Emergency First Responders' Misconceptions about Suicide: A Descriptive Study.

BACKGROUND: In 2022, suicide was the second leading cause of external death in Spain (the first among young people aged 15-29 years). This study aims to analyze the presence of myths among emergency first responders and identify the most prevalent false beliefs among them. METHODS: The research is a observational and descriptive study carried out using a questionnaire composed of a total of 25 myths, with the response options being true or false. A total of 543 professionals took part in the study. All of them could intervene before, during, and after a suicide attempt. RESULTS: The main finding of the study is that more than 50% of the participants accept as true the statement "There are more serious and less serious problems", underlining the idea that caring for patients could be related to the importance the health professional gives to the patients' problem. Myths such as "The suicidal person wants to die" and "The suicidal person is determined to die" are also evident. CONCLUSION: The subjective thought the first responder has about suicide could affect their acts, and there is a need to train first responders in suicidal behavior to be able to create an adequate approach.

Telephone-Cardiopulmonary Resuscitation Guided by a Telecommunicator: Design of a Guiding Algorithm for Telecommunicators.

BACKGROUND: Out-of-hospital cardiac arrest is considered a global problem. In the last few years, there has been a growing interest in telephone-cardiopulmonary resuscitation guided by a telecommunicator. Indeed, several studies have demonstrated that it increases the chances of survival rate. This study focuses on the key points the operator should follow when performing telephone-cardiopulmonary resuscitation. The main objective of this paper is to design an algorithm to improve the telephone-cardiopulmonary resuscitation response protocol. METHODS: The available evidence and the areas of uncertainty that have not been previously mentioned in the literature are discussed. All the information has been analyzed by two discussion groups. Later, a consensus was reached among all members. Finally, a response algorithm was designed and implemented in clinical simulation. RESULTS: All the witnesses were able to recognize the OHCA, call for emergency assistance, follow all the operator's instructions, move the victim, and place their hands in the correct position to perform CPR. DISCUSSION: The results of the pilot study provide us a basis for further experimental studies using randomization and experimental and control groups. CONCLUSIONS: No standardized recommendations exist for the operator to perform telephone-guided CPR. For this reason, a response algorithm was designed.

What can be improved in learning to care for people with autism? A qualitative study based on clinical nursing simulation.

AIM/OBJECTIVE: The aim of this study was to identify the main patterns of errors that 4th year nursing students made in simulated clinical practice with scenarios of care for people with Autism Spectrum Disorder (ASD). BACKGROUND: Clinical simulation currently plays a major role in the training of nursing students and provides the participants with the opportunity to practice and develop their clinical sills with a pediatric patient diagnosed with ASD. DESIGN: A retrospective longitudinal qualitative study was performed. METHODS: Content analysis of the existing debriefing records from a period of 7 academic years (2016-2022) was carried out. The scenario was simulated by a standardized patient diagnosed with ASD, with 23 groups of nursing students. RESULTS: The results showed different patterns of errors. These patterns were grouped into 1 main category (weaknesses) and 5 major subcategories: clinical, communication, knowledge about ASD, emotions, and behavior towards parents. The most repeated errors were excessive use of verbal communication, abundant stimuli, low demand for information from primary caregivers, low demand for information about the child's emotions and interests, and a lack of knowledge of the profile of the child with ASD. CONCLUSION: From the findings of this study, we can highlight the lack of training that students received on the practical approach for providing care to these individuals. It has also been inferred in this study that clinical simulation is a tool that favors reflection and experiential learning for students when they are faced with caring for people with ASD.

How Are You Feeling? Interpretation of Emotions through Facial Expressions of People Wearing Different Personal Protective Equipment: An Observational Study.

(1) Background: The perception of others' emotions based on non-verbal cues, such as facial expressions, is fundamental for interpersonal communication and mutual support. Using personal protection equipment (PPE) in a work environment during the SAR-CoV-2 pandemic challenged health professionals' ability to recognise emotions and expressions while wearing PPE. The working hypothesis of this study was that the increased limitation of facial visibility, due to the use of a personal protective device, would interfere with the perception of basic emotions in the participants. (2) Methods: Through a cross-sectional descriptive study, the present research aimed to analyse the identification of four basic emotions (happiness; sadness; fear/surprise; and disgust/anger) through three types of PPE (FFP2 respirator, protective overall and powered air-purifying respirator (PAPR)), by using 32 photographs. The study was conducted using volunteer participants who met the inclusion criteria (individuals older than 13 without cognitive limitations). Participants had to recognise the emotions of actors in photographs that were randomly displayed in an online form. (3) Results: In general, the 690 participants better recognised happiness and fear, independently of the PPE utilised. Women could better identify different emotions, along with university graduates and young and middle-aged adults. Emotional identification was at its worst when the participants wore protective overalls (5.42 ± 1.22), followed by the PAPR (5.83 ± 1.38); the best scores were obtained using the FFP2 masks (6.57 ± 1.20). Sadness was the least recognised emotion, regardless of age. (4) Conclusions: The personal protective devices interfere in the recognition of emotions, with the protective overalls having the greatest impact, and the FFP2 mask the least. The emotions that were best recognised were happiness and fear/surprise, while the least recognised emotion was sadness. Women were better at identifying emotions, as well as participants with higher education, and young and middle-aged adults.

