Integrative Seminar: Learning Evaluation from the Teachers’ and Students’ Perspectives

The learning evaluation is one of the main topics in educational theories, particularly in the health area. At present, the focus is on the central role of the students as constructors of their own teaching and learning process. The aim of this study was to understand the apprehension of the learning process of the Integrative Seminar from the point of view of teachers and students. A sequential exploratory research with a mixed approach was designed, with a first phase of qualitative analysis, followed by a second phase of quantitative analysis. Six teachers of the Integrative Seminar subject participated in the semi-structured interview, and sequentially approved five questions that were applied to 230 students through a questionnaire. From the teacher’s interviews, four themes emerged: a) difficulty in the teaching and learning process; b) non-standardized evaluation methodology; c) teacher’s autonomy, and d) interdisciplinarity. The students answered five closed questions using Likert-type scale responses, and 75% disagreed that the Integrative Seminar had a unique instrument of evaluation; 79% agreed that the teacher uses several methods of evaluation, and this process becomes more objective and reliable; 72% of the students believe that they are actively involved in the evaluation process; 58% agreed, 28% disagreed that the teacher evaluates the subject easily because the teaching-learning process is adequate; 96% of the students agreed that during the Integrative Seminar they brought knowledge from other subjects. The results suggest that in this subject, teachers seek to program strategies with pedagogical tools, allowing students to develop participative, integrated and critical competences. The teacher tries to fulfill his / her role as a mediator of knowledge, stimulating the student to have the ability to build logical reasoning, and to actively participate in the teaching-learning process.


Introduction
The learning evaluation is an issue that has been discussed by several scholars in education, and particularly in the health area. The concepts of evaluation are anchored in educational theories, each with its peculiarities, particularly in what concerns learning evaluation. The traditional theory, which understood evaluation as a punitive and measuring process, is cited by Hoffmann (2009, p.31) as "classificatory evaluation, quality that refers to preestablished patterns, on a comparative basis: promotion criteria (elitist, discriminatory), templates of answers, ideal behavior patterns." The evaluation also goes through the theory of the Progressive Education that contrasted with the traditional school. It has some memorization characteristics, incorporating the words by Freire (1987), a respected author in education, who points to the evaluation process as related to what the students do not know, what they could not memorize.
On the other hand, the theory of Social Critical Pedagogy, with a progressive tendency, took a step forward towards the search of transformation of society. For Gasparin (2011, p. 1794), in the historical-critical perspective, the "evaluation is a judgment of value on relevant data, compared to an ideal pattern, for decision-making".
At present, the focus is on the student's centrality and in his/her role of constructor of his/her own teaching-learning process (called "ensinagem" in Portuguese). Anastasiou (2006, p. 130) clearly defines this termensinagem -as "the construction of teaching and learning processes [...] provides clear directions for teachers and students actions." Thus, the transformations of the world, students, school and exponential knowledge lead us almost compulsorily to new and high levels of education, as a measure for the promotion of quality education, which ensures the development of citizenship and critical reflection.
The concern with the methodology of evaluation in the medical course becomes increasingly greater, because the student needs to develop specific competencies with cognitive, psychomotor and affective domains of professional practice (TRONCON, 1996).
In the medical school curriculum, in some higher education institutes, there is a subject called Integrative Seminar, which has the purpose of bringing knowledge from other subjects taught in the period, and the primary objective of integrating such contents, in such a way that the student can easily make the necessary connections that contribute to the formation and construction of clinical reasoning.
It is important to emphasize that the subject called "Integrative Seminar" differs substantially from the teaching/assessment methodology called seminar, that is when the teacher of any subject uses the seminar technique to promote relevant discussions.
In the institution studied in this research, the Integrative Seminar has been a subject present in the syllabus of the Medical course since its beginning in 2008, with a five-hour weekly load, totaling 72 semester hours, from the first to the eighth period of the Medical course. It will be detailed in the chapter about methodology, and the brief elucidation at this moment is based on the possibility of understanding the themes of reflection that will be brought in sequence. Thus, it can be said that there is a teacher in charge for each period, who elaborates themes related to the other subjects of the syllabus, trying to integrate and contextualize detailed aspects of the themes already studied. The teacher proposes ideas, questions or even clinical cases that will be structured and presented by the students, individually or in groups. After the presentation, or even during it, feedback is given to the students, and themes studied can be related to each other through interdisciplinarity.
The course on the subject is concluded with an individual or group evaluation; there is no protocol or consensus Franco C, Ribeiro E, Prado M, Gabardo B, Coelho I MedEdPublish https://doi.org/10.15694/mep.2017.000150 Page | 3 established among the teachers of this subject, because they have some difficulty, perhaps due to the lack of a clear and precise conceptual reference on the practices of evaluation.
Although interdisciplinarity and the evaluation process are points of knowledge for teachers, the whole situation becomes significant because the students bring a primordial content from other subjects with them to discuss more detailed ideas and issues, making the Integrative Seminar more motivating both to students and to teachers. Thus, elaborating and understanding the evaluative process in this subject becomes more and more challenging, since the student actively participates in this process, and the teacher has a role of facilitator, not of knowledge transmitter.
In this circumstance, the role of the students is even greater, because they need, as a pedagogical action, to give feedback to the teachers of the whole process. It is understood that a more participative and engaged teacher makes the evaluation not only a final procedure, but a continuous one (SPRUIJT et al., 2014).
It should also be considered that the main objective of the Integrative Seminar is to bring concepts from the other subjects, in which the student can review, with successive approximations, and more assertively, his/her own learning, with their interconnection, restructuring the teaching-learning (ensinagem) process, locus of mental mobilization in different aspects.
A feedback, to the teachers, of the subjects involved in each Integrative Seminar is important, so that they can review their contents and pedagogical practices when they get to know the difficulties of some students. Therefore, this study proposes, from the reflections mentioned herein, to understand the whole evaluation process of learning in search for constant improvement of the evaluative universe. Wouldn't it be necessary, then, to understand the meaning of the learning evaluation process in the Integrative Seminar subject in the medical school, from the teachers and students' perspectives?

