¡De repente, profesor! Caminos que recorren los enfermeros en busca de formación docente / Suddenly, teacher! Paths taken by nurses searching for teacher training / De repente, professor! Caminhos percorridos pelos enfermeiros em busca da formação docente

ABSTRACT Objective: to know the paths taken by the nurse-teachers of the Nursing technical course in search of their training for the teaching career. Method: a qualitative and cross-sectional research study, carried out with nurses who teach at the Nursing technical course of a Technical School of the Unified Health System in Ceará. The data were collected through a focus group in October 2019, and analyzed according to Bardin's thematic content analysis, with the aid of the Qualitative Data Analysis Software. Results: the paths for nurses' teacher training permeate their motivation to enter the teaching career, whose reasons are related to the difficulty finding a job in the assistance area, invitation to teach, job opportunity or existence of some need; initial performance in teaching, which emphasizes mid-level; and by training itself, which had its need confirmed and, from the participants' perspective, met through participation in institutional qualifications and personal search for specialization courses. Conclusion: the paths taken by nurse-teachers in search of their training for the teaching career are related to the reasons why they enter teaching, with their initial performance in teaching and with teacher training itself, regarding verification of their need and ways accessed for such qualification. The nurse's prior training for the teaching practice ultimately points to professional excellence and appreciation and commitment to the Unified Health System. Thus, it becomes imperative to (re)formulate policies that consider the complexity and professionality of teaching, with a view to expert teaching training and performance.

RESUMEN Objetivo: conocer los caminos que recorren los profesores de enfermería en el curso técnico de Enfermería en busca de su formación docente. Método: investigación cualitativa, transversal, realizada con enfermeros profesores del curso técnico de Enfermería en una Escuela Técnica del Sistema Único de Salud en Ceará. Los datos se recopilaron a través de un grupo focal, en octubre de 2019, y se analizaron de acuerdo con el análisis de contenido temático de Bardin, con el soporte del Qualitative Data Analysis Software. Resultados: los caminos para la formación del docente de enfermería pasan por su motivación para la inserción en la docencia, cuyas razones se relacionan con la dificultad de ser empleado en tareas asistenciales, invitación a enseñar, oportunidad laboral o existencia de alguna necesidad; desempeño inicial en la docencia, que enfatiza la educación secundaria; y por la formación propiamente dicha, cuya necesidad fue corroborada y, a juicio de los participantes, suplida a través de la participación en las cualificaciones institucionales y la búsqueda personal de cursos de especialización. Conclusión: los caminos que recorren los profesores de enfermería en busca de su formación docente están relacionados con las razones por las que ingresan a la docencia, con el desempeño inicial en la docencia y con la propia formación docente, en cuanto a la constatación de su necesidad y las vías de acceso para dicha cualificación. La formación previa del enfermero para la práctica docente apunta, en última instancia, a la excelencia y la valoración profesional y al compromiso con el Sistema Único de Salud, por lo que es imperativo (re) formular políticas que consideren la complejidad y profesionalidad de la docencia, con miras a la obtención de formación y actuación docente especializada.

RESUMO Objetivo: conhecer os caminhos percorridos pelos enfermeiros docentes do curso técnico de Enfermagem em busca da sua formação para a docência. Método: pesquisa qualitativa, transversal, realizada com enfermeiros professores do curso técnico de Enfermagem de uma Escola Técnica do Sistema Único de Saúde do Ceará. Os dados foram coletados através de grupo focal, em outubro de 2019, e analisados segundo análise de conteúdo temática de Bardin, com apoio do Qualitative Data Analysis Software. Resultados: os caminhos para a formação docente do enfermeiro perpassam pela sua motivação para inserção na docência, cujos motivos relacionam-se com a dificuldade de empregar-se na assistência, convite para lecionar, oportunidade de trabalho ou existência de alguma necessidade; atuação inicial no ensino, a qual confere ênfase ao nível médio; e pela formação propriamente, que teve sua necessidade constatada e, na visão dos participantes, suprida mediante a participação em qualificações institucionais e busca pessoal por cursos de especialização. Conclusão: os caminhos percorridos pelos enfermeiros docentes em busca da sua formação para a docência guardam relação com os motivos pelos quais ingressam no ensino, com a atuação inicial no magistério e com a própria formação docente, referente à constatação da sua necessidade e vias acessadas para tal qualificação. A formação prévia do enfermeiro para o exercício docente aponta, em última análise, para a excelência e valorização profissional e compromisso com o Sistema Único de Saúde. Assim, torna-se imperativa a (re)formulação de políticas que considerem a complexidade e profissionalidade do ensino, com vistas a uma formação e atuação docente experta.

A qualitative model for evaluating and improving nursing governance in medium- and long-term intermediate care.

AIM: To evaluate nursing governance in intermediate care in Catalonia Spain and propose improvements. BACKGROUND: Drawing on two existing models, the Magnet model and the corporate governance model, we propose that good nursing governance requires nursing leaders to apply the following dimensions: transformational leadership, transformational culture, commitment and sustainability, authority, scientific evidence, transparency and communication, and teamwork. METHOD: A qualitative, exploratory study conducted in two phases. First, we asked nursing leaders in intermediate care to describe their opinions and experiences in each of the dimensions. Next, we observed governance practices at two intermediate care centres and conducted interviews with their nursing leaders. Content analysis was used. RESULTS: Our participants' behaviour corresponded closely to the model in the dimensions of transformational culture and commitment and sustainability but failed to meet the model in the dimensions of scientific evidence and transparency and communication. CONCLUSIONS: Participants had a leadership style focused on transforming their surroundings. According to the model, the leaders in our sample should draw more on scientific evidence and improve their internal communication about outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Establishing committees of nurses to address areas in which governance does not adhere to the model would create sustainable benefits for patients and nurses in intermediate care.

