Systematic mapping of knowledge production in graduate training in occupational therapy in territorial and community contexts in Brazil

Abstract

This article aims to recognize and dialogue with the production of knowledge, practices and, in particular, with undergraduate teaching in occupational therapy in territorial and community contexts, through the systematic mapping of articles, dissertations and theses published between 2012 and 2022. Bibliographic search was carried out in November 2022, through the SciELO virtual library, the Brazilian Digital Library of Theses and Dissertations (BDTD), the Brazilian Institute of Information in Science and Technology (IBICT) and the databases: Web of Science, Scopus and Latin American and Caribbean Literature in Health Sciences (LILACS). 40 productions were eligible, of those, 29 articles and 11 dissertations/theses. The results were analyzed based on thematic analysis, whose topics were: What is territorial and community teaching? Where does it occur? What pedagogical strategies? Who teaches? What challenges do you face? What are the guiding concepts? The results point to interdisciplinary, interprofessional, collaborative teaching with important attributes such as the teaching-learning-assistance process in the territory and in territorial services, including actors such as students, professionals, teams and the community, in addition to the teacher who proposes, articulates and mediates of this teaching. We conclude that the mapping presents a general overview of this teaching, highlighting encounters between theories and practices, from different sub-areas of occupational therapy, which, in addition to teaching, propose actions to transform educational, social, cultural and health conditions. However, we noticed that there are gaps in the literature in the area that explain how the concepts are linked to this training, producing specific reflections on the profession in different sub-areas.

Keywords:
Occupational Therapy; Teaching; Sociocultural Territory; Review; Community Participation

Resumo

Este artigo objetiva reconhecer e dialogar com a produção de saberes, práticas e, em especial, com o ensino de graduação em terapia ocupacional em contextos territoriais e comunitários, por meio do mapeamento sistemático de artigos, dissertações e teses publicados entre 2012 e 2022. A busca bibliográfica foi realizada em novembro de 2022, por meio da biblioteca virtual SciELO, da Biblioteca Digital Brasileira de Teses e Dissertações (BDTD), do Instituto Brasileiro de Informação em Ciências e Tecnologia (IBICT) e das bases de dados: Web of Science, Scopus e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Foram elegíveis 40 produções, sendo 29 artigos e 11 dissertações/teses. Os resultados foram analisados com base na análise temática, cujos tópicos foram: O que é o ensino territorial e comunitário? Onde ocorre? Quais estratégias pedagógicas? Quem ensina? Quais desafios enfrenta? Quais os conceitos norteadores? Os resultados apontam para um ensino interdisciplinar, interprofissional, colaborativo com importantes atributos como processo ensino-aprendizagem-assistência no território e em serviços territoriais, incluindo atores como estudantes, profissionais, equipes e comunidade, além do docente que propõe, articula e faz a mediação desse ensino. Concluímos que o mapeamento apresenta um panorama geral desse ensino, evidenciando encontros entre teorias e práticas, de diferentes subáreas da terapia ocupacional, que além do ensino propõem ações para transformar as condições educacionais, sociais, culturais e de saúde. No entanto, percebemos haver lacunas na literatura da área que expliquem como os conceitos estão ligados a essa formação, produzindo reflexões específicas da profissão em diferentes subáreas.

Palavras-chave:
Terapia Ocupacional; Ensino; Território Sociocultural; Revisão; Participação da Comunidade

Introduction

The reorganization of public policies and assistance in Brazil allowed the reconfiguration of knowledge and practices in occupational therapy, as they provided opportunities for an increase in the hiring of occupational therapists and, consequently, new practices, teaching actions and knowledge production were developed, linked to territorial and community contexts (Galheigo et al., 2018; Bianchi, 2019).

These shifts meant that the hospital was no longer the main learning context and the profession's actions required training suited to professional practices in different contexts.

Thus, since the end of the 1980s, new challenges and theoretical/practical/methodological proposals have emerged in the teaching of occupational therapy with the incorporation of words/terms/concepts, such as territory and community (Bianchi & Malfitano, 2020).

Although with polysemic concepts and influences from theoretical frameworks from other areas, Bianchi & Malfitano (2022) indicate that, in the actions of occupational therapists, the territory assumes the materiality of places, expressed in streets and squares, in the circulation of people in certain spaces and also in the stories lived and constructed in these places, configuring two interconnected axes to characterize this concept. Community would correspond to people who live in these territories and/or who participate in groups/collectives indicating social participation, collectivity, and production of networks.