General Objective
To understand the notion, from teachers and students perspectives of the evaluation process in the Integrative Seminar subject.

EVALUATION PROCESSES IN THE MEDICAL SCHOOL
In the teaching-learning process, it is important to consider evaluation as the basis of knowledge construction. Its principle is the perspective of action reconstruction, based on the immediate feedback provided to the students, as a genuine educational activity (TRONCON, 1996).
It is the teacher's responsibility to use active methodologies as a motivating action for the whole teaching-learning process, and the measurement of performance should not be the main objective, nor to pass or retain the learner, but rather to direct their learning and consequent development, providing information about the teaching-learning process, monitoring their education (SILVA; SCAPIN, 2011).

INTEGRALITY AND INTERDISCIPLINARITY
In many curricula, there is evidence of fragmentation in teaching, which is centered on specific contents, which do not list the application of integrality, neither in theory nor in practice.
Interdisciplinarity is understood as the need to integrate, articulate, work together. It has as its principle the human formation in its totality and not in its peculiarities, allowing the individual to come to understand him/herself as a whole and not as parts (MORIN, 2003).
The Integrative Seminar is an important example of methodology in teaching and learning, because in addition to the participation of groups of students, it is possible to carry out deep approaches, with active participation, and involvement in the discussions with important objectives.
It is essential to link the Integrative Seminar with other subjects because students bring a core content to the discussion of the proposed topics, with more in-depth questions, and this prior knowledge makes it more challenging and motivating for both students and teachers.
Thus, Spruijt et al (2013) discuss the fundamental aspects that make the Integrative Seminar one of the main forms of teaching and learning: teachers, students, objectives and content, size and functioning of groups, preparation with coherent ideas.

