PEDAGOGICAL TRAINING OF THE TECHNICAL SCHOOLS OF THE UNIFIED HEALTH

Objective: to analyze the process of pedagogical training for teachers carried out in the technical schools of the Unified Health System. Method: integrative review, with search in publications between 2012 to 2016, in the databases LILACS, MEDLINE, BDENF and SciELO Virtual Library. Six articles met the inclusion criteria and the Descriptors to guide the research were: Continuing Education; Nursing Education; Training of Human Resources in Health and Unified Health System. Results: the categories "Challenges of Pedagogical Training" and "Autonomy of schools as a strategy of change" were identified. Conclusion: the study contributed to the knowledge about the process of pedagogical training carried out in the technical schools of the Unified Health System. It is relevant for the development and strengthening of schools to change the management model, to guarantee its autonomy, the execution of resources and the continuity of pedagogical training and courses. Descriptors: Health Human Resource Training; Education, Continuing; Health Manpower. RESUMO Objetivo: analisar o processo de formação pedagógica para docentes realizado nas escolas técnicas do Sistema Único de Saúde. Método: revisão integrativa, com busca em publicações entre 2012 a 2016, nas bases de dados LILACS, MEDLINE, BDENF e Biblioteca Virtual SciELO. Seis artigos atenderam aos critérios de inclusão e os Descritores para nortear a pesquisa foram: Educação Continuada; Educação em Enfermagem; Capacitação de Recursos Humanos em Saúde e Sistema Único de Saúde. Resultados: foram identificadas as categorias “Desafios da Formação Pedagógica” e “Autonomia das escolas como estratégia de mudança”. Conclusão: o estudo contribuiu para o conhecimento acerca do processo de formação pedagógica realizado nas escolas técnicas do Sistema Único de Saúde. São relevantes para o desenvolvimento e o fortalecimento das escolas a mudança do modelo de gestão, para garantir sua autonomia, a execução de recursos e a continuidade da formação pedagógica e dos cursos. Descritores: Enfermagem; Capacitação de Recursos Humanos em Saúde; Educação Continuada; Recursos Humanos em Saúde; Sistema Único de Saúde; Educação em Enfermagem. RESUMEN Objetivo: analizar el proceso de formación pedagógica para docentes realizado en las escuelas técnicas del Sistema Único de Salud. Método: revisión integrativa, con búsqueda en publicaciones entre 2012 a 2016, en las bases de datos LILACS, MEDLINE, BDENF y Biblioteca Virtual SciELO. Seis artículos atendieron a los criterios de inclusión y los Descriptores para orientar la investigación fueron: Educación Continuada; Educación en Enfermería; Capacitación de Recursos Humanos en Salud y Sistema único de Salud. Resultados: se identificaron las siguientes categorías: "Desafíos de la Formación Pedagógica" y "Autonomía de las escuelas como estrategia de cambio". Conclusión: el estudio contribuyó para el conocimiento acerca del proceso de formación pedagógica realizado en las escuelas técnicas del Sistema Único de Salud. Son relevantes para el desarrollo y el fortalecimiento de las escuelas el cambio del modelo de gestión, para garantizar su autonomía, la ejecución de recursos y la continuidad de la formación pedagógica y de los cursos. Descriptores: Capacitación de Recursos Humanos en Salud; Educación Continua; Recursos Humanos en Salud. Masters student, Fluminense Federal University/UFF. Niterói (RJ), Brazil. E-mail: isabelcristinademouraleite@gmail.com ORCID iD: https://orcid.org/0000-0001-8565-0827; PhD, Fluminense Federal University/UFF. Niterói (RJ), Brazil. E-mail: luciamourao@hotmail.com ORCID iD: https://orcid.org/0000-0002-7058-4908; PhD, Fluminense Federal University/UFF. Niterói (RJ), Brazil. E-mail: ana.vieiradealmeida@gmail.com ORCID iD: https://orcid.org/0000-002-9342-6179 INTEGRATIVE REVIEW ARTICLE Leite ICM, Mourão LC, Almeida ACV de et al. Pedagogical training of the technical...

