Nursing master's program at Anna Nery school 1972-1975: singularities of graduating and challenges in its implementation

Objective: To analyze the initial characteristics of the first master's degree in nursing in Brazil, to discuss the difficulties to meet the new academic requirements. Methods: This is a social-historical study. The primary sources were written documents and interviews with former students and former teachers of that course. The theoretical concepts used for analysis are the university and the three generations of researchers. Results: About the characteristics, the following stands out: taught by faculty members qualified abroad, curriculum aimed at theoretical and theoretical-practical experiences, directed at didactic and pedagogical training. Among the difficulties, the following need emphasis: lack of qualified teachers to teach, lack of subjects for critical and reflective education. Conclusion: At the start of the 1970s, the EEAN faced the challenge of implementing a course at stricto sensu post-graduate level. Despite the difficulties, in 1975, the EEAN graduated the first nine masters in Nursing, contributing to the emergence of a new generation of researchers in nursing in the country.


INITIAL CONSIDERATIONS
This research looks at the initial characteristics of the first Master's course in nursing in Brazil, implemented at the Anna Nery School of Nursing (Escola de Enfermagem Anna Nery/ EEAN) of the Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro/UFRJ) in 1972. The time horizon starts in 1972, when the Master's Program was implemented at EEAN, and ends in 1975, when the students sustained their nine theses.
In the 1960's, important changes take place in higher education, established in the Education Law (Lei de Diretrizes e Bases da Educação -LDB), Nº 4.024/1961. Among the innovations established, the inclusion of the graduate level in Brazilian education and the requirement of finished secondary education to enter any higher education program were highlighted 1,2 .
The military regime invested intensely in the country's economy. As soon as it was implemented, the regime started an economic recovery policy and, as early as at the end of the 1960's, an economic expansion took place, with the enhanced development of the industrial sector. As a consequence of this public investment, the growth of the industrial sector was intensified and the number of multinational companies in Brazil increased. The new companies and industries needed qualified workforce for their staff. At the same time, the population growth determined the increased demand for education. The middle class and the student movements started to pressure the government to facilitate the access to education.
To cope with these problems, the Brazilian government turned to the United States (USA) for help, signing the agreements called Ministry of Education and Culture/United States Agency for International Development (MEC/USAID) and set up commissions of educators for them to assess the educational situation and propose strategies to forward the matter. As a result, Law 5.540/1968 was enacted, known as the University Reform Law, which established important changes in Brazilian education, such as the principle of inseparability between teaching and research and the requirement of stricto sensu graduate education for professor career 3 . In that context, EEAN/UFRJ is impelled to implement the Master's course in nursing, facing the challenge to integrate the research practice into its pedagogical orientation, which used to be focused on care 1,2 . To guide this research, the following objectives were elaborated: analyze the initial characteristics of the first Master's Program in nursing in Brazil; and discuss the difficulties faced to attend to the new academic requirements.

THEORETICAL APPROACH
To analyze the study's historical-social context, the concept of University as a social institution will be used, as presented by the philosopher Marilena Chauí 4 , who discusses the dynamics according to which the university conducts and expresses the society it is and is part of in a certain way. Thus, the discussion agenda at the university follows the characteristics in force in the social midst, that is, the institutionalized traits reproduce the aspects that mark society and, thus, the university reveals to be an integral and constitutive part of the social tissue 4 .
To characterize the nursing knowledge, we use the three phases of its development: the Nursing techniques, the Scientific Principles and the Nursing Theories. This study is part of the Theory Phase, which started in North America in the 1960's, resulting from the search for professional autonomy and the particularity of nursing knowledge. In Brazil, it was developed in the 1970's, coinciding with the launch period of the stricto sensu graduate programs. In general, the theories express the formalization in the organization of nursing actions for care delivery, more than actually theorizing about care, aiming to understand man as a whole, that is, as a biopsychosocial being, including the incorporation of concepts from psychology, anthropology and sociology etc 5 .
Otherwise, to situate the nurse researchers, as from the mid-20 th century, we adopt the characterization of three generations of researchers (until the 1970's): the pioneers, the self-taught and the academics 6 . The research problem fits into the context of the generation of self-taught and that of academic researchers. The generation of self-taught researchers emerges in the 1960-1970's, in the context of the Habilitation Theses and contests to fill positions for Full Professorship at EEAN/UFRJ and at the University of São Paulo (USP) at Ribeirão Preto College of Nursing, in which one of the assessment phases of the candidates was the defense of a thesis. These researchers were part of the Master's program staff and thus participated in the preparation of the generation of academic researchers through the stricto sensu graduate courses. The first academic researchers were the students from the Master's program, who faced the challenge of taking a stricto sensu graduate program that was still under development 6 .

