A palavra competência, na atualidade, faz parte do repertório de temas amplamente divulgados nos mundos da formação e do trabalho, exigindo uma análise aprofundada nos seus significados e na caracterização do movimento de construção de competências para cada patamar de capacitação profissional. Assim, o estudo objetivou: a)Identificar os referenciais de competências para o Graduado, Especialista, Mestre e Doutor em Enfermagem; b) Analisar a ressonância, no âmbito do trabalho, do exercício dessas competências; c) Identificar os investimentos didático-pedagógicos que são empregados para o desenvolvimento das competências nos alunos dos diferentes níveis de titulação superior; d) Propor referências para o ensino por competências. As bases analíticas foram elaboradas a partir dos Pressupostos Teóricos que Norteiam a Construção das Competências, na medida que sustentaram a apresentação e análise de dados passíveis de serem interpretadas à luz do movimento educacional e trabalhista. A investigação foi de natureza qualitativa; os sujeitos foram ex-alunos dos cursos de Graduação, Especialização, Mestrado e Doutorado (Grupo I) e docentes (Grupo II) destes diferentes níveis de titulação, de uma instituição pública de ensino superior do município de São Paulo, num total de 34 participantes. Tanto a instituição de ensino como os sujeitos aceitaram participar do estudo, conforme as disposições legais. Os grupos foram, inicialmente caracterizados individualmente e socialmente. A análise de conteúdo, aplicada aos dados obtidos por meio de entrevista semi-estruturada, permitiu o mapeamento de famílias de competências com as suas respectivas competências específicas para cada nível de titulação, em ambos os grupos. Como síntese, os dados evidenciaram uma compreensão teórica abrangente sobre o tema competência e mapeamentos que, sendo capazes de refletir as competências que são pertinentes aos diferentes níveis, ainda trazem uma intencionalidade não conquistada nos âmbitos de prática profissional. Entre as estratégias apontadas pelos docentes para o desenvolvimento das competências nos alunos, alguns pressupostos construtivistas foram destacados. Pontos fortes e frágeis foram elencados em cada nível de titulação, buscando-se evidenciar a dimensão da convergência das construções de sentido das competências com os ideários da formação e com os dispositivos de mercado. Como proposição, o trabalho traz referências para o ensino por competências. / At present the word competence takes part of the repertoire of subjects that is very published in the world of training and work demanding a deeper analysis in their meanings and in the characterization of the competencies construction movement for each level of professional qualification. Therefore, the aim of this study was: to identify the referential of competencies to the student, expert, Master and Doctor in Nursing area; b) to analyse the resonance at the work level, in the exercise of these competencies; c) to identify the teaching-educational investment used to the development of these competencies with students of different levels of higher education; d) to propose references to the teaching by competencies. The analytical basis were elaborated from the Theoretical Presuppositions that orientate the Construction of the Competencies while it supported the presentation and data analysis liable to be interpreted by the light of educational and labour movement. The investigation was qualitative and the individuals were ex-students from Graduation curses, Specialization, Master’s or Doctoral Degree (Group I) and teachers (Group II) from these different education level in a public institution of higher teaching in São Paulo City, in the total of 34 participants. As much the teaching institution as individuals accepted to participate of this study according to the legal disposition. Initially the groups were characterized individually and socially. The content analysis permitted the listing of competencies families with their respective competencies specific for each education level in both groups, applied to the obtained data through the semi-structured interview. As synthesis, the data showed the theoretical comprehension comprising about the subject competence and listing that are capable for reflect the competencies that are relevant to the different levels even it cause a intentional action non-conquered in the scope of professional practice. Among the strategies pointed out by teachers to the development of the competencies with students, some constructive presuppositions were emphasized. Strong and fragile points were listed in each education level aiming to prove the convergence dimension of the constructions of competencies’ meaning with the training ideas and with the market device. As proposition, the work brings references to the teaching by competencies.

