A municipal health center's co-constructed therapeutic patient education program for patients with single or multiple morbidities / Co-construction d'un dispositif d'ETP mono et polypathologique dans un centre municipal de santé

Introduction: The accessibility of Therapeutic Patient Education (TPE) is essential to reduce social inequalities and to meet the challenges posed by the increase in chronic diseases. In France, the distribution of TPE throughout the territory is heterogeneous and patients still lack sufficient access. With these perspectives in mind, a municipal health center has developed an innovative TPE device by involving concerned patients from the outset. Objectives: The objectives of this article are to present the methodology implemented to co-construct a TPE program for patients with one or more prevalent diseases in the territory, as well as the results of the co-construction. Methods: Creation of a project team with various actors: patients, health professionals, administrators, researchers. Organization of synchronous and asynchronous times. Results: Four meetings and numerous exchanges made it possible to: define the common values and operating rules of the project team, reflect on the coordination of the care pathway, identify the specific and shared needs of patients affected by type 2 diabetes, arterial hypertension and/or obesity, agree on the principles of the device. Conclusion: The advantages of this device were discussed: flexible organization with numerous links with local actors, development of partnerships, expansion of the population concerned. Questions and difficulties were encountered, such as the coordination of actors and the representation of partner patients for the targeted diseases. This device will be tested and evaluated, mainly with an objective of improving it.

Introduction: L'accessibilité de l'Éducation Thérapeutique du Patient (ETP) est essentielle pour contribuer à une réduction des inégalités sociales et répondre aux défis posés par l'accroissement des maladies chroniques. En France, la répartition de l'offre d'ETP sur le territoire est inhomogène et les patients y occupent une place encore trop modeste. Dans ces perspectives, un centre municipal de santé a élaboré un dispositif innovant d'ETP en impliquant, dès le début, des patients concernés. Objectifs: Les objectifs de cet article sont de présenter la méthodologie mise en œuvre pour co-construire un dispositif d'ETP pour des patients porteurs d'une ou de plusieurs maladies prévalentes sur le territoire, ainsi que les résultats de la co-construction. Méthodes: Constitution d'une équipe projet avec divers acteurs : patients, professionnels de santé, administratifs, chercheurs. Organisation de temps synchrones et asynchrones. Résultats: Quatre réunions et de nombreux échanges ont permis de : définir les valeurs communes et les règles de fonctionnement de l'équipe projet, réfléchir sur la coordination du parcours de soins, identifier des besoins propres et partagés des patients touchés par le diabète de type 2, l'hypertension artérielle et/ou l'obésité, se mettre d'accord sur les principes du dispositif. Conclusion: Ce dispositif présente des avantages certains : organisation souple avec de nombreux liens avec les acteurs locaux, développement du partenariat, élargissement de la population concernée. Néanmoins, des questionnements et des difficultés ont été rencontrés comme la coordination des acteurs et la représentation des patients partenaires pour les maladies ciblées. Ce dispositif sera expérimenté et évalué principalement en vue de son amélioration.

Supporting nursing students with dyslexia: The situation in France in 2022 and outlook / L'accompagnement des étudiants en soins infirmiers avec une dyslexie. État des lieux en France en 2022 et perspectives

Introduction: The number of students with disabilities in higher education is increasing. Dyslexia is the most common form of disability. Few reports on this subject focus on health-sector education in France. Objectives: The survey sought to characterize and understand the support provided in nursing training institutes with regard to dyslexia. Methods: A mixed survey was carried out in 2022, mainly involving disability referents in nursing institutes. A national questionnaire collected 113 responses from metropolitan and overseas France, then three focus groups brought together twenty-eight participants from ten different regions. Results: In 2022, the most frequent measures were related to assessments and institutional communication. However, they lacked structure. There were still gaps, especially in the area of work placement. Discussion: In addition to the disability referents, all stakeholders must be made aware of the needs of students with dyslexia. Greater visibility of disability could also change attitudes in the health care sector. Conclusion: Specific support for dyslexia has been introduced in nursing training institutes. Its development requires a change in the attitudes of the stakeholders. It could then be extended to other health training courses.