METHOD
A historical-social study with a qualitative approach was undertaken. The primary sources were documentary and oral. The written documents from the Documentation Center at EEAN (CEDOC/EEAN) were consulted, including: school records, letters sent and received by the course coordination, different reports, memoranda, laws, decree-laws, opinion; Volume I of the List of Studies and Researchers who Concluded the Master's Program in Nursing at EEAN/UFRJ. Interviews were held with: four former students, identified with the letter A in the text and numbered in the order in which they appeared: one former teacher in the program, identified as P1. The copyright of the interviews was granted to CEDOC/EEAN.
The The secondary sources included articles, books, dissertations, sites, theses from university libraries in the city of Rio de Janeiro, mainly the Graduate Library of Anna Nery School of Nursing. The virtual databases consulted for the systematic search were Online Library of Health (Biblioteca Virtual de Saúde/BVS/ Bireme) and the Portal de Periódicos da Capes.
The data were collected in the first semester of 2010. The instrument used was a semistructured interview script, applied personally to five participants, while only one was applied by email. In addition, a digital recorder was used, as well as tables to classify and categorize the data. The procedures to analyze and interpret the data from the different sources were interpretation, classification, categorization, contextualization, interpretation based on theoretical concepts adopted, as well as the triangulation of the different data types with internal and external criticism against the presented facts 7 .

Initial characteristics of the Master's program at EEAN
The Master's program at EEAN received approval for its implementation and opening through Process 34.247/70, issued by the UFRJ Research and Teaching Center for Graduate Students. Due to EEAN's intense concern with attending to the urgent need for preparation and qualification of the school's teaching staff, the Master's program started its activities on August 7 th 1972, when it was still awaiting its accreditation by the MEC, according to Letter 569/1972, available at CEDOC/EEAN. The School's faculty considered that the forward thinking and teaching quality of the undergraduate program at EEAN should be maintained in the stricto sensu graduate education. Another factor that drove this group was the perception that the established knowledge production was timely and would serve as a framework for nursing knowledge and for the valuation of the profession. This importance is observed in one of the interviewees' statement. When the Master's program was implemented in 1972, the director of EEAN was professor Elvira de Felice Souza and the Master's program coordinator was professor Maria Dolores Lins de Andrade; the sectorial coordinators, that is, the coordinators of the subject groups that related to the concentration area in Nursing Fundamentals were professors Cilei Chaves Rhodus and Vilma de Carvalho. As from 1974, professor Cilei Chaves Rhodus assumes the program coordination and continues in this position until 1980, when she becomes the Dean of EEAN 8 .
The program was aimed at developing and deepening the undergraduate education, broadening the competency levels and the professional skills, including nursing teaching and care in an integrated manner. The main course objectives were to implement the high-level preparation of the nurses for teaching and research in the specific nursing areas, the development of critical studies about the nursing role, the development of research and characteristic skills appropriate for knowledge transmission, aiming to enhance nursing teaching 9 .
For the implementation of the Master's program, the composition of its Faculty member's staff was problematic due to the lack of qualified professors. To teach in stricto sensu graduate programs, the MEC accredited faculty members who had taken graduate programs abroad (category 1 in chart 1) or at other public Brazilian universities (category 2 in chart 1) 10 . For the full composition of the Faculty staff, Professors from other areas were invited, such as education and philosophy, who already held a Master's degree or were accredited to teach in stricto sensu graduate programs 9  As a strategy to mitigate the lack of qualified professors to teach in the Master's program, habilitation thesis exams were held. By taking the exam, the candidate was not running for a teaching spot. On the other hand, approved candidates gained the degree of free lecturer as well as Ph.D., and was therefore qualified to teach in stricto sensu graduate programs (category 3 in chart 1). The habilitation thesis exams at EEAN were held in 1968, 1975 and 1977, resulting in 35 new Ph.D.'s for nursing 11 .
According to the classification in chart 1, the nurse professors belonged to the generation of self-taught researchers, except for professor Haydée Guanais Dourado (who also belongs to the generation of pioneers). This shows their noteworthy contribution to the profiling of the generation of academic researchers originating in the Master's program. Master's course at EEAN (1972-1975) Mendes ALTM, Aperibense PGGS, Almeida Filho AJ, Peres MAA