TYPE OF STUDY
This research is exploratory, using the mixed approach to facilitate, explain and elucidate the object studied. Creswell and Plano Clark (2007, p.5) define mixed methods as: "As a methodology, it involves philosophical assumptions that guide the direction of the collection and analysis of data and the mixture of qualitative and quantitative data in a single study or series of studies. Its central premise is that the use of quantitative and qualitative approaches in combination provides a better understanding of research problems that either approach alone." In this approach, we opted for the sequential exploratory strategy, typically using the first phase of qualitative data collection and analysis, followed by the second phase of quantitative data collection and analysis. Creswell (2010: 248) states that the "purpose of this strategy is to use quantitative data and results to aid in the interpretation of qualitative results."

STUDY PARTICIPANTS
Teachers and students of the undergraduate medical course, specifically of the subject Integrative Seminar, of a Teaching Institution in the West of the state of Paraná, Brazil, participated in the study. Six teachers of this subject were interviewed. These teachers are responsible for the periods I, IV, V, VI, VII, VIII; periods II and III were Page | 5 excluded because this study's researcher teaches in these periods.
The teachers who teach the Integrative Seminar in the basic periods (I, II, III and IV) were called Db, and the teachers of the Integrative Seminar in the clinical periods (V, VI, VII and VIII) were called Dc, thus seeking to preserve the anonymity of the participants.
Then, the students of the medical course were invited, with a total of 500 students to answer a questionnaire. Of this, the sample was of 230 students, excluding those from periods II and III.

CONTEXT OF THE STUDY
The research was conducted in a Teaching Institution of the West of the state of Paraná, Brazil, which began its activities in the field of higher education in the 1990s, in the face of a scenario of intense development of the municipality and its region.

INFORMATION COLLECTION INSTRUMENT
The instrument used in phase one of the research was a semi-structured, recorded interview. First, there was a meeting with the teachers separately, for the trigger questions to be presented, namely: What is your perception of the learning evaluation process in the Integrative Seminar? 1.
What is your role as a teacher in the learning process evaluation in the Integrative Seminar? 2.
Can students bring content from other disciplines to the Integrative Seminar? 3.
Six teachers were interviewed separately, with three being Db (teachers of the basic subjects) and three being Dc (teachers of the clinical subjects). The recorded responses were literally transcribed and read several times. Initially, the reading was fluctuating; following this, an analytical reading was performed, with the purpose of apprehending the theme, that is, searching for the identification of the central idea of the participants' speeches. Subsequently, with the use of a quantitative methodological approach, a questionnaire consisting of five closed questions was applied to the students.
It is important to note that of the six teachers who participated in the recorded interviews, three of them approved the structure and content of the six questions in the questionnaire to the students. Haynes et al. (1995) argue that content validity is the degree to which the parts that constitute a measuring instrument are representative and relevant to the concept being evaluated. The teachers analyzed, and according to notes that were made, the questions were re-structured and then approved to be applied. For better reliability and standardization, five-point Likert prefixed response alternatives were used.

INFORMATION ANALYSIS
The method used for content analysis had the theoretical support of Bardin (2009). At first, it uses a set of analysis techniques of the communications of the systematic procedures, and objectives of the description of the messages content. Secondly, the results analysis of word association tests (stereotypes and connotations) was performed. Finally, the issue related to method and techniques is detailed, respectively: the organization of the analysis; the coding of results; the categorizations; the inferences, and the computerization of the communications analysis (FARAGO, 2007).

Analysis of Results
In this chapter, we will discuss the contents related to the two phases of data collection.
In the first phase of the research, when we tried to understand the phenomenon called learning evaluation, the content analyses were carried out in accordance with the theoretical presuppositions by Bardin (2009), and the speeches allowed the construction of the thematic nuclei by similarity of meaning, which were grouped into four categories, as presented in Table 1, and which will be detailed individually for better understanding.

Themes Categories
What is your perception of the learning evaluation process in the Integrative Seminar?

