Abstract

Educating professionals according to an innovative perspective that integrates theory and practice and favors the transformation of reality in a significant way has been a challenge to education in post-modern societies ¹1. Bauman Z. O Mal-estar da pós-modernidade. Rio de Janeiro: Zahar; 1998. .

In Brazil, with the publication, in the beginning of the 21^stcentury, of the National Curricular Guidelines (DCN) for undergraduate programs in the area of health, education has been revised based on an amplified view of the health-disease process, considering the individual in their social, economic and ethnic-cultural context. To achieve a singularized, non-fragmented education process, it is necessary to reconcile the general guidelines with specific demands deriving from diversity and with needs generated in the education setting. Other aspects that must be considered are new capacities for competence-oriented curricula, the use of innovative teaching-learning technologies, and teaching-service integration ²2. Coelho IB, Padilha RQ, Ribeiro ECO. Desafios na educação de profissionais de saúde no século XXI. In: Lima VV, Padilha RQ, organizadores. Reflexões e inovações na educação de profissionais de saúde. Rio de Janeiro: Atheneu; 2018. p. 25-36. .

In the interface between general and specific and in view of the challenges to promote contextualized education based on active teaching-learning methodologies, the role of teachers becomes strategic and represents a critical factor in the development of competence-oriented educational initiatives.

Despite the low investment in teachers’ pedagogical education in view of the new requirements of this function, the educator’s role has undergone transformations throughout the years, particularly in an attempt to meet the new emerging demands of post-modern societies.

Rethinking teacher education

One of the main challenges in teacher education concerns a shift in the focus of the teaching-learning process: from the teacher to the students’ learning needs. This change was envisioned at the end of the 18^thcentury, implemented in isolated experiences at the end of the 19^thand beginning of the 20^thcenturies, and transformed into a trend in the last decades of the 20^thcentury ³3. Gauthier C, Tardif M. A pedagogia: teorias e prática da antiguidade aos nossos dias. Petrópolis: Vozes; 2010. .

The objective of the present investigation is to examine the teaching practice in innovative postgraduate initiatives connected with the qualification of health professionals in the context of the Brazilian National Health System (SUS). This study aims to present challenges and possibilities to the teaching practice considering the new nuances of teaching and learning processes in competence-oriented initiatives, which integrate theory and practice and use active teaching-learning methodologies.

In view of this new context of teaching, the teacher’s role in relation to contents and active teaching-learning methodologies represents the problem to be investigated. With the shift of the focus of the teaching process from the teacher’s knowledge to the identification of students’ learning needs, challenges and achievements of the teachers’ action need to be investigated. Particularly, the teachers’ mastering of the contents to be taught to students and their action as a high-quality source of information are aspects loaded with tension in the development of new teaching practices.

The context and methodology of the investigation

We chose a postgraduate education initiative with a socio-interactionist nature that uses active teaching-learning methodologies in order to investigate whether teachers find it necessary to master specific cognitive contents and in what way adherence to or the level of knowledge about the methodologies interfere in the teacher’s action.

The investigated initiative was part of the Program of Support to the Institutional Development of SUS (PROADI) from 2012 to 2014 and was developed in a partnership between the Ministry of Health, the National Council of Health Secretaries (CONASS), the National Council of Municipal Health Departments (CONASEMS), and the Sírio Libanês Hospital ⁴4. Instituto Sírio-Libanês de Ensino e Pesquisa. Ministério da Saúde. Conselho Nacional de Secretários de Saúde. Conselho Nacional de Secretarias Municipais de Saúde. Fundação Dom Cabral. Especialização em processos educacionais na saúde: ênfase em facilitação de metodologias ativas de ensino-aprendizagem na gestão da clínica no Sistema Único de Saúde. São Paulo: Instituto Sírio-Libanês de Ensino e Pesquisa; 2012. . Health professionals of SUS in ten Brazilian capital cities participated in this pedagogical education initiative, characterized by a social-interactionist approach.