Los currículos en enfermería y el desarrollo de las competencias interpersonales: el caso de Colombia / Curricula in nursing and the development of interpersonal skills: the case of Colombia

OBJETIVO: Analizar y reflexionar sobre los contenidos curriculares en enfermería y la inclusión de las competencias interpersonales para la formación de profesionales en Colombia. METODOLOGÍA: A partir de una revisión documental sobre currículo, competencias interpersonales y los programas de enfermería, se realiza una reflexión crítica sobre la formación en estas habilidades, partiendo del concepto de diversos expertos y le experiencia en Colombia. RESULTADOS: Existe una prevalencia de desarrollo de competencias interpersonales a través del currículo oculto de las asignaturas prácticas y en el modelado que los estudiantes reciben de los docentes y del mismo entorno en el que se van formado. CONCLUSIÓN: La tendencia debe ser hacia un cambio en el planteamiento de los objetivos de aprendizaje y la evaluación de los mismos dentro de las asignaturas, sin embargo aún es precario y prevalecen los aspectos cognitivos e instrumentales

OBJECTIVE: Analyze and reflect on the curricular contents in nursing and the inclusion of interpersonal skills for the training of professionals in Colombia. Methos: Based on a documentary review on curriculum, interpersonal skills and nursing programs, a critical reflection is made on training in these skills, based on the concept of various experts and experience in Colombia. RESULTS: There is a prevalence of development of interpersonal competences through the hidden curriculum of the practical subjects and in the modeling that the students receive from the teachers and from the same environment in which they are trained. CONCLUSION: The tendency must be towards a change in the approach of the learning objectives and the evaluation of the same within the subjects, nevertheless it is still precarious and the cognitive and instrumental aspects prevail

Estudio Delphi de las competencias pedagógicas del profesional de Enfermería en la escuela / Delphi Study about the educational skills by the School Nursing Professional

Objetivo: definir al profesional de Enfermería promotor de salud en el entorno escolar (PEPSEE), así como su perfil competencial pedagógico: actitudes, habilidades y conocimientos necesarios para llevar a cabo una acción de calidad y efectiva en dicho entorno. Método: se planteó una investigación de tipo cualitativa, de corte interpretativo y diseño mixto. En la recogida de datos se combinó la revisión documental con el método Delphi como técnica basada en cuestionarios a expertos, cuyo desarrollo quedó establecido en tres rondas. Hubo diferentes momentos de análisis en función de la tipología de los cuestionarios que se aplicaron, combinándose el análisis de contenido con el análisis estadístico descriptivo. Por último, se efectuó un proceso de relación y comparación de los datos obtenidos, procediendo al redactado de los resultados. Resultados: se extrajeron 11 rasgos definitorios para el PEPSEE delimitados en tres categorías: rol educador, visión integral del educando y enfoque integrador de la acción, y 81 elementos competenciales delimitados en nueve categorías: conocimiento base para la enseñanza de salud en la escuela, competencia interpersonal y de trabajo en equipo, habilidades de mediación pedagógica de salud, comunicación educativa, actitud docente competente, valores profesionales inherentes a la dimensión ética, investigación pedagógica en promoción de salud, competencia digital e innovación pedagógica, coordinación y liderazgo educativo. Conclusiones: el profesional de Enfermería promotor de salud en el entorno escolar es un profesional con identidad propia que debe ser reconocido social y profesionalmente como garante de una formación en salud de calidad

Objective: to define the Nursing professional as promoter of health in the school setting (NPPHSS), as well as their profile of educational skills: attitudes, skills and knowledge required to conduct a quality action which is effective in said setting. Method: a qualitative research was conducted, with interpretive and mixed design. Data collection combined documentary review with the Delphi method as a technique based on questionnaires to experts, with its development established in three rounds. There were different moments of analysis based on the type of questionnaires applied: content analysis was combined with descriptive statistical analysis. Finally, there was a process of association and comparison of the data collected, and the results were then written down. Results: eleven (11) defining features were obtained for the NPPHSS, classified into three categories: educational role, comprehensive vision of the learner, and integrative approach to action; and 81 competence elements classified into nine categories: basic knowledge for health education at school, interpersonal and teamwork skills, educational communication, skills for pedagogical mediation in health, competent teaching attitude, professional values inherent to the ethics dimension, pedagogical research in health promotion, digital skills and pedagogical innovation, educational coordination and leadership). Conclusions: nursing professionals as health promoters in the school setting are professionals with their own identity, who must be social and professionally acknowledged as guarantors for good-quality health training

An ethnographic study of human dignity in nursing practice.

BACKGROUND: The ethical values of nursing are crucial to the provision of humane care. Human dignity is a core value that must be preserved in order to deliver such care. No studies to date have compared the perceptions of nurses and/or patients regarding the components of dignified care embedded in actual clinical practice. PURPOSE: To explore the delivery of dignified care by professional nurses. This was an ethnographic qualitative study combining inductive and deductive methods to identify emergent themes. A multicenter study carried out in the internal medicine units of four hospitals in Barcelona (Spain). Convenience sampling was used to recruit nurses from the four units. SETTING AND SAMPLE: Multicenter study carried out in the internal medicine units of four hospitals in Barcelona (Spain). Convenience sampling was used to recruit nurses from the four units. METHOD: We conducted 158 hours of participant observation of 27 nurses. Semi-structured individual interviews were undertaken with 20 of these nurses, with data saturation being reached. Data were collected between September 2014 and May 2016 and were analysed using ATLAS.ti 7.2 for Windows. RESULTS: Two themes emerged from the analysis: Delivering dignified care and Factors influencing the delivery of dignified care. The nurses regarded human dignity as one of the key values of their profession. However, there was a discrepancy between their perceptions of the care they offered and what they actually did, due mainly to a lack of awareness about their own practice. Respect, confidentiality, privacy and communication were identified as the key elements underpinning dignified care. Institutional policies were seen as the major obstacle to the delivery of humane care, the key issues being frequent shift rotations, a high patient-nurse ratio and excessive paperwork. CONCLUSIONS: The results of this study underline the importance of delivering dignified care and the need to ensure that nurses' attitudes and behaviours are consistent with this goal. The ethnographic approach, combining participant observation with individual interviews, revealed discrepancies between nurses' perceptions of the care they offered, or should offer, and what they actually did. This suggests a need for professional forums in which nurses can become more aware of their own clinical practice.