We agree with Pacheco et al. (2020) that one of the main challenges of higher education is to rethink learning, according to curricular, pedagogical changes and changes related to the contexts in which they occur. In this sense, we present a study on teaching in occupational therapy, based on the systematic mapping of national literature, focusing on research that presents the territory and the community as integral elements of training.

Methodological Procedures

Systematic mapping is a form of review of primary literature studies whose objective is to present and bring together research as a map, providing an overview of the research topic and indicating the terrain to be explored by future researchers (Pontes Júnior & Nakayama, 2022).

According to Silva et al. (2018), the objectives of this mapping are: to examine the extent of studies on a research topic and identify possible existing gaps. The systematic review aims to identify, select and evaluate research, presenting conclusions and evidence about an area of ​​study.

In this way, mapping and systematic review are complementary and the first can identify thematic groups of interest, which will be presented later in the review.

Silva et al. (2018) propose a mapping that meets the following phases: (A) General information, (B) Research question, (C) Identification and selection of studies and (E) Synthesis of data and presentation of results.

Initially, we organized the general information, the research questions and, later, the process of identifying the studies. The publications were retrieved in November 2022, through the virtual library Scientific Electronic Library (SciELO), the Brazilian Digital Library of Theses and Dissertations (BDTD), the Brazilian Institute of Information in Science and Technology (IBICT) and databases: Web of Science (WoS), SciVerse Scopus and Latin American and Caribbean Literature in Health Sciences (LILACS).

In the search strategy, the terms “occupational therapy” and “teaching” were used in Portuguese and English, limited to specific collections of national and Latin American periodicals included in the searched databases.

We defined as inclusion criteria research developed in dissertations, theses and articles published between 2012 and 2022, which present teaching focused on territorial and community contexts in Brazilian occupational therapy courses, in the Portuguese language and with full texts available. Next, we searched for the words territory, community or both in the title, abstract and keywords.

We excluded duplicate publications, those presented in other languages, those not available in full, as well as those that dealt with technical, elementary, secondary, and postgraduate education, or studies by Brazilian authors developed in other countries.

Results

We found 1.363 bibliographic productions, 413 of which were in WoS, 390 in Scopus, 285 in LILACS, 85 in SciELO and 190 in BDTD (first phase). We excluded 841 productions, mainly those duplicated, in other languages ​​and in Portuguese that do not portray Brazilian course experiences, most of them in the WoS and Scopus databases.

In the second phase, the title, summary and keywords of the 522 productions were read. Of these, we excluded 472 publications, on postgraduate, elementary, secondary, and technical education, and also those that did not contain the words territory and/or community.

In the third phase, 50 productions (32 articles and 18 theses/dissertations) were included for full reading. Ten productions that did not deal with Higher Education and those whose research was developed in other contexts were excluded. Thus, 40 publications were considered eligible for mapping, as shown in Figure 1.

Figure 1
Identification flow and studies selected in the mapping. Source: The authors (2023).

The 40 eligible productions were organized in a synthesis matrix in a data spreadsheet (Excel). In Table 1, the articles are identified and, in Table 2, the theses and dissertations.

Table 1
Articles according to title, authorship, years of publication, periodical, type.

