Eficácia da simulação realística no ensino de imunização de adultos no contexto da graduação em enfermagem

Abstract

Realistic simulation is a valuable teaching and learning strategy that has been disseminated and used in undergraduate courses in health and nursing. However, its effectiveness, when compared to traditional teaching methods, still lacks better evidence. The aim of the study was to analyze the effectiveness of teaching and learning strategies in the acquisition of knowledge and satisfaction of undergraduate nursing students in the teaching of immunization in the context of Primary Health Care (PHC). This is an experimental study, of the type Controlled and Randomized Controlled Trial (ECCR), pre-test and post-test. The sample of the non-probabilistic type for convenience was composed of 34 nursing students, assigned to two groups of 17 (control and experimental) respecting control variables: gender, age, Academic Income Index (ARI), professional experience in APS, and diagnosis of the Preferential Representational System (SRP). It obtained a favorable opinion from the Research Ethics Committee, CEP / UFRN, protocol no. 1,958,827, and registered in the platform of Brazilian Registry of Clinical Trials under protocol RBR-9sqr6b. Data were collected between May and June 2017. Students participated in a 40-hour course on adult immunization. The Control Group (GC) participated in the course in modality 1: (dialogue exhibition and skills training). The Experimental Group (GE) was directed to modality 2 (dialogical presentation, skills training and realistic simulation). The effectiveness of teaching and learning strategies was assessed through pre and posttest evaluation. The Satisfaction and Self-Confidence Questionnaire in Learning, the Educational Practices Questionnaire, and the Simulation Design Scale were also applied. In all inferential calculations the significance level of 5% was adopted. The GE students presented better performance than the CG in the four assessments of cognitive performance, with statistical significance in the assessments of immediate knowledge (p value = 0.031) late 1 - 20 days (p value = 0.031). Regarding satisfaction and self-confidence in learning, there was no statistical significance between groups in both subscales (p value ≥ 0.05). However, the GE presented higher averages. The Simulation Design Scale presented a Cronbach Alpha total of 0.930. All the dimensions of the scale obtained global averages equal to or higher than 4.60, with problem solving and realism being the dimensions that showed the greatest agreement and importance among the students of the GE. Regarding educational practices, modalities (1 and 2) were evaluated positively by the students. In EG, statistical significance was found in the subscale of importance in the "different ways of learning" domain (p = 0.018). The alternative hypothesis of the study is accepted as in module 2 students learn better and for longer. In addition, it promotes greater satisfaction and self-confidence in students. We conclude that these educational practices present their structural dimensions closer to meaningful learning. It is recommended to use the simulation and it is hoped that the evidence produced in the study will contribute to the improvement in undergraduate nursing education.