La promoción de salud en la escuela como estrategia para el abordaje de la cronicidad en España / Health promotion in schools as a strategy for addressing chronic disease in Spain / A promoção da saúde na escola como estratégia para controlar a cronicidade em Espanha / La promotion de la santé à l'école comme stratégie pour faire face á la chronicité en Espagne

Resumen Objetivo: Este artículo aborda los temas que sirvieron de referencia teórica de una disertación de tesis doctoral. Se pretende analizar las principales conductas y factores de patologías crónicas que avalan la necesidad del enfoque promocional de salud en la escuela y a lo del todo el curso de vida, así como su impacto en la mejora de la salud global de la población y la reducción del gasto público en España. Material y métodos: Se ha utilizado una perspectiva crítica desde la que se hace una revisión reflexiva sobre dichos factores en el contexto español, estudiando la necesidad de abordaje temprano. Los factores analizados han estado relacionados con la alimentación y actividad física, salud bucodental, consumo de sustancias tóxicas, seguridad vial, sexualidad y bienestar emocional. Resultados: Se observa un descenso de actividad física en la etapa escolar. Tres de cada diez niños/as tienen sobrepeso u obesidad. La prevalencia de afecciones bucodentales ronda el 40% a los 6 años. El cannabis es la tercera droga más consumidas por los escolares de 14-18 años, después del tabaco y el alcohol. Más de la mitad de los fallecimientos por accidente de tráfico entre los jóvenes (18-24 años) fue durante la noche y fin de semana. España se consolida como tercer país de la Unión Europea con mayor número de abortos. Las infecciones de transmisión sexual afectan de forma desproporcionada a las adolescentes. Los trastornos de salud mental están entre los cuatro problemas más prevalentes de los niños/as menores de 15 años Conclusiones: Se concluye que las acciones educativas realizadas en la escuela desde las edades más tempranas sobre los factores y conductas pueden reducir considerablemente los costes individuales, económicos y sociales que acarrean las enfermedades crónicas, convirtiéndose en una necesidad estratégica para el abordaje de la cronicidad, que es uno de los mayores retos a los que se enfrenta el sistema sanitario español.

Abstract Object: This article focuses on the topics that served as theoretical reference of a doctoral dissertation. The aim is to analyze the main behaviors and factors of chronic pathologies that support the need of the promotional approach of health in the school and the whole life course, as well as its impact in the improvement of the global health of the population and the reduction of the public spending in Spain. Materials and methods: A critical perspective has been used from which a reflexive review of these factors in the Spanish context has been carried out, studying the need of an early approach. Factors related to diet and physical activity, oral health, toxic substance use, road safety, sexuality and emotional well-being have been analyzed. Results: There was a decrease in physical activity in the school stage. Three out of ten children are overweight or obese. The prevalence of oral diseases is around 40% at 6 years. Cannabis is the third most consumed drug by schoolchildren aged 14-18, after tobacco and alcohol. More than half of the deaths due to traffic accidents among young people (18-24 years old) occurred during the night and weekend. Spain is consolidated as the third country in the European Union with the highest number of abortions. Sexually transmitted infections disproportionately affect teenagers. Mental health disorders are among the four most prevalent problems of children under 15 years of age. Conclusions: It is concluded that educational actions carried out in schools from the earliest ages on behavioral risk factors can considerably reduce the individual, economic and social costs of chronic diseases, becoming a strategic necessity for dealing with chronic diseases, which is one of the greatest challenges facing the Spanish health system.

Resumo Objetivo: Este artigo aborda os temas que foram usados como referência teórica numa tese de doutoramento. Pretendeu-se analisar os principais comportamentos e fatores relacionados com as patologias crónicas que suportam a necessidade de uma abordagem de promoção de saúde na escola e em todo o ciclo de vida, bem como o seu impacto na melhoria da saúde global da população e na redução das despesas públicas em Espanha. Materiais e métodos: Utilizou-se uma perspectiva crítica a partir de uma revisão reflexiva sobre esses fatores no contexto espanhol, estudando a necessidade de intervenção precoce. Os fatores analisados foram relacionados com a alimentação, a atividade física, a saúde bucal, o consumo de substâncias tóxicas, a segurança rodoviária, a sexualidade e o bem-estar emocional Resultados: Observou-se uma diminuição da atividade física em crianças de idade escolar. Três em cada dez crianças sofrem excesso de peso ou obesidade. A prevalencia de doenjas bucais é de cerca de 40% aos 6 anos. A Cannabis é a terceira droga mais consumida por alunos dos 14 a 18 anos, depois do consumo de tabaco e álcool. Mais da metade das mortes por acidentes rodoviários dos jovens entre os 18 e 24 anos ocorreram durante a noite e no fim-de-semana. A Espanha é o terceiro país da Uniao Europeia com mais número de abortos. As infecções sexualmente transmissíveis afetam desproporcionalmente as adolescentes. Os transtornos mentais estao entre os quatro problemas mais prevalentes em crianças menores de 15 anos de idade. Conclusões: Conclui-se que as ações educativas realizadas na escola, em idades precoces, sobre os fatores de risco comportamentais, podem reduzir consideravelmente os custos individuais, económicos e sociais que as doenjas crónicas acarretam, transformando-se numa necessidade estratégica para a abordagem da cronicidade, que é um dos maiores desafios que o sistema de saúde espanhol enfrenta.

