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11-25-2022
Populações vulnerabilizadas no contexto da pandemia e crises sanitárias
Revista Brasileira de Enfermagem. 2022;75:e75Suppl201
Abstract
Populações vulnerabilizadas no contexto da pandemia e crises sanitárias
Revista Brasileira de Enfermagem. 2022;75:e75Suppl201
DOI 10.1590/0034-7167.202275Suppl201pt
Views0As condições e os modos de vida da população determinam o processo de saúde e adoecimento de forma diferenciada entre os diversos grupos populacionais. As desigualdades na saúde vêm adquirindo relevância ainda maior na produção de diferentes perfis de doença, em função de recentes e surpreendentes acontecimentos mundiais, como divergências étnico-raciais, religiosas, territoriais, identidade de […]See more -
11-25-2022
Reflexões sobre a ciência em enfermagem gerontológica: possibilidades para o seu caminhar
Revista Brasileira de Enfermagem. 2022;75:e75Suppl401
Abstract
Reflexões sobre a ciência em enfermagem gerontológica: possibilidades para o seu caminhar
Revista Brasileira de Enfermagem. 2022;75:e75Suppl401
DOI 10.1590/0034-7167.202275Suppl401pt
Views0O conhecimento científico em enfermagem gerontológica brasileiro tem seus primórdios há mais de 50 anos, especificamente em meados de 1970, alinhados ao movimento mundial de reconhecimento da complexidade do envelhecimento populacional e dos seus desafios na esfera social, cultural, política e de saúde pública. Desde então, a produção científica nesse campo guarda relação com a […]See more -
11-19-2022
Advanced Practice Nursing: Canadian Perspectives and Global Relevance
Revista Brasileira de Enfermagem. 2022;75(1):e750101
Abstract
Advanced Practice Nursing: Canadian Perspectives and Global Relevance
Revista Brasileira de Enfermagem. 2022;75(1):e750101
DOI 10.1590/0034-7167.2022750101
Views0In this editorial, Advanced Practice Nursing (APN) will be explored as a practice model that could be implemented to strengthen health care systems globally. Canadian perspectives and the evolution of APN in Canada will be used as an example to identify potential opportunities for the conceptualization and implementation of advanced practice nursing that is both […]See more -
11-19-2022
Enfermagem de Prática Avançada: Perspectivas Canadenses e Relevância Global
Revista Brasileira de Enfermagem. 2022;75(1):e750101
Abstract
Enfermagem de Prática Avançada: Perspectivas Canadenses e Relevância Global
Revista Brasileira de Enfermagem. 2022;75(1):e750101
DOI 10.1590/0034-7167.2022750101
Views0Neste editorial, a Enfermagem de Prática Avançada (EPA) será explorada como um modelo de prática que pode ser implementado para fortalecer os sistemas de saúde globalmente. As perspectivas canadenses e a evolução da EPA no Canadá serão usadas como um exemplo para identificar oportunidades potenciais para a conceituação e implementação da EPA que seja abrangente […]See more -
ORIGINAL ARTICLE11-19-2022
Factors associated with the perception of fear of COVID-19 in university students
Revista Brasileira de Enfermagem. 2022;75:e20210448
Abstract
ORIGINAL ARTICLEFactors associated with the perception of fear of COVID-19 in university students
Revista Brasileira de Enfermagem. 2022;75:e20210448
DOI 10.1590/0034-7167-2021-0448
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the perception of fear of COVID-19 in Brazilian university students.
Methods:
this is an online, cross-sectional analytical study conducted at a Brazilian public university with 1,437 undergraduate students between September and November 2020. The Fear of COVID-19 Scale was used to measure the main construct. Data analysis was performed using Mann-Whitney U test, Cohen’s r test and multiple linear regression analysis.
Results:
factors associated with fear of COVID-19 in university students were the variables biological sex, perception of good sleep quality, many days of access to information, not complying with social distancing, reporting sufficient hours of sleep, not having a partner, guidance sexual non-heterosexual, being in the risk group for COVID-19 and tobacco consumption.
