Factores psicosociales asociados al clima de seguridad del paciente en estudiantes de enfermería, predictores del estrés en las prácticas clínicas y evaluación integrada de adquisición de competencias

175 p.La presente tesis es la compilación de tres artículos presentados en tres estudios. La tesis doctoral comienza con la validación del instrumento HSOPS-NS para estudiantes de enfermería (estudio 1) de la Universidad del País Vasco, en el que se busca la medición del clima de seguridad del paciente desde un enfoque mayormente organizativo-institucional (Osakidetza, Servicio Publico Vasco de Salud), trascendiendo el modelo tradicional de medida de la cultura de seguridad. Igualmente, quisimos atender otras cuestiones psicosociales (estudio 2) que pudieran afectar directamente al estudiante de Enfermería (nivel individual). Entre ellas, el estrés en las prácticas clínicas, el estrés académico, la autoeficacia general y la percepción de la eficacia del liderazgo de los responsables hospitalarios. Para ello se planteómediante un análisis S.E.M. la verificación de un modelo predictor del Estrés en las prácticas clínicas en el que no se evidenciaron niveles altos de estrés. Finalmente se introdujeron las variables autoeficacia específica, competencia percibida y resiliencia en una nueva investigación (estudio 3), con la finalidad de poder analizar el ajuste del estudiante de Enfermería al nivel académico que cursaba, obteniendo de esta forma, un modelo de evaluación integrada de la adquisición de competencias mediante la técnica estadística del análisis discriminante. En líneas generales, los resultados evidencian una buena percepción del clima de seguridad del paciente, niveles bajos-medios en la variable estrés en las prácticas clínicas, y la participación de la resiliencia, de la percepción de competencias y la autoeficacia especifica en el rol de Enfermería como variables que permiten clasificar al 76% de los-as alumnos de Enfermería en el curso que realmente cursan, evidenciando un óptimo ajuste académico

Factores psicosociales asociados al clima de seguridad del paciente en estudiantes de enfermería, predictores del estrés en las prácticas clínicas y evaluación integrada de adquisición de competencias

175 p.La presente tesis es la compilación de tres artículos presentados en tres estudios. La tesis doctoral comienza con la validación del instrumento HSOPS-NS para estudiantes de enfermería (estudio 1) de la Universidad del País Vasco, en el que se busca la medición del clima de seguridad del paciente desde un enfoque mayormente organizativo-institucional (Osakidetza, Servicio Publico Vasco de Salud), trascendiendo el modelo tradicional de medida de la cultura de seguridad. Igualmente, quisimos atender otras cuestiones psicosociales (estudio 2) que pudieran afectar directamente al estudiante de Enfermería (nivel individual). Entre ellas, el estrés en las prácticas clínicas, el estrés académico, la autoeficacia general y la percepción de la eficacia del liderazgo de los responsables hospitalarios. Para ello se planteómediante un análisis S.E.M. la verificación de un modelo predictor del Estrés en las prácticas clínicas en el que no se evidenciaron niveles altos de estrés. Finalmente se introdujeron las variables autoeficacia específica, competencia percibida y resiliencia en una nueva investigación (estudio 3), con la finalidad de poder analizar el ajuste del estudiante de Enfermería al nivel académico que cursaba, obteniendo de esta forma, un modelo de evaluación integrada de la adquisición de competencias mediante la técnica estadística del análisis discriminante. En líneas generales, los resultados evidencian una buena percepción del clima de seguridad del paciente, niveles bajos-medios en la variable estrés en las prácticas clínicas, y la participación de la resiliencia, de la percepción de competencias y la autoeficacia especifica en el rol de Enfermería como variables que permiten clasificar al 76% de los-as alumnos de Enfermería en el curso que realmente cursan, evidenciando un óptimo ajuste académico

Development, Application and Evaluation of an Active Learning Methodology for Health Science Students, Oriented towards Equity and Cultural Diversity in the Treatment and Care of Geriatric Patients

The increased aging of populations and rises in immigration have prompted the design of new methodologies and instruments for fostering the invisible care of geriatric patients among health science students in accordance with the 2030 Agenda and the SDGs. A total of 656 psychology, nursing and dentistry students participated in this study, which had a pretest–posttest design and was implemented over the course of three academic years. The intervention groups received training using an active learning methodology based on a case study involving a geriatric patient; specifically, a Maghrebi woman. The control groups were not exposed to the case study. The CCI-U questionnaire was designed ad hoc to evaluate the acquisition of invisible competences for caring for geriatric patients in accordance with their age, sex, emotional situation and ethnic origin. The questionnaire had a reliability of α = 0.63 to 0.72 and its factor solution was found to have a good fit. Students in the intervention groups scored higher than those in the control groups, with the difference being statistically significant for ethnic origin in all three undergraduate courses and all three academic years. The proper application of this active learning methodology fosters the invisible care of geriatric patients among students in accordance with the 2030 Agenda.This research project was funded by the University of the Basque Country, Office of the Pro Vice-Chancellor for Educational Innovation, grant number IKDI3-21-04, and the APC was funded by the University of the Basque Country

Patient safety and its relationship with specific self-efficacy, competence, and resilience among nursing students: A quantitative study