Résumé Objectif: Cet article se centre sur les sujets qui ont servi de référence théorique pour une thése de doctorat. L'objectif est d'analyser les principaux comportements et facteurs de pathologies chroniques qui supportent le besoin de l'approche promotionnelle de la santé á l'école et tout au long de la vie, ainsi que son impact sur l'amélioration de la santé globale de la population et la réduction du dépenses publiques en Espagne. Matériaux et méthodes: Une perspective critique a été utilisée á partir de laquelle une revue réflexive est faite sur ces facteurs dans le contexte espagnol, en étudiant la nécessité d'une approche précoce. Les facteurs analysés ont été liés á l'alimentation et á l'activité physique, á la santé bucco-dentaire, á la consommation de substances toxiques, á la sécurité routiére, á la sexualité et au bien-etre émotionnel. Résultats: Il y a une diminution de l'activité physique au stade scolaire. Trois enfants sur dix sont en surpoids ou obéses. La prévalence des maladies buccales est d'environ 40% á 6 ans. Le cannabis est la troisiéme drogue la plus consommé par les écoliers agés de 14 á 18 ans, aprés le tabac et l'alcool. Plus de la moitié des décés dus aux accidents de la circulation chez les jeunes (18-24 ans) ont eu lieu pendant la nuit et le week-end. L'Espagne est consolidée comme le troisiéme pays de l'Union européenne avec le plus grand nombre d'avortements. Les infections sexuellement transmissibles touchent de maniére disproportionnée les adolescentes. Les troubles de santé mentale sont parmi les quatre problémes les plus courantes chez les enfants de moins de 15 ans. Conclusion: Les actions éducatives menées á l'école dés le plus jeune age sur les facteurs et les comportements peuvent réduire considérablement les coúts individuels, économiques et sociaux qu'apportent les maladies chroniques, devenant une nécessité stratégique pour l'approche de la chronicité, qui est l'un des plus grands défis du systéme de santé espagnol.

Recorrido de un buen formador de enfermería. La mirada de sus protagonistas / The path of a good nursing educator. The perspective of the protagonists | O caminho de um bom educador de enfermagem. A perspectiva dos protagonistas / O caminho de um bom educador de enfermagem. A perspectiva dos protagonistas

Los buenos educadores son vitales como referentes en la formación de los docentes noveles y de estudiantes de enfermería. OBJETIVO: Explorar aspectos trascendentes para el desempeño docente de los buenos formadores en enfermería, desde sus propias perspectivas y en ámbitos de su historia personal y profesional. Materiales y MÉTODOS: Investigación cualitativa, tipo estudio de caso. Se identificaron a los mejores educadores consultando estudiantes y docentes de dos Escuelas Universitarias de Enfermería de Barcelona. Se utilizaron entrevistas, observaciones participantes y diario del profesor. Además, se usaron criterios de rigor científico, consentimiento informado y sistema de identificadores, asegurando confidencialidad y anonimato. RESULTADOS: Se describieron como trascendentes para su desempeño, la influencia de modelos como padres y docentes clínicos, el valor de la relación docente-estudiante, la intuición pedagógica y la relevancia del escenario de la práctica clínica. Discusión y CONCLUSIONES: Variados aspectos de la vida personal e historia profesional fueron influyentes para el desempeño como buenos educadores, con una potente coherencia entre el actuar profesional y el formador, corroborando la relevancia que adquiere el conocimiento práctico construido en base a experiencias personales sin requerir necesaria participación en programas formales de formación pedagógica

Good educators are vital as referents in the education process for novice nurse teachers and nursing students. OBJECTIVE: To explore transcendental aspects for the educational performance of the good trainers in nursing, from their own perspectives and in spheres related to their personal and professional history. METHODS: Qualitative research, case study METHODOLOGY: To identify the best nursing educators, students and teachers of two University Nursing Schools were consulted in Barcelona. Professor's diary, interviews and participant observations were used. Criteria of scientific rigor were applied. Informed consent and an identification system were used, ensuring confidentiality and anonymity. RESULTS: The influence of models as parents and clinical teachers, the value of the teacher-student relationship, the pedagogical intuition and the relevance of the clinical practice scenario were described as transcendental for their performance. Discussion and CONCLUSIONS: Several aspects of personal life and professional history were influential to the performance of good nursing educators, with a potent coherence between the professional act and the educative action, corroborating the importance of the practical knowledge built based on personal experiences without requiring a necessary participation in formal pedagogical training programs

Bons educadores são vitais como referentes no treinamento de docentes novatos e dicentes de enfermagem. OBJETIVO: Explorar aspectos que tenham sido importantes para o desempenho docente de bons treinadores de enfermagem, desde suas próprias perspectivas e em áreas de sua história pessoal e profissional. MÉTODOS: Pesquisa qualitativa, estudo de caso. Os melhores educadores foram identificados consultando a estudantes e professores de duas Escolas Universitárias de Enfermagem de Barcelona. Os bons professores foram questionados sobre o diário do professor, as entrevistas e as observações dos participantes. Foram utilizados critérios de rigor científico, assentimento informado e o sistema de identificação, assegurando anonimato. RESULTADOS: A influência dos modelos como pais e professores clínicos, o valor do relacionamento professor-aluno, a intuição pedagógica e a relevância do cenário de prática clínica foram descritos como transcendentes para o desempenho. Discussão e CONCLUSÕES: Tantos aspectos da vida pessoal como da história profissional foram influentes para o desempenho como bons educadores, com uma forte coerência entre a atuação profissional e o formador, corroborando a relevância adquirida pelo conhecimento prático construído sobre experiências pessoais sem requerer a participação necessária em programas formais de treinamento pedagógico

Communities of practice: influences on pedagogical reasoning and action of nursing professors.

OBJECTIVES: To analyze how the practice shared in communities of teaching practice in public and private universities influences the pedagogical reasoning and action of nursing professors based on Wenger's concepts of community, negotiation of meaning, and learning. METHODS: Case study conducted with two professors teaching nursing in a public and a private university in Brazil. Data collection included triangulation of sources and was conducted from April 2014 to July 2015. Data were organized in ATLAS.ti and analyzed using the constant comparative method, which generated three metacategories. RESULTS: In both cases the program's project is shared repertoire and grounds negotiation of meaning in the practice that takes place in the pedagogical reasoning and action phases but negotiation is different between communities and cases. Learning is either solitary or has the influence of at least one other member but does not occur on an institutional basis. CONCLUSIONS: Nursing schools could offer more than program's project to the negotiation of meaning and improve learning on practice in their communities as police of teachers education to improve pedagogical reasoning.