Conclusions:
the study findings can contribute to the discussion about the weaknesses that the university population is experiencing in this pandemic period.
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REVIEW11-19-2022
Nursing care for bed bath in patients with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2022;75:e20200704
Abstract
REVIEWNursing care for bed bath in patients with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2022;75:e20200704
DOI 10.1590/0034-7167-2020-0704
Views0See moreABSTRACT
Objective:
to identify the main nursing care procedures for performing bed bath in patients with COVID-19.
Method:
an integrative literature review. Five stages were followed for this research: research question elaboration (identification of the problem), search of studies in literature, study assessment, data analysis, and presentation of review. To search for primary studies, the VHL and SciELO databases were selected.
Results:
initially, 55 publications were found. After reading and analyzing the abstracts, the sample consisted of 15 studies.
Conclusion:
patients with the new coronavirus have specific care to perform a bed bath, oral, intimate and skin hygiene. It is important that professionals use adequate personal protective equipment, perform humanized care, continuously observing patients’ vital signs to avoid occurrence of adverse events, promoting patient safety.
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ORIGINAL ARTICLE11-19-2022
Stigma experienced by men diagnosed with COVID-19
Revista Brasileira de Enfermagem. 2022;75:e20210038
Abstract
ORIGINAL ARTICLEStigma experienced by men diagnosed with COVID-19
Revista Brasileira de Enfermagem. 2022;75:e20210038
DOI 10.1590/0034-7167-2021-0038
Views0See moreABSTRACT
Objective:
to analyze the stigma characteristics perceived in the experience of men who had COVID-19.
Method:
this qualitative study involved men living in Brazil, diagnosed with COVID-19, who answered semi-structured questions in an online form. Data were subjected to thematic and lexical analysis, interpreted in the light of the stigma theory.
Results:
92 men, adults, cisgender, heterosexual, of mixed race/color, belonging to middle class, living in the urban area, with higher education participated. The stigma characteristics evidenced were the occurrence of leave, perception of impolite treatment, use of labels and discrimination by co-workers, family members, neighbors and even healthcare professionals, with consequences for the psycho-emotional dimension.
Final considerations:
discrimination and exclusion derived from stigma surprised men marked by class and gender privileges, little used to being downgraded in interactions when compared to other groups.
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ORIGINAL ARTICLE11-15-2022
Suffering and defense mechanisms: an analysis of the work of Primary Health Care nurses
Revista Brasileira de Enfermagem. 2022;75:e20200419
Abstract
ORIGINAL ARTICLESuffering and defense mechanisms: an analysis of the work of Primary Health Care nurses
Revista Brasileira de Enfermagem. 2022;75:e20200419
DOI 10.1590/0034-7167-2020-0419
Views0See moreABSTRACT
Objective:
To analyze the suffering and coping strategies of nurses working in Primary Health Care considering the psychodynamics of their work.
Methods:
Descriptive study with a qualitative approach, carried out with 11 nurses working in Primary Health Care. Data were collected through semi-structured interviews, systematized, and interpreted using Bardin’s content analysis method applied to recurrent themes.
Results:
The suffering factors related to work in Primary Health Care are difficulties with management, the fragile structure of the health support network, and conflicts with the users. Defensive strategies to minimize these difficulties are the support of hierarchical superiors, the empowerment of the community and users, and communication between team members.
Final considerations:
It is important that there be changes in the organization of this line of work to improve the workers’ health.
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EXPERIENCE REPORT01-01-2018
Clinical and epidemiological teaching of dengue through simulated practice
Revista Brasileira de Enfermagem. 2018;71(2):451-456
Abstract
EXPERIENCE REPORTClinical and epidemiological teaching of dengue through simulated practice
Revista Brasileira de Enfermagem. 2018;71(2):451-456
DOI 10.1590/0034-7167-2016-0503
Views2See moreABSTRACT
Objective:
to describe the experience of clinical teaching on dengue and the practice of epidemiological surveillance using problematization methodology.