The Nursing
The graduate coordination was familiar with the fact that the course curriculum should offer the students theoretical and theoretical-practical experiences, as well as experiences that applied to the students' reality. In addition, the coordination acknowledged the need for the teachers to be capable of seeking new knowledge and developing critical analyses. Nevertheless, the institution's structural difficulties delimited the planning and organization of the course's first proposed curriculum. The first course curriculum was used until the Federal Council of Education (CFE) accredited the course in 1973 9 .
As observed in chart 2, in the curricular structure, disciplines were missing that discussed the social and political problems, so as to make the students establish critical and reflexive awareness about the country's social, economic and cultural context. The exclusion of the subject Nursing History is noteworthy, which encouraged a critical discourse internal to the profession, which can be explained by the dictatorial regime in power. At that time, Decree 477 from 1969 was in force, imposed by the government, which did not allow the teachers to raise questions about the political context or express their opinion in the classroom, and which also repressed the students' freedom of expression 12 .
The conditions that were considered as prerequisites to obtain the Master's degree were: attendance rate of 75% or higher in the subjects; completing 23 credits in compulsory subjects and four in elective subjects, within a maximum period of three years: demonstrating reading proficiency in the English language; presenting a thesis between six and 36 months after having concluded the study 8 .
The practical activities included undergraduate teaching and traineeships at the hospital. The purposes of the practical activities included: developing the critical potential of the Master's student with regard to the nursing interventions; monitoring undergraduate students, assessing their performance in the training area and developing their problem solution skills. Thus, these characteristics promoted the development of a professional profile in the students as being capable of leading, criticizing, teaching and solving the matters inherent in nursing work, as described in Letter 182/74, available at CEDOC/EEAN. The traineeships were divided across different hospitals in the city of Rio de Janeiro, according to the concentration area chosen, including the following: Instituto de Tisiologia e Pneumologia, at Hospital Municipal Souza Aguiar, Hospital da Lagoa, among others (A1).
As perceived, the course configuration was focused on didactical and pedagogical training. This concern with teacher training explains the requirement for the students to plan and teach classes to the nursing undergraduate program at EEAN, according to the Programa Prática de Ensino/1973, available at CEDOC/EEAN.
As the student group's heterogeneity was restricting the students' good evolution in the program, as from 1974, as a form of selection, the candidates received a preparatory course, In the first class, 20 students were enrolled, 12 of whom fulltime. They were expected to end the course in four years. The eight students enrolled part-time should end the course in up to six years. In the year the course was implemented, the teachers who served as teaching aids were automatically enrolled for the Master's program, without going through the selection process. Similarly, and teaching aids admitted were required to obtain the Master's degree within four years 13 . Excerpts from the interviews with former students demonstrate this reality: This shows a concern with the teachers' qualification and with the compliance with the requirement for the undergraduate faculty at the School to hold a degree. The implementation of the Master's program offered the essential conditions to start building a generation of nurse researchers, prepared based on institutionalized teaching. By requiring the elaboration of a research to obtain the Master's degree, the course contributed to the development of scientific research, as the product of an academic investment, with a decisive role for the progress of the profession.