Comunidades de práctica: influencia en el razonamiento pedagógico y en la acción de los profesores enfermeros / Comunidades de prática: influências no raciocínio pedagógico e ação de professoras de enfermagem / Communities of practice: influences on pedagogical reasoning and action of nursing professors

Communities of practice: influences on pedagogical reasoning and action of nursing professors Objective. To analyze how the practice shared in communities of teaching practice in public and private universities influences the pedagogical reasoning and action of nursing professors based on Wenger's concepts of community, negotiation of meaning, and learning. Methods. Case study conducted with two professors teaching nursing in a public and a private university in Brazil. Data collection included triangulation of sources and was conducted from April 2014 to July 2015. Data were organized in ATLAS.ti and analyzed using the constant comparative method, which generated three meta-categories. Results. In both cases the program's project is shared repertoire and grounds negotiation of meaning in the practice that takes place in the pedagogical reasoning and action phases but negotiation is different between communities and cases. Learning is either solitary or has the influence of at least one other member but does not occur on an institutional basis. Conclusion. Nursing schools could offer more than program's project to the negotiation of meaning and improve learning on practice in their communities as police of teachers education to improve pedagogical reasoning. (AU)

Comunidades de práctica: influencia en el razonamiento pedagógico y en la acción de los profesores enfermeros Objetivo. Analizar cómo la práctica compartida en comunidades de práctica docente de universidades públicas y privadas influye en la acción y razonamiento pedagógico de profesoras de enfermería a partir de los conceptos de comunidad, negociación de significado y aprendizaje de Wenger. Métodos. Estudio de caso realizado con dos profesoras de enfermería de universidades públicas y privadas en Brasil. La recolección de datos incluyó la triangulación de Fuentes, la cual se realizó de abril de 2014 a julio de 2015. Los datos se organziaron en el ATLAS.ti y se analizaron a partir del método de comparaciones constantes, generando tres metacategorías. Resultados. En ambos casos el proyecto pedagógico de curso es el repertorio compartido y base para la negociación de significado que ocurre en las fases de la acción y raciocinio pedagógico, pero la negociación es distinta entre comunidades y casos. El aprendizaje ocurre de forma solitaria o por influencia de por lo menos un miembro, no de forma institucional. Conclusión. Las escuelas de enfermería pueden ofrecer más que el proyecto pedagógico del curso para la negociación de significado y fomentar el aprendizaje en la práctica en sus comunidades como política de formación docente para promover el razonamiento pedagógico. (AU)

Comunidades de prática: influências no raciocínio pedagógico e ação de professoras de enfermagem Objetivo. Analisar como a prática compartilhada em comunidades de prática docente de universidades pública e privada influencia a ação e raciocínio pedagógico de professoras de enfermagem a partir dos conceitos de comunidade, negociação de significado e aprendizagem de Wenger. Método. Estudo de caso conduzido com duas professoras de enfermagem de universidades pública privada no Brasil. A coleta de dados incluiu a triangulação de fontes e foi conduzida de abril de 2014 a julho de 2015. Os dados foram organizados no ATLAS.ti e analisados através do método das comparações constantes, gerando três meta-categorias. Resultados. Em ambos os casos o projeto pedagógico de curso é o repertório compartilhado e base para a negociação de significado que ocorre nas fases da ação e raciocínio pedagógico, mas a negociação é distinta entre comunidades e casos. A aprendizagem ocorre de forma solitária ou por influência de pelo menos um membro, não de forma institucional. Conclusão. Escolas de enfermagem podem oferecer mais do que o projeto pedagógico de curso para a negociação de significado e fomentar aprendizagem na prática em suas comunidades como política de formação docente para promover raciocínio pedagógico. (AU)

The emotion: A crucial component in the care of critically ill patients.

BACKGROUND: The acquisition of experience is a major concern for nurses in intensive care units. Although the emotional component of the clinical practice of these nurses has been widely studied, greater examination is required to determine how this component influences their learning and practical experience. OBJECTIVE: To discover the relationships between emotion, memory and learning and the impacts on nursing clinical practice. RESEARCH DESIGN: This is a qualitative phenomenological study. The data were collected from open, in-depth interviews. A total of 22 intensive care unit nurses participated in this research between January 2012 and December 2014. Ethical considerations: The School of Nursing Ethics Committee approved the study, which complied with ethical principles and required informed consent. FINDINGS: We found a clear relationship between emotion, memory and the acquisition of experience. This relationship grouped three dimensions: (1) satisfaction, to relieve the patient's pain or discomfort, give confidence and a sense of security to the patient, enable the presence of family members into the intensive care unit and provide family members with a realistic view of the patient's situation; (2) error experience, which nurses feel when a patient dies, when they fail to accompany a patient in his or her decision to abandon the struggle to live or when they fail to lend support to the patient's family; and (3) the feel bad-feel good paradox, which occurs when a mistake in the patient's care or handling of his or her family is repaired. CONCLUSION: Emotion is a capacity that impacts on nurses' experience and influences improvements in clinical practice. Recalling stories of satisfaction helps to reinforce good practice, while recalling stories of errors helps to identify difficulties in the profession and recognise new forms of action. The articulation of emotional competencies may support the development of nursing ethics in the intensive care unit to protect and defend their patients and improve their relationships with families in order to maximise the potential for patient care.

Experiential learning in practice: An ethnographic study among nursing students and preceptors.

This study aimed to explore the reflective dialogues and processes that take place between preceptors and their nursing students and to examine how preceptors make use of their expert knowledge in order to enhance students' experiential learning during clinical placements. Two 30-h courses on reflective teaching were conducted. The study sample included 15 preceptors and 27 undergraduate nursing students. Data were collected during the course and during clinical placements at two X hospitals. Data collection included non-participatory observation and informal conversations with preceptors, in-depth interviews and focus groups. Preceptors used a series of strategies to promote experiential learning; these included creating links with practice, the use of examples, allowing students to adopt professional roles and enhancing autonomy. The value of preceptors is their wealth of professional experience, which is key during the learning process of nursing students. Preceptors must learn to master the art of questioning and stimulating reflective dialogues, in order to stimulate students' critical thinking and encourage them to resolve common problems that arise during practice. Students demand a more active role in their own learning processes.

