Les proves d'Avaluació Clínica Objectiva i Estructurada (ACOE) en els estudis universitaris d'infermeria

INTRODUCCIÓ: Les proves d’Avaluació Clínica Objectiva i Estructurada (ACOE) estant reconegudes com un format eficaç d’avaluació en l’àmbit de la salut i han estat implementades per un important sector d’institucions educatives com les Escoles/Facultats d’Infermeria. Durant els anys 2001-2011 es va portar terme a Catalunya un projecte conjunt entre l’Institut d’Estudis de la Salut (IES) i les Escoles/Facultats d’Infermeria catalanes per a la implementació de les citades proves. L’ACOE es considera un escenari on l’estudiant pot demostrar de forma vàlida i fiable la competència adquirida en el seu període de formació en un entorn molt similar al real. Funciona com un instrument avaluatiu que mesura la competència de forma controlada i objectiva. OBJECTIU GENERAL: Analitzar les proves ACOE com a instrument formatiu i/o avaluatiu en els estudis d’infermeria de pregrau. OBJECTIUS ESPECÍFICS: Valorar, a partir de la concurrència de professorat i alumnes, una proposta formativa-avaluativa en els estudis d’infermeria de pregrau: l’ACOE. Identificar, des de la visió dels implicats (estudiants i professorat), el valor i el que aporten les proves ACOE com a entorn facilitador de l’aprenentatge en els estudis universitaris d’infermeria. Comparar els valors identificats respecte a la prova ACOE amb els descrits a la literatura científica. Elaborar conceptes teòrics inductius a partir dels textos generats pels participants, delimitant algunes orientacions educatives. Fer una proposta per implementar les proves ACOE en els estudis de grau. METODOLOGIA: Tenint en compte els objectius de la present tesi, s’ha optat per una metodologia d’investigació qualitativa i el mètode de la Teoria fonamentada. Per analitzar la visió del implicats en les proves ACOE es va recollir informació tant de l’alumnat participant com del professorat organitzador. Les tècniques utilitzades per recollir les dades van ser diverses. En total, es van entrevistar 15 informants (incloent les entrevistes individuals als docents i els alumnes participants del grup focal) i es van administrar qüestionaris de preguntes obertes a 70 alumnes. Per realitzar l’anàlisi de les dades s’ha utilitzat el mètode de les comparacions constants per buscar el significat de les dades categorizant–les. S’ha emprat el suport informàtic del programa Atlas.ti versió 5.0. RESULTATS: Respecte a l’organització i contingut de la prova, els informants valoren les simulacions de les situacions clíniques que s’utilitzen a la prova com creïbles, rellevants i representatives. D’altra banda, destaquen la importància de que la informació abans de realitzar la prova sigui exhaustiva i acurada, aspecte que es relaciona directament amb el nerviosisme que els hi ha generat als alumnes la seva participació en la prova. El valor i les aportacions de la prova ACOE per l’alumnat són: l’autoavaluació, l’autoconeixement, rebre feedback, la possibilitat d’aprendre, ser un repte per posar-se a prova, refermar la confiança, experimentar en situacions noves o representar un assaig de la vida real. En general, la consideren una experiència recomanable. El professorat destaca la seva capacitat per integrar i avaluar competències, l’objectivitat en l’avaluació i la possibilitat d’avaluar la metodologia docent utilitzada. Els professorat unànimement i una part considerable de l’alumnat es mostra favorable a implementar la prova amb una finalitat formativa-avaluativa integrada com una avaluació continua dins dels estudis universitaris d’infermeria de pregrau. CONCLUSIONS: Per tal de millorar l’aprenentatge i l’avaluació de les competències clíniques dels estudis d’infermeria, incloure una prova ACOE com a part d’estratègia d’avaluació continua amb un enfocament multimètode. S’ha de potenciar l’autoavaluació dels alumnes com a element fonamental de la capacitat autònoma d’aprenentatge i millorar el feedback que reben fent-lo més qualitatiu. Per potenciar la viabilitat de la prova ACOE, cal millorar el seu cost-efectivitat implementant una prova d’unes dues hores de durada i buscant totes les estratègies de col•laboració a l’abast.INTRODUCTION: The Objective Structured Clinical Evaluation (OSCE) has been recognized as an effective evaluation tool in the health field and has been implemented by a large sector of educational institutions, like Schools/Faculties of Nursing. During the years 2001 to 2011, a project between the Institute of Health Studies and the Schools/Faculties of Catalan Nursing took place in Catalonia for the implementation of the OSCE, where the students’ performance was evaluated by a direct observation while they had a clinical encounter with a simulated patient. AIM: To analyze OSCE as a training and/or assessment tool in undergraduate nursing education. SECONDARY OBJECTIVES: (1) Identify, from the view of people involved in the evaluation (students and teachers), the value of the evidence OSCE as a facilitator of the learning environment in a Nursing School. (2) Compare the values identified with the OSCE results described in the scientific literature. (3) Develop inductive theoretical concepts from the texts generated by the participants, outlining some educational guidance. (4) Make an approach to implement the OSCE tests in undergraduate nursing. METHODOLOGY: A qualitative research and Grounded Theory Methodology was applied. The information was collected from the students and the faculty involved. Fifteen informants were interviewed (including interviews with teachers and students participating in the focus group) and questionnaires with open-ended questions were administered to seventy students. A constant comparison method was used to perform the data analysis in order to find the meaning of the data, and a computerized program (Atlas.ti) was used to analyze it. RESULTS: With regard to the organization and content of the test, the informants valuated the clinical situations used as credible, relevant and representative. The value and contribution of the OSCE test for the students was: Self-assessment, self-awareness, feedback, the learning and challenge involved. It strengthened confidence and represented a real clinical encounter. In general the OSCE test was considered a recommended experience. The faculty highlighted its ability to integrate and evaluate competence objectively in the evaluation and the ability to assess the teaching methods used. The faculty, as well as an important part of the students, unanimously agreed to develop the OSCE with an educational/assessment purpose within undergraduate nursing Schools/Faculties. CONCLUSIONS: Including an OSCE test with a multi-method approach as part of the evaluation strategy improves the learning and assessment of nursing studies clinical skills. It promotes student self-assessment as a fundamental element of self-learning and improves feedback, making it more qualitative. To enhance the viability of the OSCE test, however, its cost-effectiveness must improve