English/Portuguese J Nurs UFPE online., Recife, 12(3):781-9, Mar., 2018 782 The Nursing profession has been changing since its institution influenced by social, political and economic changes that seek, among other principles, humanization and integrality in health care.
As a result of the struggles of the Sanitary Reform Movement, the promulgation of the current Federal Constitution, and the implementation of the Unified Health System, the techno-health model of health incorporated the expansion of the concept of health, requiring schools to train health professionals to reformulate their health systems pedagogical projects.
The Unified Health System has assumed a role of reorientation of strategies and models to care for, treat and achieve individual and collective health, seeking to change the formation and development in health through various programs.Among them, there is the creation of technical schools in health, which have been called the Technical School of Health of the Unified Health System (ETSUS), aimed at the training and qualification of workers in the health services.
The training of a health professional is based on the acquisition of skills and technical skills to perform integral care respecting ethical and moral aspects.Specifically for the nurse, the technical-scientific, ethicalpolitical and socio-educational competencies are outlined as essential. 1he intention is to develop the capacity of this subject to be an active agent in the transformation of society, specifically in the context where it is inserted, acting as a facilitator and promoter of dialogue with the workforce in management, in comprehensive health and education practices.
In Brazil, pedagogical training or pedagogical complementation programs are regulated by the National Education Guidelines and Bases Law (LDB) No. 9.394/96. 2 In particular, the Resolution of the National Education Council No. 02/1997 makes it possible to open and flex the current structures of undergraduate courses, seeking to meet the present needs, granting a certificate and the right to exercise the teaching profession at the intermediate level. 3n order for this training to take place, according to the National Curriculum Guidelines, training centers should stimulate the formation of critical, reflective, affective health professionals capable of analyzing, making decisions, contributing to the evolution and transformation of the work process.This is a non-neutral conception of professional and requires constant analysis of its implications in the exercise of its practice. 4ontinuing education actions have been developed in services with an impact on the practice of health professionals, but the curricula continue to be fragmented.Regarding the formative aspects, the pedagogical conceptions seek to develop capacities to establish relationships that promote the quality of life and interfere in the nature of the services provided in the health system. 5edagogical training for SUS professionals is an important tool for understanding work processes, with a view to a collective construction of knowledge and strategies for a comprehensive health care with quality, promoting the integration of teaching-service and community.
The Technical Schools of the Unified Health System formed, from 2000 to 2005, thirteen thousand, six hundred and one teachers, through the Professional Project of Nursing Workers, specialists in Professional Education in the Health area. 6he professional qualification courses that were then in the Lato sensu postgraduate format, called Specialization in Pedagogical Formation in Professional Education in the Health Area, offered in the modality of Distance Education and coordinated by the National School of Public Health of Oswaldo Cruz Foundation, had face-to-face moments in the Teaching Support Centers, implanted in 49 higher education institutions, with a total workload of 660 hours.Organizational and structural problems have made it difficult to carry out the training that, in turn, generates a fragmented professional training affecting the quality of Nursing care, work relations and degree of satisfaction of users.
Working with pedagogical concepts that reorient the training methodologies aimed at health professionals, in order to develop a care practice with integrality, constitutes a challenge and possibilities for producing changes in practices, management and social participation.
The approach to service practice allows the process of reflection and learning of various experiences in the context of the service attributing meaning to the information received to interpret them, relating them to their life situations. 7he theoretical framework that guides the thought of professional formation, which bases this study, shows that this is a process in permanent becoming, not only as an update that occurs from the accumulation of information, but that occurs through contextualized training with reality and that builds knowledge from critical reflection. 8hen considering the thematic relevance of Pedagogical Training, the object of this study is the pedagogical training of teachers performed in the Technical Schools of the Unified Health System.
It is understood that active and meaningful learning is able to involve people, bring about changes and autonomy of the subjects, which is consistent with the thinking brought about ethical training.
• To analyze the process of pedagogical training for teachers carried out in the technical schools of the Unified Health System.
It is an integrative review in which six stages were developed: 1. Identification of the theme and selection of the research question; 2. Establishment of inclusion and exclusion criteria; 3. Identification of preselected and selected studies; 4. Categorization of selected studies; 5. Analysis and interpretation of results; 6. Presentation of knowledge review/synthesis. 9he integrative review is a methodological approach that offers health professionals quick access to the results of research that underlies the conduct or decision making, providing a knowledge from a critical reflection.  Theiding question of this study was: How is the pedagogical training process carried out for teachers in the Technical Schools of the Unified Health System?
The After this step, a thorough reading of all the articles was carried out in the sequence, delimiting variables for analysis and discussion of the data: database; title/authors; newspaper/year; type of study and thematic considerations.
The research data were respected to the extent that the authors of the works were duly referenced throughout the work, detailed, seeking explanations in each study and confronting them with the others.