El prácticum: eje formador de la práctica reflexiva en enfermería / Practicum: axis trainer of reflective practice in nursing / O prácticum: eixo formador da prática reflexiva em enfermagem

OBJETIVO: Caracterizar el papel que juegan las pedagogías de contextualización en la tutoría clínica y describir algunas estrategias didácticas que favorecen la práctica reflexiva del estudiante de enfermería en su prácticum. MATERIALES Y MÉTODOS: Investigación cualitativa, etnográfica, desarrollada en el marco de las asignaturas prácticum hospitalario II y estancias clínicas II durante la formación de once estudiantes de enfermería en un Hospital Universitario de Barcelona (España) entre el 2011 y 2012. Los datos fueron recolectados por medio de observación participante y no participante, conversación informal, entrevista en profundidad y materiales escritos. Para el análisis se empleó el método de comparaciones constantes de Glaser y Strauss. RESULTADOS: Emergieron ejes cualitativos como las pedagogías de contextualización y estrategias didácticas que favorecen el desarrollo del raciocinio y juicio clínico y la planificación de los cuidados de enfermería en la práctica hospitalaria, allí se hacen evidentes algunas estrategias de educación didácticas como el diálogo reflexivo y la interrogación didáctica, con las que las estudiantes verbalizan las razones de sus acciones, evitando así acciones mecánicas. CONCLUSIÓN: las pedagogías de contextualización empleadas por las enfermeras favorecen el desarrollo del razonamiento y juicio clínico, llevando a las estudiantes a desarrollar un sentido de saliencia.

OBJECTIVE: To characterize the role of contextualization pedagogies in clinical training and describe some teaching strategies that promote reflective practice nursing student in their practice. MATERIALS AND METHODS: Qualitative research, ethnographic, developed in the framework of the Practicum II hospital stays II clinical course and clinical training of eleven nursing students in a Hospital of Barcelona (Spain) between 2011 and 2012. The data were collected through participant observation and non-participant, informal discussion, in-depth interview and written materials. For the analysis, the method of constant comparisons of Glaser and Strauss was used. RESULTS: Emerged qualitative axes as pedagogies of contextualization and teaching strategies that promote the development of reasoning and clinical judgment and planning nursing care in the practice of clinical mentoring, there are some teaching strategies as reflective dialogue are evident and didactic question, with which the students verbalize the reasons for their actions, avoiding mechanical actions. CONCLUSION: Contextualization pedagogies employed by clinical nurses favor the development of clinical reasoning and judgment, leading the student to develop a sense of saliency.

OBJETIVO: Caracterizar o papel que jogam as pedagogias de contextualização na tutoria clínica e descrever algumas estratégias didáticas que favorecem a prática reflexiva do estudante de enfermagem em sua practicum. MATERIAIS E MÉTODOS: pesquisa qualitativa, etnográfica, desenvolvida no marco das disciplinas practicum hospitalaria II e estâncias clínicas II durante a formação de onze estudantes de enfermagem em um Hospital Universitário de Barcelona (Espanha) entre o 2011 e 2012. Os dados foram coletados por meio de observação participante e não participante conversação informal, entrevista em profundidade e materiais escritos. Para o analise se emprego o método de comparações constantes de Glaser e Strauss. RESULTADOS: Emergiram eixos qualitativos como as pedagogias de contextualização e estratégias didáticas que favorecem o desenvolvimento do raciocinio e juicio clínico e a planificação dos cuidados de enfermagem na prática hospitalaria ali se fazem evidentes algumas estratégias de educação didáticas como o diálogo reflexivo e a interrogação didática, com as que as estudantes verbalizam as razoes de suas ações, evitando assim ações mecânicas. CONCLUSÃO: as pedagogias de contextualização empregadas pelas enfermeiras favorecem o desenvolvimento do razoamento e juízo clínico, levando às estudantes a desenvolver um sentido de saliência.

Pensamiento reflexivo del estudiante de enfermería en su prácticum clínico / Reflective thinking of the nursing student in the clinical practicum

Objetivos: Describir cómo emergen los procesos de pensamiento reflexivo del estudiante de enfermería ante situaciones clínicas en su prácticum clínico. Método: Investigación cualitativa, hermenéutico-fenomenológica, realizada en la asignatura Prácticum Hospitalario II durante las prácticas clínicas de once estudiantes de enfermería de una Facultad de Enfermería y un Hospital Universitario de Barcelona (España), de febrero de 2011 a febrero de 2012. Las estrategias de recogida de datos fueron: observación participante, observación no participante, conversación informal, entrevista en profundidad y materiales escritos. Para el análisis de la información se empleó el método de comparaciones constantes de Strauss y Corbin. Resultados: El eje cualitativo emergente fue: Convergencia de significados entre estudiante y enfer-mer a respecto al cuidado competente en enfermería: y la metacategoría resultante fue: Pensamiento reflexivo del estudiante, con las subsiguientes categorías: capacidad perceptiva y consciencia situada de las necesidades del otro: curiosidad epistemológica; atención operativa; la anticipación: conversación reflexiva en la acción: y finalmente imitación reflexiva. Conclusiones: La observación deliberativa, la atención operativa, la conversación reflexiva en y sobre la acción, la curiosidad epistemológica y la imitación reflexiva, emergen de manera gradual y acorde a la calidad en la continuidad e interacción del estudiante con los diferentes elementos de su prácticum clínico; estos procesos reflexivos propician en el estudiante la posibilidad de reflexionar, interpretar y significar su propia práctica.

Objectives: To describe how the processes of reflective thinking emerge in the nurse student in face of clinical situations in their clinical prácticum. Method: Qualitative research, hermeneutical-phenomenological made in the subject Hospital Prácticum II during the clinical prácticum to eleven nursing students at a Faculty of Nursing and a University Hospital of Barcelona (Spain), from February 2011 to February 2012.The data collection strategies were: participant observation, non-participant observation, informal discussion, in-depth interviews and written materials. For the data analysis, the method of constant comparisons by Strauss and Corbin was applied. Results: The emerging qualitative axis was: Convergence of meanings between student and nurse regarding competent nursing care; and the resulting metacategory was: thoughtful student thinking with subsequent categories: perceptiveness and consciousness regarding the needs of others: epistemological curiosity; operative care; anticipation: reflective conversation in action; and finally reflexive imitation. Conclusions: Deliberative observation, operational attention, reflective conversation about action and in it, epistemological curiosity and reflective imitation, emerge gradually and in accordance to the quality of continuity and the student interaction with the different elements of their clinical prácticum; these reflective processes foster in the student the opportu-nity to reflect, interpret and give meaning to their own practice.

