Escola Anna Nery Revista de Enfermagem
https://app.periodikos.com.br/journal/ean/article/doi/10.1590/2177-9465-EAN-2017-0442
Escola Anna Nery Revista de Enfermagem
Research

Use of clinical simulation to improve diagnostic reasoning in nursing

Uso de la simulación clínica para mejorar el razonamiento diagnóstico en enfermería

Uso da simulação clínica para aprimorar o raciocínio diagnóstico na enfermagem

Ingrid Régia Lopes Jerônimo; Juliana Faria Campos; Mauricio Abreu Pinto Peixoto; Marcos Antônio Gomes Brandão

http://dx.doi.org/10.1590/2177-9465-EAN-2017-0442 Esc. Anna Nery, vol.22, n3, e20170442, 2018
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Abstract

Objectives: Propose a methodology for the construction of simulated scenarios and cases to improve diagnostic reasoning in nursing.

Method: A methodological study was conducted using theories and concepts from the dual processing theory to develop cases and scenarios of clinical simulation for diagnostic reasoning in nursing through proper use of analytical and non-analytical reasoning.

Results and discussion: This study presents and discusses issues of the theoretical framework and operational elements: structure of scenarios, preparation of simulation, briefing, debriefing, and modeling, incorporating any required content. The methodology articulates content that is compatible with analytical reasoning, non-analytical studies and diagnostic accuracy measurements of clinical validation studies.

Conclusion: This study demonstrated the feasibility of modeling simulated cases that combine dual processing with diagnostic reasoning in nursing.

Implications: Contribution to learning in a safer simulated environment, adopting theoretical bases from studies on human reasoning.

Keywords

Simulation; Nursing Diagnosis; Educational Technology; Methods; Learning

Resumen

Objetivos: Proponer una metodología de construcción de escenarios y casos simulados para mejorar el razonamiento diagnóstico de enfermería.

Métodos: Estudio metodológico con bases teóricas y metodológicas de la Teoría del Doble Proceso para construir casos y escenarios de simulación clínica para el razonamiento diagnóstico de enfermería utilizando correctamente los razonamientos analítico y no analítico.

Resultados y discusión: Fueron presentados y discutidos aspectos del referencial teórico y elementos operativos: estructura de los escenarios, preparación de la simulación, briefing, debriefing y construcción, incorporando contenidos necesarios. La metodología articula contenido compatible con razonamientos analíticos, no analíticos y mediciones de precisión diagnóstica de estudios de validación clínica.

Conclusión: Se entiende haber demostrado la factibilidad para construir casos simulados necesarios para el doble proceso del razonamiento diagnóstico de enfermería.

Implicaciones: Contribución al aprendizaje en ambiente más seguro; adoptando base teórica de estudios de razonamiento humano.

Palabras clave

Simulación; Diagnóstico de Enfermería; Tecnología Educacional; Métodos; Aprendizaje

Resumo

Objetivos: Propor uma metodologia de construção de cenários e casos simulados para aprimorar o raciocínio diagnóstico de enfermagem.

Métodos: Estudo metodológico com bases teóricas e conceituais da Teoria do Duplo Processamento para construir casos e cenários de simulação clínica para o raciocínio diagnóstico de enfermagem pelo uso adequado dos raciocínios analítico e não analítico.

Resultados e discussão: São apresentados e discutidos aspectos do referencial teórico e elementos operacionais, como: estrutura dos cenários, preparação da simulação, briefing, debriefing e modelagem, incorporando conteúdos necessários. A metodologia articula o conteúdo compatível com raciocínios analíticos, estudos não analíticos e medidas de acurácia diagnóstica de estudos de validação clínica.

Conclusão: Entende-se ter demonstrado a exequibilidade da modelagem de casos simulados que integram o duplo processamento ao raciocínio diagnóstico de enfermagem.

