ABSTRACT
BACKGROUND: The assessment of the acquisition of clinical competencies is a critical issue for nursing students. 360-degree evaluations are a widespread practice in professional competency assessment and can be applied to the learning/teaching process of future nurses. OBJECTIVES: To determine the effectiveness of the implementation of a 360-degree evaluation proposal for assessing the competencies acquired by third-year nursing students during their clinical placements. DESIGN: A mixed-methods design was used with a primary component (a cross-sectional descriptive observational design) and a parallel qualitative component. PARTICIPANTS: Sixty-seven third-year nursing students from a public university in Madrid, Spain, who were undertaking their clinical placements during seven weeks in medical/surgical units in hospital settings. METHODS: This study was conducted between September 2017 and May 2018. Quantitative data were obtained using assessment tools specifically developed for this 360-degree evaluation proposal. Qualitative information was collected from two focus groups, one with students and one with teaching staff. A descriptive analysis of the quantitative data was conducted. Qualitative data were studied using a thematic analysis. RESULTS: The mean scores for each of the items in the 360-degree evaluation were high, with the highest grades being observed in the evaluations made by peers and patients (a mean of 9.1 out of 10.0). On average, the 360-degree evaluation method yielded grades 0.067 percentage points higher than did the previous evaluation method (pâ¯≤â¯0.001). Students and teaching staff encountered difficulties in the evaluations made by users/families and other members of the healthcare team (nursing assistants and physicians), although they rated the overall proposal as being very powerful in terms of educational value. CONCLUSIONS: The 360-degree evaluation method is an innovative, motivating, and integrating approach to the acquisition of competencies with a focus on excellence.
Subject(s)
Education, Nursing, Baccalaureate , Students, Nursing , Clinical Competence , Cross-Sectional Studies , Humans , Learning , SpainABSTRACT
El secreto profesional y la confidencialidad de los datos siempre han estado unidos, entreotros, tanto a la Medicina como a la Enfermería. Estas cuestiones, de ámbito ético-jurídico,han ido variando con el paso del tiempo en función de los cambios que se han producido enla sociedad, el desarrollo de la Sanidad y la consolidación de los principios de intimidad y privacidadcomo derechos del individuo, así como la importancia de la libertad y la autonomía dela persona frente al bien público o colectivo. En el ámbito de la relación clínica, esta nueva visión hace que se replanteen las conviccionessobre las informaciones y los datos que se conocen en el ejercicio de la profesión y que debenreservarse al acceso de otros. No es fácil delimitar en nuestra sociedad cuál es la frontera delámbito de lo íntimo, es decir, de lo privado y lo público de las personas cuando se trata de revelarinformación respecto a enfermedades que pueden poner en riesgo a terceros. Así pues, cuando surgen conflictos entre los deseos de los afectados de no comunicar su diagnósticoa los familiares, a los que están poniendo en riesgo, y el deber de los sanitarios de proteger la saludde la comunidad y, además, de guardar el secreto profesional, una alternativa de lo más oportunapuede ser ponerlo en conocimiento de los Comités de Ética de los centros asistenciales paraque, valorando cada caso particular, puedan sugerir las recomendaciones más adecuadas, desde elconocimiento y el consenso, a los profesionales que se encuentran con ese conflicto moral
Professional secret and data confidentiality have always walked hand in hand, among other aspects,to both medicine and nursing. These issues, of an ethical and legal nature, have been changing overtime, depending on the changes that have taken place in society, in the development of healthcare,and in the consolidation of intimacy and privacy principles as rights of the individual, as well as theimportance of freedom and autonomy of the person against public or collective wellness. In a clinical relationship setting, this new vision makes us look at our convictions on the informationand data that are known to us in the practice of the profession and that must be restrictedto others by others. It is not easy to delimit in our society where the borderline lies inthe personal arena; that is, what the private or what the public information of an individual is,when it comes to reveal information regarding diseases that might endanger third parties. The conflict arises when the wish of the affected individuals is not to inform their relatives abouttheir diagnosis -whom they might be putting at risk- and the duty clinicians have of protecting thehealth of the community and more importantly to keep professional secret. A very convenient alternativeto solve this dilemma would be to inform the Ethics Committees of the institutions ofthe actual insight of the situation. These committees would have the opportunity to evaluate eachparticular case enabling them to suggest the most adequate course of action based on a soundknowledge and consensus to the professionals that are faced with such moral conflict
