Towards a set of competencies in palliative care nursing in Spain: what's getting in the way of consensus?

BACKGROUND: Spain currently lacks a competency framework for palliative care nursing. Having such a framework would help to advance this field in academic, governmental, and health management contexts. In phase I of a mixed-methods sequential study, we collected quantitative data, proposing 98 competencies to a sample of palliative care nurses. They accepted 62 of them and rejected 36. METHODS: Phase II is a qualitative phase in which we used consensus techniques with two modified nominal groups to interpret the quantitative findings with the objective of understanding of why the 36 competencies had been rejected. Twenty nurses from different areas of palliative care (direct care, teaching, management, research) participated. We conducted a thematic analysis using NVivo12 to identify meaning units and group them into larger thematic categories. RESULTS: Participants attributed the lack of consensus on the 36 competencies to four main reasons: the rejection of standardised nursing language, the context in which nurses carry out palliative care and other factors that are external to the care itself, the degree of specificity of the proposed competency (too little or too great), and the complexity of nursing care related to the end of life and/or death. CONCLUSIONS: Based on the results, we propose reparative actions, such as reformulating the competencies expressed in nursing terminology to describe them as specific behaviours and insisting on the participation of nurses in developing institutional policies and strategies so that competencies related to development, leadership and professional commitment can be implemented. It is essential ​​to promote greater consensus on the definition and levels of nursing intervention according to criteria of complexity and to advocate for adequate training, regulation, and accreditation of palliative care expert practice. Locally, understanding why the 36 competencies were rejected can help Spanish palliative care nurses reach a shared competency framework. More broadly, our consensus methodology and our findings regarding the causes for rejection may be useful to other countries that are in the process of formalising or reviewing their palliative care nursing model.

The effectiveness of an Instagram-based educational game in a Bachelor of Nursing course: An experimental study.

BACKGROUND: Gamification is a novel educational method that adopts elements of games to motivate students using participatory learning. The objective of this study was to measure the effect of participation in an Instagram-based educational game on learning outcomes. METHOD: Experimental design with 291 university students in a first-year course of the Bachelor of Nursing during the 2020-21 academic year. RESULTS: After ruling out pretest sensitization, we identified a positive effect of participation in the educational game. An average improvement of 0.62 points was observed in the final grade of the students belonging to the experimental groups. CONCLUSION: Nursing undergraduate students participating an Instagram-based educational game had better learning outcomes than their counterparts who did not participate in the game.

Gamification on Instagram: Nursing students' degree of satisfaction with and perception of learning in an educational game.

BACKGROUND: Gamification has been shown to lead to greater motivation and participation among students. Currently, many teachers use social networks to share supplementary course materials and student work, but they have not incorporated gamified educational activities into social networking sites. OBJECTIVE: To determine nursing students' satisfaction with an Instagram-based educational game and their perceptions of its effects on their learning. DESIGN: We conducted a cross-sectional, descriptive, observational study. PARTICIPANTS: First-year nursing students in the subject "Dietetics and Nutrition". RESULTS: Of the total sample, 71.7 % agreed that gamification had helped them assimilate the content. Between 66 % and 70 % agreed that the experience had motivated them to keep up with the subject and learn more about the topic, that it had helped them to better understand certain concepts of the subject, that they would recommend the experience to other students, and that they enjoyed the experience of playing a game while learning. 71.7 % of them were in favour of increased use of gamification in other subjects. CONCLUSIONS: The use of an Instagram-based educational game as a complement to in-class teaching was useful, enjoyable, and motivating for the acquisition of new knowledge.

"Spanish Palliative Care Nurses' Degree of Acceptance of a Proposal for Nursing Competencies in Palliative Care".