The characterization of the investigated pedagogical qualification was obtained from printed material and electronic media ⁴4. Instituto Sírio-Libanês de Ensino e Pesquisa. Ministério da Saúde. Conselho Nacional de Secretários de Saúde. Conselho Nacional de Secretarias Municipais de Saúde. Fundação Dom Cabral. Especialização em processos educacionais na saúde: ênfase em facilitação de metodologias ativas de ensino-aprendizagem na gestão da clínica no Sistema Único de Saúde. São Paulo: Instituto Sírio-Libanês de Ensino e Pesquisa; 2012. . The educational process that was carried out can be considered an initiative that articulates theory and practice, developed in two movements. The first one was a professional improvement course that lasted 180 hours, in which the health professionals learned about active teaching-learning methodologies. This course was mainly based on simulation activities in which the participants played the role of teachers, under supervision, in controlled and simulated situations ⁵5. Oliveira JM, Lima VV, Padilha RQ, Pereira SMSF, Petta HL, Ribeiro ECO, et al. Processos educacionais na saúde: ênfase em aprendizagem significativa. São Paulo: Instituto de Ensino e Pesquisa; 2016. (Caderno do Curso). . The second movement lasted 480 hours and its purpose was the practice of teaching in postgraduate courses in clinic management ⁴4. Instituto Sírio-Libanês de Ensino e Pesquisa. Ministério da Saúde. Conselho Nacional de Secretários de Saúde. Conselho Nacional de Secretarias Municipais de Saúde. Fundação Dom Cabral. Especialização em processos educacionais na saúde: ênfase em facilitação de metodologias ativas de ensino-aprendizagem na gestão da clínica no Sistema Único de Saúde. São Paulo: Instituto Sírio-Libanês de Ensino e Pesquisa; 2012. .

The teaching practice investigated in this study was developed by the SUS professionals who passed the improvement course. It was supervised by experienced teachers in the development of integrated curricula, who were called “learning managers”. The SUS professionals became teachers in postgraduate courses, and their practice was supervised by learning managers. These teachers, also called learning facilitators, participated in planning activities, in facilitation activities with students of specialization courses in clinic management, and in reflection activities on the teaching practice ⁵5. Oliveira JM, Lima VV, Padilha RQ, Pereira SMSF, Petta HL, Ribeiro ECO, et al. Processos educacionais na saúde: ênfase em aprendizagem significativa. São Paulo: Instituto de Ensino e Pesquisa; 2016. (Caderno do Curso). . These movements occurred in two education waves that can be seen in Figure 1 .

Thus, the teachers’ pedagogical education consisted in these health professionals’ participation in: (i) an improvement course targeted at their qualification in active teaching-learning methodologies; (ii) facilitation activities as teachers of a specialization course in the area of health; and (iii) reflection activities about the experienced teaching practice, mediated by other teachers who are specialists in the educational area. The certification of the teachers’ performance in the activities of facilitation and reflection on their practice conferred on them the title of specialists in educational processes in the area of health.

Both in the improvement course and in the Specialization, the teachers’ pedagogical qualification was guided by a competence profile ⁶6. Hager P, Gonczi A. What is competence? Med Teach. 1996; 18(1):15-8.

7. Lima VV, Ribeiro ECO, Padilha RQ, Gomes R. Processo de construção de perfil de competência de profissionais. São Paulo: Hospital Sírio-Libanês; 2014. (Série Nota Técnica nº 1).^-88. Ribeiro ECO, Lima VV, Padilha RQ. Formação orientada por competência. In: Lima VV, Padilha RQ, organizadores. Reflexões e inovações na educação de profissionais de saúde. Rio de Janeiro: Atheneu; 2018. p. 25-36. that defined the selection of knowledge and practices ⁵5. Oliveira JM, Lima VV, Padilha RQ, Pereira SMSF, Petta HL, Ribeiro ECO, et al. Processos educacionais na saúde: ênfase em aprendizagem significativa. São Paulo: Instituto de Ensino e Pesquisa; 2016. (Caderno do Curso). . The educational technologies that were used combined: (i) an active teaching-learning methodology triggered by real or simulated problems, called Constructivist Spiral ⁹9. Lima VV. Espiral construtivista: uma metodologia ativa de ensino-aprendizagem. Interface (Botucatu). 2017; 21(61):421-34. ; (ii) an interactive learning methodology grounded on interprofessional collaboration and on the application of knowledge ¹1. Bauman Z. O Mal-estar da pós-modernidade. Rio de Janeiro: Zahar; 1998.⁰, called team learning; (iii) artistic educational actions targeted at the articulation of rationalities and emotions ¹1. Bauman Z. O Mal-estar da pós-modernidade. Rio de Janeiro: Zahar; 1998. ¹1. Bauman Z. O Mal-estar da pós-modernidade. Rio de Janeiro: Zahar; 1998. , known as educational journeys; (iv) workshops for the application of educational tools and devices; (v) portfolio meetings to supervise singular learning trajectories; and (vi) formative and summative assessments, based on criteria constructed from the competence profile ⁵5. Oliveira JM, Lima VV, Padilha RQ, Pereira SMSF, Petta HL, Ribeiro ECO, et al. Processos educacionais na saúde: ênfase em aprendizagem significativa. São Paulo: Instituto de Ensino e Pesquisa; 2016. (Caderno do Curso). .