Assessment of an evaluative tool for nursing college students: the tests for Objective Structured Clinical Examination (OSCE)

Background: the OSCE test is a tool used to assess the competence of Health Sciences' students in a planned and structured way. It assesses their clinical skills based on simulations, specially designed according to the test objectives. More than 1,800 nursing students took an OSCE test which was implemented in 13 schools of nursing from to 2001 to 2011 in Catalunya. Objective: to assess the efficiency of an OSCE test from the students' and lecturer's point of view. The test has been done over ten years as part of the university nursing training. Materials and methods: a qualitative research method of the Grounded Theory was used. The tools chosen to collect information were a questionnaire with open questions, a focus group with students, and personal interviews with faculty. The method of constant comparisons and the software Atlas-ti were used to analyze the data. Results: professors and students almost unanimously agree about the credibility of the staging and the contents of the situations posed in the test. It is positive that the simulations are carried out in a healthcare environment. However, some students manifest that it bothers them and they feel uncomfortable to act in front of professors who evaluate them. Students and professors agree on rating the content of the OSCE as appropriate in relation to the nurses' role and representative of different areas of nursing practice. In general, the students believe that the difficulty of the test is reasonable. Coinciding with results from other studies [2], students considered that the OSCE test is stressful but a worthwhile experience. Conclusions: the OSCE test has been evaluated as an effective tool to assess skills in nursing students. Previous test information must be improved to decrease the stress generated by the students

Health and disease in the movie: una asignatura de cine

Podeu consultar la Vuitena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/66524Se presenta una experiencia docente que conjuga la enseñanza-aprendizaje de contenidos de metodología, ética y clínica de diferentes problemas de salud a través de la asignatura optativa: Health and disease in the movies EUI-UB. El objetivo principal de la asignatura es que los estudiantes sean capaces de: Identificar y comprender las etapas de la investigación, con énfasis en el manejo de bases de datos bibliográficos sobre salud (CINAHL, CUIDEN y MEDLINE) y cine (IMDB), el uso de cuestionarios y la comunicación científica oral. La metodología docente que se aplica en el aula consiste en exposiciones teóricas acompañadas de la visualización de secuencias cinematográficas y actividades autónomas de autoaprendizaje. En grupos de tres, los alumnos seleccionan una película donde un problema de salud tiene carácter argumental, realizan una búsqueda bibliográfica relacionada con dicho problema de salud y responden a un cuestionario prediseñado (variables: clínica, diagnóstico, tratamiento y evolución de la enfermedad; características sociodemográficas del paciente; análisis de la intervención de profesional/es sanitarios y cuidadores; aspectos éticos, valores y creencias). Finalmente, los alumnos realizan una presentación oral en inglés, donde exponen el desarrollo argumental de la película seleccionada, aspectos relacionados con la enfermedad y con el paciente principal. Destacamos los siguientes resultados correspondientes a la edición 2013-14: Se matricularon 54 alumnos y, abandonaron la asignatura 6. Superaron el curso el 98% con una media global de 7,8. Un 87% valoró la experiencia de la presentación oral como muy positiva; el 94% considera que la visualización de una película potencia la observación atenta de la imagen (comunicación no verbal) y la reflexión sobre el enfoque sociocultural de los problemas de salud. Conclusiones: A través de la metodología empleada los alumnos cubren algunas de las etapas de la investigación y aprenden de forma autónoma. Al evaluar la asignatura expresaron satisfacción respecto al esfuerzo que les supuso la presentación oral en inglés, al igual que el responder al cuestionario

Towards a set of competencies in palliative care nursing in Spain: what’s getting in the way of consensus?