Risk of Dehydration Due to Sweating While Wearing Personal 2 Protective Equipment in COVID-19 Clinical Care: A Pilot Study.

OBJECTIVE: The objectives of this study were (a) to determine the physical impact of the personal protective equipment (PPE) used in COVID-19 care, specifically the impact on the hydration state of the temperature and the comfort of the healthcare workers who use it, and (b) to show the high-fidelity simulated environment as an appropriate place to test the experimental designs to be developed in real environments for COVID-19. BACKGROUND: All healthcare staff use full PPE in the care of COVID-19 patients. There are problems, such as excessive sweating, which have not been quantified thus far. METHODS: A descriptive pilot design was used in a simulated high-fidelity setting. There was paired activity, with mild-moderate physical activity, between 45 and 60 min continuously, with the COVID-19 PPE. Sixteen intensive care nurses were selected. The before-after differential of weight, thirst, weight use of the PPE, body temperature, thermal body image, general and facial warmth sensation, and perspiration sensation were measured. RESULTS: All subjects lost weight in the form of sweat with both PPEs during the simulation scenario, with a mean of 200 g (0.28% of initial weight), and increased thirst sensation. Body thermal image increased by 0.54 °C in people using the full COVID-19 PPE. CONCLUSIONS: The use of PPE in the management of critically ill COVID-19 patients generates weight loss related to excessive sweating. The weight loss shown in this pilot test is far from the clinical limits of dehydration. The use of ventilated PPE, such as PAPR, reduce the body temperature and heat sensation experienced by the users of it; at the same time, it improves the comfort of those who wear it. The simulated environment is a suitable place to develop the piloting of applicable research methodologies in future studies in a real environment.

Training with High Fidelity Simulation in the Care of Patients with Coronavirus-A Learning Experience in Native Health Care Multi-Professional Teams.

The training of emergency and intensive care teams in technical and non-technical skills is fundamental. The general aim of this study was to evaluate the training of various professional teams with simulations based on the care of COVID-19 patients using Zone 3 simulations (native emergency medical services and intensive care units-ICU teams) in the Region of Murcia (Spain). A mixed pilot study was designed (qualitative/quantitative) comprised of three phases: Phase 1: detection of needs (focus groups), Phase 2: design of simulation scenarios, and Phase 3: training with high-fidelity simulation and evaluation of competences. The results were used to determine the real training needs of these health professionals, which were used to design four simulation scenarios in line with these needs. The team competences were evaluated before and after the training session, with increases observed after the training sessions, especially in non-technical skills such as communication. Training with zone 3 simulation, with multi-professional native emergency and intensive care teams who provided care to patients with coronavirus was shown to be an effective method, especially for training in non-technical skills. We should consider the training needs of the professionals before the start of any training program to stay one-step ahead of crisis situations.

Motivation: bringing up the rear in nursing education. Motivational elements in simulation. The participants' perspective.

BACKGROUND: Motivation is a fundamental element of human behavior and learning. We believe that this aspect has not been sufficiently addressed in the field of simulation-based learning in nursing. PURPOSE: The aim of this study was to explore the views and perspectives of students involved in simulation-based learning related to their process of motivation. Also, to identify the motivational elements they perceived, as well as the aspects that could reduce their motivation in the simulation sessions. METHODS: A qualitative study was conducted based on content analysis from 7 focus groups composed of simulation students (n = 101). RESULTS: The study obtained 26 subcategories, 10 categories, and 2 emerging themes (in total, 17 motivational elements and 7 demotivational elements). CONCLUSION: The motivational elements were related with the non-directive/imposing style of the facilitator, the adequate structure and planning of the sessions, the possibility of transferring what was learned to the real world, and especially the atmosphere created in the simulation session. The main demotivational elements were directed simulation, an uncomfortable environment, and the planning and structure of the sessions (with an excessive theoretical content or with stringent evaluations).

Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in Nursing students: A randomized trial.