Implicações:  Contribuição para o aprendizado em ambiente simulado mais seguro; adotando base teórica de estudos de raciocínio humano.

Palavras-chave

Simulação; Diagnóstico de Enfermagem; Tecnologia Educacional; Métodos; Aprendizagem

Referencias

1 Considine J. Nurses, diagnosis and diagnostic error. Diagnosis (Berl) [Internet]. 2017 Nov; 4(4):197-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29536936

2 Papa FJ. Learning sciences principles that can inform the construction of new approaches to diagnostic training. Diagnosis (Berl) [Internet]. 2014 Jan; 1(1):125-9. Available from: http://www.degruyter.com/view/j/dx.2014.1.issue-1/dx-2013-0013/dx-2013-0013.xml

3 Papa FJ, Li F. Evidence of the preferential use of disease prototypes over case exemplars among early year one medical students prior to and following diagnostic training. Diagnosis (Berl) [Internet]. 2015 Dec; 2(4):217-25. Available from: http://www.degruyter.com/view/j/dx.2015.2.issue-4/dx-2015-0024/dx-2015-0024.xml

4 Kuiper R, Pesut D, Kautz D. Promoting the Self-Regulation of Clinical Reasoning Skills in Nursing Students. Open Nurs J [Internet]. 2009 Oct; 3:76-85. Available from: http://benthamopen.com/ABSTRACT/TONURSJ-3-76

5 O'Neill ES. Heuristics reasoning in diagnostic judgment. J Prof Nurs [Internet]. 1995 Jul/Aug; 11(4):239-45. Available from: http://linkinghub.elsevier.com/retrieve/pii/S8755722395800263

6 Dowding D, Gurbutt R, Murphy M, Lascelles M, Pearman A, Summers B. Conceptualising decision making in nursing education. J Res Nurs [Internet]. 2012 Jul; 17(4):348-60. Available from: http://journals.sagepub.com/doi/10.1177/1744987112449963

7 Evans JSBT. Dual-Processing Accounts of Reasoning, Judgment, and Social Cognition. Annu Rev Psychol [Internet]. 2008 Jan; 59:255-78. Available from: http://www.annualreviews.org/doi/10.1146/annurev.psych.59.103006.093629

8 Kim J, Park JH, Shin S. Effectiveness of simulation-based nursing education depending on fidelity: a meta-analysis. BMC Med Educ [Internet]. 2016 May; 16:152. Available from: http://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-016-0672-7

9 Evans JSBT, Stanovich KE. Dual-Process Theories of Higher Cognition. Perspect Psychol Sci [Internet]. 2013 May 7; 8(3):223-41. Available from: http://journals.sagepub.com/doi/10.1177/1745691612460685

10 Kahneman D, Klein G. Conditions for intuitive expertise: a failure to disagree. Am Psychol [Internet]. 2009 Sep; 64(6):515-26. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=Kahneman+D.+Conditions+for+Intuitive+Expertise.+2009%3B64(6)%3A515%E2%80%9326

11 Rashotte J, Carnevale FA. Medical and nursing clinical decision making: a comparative epistemological analysis. Nurs Philos [Internet]. 2004 Jul; 5(2):160-74. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=Medical+and+nursing+clinical+decision+making%3A+a+comparative+epistemological+analysis.+Nurs+Philos.+2004+Jul%3B5(2)%3A160%E2%80%9374.

12 Thompson C, Dowding D. Essential Decision Making and Clinical Judgement for Nurses. 1st ed. New York: Elsevier Health Sciences; 2009. 288 p.