Introduction: Le nombre d'étudiants en situation de handicap augmente dans l'enseignement supérieur. La dyslexie en constitue la forme la plus fréquente. Peu de communications sur ce sujet ciblent les formations en santé en France. Objectifs: L'enquête menée cherchait à caractériser et à comprendre l'accompagnement mis en place en instituts de formations en soins infirmiers (Ifsi) au regard de la dyslexie. Méthodes: Une enquête mixte a été réalisée en 2022 principalement auprès de référents handicap en Ifsi. Un questionnaire national a recueilli 113 réponses de métropole et d'Outre-Mer, puis trois focus groups ont réuni 28 participants originaires de dix régions différentes. Résultats: Au moment de l'étude, les mesures les plus fréquentes concernaient les évaluations et la communication institutionnelle. Cependant, elles manquaient de structuration. Des zones lacunaires persistaient, notamment en stage professionnel. Discussion: Au-delà des référents handicap, l'ensemble des acteurs doivent être sensibilisés aux besoins des étudiants avec une dyslexie. Une plus grande visibilité du handicap pourrait également faire évoluer les mentalités dans le milieu soignant. Conclusion: L'accompagnement spécifique concernant la dyslexie est initié en Ifsi. Son développement nécessite un changement de regard des parties prenantes. Il pourra secondairement se prolonger à d'autres formations en santé.

Supporting nursing students with dyslexia: The situation in France in 2022 and outlook / L'accompagnement des étudiants en soins infirmiers avec une dyslexie. État des lieux en France en 2022 et perspectives

INTRODUCTION: The number of students with disabilities in higher education is increasing. Dyslexia is the most common form of disability. Few reports on this subject focus on health-sector education in France. OBJECTIVES: The survey sought to characterize and understand the support provided in nursing training institutes with regard to dyslexia. METHODS: A mixed survey was carried out in 2022, mainly involving disability referents in nursing institutes. A national questionnaire collected 113 responses from metropolitan and overseas France, then three focus groups brought together twenty-eight participants from ten different regions. RESULTS: In 2022, the most frequent measures were related to assessments and institutional communication. However, they lacked structure. There were still gaps, especially in the area of work placement. DISCUSSION: In addition to the disability referents, all stakeholders must be made aware of the needs of students with dyslexia. Greater visibility of disability could also change attitudes in the health care sector. CONCLUSION: Specific support for dyslexia has been introduced in nursing training institutes. Its development requires a change in the attitudes of the stakeholders. It could then be extended to other health training courses.

Introduction: Le nombre d'étudiants en situation de handicap augmente dans l'enseignement supérieur. La dyslexie en constitue la forme la plus fréquente. Peu de communications sur ce sujet ciblent les formations en santé en France. Objectifs: L'enquête menée cherchait à caractériser et à comprendre l'accompagnement mis en place en instituts de formations en soins infirmiers (Ifsi) au regard de la dyslexie. Méthodes: Une enquête mixte a été réalisée en 2022 principalement auprès de référents handicap en Ifsi. Un questionnaire national a recueilli 113 réponses de métropole et d'Outre-Mer, puis trois focus groups ont réuni 28 participants originaires de dix régions différentes. Résultats: Au moment de l'étude, les mesures les plus fréquentes concernaient les évaluations et la communication institutionnelle. Cependant, elles manquaient de structuration. Des zones lacunaires persistaient, notamment en stage professionnel. Discussion: Au-delà des référents handicap, l'ensemble des acteurs doivent être sensibilisés aux besoins des étudiants avec une dyslexie. Une plus grande visibilité du handicap pourrait également faire évoluer les mentalités dans le milieu soignant. Conclusion: L'accompagnement spécifique concernant la dyslexie est initié en Ifsi. Son développement nécessite un changement de regard des parties prenantes. Il pourra secondairement se prolonger à d'autres formations en santé.

