Search

Aim/Objective To describe and analyse the use of a station within an OSCE to assess interprofessional competence performance in undergraduate nursing students. The specific objectives were: - To measure the students' level of competence performance in relation to the interprofessional competences Roles and Responsibilities, Communication and Teamwork. - To determine inter-observer concordance in the assessment of the interprofessional competences. Background Teamwork competencies are key to improving patient safety and avoiding medical errors. Today, healthcare professionals work in interdisciplinary teams. To foster a culture of safety, some of the measures that can be taken at the individual, team and organisational levels include fostering clear communication among team members, knowledge of respective roles and functions, and deepening team functioning through respect and trust in judgement and capabilities. The World Health Organization recommends starting to develop these competencies in university studies, through interprofessional education. There are numerous programmes in universities all over the world, but more research is needed on the assessment of interprofessional education activities, preferably through objective methods. Competency performance can be assessed by an external evaluator, in a simulated environment, with the Objective Structured Clinical Examination, which is widely used in nursing. Design Cross-sectional study. Methods 63 second-year nursing undergraduate students completed an interprofessional competencies station within an 8-station OSCE. Communication, Roles and Responsibility and Teamwork competences were assessed. The Interprofessional Collaborator Assessment Rubric (ICAR) was used as a model to assess the performance of students. Inter-observer concordance analysis was performed using the kappa coefficient and the concordance rate. Results 92.1% of students reached a good level in communication competence, 88.9% in roles and responsibility competence, and 55.6% in teamwork competence. The global concordance rate was 83.8%, and the kappa coefficient was 0.67. Conclusions Most students have demonstrated interprofessional competence performance at a good level. However, the inter-observer concordance obtained for some of the items was not as expected. The assessment of interprofessional competencies, as it deals mainly with relational and communicative aspects, requires greater preparation both in terms of the specification of assessment items and in agreement between examiners.

La acción tutorial implica asesoramiento académico, personal y profesional. El presente estudio tuvo como objetivo principal, indagar en las relaciones profesor-estudiante en la tutoría universitaria desde la visión del tutor, e identificar elementos de mejora. Se utilizó un diseño cualitativo. Como método, un estudio de caso múltiple, considerando “el caso”: universidad pública y universidad privada. Como resultados, surgen seis temas. Presentamos “la tutoría como espacio de relación”. Este tema muestra que la tutoría debe fundamentarse en la comunicación y la relación personal cercana, basada en el respeto y la privacidad. Dado que, no es una relación entre iguales, los profesores coinciden en la necesidad de establecer límites para no perder su estatus. Se concluye que, cuanto menos asimétrica y jerárquica es la relación tutor-estudiante, más efectivo es el aprendizaje. La motivación y formación del profesorado, entre otros aspectos, han de tenerse en cuenta para un modelo de tutoría sólido. The action of tutoring implies academic, personal and professional guidance. The main objective of this study was to deepen our understanding of the teacher-student relationships in university tutoring from the point of view of the tutor, and to identify elements for improvement. A qualitative design was used. The method employed was a multiple case study, considering “the case” as the public and private university. Six themes emerged from the data. We present “tutoring as a space for relationships”. This theme shows that tutoring should be based on communication and a close personal relationship, with respect and privacy. Considering it is not a relationship among equals, teachers agree on the need to stablish limits, to avoid losing their status. In conclusion, the less asymmetric and hierarchic the tutor-student relationship is, learning becomes more effective. Motivation and teacher training must be considered, among other aspects, for a solid model of tutoring. Sin financiación No data JCR 2018 0.947 SJR (2018) Q1, 160/1614 Education 1.426 IDR (2018) C1, 6/233 Educación UEM

