMS of the Northeast Region, as well as a classification of PIC in the alert zone for all variables of interest. The fifth article analyzed the perception of residents regarding the factors that affect interprofessional teamwork. This is an exploratory and descriptive study with a qualitative approach by remote interview with data analysis by lexicometry. The sample had six residents. The results showed weaknesses for: the issues of the formation process and belonging; interprofessional education; interprofessional collaboration. The results also indicated that the COVID-19 pandemic affected teamwork. The weaknesses highlighted by the residents directly affect collaboration and interprofessional work and may be barriers to the implementation of a collaborative interprofessional practice. It is concluded that the five studies advance the discussion on teamwork in the context of EIP for CIP.