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1.
West Afr J Med ; 36(2): 138-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385600

RESUMO

BACKGROUND: Holistic ward round (HWR) is a polyadic, multiphasic, holistic model of neurosurgical patient care. It is a multidisciplinary ward round where all healthcare providers involved in patients care, the patients, the relations, as well as clergymen (depending on the patients' faith and need) collectively work to review patient's condition and make decisions in the patient's best interest. OBJECTIVES: The study assessed the effectiveness of the holistic model of care and identified the challenges facing this model of healthcare delivery. METHODS: The study was qualitative in design and In-depth Interviews (IDIs) were conducted with eighteen (18) participants who were purposively selected. They include neurosurgeons, nurses, medical social workers and physiotherapists. The data were thematically content analysed with the help of ATLAS.ti (v.7) software. RESULTS: The study found that patients and relations have immensely benefitted from the model of care through psychosocial support. The major challenges facing HWR were logistic, timing and common problems found in the Nigerian healthcare system. CONCLUSION: It was concluded that for HWR to effectively help spinal cord injured patients further, the healthcare providers, patients and their families require support in different forms from outside the hospital.


Assuntos
Saúde Holística , Equipe de Assistência ao Paciente , Assistência ao Paciente , Assistência Centrada no Paciente/métodos , Adulto , Feminino , Hospitais Universitários , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Neurocirurgiões , Neurocirurgia , Nigéria , Fisioterapeutas , Pesquisa Qualitativa , Assistentes Sociais
2.
J Nurs Adm ; 49(9): 441-446, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31436743

RESUMO

OBJECTIVE: This study uses Leader-Member Exchange theory to explore the associations between contact frequency (CF) of nurse leaders and their team members, leader-member relationship, and patient safety culture. BACKGROUND: Leader-member relationships are an important part of patient safety culture development. The behaviors of leaders to achieve these relationships are unknown. This study explores CF as a leader behavior to improve patient safety culture. METHODS: Cross-sectional survey of bedside nurses (N = 746) from an 8-hospital system. RESULTS: A significant association was found between relationship strength and patient safety culture; CF's effect on relationship and patient safety culture was demonstrated. CONCLUSION: Contact frequency may support relationships between leaders and members and improve patient safety culture on nursing units. Future studies should explore factors that could be enhancing and limiting CF.


Assuntos
Atitude do Pessoal de Saúde , Relações Interprofissionais , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Segurança do Paciente/normas , Gestão da Segurança/métodos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Adulto Jovem
4.
Hu Li Za Zhi ; 66(4): 7-13, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342496

RESUMO

The majority of patient safety incidents cited in the latest Taiwan Patient Safety Reporting System Annual Report were medication-related, with human factors and communication issues identified as the key underlying causes of these incidents. Focusing on inpatient settings, the complex yet multiprofessional-linked drug supply scheme currently in place in medical institutions in Taiwan is described, with the aim of facilitating the accessibility and appropriateness of medication use by detailing the responsibilities of each professional role. Institutional medication management and use comprise several sequential and interconnected stages, including formulary management and drug procurement, medication storage, physician prescribing, pharmacist dispensing, nurse administration, and efficacy-and-safety monitoring and reporting. The principal tasks and personnel duties at each stage are addressed. In summary, institutional drug distribution and control is an intricate process that involves multiple processes and a diverse array of professionals and administrative staff. It is imperative to actively engage the relevant parties, especially through in-service training, in order to understand their essential roles and responsibilities and to enable communication and collaboration among stakeholders in the drug distribution chain. Implementing the appropriate initiatives in a timely manner will help establish an effective and robust safe-medication-use system.