Patient engagement in nursing training: An exploratory study / L'engagement des patients dans la formation des étudiants en soins infirmiers : une étude exploratoire

Context: The initial training of healthcare professionals can be used to develop health democracy if patients are sufficiently involved. Objectives: To describe the level of patient engagement in some nurse training institutes and to understand what motivates and hinders this engagement. Method: Exploratory study based on interviews with five patient trainers and eight nurse training institute trainers. The analysis of patient engagement levels was based in part on the Carman scale and the Montreal model. Results: Two trends emerged from this first study: consultation-style patient involvement, and partnershipstyle involvement, where the patient is involved in the pedagogical co-construction of a few teaching units and not of the entire training course. Elements facilitating patient involvement were linked to the participants' motivation, patient support, and patient recruitment methods. Conversely, a lack of institutional motivation, overly demanding recruitment, the absence of remuneration, and inaccessibility could be barriers to patient engagement. Conclusion: Patient engagement in preliminary healthcare training should be considered across the entire curriculum and formalized.

Contexte: La formation initiale des professionnels de santé peut être un levier au développement de la démocratie en santé si l'engagement des patients dans ces formations est suffisant. Objectifs: Décrire le niveau d'engagement des patients dans quelques instituts de formation en soins infirmiers et comprendre ce qui motive et ce qui freine cet engagement. Méthode: Étude exploratoire basée sur des entretiens auprès de cinq patients formateurs et de huit formateurs en IFSI. L'analyse des niveaux d'engagement des patients s'est basée en partie sur l'échelle de Carman et sur le modèle de Montréal. Résultats: Deux tendances ont été dégagées de cette première étude : un engagement patient de type consultation, et un engagement de type partenarial où le patient est impliqué dans la coconstruction pédagogique sur quelques unités d'enseignement et non sur l'ensemble de la formation. Les éléments favorisant l'engagement des patients étaient liés à la motivation des deux protagonistes, l'accompagnement et les modalités de recrutement des patients. À l'inverse, un manque de motivation institutionnelle, un recrutement trop exigeant, l'absence de rémunération et l'inaccessibilité des locaux pouvaient constituer des freins à l'engagement des patients. Conclusion: L'engagement des patients dans la formation initiale en santé doit être réfléchi sur l'ensemble du curriculum et formalisé.

Besoins éducatifs en santé en Appartement de Coordination Thérapeutique.

OBJECTIVE: The aim of this study was to identify the health education needs of people suffering from several pathologies including HIV and/or hepatitis, living in vulnerable conditions in Therapeutic Coordination Apartments (known in French as Appartements de Coordination Thérapeutique under the acronym ACT). METHOD: This article is based on a qualitative and collaborative study involving in research team people living in ACT, professionals of ACT and academics. Interview guides based on the literature were developed. Nine ACTs participated: there were interviews with 36 people with chronic conditions, 9 focus groups with staff members and 9 additional interviews with ACT managers. RESULTS: Health education needs were identified. These involved: managing one's multiple conditions, managing certain diseases in particular, daily life with multiple chronic conditions, the connections and origins of the diseases. Factors influencing how they deal with one disease rather than another were expressed. The educational needs of people with HIV and/or hepatitis have been highlighted. CONCLUSION: Health education needs still exist despite the care that people living in ACTs receive. The study makes it possible to put forward proposals for improving support and, more specifically, health education interventions implemented in ACTs: asking additional questions to identify health education needs more precisely, providing polypathology therapeutic patient education (TPE) training to the teams, involving the affected populations, taking into account health literacy levels.

First use of Simulation in Therapeutic Patient Education (S-TPE) in adults with diabetes: a pilot study.

