Herança e promessa na política curricular do Profaps: a subjetivação dos técnicos da saúde nos discursos da integração ensino-serviço e da profissionalização

Abstract

This thesis has as its central theme the curricular policies of middle-level professional education in health, and comprises the investigation of the processes of subjectivation of technicians from the hegemonic discourses in Profaps. Assuming a post-structural perspective, I seek in the Discourse Theory of Laclau and Mouffe and in the deconstruction of Derrida the contributions to understand politics as ontology of the social. With the appropriation of these records to the field of curriculum, mainly by the works of Alice Casimiro Lopes and Elizabeth Macedo, curricular policies are interpreted as a struggle for the meaning of what is the curriculum, education and health. I hold my interest in the investigation of two discursive formations that have hegemonized technical training in health in recent decades and that emerge (im)made possible by antagonism to flexnerian discourse and unskilled work: integration education-service and professionalization. As textualities of politics, documents signed in the official sphere, journalistic journals of political communities and academic publications were investigated. In reactivating the contingencies that provided the sedimentation of these discourses, I highlight the inheritance as an emergency condition of Profaps and the promise structure as part of a political logic that seeks to suture the constitutive lack of social objectivity. I argue that such discourses do not promote what they intend to affirm. On the contrary, by attributing to training the fantasmatic power of performing the change of the care model and professionalization, they insist on giving a normative content to the curriculum and subjective technicians as unlikely agents of change of the care model, subordinate workers and competent professionals in the frameworks of managerialism. I state that the teaching-service integration in the training of technicians is supported by the discursive construction of the impossibility of workers absent from their activities for the formative processes, constituting a precarious arrangement that disputes the spaces of the routine of services and privileges the practical dimension of know-how. I argue that the discourse of professionalization involves an eschatological messianism that announces emancipation, efficiency and quality through skills development. Through a methonicmic operation, professionalization is reduced to training, erasing or excluding the other dimensions of this meaning. The attempt to overcome the disciplinary matrix favors the articulation of teaching-service integration discourse with the pedagogy of skills, hegemonizing the meanings of professionalization. In the defense of change in training, the traditions of collective health and the managerial biomedical model are displaced, articulating in defense of the normativity of curricula and the centrality of knowledge. I question the possibility of establishing epistemological and identity foundations capable of suture, once and for all, the adequacy of professional contents and profiles to health needs. I argue, on the contrary, that politics should not be understood only as the production of a center, the fixation of a sense, but also as production of instability, of lines leaking meaning, new hegemonic articulations and new possibilities of being Professional.