Starting from an analysis of risk and partnership meaning and of the relationship existing between them in health education, the paper aims at presenting an educational proposal useful for European health professionals about the topic of the partnership with patients.

The risk, always present in man history, becomes different from the past because it cannot be calculated (Beck, 2001), that is for its unpredictability as regards the forms it can take and for the measure (global and generational) of the produced consequences, liable to a constant oscillation between minimization and exasperation. This form of risk imposes itself both on society and education, especially in the health field which is characterized by the four risk’s emergencies in organizations: Volatility, Uncertainty, Complexity and Ambiguity (Otter, 2019).

These dimensions permeate care work, where the partnership professional-patient holds a central role (Kanzivan, 2015). The same educational relationship with the patient is frequently defined as “partnership”: a relation where professional and patient “have to feel mutually involved in respecting values which each takes in the relation, both have to share responsibility, risks, power” (Cipolla, Artily, 2003, p. 132). This definition explains that the educational partnership in the care work is not a riskless ‘comfort zone’. However it would be restrictive and misleading to state that the risk is present in the partnership as a possibility (the risk in the partnership). The educational partnership is necessarily involved in the risk dimension and cannot be set aside in any case and time (partnership as risk). In favor of partnership-as-risk, we can find two connecting basis: the educational nature of the partnership and the society of the risk into which it works. Firstly, therefore, if the partnership is educational it sees in the risk an “insuperable” condition (Ricoeur, 2014). The risk to educate appears even more clearly in the health relation, even in terms of the patient survival. Secondly if the health partnership works in the society of the risk (and in organizations strongly marked by risk) presupposes a recurrent decision among uncertain, complex, ambiguous and unstable alternatives without being certain of the consequences. These alternatives are represented by polarity which coexist (Jaspers, 1983) in the health educational partnership: the operator power requests & the patient push to autonomy, the necessity to trust & the need of scientific evidence, the recurrence to rationality & the surfacing instinct, the search for order & the bursting chaos, the recall to act & the sense of guilt, the illness inevitability & the fight for health, the relational satisfaction & the frustration perception, the closeness building & the separation push, the sense of restlessness & the quietness need, the tension toward awareness & the unconsciousness shelter, the individual responsibility & the group choice. These polarities are not simple opposites marked by a clear difference which makes the decision predictable. These polarities are aspects that coexist in the educational partnership, you do not recognize their differences at once, they ask for a choice which is not predictable. It would not be correct to define these aspects as opposites, but as paradoxes, either because they diverge from what in public opinion is predictable and because they contain polarity which coexist and determine situations of uncertainty and of difficult decidability (Ricoeur, 2014). The competence of recognizing paradoxes and of managing them is a transversal competence (relational and communicative) of health professionals across all Europe (Foldspang, Birt, Orok, 2018; Sànchez-Pozo, 2017).

Within this theoretical frame, the study aims at answering the following research question: which educational proposal is able to train the future health professional to the comprehension and decision regarding paradoxes of the partnership-as-risk?

The formative proposal is set in research field on adult learning, centered on the complexity and the reflexive oriented interaction. This adult learning promotes adult transformation (Mezirow, 2016) through biographical and narrative learning types (connected to life histories and life – based methods) (West, Formenti, 2018; West, Alheit, Anderson, Merril, 2007). The produced study is the result of an analysis on an educational experience led in the school years 2016-17, 2017-18, 2018-19 with the Second Year students of the Degree Course in Psychiatric Rehabilitation at Turin University. The educational proposal, carried out on the basis of previous studies on sense and method of professional identity education (Nosari, Guarcello, 2019) is centered on the use of texts which develop through a dialogue (among professionals and patients) aimed at performing the partnership-as-risk in health practice. The texts are short stories written according to a “philosophical” writing method (Striano, Cosentino, Oliverio, 2011) and inspired to a professional real life. The elements of narrative contextualization (places, situations, characters, …) are described in a basically vague way since the test doesn’t mainly aim at narrating the facts in their sequence, but it has the object of bringing the readers to build a reflexive path on a general and broad situation, in which everyone can find a personal position. The text dialogues don’t provide final answers in order to avoid specific stances and to allow the group a relaunching of the reflection. The use of these texts within educational paths follows a specific method, which plans the individual reading of the situation, the comparison in a small group (a title attribution to the text, paradoxes and risks identification, professional hypothesis decisions) and the plenary discussion. This work phase on texts (written by educators) is followed by the elaboration of original stories created by the students in small groups. In the texts the students perform the partnership-as-risk based on their personal and training experience. After the devising the texts are presented to the mates following the methodological path previously displayed. In order to deepen the relapses of this educational practice on the professional identity change, paying peculiar attention to the capacity of the partnership promotion, a pre-post educational interventionist survey has been carried out, analyzed through an a posteriori text codification, following a logic-chronological scheme: the text unity - codification in vivo /labels - categories - axial and selective codification. (Atkinson, 2002; Strauss, Glaser, 2009; Alheit, Bergamini, 1996).

On the basis of the data analysis the following findings have come out: - the professional identity shift from a logic of the treatment as deterministic estimation and the patient adaptation to a logic of the treatment as co-building; - overcoming of a linear and simplistic vision of the partnership, identification of its paradoxes and decision ability in complex situations; - a higher professional feeling of security and competence perception in the paradoxes management, the professionals had already sensed but they could not recognize clearly; - a higher wellbeing of the patient. The educational path was suspended for a period in which the students were doing their training. Then, the students established that, thanks to their higher awareness and self-control, they were able to avoid relational behaviors which might have negatively weighed on the therapeutic path of the patient (Bourdieu, Passerine, 1964); The main problematic aspects of the educational proposal have to be taken again to the necessary times of realization, to the possession from the students of a margin of experience in the field and to their willingness to comparison and meditation. The educational proposal as a whole proves to be a meaningful and valid way to promote the professional identity definition, with particular concern to partnership-as-risk. The partnership is considered transversal competence so the educational path can represent a successful proposal for every health professional with reference to his/her experience with colleagues and patients. For the same reasons, the educational proposal has to be thought, with the due patterns, as an opportunity of interest at European level both for health professionals and other figures for whom the partnership and the risk are central dimensions of the professional practice (for example, for political and diplomatic roles).

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