The portfolio, as an educational action developed in face-to-face and distance meetings, represented a critical process of production of materials related to the teaching practice and reflections made on the learning trajectories. These materials, although presenting a broad degree of diversity regarding the process of creation and the nature of the productions, included reflective narratives written by the learning facilitators as products to be shared and analyzed ⁵5. Oliveira JM, Lima VV, Padilha RQ, Pereira SMSF, Petta HL, Ribeiro ECO, et al. Processos educacionais na saúde: ênfase em aprendizagem significativa. São Paulo: Instituto de Ensino e Pesquisa; 2016. (Caderno do Curso). .

We consider that narratives are reflective documents constructed from a certain educational experience to organize and give a singular meaning to reports, studies, theorizations, associations, feelings and values built in the practice of teaching. According to Bruner ¹²12. Bruner JS. La importancia de la educación. Barcelona: Paidós Ibérica; 1987. , narratives reflect the perspective of the individuals who construct them and translate desires, interests and knowledge.

The reflective narratives were included in the facilitators’ course completion essays and were the source of information used in this investigation. Course completion essays are public documents provided by the certifying Institution. Of the twenty facilitators - two from each of the ten participating capital cities -, a convenience sample of half of the essays was defined. The ten selected essays, one from each capital city, were obtained by means of a random draw. To preserve subjects’ identity, the works were coded T (teacher) and numbered from one to ten.

The essays were analyzed through the application of the thematic modality of the content analysis technique ¹³13. Bardin L. Análise de conteúdo. Lisboa: Edições 70; 2009. . The emerging themes were: (i) Teaching practice in active teaching-learning methodologies and (ii) Perspectives for health professionals’ education.

In relation to teaching practice in active teaching-learning methodologies, the following meaning units were found: the social-interactionist perspective; construction of knowledge and practices; emotions in the process of learning how to learn.

In relation to perspectives for health professionals’ education, the meaning units that were found revolved around: (i) theory-practice integration and resignification of the practices.

The learning facilitator’s action in the social-interactionist perspective

This meaning unit revealed the importance teachers give to the role of learning mediator or facilitator in small and/or large groups of students. According to them, this role can focus on the promotion of a balanced participation of the members, on the construction of an inclusive atmosphere, on qualified hearing and respect for differences and for students’ previous knowledge, and on stimuli to the development of critical and reflective thought.

In the constitution of this role, different testimonies emphasize that there is not one single manner to facilitate learning; there are ways that, depending on the context, on the people, on the educational action to be mediated and on the educational intentionality, require the mobilization of different capacities.

According to the teachers, the power of inertia hinders the openness to new types of learning, as teachers’ previous knowledge and the traditional teaching practice, which is already rooted, function as ready responses that prevent reflections and the construction of new meanings.

Hoffmann ¹⁴14. Hoffmann J. Avaliar para promover: as setas do caminho. 15a ed. Porto Alegre: Mediação; 2014. argues that, according to the social-interactionist approach to education, the learning process promotes the construction of identities, values, knowledge, practices and cultures that characterize the societies in which we live, through the interaction between teacher and student and between them and the world. The trajectories constructed in these interactions sometimes go their separate ways and, “other times, come cross each other, but move on in the same direction” ¹⁴14. Hoffmann J. Avaliar para promover: as setas do caminho. 15a ed. Porto Alegre: Mediação; 2014. (p. 46).

