Editorial: Ser reflexivo, ser profesional, transformarse más allá del hoy / Editorial: Being reflective, being professional, becoming beyond today

La práctica de enfermería hoy en día es compleja y cambiante. Como Frenk et al. (1) notan, la educación en ciencias de salud ha experimentado cambios fundamentales durante el siglo pasado; de un enfoque basado en ciencia, a currículos basados en problemas, hasta currículos basados en sistemas y competencias. Sin embargo, el eje constante en la práctica de enfermería ha sido, y continúa siendo la reflexión en la práctica y la reflexión sobre la práctica (2).

Influence of maternal birthplace on postpartum health and health services use.

This study examined differences in health status, rates of postpartum depression, perceptions of health services, unmet service needs, and barriers to service use among women born in and outside of Canada at 6 weeks following postpartum discharge from hospital. A secondary analysis of data gathered for a longitudinal cross-sectional survey of postpartum health and service use was conducted. Data from participants recruited from two urban hospitals were used for this analysis (n = 1,045). Analyses examined differences between women born in and outside of Canada. Immigrant women were significantly more likely to experience fair/poor postpartum health status and risk for postpartum depression. Immigrant women were also more likely to rate community health services as fair/poor, and were less likely to be able to get care for emotional health problems. Postpartum health services need to be responsive and accessible in order to meet the needs of immigrant women.

Evolving as nurse educators in problem-based learning through a community of faculty development.

Effective faculty development programs are of paramount importance in this era of profound change in nursing education driven by baccalaureate-degree entry to practice and the concurrent implementation of college/university collaborative partnerships in Ontario, Canada. The overall purpose of this study was to design, disseminate, and evaluate a faculty development program involving nursing faculty from the McMaster University, Mohawk College, and Conestoga College. In keeping with selected conceptual models and responses to a needs assessment, faculty participated in a collaborative faculty development program that included a planned workshop, a mentorship program, and regular faculty development activities. This article presents the qualitative program evaluation component that included focus group discussions and subsequent content analysis to gain an understanding of the experiences and meaning of the faculty who participated in the faculty development program. The overarching theme was that the faculty experienced a sense of evolving as nurse educators in problem-based learning (PBL) through a community of faculty development. The following themes emerged: becoming certain in the midst of uncertainty; developing collegial trust and community; embracing PBL; valuing faculty development; and evolving as a nurse educator in PBL through faculty development. The results attest to the benefits of a collaborative faculty development program, guide future faculty development, and promote mastery in PBL.

Development of professional confidence by post diploma baccalaureate nursing students.

Professional confidence should be nurtured in a caring nursing curriculum, however there is a lack of clarity as to what confidence means, how it is perceived by students, and what educators can do to instill professional confidence in nursing students. A qualitative study using focus groups was conducted to explore the components of professional confidence as perceived by diploma-prepared registered nurses enrolled in a two-year student-centered, problem-based baccalaureate degree program. Students identified professional confidence as developing through a two-phase process. During the first phase, Becoming Informed, students reported acquiring knowledge, theory and critical thinking in the supportive environment of small tutorial groups, which in turn enabled them to examine nursing practice and defend decisions with clarity and confidence. In Finding a Voice of My Own they clearly articulated an evidence-based nursing position in both academic and clinical environments with a sense of ownership and congruence with their own values. Each phase was further composed of four processes: feeling, knowing, doing and reflecting. When supported through these phases, students felt prepared (i.e. confident) to assume broader roles in health care. Post diploma programs should acknowledge and build on the skills and abilities nurses bring to the educational setting, yet challenge learners to develop critical self appraisal.

Effects of cultural sensitivity training on health care provider attitudes and patient outcomes.

PURPOSE: To determine the effectiveness of cultural sensitivity training on the knowledge and attitudes of health care providers, and to assess the satisfaction and health outcomes of patients from different minority groups with health care providers who received training. DESIGN: In this randomised controlled trial, 114 health care providers (nurses and homecare workers) and 133 patients (from two community agencies and one hospital) were randomly assigned to experimental (training) and control groups, and were followed for 18 months. METHODS: Providers completed the Cultural Awareness Questionnaire and the Dogmatism Scale. Patients completed the Off-Axis-Ratio (OAR) Multidimensional Measure of Functional Capacity, the Client Satisfaction Questionnaire, the Physical and Mental Health Assessment Questionnaire, and the Health and Social Services Utilization Questionnaire. A qualitative analysis was conducted to identify and analyse themes from personal journals kept by participating nurses. FINDINGS: Cultural sensitivity training resulted in increased open-mindedness and cultural awareness, improved understanding of multiculturalism, and ability to communicate with minority people. After 1 year patients of mostly European and British origin, who received care from trained providers, showed improvement in utilizing social resources and overall functional capacity without an increase in health care expenditures. CONCLUSIONS: The results of this study indicate that a cultural sensitivity training program not only improved knowledge and attitudes among health care providers, but it also yielded positive health outcomes for their patients.

Professional confidence in baccalaureate nursing students.

"You need to develop more confidence" is a common refrain noted by students and faculty alike. As nurse educators, we believe that encouraging students to develop their professional confidence is an important role. Moreover, the nursing profession demands that nursing care be delivered with confidence. Although the importance of professional confidence is acknowledged in the literature, there is surprisingly little written about its development or strategies that promote professional confidence in nursing education. A qualitative study was conducted to explore the meaning and influences on professional confidence as perceived by nursing students enrolled in a four year generic baccalaureate nursing program. Focus groups were audiotaped, transcribed verbatim and analyzed using thematic content analysis method. The meaning of professional confidence involved: feeling, knowing, believing, accepting, doing, looking, becoming, and evolving. Positive and negative influences in developing professional confidence centered around two time periods, prior to entering nursing, and within the nursing program. Students identified strategies to assist themselves in developing professional confidence. Faculty development is one recommendation for faculty.