Method:
report of experience on educational activity with undergraduate nursing students, held in March 2016, at a public university in the city of São Paulo, conceived in four stages: dialogic lecture, active search of Aedes aegypti, case study and simulation of nursing consultation to individuals with dengue.
Results:
The activity allowed to retrieve previous knowledge about the disease, respond to exercises that addressed different clinical situations and epidemiological surveillance, including in situ evaluation of possible mosquito outbreaks, and discuss the need to expand prevention and health of the individual and the community, the impact of the media in the dissemination of cases and the coping difficulties experienced in the different levels of attention.
Conclusion:
the methodology adopted enabled qualified training of students to cope with dengue.
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ORIGINAL ARTICLE07-18-2022
Beliefs, knowledge, actions of nursing techniques in breastfeeding in pain management in immunization
Revista Brasileira de Enfermagem. 2022;75(6):e20210546
Abstract
ORIGINAL ARTICLEBeliefs, knowledge, actions of nursing techniques in breastfeeding in pain management in immunization
Revista Brasileira de Enfermagem. 2022;75(6):e20210546
DOI 10.1590/0034-7167-2021-0546
Views1See moreABSTRACT
Objective:
Understand the beliefs, knowledge, and actions of nursing technicians on breastfeeding as a form of non-pharmacological intervention to relieve pain in newborns and infants during immunization.
Methods:
Qualitative study carried out through semi-structured interviews with nine nursing technicians from three Basic Health Units in a city in the state of São Paulo. The theoretical approach of the Belief Model and the methodological framework of Thematic Analysis supported this study.
Results:
Three themes originated: Beliefs, Knowledge, and Actions of nursing technicians.
Final considerations:
Despite knowledge about the benefits of breastfeeding as the most effective method for relieving pain in newborns and infants during vaccination, their restrictive beliefs overrode the evidence, leading them to act in ways that discourage or prevent the mother from breastfeed during vaccination. Formal training is recommended to align with current evidence-based practices.
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REVIEW12-08-2023
Educational technologies for accident prevention due to falls in childhood: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220807
Abstract
REVIEWEducational technologies for accident prevention due to falls in childhood: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220807
DOI 10.1590/0034-7167-2022-0807
Views2See moreABSTRACT
Objectives:
to map evidence on educational technology use for accident prevention due to falls in childhood.
Methods:
a scoping review, carried out in October and November 2022, in the MEDLINE, Web of Science, BDENF and CINAHL databases and LILACS bibliographic index. There was no delimitation of language or time. Data were extracted and analyzed descriptively by two independent researchers. The research protocol was registered in the Open Science Framework.
Results:
twenty-six studies were selected. Booklets, pamphlets and leaflets were the most used technologies, presenting health services as the most frequent environment to develop research on fall prevention. The technologies developed were important outcomes: increased knowledge of children, family members, caregivers, health and education professionals.
Conclusions:
educational technology use makes it possible to increase knowledge, adopt safe practices and reduce falls.
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REVIEW03-15-2024
Resources for health literacy among caregivers of prematurely born children: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230062
Abstract
REVIEWResources for health literacy among caregivers of prematurely born children: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230062
DOI 10.1590/0034-7167-2023-0062
Views1See moreABSTRACT
Objectives:
to map the available evidence on resources used to promote health literacy among caregivers of prematurely born children during outpatient follow-up.
Methods:
the Joanna Briggs Institute’s scope review protocol was utilized. The search encompassed six databases, incorporating studies from 2012 to 2022.
Results:
the three included publications revealed that the resources employed are: mobile applications, phone calls, individual counseling, videos, educational pamphlets, and group discussions. Implementing an education protocol during the transition home enhances scientifically grounded health promotion rates.