BACKGROUND: Nursing students experiencing high stress levels before exams could suffer worse academic performance. OBJECTIVE: We evaluated an intervention combining Progressive Muscle Relaxation (PMR) and music therapy on the decrease of before exams stress and the improvement of academic results. DESIGN AND METHODS: Randomized controlled trial including students from the Nursing Degree during the first semester of the 2017-2018 academic year. All participants were randomized to the control (CG) or the experimental group (EG). The CG took the exam as usual whereas in the EG, PMR and music therapy were performed before exams. Blood samples were drawn to investigate variations in biochemical parameters. The academic performance was assessed by the score obtained in the "Clinical Nursing" exam. RESULTS: We included 112 students (75% females, mean age 24.3 ±â€¯6.2 years, 56 students in every group). There were no differences in any parameter during the first measurement. Regarding the second measurement, we observed a reduction in heart rate for the EG and an increase in blood pressure, heart rate, and cortisol for the CG. Indeed, these parameters were significantly higher compared to the EG. The EG had a mean score of 5.07 ±â€¯1.59 in the Clinical Nursing exam, which was significantly higher compared to the CG (4.42 ±â€¯1.58, p = 0.033). The proportion of fails in the CG was also higher (62.5% vs. 42.9%, p = 0.037). CONCLUSION: In this study including students from the Nursing degree, the combination of PMR and music therapy was effective for the control and decrease of stress before exams, and also demonstrated improvements in academic results.

Enseñando con metodología de autoaprendizaje en entornos simulados (MAES(C)). Un estudio cualitativo entre profesores y alumnos de grado en Enfermería / Teaching with self-learning methodology in simulated environments. A qualitative study among teachers and students of nursing degree

INTRODUCCIÓN: La metodología de autoaprendizaje en entornos simulados (MAES©) es un método activo de enseñanza-aprendizaje con simulación clínica de alta fidelidad. Esta metodología consta de 6 etapas y posibilita la adquisición de competencias de manera experiencial y reflexiva. El propósito de este estudio fue analizar el impacto subjetivo (percepción) de la metodología MAES© en alumnos y profesores del grado en Enfermería, en áreas como la motivación, el aprendizaje, el papel del facilitador o la transferencia/aplicabilidad a la vida real. MÉTODO: Se diseñó un estudio cualitativo y se obtuvieron los datos a través de la técnica del grupo focal. Se realizaron 3 grupos focales de alumnos y uno de profesores. RESULTADOS: Los principales resultados se refieren a un aumento en la satisfacción del alumnado y el profesorado en las áreas exploradas, junto con la consideración de este método como una importante herramienta docente y de aprendizaje. Aparecieron conceptos como el aprendizaje bidireccional, el cambio de rol de profesor/instructor a facilitador, la aplicabilidad en contextos reales, la motivación intrínseca y una elevada percepción de aprendizaje y aprovechamiento. También se identificaron áreas de mejora, como la necesidad de intensificar la formación de los alumnos en el diseño de los casos o mejorar el sistema de evaluación con el objeto de simplificarlo. CONCLUSIONES: Como conclusión se puede considerar que el impacto subjetivo de la metodología MAES© en alumnos y profesores fue positiva en las áreas investigadas

INTRODUCTION: Self-learning methodology in simulated environments (MAES©) is an active teaching-learning method with high fidelity clinical simulation. This methodology consists of 6 stages and enables the acquisition of skills in an experiential and reflective manner. The purpose of this study was to analyse the subjective impact (perception) of the MAES© methodology on students and lecturers of the nursing degree, in areas such as motivation, learning, the role of the facilitator, or the transfer / applicability to real life. METHOD: A qualitative study was designed, and the data were obtained using the focus group technique. There were 3 student focus groups and one teacher focus groups. RESULTS: The main results referred to an increase in the satisfaction of students and teachers in the areas explored. It was also considered that this method could be an important teaching and learning tool. Concepts such as two-way learning appeared, as well as the change of role from teacher/instructor to facilitator, the applicability in real contexts, intrinsic motivation, and a high perception of learning and use. Areas of improvement were also identified, such as the need to intensify the training of students in the design of cases, or improve the evaluation system in order to simplify it. CONCLUSION: In conclusion, it can be considered that the subjective impact of the MAES© methodology on students and teachers was positive in the areas explored

Improving simulation performance through Self-Learning Methodology in Simulated Environments (MAES©).

BACKGROUND: One of the main challenges faced by nursing educator is using the best strategy for students to learn. In MAES© (Self-learning methodology in simulated environments), the students are guided by a facilitator, and perform their simulations in a knowledge-specific area in a self-directed learning manner. METHOD: The performance by the students in the MAES© simulation was compared to traditional Simulation-based learning (SBL). With this aim in mind, a study was conducted which quantitatively analyzed and compared the scores in SBL and MAES© scenarios from 274 students enrolled in the 4th year of the nursing degree. The students were assessed with the Clinical Simulation in Nursing Assessment Questionnaire (CLISINAQ) and the Knowledge Management Scale (KMS). RESULTS: The students received a higher score in the scenarios with the MAES© methodology in clinical and non-technical skills. CONCLUSIONS: When compared to SBL, MAES© granted students a better degree of performance in learning with simulation.