THE PROCESS OF PERFORMANCE APPRAISAL IN THE LIGHT OF THE FREIRIAN REFERENCE : HEALTH PROFESSIONALS IN A PUBLIC HOSPITAL HAVE THE

This study aims to identify the aspects that optimize and/or hamper the process of performance appraisal in a public hospital and to discuss strategies that facilitate this process with health professionals. This is a qualitative, exploratory-descriptive study conducted in a public hospital in the southern region of Brazil. Data collection took place through focal group and information was submitted to thematic analysis. The following categories emerged as a result of this study: considerations about the purpose of the evaluation process in the dialogical process of the focal group; the culture of performance appraisal as an optimization / obstacle to the evaluation process; and strategies that facilitate the process of performance appraisal. The results reinforce the need for the institution to conduct performance appraisal based on a reflexive and dialogical process that seeks a critical analysis of the circumstances health professionals work in.


RESUMEN
El objetivo de este estudio fue identificar los aspectos que dinamizan y/o obstaculizan el proceso de evaluación de desempeño de un hospital público y discutir con los profesionales de la salud estrategias facilitadoras de dicho proceso.Investigación cualitativa, exploratoria, descriptiva llevada a cabo en un hospital público del sur de Brasil.La recogida de datos se efectuó por medio de la realización del grupo focal; las

INTRODUCTION
In the last decades, improving human and organizational performance has been a highlighted issue in public management.Thus, strategies are necessary to enable the implementation of reliable and motivating performance management process 1 .Considering the contemporary scenario and its dynamicity and the valorization of knowledge and the relationship between human performance and the quality of the organization's results, the process of performance evaluation emerges as an important tool for the promotion of personal growth and professional development.As much as the tonic gains space for reflection, it also generates controversy between managers and employees.
Institutions understand the process of evaluating professional performance as an integral part of the human resources policy, being an essential component of the administrative activity. 2owever, a systematic review 3 on the development of research in the area of human resources revealed that only 3.7% of research on people management is about performance evaluation.This observation emphasizes the need for more studies on the topic.
However, despite the many contributions from the evaluation process, several obstacles remain, some of them are explicit, others not so much.The absence of a specific occasion for the employee discuss his practice and self-assessment may result in an interlocution impairment between evaluators and evaluated and engagement in the evaluation process.Thus, 4 establishing a continuous upward and downward dynamic between managers and employees is essential for negotiating goals, consolidating and matching contracted objectives and expected results, and constructing evaluation indicators based on the participatory management.
The proposal of an evaluation with a reflexive and emancipatory approach shows the constant struggle of Paulo Freire in the defense of democratic practices of evaluation in a way that allows the "appreciation of what to do of critical individuals in the service, therefore, of liberation and not of domestication" 5:114 .In this sense, the relevance of this research is highlight-ed, since it allows the reflection on a democratic evaluation practice.Furthermore, performance evaluation is emphasized as a process of continuous movement in which its multiple understanding and applicability by the members of the work teams represent an important obstacle to the achievement of a reflexive, democratic and dialogical evaluation process.
Thus, through the creation of a dialogue space, based on the participation of the actors involved in the proposed questions, the objective of the study is to identify the aspects that optimize and/or hamper the process of performance evaluation and discuss the facilitating strategies of this process with the professionals.

METHOD
The research with an exploratory-descriptive approach was developed in a public hospital linked to the Sistema Único de Saúde (SUS), contemplating the bioethical considerations advocated in Resolution 466/2012 of the Conselho Nacional de Saúde 6 .This study is a cut of the research entitled "Performance evaluation of health professionals of a public hospital institution" processed in the Brazil Platform under the presentation Certificado de Apresentação para Apreciação Ética (CAAE) number 47689015.0.0000.5347,with subsequent analysis and approval by the Comitê de Ética em Pesquisa of the proposing institution under opinion number 1, 193,585 and by the Comitê de Ética em Pesquisa of the cooperating institution under opinion number 1,289,551.
Data collection took place through the focus group technique, which its systematic provides for carefully planned discussions with the participants, as already adopted in other studies. 7,8In order to enrich the data produced, it was sought from the analysis to know how the group operates by anchoring in the assumptions of the reflexing group during the debate with a problematizing approach. 9he inclusion criteria consisted of having participated in the quantitative stage of the study, expressing an interest in discussing the theme and being available to participate in the meetings.The selection of the participants used the snowball technique already adopted in previous research 10,11 until complementing the desired module to compose the group.Thus, the focus group was consolidated with six participants.However, there was the presence of five professionals in each meeting.The research group was a physician, an administrator, a social employee, a psychologist, and two nurses.The illustrative speeches of the focus group discussions are identified as P1 (Participant 1), P2 (Participant 2), and so on to preserve participants' anonymity.
The coordination of the activities in the focus group was carried out by the researcher doctorate student, with the help of a research assistant in the role of non-participant observer.He was responsible for recording the reactions of the partici-informaciones fueron sometidas al análisis temático.Como resultados del estudio se generaron las siguientes categorías: en la dialogicidad del grupo focal, consideraciones sobre la finalidad del proceso de evaluación; cultura sobre la evaluación de desempeño como dinamizadora/ obstaculizadora del proceso de evaluación y estrategias facilitadoras del proceso de evaluación de desempeño.Los resultados subrayan la necesidad de realizar la evaluación de desempeño basada en un proceso dialógico, reflexivo con miras a la lectura crítica de la realidad que viven los profesionales.Palabras clave: Evaluación del Rendimiento de Empleados; Gestión en Salud; Administración Hospitalaria; Investigación en Administración de Enfermería.