Assuntos
Relações Interprofissionais , Conduta do Tratamento Medicamentoso/organização & administração , Comunicação , Humanos , Recursos Humanos de Enfermagem no Hospital/psicologia , Segurança do Paciente , Papel Profissional , Taiwan
5.
Am Surg ; 85(6): 663-670, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31267909

RESUMO

Ineffective communication between surgical trainees and attending surgeons is a significant contributor to patient harm. The aim of this study was to evaluate a tool to improve resident-to-attending communication regarding changes in patient clinical status. Ten critical patient events were compiled into a list of triggers for direct attending surgeon notification at a single academic institution. Residents and faculty were surveyed to assess communication before and after implementation of the list. Institution of the triggers list was associated with a nonstatistically significant increase in resident-to-attending notification regarding 7 of 10 critical patient events. There was no reported change in frequency of calls associated with the list's implementation. Most residents felt that the list improved patient care and increased their comfort with calling attending surgeons. Comments were generally positive; however, both groups expressed concern that the list could negatively impact resident autonomy and supervision. Implementing a list of triggers for attending notification of critical patient events subjectively improved resident-to-attending communication in an environment with high baseline levels of communication.


Assuntos
Internato e Residência/organização & administração , Corpo Clínico Hospitalar/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Melhoria de Qualidade , Inquéritos e Questionários , Centros Médicos Acadêmicos , Adulto , Educação de Pós-Graduação em Medicina/organização & administração , Feminino , Humanos , Comunicação Interdisciplinar , Relações Interprofissionais , Masculino , Erros Médicos/prevenção & controle , Pessoa de Meia-Idade , Ohio
6.
Infect Dis Poverty ; 8(1): 43, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174612

RESUMO

BACKGROUND: A key issue in achieving and sustaining malaria elimination is the need to prevent local transmission arising from imported cases of malaria. The likelihood of this occurring depends on a range of local factors, and these can be used to allocate resources to contain transmission. Therefore, a risk assessment and management strategy is required to identify risk indexes for malaria transmission when imported cases occur. These risks also need to be quantified and combined to give a weighted risk index score. This can then be used to allocate the resources to each administrative region to prevent transmission according to the degree of risk. METHODS: A list of potential risk indexes were generated from a literature review, expert consultation and panel discussion. These were initially classified into 4 first-level indexes including infection source, transmitting conditions, population vulnerability and control capacity. Each of these was then expanded into more detailed second-level indexes. The Delphi method was then used to obtain expert opinion to review and revise these risk indexes over two consecutive rounds to quantify agreement among experts as to their level of importance. Risk indexes were included in the final Transmission Risk Framework if they achieved a weighted importance score ≥ 4. The Analytic Hierarchy Process was then used to calculate the weight allocated to each of the final risk indexes. This was then used to create an assessment framework that can be used to evaluate local transmission risk in different areas. RESULTS: Two rounds of Delphi consultation were conducted. Twenty-three experts were used at each round with 100% recovery rate of participant questionnaires. The coordination coefficients (W) for the two rounds of Delphi consultation were 0.341 and 0.423, respectively (P < 0.05). Three first-level indexes and 13 second-level indexes were identified. The Analytic Hierarchy Process was performed to calculate the weight of the indexes. For the first-level indexes, infection source, transmitting conditions, and control capacity, the index weight was 0.5396, 0.2970 and 0.1634 respectively. For the three top second-level indexes, number of imported malaria cases, Anopheles species, and awareness of timely medical visit of patient, the index weight was 0.3382, 0.2475, and 0.1509 respectively. CONCLUSIONS: An indexed system of transmission risk assessment for imported malaria was established using the Delphi method and the Analytic Hierarchy Process. This was assessed to be an objective and practical tool for assessing transmission risk from imported cases of malaria into China.