Estudo exploratório, de abordagem qualitativa, que objetivou analisar a repercussão do estágio curricular supervisionado (ECS) no desenvolvimento da dimensão ética da competência de graduandos em Enfermagem. Foram realizadas entrevistas semiestruturadas com 28 estudantes, docentes e enfermeiros colaboradores de uma instituição de ensino superior pública do estado de São Paulo, no período entre outubro de 2010 e março de 2011. O material empírico resultante foi submetido à técnica de análise de discurso e resultou nas seguintes categorias empíricas: a preservação da autonomia; a responsabilidade social e o respeito nas relações intersubjetivas na produção do cuidado em saúde e no processo de ensino e aprendizagem; a terapêutica e o cuidado a partir da dimensão ética; a responsabilidade pública e a justiça social. Em relação ao desenvolvimento das atitudes e valores para atuação em saúde, a análise dos discursos resultou em outras duas categorias empíricas, que dizem respeito às ferramentas a serem utilizadas no processo de ensino e aprendizagem em ética: a reflexão crítica na e sobre a ação a partir do valor humano e as possibilidades de ações e de atitudes a partir da análise dos exemplos. Concluiu-se que o ECS é um espaço privilegiado de integração e desenvolvimento das dimensões técnica, estética, política e, em especial, ética. Na formação inicial, a formação dos valores é tão necessária quanto à aquisição de conhecimentos, pois ambos influenciam a tomada de decisão e a qualidade dessas decisões. No ensino da ética, a abrangência, a profundidade e a exploração dos valores referentes à esfera micro, de preservação da autonomia, responsabilidade e respeito, devem dialogar com os valores macro de responsabilidade pública, equidade e justiça social. / This is an exploratory qualitative study aimed at analyzing the impact of supervised curricular internship (SCI) in the development of the ethical dimension of nursing graduates professional competence. Semi-structured interviews were carried out with 28 students, teachers and nurses, employees of a public higher education institution in the state of Sao Paulo, from October 2010 to March 2011.The obtained empirical material was submitted to the discourse analysis technique and resulted in the following empirical categories: preservation of autonomy; social responsibility and respect in intersubjective relations in health care production and in the process of teaching and learning; therapy and care from the ethical dimension; public responsibility and social justice. Regarding the development of attitudes and values to work in health care, the discourse analysis resulted in two other empirical categories concerning the tools to be used in the teaching and learning process in ethics: a critical reflection in and on action from the viewpoint of human value and possibilities of actions and attitudes from the analysis of examples. It was concluded that the SCI is an ideal opportunity for integration and development of the technical, esthetic, political and mainly ethical dimensions. At the initial training, the formation of values is as necessary as knowledge acquisition, as they both influence decision-making and quality of those decisions. In the teaching of ethics, the scope, depth and exploration of values regarding the micro sphere of preservation of autonomy, responsibility and respect should be in close contact with the macro values of public responsibility, equity and social justice.

Skills of inquiry are essential outcomes from a baccalaureate nursing education. Students who demonstrate intellectual curiosity can develop effective skills of inquiry. Nurse educators must place emphasis on teaching and learning strategies which engage student intellectual curiosity. However, the concept of intellectual curiosity is not well-studied across multiple contexts of teaching and learning environments within nursing education. In addition, there is little known about the experienced nurse educator and the meaning of student intellectual curiosity across multiple teaching and learning environments. With the increased emphasis on online teaching and learning in nursing education as a solution for expanding student access and capacity, the concept of intellectual curiosity within the context of online learning needs further exploration. Under the assumptions of philosopher Max van Manen (1990, 1997) and Martin Heidegger (1962), the purpose of this qualitative, hermeneutic phenomenological study was to understand the lived experience of baccalaureate nursing student intellectual curiosity for the experienced nurse educator teaching within the online learning environment. The research question was: What does intellectual curiosity mean to experienced nurse educators teaching in the online environment? A total of eight participants from three different institutions of higher education in the southeastern United States were interviewed through a socratic approach. Diekelmann, Allen, and Tanner’s Steps for Data Analysis (1989) are utilized for data analysis. Three constitutive patterns and seven relational themes emerged through the data analysis process. Ontological considerations of findings, implications for nursing education, and future research investigations are identified.

Nursing education courses and professional development (PD) do not include coping and resilience training for registered nurses (RNs) who work in emergency departments (EDs). Exposure to traumatic events, death, and dying may lead to health issues, substance abuse, stress symptoms, nursing staff turnover, and compassion fatigue among ED RNs. Without training, the pattern of adverse outcomes may continue. The purpose of this study was to explore ED RNs' experiences with occupational traumatic stress (OTS), and their recommendations for change to nursing PD programs, using a qualitative bounded intrinsic case study. The conceptual framework for this study included social learning and experiential learning theories. Data were collected through semi-structured interviews with 7 licensed and employed ED RNs with more than 1 year in EDs and who volunteered to participate in the study. Data were examined analytically using descriptive, emotion, and patterns coding strategies and In Vivo to identify categories and themes. Based on nurses' experiences, ED RNs require a collaborative team training approach in learning and sharing opportunities regarding preparatory, de-escalation, and self-care strategies to overcome OTS. Based on the findings, a 3-day interactive PD workshop program was created for ED nurses to address those needs. These endeavors may contribute to positive social change by increasing wellness, cohesive ED teamwork, healthy stress management practices, better patient care, and reduced turnover for ED RNs. Furthermore, nurse educators may benefit from adding coping and resilience training to the nursing education curriculum to address and possibly mitigate the effects of OTS.