OBJECTIVE: To pilot test the feasibility and acceptability of Simulation in Therapeutic Patient Education (S-TPE), in both adult patients with diabetes and educators. CONCEPTION: Adult patients with insulin-dependent diabetes and who participated in a full TPE programme for the implementation of a FreeStyle were included in this monocentric pilot study. S-TPE intervention was based on a consensus conference determining the conditions and objectives of S-TPE. Main outcomes were the patients' and educators' perception of the usefulness of S-TPE and the patient's satisfaction level at the conclusion of the simulation sequence, measured on validated scales. Secondary outcomes were organisational, human, material and temporal, facilitating and limiting factors for patients and educators, patient self-efficacy and anxiety scores. INTERVENTIONS: The final session of TPE used the simulation. For each group, one patient volunteered to be the simulated patient. Intervention was divided into three steps: (1) a pre-briefing, (2) a simulation of hypoglycaemia and (3) a debriefing with the group of patients and educators. The whole intervention lasted about 2 hours. RESULTS: We included 23 patients (mean age ±SD 63±15 years, 14 men) and 3 educators. After S-TPE intervention, patients' and educators' perceived usefulness score were 20.6/25 and 37.5/40, respectively. Patient's satisfaction score was 51.9/60. Qualitative analysis revealed no limiting factors to implementing S-TPE. Self-efficacy was stable. Decrease in anxiety score after S-TPE reached statistical significance in women (from 35.1±4.5 to 32.7±5.5, p=0.04) but not in men. CONCLUSION: No limiting factors that could prevent the conduct of clinical trials to assess S-TPE efficacy in patients with diabetes were identified. S-TPE appears as a promising technique to improve diabetes management. TRIAL REGISTRATION NUMBER: Registration N°: 2019-A00773-54 and NTC: 03956927.

Bioinspired and Post-Functionalized 3D-Printed Surfaces with Parahydrophobic Properties.

Desertification is a growing risk for humanity. Studies show that water access will be the leading cause of massive migration in the future. For this reason, significant research efforts are devoted to identifying new sources of water. Among this work, one of the more interesting strategies takes advantage of atmospheric non-liquid water using water harvesting. Various strategies exist to harvest water, but many suffer from low yield. In this work, we take inspiration from a Mexican plant (Echeveria pulvinate) to prepare a material suitable for future water harvesting applications. Observation of E. pulvinate reveals that parahydrophobic properties are favorable for water harvesting. To mimic these properties, we leveraged a combination of 3D printing and post-functionalization to control surface wettability and obtain parahydrophobic properties. The prepared surfaces were investigated using IR and SEM. The surface roughness and wettability were also investigated to completely describe the elaborated surfaces and strongly hydrophobic surfaces with parahydrophobic properties are reported. This new approach offers a powerful platform to develop parahydrophobic features with desired three-dimensional shape.

Reflective writing: Implementation and learning perception from students and teachers of French nursing schools.

To support reflective skills development, French nursing students write analyses of professional situations (Situation Analysis) experienced during their practice. Sixteen nursing schools in Paris have developed a common framework to support and evaluate students on these skills. The aims of the study were to assess and understand the implementation of the Situation Analysis in French nursing schools as well as their effects on students' learning. A quantitative approach was based on two questionnaires: students (n = 1525, 27.6% of participation) and teachers (n = 131, 49.2%). The results showed that there were variations in teaching of situation analysis. There were correlations between the perception of learning and the modalities of implementation. Not always easy to choose, the situations described were authentic for 97.8% of students, concerned mainly their own practice and relationship with patients. Emotional situations were less frequent. Feedback was generally present and encouraging, but not enough on the students' self-evaluation skills. Slightly more than half of students and teachers were satisfied of the situation analysis. Both of them made positive and negative comments. The study highlights what can be improved in teaching to increase student's learning through situation analysis, for example teamdefined objectives.

