Caracterización de la motivación académica de residentes en especialidades de enfermería / Characterization of Academic Motivation in Residents of Nursing Specialties

Introducción: A pesar de la contingencia epidemiológica ocasionada por la COVID-19, la formación académica de los profesionales de enfermería no cesó, y Cuba reinició el proceso de especialización de sus licenciados en cuatro especialidades. Las solicitudes de bajas definitivas recibidas en las primeras semanas motivaron a los autores a realizar este trabajo, en el que se asume que esta formación requiere de elevada motivación hacia el estudio. Objetivo: Caracterizar la motivación académica de los residentes en especialidades de enfermería en Camagüey. Métodos: Estudio descriptivo de corte transversal, realizado desde diciembre de 2020 a febrero de 2021, en los centros hospitalarios de Camagüey, donde se realiza la especialización. Se trabajó con la población de 47 residentes matriculados en las especialidades. Como métodos empíricos fueron aplicados la Escala de Motivación Educativa adaptada, la entrevista semiestructurada y la observación. Se asumieron como dimensiones: motivación intrínseca, extrínseca y amotivación. Para el análisis de los datos cuantitativos se empleó la distribución de frecuencias absolutas y el cálculo porcentual. Se cualificaron los datos mediante el análisis de contenidos del que resultaron dos categorías. Resultados: Predominó la motivación académica de tipo intrínseca en 63,00 por ciento de los residentes, seguido por la motivación extrínseca en 23,00 por ciento. Solo 5,00 por ciento se encontraba desmotivado. Conclusiones: Existen diversas tipologías de motivación académica intrínseca que guardan relación con la especialidad matriculada. Predominó la motivación dirigida al logro. Dentro de la regulación extrínseca, la mayoría de los sujetos de la muestra poseía regulación identificada, seguido por las regulaciones introyectada y externa(AU)

Introduction: Despite the epidemiological contingency caused by COVID-19, the academic training of nursing professionals did not cease, and Cuba restarted the process of specialization of its graduates in four specialties. The requests for definitive quits received in the first weeks motivated the authors to write this article, in which this training is assumed as requiring high motivation towards study. Objective: To characterize the academic motivation of residents in nursing specialties in Camagüey. Methods: Cross-sectional and descriptive study carried out from December 2020 to February 2021 in the hospital centers of Camagüey where the specialization is received. The work was completed with the population of 47 residents enrolled in the specialties. As empirical methods, the adapted educational motivation scale, the semistructured interview and observation were applied. The following dimensions were assumed: intrinsic motivation, extrinsic motivation and amotivation. For the analysis of quantitative data, distribution of absolute frequencies and percentage calculation were used. The data were qualified by means of content analysis, which yielded two categories. Results: Intrinsic academic motivation predominated, accounting for 63.00 percent of the residents; followed by extrinsic motivation, present in 23.00 percent. Only 5.00 percent were unmotivated. Conclusions: There are different typologies of intrinsic academic motivation related to the studied specialty. Achievement-directed motivation predominated. Within extrinsic regulation, most of the sample subjects had identified regulation, followed by introjected and external regulation(AU)

Challenges and strategies of early career nurse scientists when the traditional postdoctoral fellowship is not an option.

PURPOSE: The purpose of this article is to discuss challenges and strategies related to maintaining a program of research for early career nurse scientists. Nurse scientists who do not complete a traditional postdoctoral fellowship or who work in low research-resourced institutions may struggle with research collaboration and development. PRINCIPAL RESULTS: Specific challenges experienced by nurse scientists in early career development included: advanced age at the completion of the research doctorate, gender roles and research careers, sustainable work-life balance, employment in low research-resourced institutions, and time. Strategies to assist nurse scientists in finding support and opportunities for research and career development included: professional networking, institutional collaboration, non-traditional training experiences for new nurse scientists, sustainable work-life balance, professional development and service, and competing needs of teaching mission and research. One group's experience with fostering support and collaboration is presented as an example. MAJOR CONCLUSIONS: It is possible for nurse scientists in low research-resourced institutions to find opportunities to develop their program of research and foster their professional growth. Implementing the identified strategies helps to provide sustainability of new nurse scientists' research efforts. Engaging nurse scientists in supportive and collaborative opportunities paves the way for early career nurse scientists to become experts in their field.

2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis.

To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse's role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.

Health Equity-Caring for the Indigent-A Nursing Specialty: An Interview With Dr Karen Bankston.

In this month's Inspiration Point, Dr Patricia Reid Ponte interviews Dr Karen Bankston, PhD, MSN, FACHE.

Advancing the practice of nursing through specialty fellowship development for pediatric nurse practitioners.

Fellowship training for physicians has historically been a training model for physicians to specialize their practice and develop research skills following medical school and residency. Advanced practice registered nurses, specifically nurse practitioners (NPs) practice in primary care, acute care, and specialty settings across the lifespan. Fellowship programs have emerged as a way for NPs to specialize their practice and meet the needs of an expanding health care system. This article describes the design, implementation, and outcomes of two similar yet distinct specialty NP fellowship programs: one in Developmental-Behavioral Pediatrics and one in Pediatric Physical Medicine and Rehabilitation.