Investigación acción participativa; la educación para el autocuidado del adulto maduro, un proceso dialógico y emancipador / Participative action research; self-care education for the mature adult, a dialogic and empowered process

OBJETIVO: Explorar y trasformar los procesos de aprendizaje, orientados hacia la capacitación para el autocuidado, el empoderamiento y la promoción de vida saludable del "adulto-maduro". DISEÑO: Investigación-acción-participativa bajo un enfoque cualitativo y sociocrítico. Emplazamiento: El trabajo de campo se centra en el desarrollo del programa educativo "Cuidarse está en tus manos" en 2 pueblos (Atención Primaria, Comarca Araba). PARTICIPANTES: A través de un muestreo teórico participaron personas que se encuentran en la etapa "adulto-maduro" y 3 enfermeras con experiencia en intervenciones educativas. MÉTODOS: Se utilizó la observación participante, donde se realizaron grabaciones en vídeo de las sesiones educativas y grupos de reflexión sobre la acción. Para triangular los datos, se han realizado entrevistas en profundidad con 4 participantes. Se lleva a cabo un análisis del contenido y del discurso. RESULTADOS: Los marcos previos de participantes y enfermeras, así como los discursos de estas últimas, desvelan una racionalidad técnica (unidireccional, informativa) presente todavía en la práctica que perpetúa el papel de receptor pasivo de cuidados. Las claves educativas construidas desde una mirada del aprendizaje dialógico emergen como elementos que facilitan superar estos marcos previos limitantes. Por último, el aprendizaje reflexivo puesto en marcha, ha representado un elemento esencial para avanzar en el conocimiento profesional y en la mejora de los procesos de EpS. CONCLUSIONES: El aprendizaje dialógico emerge como clave para la capacitación y el empoderamiento, donde es la racionalidad práctica-reflexiva y no la técnica la verdaderamente útil en el enfrentamiento con las situaciones complejas de la educación sobre el autocuidado

OBJECTIVE: Explore and transform dialogic-reflexive learning processes oriented to self-care, capacitation, empowerment and health promotion for "mature-adult" collective. DESIGN: Participative action research on a qualitative and sociocritic approach. Data generation methods are Site: Field work focuses on the development of the educational program "Care is in your hands" that takes place in two villages (Primary Care.comarca Araba). PARTICIPANTS: Through a theoretical sampling involved people who are in a "mature-adult" life stage and three nurses with extensive experience in development health education programs. METHODS: Participant observation where health education sessions are recorded in video and group reflection on action. To triangulate the data, have been made in-depth interviews with 4 PARTICIPANTS: Carried out a content and discourse analysis. RESULTS: Participant and nurses' Previous Frameworks, and these last ones' discourses as well, reveal a current technical rationality (unidirectional, informative,. ) yet in practice that perpetuates the role of passive recipient of care. Educational keys constructed from a viewpoint of Dialogic Learning emerge as elements that facilitate overcoming these previous frames limitations. Finally, Reflective Learning launched, has provided advance in professional knowledge and improve health education. CONCLUSIONS: Dialogical learning emerges as key to the training and empowerment, where we have seen how practical-reflexive, and not technical, rationality is meanly useful confronting ambiguous and complex situations of self-care practice and education

[Participative action research; self-care education for the mature adult, a dialogic and empowered process]. / Investigación acción participativa; la educación para el autocuidado del adulto maduro, un proceso dialógico y emancipador.

OBJECTIVE: Explore and transform dialogic-reflexive learning processes oriented to self-care, capacitation, empowerment and health promotion for "mature-adult" collective. DESIGN: Participative action research on a qualitative and sociocritic approach. Data generation methods are SITE: Field work focuses on the development of the educational program "Care is in your hands" that takes place in two villages (Primary Care. Comarca Araba). PARTICIPANTS: Through a theoretical sampling involved people who are in a "mature-adult" life stage and three nurses with extensive experience in development health education programs. METHODS: Participant observation where health education sessions are recorded in video and group reflection on action. To triangulate the data, have been made in-depth interviews with 4 participants. Carried out a content and discourse analysis. RESULTS: Participant and nurses' Previous Frameworks, and these last ones' discourses as well, reveal a current technical rationality (unidirectional, informative,.) yet in practice that perpetuates the role of passive recipient of care. Educational keys constructed from a viewpoint of Dialogic Learning emerge as elements that facilitate overcoming these previous frames limitations. Finally, Reflective Learning launched, has provided advance in professional knowledge and improve health education. CONCLUSIONS: Dialogical learning emerges as key to the training and empowerment, where we have seen how practical-reflexive, and not technical, rationality is meanly useful confronting ambiguous and complex situations of self-care practice and education.

Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses.

OBJECTIVE: To identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups. METHOD: An intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups. RESULTS: The results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice. CONCLUSIONS: The teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life.

Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses / Pontos fortes e deficiências da Aprendizagem Baseada em Problemas sob a perspectiva profissional de enfermeiras / Fortalezas y debilidades del Aprendizaje Basado en Problemas desde la perspectiva profesional de las enfermeras tituladas

OBJECTIVE: to identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups. METHOD: an intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups. RESULTS: the results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice. CONCLUSIONS: the teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life. .

OBJETIVO: identificar os pontos fortes e as deficiências na competência percebidos pelas enfermeiras formadas com um currículo totalmente constituído por competências resultantes da Aprendizagem Baseada em Problemas, realizada com grupos pequenos. MÉTODO: foi utilizado um estudo de caso intrínseco que analisa essa inovação através de ex-alunas (da primeira turma), após completarem três anos de prática profissional. Os dados foram coletados por meio de questionários e grupos de discussão. RESULTADOS: mostram que seu nível de competência é avaliado de forma muito satisfatória, contrastando, paradoxalmente, com a deficiência de conhecimento teórico que perceberam ao terminar os estudos e ingressar no campo de trabalho em saúde. CONCLUSÕES: julgam que a estratégia de ensino foi fundamental para motivar um estudo aprofundado e despertar o desejo de saber. Além disso, a Aprendizagem Baseada em Problemas favorece e reforça a decisão de aprender, tão necessária durante toda a vida profissional. .

