Abstract:

BACKGROUND
Clinical sessions are structured meetings where professional nurses analyze and discuss about a case in order to make decisions based on scientific evidence to improve patient care. At Algeciras Nursing School (University of Cádiz), this approach has been used for two years as an instrument to support students’ learning in clinical practice. The implementation of operational simulations of clinic sessions (OSCS) allows undergraduated nurses to integrate the theoretical contents with the abilities, skills and attitudes that qualify them to their future professional practice.

OBJETIVES
Analyze the degree of learning and difficulty perceived by the students with regard to the accomplishment of an OSCS.
Identify the skills that students perceive that they have acquired to a greater extent and those that have meant major difficulties to them.

METHOD
Design: Cross-sectional descriptive study.
Participants: Surgical nursing students who have participated in operational simulations of clinical sessions, N=100.
Sample: Due to voluntary participation a convenience sampling was used, n=47.
Variables: 1. Perceived learning; 2. Perceived difficulty; 3. Main skills that students perceive they have acquired to a greater extent and ones with great difficulty. Variable quantification: 1=Minimum, 5=Maximum. For variable 3 we consider, in terms of frequency, than main skills are those which more than half of students surveyed have qualified them with a score >= 4.
Instrument: Anonymous self-administered questionnaire designed following the Grau’s premises (1) and based on specific literature (2,3). A cognitive pretest was conducted in a group of 8 students. The final version of questionnaire was validated using a qualitative triangulation by expert judgment-based approach.
Data Analysis: Statistical descriptive analysis was performed using SPSS 17.0.

FINDINGS
Perceived degree of:
Learning: X=3,766 (Standard Deviation (SD)=0,983).
Difficulty: X=3,319 (SD=0,98).
Main skills that students have declared to acquire:
Develop critical thinking: 68,1%
Apply the nursing process: 68,1%
Provide optimal patient care: 63,9%
Main difficulties faced by students:
Search for evidence about healthcare: 81,9%
Oral presentation: 64,85%
Find information and access to library resources: 56,37%

DISCUSSION
We consider relevant that the students have identified the use of clinical session as a useful methodology to provide optimal patient care. Likewise, they declared that the activity has favoured their reflexive capacity and the application of the nursing process to real cases. These aspects are fundamental for their future professional practice and the development of nursing discipline. Students perceived this learning technique as highly difficult, but they express to have reached a high degree of learning. Main difficulties are related to search and access to information about evidences in healthcare and oral presentation. Although we do not pretend to extrapolate these results, similar findings have been described in the literature (4,5). In future experiences we consider necessary to improve in that regard. On a practical level, we think that clinical session-based learning is an adequate instrument for the acquisition and evaluation of skills.

CONCLUSION
The operative simulation of clinical sessions is perceived by students as a complex methodology but useful and efficient for their learning in clinical practice.

Keywords:

operational simulation of clinical sessions, nursing students, students perception.