Title	Authors (year)	Periodical or HEIs	Type of publication
Training of occupational therapists for Primary Health Care (PHC): contributions to the debate.	Oliver et al. (2012)	Brazilian Journal of Occupational Therapy	Article
Problematization methodology in the context of supervised therapeutic practice disciplines.	Ballarin et al. (2013)	Brazilian Journal of Occupational Therapy	Experience report
The vocational training of occupational therapists and the Undergraduate Course at the University of Brasília, Ceilândia College.	Furlan et al. (2014)	Brazilian Journal of Occupational Therapy	Review article
Mental health training in the occupational therapy courses of the southern region of Brazil	Palm et al. (2015)	Cogitare	Article
Experience in a curricular internship in primary care occupational therapy: focus on infant health needs.	Ruas et al. (2015)	ABCS Health Sci	Experience report
Occupational therapy internship in the community.	Anversa & Borges (2016)	Brazilian Journal of Occupational Therapy	Experience report
Territory and diversity: paths of Occupational Therapy in art and culture experiences.	Castro et al. (2016)	Brazilian Journal of Occupational Therapy	Article
Teaching career path and training of occupational therapists to primary health care.	Silva & Oliver (2017)	Revista Interface- Comunicação, Saúde e Educação	Article
Interprofessional education and provision of care: analysis of an experience	Capozzolo et al. (2018)	Revista Interface- Comunicação, Saúde e Educação	Article
Training process and teaching-learning scenarios: discussion on health practices and service education in Occupational Therapy degree course of FMUSP	Pastore (2018)	Brazilian Journal of Occupational Therapy	Article
Perceptions of occupational therapy students about experience of teaching-service-community integration.	Teixeira et al. (2018)	Brazilian Journal of Occupational Therapy	Article
Encounters with the difference at health education: youth, sexualities, and genders at school	Silva & Borba (2018)	Saúde e Sociedade	Article
The reach of occupational therapy in local development.	Correia (2018)	Brazilian Journal of Occupational Therapy	Article
Experience of social groups for older people: interfacing with occupational therapy	Missio & Vieira (2019)	Revista Brasileira em Promoção da Saúde	Experience report
The teaching of the professional practices of Occupational Therapy with elderly people: propose of organization of the practices in the Graduation	Cunha & Sime (2019)	Revista Kairós-Gerontologia	Article
The utilization of public squares: considerations on the action of the social occupational therapist.	Silva et al. (2019)	Brazilian Journal of Occupational Therapy	Experience report
Welcome experiences in the family health unit: the experience of the tea corner at UBS do Grotão, João Pessoa, PB.	Carvalho et al. (2020a)	Saúde em Redes	Experience report
Candangos: occupational reconstruction as a tool to understand social problems and transformative action in the utopian city of Brasília	Santos et al. (2020)	Brazilian Journal of Occupational Therapy	Article
Research group “human aging, health, culture and society”: essay on the research and university extension actions	Carvalho et al. (2020b)	Revista Chilena de Terapia Ocupacional	Original article
Autoethnography as a decolonizing education strategy in Occupational Therapy	Almeida et al. (2020)	Revista Interface- Comunicação, Saúde e Educação	Open space
Community Service and Bond Strength and occupational therapy: an experience report building citizenship and social participation	Minatel & Andrade (2020)	Brazilian Journal of Occupational Therapy	Experience report
Workshops of activities, dynamics, and projects in Social Occupational Therapy as a strategy to foster public spaces	Silva & Malfitano (2021)	Revista Interface- Comunicação, Saúde e Educação	Open space
Wander and occupy: 10 years of narratives in the TOCCA program - knowledge and practices in arts and health	Angeli (2021)	Revista Interface- Comunicação, Saúde e Educação	Open space
Training for SUS: the adhesion trajectory of a course on occupational therapy to the inducing policies of curricular change Pró and PET- Saúde.	Alonso et al. (2021)	Brazilian Journal of Occupational Therapy	Experience report
Human development and interdisciplinary education: the confluence between Psychology and Occupational Therapy courses	Panciera et al. (2021)	Revista Interface- Comunicação, Saúde e Educação	Open space
The role of occupational therapy in primary health care: perspectives from professors and students.	Silva et al. (2021)	Cadernos Brasileiros de Terapia Ocupacional	Article
The experience of Unifesp Baixada Santista in Interprofessional Education	Chriguer (2022)	Revista USP/Medicina FMRP	I São Paulo PET-Saúde State Symposium
University outreach in occupational therapy: scoping review in Brazilian literature	Figueiredo et al. (2022)	Cadernos Brasileiros de Terapia Ocupacional	Review article
The university in covid-19 pandemic: report of experience at the lab of emancipatory and territorial practices (LAPET)	Cordeiro et al. (2022)	Revista Chilena de Terapia Ocupacional	Article

• Source: The authors (2023).

Table 2
Theses and dissertations according to authorship, year of publication, title, HEI.