OBJECTIVE METHOD
English/Portuguese J Nurs UFPE online., Recife, 12(3):781-9, Mar., 2018 784 The results were collected and discussions developed after a thorough reading of all the articles compiled and described in figure 1.

Lilacs
The technical schools of SUS: what political-pedagogical projects sustain them? 13 Galvão EA, Sousa MF.He reported on experiences in ETSUS Blumenau's pedagogical training.The study concludes that the pedagogical training makes possible the learning about the problematizing method of the teachers of the permanent staff of the school.They revealed that the turnover of professionals in the health service limits and influences the applicability of the methodology in care.

Lilacs
The teaching-learning process in the training of SUS: reflections from the Etsus experience. 18iqueira MCG, Leopardi MT.
Journal Work, Education, Health.

2016
Qualitative research He evaluated the development of teaching and learning using the problematic methodology from the perspective of teachers and students of Etsus de Tocantins.Three themes were identified: problematization as a methodological option; application of problematizing methodology; challenges of the process; and factors that hinder or facilitate the teaching-learning process.The studies revealed that the teachers do not use the problem methodology because of the time for class planning; the group became more involved and involved in the process.They score advances in school, report the need for updating for teachers, lack of infrastructure, insufficient teaching resources and lack of school autonomy.
English/Portuguese J Nurs UFPE on line., Recife, 12(3):781-9, Mar., 2018 786 Of the six original articles selected for the study, five (83.3%), published in LILACS, and one (16.7%)article, in BDENFE, are characterized as qualitative research.As for the year of publication: two (33.3%) were published in 2012; one (16.7%)article in 2013; two (33.3%)articles were published in 2014 and one (16.7%)articles in 2016.In the search, no publications appeared for the year 2015.The data show the need for publications on teacher education and training held in the SUS Technical Schools.
Regarding the origin of the studies, all the research was carried out in Brazil.In four (66.7%) articles, the authors were managers of Etsus; in two (33.3%)articles, the authors serve as coordinators of course at Etsus.The data show the lack of publications of the teachers who participated in the pedagogical training offered by the schools.
It is believed that the experience report, the experience, the look, the perception and the critical reflection of the professionals who participated in the pedagogical training as students would contribute to the dissemination, evaluation, improvement and discussion of this process.
To legitimize educational actions, it is important that individuals are protagonists of this process, actively participating in the production of health and knowledge, merging what is known as popular knowledge and scientific knowledge. 19uring the searches in the databases, we found papers of conclusion of course, dissertation of master and books published like product of the formation, but these were the criteria of exclusion of this study.Among the selected sample, (83.3%) articles highlight the need for updating and specific training for teachers, while one (16.7%)article does not report this problem.
The six (100%) articles show the human resource deficit and staff turnover as a problem for the effectiveness of training.The lack of regulation of the teaching activity in service makes difficult the formation of a permanent framework for pedagogical training.The fragility and precariousness of employment bonds are a reality in most schools.
The permanent staff, mostly from the health department, the municipality or the Ministry of Health, are assigned to work as health professionals in the school, but work in teaching without a career plan.
The strength of work in most schools is through projects.When there are financial resources for the execution, a selective process is carried out for the temporary hiring of health professionals to perform the teaching function.
Regarding the lack of school infrastructure, five (83.3%) articles highlight this problem and only one (16.7%)does not report it.The data show that Etsus have different realities due to their own legal identity and administration.
The results obtained in the articles were grouped, according to the thematic axis, emerging two categories for the discussion: Challenges of Pedagogical Formation; Autonomy of schools as a strategy for change.

 Category 1-Challenges of Pedagogical Training
In the selected articles for this category, one can highlight the use of the active methodologies in the process of formation of the schools.
The methodology of the problematization aims at the construction of the individual's knowledge stimulating the reflexive act, the capacity for observation and the critical analysis. 20The use of this methodology makes possible the daily performance, since it uses a real scenario and does not require many physical changes in the organization.
For the competence in the field of education and health, it is necessary to maintain a critical perspective for the liberating perspective in which the training of health workers can be reconfigured to approximate professional training built on more solidary logic of existence in relationships between people. 21his pedagogy of education is liberating because it values dialogue and reality and because there is social transformation through a critical and conscientious practice.Problematizing is not restricted to merely presenting questions, but to reflecting. 22he professionals talk about the quality of the course, feel qualified for teaching after the course, see the transformation in the health service where they work and the methodology enables learning.  Thex (100%) articles point to the human resources deficit and staff turnover as a problem for the effectiveness of training.The lack of regulation of the teaching activity in service makes difficult the formation of a permanent framework for pedagogical training.The precariousness of employment links is a reality in most schools.
The permanent staff, mostly from the health department, the municipality or the Ministry of Health, are assigned to work as health professionals in the school, but work in teaching without a career plan.