OBJETIVO: identificar fortalezas y debilidades competenciales que perciben las profesionales de enfermería formadas con un currículum totalmente integrado por competencias mediante el Aprendizaje Basado en Problemas en grupos pequeños. MÉTODO: utilizado fue el de un estudio de caso intrínseco que analiza dicha innovación a través de ex alumnas (de primera promoción) cuando llevaban tres años de ejercicio profesional. Los datos se recogieron mediante cuestionario y grupos de discusión. RESULTADOS: muestran que se valora de manera muy satisfactoria su nivel competencial. Nivel que contrasta, paradójicamente, con el déficit de conocimientos teóricos que han percibido al terminar los estudios e incorporarse al campo laboral asistencial. CONCLUSIONES: arrojan que la estrategia docente fue clave para motivar un estudio en profundidad y despertar el deseo de saber. También, que el Aprendizaje Basado en Problemas favorece y refuerza la decisión de aprender tan necesaria a lo largo de la vida profesional. .

From ''being to the self'' to ''become to be'': on development of autonomy construction in nursing students.

OBJECTIVE: To understand nursing student's self-consciousness and his/her autonomy in the discipline of fundamentals of professional care in the context of a liberating pedagogical proposal. METHODOLOGY: This qualitative, case-based research in the model of Ludke and André involved 14 students participating in the discipline. Data were collected by non-participatory observation and analysis of documents. Field observation was conducted from March to July 2010 and data were collected according to the proposal of Minayo: pre-analysis, exploration of material and treatment of results. RESULTS: We constructed two thematic units of analysis: from ''being to the self'' and exercise of ''become to be''. CONCLUSION: When nursing students feel more liberty, they have the opportunity to substitute the scary prospect of learning something new material to something that motivates their curiosity and leads them to become more autonomous.

Entre la complejidad y el arte: el análisis de datos en cualitativa / Between complexity and art: the qualitative data analysis

El análisis cualitativo es un proceso complejo que genera inquietud en los investigadores. Algunas de las características principales del análisis son la creatividad, la incertidumbre, la imprevisibilidad; circunstancias que contribuyen a que sea valorado como una de las actividades más complejas de la investigación. El objetivo de este artículo es servir de apoyo a los investigadores noveles, de forma que cuenten con una descripción lo más detallada posible de cómo se puede realizar el análisis en una investigación cualitativa. La pretensión, por tanto, es presentar unas pautas con la finalidad de que sirvan de apoyo en las dificultades que se vayan presentando a lo largo de todo el proceso

Qualitative analysis is a complex process that concerns among researchers. Some of the main features of the analysis are creativity, uncertainty, unpredictability; circumstances that contributing to the idea that it is one of the most complex activities of research. The aim of this paper is to support junior researchers, so that they have a description as detailed as possible of how you can perform the analysis in qualitative research. The intention, therefore, is to present some guidelines to help with the difficulties that arise throughout the entire process

From ''being to the self'' to ''become to be'': on development of autonomy construction in nursing students / Del ''ser para sí'' al ''llegar a ser'': sobre el desarrollo o la construcción de la autonomía del alumno de enfermería / Do ''ser para si'' ao ''chegar a ser'': sobre o desenvolvimento ou a construção da autonomia do aluno de enfermagem

Objective. To understand nursing student's self-consciousness and his/her autonomy in the discipline of fundamentals of professional care in the context of a liberating pedagogical proposal. Methodology. This qualitative, case-based research in the model of Ludke and André involved 14 students participating in the discipline. Data were collected by non-participatory observation and analysis of documents. Field observation was conducted from March to July 2010 and data were collected according to the proposal of Minayo: pre-analysis, exploration of material and treatment of results. Results. We constructed two thematic units of analysis: from ''being to the self'' and exercise of ''become to be''. Conclusion. When nursing students feel more liberty, they have the opportunity to substitute the scary prospect of learning something new material to something that motivates their curiosity and leads them to become more autonomous.

Objetivo. Comprender la consciencia de sí mismo (alumno de enfermería) y su autonomía en la asignatura de Fundamentos para el Cuidado Profesional (FCP), en el contexto de una propuesta pedagógica liberadora. Metodología. Investigación cualitativa en la modalidad de estudio de caso fundamentado en el modelo de Ludke y André. Participaron 14 alumnos de la asignatura FCP. Para la recolección de la información se utilizó la observación no participante y el análisis documental. La observación de campo fue realizada de marzo a julio de 2010 y la recolección de los portafolios fue en julio del mismo año. Se hizo el análisis de contenido de acuerdo con tres fases según la propuesta de Minayo: preanálisis, exploración del material y tratamiento de los resultados. Resultados. Fueron construidas dos unidades temáticas de análisis: del ser para sí y el ejercicio de llegar a ser. Conclusión. Los estudiantes de enfermería, en la medida en que se sienten libres, tienen la oportunidad de reemplaza la imagen atemorizante del nuevo aprendizaje por algo que motive su curiosidad, lo que los lleva a ser sujetos autónomos.

Objetivo. Compreender a consciência de si (aluno de enfermagem) e sua autonomia na matéria de Fundamentos para o Cuidado Profissional (FCP), no contexto de uma proposta pedagógica liberadora. Metodologia. Trata-se de uma investigação qualitativa na modalidade de estudo de caso fundamentado no modelo de Ludke e André. Participaram 14 alunos da matéria FCP. Para a recolha da informação se utilizou a observação não participante e a análise documentário. A observação de campo foi realizada de março a julho de 2010 e a recolha dos porta-fólios foi em julho do mesmo ano. Fez-se análise de conteúdo de acordo em três fases de acordo à proposta de Minayo: pré-análise, exploração do material e tratamento dos resultados. Resultados. Foram construídas duas unidades temáticas de análises: do ser para si e o exercício de chegar a ser. Conclusão. Os estudantes de enfermagem, na medida em que se sentem livres têm a oportunidade de substituem a imagem atemorizante da nova aprendizagem por algo que motiva sua curiosidade, o que os leva a ser sujeitos autônomos.