The interaction between subjects who learn and objects to be known is mediated by the teacher in the role of facilitator, as they guide their educational action based on students’ learning needs and questions, instead of directing it based on their (the teachers’) knowledge and questions. Openness to dialog and problematization based on students’ previous knowledge were mentioned as differential elements in relation to traditional teaching, which focuses on the transmission of information. Dialog was considered a resource that enables a continuous exchange and construction of meanings by means of language. Freire ¹⁵15. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 53a ed. São Paulo: Paz e Terra; 2014. highlights that “teaching demands availability for dialog”, which is the space where the subjects open themselves to the world and to others, inaugurating “with their gesture the dialogic relationship in which they confirm themselves as uneasiness and curiosity” ¹⁵15. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 53a ed. São Paulo: Paz e Terra; 2014. (p. 113).

According to Freire ¹⁵15. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 53a ed. São Paulo: Paz e Terra; 2014. , it is in language, in communication, in the interaction with the other that the simultaneous movement of teaching and learning takes place, as “socially and historically, women and men discovered that it was the process of learning that made (and makes) teaching possible” ¹⁵15. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 53a ed. São Paulo: Paz e Terra; 2014. (p. 26).

One of the testimonies reveals different examples of the shift that is necessary to the practice of facilitation oriented to students’ learning needs:

The teacher’s role in the construction of knowledge and practices

It seems that the competence profile guided the teachers’ qualification process and contributed to the construction of knowledge and practices by the students of the clinic management course in which the facilitators developed their teaching practice. The concept of competence used here refers to the meta-capacity for mobilizing resources in different contexts to successfully solve problems of the professional practice ⁶6. Hager P, Gonczi A. What is competence? Med Teach. 1996; 18(1):15-8.^,1616. Lima VV. Competência: distintas abordagens e implicações na formação de profissionais de saúde. Interface (Botucatu). 2005; 9(17):369-79. .

Although the competence profile that guided the facilitators’ qualification reinforced that they must act in a problematizing way towards students, some testimonies highlighted the facilitator’s interaction with contexts and contents explored in the clinic management course.

Although mastering specific contents of clinic management was not required of the teachers due to the presence of specialists that fulfilled this function and to the competence profile expected of the facilitator, the interactions between students and facilitators and the supervision of the educational activities enabled the facilitators to be in contact with the specific themes/contents of clinic management. This contact was reflected in the narratives that composed the course completion essays, revealing an area of competence that had not been included in the facilitator’s profile but maintained, to some extent, a relationship to the working routine of these facilitators.

In this sense, it is clear that the action of teaching is directly related to the action of learning and that, in the interaction process between students and teachers, knowledge and practices are reconstructed and amplified. Thus, the construction of new meanings occurs in action, by means of interactions powered by dialog and problematization ¹⁷17. Anastasiou LGC. Ensinar, aprender, apreender e processos de ensinagem. In: Anastasiou LGC, Alves LP, organizadoras. Processos de ensinagem na universidade: pressupostos para as estratégias de trabalho em aula. 10a ed. Joinville: Univille; 2015. p. 15-43. . The interactions resulted in the development of knowledge and practices that went beyond the competence areas established in the Competence Profile of the Learning Facilitator. Therefore, the teachers could have experiences and construct practices in the educational area as facilitators, at the same time in which they participated in the problematization of knowledge about clinic management, due to the scope and focus of the educational activities they facilitated.

The fluidity of emotions during the learning process

The meaning unit related to the development of emotions had a relevant presence in the investigated course completion essays. Among different capacities reported by the facilitators, the highlight were the relationships established between students and teachers. These relationships were revealed by means of emotions, which were highly valued by the teachers.

Different testimonies attributed to the constructivist spiral methodology ⁹9. Lima VV. Espiral construtivista: uma metodologia ativa de ensino-aprendizagem. Interface (Botucatu). 2017; 21(61):421-34. and to the educational journeys ¹¹1. Bauman Z. O Mal-estar da pós-modernidade. Rio de Janeiro: Zahar; 1998. the exploration articulated between reason and emotion. This articulation, according to the teachers, enabled the amplification of critical conscience and the development of greater intellectual independence and autonomy to learn.