It is perhaps used for other purposes. It is used as the bargaining coins for various things other than for what it should be done (P6).
(Source: Focus Group, 04/01/2016) Although it was suggested that the evaluation has multiple purposes in the institution, these "various things" that the evaluation is employed were not explicitly stated at that time.Further to the discussion, the members of the group indicated that the results of the performance evaluation are mostly used for the granting of extra days, known as bonus days; or as a subsidy in the reallocations for the night shift, very disputed by the professionals.In this direction, it was explicit in the debates that the conditioning of performance evaluation with some kind of reward is an apprehension that also mobilizes the participants: Because the evaluation has benefits today for the person being evaluated.Like, the vacation, prize breaks, okay?Some of them depend on this evaluation (P6).

There's this thing tied to a prize vacation, you can´t imagine people's indignation when they only get four days of the prize (P5).
(Source: Focus Group, 04/01/2016) Campos 13 has a concern identified in the FG in and its alert about the risks of conditioning payment to productivity, thus, to encourage the notion of work as something without regard to the final purpose of the activity carried out.The purpose of evaluation, according to Freire, 14 is to awaken the desire to develop a critical awareness of reality so through a process of self-reflection and occupying the existing spaces of autonomy, people may be capable of weaving alternatives and provoking transformations.Through this exercise, it may be possible for evaluators and evaluated people to understand the difficulties they face as learning opportunities rather than weaknesses or threats.When the performance evaluation is focused on this intention, it is more likely that the individuals involved in the evaluation process can experience a qualitative leap of knowledge.
When proposing a methodology of participatory and dialogic evaluation, the research field institution indicates an important concern in stimulating employee participation.Thus, the dialogue was chosen as the guiding axis, since besides being a principle of the SUS, the participatory and democratic management is also an organizational guideline of the institution.Also, as a space for open and periodic discussion, Collegiate Management was instituted, where managers and employees can reflect on the work process and how to produce health. 15owever, it is important to find out if the professionals have taken advantage of the space provided by the institution with pants in their verbal and non-verbal expressions in a field diary, as well as assisting in organizational and logistical aspects such as handling the tape recorder.The focus group meetings were recorded in audio, taking place in April 2016 and totaling three consecutive weekly meetings, with an average duration of 1 hour and 30 minutes, in a room in the hospital.The schedule was set in common agreement with the participants.
The source of information generated in the focus group was submitted to thematic analysis. 12In the operationalization, the results were classified by content similarity through organization in files, grouping them into categories.Thus, the following steps were taken: a. pre-analysis: it is the ordering of the material coming from the FG, that is, literal transcription of each meeting of the group, followed by re-reading the information and its organization to assist in the beginning of the interpretation process; b. exploration of the material: in this stage, there is the codification of the text and the transformation of the raw data to understand the text; c. treatment of the results obtained and interpretation: at that moment, it was sought to articulate the empirical material found with the theoretical contribution of the study and the objectives proposed by the research, seeking to establish relationships, convergences and divergences.It focused on certain themes that could denote structures of relevance, reference values and behavior models present or underlying in the dialogues.

RESULTS AND DISCUSSION
The results obtained were grouped into three thematic categories: considerations about the purpose of the evaluation process in the dialogue of the focus group; the culture of performance evaluation as an enhacing/obstacle to the evaluation process; and facilitating strategies for the process of performance evaluation.