Author (year)	Title	HEI	Type of publication
Krug (2014)	Formação e perfil do terapeuta ocupacional no Rio Grande do Sul em sintonia com o Sistema Único de Saúde	UFRGS	Professional Master’s Dissertation
Angeli (2014)	TOCCA Uma terapêutica ocupacional	UFRGS	Thesis
Pan (2014)	Políticas de ensino superior, graduação em terapia ocupacional e o ensino de terapia ocupacional social	UFSCar	Dissertation
Palm (2014)	Formação em Saúde Mental nos cursos de Graduação de Terapia Ocupacional da Região Sul do Brasil	UFPR	Thesis
Silva (2016)	A formação graduada de terapeutas ocupacionais para o cuidado na atenção primária à saúde no estado de São Paulo	UFSCar	Dissertation
Baldani (2016)	Contribuições de experiências de estágio em CAPS III para a formação interdisciplinar em Saúde Mental na perspectiva da Reforma Psiquiátrica	USP	Professional Master’s Dissertation
Porto (2017)	A extensão universitária e a formação profissional em cursos de graduação em saúde	UFAL	Dissertation
Generino (2019)	As contribuições da prática discente de terapia ocupacional nos núcleos ampliados de Saúde da Família e Atenção Básica	UFAL	Professional Master’s Dissertation
Silva (2019)	Terapia ocupacional social, juventudes e espaço público	UFSCar	Thesis
Alves (2020)	A graduação em cursos da área da saúde e a formação interprofissional na FMRP: o ponto de vista de estudantes e professores	USP	Dissertation
Barbosa (2020)	Disponibilidade de estudantes de oito cursos da saúde de uma universidade pública brasileira para a educação interprofissional	UNICAMP	Thesis

• Source: The authors (2023).

The majority of articles were composed of: original articles (n=14), experience reports (n=08), review articles (n=2) and others (n=05), such as those published in open spaces and annals, having been published, mostly, in Cadernos Brasileiros de Terapia Ocupacional, as shown in Table 1.

Seven dissertations and four theses were also considered eligible, four of which were presented between 2014 and 2020, as shown in Table 2. We chose reflective thematic analysis for the treatment and analysis of publications, based on the considerations presented by Souza (2019). After the data synthesis matrix, we prepared a list of themes and defined the following: (1) What is territorial and community education? (2) Where does territorial and community teaching take place? (3) What are the pedagogical strategies and who teaches them? (4) Challenges for training in territorial and community contexts, (5) Concepts guiding teaching in territorial and community contexts and (6) Summary of the mapping.

Discussion

What is territorial and community education?

In this form of teaching, students live and learn from life situations and people in their contexts, articulating with other knowledge (Oliver et al., 2012). It is a border space, for exchanges, bonds, coexistence, meetings, partnerships and building networks.

In this direction, teaching, research, and university extension actions are developed with participation in federal programs; in this way, partnerships with health services, social assistance, education, culture, teams and professionals make continuing education an important support for this teaching (Oliver et al., 2012; Alonso et al., 2021).

In the publications, teaching guided by the National Curricular Guidelines (DCN) of the area stands out, mainly for professional training focused on the changes necessary to the Unified Health System and the approach to the real world of work, teams, services, and communities. In this sense, the objectives of this training are described as: articulation with public policies, professionalization of occupational therapists for territorial practices, training for the Unified Health System at all levels of care and at the individual, group and collective level (Krug, 2014; Palm, 2014; Palm et al., 2015; Furlan et al., 2014; Silva & Oliver, 2017; Pastore, 2018; Alonso et al., 2021; Chriguer, 2022).

Interdisciplinary and interprofessional teaching is highlighted as an important assumption in consolidating this training. From this perspective, the challenge is to bring together actors (teachers, students, professionals) from different areas in the same space, providing partnerships to consolidate interactive and cooperative learning (Castro et al., 2016; Capozzolo et al., 2018; Silva & Borba, 2018; Panciera et al., 2021; Carvalho et al., 2020b; Chriguer, 2022).

Two recent surveys sought to understand the availability of interprofessional education among students of health courses, including occupational therapy (Alves, 2020; Barbosa, 2020). In one of them, in the context of teaching supported by active methodologies, it was found that occupational therapy students showed a greater propensity and availability for teamwork and collaborative practices than others. They also demonstrated greater availability for attention focused on the user/person's demands (Barbosa, 2020).

According to the researcher, actions in the field of mental health and social assistance included in the training of occupational therapists may have provided training characteristics that connect students to the demands of populations in the territories, in addition to health demands, providing experiences and learning more targeted to social questions.

This recognition points to a greater incorporation of social occupational therapy in Brazilian training. Pan's research (2014) investigated the insertion of social occupational therapy teaching in Higher Education institutions and found that training activities for the social field were still incipient, in addition to the scarcity of professionals, especially teachers, to develop and compose dialogues in this field with particularities not covered by health training.