Consensus Recommendations for the Use of Simulation in Therapeutic Patient Education.

INTRODUCTION: Simulation is rarely used to help individuals with chronic diseases develop skills. The aim of the study was to provide recommendations for the use of simulation in therapeutic patient education (S-TPE). METHODS: Expert consensus was achieved with the participation of the following 3 groups of experts: (a) expert patients and caregivers; (b) health professionals specialized in therapeutic patient education (TPE); and (c) simulation experts. Each expert received a list of questions by e-mail in 3 iterations. The synthesis of the 2 first questionnaires resulted in 34 first recommendations voted during the consensus conference meeting. Each recommendation was subject to an extensive literature review. The quality of the evidence and the strength of the recommendations were assessed through the evaluation, development, and evaluation criteria categories (GRADE criteria). The third questionnaire selected and illustrated recommendations more specific to the use of S-TPE. RESULTS: At the end of the process, the experts identified 26 recommendations specific to the use of S-TPE. They proposed examples of skills in different diseases and stressed the importance of adapting the conditions of use (location, equipment, time of the care) to the circumstances of the patient learner and skills to be developed. Experts should exercise great caution as this technique presents ethical considerations related to patient care. CONCLUSIONS: These recommendations underline the fact that simulation could bring added value to TPE. They provide a framework and examples for the experimental use of simulation in TPE. Research into feasibility and acceptability is needed.

The Patient Teacher in General Practice Training: Perspectives of Residents.

BACKGROUND: Patient teachers were involved in training general practice residents (GPRs) to strengthen the patient-centered approach. They teach a course on health democracy by themselves and teach in tandem with a physician teacher during reflective practice-based classes (named GEPRIs). We present the GPRs' representations of patient teacher characteristics and capacities and their perception of how useful patient teachers are to their professional development. METHODS: We administered a questionnaire based on a preliminary qualitative study to 124 GPRs. It explored (a) changes in the GPRs' representations about patient teacher characteristics and capacities with regard to teaching over the first year of the experiment; (b) GPRs' perception of patient teacher utility to their training and their contribution to developing patient perspective-related competencies. RESULTS: The response rate was 89.5% (111/124). The majority of GPRs agreed with 17 (before) and 21 (after) of the 23 patient teacher characteristics and with 17 (before) and 19 (after) of the 20 capacities. The agreement rate increased, overall, after patient teacher participation. The GPRs found patient teacher useful to their training in 9 of 11 topics (agreement rate 65%-92%). They felt they had developed the 14 patient knowledge-related competencies (agreement rate 62%-93%), and 52% to 75% of the GPRs rated the patient teachers' contribution to those competencies "high or very high," depending on the competency. CONCLUSION: This study demonstrates the specific contribution of patient teachers to university-level medical training in France. The GPRs recognized that patient teachers helped them develop competencies by providing patient-specific content.

[Therapeutic Patient Education training for nursing students: A case study.] / La formation en éducation thérapeutique « niveau 1 ¼ des étudiants en soins infirmiers : étude de cas.

INTRODUCTION: Many educational institutions offer professionals continuing education in therapeutic patient education (TPE). Some also provide it for students in initial training. OBJECTIVES: 1) Describe the methods of implementing the training in two nurse training institutes (IFSI); 2) Determine the conditions conducive to the development of competencies for students in initial training. METHOD: Nineteen semi-structured interviews were conducted with trainers, external speakers, students in training, and registered nurses. A questionnaire sent to trainers and external speakers was used to supplement the information gathered. RESULTS: All stakeholders had different levels of training and had experience in TPE. Multiprofessionality in teaching was favored. Several pedagogical activities were proposed to make up for the lack of experience of the students and the shortage of internships, among them role-playing, exchanges of practices, and creation of tools. The training was evaluated in terms of satisfaction and acquisition. DISCUSSION: The training courses implemented largely follow the quality criteria described in the literature. CONCLUSION: This type of training could be replicated with other students in initial training, or even interprofessional training. The effects of this training should be assessed.