According to Maturana ¹⁸18. Maturana H. Emoções e linguagem na educação e na política. Fortes JFC, Tradutor. Belo Horizonte: UFMG; 1998. , rationality is the expression by means of which we justify or deny desires, intentions and preferences. This dimension is intrinsic to the process that produces knowledge and culture. According to this author, we live in a culture that undervalues emotions and overvalues reason, in a desire to say that we, humans, are distinct from the other animals because we are rational beings. Even though we are rational, emotions are body dynamics that specify our form of acting in the world, and verbal or non-verbal communication is an important resource that expresses emotions and feelings. It is through language and conversations that human beings, despite their differences, can build consensuses that transform reality.

We, as human beings, are complex units formed simultaneously by the biological, psychical and social dimensions. Considering these dimensions in the teaching-learning process enables the emergence of a complex thought that joins the parts, instead of separating them ¹⁹19. Morin E. Educação e complexidade: os sete saberes e outros ensaios. 6a ed. São Paulo: Cortez; 2013. . Authors like Mourthé et al. ¹¹11. Mourthé JCA, Lima VV, Padilha RQ. Integrando emoções e racionalidades para o desenvolvimento de competência nas metodologias ativas de aprendizagem. Interface (Botucatu). 2018; 22(65):577-88. suggest strategies to power the integration of reason and emotion into educational actions. These authors explore the simultaneous development of capacities for using the scientific method and for identifying and understanding the emotions that underlie our choices and preferences, even when we are making science. Recognizing the values, emotions and preferences that are the foundations of our rationalities help us to access and understand previously established cognitive schemes, allowing to problematize and re-signify them.

As health professionals experience situations in their working routine that involve patients’ physical and emotional suffering, the teaching of strategies that enable to welcome and explore emotions was highly valued in the facilitators’ testimonies. This finding shows the importance of spaces where professionals can reflect on the emotions involved in situations and in the assistance.

The educational actions developed in the facilitators’ qualification offered this type of activity as a constitutive part of the qualification process. In these activities, each professional was stimulated to express their emotions and rationalities in a given situation. Thus, the exploration of one’s own emotions and the respect for the other participants’ expression of emotions and feelings in the qualification groups tend to favor the circulation and fluidity of emotions. This activity is considered as important to the teacher’s development as mastering new educational technologies.

Integrating theory and practice

Different narratives analyzed here stated that health and education are integrated fields in care and professional education practices. In this sense, fragmentation in disciplines, separation between theory and practice, and lack of articulation between the worlds of work and education represent curricular organization models that must be overcome.

We believe that education is historically and socially constituted and that the learning process is intersubjective and social; therefore, the utilization of integrated curricula and active methodologies values interdisciplinarity, the contextualization of knowledge, previous knowledge, students’ learning needs, and the capacity for learning throughout life ²⁰20. Lima VV, Padilha RQ, organizadores. Reflexões e inovações na educação de profissionais de saúde. Rio de Janeiro: Atheneu; 2018. p. 15-23. . These ideas were found in the majority of the narratives analyzed here. Some of them attempted to build bridges between the health professionals’ education and their action in real work settings.

Active methodologies take into account students’ and teachers’ preexistent knowledge to subsidize the construction of new knowledge. Thus, learning becomes meaningful. In this sense, understanding phenomena instead of memorizing contents arbitrarily was emphasized, in a movement where new elements were associated with what the subjects already know. As a result, learning re-signifies beliefs and focuses on scientific evidences and best practices.

Some narratives disclosed the importance of identifying learning gaps by formulating learning questions and searching for new information in the scientific literature, in light of practice situations considered relevant in the professional action.

Curiosity and the desire to discover function as forces that drive learning, so that subjects get involved and become responsible for searching for information and sharing new knowledge ¹⁵15. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 53a ed. São Paulo: Paz e Terra; 2014. .

Many narratives approach the Constructivist Spiral ⁹9. Lima VV. Espiral construtivista: uma metodologia ativa de ensino-aprendizagem. Interface (Botucatu). 2017; 21(61):421-34. as an active teaching-learning methodology that produces individual and collective reflection movements, with recognition of preexistent cognitive structures, deconstruction and reconstruction of knowledge, unbalance of the mind, and stimulus to search for new knowledge, with development of autonomy and protagonism for the transformation of society.

