Trabajo final de grado y plan de acción tutorial en el curriculum del grado en enfermería. Diseño, desarrollo y evaluación / Final project degree and tutorial action plan in the curriculum of the degree in nursing. Design, development and evaluation

La acción tutorial (PAT), en los estudios universitarios de Enfermería, se halla en el centro de la acción docente del profesorado. El tutor/a orienta en el proceso de aprendizaje y en la preparación del Trabajo Final de Grado (TFG). En este artículo presentamos los resultados de la investigación realizada con tutores y estudiantes, que tiene por objetivo evaluar el diseño y desarrollo del TFG, los resultados académicos y su vivencia y experiencia. Diseño mixto cuantitativo descriptivo y cualitativo de investigación acción participación. Muestra total de 124 estudiantes de 4º curso de Grado Enfermería y 37 tutores del TFG. Técnicas de recogida de datos: resultados académicos y evaluativos; 3 grupos focales con estudiantes y profesores; 3 entrevistas semiestructuradas abiertas a estudiantes. Los resultados constatan que las tipologías más elegidas fueron revisiones bibliográficas (38,75%) y Planes de cuidados (24,2%). El 63,9 % de la temática escogida es Enfermería Maternal, Pediátrica y Clínica. Estudiantes y tutores viven con dificultad la elaboración del TFG y se requiere una mayor cultura tutorial. Es un proceso complejo de organización y coordinación que, sin embargo, permite un trabajo colaborativo de todo el equipo docente (AU)

The Tutorial Action Plan (PAT) in the University School of Nursing, is central to the teaching action of professors. The tutor orients in the learning process and the preparation of the Final Degree Project (TFG). In this paper we present the results of research conducted with tutors and students, which aims to evaluate the design and development of the TGF, academic results and their experience and expertise. A descriptive qualitative and quantitative joint design of research and participation. A total sample of 124 students of 4th year in the nursing degree and 37 TGF tutor. Data collection techniques: Academic and evaluation results; 3 focus groups with students and professors; three semi-structured interviews open to students. Results indicate that the most commonly chosen typologies were literary reviews (38.75%) and care plans (24.2%). 63.9% of the chosen topics include Maternal, Pediatric and Clinical Nursing. Students and tutors struggle to develop the TGF and greater tutorial culture is required. It is a complex process of organization and coordination which, however, allows collaborative work of the entire faculty (AU)

[An analysis of professional practice as a means to enhance one's skills: theoretical basis, actual process and associated limitations]. / L'analyse des pratiques professionnelles comme moyen de développement des compétences: ancrage théorique, processus à l'oeuvre et limites de ces dispositifs.

With the advent of skill-based approaches in the training of health professionals, trainers have been encouraged to make use of a methodology which analyses actual practice. This paper's main objective is to take a deeper look, from a theoretical perspective, at the process of analysing professional practice. This particular training method, which has been in use for a considerable amount of time in certain professional circles, has two "historical" sources: Balint Groups and Schön's Reflective Practice. I intend to concentrate on the latter, Reflective Practice approaches. These involve a group of peers working with a facilitator, whose objective is to consider the various work contexts associated with the participants. As a result, they are involved with a "hindsight approach", so that real work situations, the way in which practitioners have carried out a contextual analysis, how this has been interpreted and the strategies which have been put in place can be understood. So, what process do these approaches enable as regards developing professional skills? How does this evaluation of practice challenge knowledge, experience and representations? Finally, if this approach indeed facilitates a change in practice, what are the constraints?

Spiraling evidence-based practice and outcomes management concepts in an undergraduate curriculum: a systematic approach.

Preparing undergraduate nursing students to practice nursing in the 21st century requires a focus on the development of evidence-based practice and outcomes management knowledge and skills throughout the nursing curriculum. To this end, seven learning activities were created that spiral and increase in complexity while building on previously acquired skills. Working in teams and practicing team-building techniques, students learned how to develop a clinical question, search the literature, synthesize the current knowledge, identify the significance of the issue in an ecological model, decipher existing quality data and compare that data to national benchmarks, investigate a health care quality issue using quality improvement methods, and draft a proposal for implementation of a continuous quality improvement initiative. Work was presented in both written and oral presentation formats, with emphasis on engaging various audiences in a compelling health care issue.