[Designing and evaluating therapeutic education tools for people living with HIV]. / Concevoir et évaluer des outils d'éducation thérapeutique pour les personnes vivant avec le VIH.

In the context of therapeutic education for people living with HIV in Africa, educational tools must be adapted to their living environment. OBJECTIVES: To describe the process of designing education tools for patients living with HIV and evaluate their use by African caregivers-educators. METHODS: An eight-step participatory and formative process was carried out to design educational tools. Twenty-one caregivers-educators from nine French-speaking African countries in three focus groups were interviewed on the way in which they used these tools. RESULTS: Fourteen people were trained in the process of designing the tools and training caregivers-educators in their use. Two toolkits were developed (adults and children/adolescents). The image folder was the tool most commonly used. Educators in all countries used tools to address self-care and psychosocial coping skills. The criteria for choosing the tools were linked to their attractiveness, ease of use, their adaptation to the patient's needs and characteristics, and the degree of mastery by the caregiver-educator. The tools helped to structure the education sessions. Brakes to their use were organizational and lack of experience or mastery. CONCLUSION: The participatory and formative approach enabled educators working with patients living with HIV in French-speaking Africa to appropriate the tools. Training was a crucial step in enabling caregiver-educators to master and disseminate the tools, and design new tools.

Multiple brief interventions in police custody: The MuBIC randomized controlled study for primary prevention in police custody. Protocol and preliminary results of a feasibility study in the Paris metropolitan area, France.

BACKGROUND: The 15- to 35-year-old population has little contact with the health care system and is exposed to risk factors. Several studies demonstrated the feasibility of brief interventions (BIs) in different settings, e.g., in addiction medicine during police custody, where arrestees are entitled to a medical examination. Approximately 700,000 individuals are detained in police custody in France annually, and custody is an opportunity for young people to be medically examined. The characteristics of the detainees and previous experience with BIs suggest that custody is an opportunity to contribute to primary prevention. We propose to investigate the feasibility of such a contribution. OBJECTIVES: The aim of this article is to present a study protocol and some preliminary results. The primary research objective is to assess the feasibility of performing brief interventions without a specific topic in police custody settings in arrestees aged 15-35 years. The secondary research objectives include i) testing four strategies for engaging in BIs that maximize the chances of success of the BI; ii) identifying the determinants that can orient the practitioner's choice to use a specific strategy over another one; and iii) analysing the differences between individuals who engage in BIs and those who do not and, in those who do engage, the determinants of success of the intervention. METHODS: A two-step randomized and prospective study: i) randomization of eligible patients into 4 groups of 500 patients each; analysis of the response rates for each strategy; performance of the BI; and analyses of the associated factors and ii) a real-life, full-scale phase study evaluating the effectiveness of BIs performance of the BI; and analyses of the interventions. Analyses of the determinants of a positive response to BI, of success and of the topic of intervention will be conducted. EXPECTED RESULTS: The rates of BI performed, rates of success, and characteristics associated with response and with success are the main expected results. Additionally, the development and assessment of filter questions and an improved BI dedicated to primary prevention for police custody settings will be attained.

[Training and action research in a short-stay geriatric oncology unit]. / Recherche-action et formation dans une unité de court séjour oncogériatrique.

A participative action research project was undertaken in a geriatric oncology hospital unit. It resulted in the training of paramedical staff regarding the specific care to be provided to elderly people with cancer.

Children with chronic disease and extracurricular activities: training needs / Enfants atteints de maladies chroniques et activités périscolaires : des besoins de formation.