In this study, we noticed that there are two ways of linking to teaching in territorial/community contexts. The first demonstrates the experimentation of professional practice in different social and health facilities, denoting in-service training, proposing observation and experimentation of real situations of work and professional practice, mainly within the scope of social policies (Sistema Único de Saúde, Sistema Único de Assistência Social).

The second mode provides opportunities for students to encounter, contact and intervene with different ways of life and everyday situations in the territories. Teaching focuses on contextual reflections on reality, social demands, implying complex care that requires interprofessional support and the creation of networks for its establishment.

Thus, teaching in territorial and community contexts depends on a confluence of knowledge, practices, and knowledge production, which reflects the plurality of trajectories of Brazilian occupational therapy, in health, education, arts, culture and social, but also with similarities between them.

Where does territorial and community teaching take place?

Teaching takes place in the territory, as a social space, which reproduces the social totality, being modified by the subjects and their social relationships (Silva et al., 2019), which calls for the apprehension and contextualization of the reality of spaces, people, groups, and communities who live there with their diverse health, social and cultural demands. And which also proposes an articulation between the micro and macrosocial (Minatel & Andrade, 2020).

Thus, teaching actions in health care settings, linked to primary care, are described (Oliver et al., 2012; Anversa & Borges, 2016; Cunha & Sime, 2019; Silva, 2016; Generino, 2019; Silva et al., 2021), especially in Basic Health Units, Family Health Units, Community Centers and Cooperatives, Occupational Health Reference Centers and Psychosocial Care Centers.

Regarding social occupational therapy, actions are mentioned in public spaces, such as public schools (Silva & Borba, 2018), Youth Centers, Social Assistance Reference Centers, especially Coexistence and Bond Strengthening Services, among others. It also includes public squares, spaces for social circulation and sharing of collective and democratic interests (Silva et al., 2019; Silva, 2019; Silva & Malfitano, 2021).

With regard to theoretical principles, it is important to highlight as important contributions to training in the field of health a theoretical and practical link to the principles of community-based rehabilitation, psychosocial rehabilitation, collective health and occupational reconstruction (Oliver et al., 2012; Silva, 2016; Santos et al., 2020). In the social sphere, social occupational therapy and participatory local development are presented (Correia, 2018; Silva et al., 2019; Pan, 2014; Silva, 2019, Silva & Malfitano, 2021; Minatel & Andrade, 2020).

The publications by Porto (2017), Silva & Borba (2018) and Figueiredo et al. (2022) point out the importance of extension actions that enable assistance and care, fulfilling the social commitment of educational institutions. In this sense, extension emerges as a facilitator of the theoretical and practical teaching-learning process.

The productions presented in Table 3 list extension experiences, linked to teaching, health, culture, and social aspects aimed at people, groups, and communities in the territories. Extension actions promote knowledge and, in them, the teaching-learning process enables knowledge constructed dialogically and contextually between teachers and students with the applicability of theories (Figueiredo et al., 2022).

Table 3
Extension projects mentioned in the literature in the area.

Extension projects	Publications
Programa Arte, Corpo e Terapia Ocupacional – PACTO	Castro et al. (2016)
Juventudes e funk na Baixada Santista: territórios, redes, saúde e educação	Silva & Borba (2018)
Programa METUIA/UFSCar	Silva et al. (2019), Silva (2019), Silva & Malfitano (2021)
Acompanhamentos de idosos – atividades de vida diária na atenção básica Grupo de terapia ocupacional na atenção básica: novas tecnologias para a participação social de pessoas idosas	Cunha & Sime (2019)
Conversando sobre comunicação com idosos
Terapia ocupacional e ações básicas de prevenção e proteção
Projeto Cantinho do Chá e da Horta agroecológica	Carvalho et al. (2020a)
Terapia ocupacional no atendimento a idosos em situação de vulnerabilidade social	Carvalho et al. (2020b)
Terapia ocupacional na saúde do idoso: Vila residencial
Programa Terapia Ocupacional, Corpo, Cultura e Artes – TOCCA	Angeli (2014, 2021)
Formando tessituras do cuidado em saúde mental	Alonso et al. (2021)
Arte, cultura e acessibilidade na atenção básica
Atenção à saúde da pessoa com deficiência na estratégia saúde da família

• Source: The authors (2023).