Revisiting the Pain Resource Nurse Role in Sustaining Evidence-Based Practice Changes for Pain Assessment and Management.

BACKGROUND: Effective pain management is unlikely to occur without consistent and timely assessments. To improve assessment and management of pain, ward-based pain resource nurses were introduced in 2007 to facilitate hospital-wide evidence-based practice changes using three key targets. One-year post implementation of this quality improvement project, promising results were revealed. AIMS: The purpose of this study, 8 years post implementation, was to (a) evaluate sustained practice improvements in pain assessment and management, (b) assess current pain resource nurse knowledge and attitudes to pain, (c) explore characteristics of the pain resource nurse role, as well as (d) any perceived contextual changes regarding study findings. METHODS: A mixed-methods approach was used to address study aims. Quantitative data were collected from documentation audits and a "Knowledge and Attitudes Survey Regarding Pain." Qualitative interviews explored the characteristics of the pain resource nurse role, and a focus group discussion explored the context of change. RESULTS: Significant improvements were observed for the documentation of pain scores on admission and for each nursing shift. Survey results highlighted potential knowledge deficits in key practice areas, even though interview findings suggested that pain resource nurses provided a resource for peers, raised awareness of best practice, and imparted knowledge to other ward staff. An important facilitator for the pain resource nurse role was the ongoing collaboration and support from specific pain teams, and barriers to engage in the role were competing workload priorities, and limited awareness among other ward staff. LINKING EVIDENCE TO ACTION: Implementing and sustaining evidence-based practice change in clinical practice is challenging. Ongoing evaluation is necessary for identifying the long-term implications of practice improvement interventions and issues that influence the adoption of evidence-based practice. Strategies to address barriers, and to increase awareness and engagement of the pain resource nurse role with wider collaboration require further investigation.

Using a risk assessment tool for parastomal hernia prevention.

All patients with a stoma are at risk of developing some degree of parastomal herniation given enough follow-up time. Based on current evidence, preventive measures are strongly advised to minimise the incidence of a parastomal hernia forming. This article explores the evidence for consistency in care and management of parastomal hernia, focusing on the development of a risk assessment tool, taking into consideration the patient's and the nurse's perspective.

Training nurses in a competency framework to support adults with epilepsy and intellectual disability: the EpAID cluster RCT.

BACKGROUND: People with an intellectual (learning) disability (ID) and epilepsy have an increased seizure frequency, higher frequencies of multiple antiepileptic drug (AED) use and side effects, higher treatment costs, higher mortality rates and more behavioural problems than the rest of the population with epilepsy. The introduction of nurse-led care may lead to improvements in outcome for those with an ID and epilepsy; however, this has not been tested in a definitive clinical trial. OBJECTIVE: To determine whether or not ID nurses, using a competency framework developed to optimise nurse management of epilepsy in people with an ID, can cost-effectively improve clinical and quality-of-life outcomes in the management of epilepsy compared with treatment as usual. DESIGN: Cluster-randomised two-arm trial. SETTING: Community-based secondary care delivered by members of community ID teams. PARTICIPANTS: Participants were adults aged 18-65 years with an ID and epilepsy under the care of a community ID team and had had at least one seizure in the 6 months before the trial. INTERVENTIONS: The experimental intervention was the Learning Disability Epilepsy Specialist Nurse Competency Framework. This provides guidelines describing a structure and goals to support the delivery of epilepsy care and management by ID-trained nurses. MAIN OUTCOME MEASURES: The primary outcome was the seizure severity scale from the Epilepsy and Learning Disabilities Quality of Life questionnaire. Measures of mood, behaviour, AED side effects and carer strain were also collected. A cost-utility analysis was undertaken along with a qualitative examination of carers' views of participants' epilepsy management. RESULTS: In total, 312 individuals were recruited into the study from 17 research clusters. Using an intention-to-treat analysis controlling for baseline individual-level and cluster-level variables there was no significant difference in seizure severity score between the two arms. Altogether, 238 complete cases were included in the non-imputed primary analysis. Analyses of the secondary outcomes revealed no significant differences between arms. A planned subgroup analysis identified a significant interaction between treatment arm and level of ID. There was a suggestion in those with mild to moderate ID that the competency framework may be associated with a small reduction in concerns over seizure severity (standard error 2.005, 95% confidence interval -0.554 to 7.307; p = 0.092). However, neither subgroup showed a significant intervention effect individually. Family members' perceptions of nurses' management depended on the professional status of the nurses, regardless of trial arm. Economic analysis suggested that the competency framework intervention was likely to be cost-effective, primarily because of a reduction in the costs of supporting participants compared with treatment as usual. LIMITATIONS: The intervention could not be delivered blinded. Treatment as usual varied widely between the research sites. CONCLUSIONS: Overall, for adults with an ID and epilepsy, the framework conferred no clinical benefit compared with usual treatment. The economic analysis suggested that there may be a role for the framework in enhancing the cost-effectiveness of support for people with epilepsy and an ID. Future research could explore the specific value of the competency framework for those with a mild to moderate ID and the potential for greater long-term benefits arising from the continuing professional development element of the framework. TRIAL REGISTRATION: Current Controlled Trials ISRCTN96895428. FUNDING: This trial was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 10. See the NIHR Journals Library website for further project information.

