Developing reflective competence between simulation and clinical practice through a learning transference model: A qualitative study.

OBJECTIVE: This study sought to understand the effects of a pedagogical resource combining a multi-moment debriefing model with reflective journaling that is designed to develop reflective competence. DESIGN: A qualitative educational study was used with an instrumental case study design. Participating in the study were 32 nursing students who wrote 96 individual reflective journals in accordance with each moment (M1, M2, M3) of the proposed reflective practice resource. The journaling was conducted during both the clinical simulation activity and the period of clinical practice. METHODS: The reflective journals resulting from the high-fidelity clinical simulation process were used to explore three moments of learning: debriefing immediately after simulation, post-scenario debriefing, and clinical practice. The typology of content analysis used was classical content analysis, which followed a deductive logic, since to assess reflection levels the 5Rs Reflective Writing Scale was used. RESULTS: In the post simulation moment (M1), students produced a greater number of meaningful units associated with a level of strategic narrative reflection. During clinical practice however reflection was more analytical, with the highest level of reflection. CONCLUSION: Nursing students developed reflective competence through an iterative process of reflective practice establishing a continuum between simulation experience and clinical.

Efficacy of radial extracorporeal shock wave therapy compared with botulinum toxin type A injection in treatment of lower extremity spasticity in subjects with cerebral palsy: A randomized, controlled, cross-over study.

OBJECTIVES: To investigate whether botulinum toxin type A (BTX-A) injection is more effective than radial extracorporeal shock wave therapy in reducing plantar flexor muscle spasticity in subjects with cerebral palsy. METHODS: A total of 68 subjects with cerebral palsy were randomly allocated to BTX-A injection (Group 1) or radial extracorporeal shock wave therapy (Group 2) (first experiment; E1). Outcome was evaluated using the Tardieu V1 and V3 stretches, at 3 weeks, 2 months (M2) and M3 after baseline. At M6 subjects in Group 1 received radial extracorporeal shock wave therapy and subjects in Group 2 received BTX-A injection (second experiment; E2); outcome was evaluated as in E1. Treatment success was defined as improvement in foot dorsiflexion ≥10° when performing the V3 stretch at M2 in both experiments. RESULTS: In both experiments mean V1 and V3 significantly improved over time. In E1 both treatments resulted in similar treatment success. In E2 fewer subjects treated with BTX-A injection reached the criteria of treatment success than did subjects treated with radial extracorporeal shock wave therapy, which was due to a carry-over effect from E1. No significant complications were observed. CONCLUSION: BTX-A injection is not superior to radial extracorporeal shock wave therapy in the treatment of plantar flexor muscle spasticity in subjects with cerebral palsy.

Analysis of and reflection on bachelor thesis in nursing students: A descriptive study in Spain.

INTRODUCTION: The bachelor thesis, a final year subject to obtain a nursing degree, presents an ideal opportunity for the development and assessment of professional competencies. Thus, it is necessary to specify that the structure of the bachelor thesis works as an element of review and reflection from both a pedagogical and professional perspective. OBJECTIVE: To analyse the main elements of the bachelor thesis in the nursing degree 2015-16 in Spain. METHODOLOGY: A transversal descriptive study was conducted using a quantitative documentary analysis via study guides or grade reports. The variables were the main academic elements of the bachelor thesis subject (credits, competencies, learning outcomes, contents, methodologies, training activities and assessment). A probabilistic sample of 66 institutions was studied using descriptive statistics with statistical measures of central tendency and measures of variability. RESULTS: The results showed a maximum range of 12 and a minimum of 6 European Credit Transfer and Accumulation System. The definition and number of competencies to be developed varied and the learning outcomes were formulated in only 40.9% of the guides consulted. The most widely used teaching methodologies and training activities were academic supervision (87.9%) and autonomous work (80.3%). Regarding types of work, basic investigation (34.8%), care plans (33.3%) and literature review (30,3%) ranked highest. No specific descriptors could be linked to the contents. Finally, two main assessment tools were found: process and product. The rubric is presented as a main element of the assessment. DISCUSSION AND CONCLUSIONS: The bachelor thesis is conceived as autonomous, personal and original academic work. But no homogeneity was observed in the key development elements such as competencies, teaching strategies, or type of bachelor thesis. Therefore, the findings from the analysis and the bibliographic review are presented as recommendations as regards the outcome, structure and/or teaching elements linked to the bachelor thesis.

Assessment of physical activity levels, fitness and perceived barriers to physical activity practice in adolescents: cross-sectional study.

Adolescence is a time of rapid physical, psychological and social changes. Recent studies show that, at this stage, there is a decrease in physical activity (PA) levels, along with high rates of overweight and obesity. The purpose of this study was to assess PA levels and physical condition (PC) related to perceived barriers (PB) and limiting factors for PA practice in a randomised sample of adolescents in Barcelona (Spain) considering overweight status and gender. One hundred and forty-three adolescents (53.8 % boys; median age of 15 years) of Secondary Education in public schools located in a randomly selected district (Sants - Montjuïc) in Barcelona (Spain) participated in a cross-sectional study. Variables assessed were (a) PC (ALPHA-Fitness), (b) PA levels (Physical Activity Questionnaire PAQ-A), and (c) perceived barriers (Self-Reported Barriers to Participation in Physical Activity questionnaire). The different variables were tested by calculating means and standard deviations, with the presence/absence of overweight, and according to the adolescents' gender. Means between groups were compared using Student's t test. CONCLUSION: Significant differences in most results suggest a correlation between being overweight or obese and having a worse PC. The variables gender (being a girl) and body mass index (overweight or obese) showed a direct correlation to perceive significantly greater barriers to PA practice. What is known: • Epidemiological studies indicate that there is a high prevalence of overweight and obesity linked to an insufficient amount of physical activity (PA) practice in children and adolescents, which is accompanied higher rates of abandonment of the common PA practice as they grow up. • Perceived barriers to regular PA practice had increased in the adolescent population, accompanied with lower levels of PA practice. What is new: • This study shows for the first time the correlation between physical condition, PA levels, and perceived barriers to regular PA, considering overweight and gender. • There is a correlation between being overweight or obese and having a worse physical condition. The variables gender (being a girl) and body mass index (overweight or obese) showed a direct correlation to perceive significantly greater barriers to PA practice.

Learning outcomes of "The Oncology Patient" study among nursing students: A comparison of teaching strategies.

INTRODUCTION: Teaching strategies are essential in order to facilitate meaningful learning and the development of high-level thinking skills in students. OBJECTIVE: To compare three teaching methodologies (problem-based learning, case-based teaching and traditional methods) in terms of the learning outcomes achieved by nursing students. METHOD: This quasi-experimental research was carried out in the Nursing Degree programme in a group of 74 students who explored the subject of The Oncology Patient through the aforementioned strategies. A performance test was applied based on Bloom's Revised Taxonomy. RESULTS: A significant correlation was found between the intragroup theoretical and theoretical-practical dimensions. Likewise, intergroup differences were related to each teaching methodology. Hence, significant differences were estimated between the traditional methodology (x-=9.13), case-based teaching (x-=12.96) and problem-based learning (x-=14.84). CONCLUSIONS: Problem-based learning was shown to be the most successful learning method, followed by case-based teaching and the traditional methodology.