Resumen Introduccion El sindrome de movilidad articular limitada (SMAL) aparece exclusivamente en pacientes con diabetes, tanto tipo 1 como tipo 2. Se manifiesta como una limitacion en la movilidad articular que inicialmente afecta a las falanges proximales de las manos, seguidas, por orden de frecuencia, por munecas, codos, hombros, rodillas y esqueleto axial. El diagnostico se puede realizar mediante pruebas sencillas, como «el test de la oracion». El objetivo fue conocer la prevalencia de pacientes diabeticos con SMAL, evaluar la asociacion entre el SMAL y el grado de control glucemico y el riesgo de caidas accidentales. Pacientes y metodos Estudio observacional transversal en el Centro de Salud de San Fernando II, Madrid (periferia). La muestra fueron 184 pacientes con un diagnostico de diabetes superior a 5 anos entre noviembre-marzo de 2013. Se utilizo el test de la oracion para evaluar si los pacientes presentaban SMAL. El riesgo de caidas fue determinado segun el test Timed Up & Go. Resultados Un total de 99 pacientes (53,8%) (IC 95% 46,6-61) presentaron un test de la oracion positivo. No se obtuvo una relacion estadisticamente significativa con la HbA1c, en cambio, si que se vio una asociacion entre el test Timed Up & Go y el SMAL (p Conclusiones Existe una alta prevalencia de SMAL en nuestro medio. Presentamos el primer estudio en donde se relaciona el SMAL con el riesgo de caidas en los pacientes diabeticos.

Nevus anemicus (NA) is a cutaneous anomaly characterized by pale, well-defined patches with limited vascularization after rubbing. They are largely known to be associated with neurofibromatosis 1 (NF1) and have received little attention in the literature until recently. We sought to characterize the prevalence and clinical features of patients with NA and NF1. We conducted an observational prospective study of 99 children with NF1 at the Hospital Niño Jesús, Madrid, Spain, from January 1, 2012, through July 31, 2013, and reviewed three other series of patients with NF1 and NA recently reported. The prevalence of NA in children with NF1 ranged from 8.8% to 51%, being much more prevalent at younger ages. Prospective studies yielded a higher prevalence than retrospective studies. NA was located most commonly on the trunk, particularly on the anterior chest wall, and was often multiple. Patients with segmental NF1 or isolated café au lait spots rarely had NA, and NA was absent in other genodermatoses. The collection of data was not homogeneous in all studies. NA has a high prevalence in individuals with NF1 patients but seems to be absent in connection with other genodermatoses, therefore its presence can assist in the diagnosis of suspected cases of NF1. The subtle clinical appearance of NA makes its detection difficult, and physicians involved in the care of children with NF1 must be aware of its possible presence and significance.

Palliative care is a group of actions performed by nurses in order to increase the comfort and well-being of patients with terminal illnesses. The World Health Organization (WHO) defines this term as: An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual [1]. Cicely Mary Strode Saunders is considered as the precursor of the palliative care, who explained the need to change the Palliative Care Units in order to improve the quality of life of patients with terminal illnesses. Palliative care is necessary for patients with a terminal illness. In such cases, the life expectancy is less than six months. Human being is considered a biopsychosocial model. For this reason, the nurse must take into account all the requirements arising from these three dimensions of the human being. In this essay, we deal with palliative care in patients with terminal illnesses, considering the role of the nurse as an important reference when teaching palliative care to the main carer.