Background: ln the current context of increasing numbers of children living with a chronic disease and increasing numbers of people supervising extracurricular activities, difficulties appear to persist despite the Personalised Core Project (PCP). This study explores the accessibility and usefulness of the information provided by the Personalised Care Project and the value of complementary support. Methods: Based on the key messages identified by experts in the four most common chronic diseases, a questionnaire was deve/oped and sent to people supervising extracurricular activities in three districts of the Saône-et-Loire department. Descriptive statistical analysis was performed. Results: 55 people participated in the study. 30 (54.5%) had already supervised children with a chronic disease, 21 (70%) of them had been able to read the PCP and 17 (57%) had participated in an information meeting. 23 out of 28 (82%) considered thot the information contained in the PCP was helpful and 21 (81%) expressed their needs for further information. 98% of respondents thought thot additional support would be useful. Their main needs corresponded to 3 main self-core ski/Js: to recognize, analyse and measure; to deal with and decide; to resolve prevention problems. Conclusion: This study confirms the value of the PCP, but also the Jack of preparation of people supervising extracurricu/ar activ ities. lt highlights the need for training to allow these people to ensure the safety of chi /dren living with chronic diseases.

Identifying the educational needs of lung transplant recipients with cystic fibrosis.

PURPOSE: To elucidate the education needs of patients who have undergone lung transplant for cystic fibrosis while participating in the development of therapeutic education programs in French transplant centers. METHODS: From January 2009 to March 2012, in-depth educational diagnosis interviews were conducted with 42 adult transplant recipients with cystic fibrosis who were being followed up at 7 French transplant centers. Several areas were explored: health status, social and occupational outcomes, knowledge about the disease and treatments, and experience of the disease. The interviews combined open- and closed-ended questions for more systematic exploration of knowledge about the disease and treatments. RESULTS: After receiving the transplant, the patients' health had improved and their lives were returning to normal. They had acquired much usable knowledge about managing their disease. Educational needs regarding transplant-related complications and management of immunosuppressive drugs were evident. The analysis also demonstrated the need to better inform patients about pregnancy and new social rights and to offer them psychological support in adjusting to their new health status. CONCLUSION: Therapeutic education of patients should continue well after transplant to maintain safety knowledge and meet patients' new needs. A comprehensive therapeutic education program for transplant candidates that includes the preparatory, immediate posttransplant, and late posttransplant phases is needed.

[Formalization of a training method to develop reflective practice and emotion skills in nursing students]. / Formalisation d'une technique pédagogique favorisant le développement de la pratique réflexive et des compétences émotionnelles chez des étudiants en soins infirmiers.

CONTEXT: among health professional skills, emotion skills and reflective practice are very important. This article proposes a reflection on a training method used in a French nursing school. The method aims to develop reflective practice and emotion skills of nursing students. METHOD: the training method was experimented with fifteen students. During an individual interview, the students were invited to describe a situation loaded emotionally that they lived in clinical internship. The trainer boosted the student from a plan drawn on the base of his speech so that the student deepens his reflection. After experimentation, the trainer analysed his own practice using the method. Students' opinion and the trainer's logbook were analysed. RESULTS: the students declare to have improved their capacity for analysing, their self-knowledge and their emotional skills. They appreciated the technique and the help brought by the plan. All students expressed feelings. The analysis allowed specifying the stages, principles and foundations of the method as well as the conditions of its implementation. The transfer of the technique with the nurse trainers is described. CONCLUSION: the analysis of the training method testifies of its relevance to help nursing students to realize a reflective practice from an emotional clinical care. More research is needed to assess its effects and limitations.

[Exploratory study of clinical reasoning in nursing students with concept mapping]. / Etude exploratoire du raisonnement clinique chez les etudiants en soins infirmiers à l'aide de la carte conceptuelle.