Conclusions:
there is limited literature addressing the health literacy of these caregivers. The nursing team plays a crucial role in health education and in developing resources applicable to these families.
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ORIGINAL ARTICLE01-13-2024
Social representations of oncologic surgery for patients with cancer
Revista Brasileira de Enfermagem. 2024;77(6):e20230273
Abstract
ORIGINAL ARTICLESocial representations of oncologic surgery for patients with cancer
Revista Brasileira de Enfermagem. 2024;77(6):e20230273
DOI 10.1590/0034-7167-2023-0273
Views2See moreABSTRACT
Objectives:
to analyze the social representations of patients with cancer regarding oncologic surgery.
Methods:
a qualitative study based on Social Representation Theory was conducted with 126 participants between October 2021 and May 2022 in a public hospital in Rio de Janeiro. A characterization questionnaire, free evocations of the inducing term “surgery”, and semi-structured interviews with 60 participants were applied. Data were analyzed using Microsoft Excel® and IRaMuTeQ.
Results:
the central core of the representation is composed of fear, cure, hope, and removing the disease. The analysis of interviews resulted in six classes that highlight the social changes caused by treatment as well as the need for a support network to cope with the surgical process.
Final Considerations:
the representations reflect fear and hope towards the procedure and the desire to remove the disease, thus translating the cure through surgery.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views3See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views2In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1:Where it read:[…]See more -
ORIGINAL ARTICLE09-29-2022
Palliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
Abstract
ORIGINAL ARTICLEPalliative care production for health professionals in the context of home care
Revista Brasileira de Enfermagem. 2022;75(1):e20210030
DOI 10.1590/0034-7167-2021-0030
Views1See moreABSTRACT
Objectives:
to analyze palliative care production developed by health professionals to home care patients.
Methods:
this is an exploratory study, with a qualitative approach, using the transpersonal care theoretical framework. Thirteen interviews were conducted with health professionals and 18 observations were conducted on different cases. Content analysis was performed using MAXQDA©.
Results:
actions performed: maintenance and follow-up measures to people eligible for palliative care, in acts of dialogue and “listening” to caregivers and users, conducting guidelines for the care and self-care process, performing technical procedures, delivery of materials, referrals and medical prescriptions to users.
Final Considerations:
it is perceived the need for advances in the implementation of government policies in Brazil that insert palliative care into the Health Care Network through educational, managerial and care actions that ensure human dignity, thus allowing the development of these and other palliative care interventions.
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ORIGINAL ARTICLE10-21-2019
Permanent education for good practices in the prevention of pressure injury: almost-experiment
Revista Brasileira de Enfermagem. 2019;72(6):1646-1652
Abstract
ORIGINAL ARTICLEPermanent education for good practices in the prevention of pressure injury: almost-experiment
Revista Brasileira de Enfermagem. 2019;72(6):1646-1652
DOI 10.1590/0034-7167-2018-0778
Views0See moreABSTRACT
Objective:
To verify the effectiveness of the educational intervention through the evaluation of nurses’ knowledge about prevention of pressure injury.
Method:
A quasi-experimental study with a single group, carried out with 95 nurses from a teaching hospital in the interior of Minas Gerais, in August and September 2017. As a teaching strategy, the active methodology and hybrid teaching were used, based on the reference of the Method of the Arch of Charles Maguerez. Data were collected from a validated instrument, called the Pieper Knowledge Test, and analyzed by descriptive statistics and Student’s t-test with significance level of p <0.001.
Results:
The mean number of correct answers obtained by the nurses was 78.8% in the pre-test and 88.8% in the post-test, and the difference was statistically significant (p <0.001).
Conclusion:
The educational intervention developed was effective, since it contributed to the improvement of nurses’ knowledge.