Evaluación clínica objetiva y estructurada (ECOE) en la maestría de Enfermería Ginecobstétrica y Perinatal: una sistematización de la experiencia / Objective and structured clinical evaluation (ECOE) in the masters of Gyneco-Obstetrical and Perinatal Nursing: a systematization of experience / Avaliação clínica objetiva e estruturada (ECOE) em Enfermagem gynecobstetric e Perinatal mestre: experiência sistematizar

ResumenEn busca de la excelencia profesional, la maestría en Enfermería Ginecológica, Obstétrica y Perinatal de la Universidad de Costa Rica, se mantiene a la vanguardia respecto de los procesos de enseñanza y aprendizaje. La inclusión de la simulación clínica forma parte de estas innovaciones educativas desde el año 2012; sin embargo esta es la primera vez que se incluye los procesos evaluativos de tipo ECOES los cuales, en experiencias internacionales, han demostrado pertinencia en el cumplimiento de los objetivos de enseñanza. Esta experiencia se sistematiza, según los cinco tiempos que Óscar Jara establece en su libro Para sistematizar experiencias, con el objetivo de definir la pertinencia del ECOE en cuanto a cumplir los objetivos de aprendizaje del curso. La profesora del curso y la autora recopilaron la experiencia en un diario de registro que incluye la elaboración de los escenarios, y la creación de las rubricas de evaluación. Además las estaciones fueron grabadas. La evaluación se llevó a cabo con la totalidad de estudiantes matriculados, en el curso de Enfermería Ginecoobstétrica y Perinatal I. Se estableció tres estaciones que permitirían evaluar aspectos teóricos, habilidades técnicas y sociales en la atención de las personas. Además, se creó rúbricas de evaluación, basadas en guías clínicas procedimentales y en protocolos de atención de la seguridad social costarricense. Se concluye que la experiencia demuestra clara pertinencia de los ECOEs, para evaluar la aplicación de conocimientos teóricos y habilidades psicomotoras, sociales y de comunicación en estudiantes que cursan la maestría y evidencia su preparación para continuar con los niveles más complejos de la carrera.

AbstractIn search of professional excellence, the master's degree in Gynecological, Obstetrical and Perinatal Nursing at the University of Costa Rica remains at the forefront of teaching and learning processes. The inclusion of clinical simulation is part of these educational innovations since 2012. However, this is the first time that includes ECOES evaluation processes which, in international experiences, have demonstrated relevance in the fulfillment of teaching objectives. This experience is systematized, according to the five times that Oscar Jara establishes in his book. To systematize experiences, with the objective of defining the relevance of the ECOE in terms of meeting the learning objectives of the course. The course teacher and the author collected the experience in a log diary that includes the elaboration of the scenarios, and the creation of the evaluation rubrics. In addition, the stations were recorded. The evaluation was carried out with all the enrolled students, in the course of Gyneco-Obstetric and Perinatal Nursing I. Three stations were established that would allow to evaluate theoretical aspects, technical and social skills in the attention of the people. In addition, evaluation rubrics were created, based on procedural clinical guidelines and Costa Rican social security care protocols. It is concluded that the experience shows a clear relevance of the ECOEs, to evaluate the application of theoretical knowledge and psychomotor, social and communication skills in students who are masters and evidence their preparation to continue with the most complex levels of the career.

ResumoProcurando por excelência profissional, especialização em Enfermagem Ginecológica, Obstétrica e Perinatal mestre da Universidade da Costa Rica, continua na vanguarda no que diz respeito ao ensino e aprendizagem. Incluindo simulação clínica faz parte dessas inovações educacionais desde 2012; no entanto esta é a primeira vez que tais processos de avaliação que incluem ECOES em experiências internacionais têm mostrado relevância no cumprimento dos objectivos de ensino. Esta experiência é sistematizado como cinco vezes Óscar Jara afirma em seu livro de sistematizar experiências, com o objetivo de definir a relevância da OSCE na prossecução dos objectivos de aprendizagem do curso. Professor do Curso e autor reuniu experiência em um diário de bordo, que inclui o desenvolvimento de cenários e criando rubricas de avaliação. Além disso estações foram registrados. A avaliação foi realizada com todos os alunos inscritos no curso e Enfermagem Gynecoobstetric Perinatal I três estações que permitem avaliar competências teóricas, técnicas e sociais para lidar com pessoas foi estabelecida. Além disso, as rubricas de avaliação com base em diretrizes clínicas e protocolos processuais atenção da segurança social da Costa Rica foi criado. Concluise que a experiência mostra clara relevância de ECOES para avaliar a aplicação de conhecimentos e psicomotoras competências teóricas, habilidades sociais e de comunicação em estudantes perseguir mestrado e preparar provas para avançar para níveis mais complexos da corrida.