Academic requirements: initial difficulties and obstacles
The challenge the EEAN faced, which had been engaged until then in professional education focused on care, was to implement the first Master's program in nursing in Brazil and thus start the preparation of a generation of academic researchers.
The MEC accreditation standards for graduate programs were established in CFE Opinion 77/1969, elaborated by Newton Sucupira. The requirements for accreditation included: the applying institution should demonstrate the high level of its undergraduate programs in the area intended for the graduate program; the legal nature of the institution should be considered, as well as the institution's teaching and research tradition, its financial capacity to maintain the course, the qualification of the teaching staff, the facilities and equipment, such as laboratories and library 13 .
In the accreditation process of the Master's program in Nursing Fundamentals by the CFE, the School had to respond to two enquiries. The first was related to the faculty members' qualification and degree, despite holding graduate degrees at high-level universities. Departing from this principle, that the nurse teachers were not qualified, they were considered in no conditions to create an appropriate curricular proposal for a Master's program 13 . Hence, the second enquiry was related to the course's proposed curriculum. To respond to the CFE requirements, a second proposed curriculum was elaborated, including compulsory and elective subjects, as shown in chart 2. After many incidents and struggles, the accreditation was granted in opinion 1726/73, on October 3 rd , 1973 13 .
Besides the CFE requirements, the EEAN had to face the difficulties of teachers and students. The main difficulty the former students mentioned for the evolution and conclusion of the program, is the advice process of the thesis, which only started after the end of the subjects. The students did not participate in the choice of their advisor. Some former students believe that the faculty members were not prepared, neither to teach the course subjects nor to advise theses, due to a lack of mastery of the research method. The student chose the research question, also because the advisors had not research area the Master's students could take part in. As observed in the following statement: Others also mentioned the faculty members' work overload, as they were responsible for teaching, helping with the coordination and advising the thesis. In addition, the students had many practical activities, which involved both direct patient care and management and leadership activities, taking traineeships at different hospitals in the city. The transportation difficulty was another obstacle that hampered the course activities. These difficulties affected the quality of the student-advisor relationship and the elaboration of the research. It should also be highlighted that the material resources the student and advisor had at their disposal negatively affected the dynamics of the advice, which also contributed to clog up the conclusion of the process. Another important aspect was the performance of undergraduate teaching activities at the same time as the Master's program, a fact that clearly wore them out, as verified in the following statements: In short, the Graduate Coordination Committee at EEAN found that the main obstacles to produce the theses were: the faculty members' lack of experience with the advice process and the students' lack of scientific initiation in the undergraduate and/ or specialization programs. To deal with these problems, a leveling course was created for the candidates (pre-Master's), the number of credits was created and the list of subjects expanded. This new curriculum would only be implemented in 1976 2,14 . That was a mistake at that time, as the students manifested difficulties to conciliate the subjects' different activities with the elaboration of the thesis. The increase in the list of subjects and in the total number of credits would only aggravate this existing problem.
Despite all of these initial obstacles the course coordination and its first students faced, in 1975, the first nine theses were presented. These students were able to overcome these barriers and present their theses before the established deadline. On May 20 th 1975, the first three theses produced in the course were presented, written by Lygia Paim (EEAN), Ana Maria Palermo (EERP) and Ieda Barreira e Castro (Ministry of Health, under the respective advice of professors Wanda de Aguiar Horta from the University of São Paulo School of Nursing, Cilei Chaves Rhodus and Vilma de Carvalho, both from EEAN. And, during the year of 1975, six other theses were sustained. All of the theses were elaborated in the area of nursing fundamentals, the sole concentration area offered that far. The research problems addressed in the theses were predominantly in the care area, demonstrating that the students took interest in questioning the substantial elements in the performance of their teaching practice for nursing care and in reconsidering the role, functions and tasks of nurses in clinical care 14 .
To undertake the project of implementing the Master's program in a timely manner, in compliance with the legal requirements, Anna Nery School of Nursing had to overcome difficulties with regard to the students and teaching staff and their adaptation to the course, as well as infrastructural difficulties. Nevertheless, it was able to achieve its goal as, at the end of these first four course years, nine students were able to conclude the subjects and defend their respective theses within the deadline. Another aspect that should be considered is that EEAN, as the pioneer in the creation of the Master's program, had to face the challenge of developing a course without bases or examples to support the decision process.
The university as a social institution, influenced by the transformations that took place in the Brazilian society, receives influence from the changes in the Brazilian educational laws that happened at the end of the 1960's. And these legal requirements and the modifications that took place in higher education in Brazil will benefit the start of nursing research development. Thus, a new generation of researchers gains room to assert themselves, that is, the academic researchers.
By 1975, two other Master's programs in nursing were created, one at the School of Nursing of the University of the State of São Paulo (USP) in 1973 and the other at the USP at Ribeirão Preto College of Nursing, which means that there were three Master's programs in Nursing in 1975. In that same year, the Master's program at the USP School of Nursing in São Paulo also graduates its first four students in nursing, totaling 13 M.Sc. graduates in nursing in Brazil 14 .
Thus, with regard to the initial requirements, difficulties and obstacles, these were external, transportation and infrastructurerelated; and internal, education-related (advice-research).

CONCLUSION
Brazilian graduate education emerges in the context of an economic and social development process that depended on the production of science and technology. When graduate education in nursing emerges in Brazil, most of the Nursing Schools were already part of universities. In line with this institutionalization process of stricto sensu graduate education, courses at this level were created in nursing, aiming to qualify teachers and advance nursing knowledge.
The Anna Nery School of Nursing undertook the project of implementing the Master's program in nursing in a timely manner, in compliance with the legal requirements, and was able to achieve that goal in 1972, as a pioneer in this undertaking, although all Schools mobilized for that purpose. For the initial constitution of the teaching staff, the Ministry of Education accredited professors as qualified to teach in the Master's program. The first class of students was characterized as very heterogeneous, and the teaching aids at EEAN were automatically enrolled for the course.
Historical research demonstrates events (successes or failures) of interest to historians. The answers to the problems focused on in this research demonstrate that, initially, the School overcomes difficulties related to the students and teaching staff, their adaptation to the course, infrastructural difficulties, as well as in the course accreditation process by the CFE, and only gains the accreditation in the second course year. As observed, at the end of these first four course years, nine students were able to conclude the subjects and defend their respective theses before the established deadline, which represents a victory and a landmark to affirm that the course was in place.