[ES] La materia “Habilidad es para Comunicary Educar en Salud” incluye la comprensión de la enfermería como una relación humanacliente ‐ enfermero/a para identificar y responder a la necesidad de ayuda,desarrollando la comunicación como principal instrumento para la prestación de cuidados. Para alcanzar las competencias en esta asignatura, durante el curso 2009‐ 10, se desarrolló una metodología activa basada en un aprendizaje significativo. La evaluación se realizó a través de la demostración práctica de la adquisición de habilidades en comunicación verbal y no verbal, mediante técnicas de dramatización evaluadas por el profesorado y complementada por una evaluación entre iguales. Este sistema supuso un desafío tanto para estudiantes como para profesores. Con objeto de conocer: grado de acuerdo del alumnado con esta metodología de aprendizaje y evaluación, con cordancia de resultados en evaluaciones de profesorado ‐alumnado y nivel de consecución de los objetivos de aprendizaje respecto al bloque temático de Comunicación y Relación de Ayuda, se diseñó un estudio descriptivo transversal con 95 alumnos/as. Los resultados mostraron la satisfacción de los alumnos/as, la falta de concordancia en las evaluaciones de profesorado y alumnado (coincidiendo con otros estudios) y evidenciaron la eficacia de esta metodología para adquirir habilidades específicas en comunicación., [EN] Communication and Education Skills for Health "includes an understanding of nursing as a humanrelation client ‐ nurse to identify and respond to the need of help, developing communication as the main instrument for the provision of care. To achieve competence in this subject during the academic course 2009-10, we developed an active methodology based in meaning fullearning. The evaluation was made through practical demonstration of the acquisition of in verbal and non verbal communication through dramat echniques(rol‐playing) evaluated by teachers and supplemented by apeer review. This system was a challenge for both students and teachers. In order to know: the agreement of students with this method of learning and assessment, the agreement of results between teacher and students assessments and the level of achievement of learning objectives in the unit “Helping Relationship and Communication”, we designed a descriptive study with 95 students. The results showed the satisfaction of the students, the lack of consistency in the evaluation sof teachers and students (coinciding with other studies)and demonstrated the effectiveness of this methodology to acquire specific skills in communication., [FR] La matière "Compétences pour la communication et l’éducation pour la santé ”comprende une compréhension des soins infirmiers comme une relation client–in firmièr/e pour identifier et répondre aux besoins d'aider à développer la communication comme instrument principal de la prestation de soins. Pour atteindre les compétences dans cette matière au cours de l'année académique 2009‐10, nous avons développé une méthodologie active baseé sur un apprentissage significatif. L'évaluation a été réalisée par des démonstrations pratiques de l'acquisition d'aptitudes en communication verbale et non verbale grâceà des techniques théâtrales évalués par les professeurs et complétées par les pairs. Cesystème a representé un défi pour les étudiants et les enseignants.Nos objetifs ont été: connaître le degré d’acceptation de cette méthode d'apprentissage et d'évaluation para les étudiants,connaître la concordance de l'évaluation des enseignants et de celle des élèves, en plus du niveau d’atteinte des objectifs d'apprentissage de l'unité thématique “Communication et Relations d 'aide”. Nous avons réalisé une étude descriptive avec 95 étudiants. Les résultats ont montré la satisfaction des étudiants, ont révélé un décalage entre les évaluations des enseignants et celles des étudiants (confirmées par d'autres études) et ont démontré l'efficacité de cette méthode pour acquérir des compétences spécifiques en matière de communication.

PROPOSITO: Presentamos el caso de un tumor de origen desconocido que debutó como derrame pericardio con taponamiento cardiaco. El estudio necrópsico del pericardio resultó ser adenocarcinoma pobremente diferenciado de pulmón. MATERIAL Y MÉTODOS: Mujer de 60 años que presento cuadro de taponamiento cardiaco secundario a un derrame pericárdico metastásico de un tumor no filiado tras las pertinentes pruebas diagnósticas. RESULTADOS Y CONCLUSIONES: Los tumores de origen desconocido (TOD) son un problema relativamente frecuente en la práctica clínica oncológica, estimándose su incidencia en un 5-10% de todos los enfermos con cáncer¹, presentando un problema de dificultad diagnóstica y manejo terapéutico. La forma de presentación clínica varía dependiendo de la localización a distancia sin existir un patrón metastásico similar al de sus homólogos con primario establecido. Así mismo la búsqueda exhaustiva del tumor primario suele ser la mayoría de las veces improductiva y muy costosa². PURPOSE: We report the case of a woman with cancer of unknown primary site, presented with pericardial effusion and cardiac tamponade. Necropsy showed a pericardium with poorly differentiated lung adenocarcinoma lesions. MATERIAL AND METHODS: We present a 60 year old woman who after the pertinent tests was diagnosed of cardiac tamponade secondary to pericardial metastasis of cancer of unknown primary site. RESULTS AND CONCLUSIONS: Cancer of unknown primary site is a very common problem in the oncology clinical practice, that has been estimated between 5 and 10 % of all cancers, representing a common medical problem because of the difficult diagnosis and therapeutic management. The clinical manifestations depend on the localization of the distant metastases, whose pattern differs from that of the metastatic localizations of the homologous cancers of known primary site. The lack of results after an exhaustive search make further studies unnecessary.