Assuntos
Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/transmissão , Malária/transmissão , Medição de Risco/métodos , Adulto , Idoso , Animais , Anopheles/parasitologia , China/epidemiologia , Técnica Delfos , Feminino , Humanos , Relações Interprofissionais , Malária/epidemiologia , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
7.
J Dent Educ ; 83(6): 645-653, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31154434

RESUMO

In a multicultural society, the ability to work effectively with spoken-language interpreters is a critical skill for oral health professionals. The aims of this study were to design and evaluate training for oral health professions students to work effectively with interpreters as a health care team. A total of 89 University of Minnesota dental, dental hygiene, and dental therapy students and 41 Century College translating and interpreting students participated in the elective three-hour training from 2016 to 2018. The 89 oral health professions participants were invited to respond to a seven-item survey about working with interpreters and patients who are limited English proficient (LEP), along with a comparison group of an additional 462 oral health professions students who did not participate in the program. Of the oral health professions participants, 49 responded to the survey, for a 55% response rate; and 245 of the comparison group responded, for a 53% response rate. A qualitative focus group with 11 program participants and inductive analysis provided further insights. The differences between participants' pre and post self-ratings were statistically significant (p<0.001) for each of the seven survey questions. After training, students were more familiar with provider and interpreter best practices and the context for patients who are LEP, as well as more confident in their skills to work effectively with interpreters. Student focus groups identified training relevance and necessity and learning format as the most significant success factors. This project highlights the process and value of creating these experiences for and with students and the value of simulation to develop knowledge, skills, and confidence.


Assuntos
Educação em Odontologia/métodos , Tradução , Competência Clínica , Currículo , Humanos , Relações Interprofissionais , Saúde Bucal/educação , Higiene Bucal/educação , Equipe de Assistência ao Paciente , Estudantes de Odontologia
8.
J Dent Educ ; 83(6): 654-662, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31154435

RESUMO

The aims of this study were to implement and evaluate an innovative collaborative event with hospitalized patients to help develop dental hygiene and nursing students' interprofessional competence. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used to assess the students' perceptions of interprofessional skill acquisition. Participants were 24 dental hygiene and 25 nursing students at the University of Southern Indiana in spring 2016. The results showed that all students had statistically significant improvement on the ICCAS items from pretest to posttest. There were no significant differences in improvement between the two groups on any single posttest item as the impact of the responses was similar. These results suggest that incorporating collaborative experiences in hospital settings can be an effective means to develop students' skills in interprofessional competence.


Assuntos
Relações Interprofissionais , Higiene Bucal/educação , Estudantes de Ciências da Saúde , Estudantes de Enfermagem , Educação em Enfermagem/métodos , Educação em Enfermagem/organização & administração , Avaliação Educacional , Hospitais , Humanos , Indiana
9.
Nurse Educ Today ; 79: 194-197, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31154265

RESUMO

INTRODUCTION: With increasing acuity, patient care requires a collaborative approach by a team of providers. Recent literature indicates healthcare professionals lack the ability to work in collaboration with other healthcare professionals resulting from communication and collaborative practice gaps. BACKGROUND/LITERATURE: Disasters require a rich collaboration of teams in order to be effective. As a result, interprofessional collaboration is a foundational underpinning of disaster preparedness. The overall purpose of this study was to assess perceptions of interprofessional collaboration before and after participating in an interprofessional simulated disaster drill as part of a Community Health Nursing course. METHODS: This pre-test, post-test descriptive research design assessed communication, collaboration, roles/responsibilities, patient focus, team functioning and conflict management of nursing students who participated in a simulated disaster drill. DATA/RESULTS: Participants were nursing majors and primarily Caucasian females (n = 50, 89% and n = 56, 97% respectively), representative of the school of nursing population at the University. Wilcoxon Signed-Ranks test indicated that scores for the total ICAR post-test were significantly lower than the Total ICAR pre-test (Z = -2.006, p = .045, r = -0.19). While each of the individual sections of the ICAR had a lower mean score on the ICAR post-test as compared to the pre-test, collaborative patient/client-family centered approach was statistically significant (p = 0,0.002). DISCUSSION: Following the simulated disaster drill experience, nursing students identified gaps in communication, collaboration, roles and responsibilities, collaborative patient/client-family centered approach, team functioning, conflict management/resolution. CONCLUSIONS: The study assessed the perceptions of interprofessional collaboration among undergraduate nursing students before and after a simulated disaster drill. The assessment identified the need to integrate interprofessional competencies in disaster preparedness education.