Difficulty in the evaluation process Non-standardized evaluation methodology
What is your role as a teacher in the learning evaluation process in the Integrative Seminar?
Teacher autonomy Can students bring knowledge from other disciplines to the Integrative Seminar?
Interdisciplinarity SOURCE: THE AUTHOR (2017) When asked 'What is your perception of the learning evaluation process in the Integrative Seminar?' several notes emerged from this question, which allowed the identification of two categories: The first category that emerged from the speeches was: Difficulty in the evaluation process.
Understanding the teaching and learning process is not easy. In addition, there is also the whole con juncture of the evaluation process, which is loaded with precepts still coming from the traditional pedagogy.
In this context, the authoritarianism by the teacher, and the subjection of the student are summarized, marking the distance in the relation between these two individuals and knowledge (MORENO et al., 2009).
The speeches really point to the difficulty the teacher has in the evaluation process, which can be evidenced in the speech of one of them: "In the evaluation of this subject, I realize that we have a lot of difficulties ... although they get a good grade and they do not have major problems with the subject, I cannot say that they really

had a good performance, both in classes and acquiring the necessary and proposed knowledge". Dc
Moretto (2007) brings a new perspective on the evaluation process, presenting topics for the teachers to reflect on their attitude, action manner, how to achieve satisfactory results, so that evaluation becomes a moment of study, proposing to the students that they do not face the test as a search for success (grade), but as a moment of knowledge construction, demonstrating skills and competencies in a contextualized process (NETTO, 2002).
"It is one of the most difficult stages of the seminar, ... I think this process is flawed, for the following reason: We do not have a base, each teacher has created his/her own base to make the evaluation, and the increasingly larger classes are detrimental to individual assessment."-Db The second category that emerged from the question 'What is your perception of the learning evaluation process in the Integrative Seminar?' was: Non-standardized evaluation methodology.
The evaluation has been a topic of increasing attention among educators, this leading to several proposals for curricular reforms in the courses of the health area, mainly when the aim is to search for fair, accurate and valid forms of learning evaluation (GOMES and ORTEGA, 2010).
The written test is still the most used and commonest instrument in our culture among the various forms of evaluation. If we have to elaborate tests, they have to be well-done, reaching their real objective, which is to check whether there was significant learning of relevant contents. (Moreno et al., 2009). The statements of the teachers described below highlight the subject: "In these 8 years we have been working with the seminars we have tried to evaluate in different ways. We tried the test, we tried to evaluate the group, we tried to encourage the groups to participate, in fact, we have already tried several methods, and in all of them, we identified that there were flaws, that they did not reach our goal."-Db "We usually make written evaluations, the most conservative as possible, which I also do not think is the most appropriate way. Unfortunately, my conclusion is that I cannot have such an accurate method of evaluation for each of the seminars. "-Dc.
Considering the objectives to be achieved, contents to be worked on, a methodology for developing the work, and a process for evaluating results, the pedagogical dimension of excellent teaching work can be obtained. The operational structure of the evaluation comprises the forms, the instruments and the means that the teachers use to obtain data on the academic performance regarding the teaching-learning process. This should be integral, which presupposes the evaluation of the students in their cognitive and affective aspects, with the use of different techniques (SILVA; SCAPIN, 2011). The statements of the teachers described below highlight the subject: "... when I evaluate who is presenting, that is, the participation of the public, and I give a short "There is no protocol to follow, because the college did not institute any, each one evaluates on his/her own way. I created mine, the other teacher created his, and the others who coordinate the other seminars should each have their methodology. And there is no single methodology based on pedagogical studies"-Dc.
Then, the teachers were asked the following questions: What is your role as a teacher in the learning evaluation process in the Integrative Seminar? As a category, the teachers' autonomy was highlighted.
Autonomy comes from a Greek word and means self-government, governing the own self. In this sense, an autonomous school is one that governs itself.
The autonomous individual would then be the one who perceives him/herself in the world, who becomes an actor and author of his/her history, aware that he/she is not alone, seeing him/herself as different, and learning from differences; the one who has the resources to express him/herself freely, and to be understood by the other, in a permanent exercise of dialogue and reflection, where he/she exercises his/her freedom (PETRONI; DE SOUZA, 2010). It is imperative that the teacher is constituted as such, exercising education in an emancipated and critical way, to emancipate, educate and train the student as autonomous, such as that represented in the following statements: "I try to participate in the best way possible, both to stimulate them, and to have a perception of whether they are learning, or if they are learning to build a line of reasoning" -Dc.
actively involved in the learning evaluation process itself.
Both teachers and students need to demonstrate skills and competencies, leaving no doubts about the teacher's ability to act as a mediator of knowledge, enabling the student to construct satisfactory results, being critical, communicative with autonomy.
This is the question where the students showed more dispersion regarding the statement. It is observed that teachers have used several instruments to evaluate learning, despite the influence of the traditional model, and also due to the Institution curriculum itself, trying to diagnose students' learning, indicating an important change in their performance towards a more flexible and contextualized model, valuing the characteristics of evaluations in the constructivist perspective.
Thus, it is believed that the difficulty of teachers in the evaluation of this subject is due to not having a methodology of their own, but above all, because there is no reflective systematization about the evaluation process that is adherent to the learning objectives. It is also noticed that this difficulty appears in the students' answers, because they often cannot make self-evaluation, and because it is a subject that presupposes an integration, the formatting of an evaluation instrument in consonance with the other subjects becomes complicated.
When asked about his/her role in the evaluation of the Integrative Seminar subject, the teacher understands that to be able to play his/her role, he/she has to have autonomy related to freedom of action, but should understand the development of the most effective educational practices, especially the meanings that may interfere with the way they act.
The teacher of the Integrative Seminar seeks to act assertively, trying to fulfill his/her role as a mediator of knowledge, stimulating the student to build logical reasoning, and to participate actively in the teaching-learning process.
Even with all these difficulties in the development of student autonomy, 72% recognize, in the Integrative Seminar, the active participation in the evaluation process, because within this subject, the domain of social and emotional relations is very evident; the teacher/student proximity facilitates learning, feedback, making students more participative and interactive.
What called the attention in this study was the fact that the teachers responsible for the Seminar within the areas of the basic subjects report that the students are able to bring knowledge, and to adopt integrality with the connection of the specific knowledge of each area. The teachers who teach the Integrative Seminar within the clinical subjects said that students cannot "put the parts together", do not bring knowledge, concepts from other subjects, and that knowledge is fragmented, since they do not reach the objective of the Integrative Seminar. On the other hand, the students' response to the same focus demonstrates agreement about their own learning with successive approaches.
Despite not having a defined, unique, concrete and objective methodology of the entire teaching-learning process, the students see the Integrative Seminar not only as an additional subject, but as a facilitating tool for interdisciplinary integration, providing conditions for the development of skills and abilities.
The difficulty found in the evaluative process, mainly due to the lack of a defined methodology, which often presents with excessive autonomy of the teacher that is not understood, and is frequently not transmitted to the student, due to the difficult real perception of the crucial point of integrality outside the perspective of the fragmented subject, can lead to teachers' and students' distress. In addition, the institutional support is required to maintain and deepen this descriptive bond, so that learning becomes stable and structured.