Background: In Spain, palliative care (PC) nursing is not a recognized specialization and PC nurses do not receive systematic specialized academic training in PC. To ensure the quality of PC in Spain, the Spanish Association of Palliative Care Nursing has been working since 2011 to design a model of competencies for PC nurses. Objective: Verify whether a sample of Spanish PC nurses accepts the proposed model of PC nursing competencies describing their work. Methods: Descriptive cross-sectional observational study based on an ad-hoc questionnaire about 98 proposed competencies, which participants rated for whether they belong to the purview of PC nurses and for their degree of concordance with their own practice and their degree of importance in PC nursing. Competencies receiving approval by more than 75% of participants for the three dimensions were considered to have been accepted by consensus. Mixed logistical models were developed to study the association between demographic variables and the responses. Results: Sixty-two out of 98 proposed competencies were accepted by more than 75% of participants. We therefore considered these competencies to have been accepted by consensus. Thirty-six proposed competencies failed to meet the threshold of 75% acceptance. For competencies that were accepted overall, participants with more than 10 years of experience in PC and participants with specialized training in PC were more likely to report that these competencies were part of the purview of PC nursing. Participants age >50 were less likely to report that competencies related to research concorded with their practice. Participants accepted the importance of all 98 proposed competencies. Conclusion: The variables of experience, training and age had a statistically significant relationship with the acceptance or rejection of the proposed competencies on the basis of purview and concordance. Further research is necessary to understand more fully these relationships to eventually arrive at a consensus model for the competencies of PC nurses.

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.

The usefulness and acceptance of the OSCE in nursing schools.

This qualitative study explores the usefulness and acceptance attributed by students and faculty members to an Objective Structured Clinical Evaluation (OSCE) administered to nursing undergraduates in Catalonia (Spain) for 10 years. Seventy undergraduate nursing students and twelve faculty members participated in the study. The data collection techniques included an open-ended questionnaire, a student focus group, and individualized faculty interviews. The students experienced the OSCE positively as a learning event that offered an opportunity for feedback that could help them master the required competencies. The OSCE increased students' responsibility by presenting them with a set of challenges that they had to tackle individually. Moreover, it reaffirmed their confidence in situations that closely resembled professional practice. Faculty members valued the ability of the OSCE to integrate and assess competencies, its objectivity, and the indirect information it provided on the effectiveness of the curriculum. The educational impact attributed to the OSCE and its acceptance among faculty and students suggest that it would be useful to re-implement it in the Bachelor's of Nursing in Catalan universities. Our findings may be of use to other nursing programs considering how to assess competency-based education, especially in the context of the European Higher Education Area.

[Testing objective structured clinical evaluation (OSCE) for nursing students experience developed during the years 1995-2009]. / Pruebas de evaluación clínica objetiva y estructurada (ECOE) para estudiantes de enfermería.

The objective structured clinical examination (OSCE) has been recognized as an effective evaluation tool in the health area and has been implemented by an important sector of educational institutions, the Faculty of Medicine and School of Nursing. The present article describes the OSCE organized by the Institute of Health Studies in collaboration with the University Schools of Catalan Nursing. Between the years of 2002 and 2009, OSCE annual exams took place with the participation of 1.803 students. The global results remained stable with a median grade of slightly less than 60%, and the competence component that evaluated communicative capacity was the one in which students obtained the best results. The reliability obtained surpassed the minimum recommended by international standards. It's important underline the positive value to the students of all aspects of the test. From this experience it seems evident that it would be useful to take advantage of the OSCE tests in order to show the students their strong points and ways to improve. We should highlight, not only as a goal but also as an opportunity the assessment by competencies that the European space of higher Education provides at the end of studies for a Nursing degree.

Pruebas de evaluación clínica objetiva y estructurada (ECOE) para estudiantes de enfermería / Testing Objective Structured Clinical Evaluation (OSCE) for nursing students experience developed during the years 1995-2009

Las pruebas de Evaluación Clínica Objetiva y Estructurada (ECOE) han sido reconocidas como un formato eficaz de evaluación en el ámbito de la salud e implementadas por un importante sector de instituciones educativas: Facultades de Medicina y Escuelas de Enfermería. El presente artículo describe la experiencia en la realización de las pruebas ECOE organizadas por el Institut de Estudis de la Salut con la colaboración de la Escuelas Universitarias de Enfermería catalanas. Entre los años 2002 y 2009 se realizaron ECOE anuales en las que participaron 1.803 alumnos. Los resultados globales se mantuvieron estables con una nota media ligeramente inferior al 60% y la competencia que evaluó la capacidad comunicativa fue en la que los estudiantes obtuvieron mejores resultados. Las cifras de fiabilidad obtenidas superaron el mínimo recomendado por los estándares internacionales y los alumnos valoran positivamente su participación en las mismas. De la experiencia se concluye que sería conveniente aprovechar las pruebas ECOE para mostrar a los estudiantes sus puntos fuertes y aspectos a mejorar. Cabe destacar, como un reto pero también como una oportunidad, la evaluación por competencias que contempla el Espacio Europeo de Educación Superior al final de los estudios del Grado en Enfermería(AU)

