Work education in primary health care: interfaces between permanent education in health and the communicative action

Abstract

Health work and work education are a double dimension - instrumental action and intersubjectivity. OBJECTIVE: To analyze the conceptions of education that support educational activities of health care workers in Primary Health Care. METHOD: This qualitative study was conducted in two primary health care units (PHCU) in São Paulo, through semi-structured interviews with 36 key informants representing each professional category, including managers and health care workers. Data were analyzed based on thematic content analysis and on the theoretical framework: the healthcare work process, theory of communicative action, continuing education (CE), permanent education in health (PEH) and integrality (comprehensive approach), which allowed the construction of the empirical categories: instrumental/traditional education and communicative/emancipatory education. RESULTS: The results show the prevailing notion of work education as a collective construction of knowledge from the reality of work, relevant to the PEH that is intended to be introduced in order to change the practices and the biomedical health care model. However, some interviewed subjects expressed an instrumental conception of education that emphasizes technical actions and knowledge updating, which is closer to CE. Conclusion: Results show the coexistence of the two conceptions of workers' education: instrumental and communicative, with the predominance of the second one, which shows the reach of the PEH policy among the health workers of PHCU and the need for deepening the discussion to consolidate educational practice in daily work.