Conclusions
The study presents considerations based on the evaluation process in the Integrative Seminar subject, which is carried out from the first to the eighth period in a medical course of an Institution in the west of the state of Paraná, Brazil. It reveals and unveils important contributions in the context of teaching and learning in this institution, and especially in this subject, both for teachers and for students.
In general, the research has brought relevant and satisfactory data to light. It was highlighted that the center of learning is, and should be, the student, in an attempt to make him/her actively participate in the whole process of teaching and learning, especially considering that the evaluation is part of this process, not its completion.
Make teachers enhance their knowledge of pedagogical aspects, and especially see, notice and become aware of teaching as an integral, rather than fragmented entity. Provide teachers with a greater perception and broader view of educational paradigms and their evaluative attitude, since this can avoid reactions that increase anxiety and jeopardize their role as educators.
It is now appropriate to indicate, as a recommendation of this study, the development of an evaluation instrument, or different instruments, that are effective to achieve the subject learning objectives. It is important that, after some time from this construction feedback to the teachers and students, a new research is conducted to strengthen the construction of the knowledge achieved here.

Take Home Messages
The center of learning is, and should be, the student, in an attempt to make him/her actively participate in the whole process of teaching and learning, especially considering that the evaluation is part of this process, not its completion.
Provide teachers with a greater perception and broader view of educational paradigms and their evaluative attitude.