Teaching and learning in a context of articulation between theory and practice was considered, by the teachers, an extremely powerful strategy. This combination, according to the facilitators, brought new perspectives to the teacher-health professional, requiring specific pedagogical skills to mediate the interaction among students and support the discussions each individual brought from their practical context. Thus, teaching was considered an interpersonal, intentional movement, grounded on communication and stimulated by a teacher who triggers knowledge or know-how ²¹21. Altet M. As pedagogias da aprendizagem. Lisboa: Instituto Piaget; 1999. .

The transformative power of the re-signification of practices

A set of testimonies was grouped around a meaning unit related to the transformative power of the educational initiative analyzed here.

Different narratives attributed the power of dissipating insecurities and producing displacements to the constant reflections and exchanges between facilitators and learning managers. This highlights the interactions produced in the teachers’ permanent education processes, characterized by reflection on the teaching practice. The reflections were invariably accompanied by changes in practices.

Dealing with uncertainty and unpredictability started to be considered a capacity that teachers who use active teaching-learning methodologies should develop. According to Morin ²²22. .Morin E. Os sete saberes necessários à educação do futuro. 2a ed. São Paulo: Cortez; 2000. , “it is necessary to navigate an ocean of uncertainties in the midst of an archipelago of certainties” ²²22. .Morin E. Os sete saberes necessários à educação do futuro. 2a ed. São Paulo: Cortez; 2000. (p. 86). Recognizing that the educational process is unfinished allows the facilitator to construct their competence profile simultaneously with the students’ construction of competence, in spite of the specificities of each educational background. Furthermore, it allows that the subjects involved in these qualifications internalize new knowledge and practices to such a degree that they become part of their daily lives, independently of their previous education.

Final remarks

Rethinking teacher education based on reflective narratives deriving from the facilitation of groups of specialization students showed that, in a social-interactionist education, there is the possibility that teachers and students consider one another a legitimate subject in the construction of knowledge and practices. This process tends to increase tolerance for diversity, include different perspectives, and favor the production of changes and the transformation of reality.

In addition to this more general aspect, it was possible to perceive that, in some dimension, the facilitators that participate in learning processes with integrated curricula and use active methodologies end up incorporating certain concepts even when the explored contents are not part of their previous repertoire nor of the competence profile of facilitators.

The analyzed testimonies indicated the power of an initiative that, by means of qualification waves, represented a concrete expression of theory-practice integration. The teaching practice was the axis of the teachers’ qualification. Thus, the articulation between the facilitation practice in a specialization course in clinic management and the reflection on this practice by means of a specialization course in educational processes in the area of health points to the multiplying capacity of this kind of qualification in the format of waves, as well as its potential for constructing new meanings.

A qualification that promotes reflection on practice, characterized as a permanent education process for teachers, ends up being extended beyond an educational initiative, becoming part of the working routine in the area of health. These spaces can activate the critical and reflective capacities of groups of teachers-health professionals, representing an investment in the subjects, in their relationships, and in the qualification of the services or institutions in which they work.

Only permanent education processes will be able to face some of the challenges found in this investigation, which reflect limitations both of education and of the organization of health work, like: (i) undergraduate courses that do not explore the competence area of health education as inherent in the professional profile: (ii) low utilization of teaching methodologies that stimulate reflection on practice and development of critical thought; (iii) fragmented care practices produced by disarticulated teams with little space for dialog; (iv) healthcare centered on and organized around assistance to disease.

In the educational initiatives studied here, these challenges were faced by means of a qualification process oriented towards students’ learning needs, considering these professionals’ context of health work. The teaching practice grounded on social-interactionist theories and on active teaching-learning methodologies promoted a teaching-learning process grounded on the teacher’s mediation between the subjects who learn and the objects or contents to be known. This practice, according to Freire ¹⁵15. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 53a ed. São Paulo: Paz e Terra; 2014. , transforms students and teachers, as “[...] the person in charge of education is being formed or re-formed as he/she teaches, and the person who is being taught forms him/herself in the process and [equally] teaches while he/she is formed” ¹⁵15. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 53a ed. São Paulo: Paz e Terra; 2014. (p. 25).

References

Publication Dates

History