A porta está aberta : aprendizagem colaborativa, prática iniciante, raciocínio clínico e terapia ocupacional

Abstract

This action-research tries to reveal the contributions of a mentorship program focused on collaborative learning to improve professional development and clinical reasoning of occupational therapists in the beginning of the career, supported by the epistemology of practical rationality, narrative reasoning and learning community framework. The intervention included the participation on a collaborative group of six beginner occupational therapists, two experienced occupational therapists, and the mentor-researcher, and the writing of reflective journals by the beginner professionals. The information provided by the transcriptions of the group meetings and by the reflective journals was submitted to a threestage study: an analysis of the themes and their development; an analysis of the transformations of the modus operandi of the group in a timeline; and a final analysis of the reflective processes that showed up in the written narratives. The results reveal dynamical aspects of the collaborative work and indicate mutation points characterized by an open and honest treatment of the conflicts and by the building of mutual confidence, allowing the recognition of the doubts and enabling negotiation on the essential tension between being an occupational therapist and the practice of occupational therapy. The negotiations and constructs centered around the first pole involved dilemmas related to the professional competence in the beginning of the carrier, to the work in mental health, to the questions regarding professional identity and to the negotiations with institutional contexts. The production related to the second pole highlighted the construction of an assistance that contrasts with the biomedical model and the appropriation of theoretical concepts that sustain the practice of the occupational therapist regarding the triadic relation therapist-patientactivities. Besides that, the results of the reflexive processes revealed in the journals and viewed as clinical reasoning processes were interpreted differently of the literature, indicating that the procedural reasoning was aiming to the dynamics of the triadic relationship, in an intentional practice of creating therapeutic histories. Moreover, the results also highlighted relations between the situational diagnostic reasoning and the conditional one, reflecting an effort to view the patient in his/her daily life and culturemolded social and emotional conditions. Given this context, it is possible to view this research-action as an investigation embedded in the universe of professional formation and practice, and that gathers results that amplify the discussion of how powerful collaborative processes are in boosting investigative attitudes capable of sustaining the learning that care to the development of the therapist and his/her practice. By placing occupational therapy practice as a study subject and occupational therapists as agents capable of generating knowledge about it, this research revealed results that, besides highlighting constitutive aspects of a client-centered care, also indicates new directions to forthcoming further studies to strength the foundations of occupational therapy practice.