Background Spain currently lacks a competency framework for palliative care nursing. Having such a framework would help to advance this field in academic, governmental, and health management contexts. In phase I of a mixed-methods sequential study, we collected quantitative data, proposing 98 competencies to a sample of palliative care nurses. They accepted 62 of them and rejected 36.MethodsPhase II is a qualitative phase in which we used consensus techniques with two modified nominal groups to interpret the quantitative findings with the objective of understanding of why the 36 competencies had been rejected. Twenty nurses from different areas of palliative care (direct care, teaching, management, research) participated. We conducted a thematic analysis using NVivo12 to identify meaning units and group them into larger thematic categories.ResultsParticipants attributed the lack of consensus on the 36 competencies to four main reasons: the rejection of standardised nursing language, the context in which nurses carry out palliative care and other factors that are external to the care itself, the degree of specificity of the proposed competency (too little or too great), and the complexity of nursing care related to the end of life and/or death.ConclusionsBased on the results, we propose reparative actions, such as reformulating the competencies expressed in nursing terminology to describe them as specific behaviours and insisting on the participation of nurses in developing institutional policies and strategies so that competencies related to development, leadership and professional commitment can be implemented. It is essential to promote greater consensus on the definition and levels of nursing intervention according to criteria of complexity and to advocate for adequate training, regulation, and accreditation of palliative care expert practice. Locally, understanding why the 36 competencies were rejected can help Spanish palliative care nurses reach a shared competency framework. More broadly, our consensus methodology and our findings regarding the causes for rejection may be useful to other countries that are in the process of formalising or reviewing their palliative care nursing model

La cirugía en la tetralogía de Fallot en "Something de Lord Made" (J. Sargent, 2004): una oportunidad para la ética

Podeu consultar la Vuitena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/66524Something the Lord Made (J. Sargent, 2010) presenta la planificación, el desarrollo experimental y el éxito del Dr A. Blalock (1899-1964) tras la realización, en 1944, de la primera intervención quirúrgica de la tetralogía de Fallot (TdF), enfermedad que afecta al 10/10000 de la población general y que sin cirugía significaría la muerte antes de los 20 años del 85-90% de los pacientes. La película muestra la relación del Dr. Blalock con Vivien Thomas (1910-1985), el joven carpintero negro que inicia su labor en el Hospital J. Hopkins como personal de limpieza y que acabará guiando las maniobras que Blalock realizará en un recién nacido que será sometido a la primera intervención de la TdF y en la que se empleará una grapa diseñada por el propio Thomas. Something the Lord Made ofrece múltiples posibilidades para el análisis de la ética en la investigación y su evolución en los últimos 70 años. Desde el nacimiento de los Comités de Ética, pasando por la atribución, como propias, de técnicas quirúrgicas desarrolladas por otros, hasta la omisión de colaboradores que han participado activamente en una investigación. Además Something the Lord Made, contribuye al desarrollo de competencias transversales (idioma inglés, análisis del contexto histórico a través de un argumento que permiten analizar la discriminación social y racial así como los prejuicios científicos y religiosos ante el avance científico, además es posible observar técnicas cinematográficas como movimientos y ángulos de la cámara que enriquecen el lenguaje audiovisual). La película se puede complementar con la consulta de los informes de la intervención quirúrgica y las biografías de sus protagonistas en The Alan Mason Chesney Medical Archives (The Blue Babies Operation Available at: http://www.medicalarchives.jhmi.edu/page1.htm). Bibliografía Icart MT, Donoghy K. Films in Health Sciences Education. Learning through moving images. Barcelona: Eds UB; 201

Analysis of household medicine chests: A significant learning experience for nursing students

Podeu consultar la versió en castellà a http://hdl.handle.net/2445/110908This is an observational, descriptive, cross-sectional study in which 214 nursing students from the University of Barcelona participated, in order to examine and assess the state and management of their household medicine chests. A semi-structured questionnaire specifically prepared for the study was used to collect data. The results showed that only 18.2% of the medicine chests examined contained all the recommended dressing materials and medicines. Inspection frequency was less than 12 months in 66.4% of the cases. A high percentage of the nursing students' homes stored medications in unsuitable locations and held on to them beyond their expiration dates or without their package. In contrast, knowledge about the use of the medications and the habit of recycling was better. Carrying out an analysis of their own medicine chest can help nursing students improve their competences in this area