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ORIGINAL ARTICLE02-10-2020
Nursing practices in a psychological care center
Revista Brasileira de Enfermagem. 2020;73(1):e20180175
Abstract
ORIGINAL ARTICLENursing practices in a psychological care center
Revista Brasileira de Enfermagem. 2020;73(1):e20180175
DOI 10.1590/0034-7167-2018-0175
Views0See moreABSTRACT
Objective:
To analyze the practices developed by nursing professionals in a Psychosocial Care Center (CAPS).
Method:
A qualitative and evaluative research based on the Fourth Generation Assessment and conducted in a CAPS II of Santa Catarina State in 2014. For data collection, semi-structured interviews, field observation, and data recycling group were used with workers. Constant Comparative Method was used for data analysis.
Results:
Practices aimed at the subject and their clinical, social, prevention, treatment and articulation with the health network were identified. Medication care is a specificity of nursing that aims to promote autonomy and social reintegration. There is a need for greater articulation between the nursing and pharmacy staff, as well as creating spaces for users to talk about medication.
Conclusion:
Nursing practices are focused on biopsychosocial care, aiming to deconstruct care models focused on the disease and symptoms.
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ORIGINAL ARTICLE06-17-2020
Cardiovascular risk factors: differences between ethnic groups
Revista Brasileira de Enfermagem. 2020;73(4):e20180918
Abstract
ORIGINAL ARTICLECardiovascular risk factors: differences between ethnic groups
Revista Brasileira de Enfermagem. 2020;73(4):e20180918
DOI 10.1590/0034-7167-2018-0918
Views0See moreABSTRACT
Objectives:
to compare the metabolic, anthropometric, tobacco and alcohol consumption indicators considered as risk factors for cardiovascular diseases, as well as the demographic and socioeconomic characteristics between indigenous from Rio Negro, Sateré-Mawé, mixed-race/black and white people living in the city of Manaus.
Methods:
a cross-sectional observational study guided by the STROBE tool. There was a sample of 191 adults of both sexes. Anthropometric measurements, blood pressure and biochemical analyzes were performed. Statistical test was applied to cross color/race/ethnicity variable with the investigated variables.
Results:
indigenous had better metabolic and anthropometric indicators related to cardiovascular diseases than mixed-race/black and white, as well as Sateré-Mawé in relation to Rionegrinos (from Rio Negro).
Conclusions:
the main differences were obesity, dyslipidemia, pre-systemic arterial hypertension/systemic arterial hypertension, and increased circumferences, with a worse situation for mixed-race/black people. The findings indicate differences in risk factors between race/color and ethnicity groups evaluated.
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ORIGINAL ARTICLE05-18-2020
Construction and validation of an educational video for human papillomavirus vaccination
Revista Brasileira de Enfermagem. 2020;73(4):e20180900
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational video for human papillomavirus vaccination
Revista Brasileira de Enfermagem. 2020;73(4):e20180900
DOI 10.1590/0034-7167-2018-0900
Views0See moreABSTRACT
Objectives:
to validate an educational video aimed at the adhesion of human papillomavirus vaccination.
Methods:
a methodological study, where the knowledge about the theme and the technology to be constructed in six focal groups was identified; a theoretical framework was set up and the existing videos were uploaded. After that, pre-production, production and post-production were followed. In validation of content, 22 specialists participated, and in appearance, ten adolescents, ten mothers, ten teachers and ten audiovisual professionals. Absolute frequency, Binomial Test, and Content Validity Index were used.
Results:
agreement was satisfactory in most items. Regarding relevance, 20 items had indices above 0.80 among judges. Assessment was positive among girls and mothers. Only three items had indices less than 0.80 among teachers and video professionals.
Conclusions:
the educational video was validated, conferring credibility to contribute to educational actions and improve vaccination indexes.