We identified that the extension activities of teachers from public universities played a pioneering role in teaching territorial and community actions. However, initially, these experiences were restricted to the portion of students who participated in them. Currently, extension has been incorporated into teaching, favoring greater possibilities for involvement of all students, as well as greater inclusion of territorial and community discussions in curricular components.

We emphasize that in the historical process of establishing territorial and community education, the practical components of the curricula (practical curricular units and supervised internships) were fundamental to its growth and we identified a recent expansion of productions, presenting the theoretical components, considering theoretical and practical components in different areas of attention and justification, as shown in Table 4. We note that the approach to territories and communities delimits this space of convergence between knowledge and actions, proposing teaching/action as elements for transforming social realities.

Table 4
Curricular components mentioned in the literature in the area.

Curricular components	Publications
Social occupational therapy	Oliver et al. (2012)
Occupational therapy
Mental health
Health and work
Health of people with disabilities
Geriatrics and Gerontology
Supervised internship in territorial and community care in rehabilitation
Supervised internship in occupational therapy and physical disability
Supervised internship in occupational therapy in geriatrics and gerontology
Supervised practice and internship in mental health
Public health notions
Public health and adult care
Supervised therapeutic practices VI and VII	Ballarin et al. (2013)
Occupational reconstruction and social transformation	Santos et al. (2020)
Assisted practice in occupational therapy in old age, Supervised Internship	Cunha & Sime (2019)
Supervised Internship in Primary Health Care	Ruas et al. (2015)
Therapeutic Activities and Resources – Daily life	Almeida et al. (2020)
Professional internship in rehabilitation	Teixeira et al. (2018)
Occupational therapy in mental health	Alonso et al. (2021)
Occupational therapy, anthropology and sociology
Administration, planning and management in occupational therapy
Occupational therapy in children's health
General occupational therapy
Occupational Therapy Internship: Mental Health and Social Occupational Therapy
Supervised internship in Community health	Anversa & Borges (2016)
	Missio & Vieira (2019)
Therapeutic Activities and Resources I: recreational activities and leisure	Panciera et al. (2021)
Integration practice in teaching and service in therapy occupational I	Minatel & Andrade (2020)

• Source: The authors (2023).

In this way, we argue that the learning context is not just a place/environment/scenario, in which teaching and professional practices occur outside universities, but requires a set of facts related to theoretical teaching, circumstances, people and learning situations involved and not just learning scenarios that only receive students and professional practices.

What are the pedagogical strategies and who teaches?

Among the teaching strategies presented, we highlight, in the field of health: mapping and recognition of the territory, identification of people with disabilities and alternatives and services, observation of different sectors and jobs, articulation and bonding with teams and professionals, the identification of health needs in an expanded manner, participation in the construction of individual, group and collective care plans within the scope of health promotion, prevention and treatment, as well as contact with different population groups, their demands and with social movements, which enables experiences and interactions with different everyday situations (Oliver et al., 2012).

Playful workshops in schools, beaches and youth centers (Panciera et al., 2021) and difference workshops (Silva & Borba, 2018) are also described. The latter was conceived as meetings aimed at triggering reflections that express the multiplicity of youth experiences. They use audiovisual resources, music, expressive dynamics, presentation of research data summaries as triggering elements and drivers of the objective of each meeting.

Publications by Palm (2014), Baldani (2016) and Alonso et al. (2021) indicate that the strategies found within the scope of mental health teaching reveal the predominance of teaching-learning methods supported by the problematization and contextualization of reality, with training in context, dialogue and interaction with the various points of the Care Network being important. Psychosocial (RAPS).

In the teaching of social occupational therapy, teaching-assistance strategies aimed at articulating resources in the territory, singular and territorial monitoring, dynamization of the care network and workshops of activities, dynamics and projects are described. Strategies such as recognition of public spaces in neighborhoods and the city are also presented, seeking to accommodate issues and expand social, micro and macrosocial repertoires (Silva et al., 2019; Silva & Malfitano, 2021).

In the field of interface between health, culture and arts, teaching and intervention strategies linked to cultural workshops (drawings, graffiti, capoeira, storytelling) and unique therapeutic accompaniments are presented, which seek to produce citizenship, accessibility to cultural assets and production of culture in the city (Angeli, 2014, 2021; Castro et al., 2016).

In this teaching-learning-assistance process, the student learns from the knowledge and recognition of others in the learning process, but it is not only the student who learns and transforms. The teacher, professionals and also the subjects/groups/community participating in the actions also learn and transform when participating in this process.