Background: Patient safety is a relevant subject in the nursing curriculum. Each university programs patient safety teaching and practical training differently. However, few studies have sought to explore the relationship between patient safety as perceived by nursing students and other important psychosocial competencies in the nursing curriculum, such as self-efficacy, competence, and resilience. Objectives: To analyze differential patient safety integration into three nursing education programs, and to assess agreement levels regarding patient safety climate, students' knowledge of patient safety and correlations with specific self-efficacy, competence and resilience. Methods: Participants were 647 undergraduate students from three universities. Patient safety climate and knowledge of patient safety (good praxis) were measured using the Hospital Survey on Patient Safety Culture for nursing students, and other psychosocial variables were also analyzed using other instruments: specific self-efficacy, perceived competence and resilience. Nursing education programs and patient safety climate were analyzed using the Rwg(j) and ICC measures of inter-rater agreement across different academic levels. Results: The ICC and Rwg indexes revealed high inter-rate agreement in all three universities. Differences were observed between Univ-2 and Univ-3 in patient safety climate scores and agreement values between academic levels. Differences in good praxis were found when academic levels were compared in Univ1-and Univ-2. Patient safety climate was found to correlate significantly with the psychosocial variables studied, but only in Univ-1. Conclusions: Perceived patient safety climate differs between universities and academic levels. This competency is related to self-efficacy, competence and resilience, which endorses the assessment of patient safety integration from a broader perspective

Association among University Students’ Motivation, Resilience, Perceived Competence, and Classroom Climate from the Perspective of Self-Determination Theory

Self-determination theory (SDT) suggests that motivation can interact with resilience and perceived competence. The climate-related characteristics of the classroom can influence student motivation. This study aimed to evaluate the associations between the differentiated motivation of theoretical and practical teaching, resilience, and perceived competence, considering the number of students per class and the profiles of the lecturers. A total of 789 students participated (mean age = 19.31; SD = 3.37) from Psychology, Nursing, and Education degrees from different Spanish universities. The BRS (resilience), PCNS (perceived competence), and PLOC-U (university student motivation) questionnaires were used with a new scale designed ad hoc to measure motivation in practical teaching. Student-to-class ratios and different levels of teaching experience were also recorded. A test–retest design was used to verify the stability of the measures before and after the examination of the subjects. Intrinsic motivation in practical teaching was significantly associated with resilience (r = 0.09, p < 0.03) and perceived competence (r = 0.23, p < 0.01), and in theoretical teaching, it was associated only with perceived competence (r = 20, p < 0.01). The factorial analysis of the new subscale of the PLOC-U for the measurement of motivation in practical teaching presented a good fit and reliability (α = 0.60 to 0.84) in the five factors. Test–retest analyses revealed good temporal stability. Students in small groups with more experienced lecturers scored higher on intrinsic motivation, particularly in practical classes. The stable and reliable measurement of the different types of student motivation allows their analysis and association with other variables of interest in university education, which could lead to significant improvements in teaching planning.The APC was partially funded by the University of the Basque Country and by the Biodonostia Health Research Institute

Factors contributing to stress in clinical practices: A proposed structural equation model

Correction added on 18 November 2019, after first online publication: The first name of Andrea Izagirre Otaegi was previously incorrect and has been updated in this version.Aim To propose a predictive model of procedural and emotional stress in clinical placements while testing self-efficacy as a possible mediator factor. Design The study used an exploratory correlational design. Method A total of 334 nursing students completed the KEZKAK-stress in clinical practice, AG-general self-efficacy and CEA-academic overload questionnaires, along with one about leadership. Sociodemographic information was also included. Results Confirmatory factor analyses and internal consistency reliabilities were satisfactory in all questionnaires. Procedural stress and emotional stress were confirmed by KEZKAK [chi(2) (674) = 1,555.58, p = .001; chi(2)/df = 2.308, CFI = .90, IFI = 91, RMSEA = .06]. The structural equation method for procedural stress and emotional stress had an acceptable fit. They revealed that academic level influenced the perception of leadership and academic overload in both procedural stress and emotional stress. General self-efficacy only mediated emotional stress. Hospital unit acted independently as a predictor of procedural stress

Adapting and validating the Hospital Survey on Patient Safety Culture (HSOPS) for nursing students (HSOPS-NS): a new measure of Patient Safety Climate

Background: Patient Safety Culture and Patient Safety Climate (PSC) are different factors. PSC is the shared perception that is held within a hospital’s area or unit at aspecific moment in time. This measure is necessary for designing activities for promoting and improving safety. It must include the perception of all the agents involved, including future nurses throughout their patient safety education. Objectives: The aim was to adapt and validate a new version of the Hospital Survey on Patient Safety Culture (HSOPS), targeted specifically at nursing students. It provides a new comprehensive and more complete measure of PSC that contributes to improving patient safety. Methods: Data were obtained from 654 undergraduate and postgraduate nursing students. PSC was tested using factor analyses and structural equation modeling. In order to facilitate the improvement of PSC, we examined differences in climate strength across different academic groups using the Rwg(j) and ICC measures of interrater agreement. Results: Factor Analyses confirmed a five-factor solution that explained between 52.45% and 54.75% of the variance. The model was found to have adequate fit χ2 (5)=14.333, p=0.014; CFI=0.99; RMSEA=0.05. Cronbach’s alphas for PSC were between0.74 and 0.77. “Teamwork within units” was the highest rated dimension, and “Staffing” the lowest rated. Medium-to-high scores were obtained for PSC. The median of Rwg (j) was high in the five dimensions of the PSC survey, supporting the idea of shared climate perceptions (0.81-0.96) among undergraduate and postgraduate nursing students. Conclusions: HSOPS-NS is a useful and versatile tool for measuring the level and strength of PSC. It screens knowledge regarding patient safety in clinical practice placements and compares nursing students’ perceptions of the strength of PSC. Weaknesses perceived in relation to PSC help implement changes in patient safety learning