Eficácia da simulação clínica no ensino do raciocínio diagnóstico em enfermagem na saúde da criança e do adolescente

Abstract

The teaching of diagnostic reasoning in nursing focused on the health of children and adolescents is very relevant for the training of critical, reflective nurses with specific knowledge about these unique periods in the individual's life cycle. In this context, it is believed that realistic simulation is a positive and beneficial teaching strategy for the training of future nurses. This study aims to analyze the effectiveness of realistic simulation in teaching diagnostic reasoning in nursing focused on the health of children and adolescents. Methodological study, carried out in three stages, namely: construction of scenarios for realistic simulation; validation of the content of these scenarios by specialists; and, application of simulation as an educational strategy in the teaching of diagnostic reasoning in nursing aimed at the health of children and adolescents in the period from December 2018 to September 2019. In the first two stages, four clinical cases were prepared for the pre and post-test and two scenarios for the simulation process, which had their contents analyzed by 25 experts who judged the relevance, specificity and coherence of the clues provided in each case. and nursing scenario and diagnosis, using the Diagnostic Accuracy Scale. In the third stage, the strategy was applied to students in the seventh period of the undergraduate course at a public university in northeastern Brazil. They were randomly divided into the intervention and control groups. The intervention group, in addition to participating in the simulation, also assessed satisfaction with the process. The data were analyzed using descriptive and inferential statistics. The project was approved by the Research Ethics Committee of the responsible institution, under opinion number 3,175,619 and Certificate of Presentation for Ethical Appreciation 07990418.4.0000.5537. The results showed that the four clinical cases (S coefficient: 0.916) and the two scenarios (S = 0.535) created obtained an acceptable coefficient of agreement among specialists. In the experiment, the pre-test indicated homogeneity of the intervention and control groups. In the post-test, there was no statistically significant difference in performance between the groups, however the results showed a slight improvement in the diagnostic reasoning performance of the intervention group compared to the control group. The intervention group was able to infer more diagnoses and their components than the control group. In evaluating the educational strategy, students expressed high satisfaction and relevance to improve diagnostic reasoning skills aimed at the health of children and adolescents. It is concluded that the strategy on teaching diagnostic reasoning in nursing focused on the health of children and adolescents was not effective, but promising and attractive for undergraduate students.