Measuring patient-oriented outcomes in palliative care: functionality and quality of life.

Outcomes measurement is necessary to evaluate quality of care, increase knowledge about experiences with cancer and therapies, and determine the effectiveness of interventions directed toward improving symptoms and quality of life (QOL) in research and clinical care. Recent attention on outcomes measurement and research in palliative care settings has emphasized the need to incorporate patient-reported outcomes. Unlike other areas of research in oncology, palliative care research is comprised largely of descriptive studies elucidating the process involved with palliative care, with a notable void in well-designed patient-oriented studies employing standard instruments for measuring functional status, QOL, symptoms, and psychosocial well-being. Outcomes programs in practice settings where palliative care is an integral part of clinical services can offer important information about patient experiences across the continuum of care and help to identify patients most likely to benefit from palliative care interventions. Therefore, oncology nurses must be informed about outcome-measurement issues, including ways to select reliable and valid instruments and determine which ones are appropriate for palliative care populations. Content related to the measurement of patient-oriented outcomes is presented to assist nurses in developing outcomes programs in palliative care settings.

The moved to evidenced-based practice from a clinical nursing question.

Registered nurses on a medical unit questioned whether current practice adequately met the emotional needs of patients with chronic obstructive pulmonary disease hospitalized for acute dyspnea. The unit's education committee surveyed nursing staff regarding priority nursing activities during dyspneic episodes. After discussion with staff development educators, several registered nurses met with the center's nurse researcher, formed a research team, and designed a descriptive study. Findings of the study gave evidence for clinical practice change and revision of care guidelines.

Integrating quality and safety content into clinical teaching in the acute care setting.

Teaching the highest quality and safest practice has long been a goal of faculty members in pre-licensure nursing education programs. This article will describe innovative approaches to integrating quality and safety content into existing clinical practica. The core competencies identified by the Quality and Safety Education for Nurses project--patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics--serve as the framework for the teaching/learning exercises. The strategies described require a shift in attention rather than changes in course content and can be included in any clinical rotation in an acute care setting.

Academic-practice partnerships to promote evidence-based practice in long-term care: oral hygiene care practices as an exemplar.

Learning in practice disciplines suffers when gaps exist between classroom instruction and students' observations of routine clinical practices.(1) Academic institutions, therefore, have a strong interest in fostering the rapid and effective translation of evidence-based care techniques into routine practice. Long-term care (LTC) practice sites are particularly vulnerable to gaps between classroom teaching and how daily care is implemented, owing to the recent rapid advances in the scientific bases of care for frail older adults, the relative isolation of most LTC sites from academic settings,(2) and the relatively small number of registered nurses (RNs) available in LTC settings who can facilitate translation of research-based practices into care.(3) The aim of this project was to demonstrate the feasibility and value of an academic practice partnership to implement evidence-based approaches to solving resident care problems in LTC, as many scientifically proven practices hold promise for improving resident outcomes yet adoption is often slow.(4) We developed and implemented a clinical practice improvement process, based on diffusion of innovations theory and research,(5-8) to serve as a new model of academic-practice collaboration between a university school of nursing, LTC facility management and direct-care staff, as a means of developing high quality clinical sites for student rotations. The goal was to implement a sustainable evidence-based oral care program as an exemplar of how scientific evidence can be translated into LTC practice. This project focused on oral hygiene because the staff was dissatisfied with their existing resident oral care program, and an evidence-base for oral care in LTC existed that had not yet been incorporated into care routines. This article describes a systematic, replicable process for linking advanced practice registered nurse expertise with staff insights about care systems to reduce the gap between teaching and practice in long-term care settings. Our experience demonstrates that translation of research on oral care practices into LTC practice through academic-practice partnerships is feasible, is associated with positive resident outcomes, and illustrates a process that has broader applicability to other common problems in LTC, where incomplete implementation of an extant research base for practice may inhibit student learning.