In only one publication did we identify reference to professional reasoning. According to Minatel & Andrade (2020), this reasoning dialogues with the perspectives of the Arco de Manguerez, the basis for the problematization methodology. In this way, based on the experience portrayed by the authors, the territory emerges as a learning context that stimulates social transformation, by allowing learning of different types to be carried out.

We identified, however, that when incorporating other actors, knowledge and perspectives in the teaching-learning process, the literature does not present theoretical contributions on the process of forming professional reasoning in these contexts, making it an important subject for new research.

Furthermore, although it is described in the literature how this teaching is carried out, including the main strategies, there is a lack of elements to identify what is taught, that is, what content is relevant to this training.

As in every teaching process, the role of the teacher is highlighted. The teaching knowledge profile, training and functions are presented (Ballarin et al., 2013; Silva & Oliver, 2017), corroborating the research by Feriotti (2007), which considers the characteristics of Brazilian occupational therapy teachers: creativity, importance attributed to collective processes and, also, an important training axis is political action/training, arising from the academic and professional trajectory. The author proposes the “teacher-militant-professional-subject” identity, in which technical and personal knowledge and participation in social movements facilitate the development of social and institutional criticism, qualifying pedagogical practice.

Although the teacher is an important articulator, integrator of knowledge and facilitator of the teaching-learning-intervention process, the actors in this process go beyond teaching relationships centered on students and teachers. From this perspective, teams, professionals, services, and the community also gain prominence, mainly in ongoing training.

This incorporation invites greater articulation with social movements and public policies, demonstrating that this teaching is constructed by many strategies, whether with an emphasis on health, culture, participatory local development, or social occupational therapy.

Challenges for training in territorial and community contexts

One of the challenges for this training perspective is the articulation of complex and diverse processes and practices, in which intervention requires the integration of care and pedagogical actions (Carvalho et al., 2020a). These actions would be increasingly difficult in the university environment, whether due to increasing budget cuts in public universities or due to increased competition and productivity among Higher Education participants (Angeli, 2021).

The transfer of the teaching-learning process to extramural spaces of universities with the participation of professors and students often requires transportation by the university and also brings the unforeseen into the teaching-learning process (Capozzolo et al., 2018).

There is even a need to move materials from the university to services and communities, which implies the transit of heritage materials and the responsibility of teachers and students for their use (Anversa & Borges, 2016).

Other challenges are the difficulties in teaching dialogue, planning actions together with the services and, also, the lack of occupational therapists hired in the services and the need for teachers to be present with students so that teaching can take place in the territory (Teixeira et al., 2018; Minatel & Andrade, 2020).

We emphasize that the presence of the teacher is fundamental, but as an articulator of this process and not in the role of service professional. Joint planning between universities and public services is necessary to hire professionals to improve care for the population and consequently strengthen teaching.

The university can affirm the potential and possibilities of the profession and have a political role in incorporating professionals into services and in the construction of the field of care, valuing the autonomy of those who learn and teach, experience and reflective practice in the construction of knowledge and care. (Minatel & Andrade, 2020; Figueiredo et al., 2022; Porto, 2017).

With the Covid-19 pandemic, the challenges for teaching in territorial and community contexts were increased, and the professional category was able to review its practices, considering denialism, the scrapping of public policies, the affront to public universities and the social inequalities present. in territorial and community contexts. The resonance of such situations in undergraduate training is presented by Cordeiro et al. (2022). The authors point out that the current challenge for universities is not only to disseminate knowledge, but to produce it in partnership with the needs of the territories.

Concepts guiding teaching in territorial and community contexts

In the literature in the area, territory and community are fundamental concepts for the actions of occupational therapists (Bianchi, 2019; Bianchi & Malfitano, 2020). Would the same apply to teaching?

Although the words are presented in the publications, the concepts of territory and community only emerge in some. In Correia's article (2018), the concept of community is presented not as a place, a territory, but as the expression of social issues, a device that emerges from strategies for confronting processes of domination, considering criticism of colonial processes.

The concept of territory is presented in publications by Silva et al. (2019); Silva (2019), Silva & Malfitano (2021) and Minatel & Andrade (2020). The theoretical contributions of Milton Santos and Hannah Arendt are referenced to compose the characterization of the territory and its use. Publications that make reference to these concepts discuss public space as one of the dimensions of social occupational therapist action and reflection (Silva et al., 2019; Silva, 2019; Silva & Malfitano, 2021).