BACKGROUND: The training reference leading to the state nursing diploma places the learning of clinical reasoning at the center of the training. We have been wondering about the possibilities of making visible the student nurse's mental processes when they provide nursing care in order to identify their strategies and reasoning difficulties. It turns out that concept mapping is a research tool capable of showing these two aspects. OBJECTIVES: The aim of this study is to verify a concept mapping made during an interview and built from the speech of a nursing student when analyzing a simulated clinical situation, is able to make visible its strategies clinical reasoning and reasoning difficulties. In a second phase of it, is to explore how the concept map once elaborated allows students to identify their own intellectual reasoning. METHOD: 12 nursing second year students have participated in the study. Concept maps were constructed by the trainer/researcher as the students analyzed aloud a simulated clinical situation written. Concept maps were analyzed from a reference grid. Interviews were conducted following the elaboration of concept maps and student's comments were analyzed. RESULTS: Students reasoning strategies were either mixed inductive dominant (5/12) or hypothetical-deductive dominant (5/12). Reasoning difficulties identified are related to the lack of identification of important information, the lack of analysis of data, lack of connection or the existence of faulty links. Analysis of the comments highlights that concept mapping contributed to the development of metacognitive skills. CONCLUSION: The concept mapping has shown benefits in contributing to a diagnostic assessment of clinical reasoning learning. It is an additional resource tool to facilitate the development of metacognitive skills for students. This tool can be useful to implement support learning strategies in clinical reasoning.

From Bretonneau to therapeutic antibodies, from specificity to specific remedies, Saint-Cyr-Sur-Loire, France, November 19, 2012.

Held on November 19, 2012 in Saint-Cyr-sur-Loire, France, the symposium "From Bretonneau to therapeutic antibodies, from specificity to specific remedies" focused on the historical development of antibodies as therapeutics, with an emphasis on the seminal work of the French physician Pierre-Fidèle Bretonneau (1778-1862). The morning session was devoted to discussion of the evolution of the concept of specificity in medicine, which started with an epistemological definition. The contributions of Bretonneau to the emergence of the concept of specificity, notably with his studies on diphtheria, and the subsequent development of antidiphtheric serotherapy in Europe during the period 1894-1898 were then presented in detail. The afternoon session began with a presentation on the role of French physiologists during the years 1860-1890 in establishing the basic concepts of specific immunity and the principles of serotherapy. The history of antivenom serotherapy, particularly its discovery by Césaire Phisalix, and the development of antilymphocyte globulins as successful transplantation drugs were then discussed. The symposium ended with the inauguration of a stele representing Bretonneau, who lived in Saint-Cyr-sur-Loire and died 150 y ago.

[Portfolio in nursing school: myth or reality]. / Portfolio en institut de formation en soins infirmiers: mythe ou réalité.

CONTEXT: The portfolio is a new tool that has been introduced for the setting up of a new program concerning the nurse training. It aims at the would-be nurse to improve their self-reliance and make them assess themselves through a critical and reflexive approach. Indeed, the portfolio is mostly made up of sheets that the student has to fill in when describing and analysing several professional conditions. AIM: This study is about the assessment of the relevance in the portfolio that each nurse student owns in order to make them improve their reflexive practical. The work will, thus, suggest different ways of thinking and improving the use of the tool. METHODS: 30 portfolios were chosen randomly among the 2nd year students, because 180 analysis were assessed thanks to a grid. 10 viewpoints from volunteer students were gathered after several semi directive interviews. RESULTS: The qualitative and evaluative analysis shows that the students develop the reflexive practical throughout their trainings. It seems, indeed, relevant to choose the portfolio in order to help the students to develop this way of working. According to them, there are several positive points such as the distance towards an event, an awareness-raising of the acquisition, feedbacks about the quality of the text by the trainer and an ability to assess oneself. Yet, even though it was created 18 months ago, there are some limits such as the too short period of mentoring and feedback, the lack of time for the students to write their analysis, the fact that it is not a practical tool, and the unclear description of assessment criteria. In order to fulfil the needs, some solutions are to be found. CONCLUSION: The portfolio is clearly helpful for the students who wish to increase/improve gradually their reflexive practice. Thus, the trainer's role is crucial, when he is a supervisor.