Assuntos
Comportamento Cooperativo , Desastres , Relações Interprofissionais , Treinamento por Simulação , Adulto , Comunicação , Enfermagem em Saúde Comunitária , Feminino , Humanos , Masculino , Estudantes de Enfermagem , Adulto Jovem
10.
Nurs Adm Q ; 43(3): 274-279, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31162347

RESUMO

Nurse bullying is a systemic, pervasive problem that begins well before nursing school and continues throughout a nurse's career. A significant percentage of nurses leave their first job due to the negative behaviors of their coworkers, and bullying is likely to exacerbate the growing nurse shortage. A bullying culture contributes to a poor nurse work environment, increased risk to patients, lower Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores, and greater nurse turnover, which costs the average hospital $4 million to $7 million a year. Addressing nurse bullying begins with acknowledging the problem, raising awareness, mitigating contributing factors, and creating and enforcing a strong antibullying policy. Nurses and stakeholders also must actively work to change the culture, and understand that bullying has no place in the nursing profession or anywhere else in health care.


Assuntos
Bullying/psicologia , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Esgotamento Profissional/etiologia , Esgotamento Profissional/psicologia , Humanos , Intenção , Relações Interprofissionais , Local de Trabalho/psicologia , Local de Trabalho/normas
11.
Rev Infirm ; 68(249): 42-44, 2019 Mar.
Artigo em Francês | MEDLINE | ID: mdl-31056179

RESUMO

As part of a process to improve the safety of medication management on the wards, designated nurses in each department work in close collaboration with the pharmacist to prevent medication errors on a daily basis. In an isolated facility situated in a remote environment where the rate of replacement of team members is high, their role is essential and helps to reduce the risk of errors favoured by the high turnover of medical and paramedical staff.


Assuntos
Erros de Medicação , Papel do Profissional de Enfermagem , Farmacêuticos , Humanos , Relações Interprofissionais , Erros de Medicação/prevenção & controle
13.
Public Health ; 171: 31-40, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31082758

RESUMO

OBJECTIVES: The aims of this study were (1) to identify attributes for patient safety at a primary healthcare level and (2) to analyze conceptions of patients, professionals, and managers about how these attributes are being addressed. STUDY DESIGN: This was a qualitative study. METHODS: Participants were recruited from three primary care settings in Brazil. A total of 37 subjects (four physicians, three nurses, three dentists, three managers, five community assistants, and 19 patients) participated on interviews about their perceptions of safety attributes at the primary care settings involved in the study. Some of these participants attended a focus group meeting. A thematic categorical analysis was carried out to interpret the interviews. RESULTS: The main attributes for patient safety were valued by the participants. However, barriers such as discontinuity of care, interruptions during consultations, breakdowns in the communication, and ineffective teamwork were reported as frequent sources of patient safety issues. Reports of patients left unattended for excessive time because of the lack of accurate information and disruptions that took up to 35 min show that there is still a long way to go for primary care to be safe and effective in the study settings. CONCLUSIONS: It is necessary that the strategies meet the patient safety needs more effectively and efficiently. Further research is needed to understand the complex nature of the problems that affect patient safety in these settings so that appropriate decisions can be made.


Assuntos
Determinação de Necessidades de Cuidados de Saúde , Segurança do Paciente , Atenção Primária à Saúde/organização & administração , Pessoal Administrativo/psicologia , Pessoal Administrativo/estatística & dados numéricos , Adulto , Brasil , Comunicação , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
14.
Rev Med Suisse ; 15(650): 942-946, 2019 May 08.
Artigo em Francês | MEDLINE | ID: mdl-31066524

RESUMO

Health services have a significant carbon footprint on the environment, of which about 20 % come from drug prescriptions. For a sustainable health system, it is important to assess the environmental footprint of drugs and promote sustainable drug manufacturing, prescription, dispensing and use that limit carbon emissions and drug wastage. All, governments, pharmaceutical industry, health professionals and patients, must share this responsibility. This article gives practical recommendations for each of these protagonists to promote sustainable drug prescription.