For Minatel & Andrade (2020), the theoretical foundation of territory is based on the conception of space for human actions and relationships, which enable different forms of expression of existing, living and carrying out social exchanges. Thus, the development of a good contextualization of the territory provides the occupational therapist with greater possibilities for action, expanding the visualization of individual and collective demands.

The authors rely on the perspective presented by Malfitano (2016), in which the territory would be intertwined with the concept of everyday life, as a central element for intervention strategies. Silva et al. (2021) corroborate the statement, especially considering teaching in primary health care and reveal that occupational therapy teachers and students participating in research pointed out the relevance of understanding the daily lives of people in the territories.

We identified that the concept of social participation also emerges in the literature in the area and is mentioned in publications by Oliver et al. (2012) and Anversa & Borges (2016). In these, the actions and teaching of occupational therapy contribute to implementing participatory processes and affirmation of rights in territories, in addition to increasing understanding of the complexity of populations' health problems. In this way, the training seeks to teach, in practice, greater social participation and strengthening community bonds, focusing on new sociability and forms of resistance to processes of social exclusion.

We also identified the concept of occupational reconstruction presented by Santos et al. (2020). According to the authors, this theory, little publicized in Brazil, is aligned with southern epistemologies and proposes, with a focus on collective action and occupations, to explain social transformation as part of philosophy and occupational knowledge.

In this sense, we consider it essential to create a conceptual framework for characterizing teaching in territorial and community contexts.

Synthesis of systematic mapping

We found that teaching aimed at territorial and community contexts involves training involved with actions aimed at the individual and the collective (different subjects, groups, communities and/or populations) and that incorporates different strategies and theoretical constructs to recognize the plurality of life and the scope of occupational therapy.

Thus, the actions/teaching focus on the different dimensions of everyday life, seeking insertion in micro and macrosocial territories, as places of production of different ways of being, existing and modifying the world, identified as plural spaces of meeting, coexistence and promoting social participation. But they also focus on insertion in the world of work, especially in proposals linked to Brazilian social policies, especially health and social assistance.

The publications do not develop the guiding concepts of this teaching, however, we identify the concepts of territory, community, daily life and social participation as part of this training.

Consequently, it is not enough to have the territory and the community as an environment, space or teaching scenario, reproducing practices that are not in line with their specifications. We have to understand these learning contexts as life contexts, requiring the characterization of facts, circumstances and people in interaction to integrate them as learning contexts.

From this perspective, we identify that territorial and community contexts are shared learning contexts, since, in them, teachers, students, technicians, services, community, all involved in the process, share the construction and management, making it necessary to weave together the plots of this teaching.

Final Considerations

Even though territorial and community contexts have involved Brazilian occupational therapy practices for 20 years, we observed that training was not structured solely by extension actions, practices and processes carried out outside universities or hospital and nursing home institutions, but that, when reporting to territories and communities, sought to intertwine technical action with ethical-political aspects, based on interdisciplinary actions and in dialogue with the health, social, cultural, educational fields, among others.

In this way, when we point out the territorial and community contexts in graduate training in occupational therapy, as contexts of life, learning, intervention and convergence between theories and practices, we consider ourselves fundamental for the transformation of social, cultural and health realities. Thus, systematic mapping enabled a general overview of this teaching and various training experiences of Brazilian courses and teachers.

Furthermore, we consider that future research can delimit professional reasoning in its particularities for teaching in territorial and community contexts, as well as core occupational therapy actions associated with productions in other languages, including specific collections not yet incorporated into bibliographic databases. referred to in this study.

• How to cite: Carrasco Bassi, B. G., & Oliver, F. C. (2024). Systematic mapping of knowledge production in graduate training in occupational therapy in territorial and community contexts in Brazil. Cadernos Brasileiros de Terapia Ocupacional, 32, e3599. https://doi.org/10.1590/2526-8910.ctoAR276635992

• Funding Source

  This study was financed by the Coordination for the Improvement of Higher Education Personnel (CAPES) – Financing Code 001.

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Edited by

Section editor

Profa. Dra. Késia Maria Maximiano de Melo

Publication Dates

• Publication in this collection
  10 May 2024
• Date of issue
  2024

History

• Received
  27 June 2023
• Reviewed
  11 July 2023
• Accepted
  04 Jan 2024