Consider ations about the purpose of the evaluation process in the dialogue of the focus group
At the first meeting of the focus group, the debate was triggered by the following question: "What do you consider significant in the act of evaluating and in space/time to be evaluated?"Thus, after a brief period of silence, considerations about the purpose of the performance evaluation emerged in the FG.This uneasiness ran through the lines: It ends up being used for various things and not for the purpose that it should be, you know?(P5).
property and to encourage the dialogue between the employees.For Freire 16 , the dialogue involves critical thinking and understanding of reality as being possible to be transformed.According to this conception, there is not a single holder of knowledge, but a collective knowledge constructed from the criticality exercised by both, in this case, the evaluator and the evaluated person.The employee is considered a historical individual, valuing his knowledge and practices and adopting his perception about the object to be discussed as his initial starting point.
As defended by the Freire referential 14 , the evaluation presupposes a critical reflection on the practice developed.However, the difficulty inherent in the human being in developing this criticality was manifested by the FG participants in discussing the obstacles present in the development of the evaluative interview: Our society has to understand that criticism is part of this process of life, criticism, and self-criticism (P1).

People have a narrow, very impoverished view (P4).
(Source: Focus Group, 04/01/2016) Throughout the discussions, the obstacles experienced by the professionals were perceived, seeking a dialogue between the individuals involved in the evaluation process, since people are not "born" with a critical sense of the lived reality, it is necessary to develop it.The process of awakening to critical reality is called as awareness by Freire 5 .In this process, people become cognitive individuals, capable of critically understanding the reality that permeates them and, knowing the reality, they are also aware of their potentialities and their capacity to transform reality.However, if the employees remain chained to a transitive-naive consciousness, they continue to perceive reality as static and unchanging, considered as superior to facts and incapable of understanding them in depth. 5t has also emerged in the dialogues that the process of establishing a dialogue in a critical and constructive way, as well as extremely difficult and complex, cannot be imposed.It is important to return to the alert of Freire 16 , that it is not possible to perform the critical reading of reality if the person does not wish to do so.In this process, mass culture is still available as an aggravating factor, which clutters and restricts freedom of thought, pretending to be more comfortable and requiring less effort to "follow the flow" and to accommodate the reality that is set.
In FG, it was mentioned that sometimes the dialogues are established superficially with both agents of the process, staying in neutral and safe territory.Following the Freire perspective, the evaluator and the evaluated person can collectively construct reflections about the presented performance, through a critical exercise of conscience and within a dialogi-cal context.This is the dynamics that the institution proposes based on its Política de Avaliação e Desenvolvimento. 15It aims at evaluating performance through a reflexive process, based on the dialogue between employees and managers, allowing actions for the development of the employee thought and agreed in a critical and collective way.
From the signalization of the difficulties that the employees have experienced, the understanding of an important obstacle for the development of the evaluation process emerged in the group: People have a culture of defense that was also printed (P1).
The employee sees the evaluation as another way that we have to punish him (P5).(Source: Focus Group, 04/01/2016) According to the participants, both the evaluators and the evaluated people are living what to say and where to go during the evaluation.In a certain way, both are immobilized, avoiding the clash of opinions.
In the scenario described by the FG members, evaluators and evaluated people are both oppressors and oppressed, and vice versa, alternating in these roles as they assume passive and previously conditioned postures.In such circumstances, as Freire said, 17 the human being experiences an internal struggle: "they want to be, but they fear to be.[…] Between becoming detached or alienated.Between following prescriptions or having options.Between being spectators or actors.Between acting or having the illusion that they act.[…]" 17: 47,48 In other words, there is an intrinsic dilemma that must be overcome.
:48 Hence, the reluctance of the human being to leave his status quo and seek alternatives for change and transformation.From that moment, discussing possibilities that could help in this process of awareness, the group signaled that one of the great obstacles to be overcome for the evaluation process could be the culture about the performance evaluation present in the institution.

The culture about performance evaluation as an enhancing/ obstacle to the evaluation process
In terms of enhancing and/or obstacle aspects of the performance evaluation process, the organizational culture regarding the evaluation process was highlighted in the discussions.In this second meeting, the debate was triggered by the synthesis of the previous meeting and the triggering question: However, in the discussions of the group, the demand of the employee for the advice of the Board of Appeal was remembered as something common:

Most are motivated to complain […] To go to the Board (P3).
They are motivated to complain to the Board.To complicate (P6).(Source: Focus Group, Meeting 2, 04/08/2016) The demonstrations show how the role of the board of appeal is seen by employees and managers.The merit of the institution cannot be withdrawn by having the initiative to provide a space for employees to expose their dissatisfaction with the result of the performance evaluation.However, both the apparent frequency the board of appeals have been requested and, on the other hand, the perception of un-management by the managers or the employee who challenges the evaluation "complicating" warns to analyze on how the evaluation process has taken place in the institution.Probably, if the evaluation was actually carried out in a dialogical context, allowing for the problem-solving between the evaluators and evaluated people, the search for the board of appeal might not be as representative or, on the other hand, the contestation of the opinion could be viewed as an opportunity for learning and revise conceptions.
As developing the dialogue and criticality is not something that can be done from one day to the next, it may be possible to initiate this process by encouraging the recognition of the importance of the evaluation process and its impact on the development of the potential of the employees.Moreover, without the validation of the individuals involved in the performance evaluation, it would be risky to blame the evaluation process for its ineffectiveness.
At that moment, Freire 5 proclaims again: without awakening to a critical view of reality and the unfolding of a process of awareness, the human being will hardly be able to visualize its potentialities for transformation.Also, even if employees are faced with the opportunity to participate in the standard configuration of their performance, unless they critically understand how their work contributes to the scope it is inserted, it is unlikely that true ownership will be done.

FACILITATING STR ATEGIES FOR THE PROCESS OF PERFORMANCE EVALUATION
The facilitating strategies discussed by the group during the meetings were related to the creation of spaces for dialogue and discussion that favor reflection in employees about

For you, what are the aspects that optimize and/or hamper the performance evaluation process here in the institution? (Moderator).
There is a resistance culture to be evaluated (P1).
We have a deadline and we always protect and we end up evaluating when everyone is closing, it is overcoming the deadline (P3).(Source: Focus Group, 08/04/2016) The resistance both to evaluate and to be evaluated highlighted in the dialogues of the group is similar to the notes of a previous study carried out on the theme 19 and it is not a unique situation of the institution where the research was developed.In a way, the human being is evaluated from the first instants of his existence, receiving the first note already in the test of Apgar.However, empirically, the act of evaluating and being evaluated is usually not perceived as a pleasurable activity.
Throughout the discussions, the participants pointed out the difficulties experienced during the evaluation interview.Probably, the individuals involved in the process have not been able to establish a dialogical communication that allows them not only to express their opinion but also to be able to listen to the other's considerations.
The inevitability of this cultural change signaled in group meetings has also been discussed in the literature. 20,21It does not matter how efficient the performance evaluation system may be, if the process does not have credibility by the employee, the evaluative system is not perceived as relevant and timely. 20Much of the effectiveness of performance appraisal systems in promoting development is linked to employees' understanding of the process. 22he promotion of a cultural change for the performance evaluation includes the movement to stimulate the participation and the involvement of the employees in the evaluation process, meeting with the teachings of Freire. 5Once the performance evaluation in a dialogical context between evaluators and evaluated people, the employees could question or even change the decision of their supervisor in their area of autonomy.In the dialogical context, there is no "my" or "your" conception, but a conception built from a clash of ideas.
In the FG, the understanding that the evaluation process occurs in a democratic way in the institution and, once there is no consensus regarding the established concepts, employees have the opportunity to challenge the result of the performance evaluation from the Board of Appeal.The main attribution of this commission, made up of employees and managers, is to assess whether the facts actually evidence that the employee received an evaluation inferior to his performance or that does not reflect his commitment and contribution to the work process. 15earning in the workplace enables it to be a space for collective knowledge construction and not just task execution.
After talking about the current and effective opportunities for discussion, the participants referred to the introductory training that is given to the employee when it is inserted in the work scenario of the institution and the importance of deepening this discussion.At the time of admission, the evaluation and development policy and the methodology adopted for the evaluation at its various levels are presented: institution, teams, management and employees. 15owever, as a consensus in the FG, a single initial approach to the performance evaluation process cannot encompass and provide the critical reflection that the individual demands.Therefore, the participants expressed the inevitability of the establishment of discussion forums in a systematic and continuous way.
The importance of facilitating the participation of managers and employees dialogical process had been emphasized.Although the manager may have inherent responsibilities for the position he occupies, in the case of an evaluation process, the responsibility rests on both.It is the joint reflection and collective construction that enable the learning necessary to generate transformations.:71 For this, employees and managers need spaces where they can speak.Freire 18 argues about the importance of the human being to speak and not be silent about his doing.Thus, "dialogue stands as the way men gain meaning as men.:109 Therefore, the dialogue is not restricted to the deposit or common exchange of ideas previously conceived between one and another individual, but the act of producing knowledge is orchestrated by both.
The discussions in the focus group have shown that, although the institution provides opportunities for dialogue, there is a long and arduous path for both parties.Not only the employee is responsible for its development, just as the manager is not the only one to provide the means to do so.This task requires mutual commitment.Also, it is important to consider the particularities of the public area by focusing on the repercussions that changes of government and political and power issues entail for the institutions. 24Also, people are more directed to wait for ready solutions or magic formulas. 25hrough the critical-reflexive exercise carried out during the meetings about the context lived in the institution, the participants realized how essential it is to concentrate efforts to promote occasions that allow the discussion about the evaluation process.For the group, it was very clear that the consolidation of these spaces to promote interaction and exchange of the evaluation process.Although this topic was present in all the group's debates, the third meeting of the FG sought to return to the theme and start the discussion, through the synthesis of the previous meeting and the triggering question.
After a brief period of silence, the moderator of the group rescued the theme and proposed the following strategy: For you, what strategies could be facilitative in the performance evaluation process?(Moderator).
More workshops could be done to elucidate the timing of appraisal and self-assessment.Because, many times, we become managers and we do not go through a qualification evaluation of the employee.One thing is for me to be evaluated, another thing is for me to give the information to the examiner (P4).(Source: Focus Group, 04/15/2016) The comments emerged from the FG highlighted the role of the institution, as co-responsible for the evaluation process.Although the hospital recommends that the evaluative process be based on a dialogical context and there are formal spaces already established for discussions regarding work processes (Management Collegiate), the need to effectively consolidate this proposal is noticed.According to a study 23 in this same field of research, evaluating within a dialogical proposal is still a great challenge, considering the history of adopting conservative practices in previous evaluative processes.
Regarding the skills understood as necessary and evidenced in the discussions, it is important to question about their real purpose and implication in the employees´ lives.The suggested training would only make sense if it resulted in learning for the employee.Learning as defended by Freire 18 , that is, with the aim of encouraging the human being to learn to think or, further, relearn to think and, within a critical apprehension of the reality in which it is inserted, to become an individual capable of producing transformations.
Obviously, as the previous study 22 argues, it is clear that there is a need to technically equip managers with relevant information so they can provide employees with a continuous return on their skills, points of improvement and potentialities, aiming at the development of employees and the evolution in performance.However, these capabilities cannot be conducted dissociated from a critical context.
Rather than empowering the evaluators or clarifying the doubts of the employees, it is essential that people can use existing spaces for reflection and also include the employees and not only managers and evaluators.In this sense, Freire 18 emphasizes that the learning process is only possible through the exchange of experiences between the involved individuals.Thus, experiences among all agents of the evaluation process could be the main strategy for the collective construction of knowledge for the practice of performance appraisal.