13 Amaya Afanador A. Importancia y utilidad de las "Guías de simulación clínica" en los procesos de aprendizaje en medicina y ciencias de la salud. Univ Médica [Internet]. 2011 Jul/Sep; 52(3):309-14. Available from: http://www.redalyc.org/articulo.oa?id=231022506006

14 Alinier G. Developing High-Fidelity Health Care Simulation Scenarios: A Guide for Educators and Professionals. Simul Gaming [Internet]. 2011 Feb 14; 42(1):9-26. Available from: http://journals.sagepub.com/doi/10.1177/1046878109355683

15 Nehring WM, Lashley FR. Nursing Simulation: A Review of the Past 40 Years. Simul Gaming [Internet]. 2009 Jul; 40(4):528-52. Available from: http://journals.sagepub.com/doi/abs/10.1177/1046878109332282

16 Negri EC, Mazzo A, Martins JCA, Pereira Junior GA, Almeida RGS, Pedersoli CE. Clinical simulation with dramatization: gains perceived by students and health professionals. Rev Latino Am Enferm [Internet]. 2017 Aug; 25:e2916. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-11692017000100604&lng=en&tlng=en

17 Fabri RP, Mazzo A, Martins JCA, Fonseca AS, Pedersoli CE, Miranda FBG, et al. Development of a theoretical-practical script for clinical simulation. Rev Esc Enferm USP [Internet]. 2017 Apr; 51:e03218. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342017000100418&lng=en&tlng=en

18 Banning M. A review of clinical decision making: models and current research. J Clin Nurs [Internet]. 2008 Jan; 17(2):187-95. Available from: http://doi.wiley.com/10.1111/j.1365-2702.2006.01791.x

19 Lopes MVO, Silva VM, Araujo TL. Methods for Establishing the Accuracy of Clinical Indicators in Predicting Nursing Diagnoses. Int J Nurs Knowl [Internet]. 2012 Oct; 23(3):134-9. Available from: http://doi.wiley.com/10.1111/j.2047-3095.2012.01213.x

20 Grady JL, Kehrer RG, Trusty CE, Entin EB, Entin EE, Brunye TT. Learning nursing procedures: the influence of simulator fidelity and student gender on teaching effectiveness. J Nurs Educ [Internet]. 2008 Sep; 47(9):403-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=earning+nursing+procedures%3A+the+influence+of+simulator+fidelity+and+student+gender+on+teaching+effectiveness.+J+Nurs+Educ.+2008+Sep%3B47(9)%3A403%E2%80%938

21 Maran NJ, Glavin RJ. Low- to high-fidelity simulation - a continuum of medical education? Med Educ [Internet]. 2003 Nov; 37(Suppl 1):22-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=Low-+to+high-fidelity+simulation+-+a+continuum+of+medical+education%3F+Med+Educ.+2003+Nov%3B37+Suppl+1%3A22%E2%80%938

22 Brandão MAG, Cerqueira FA, Matos LN, Campos JF, Peixoto MAP, Primo CC. Características definidoras da Resposta Disfuncional ao Desmame Ventilatório como indicadores de acurácia do desmame ventilatório. Rev Bras Enferm [Internet]. 2014 Oct; 67(5):737-43. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672014000500737&lng=pt&tlng=pt

23 Waxman KT. The development of evidence-based clinical simulation scenarios: guidelines for nurse educators. J Nurs Educ [Internet]. 2010 Jan; 49(1):29-35. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=Waxman+KT.+The+Development+of+Evidence-Based+Clinical+Simulation+Scenarios%3A+Guidelines+for+Nurse+Educators.+J+Nurs+Educ.+2010+Jan%3B49(1)%3A29%E2%80%9335

24 Banning M. Clinical reasoning and its application to nursing: Concepts and research studies. Nurse Educ Pract [Internet]. 2008 May; 8(3):177-83. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1471595307000595

25 Chartier L. Use of Metacognition in Developing Diagnostic Reasoning Skills of Novice Nurses. Int J Nurs Terminol Classif [Internet]. 2001 Apr; 12(2):55-60. Available from: http://doi.wiley.com/10.1111/j.1744-618X.2001.tb00119.x
 

Submitted date:
04/01/2018

Accepted date:
14/03/2018

6823a5cea953953c62284b74 ean Articles
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