Graduate nurses are being employed to provide care in high acuity care areas, and this becomes a problem of significance as the literature suggests that graduate nurse's experience a deficit in integrating theoretical concepts in the clinical environment, described as the theory-practice gap; which can result in a risk to patient safety and the potential for negative outcomes. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses employed at a community hospital in northern New Jersey. After recruiting the participants through purposive sampling, semi-structured interviews were conducted with them utilizing a researcher-developed interview protocol based on the Casey-Fink Graduate Nurse Experience Survey. The research questions addressed the graduates' clinical experiences and their perceptions of simulation in facilitating the integration of theory to practice. Interviews were transcribed verbatim, coded, and analyzed to identify 4 themes: (a) the theory-practice gap, (b) effective educational pedagogy, (c) theory-practice integration, and (d) simulation-based learning. The crucial finding was that graduate nurses perceived the theory-practice gap could be reduced through the use of high-fidelity simulation utilizing scenario-based learning exercises in prelicensure programs prior to entry to practice. Based on these findings, the recommendations presented in a white paper will help the administration of the school of nursing at the local site make informed decisions to effect curricular changes that promote the students' integration of theory into practice. Further, the results of this study impact social change by serving as a model for similar programs to improve the preparation of graduate nurses to provide care to optimize positive patient care outcomes.

Accurate temperature assessment is essential in neonatal patients and allows for prompt recognition of illness. Temperature can be measured by rectum, which is subject to injury, axillary, which is time-consuming, and temporal artery, which is safe and fast. The purpose of this evidence-based practice quality improvement project was to create an educational toolkit for nurses teaching temporal artery thermometers for routine temperature measurement on neonates, to establish the content validity of the toolkit, and to make recommendations for implementation of the toolkit. The format applied was the Kellogg Logic Model that proceeded from the assumption, to planned work, and results. The theoretical framework was Roger's Diffusion of Innovations, which identifies champions as the initial change agents, helps engage the staff, and facilitates the change. The project consisted of a two-phase process. Phase 1 was the development of the toolkit contents by integrating the evidence and applying the framework in the context of working nurses. Phase 2 was the validation of the toolkit by expert nurses and educators with Item-CVI ranging from 0.80 to 1.00 and the scale-CVI at 0.98. The Toolkit for Implementation of Temporal Artery Thermometers for Neonates with three short video presentations was validated. The toolkit is shared on multiple webpages and is available to the public. Adopting the temporal artery thermometer for routine temperature measurement could be a new standard for temperature monitoring that is accurate and fast. Improved family satisfaction would result from a quicker temperature process and a less invasive method resulting in a more comfortable experience for their infant.

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions for the study examined the treatment (human patient simulators, stressful situational scenarios, and role playing) for changing EI skill levels. Repeated measures, within factors analysis of variance was used to test for a relationship between the variables at three time periods during a semester. Key results for emotion understanding were significant with small effect, F(1.973, 171.686) = 7.526, p = .001, partial ω2 = .047. Key findings for emotion management were significant with medium effect, F(1.827, 158.965) = 9.981, p < .0005, ω2 = .063. However, conclusions were mixed for influence, as the instructional strategy resulted in negative EI learning (consistent decreased gain) for most participants. By weeding out irrelevancies, this study contributes to current nursing research and informs nursing educators of the need to continue the search for an effective strategy for teaching emotion understanding and management skills in nursing curricula.

<p> </p><p>Bakgrund: I ett samhälle där heteronormativiteten är en norm kan homosexuella personer vara mer eller mindre öppna med sin sexuella läggning och negativa erfarenheter av tidigare vård kan leda till att vård söks i mindre utsträckning. Syfte: Syftet var att belysa attityder i sjukvården gentemot homosexuella, bisexuella och transpersoner. Metod: En systematisk litteraturstudie gjordes som inkluderade 15 vetenskapliga artiklar. Materialet har analyserats med hjälp av innehållsanalys. Resultat: Tre kategorier och fem subkategorier identifierades. Kategorier: Bemötande, Kommunikation samt Kunskap. SubKategorier: Vårdpersonalens attityder, Vårdstudenternas attityder, Patienternas attityder, Att våga berätta om sin sexualitet samt Utbildning. Resultatet visar att god kunskap om homosexuella, bisexuella och transpersoner inverkar positivt på vårdpersonalens attityder gentemot dessa personer. Resultatet belyser även vikten av god, icke-heteronormativ kommunikation i vården. Diskussion: Att ge vårdpersonal och vårdstudenter utbildning om hur homosexuella, bisexuella och transpersoner lever sina liv samt att ge dem erfarenhet av möten med dessa patienter kan leda till ett bättre bemötande, minskade negativa attityder samt en mer holistisk vård. Slutsats: Negativa attityder gentemot homosexuella, bisexuella samt transpersoner hos vårdpersonal leder till att de riskerar att få en sämre vård än heterosexuella patienter.</p>