CONCLUSION
The participants' perception of the study shows the understanding of the evaluation process as an opportunity for professional development and employee motivation.However, the concern expressed was that the performance appraisal is used for other purposes such as the granting of benefits and internal reallocations.It is understandable the unrest revealed since conditioning performance appraisal only with extrinsic rewards can lead to losses in the appropriation of the evaluation process as a space for fostering critical reflection.
The emphasis given in the discussions regarding the culture on performance appraisal present in the institution is important to highlight.There was an emphasis on the culture of resistance to be evaluated and the preconceived understanding that performance appraisal is unproductive and incapable of propitiating transformations.Also, the worker's recurring demand for the advice of the board of appeals was an issue that mobilized the discussions and raised questions about the way in which professionals have used this resource.
In the debates, the perception was that, although the evaluation process occurs in a democratic way in the institution, it is necessary to mobilize efforts to encourage the appropriation of this process by the professionals.Although there is a considerable commitment by some managers and employees to consolidate this participative methodology, the lines that emerged in the focus group suggest that the spaces of dialogue in the institution seem to have not been enjoyed in their entirety by the employees.
As limitations of the study, there are the results found concern the scope of a public hospital whose specificities of managers and employees are inherent in this context.While the data cannot be generalized, they allude to the challenges faced by managers and employees in the course of the process of evaluating professional performance and can be used as triggers for future research.Moreover, the results allow establishing relationships with other contexts and appraisal models, stimulating perspectives and additional questions.
The study of the performance appraisal in a public hospital brought the emphasis on the dialogue between manager and employees as the guiding axis, based on a democratic and participatory model of people management.Freire perspective added problematization and critical vision as elements that stimulate the people involved in this evaluative process to question themselves and, at the same time, allow them to transform their understanding of their status quo.In this way, the appraisal goes beyond the limits of performance quantification, stimulat-