Currículo por competencias en la Universidad de La Sabana / Competence Curriculum at La Sabana University

La presente investigación tiene como objetivo analizar si el desarrollo de la práctica educativa de los profesores de las asignaturas de Cuidado de Enfermería corresponde a la formación por competencias, con relación a la planeación, ejecución y evaluación de los procesos de enseñanza y aprendizaje. El estudio, de tipo descriptivo cualitativo, se llevó a cabo durante el primer semestre de 2006 en la Facultad de Enfermería de la Universidad de La Sabana. Sus principales hallazgos son: con relación a la programación de las asignaturas se encontró que éstas tienen los elementos básicos de la educación por competencias, contemplando el saber ser, el conocer y el hacer propios de cada asignatura. Sin embargo, dentro de esta programación no se encuentra la metodología que se empleará en las clases. Tampoco hay una relación clara entre las estrategias didácticas, el proceso evaluativo y el logro de las competencias. En el desarrollo de las clases se encontró que los profesores manejan los temas en forma clara y concisa, pero hay diferencias entre el profesor novato, que se centra más en los contenidos, y el experto, que se ocupa de forma más natural por los procesos y por promover el análisis. La metodología más utilizada por los profesores durante las clases consiste en realizar y responder preguntas mientras se expone o se discute determinado tema. Con relación al proceso evaluativo, éste se centra principalmente en los contenidos, excepto en las prácticas donde se valora el saber, el hacer y el ser en forma integral. Falta evidenciar la autoevaluación y la coevaluación en todas las asignaturas, aspectos necesarios dentro de la formación por competencias. La recuperación es una herramienta valiosa que apunta a la educación por competencias, es aplicada en todas las asignaturas y permite valorar en forma individual los logros del alumno al establecer un plan de mejoramiento orientado por el profesor.

Research on the frontlines of healthcare: a cooperative learning approach.

BACKGROUND: Evidence-based practice is a common goal in hospitals, but learning about research so that the practice can be done is often challenging for clinicians. OBJECTIVES: The aims of this study were to (a) develop a process that supports organizational and staff development while conducting research and (b) conduct a research study in the emergency department (ED) to examine patient population, satisfaction, and waiting room issues. METHODS: A multidisciplinary team of clinicians and scientists was assembled to learn and do research while evaluating the ED waiting room of a Level I trauma center. A cooperative learning method approach was used to teach research concepts as the study was designed and implemented. RESULTS: The team demonstrated their knowledge and understanding of research concepts by being involved actively in the creation and implementation of the preintervention study. Using information from photographs, observations, and a questionnaire, the team identified the following key dissatisfaction areas: (a) atmosphere (including comfort with environment, neatness and cleanliness, and noise), (b) telephones, (c) parking and thoroughfare, (d) professional behavior and staff presence (including personal attention), (e) security, and (f) triage and confidentiality. DISCUSSION: The model of working in partnership with researchers and using cooperative, collaborative research is an effective way to evaluate and address issues related to quality of care while learning about the research concepts needed to put evidence into practice.

Designing study nurses' training to enhance research integrity: a macroergonomic approach.

Successful field evaluation of informatics initiatives designed to create technology-enhanced professional practice relies on adequate training of experimental participants. However, such training presents design, implementation and evaluation challenges. A macroergonomic approach, focusing on an organizational view of people, technology, task and environment interactions in work systems, provides a framework for training that allows anticipation and compensation for challenges. In the HeartCare II project, we developed a multi-level training program for nurses and patients enrolled in a field trial of an innovative technology-enhanced professional practice model. Using a macroergonomic approach, we designed three waves of training centered on a train-the-trainer model. Evaluation tools for each training wave provided improvement feedback. Despite planning, a drop-off occurred between training waves, affecting both recruitment and patient training. Troubleshooting identified people, task, technology, and organizational concerns. Strategies to increase nurse buy-in and improve technical performance are making a difference. Organizational challenges remain the most intractable.