Assuntos
Prescrições de Medicamentos , Farmacêuticos , Médicos , Pessoal de Saúde , Humanos , Relações Interprofissionais
15.
Ter Arkh ; 91(3): 101-106, 2019 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-31094467

RESUMO

The article provides a modern classification of interstitial lung diseases. The focus is on the poorly studied and difficult to diagnose idiopathic nonspecific interstitial pneumonia, isolated in a separate nosological form and included in the classification only in 2002. The paper presents the features of the clinical, radiological, histological picture of idiopathic nonspecific interstitial pneumonia in comparison with idiopathic pulmonary fibrosis. The presented materials are based on the results of the largest study conducted by the working group of the American Thoracic Society, which shows the importance of the interaction of specialists in the diagnosis of idiopathic nonspecific interstitial pneumonia. A comprehensive assessment of the examination of patients conducted in collaboration with the clinician and radiologist, after their cooperative discussion, in many cases can help to avoid lung biopsy, and the study of morphological material is more often necessary only in difficult diagnostic situations.


Assuntos
Fibrose Pulmonar Idiopática/diagnóstico , Relações Interprofissionais , Doenças Pulmonares Intersticiais/classificação , Biópsia , Diagnóstico Diferencial , Humanos , Pulmão , Doenças Pulmonares Intersticiais/diagnóstico , Tomografia Computadorizada por Raios X/métodos
16.
Zhonghua Shao Shang Za Zhi ; 35(4): 316-318, 2019 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-31060182

RESUMO

On August 2nd, 2014, 35 patients with extremely severe burns involved in August 2nd Kunshan factory aluminum dust explosion accident, including 18 males and 17 females, aged from 21 to 50 years, were admitted to our unit. According to the patient's condition, the rescue members divided the participants into groups according to their characteristics, and used the multi-disciplinary cooperative treatment and management mode of integrating critical care medicine, anesthesia, traditional Chinese medicine, rehabilitation, and nursing led by burn medicine. Totally 27 patients were successfully treated, with a success rate of 77.14%.


Assuntos
Acidentes de Trabalho , Alumínio/toxicidade , Traumatismos por Explosões , Queimaduras/terapia , Comportamento Cooperativo , Cuidados Críticos/organização & administração , Explosões , Adulto , Queimaduras/complicações , Poeira , Feminino , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Adulto Jovem
17.
N C Med J ; 80(3): 178-181, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31072951

RESUMO

An important facet of pharmacist training is interprofessional education (IPE), which prepares students to think and practice collaboratively. As health profession programs continue to emphasize IPE across curricula, it is also important to integrate IPE into continuing education programming for licensed clinicians to promote improved patient care and outcomes.


Assuntos
Relações Interprofissionais , Farmacêuticos , Papel Profissional , Educação Médica Continuada/organização & administração , Pessoal de Saúde/educação , Humanos
18.
J Prof Nurs ; 35(3): 156-161, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31126390

RESUMO

BACKGROUND: How to be an effective mentor is typically not taught formally because good mentoring is thought to beget good mentoring, but there is little concrete data to support that connection. PURPOSE: Scholars in the Robert Wood Johnson Foundation's Nurse Faculty Scholars (NFS) program were surveyed to find out if the mentoring they received influenced their subsequent mentoring. METHOD: The qualities that form the Mentorship Effectiveness Scale were used to investigate if the experience changed scholars' views of mentoring; open-ended questions provided an opportunity for scholars to describe additional insights. RESULTS: Thirty-nine out of 93 scholars (42%) replied. Scholars were influenced by the mentoring they received: they were now more inclined to give guidance on professional issues, provide constructive critiques, suggest resources, acknowledge mentees' contributions, and challenge mentees to extend their abilities. Scholars' experiences made them more aware of the power of mentoring, provided them with insights into how they might do the same, convinced them that mentoring shouldn't be confined to one advisor, made them realize that one style of mentoring doesn't work for everyone, and improved their likelihood of using an individual development plan when they mentored. CONCLUSIONS: Effective mentoring does seem to beget effective mentoring because the interaction with mentors seems to leave a lasting impression and the perceived obligation to "pay it forward."