Tutoras y estudiantes de Enfermería con foco en Atención Primaria

La Atención Primaria de Salud configura un área asistencial influenciada por la relación entre profesionales y usuarios, en la que distintas disciplinas, como enfermería, desarrollan su proceso de aprendizaje tanto en la enseñanza de grado como en la de posgrado y la formación especializada. En este contexto, los estudiantes son tutelados por profesionales que han ido desarrollando competencias docentes. Siguiendo esta línea argumental, este manuscrito pretende identificar las distintas tipologías de estudiantes de Enfermería y de tutores que desarrollan su competencia docente en los Centros de Atención Primaria (CAP). Con esta finalidad, invitamos al lector a conocer los hitos históricos y actuales que marcan los sistemas de aprendizaje e influyen en los perfiles de estudiantes y formadores

Gamification on Instagram: Nursing students' degree of satisfaction with and perception of learning in an educational game.

Background: Gamification has been shown to lead to greater motivation and participation among students. Currently, many teachers use social networks to share supplementary course materials and student work, but they have not incorporated gamified educational activities into social networking sites. Objective: To determine nursing students' satisfaction with an Instagram-based educational game and their perceptions of its effects on their learning. Design: We conducted a cross-sectional, descriptive, observational study. Participants: First-year nursing students in the subject "Dietetics and Nutrition". Results: Of the total sample, 71.7 % agreed that gamification had helped them assimilate the content. Between 66 % and 70 % agreed that the experience had motivated them to keep up with the subject and learn more about the topic, that it had helped them to better understand certain concepts of the subject, that they would recommend the experience to other students, and that they enjoyed the experience of playing a game while learning. 71.7 % of them were in favour of increased use of gamification in other subjects. Conclusions: The use of an Instagram-based educational game as a complement to in-class teaching was useful, enjoyable, and motivating for the acquisition of new knowledge

Un modelo de atención integral al paciente crónico complejo

INTRODUCCIÓN. El aumento de la esperanza de vida ha compor­tado un incremento de patologías crónicas. La evolución de las enfermedades crónicas es causa de disfunciones orgáni­cas y sistémicas, las cuales causan limitaciones físicas y psí­quicas que obligan a establecer ayudas para poder realizar las tareas vitales básicas. La Atención Primaria (AP) tiene un papel clave en el segui­miento de la fragilidad, cronicidad y complejidad de la po­blación, pero para atender la alta complejidad de forma ade­cuada es preciso conocer y coordinar los distintos recursos existentes en el territorio. DESARROLLO DEL MODELO DE ACTUACIÓN: CREACIÓN DE UNA UNIDAD FUN­CIONAL. La AP debe garantizar la equidad, la accesibilidad, la longitudinalidad y la continuidad asistencial, sin olvidar que los resultados en salud deben ser óptimos. En el SAP Delta del Llobregat existen varios proveedores de la salud, por lo que se elaboró un plan estratégico centra­do en la coordinación i/o conciliación de todos los dispositi­vos implicados en la asistencia para dar una atención integral a la persona. Los pacientes incluidos en este programa debían estar identificados como PCC, en fase evolucionada y tributaria de seguimiento intensivo. CONCLUSIONES. La identificación de las persones catalogadas como PCC y en situación de riesgo clínico permite un segui­miento exhaustivo a fin de evitar exacerbaciones y la hi

Physical activity among adolescent girls and the factors linked to it: a scoping review

The low level of physical activity in Western countries is one of the major public health problems of the 21st century, and the problem is especially dire among adolescent girls, worsens their health and increases social inequality. The objective was to identify the factors linked to the initiation, maintenance, and abandonment of physical activity among adolescent girls. A scoping review of the literature was conducted in PubMed, CINAHL, Cochrane Library, SCOPUS and Web of Science databases. Studies published 2006-2020 were included in the search and the keywords used were Adolescent girls, Physical activity, Experience and the boolean operator AND. The studies reflected psychosocial factors, perceptions, or experiences of adolescent girls linked to physical activity. Both quantitative and qualitative research from any discipline were included. Forty-two studies were selected. Using Pender's health promotion model to evaluate the results, we conclude that perception of barriers and situational factors are the main reasons for low levels of physical activity. Perceived self-efficacy, positive affect linked to the activity, and the physical and social environment are the key to starting and maintaining physical activity. These factors should be kept in mind in designing health promotion plans that aim to increase physical activity in adolescent girls