DISCUSSION
English/Portuguese J Nurs UFPE on line., Recife, 12(3):781-9, Mar., 2018 787 The strength of work in most schools is through projects.When there are financial resources for the execution, a selective process is carried out for the temporary hiring of health professionals to perform the teaching function.
All articles report needs and difficulties of updating teachers and of teaching-service integration due to the reduced number of permanent staff, the high turnover of teachers due to the fragile employment relationship and the lack of financial resources.It is important to emphasize that the articulation of the schools with the health service depends very much on health secretariats.
Being a teacher is not a simple mission: it requires preparation, awareness and ethical commitment to society, with professional training permeated by the critical reflection of educational practice and the development of intellectual autonomy. 23here are 40 technical schools that have specificities.Most are linked to municipal or state health management, but some are linked to education (state or municipal training center, faculty) in co-management with the health sector and a school is linked to federal management (has autonomy and financial resources own).
Bureaucratic obstacles and local political issues have a negative influence on this process, since most schools do not have administrative, financial and decision-making autonomy and present difficulties for the articulation and management of training.
Three (50%) articles indicate that teachers do not use the problem-solving methodology in the classroom.Most of the teachers are tied to the assistance and have specific training in the health areas, but do not have training for teaching.It is believed that this contributes to the non-adherence, in the classroom, to this methodology and, in addition to the aforementioned problems, there is fragmentation of the teacher training process, with reduced working hours, increased work, lack of conditions lack of collective planning, supervision, and teacher support.
Opening services as places of production of subjectivity and taking relations as production, place of problematization, openness to production and not as conformation allow us to practice vigorously the Permanent Education in Health.
Teacher training is a process of construction throughout a professional career in which the teacher progressively learns to master his/her work environment.For this, the formation and the updating must be constant for the fulfillment of the educational requirements of the contemporaneity. 25

 Category 2 -Autonomy of schools as a strategy for change
Studies have shown that schools need to change the management model by ensuring autonomy for the coordination of their workforce and the execution of financial resources and courses.Most schools use the same managerial models since they were created and there is a need for participatory and qualified management.
The lack of autonomy of some schools for the management and execution of resources does not contribute to the changes that are necessary and increases the precariousness of the training and the qualification of the workers.There is a need for the regulation of legal instruments for the management and execution of resources.Physical structures and facilities also have peculiarities, depending on the school.
Regarding the lack of school infrastructure, five (83.3%) articles highlight this problem and only one (16.7%)does not report it.The data show that the Etsus present different realities due to their own legal identity and the administration.
The results of the review allowed us to identify that staff turnover, lack of physical structure and technological equipment, lack of autonomy and the difficulty of managers to execute financial resources are challenges to effectiveness and pedagogical training.
Despite the difficulties, the pedagogical training offered by the schools can be considered as a strategy for the consolidation of the Unified Health System, by provoking changes in the work process, allowing the involvement of teachers with the methodology to promote integrated and integrated care practices, of critical reflections and shared knowledge.
The study contributed to the knowledge and critical reflection about the process of pedagogical training carried out in the technical schools of the Unified Health System.It is relevant for the development and strengthening of schools to change the management model to guarantee its autonomy, the execution of continuity of pedagogical training and courses.
It is necessary to carry out research to explore more the thematic of the process of pedagogical formation of the Technical Schools of the SUS by teachers who have experienced this formation in the schools.

CONCLUSION
The actions of the network are coordinated by the General Coordination of Technical Actions in Health Education of the Ministry of Health's Department of Labor Management and Health Education (DEGES/SGTES/MS).
: Collective health research magazine /2012 Qualitative research It aimed to explore the political-pedagogical visions expressed by the managers of the five Technical Schools of SUS, in the five regions of the country.They identified how these institutions organize, structure and sustain themselves.The results showed the lack of specific training and the human resource deficit.They underscored the pedagogical quality and contribution to strengthening SUS.He analyzed the projections and expectations of the participants in a teacher training course for Etsus professionals.The results revealed the transformation of the process and concern of the teachers with the increase of the work overload.They point to permanent updating needs and evaluative studies.