Assuntos
Docentes de Enfermagem/psicologia , Relações Interprofissionais , Tutoria/estatística & dados numéricos , Desenvolvimento de Pessoal , Mobilidade Ocupacional , Bolsas de Estudo , Feminino , Fundações , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos
19.
J Prof Nurs ; 35(3): 195-200, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31126396

RESUMO

BACKGROUND: Educating undergraduate healthcare students is challenging due to the complexity of the healthcare environment today. Healthcare education systems focus mainly on discipline specific thinking using linear frameworks and reductionist approaches. Education of nurses, pharmacists, physicians, social workers, respiratory therapists takes place in a siloed environment with minimal interprofessional interaction. Yet, organizations expect new graduates to have skills and understanding of collaborative care with knowledge of healthcare systems thinking, IPP, TeamSTEPPS®, methods of group dynamics, and a knowledge of Informatics when they enter the workforce. PURPOSE: The purpose of this article is to 1) discuss and describe challenges in a high-tech complex healthcare environment that necessitate teaching systems thinking to future healthcare students, and 2) describe the use of interprofessional education (IPE), interprofessional practice (IPP), Team STEPPS®, curricular content, and other teaching methods as strategies for teaching systems thinking. CONCLUSION: Systems thinking in healthcare supports a holistic approach to care, inclusive of high-tech in the complex environment. With the rapid changes it is necessary to modify our teaching theories we use to educate new healthcare providers. Educating and practicing the key concepts/principles of IPE, IPP, and TeamSTEPPS®, and group dynamics, along with the important integration of technology, can provide the foundation to develop systems thinking and critical thinking in our complex healthcare environment.


Assuntos
Currículo , Relações Interprofissionais , Informática Médica , Estudantes de Ciências da Saúde/psicologia , Pensamento , Educação de Graduação em Medicina , Bacharelado em Enfermagem , Humanos
20.
J Prof Nurs ; 35(3): 216-223, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31126399

RESUMO

BACKGROUND: Educational taxonomies are utilised within nursing programmes to design curriculum, develop learning objectives, and measure attainments including the assessment of values, behaviours, and attitudes. Current measurement of the affective domain is limited, relying on quantitative tools, often immediately before and after learning activities. PURPOSE: This paper examines the reliability of a qualitative framework to assess the long-term impact of learning activities known to stimulate affective domain development. METHOD: Epstein's (1977) qualitative framework was applied to the self-reported responses of twelve international nurses (20-24 months post nurse registration) who had engaged in learning activities during their pre-registration programme that were considered to be enrichment (international placement, interprofessional learning, simulation and blended learning). RESULTS: Epstein's framework was used to measure the degree of affective domain development from the self-reported responses of the students. The degree of modification in affective domain development was assessed as dentification level (assuming a different attitude or behaviour) for four nurses and internalisation stage for eight nurses (embracing new values and attitudes). CONCLUSION: Epstein's framework is a reliable tool that can capture the short and long-term modification in affective domain development of nurses after they have experienced transformational learning activities. Key elements that move a nurse from identification to internalisation level are the motivating reason for undertaking the activity and reflection on the learning.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Enfermeiras Internacionais/psicologia , Aprendizagem Baseada em Problemas/métodos , Currículo , Bacharelado em Enfermagem , Teoria Fundamentada , Humanos , Relações Interprofissionais , Reprodutibilidade dos Testes
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