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08-10-2020
Repercussions of intestinal ostomy on male sexuality: an integrative review
Revista Brasileira de Enfermagem. 2020;73(6):e20190245
Abstract
Repercussions of intestinal ostomy on male sexuality: an integrative review
Revista Brasileira de Enfermagem. 2020;73(6):e20190245
DOI 10.1590/0034-7167-2019-0245
Views2INTRODUCTIONThe intestinal ostomy, also known as stoma and ostomy, consists of an artificial opening, produced surgically, whose purpose is to divert the flow of effluents to the external environment. Such a condition can impact the lives of affected individuals due to transformations that affect human multi-dimensionality, including negative repercussions involving sexuality(–).In the United States of […]See more -
ORIGINAL ARTICLE08-20-2021
Risk of suicide among nursing students
Revista Brasileira de Enfermagem. 2021;74(6):e20200867
Abstract
ORIGINAL ARTICLERisk of suicide among nursing students
Revista Brasileira de Enfermagem. 2021;74(6):e20200867
DOI 10.1590/0034-7167-2020-0867
Views0See moreABSTRACT
Objectives:
to identify the risk and degree of risk of suicide in nursing students of a public institution in the countryside of Pernambuco, Brazil.
Methods:
this was a cross-sectional, quantitative research conducted with 150 students. For data collection, a sociodemographic questionnaire and the instrument, M.I.N.I. – Brazilian version 5.0.0 – Module C – Risk of suicide were used. Statistical analyses were performed with IBM(® )SPSS(®), version 23.
Results:
53.3% of nursing students had a risk of suicide, of which 20.7% had a high risk. Moreover, 22.67% reported previous suicide attempt. It is noteworthy that students without a partner have a higher risk of suicide (56.8%) than those with a partner (29.4%).
Conclusions:
it is perceived the need to develop programs that identify students at risk of suicide in higher education institutions, in order to raise awareness of the problem and implement policies to promote mental health in the academia.
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ORIGINAL ARTICLE06-01-2020
Primary care mental health: nurses’ activities in the psychosocial care network
Revista Brasileira de Enfermagem. 2020;73:e20190104
Abstract
ORIGINAL ARTICLEPrimary care mental health: nurses’ activities in the psychosocial care network
Revista Brasileira de Enfermagem. 2020;73:e20190104
DOI 10.1590/0034-7167-2019-0104
Views0See moreABSTRACT
Objective:
to describe and analyze the role of expert nurses in mental health in the Family Health Strategy.
Method:
a qualitative study, with 20 Basic Health Units nurses of Teresina, Piauí. The information was collected through semi-structured interviews from March to May 2017 and analyzed using the content analysis method.
Results:
it was found that the conceptions of the mental health disease process were based on the biological model, there was little communication between mental health and basic network, nurses did not feel qualified to work mental health and there were few mental health actions in Primary Care.
Final considerations:
it becomes urgent to implement public policies that articulate mental health and Primary Care, raising awareness and continuing education for nurses.
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ORIGINAL ARTICLE03-30-2020
Team-Based Learning: a randomized clinical trial in undergraduate nursing
Revista Brasileira de Enfermagem. 2020;73(2):e20180621
Abstract
ORIGINAL ARTICLETeam-Based Learning: a randomized clinical trial in undergraduate nursing
Revista Brasileira de Enfermagem. 2020;73(2):e20180621
DOI 10.1590/0034-7167-2018-0621
Views0See moreABSTRACT
Objectives:
To compare the knowledge on surgical safety through the team-based learning methodology and lecture classes for undergraduate Nursing students, and evaluate the learning satisfaction with team-based learning.
Methods:
Randomized, controlled, parallel, two-arm, unblinded clinical trial developed in the Faculty of Medicine of a public university in Botucatu, Brazil. The groups included 14 students for team-based learning and 11 students for lecture classes.
Results:
Students’ apprehension of knowledge in the team-based learning group was significantly higher compared to the control group (p<0.002) by considering the pre-test results. After 30 days, there was no significant difference between groups. The experience with the methodology was considered positive among students.
Conclusions:
Team-based learning is an important pedagogic tool available and has proven effective in education and learning with students playing the role of protagonists.
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