Global Journal of Human-Social Science, A: Arts and Humanities, Volume 22 Issue 7

These, in addition to changing the curriculum, highlight the role of active learning and practice, in addition to the need for the undergraduate student to understand that falling ill is a process inscribed in the culture, historically determined and conditioned by socio-economical parameters. Undergraduate courses should enable those students to experience teamwork and favor the formation of bonds and respect for the diversity and autonomy of those who seek the health service. Another common point to be highlighted is the need to train professionals to work in Primary Health Care (PHC), thus, shifting the hospital spotlight, seen as a priority teaching center 5-8 . Training professionals to work in PHC implies prioritizing bonding and communication technologies. Understanding health as a positive concept, and not just the absence of disease, the professional's perspective starts to include, in addition to diagnosis and treatment, health promotion, disease prevention, rehabilitation, reception, monitoring, care and, when necessary, palliation. PHC focuses on the different family arrangements and on the active participation of the subjects, assuming the co-responsibility of the professionals who make up the health teams and the people they serve, stimulating the protagonism of users, in addition to interprofessional work 9 . Based on the Dawson Report, an English counterpoint to the Flexner model, the PHC organizes and coordinates the health system, guaranteeing universality, equity, integrality, society's participation and problem-solving capacity of care, thus, transposing to the Brazilian practice, the principles of the Unified Health System (UHS- SUS - Sistema Único de Saúde) listed in the Federal Constitution. Due to its characteristics, it demands generalist professionals, in line with the profile of graduates established in the NCG. Several authors report difficulty in training physical therapists, doctors and nutritionists in Brazil who want to work in the PHC. Authors 10 emphasize that most physiotherapists are still trained for the individual, rehabilitative work performed in the hospital. Thus, it is necessary to expand the focus of action and, for this change to properly materialize, it is important to build new teaching paradigms in the undergraduate area. In turn, the Federal Nutrition Council 11 emphasizes that most nutrition courses in the country still work separating the biological aspect from the social one, theory from practice, being overly standardized, not prioritizing the specificities of each region, nor the country's inequalities. As a consequence, graduates generally do not want to work in the UHS. As for the medical courses, the medical demography, a national survey promoted by the Federal Council of Medicine, shows the permanence of newly graduated doctors in large Brazilian cities, in hospital work and with excessive specialization 12 , far from the profile of graduates desired by the NCG. In order to consolidate the implementation of the new NCG and sensitize undergraduates to work in PHC-UHS, having the above explained as context and justification, the project “Innovate-UHS Narrative-Based Teaching” (“Inova-SUS Ensino Baseado em Narrativas”) was conceived involving courses on Physiotherapy, Medicine and Nutrition at a University located in the city of São Paulo. Illness narratives have proved to be a valuable resource in medical education, where they have been used in different contexts for over 30 years. Considered as transforming care practices, they promote empathy, accountability of the graduating student towards the sick person, bond formation, active listening and favors the expansion of the view on the process of becoming ill. Thus, they break the Flexner rationality, adding humanistic skills 13-15 . Although there is no description in the literature about the use of narratives with students from undergraduate courses on Nutrition and Physiotherapy, the project proposes their inclusion. Being based on what has been observed so far, this research aims to present the perceptions that emerged from the undergraduates participating in the project “Innovate-UHS Narrative-Based Teaching”. II. M ethodology This is a qualitative research that presents the perceptions of the undergraduates participating in the project “Innovate-SUS Narrative-Based Teaching” developed during the years 2018 and 2019. The population of this study is made up of 22 students enrolled in the Physiotherapy, Medicine and Nutrition courses at a University located in the city of São Paulo, selected according to the criteria contained in a public notice. Those approved signed a Free and Informed Consent Term, in which they became aware that their personal production (portfolios, participation in conversation circles and groups) would be analyzed and published. After those steps, the project was initiated. The students collected illness narratives from people with chronic conditions in a health service also located in the city of São Paulo. For the collection of those narratives, we decided to use an instrument which deviates from the traditional model for collecting the stories of diseases used by professionals in the health areas, commonly referred to as anamnesis. The instrument chosen, adapted and cross-culturally validated for Brazil, called McGill MINInarrative of Illness, is a semi-structured, qualitative script that allows the apprehension of events or problems related to health, guiding the narrative of the subject's experience about health and disease, their explanations for their illness, the information and words they use to describe their experience, their relationships with the various health services and their professionals. This script was used so Volume XXII Issue VII Version I 2 ( ) Global Journal of Human Social Science - Year 2022 © 2022 Global Journals A The Use of Illness Narratives in Undergraduate Physiotherapy, Medicine, and Nutrition: Innovative Experiences at a University in São Paulo