The implementation of a quality Tutorial Action Plan (TAP), in which the integral formation of students is the main objective, is a topical issue in the Spanish university environment . This paper aims to identify the actions contemplated in the TAPs of different Spanish universities and catalog the different types of activities performed by the teachers-tutors in the context of tutorial action. To achieve this, the authors conducted a qualitative analysis based on expert panels. As a result, three main vectors were extracted: Standard elements in a college TAP, critical aspects from tutors and managers of tutorial actions, and tutorial actions with a seal of quality. From the analysis it was concluded that quality tutorial action is the basis for academic excellence. Its achievement requires to clarify and recognize the role of the tutor, adjust appropriately the ratio of students allocated per tutor, and promote the development of transversal skills in students. For this, the authors propose a cross-coordination among teachers, as well as counseling and support; tutor training and professionalism; and the application of working methods that allow proper guidance and monitoring of students. ----------------------------- Estudio Cualitativo sobre Tutoria Universitaria a Traves del Metodo de Panel de Expertos Resumen La implantacion de un plan de accion tutorial (PAT) de calidad, en el cual la formacion integral del alumnado sea lo principal, es un tema de actualidad en el entorno universitario espanol. El presente trabajo persigue identificar las acciones contempladas en los PAT de diferentes universidades espanolas, asi como catalogar los diferentes tipos de actividades realizadas por los profesores-tutores en el contexto de la accion tutorial. Para ello se realizo un analisis cualitativo basado en paneles de expertos. Como resultado, se extrajeron tres vectores principales: Elementos habituales en un PAT universitario; Aspectos criticos desde los tutores y gestores de la accion tutorial; y Acciones en tutoria con sello de calidad. Del analisis realizado se concluyo que la accion tutorial de calidad es la base de la excelencia academica. Su consecucion requiere clarificar y reconocer el papel del tutor, ajustar las proporciones de tutelados asignados de manera adecuada y potenciar el desarrollo de competencias transversales en el alumno. Para ello, se propone la coordinacion transversal entre el profesorado, asi como con servicios de orientacion y apoyo; la formacion y profesionalizacion de los tutores; y la aplicacion de metodos de trabajo que permitan la adecuada orientacion y seguimiento del alumnado. DOI: 10.18870/hlrc.v4i1.197 PDF document contains both the original in Spanish and an English translation.

[ES] Este estudio forma parte de la tesis doctoral “Significados de la tutoría universitaria desde la percepción de los profesores”, finalizada en 2012. El propósito ha sido comprender los significados de la tutoría en la universidad a través de la percepción de los profesores, conocer cómo influye este escenario en la forma de entender la tutoría y profundizar en las relaciones profesor-estudiantes en dicho contexto. Metodología: investigación cualitativa, método de estudio de casos, instrumental y múltiple. Los casos han sido la Universidad Pública y Privada. Resultados: El análisis produce seis dominios interrelacionados: Ser y ejercer de profesor en mi universidad, discusión sobre la reforma en Educación Superior y sus implicaciones en la acción tutorial, los múltiples significados de la tutoría, ser y ejercer de estudiante: la pieza que ignora el sistema, ser y ejercer de tutor y, la tutoría como espacio docente y de relación. En este artículo se expone el dominio “Ser y Ejercer de tutor” por ser uno de los temas más relevantes en el estudio. Se identifican elementos que inciden en el significado de ser y hacer de tutor, así como los roles, estrategias y acciones en tutoría. Conclusiones: En el “ser tutor” influye el tipo de universidad, “ser profesor” y el sentido de la tutoría para estos. La función tutorial se adquiere, no se improvisa. Los programas de formación del profesorado deben ser potentes instrumentos de cambio, de significados en torno a la docencia y de actitudes hacia la tutoría., [EN] This study is part of the PhD thesis entitled “Meanings of university tutoring from the teachers’ perspective”, completed in 2012. The purpose was to understand the sense of tutoring at university through the teachers’ perceptions. For it, we tried to know this scenario in order to understand its influence on the tutoring. Finally, we tried to understand further the teacher-student relationship in this context. Methodology: qualitative research, instrumental and multiple cases study method. Cases studied were public and private Universities. Results: the analysis produced six interrelated domains: being and practicing as a teacher in my university, a discussion about Higher Education reform and its implications on tutoring activities, the multiple meanings of tutoring, being and practicing as a student: the part ignored by the system, being and practicing as a tutor and, tutoring as a teaching and relationship space. The domain “being and practicing as a tutor” is presented in this paper as it is one of the most relevant issues of the study. Elements that impact on the meaning of being and practicing as a tutor are identified, as well as the roles, strategies and actions in the tutoring activities. Conclusions: “being a tutor” is influenced by the type of university, “being a teacher” and the sense of tutoring for teachers. Tutoring role is acquired, it can’t be improvised. Teacher Training programs should be a powerful tools in order to change the meanings about teaching and to encourage attitudes towards tutoring action.