From theory to practice, operating the clinical simulation in Nursing teaching / De la teoría a la práctica, operacionalizando la simulación clínica en la enseñanza de enfermería / Da teoria à prática, operacionalizando a simulação clínica no ensino de Enfermagem

ABSTRACT Objective: To report the experience of the operationalization of clinical simulation as a pedagogical strategy in a subject of an undergraduate course in Nursing. Method: Clinical simulation cycles were carried out following the steps of action research, such as: planning, action, observation and reflection, from March 2014 to July 2015 with 10 professors and 44 students from a Primary Care and Mental Health subject of an undergraduate course in Nursing. Results: Five cycles of clinical simulation were performed, at the end of each cycle modifications were suggested by students and professors and the operation was adjusted to meet the needs of the subject. The main points of change were: professor role, logistics, equipment, debriefing model and preparation of "simulated patients". Final considerations: The clinical simulation is a possible method to be operationalized in undergraduate course in Nursing, needs pedagogical and logistic planning as well as, sensitization of professors and students.

RESUMEN Objetivo: Informar la experiencia de la operacionalización de la simulación clínica como estrategia pedagógica en una disciplina de un curso de graduación en enfermería. Método: Se realizaron ciclos de simulación clínica siguiendo los pasos de la investigación-acción: planificación, acción, observación y reflexión, en el período de marzo de 2014 a julio de 2015 con 10 profesores y 44 estudiantes de una disciplina de atención básica y salud mental de un curso de graduación en enfermería. Resultados: Se realizaron 5 ciclos de simulación clínica; al final de cada ciclo, modificaciones fueron sugeridas por estudiantes y profesores y la operacionalización fue ajustada para adecuarse a las necesidades de la disciplina. Los principales puntos de cambio fueron: papel del profesor, logística, equipamientos, modelo de debriefing y preparación de los Pacientes Simulados. Consideraciones finales: La simulación clínica es un método posible de ser operacionalizado en el curso de graduación en enfermería, necesita de planificación pedagógica y logística así como de la sensibilización de profesores y estudiantes.

RESUMO Objetivo: Relatar a experiência da operacionalização da simulação clínica como estratégia pedagógica em uma disciplina de um curso de graduação em Enfermagem. Método: Foram realizados ciclos de simulação clínica seguindo os passos da pesquisa-ação, como: planejamento, ação, observação e reflexão, no período de março de 2014 a julho de 2015 com 10 professores e 44 estudantes de uma disciplina de Atenção Básica e Saúde Mental de um curso de graduação em Enfermagem. Resultados: Foram realizados 5 ciclos de simulação clínica, ao final de cada ciclo modificações foram sugeridas por estudantes e professores e a operacionalização foi sendo ajustada visando adequar-se às necessidades da disciplina. Os principais pontos de mudança foram: papel do professor, logística, equipamentos, modelo de debriefing e preparo dos "pacientes simulados". Considerações finais: A simulação clínica é um método possível de ser operacionalizado no curso de graduação em Enfermagem, necessita de planejamento pedagógico e logístico bem como, sensibilização de professores e estudantes.

Development and Evaluation of a Family of Human Face and Upper Airway Models for the Laboratory Testing of Orally Inhaled Products.

Many orally inhaled products are supplied with a facemask instead of a mouthpiece, enabling aerosolized medication to be transferred from the inhaler to the lungs when the user lacks the capability to use a mouthpiece. Until recently, laboratory evaluation of an orally inhaled product-facemask was frequently undertaken by removing the facemask, treating the facemask adapter as being equivalent to a mouthpiece. Measurements of delivered drug mass were therefore subject to bias arising from the absence of dead volume, had the facemask been present. We have described the development of the Aerosol Delivery to an Anatomic Model (ADAM) infant, small child, and adult faces and upper airways, and their subsequent evaluation. Each model possesses physical features of appropriate size, and the soft tissues are also simulated. Rudimentary underlying bony structure is also present, because its purpose is only to provide support, enabling the mechanical response of the facial soft tissues when a facemask is applied to be realized. A realistic upper airway (nasopharynx for the infant model, naso- and oropharynx for the child and oropharynx for the adult models) is also incorporated, so that each model can be used to determine the mass of inhaled medication likely to penetrate as far as the lungs where therapy is intended to be applied. Measurements of the mass of pressurized metered-dose inhaler-delivered salbutamol at a filter distal to the upper airway of each model, simulating age-appropriate tidal breathing, were remarkably consistent, almost all being in the range 0.3 to 1.0 µg/kg across the model age ranges, when expressed as a fraction of body weight.