In this thesis, the aim was to attain a deeper understanding according to the students meaning of learning related to their own responsibility and independence within a framework of an educa¬tional programme. An empirical study with an ethnographic approach was carried out during one term of a nursing programme that uses the PBL-approach. Based on observations, conversations, inter¬views and documents, three narratives were formulated. One describes the phases students experience in the planned curricula. Periods characterised of chaos, uncertainty and a heavy workload, alternate with periods of ‘cosmos’, optimism, curiosity and satisfaction. The second narrative is about students' learning objectives while realising that they have to make choices and decisions on their own to succeed. A dialectic driving force emerging from frustration and stimulation, chaos and cosmos, results in questions about what to learn and how to act. The third narrative describes how students handle these questions. The narratives reveal two dimensions. One concerns how the students form attitudes about the relevance of learning objectives and how they go about learning a knowledge base necessary for their future profession. The other dimension takes as its starting point the fact that students try to manage their learning situation taking into consideration the framework of the educa¬tional programme. These dimensions were further analysed using theoretical references. The first dimension was analysed from the perspective of teacher/learner control and a didactic analysis of the meaning of an educational setting. The second dimension was analysed on the basis of phenomenographic learning theory. As regards responsibility and independence there seems to be a point in abandoning the concept of self-directed learning. Instead of emphasising self, the interaction between people, the individual and the educational framework and the interaction with content, are found to be fundamental. This interaction includes communication, dialogue and active participation in all the parts of a learning situation. Based on the results of this study, I claim that the driving force in student-centred learning is the dialectic relation between frustration and stimulation, chaos and cosmos. This stimulates the students to engage in the teachers' traditional didactic ques¬tions concerning an educational programme: what are we going to study, how and why, and what are the objectives? The students' conduct as regards independence, vis à vis dependence, are related to a dialectic relationship between the prerequisites provided by the educational frame¬work and the students' interpretation and ability to use them. Expressions of responsibility and independence emerge as choices and decisions concerning the didactic questions, initiative, activity, search for opportunities to reflect and co-operate and self-confidence. The opposite, dependence, is characterised by strategies for “survival”. The students plan their learning situa¬tion so that the examinations and assignments can be successfully tackled, and the learning situation takes on features of a surface approach. I believe that further insights into learning in student-centred education can be found in the two dialectic relationships described above.

During recent years there have been noticeable shortcomings in the human encounter of people seeking some form of health care in Sweden. This is something that affects professional education within ‘the welfare state’ and implies that human expectations, societal demands and questions about knowledge, basic values and competence have become pedagogically interesting. The basic aim of the dissertation is - to contribute to a practically, relevant and theoretical in-depth understanding of the learning and teaching of ethics in professional education. By taking nursing education as an example and focussing on the human encounter of the person seeking care, the dissertation aims - by analysis of the pedagogic practice and from a critical-theoretical perspective – to provide a foundation for such an understanding. The research perspective includes a social-philosophical point of departure with a focus on Mead’s interactional view of learning and Habermas’s critical theory of social communication. Methodologically an emphasis is placed on discourse analysis. The results demonstrate how the learning and teaching of ethics in human encounters can be understood as a question of communication of both knowledge and values. In the theoretical reconstruction that follows it is shown how pedagogic actions, learning and competence can be understood as communication of and in particular contextual discourses. The six discourses are: ‘the efficiency-related discourse’, ‘the expert-related discourse’, the ‘care-related discourse’, ‘the communicative-related discourse’, ‘the egocentric discourse’ and ‘the ethnocentric discourse’, all of which are mutually related to each other. The contextual discourses focus on different values. Those that are most conducive to creating pleasant human encounters are the communicative- and the care-related discourses, which also form the foundation for the pedagogic recommendation that makes up the concluding discussion of the dissertation. The recommendation concerns a pedagogical practice that affirms, pays attention to, safeguards and challenges and thus generates creativity, as well as the legitimacy of pluralism. To engage in stimulating pedagogical discussion means being committed, taking responsibility and practicing solidarity in the profession of education. Such a ‘deliberative pedagogy’ creates possibilities for people to develop solidarity of judgement in a society that increasingly demanding that. In conclusion, the recommendation for a new and challenging human encounter-ethical-pedagogy is intended to show that ‘ideals can be realistic’. Normative recommendations do not have to be abstract visions of the future, but can be looked upon as means of focussing on alternative actions, that despite the difficulties are possible to realise – here and now.