The objective structured clinical examination (OSCE) has been recognized as an effective evaluation tool in the health area and has been implemented by an important sector of educational institutions, the Faculty of Medicine and School of Nursing. The present article describes the OSCE organized by the Institute of Health Studies in collaboration with the University Schools of Catalan Nursing. Between the years of 2002 and 2009, OSCE annual exams took place with the participation of 1.803 students. The global results remained stable with a median grade of slightly less than 60%, and the competence component that evaluated communicative capacity was the one in which students obtained the best results.The reliability obtained surpassed the minimum recommended by international standards. It's important underline the positive value to the students of all aspects of the test. From this experience it seems evident that it would be useful to take advantage of the OSCE tests in order to show the students their strong points and ways to improve. We should highlight, not only as a goal but also as an opportunity, the assessment by competencies that the European space of higher Education provides at the end of studies for a Nursing degree(AU)

[Evaluation of clinical competence in the nursing profession]. / Evaluación de la competencia clínica en Enfermería. Bases conceptuales y experiencias.

The quality of health services depends on the competence of the health service professionals. It is essential to define and evaluate professional competences in order to improve professional development, ensure the quality of, and manage, professionals in terms of their competences. To do so, it is necessary to utilize a combination of different methods. The evaluation of the diverse stages related to nursing--at the end of undergraduate studies, postgraduate studies or specialization, and during independent work--has different proposals, content and methods; and the institutions implicated in these stages should make themselves responsible to acquire the professional which society needs. Since 1994, more than 150 projects have been carried out in Catalonia which confirm the validity, trustworthiness, acceptability and utility of these evaluative methods in undergraduate and postgraduate studies and in the selection and accreditation of professionals.

Evaluación de la competencia clínica en enfermería. Bases conceptuales y experiencias / Evaluation of clinical competence in the nursing profession

La calidad de los servidos sanitarios depende de la competencia de los profesionales. Es imprescindible definir y evaluar. Las competencias profesionales para mejorar la formación, asegurar la calidad y gestionar a los profesionales por competencias. Para ello hay que utilizar una combinación de diferentes métodos. La evaluación de las diversas etapas (al finalizar la formación pregraduada, la formación postgraduada o de especialización y durante el trabajo independiente)tiene propóstios, contenidos y métodos diferentes, y las instituciones implicadas deben responsabilizarse para conseguir los profesionales que la sociedad necesita. Desde 1994 se han realizado en Cataluña más de 150 proyectos que confirman la validez, fiabilidad, aceptabilidad y utilidad de estos métodos evaluativos en la formación de pregrado y de postgrado y en la selección y acreditación de profesionales

The quality of health services depends on the competence of the health service professionals. It is essential to define and evaluate professional competences in order to improve professional development, ensure the quality of and manage, professionals in terms of their competences... To do so, it is necessary to utilize a combination of different methods. The evaluation of diverse stages related to nursing -at the the end of undergraduate studies, postgraduate studies or specialization, and during independent work- has different proposals, content and methods; and the institutions implicated in these stages should make themselves responsible to acquire the professional which society needs. Since 1994, more than 150 projects have been carried out in Catalonia which confirm the validity, trustworthiness, acceptability and utility of these evaluative methods in undergraduate and postgraduat estudies and in the selection and accreditation of professionals

Recomendaciones para una presentación oral / Recommendations for oral presentations

Los profesionales de la salud deben ser competentes en el desarrollo de su disciplina, pero además deberán ser hábiles en el manejo de las herramientas destinadas a la comunicación, cuyo uso será necesario en algún momento de su carrera profesional. El presente artículo describe algunos de los elementos que intervienen antes, durante y después de la comunicación oral y que pueden ser útiles para mejorar las habilidades personales para realizar una exposición oral. Enfrentarse a una audiencia puede producir cierta angustia y nerviosismo que es necesario controlar, la preparación de la intervención oral y de los medios audiovisuales, así como el uso de los elementos paralingüísticos y el lenguaje del cuerpo, pueden disminuir la tensión nerviosa y aumentar el rendimiento de la exposición oral, condiciones indispensables para una exposición efectiva (AU)