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ORIGINAL ARTICLE12-13-2024
Nurses’ experience regarding patient safety in mobile pre-hospital care
- Eduardo Dias Filipe
, - Roberto Chrispim Modesto ,
- Hercules de Oliveira Carmo ,
- Haviley Oliveira Martins ,
- Maristela Santini Martins
Abstract
ORIGINAL ARTICLENurses’ experience regarding patient safety in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77(5):e20230529
DOI 10.1590/0034-7167-2023-0529
- Eduardo Dias Filipe ,
- Roberto Chrispim Modesto ,
- Hercules de Oliveira Carmo ,
- Haviley Oliveira Martins ,
- Maristela Santini Martins
Views0See moreABSTRACT
Objectives:
to understand nurses’ experience regarding patient safety in mobile pre-hospital care.
Method:
a qualitative, exploratory and descriptive study, conducted with nurses active in mobile pre-hospital care services. Semi-structured interviews were conducted, audio-graved and submitted to Bardin’s content analysis.
Results:
from four thematic categories established, nurses reported the care and management skills necessary to work in this service. They demonstrated a commitment to ensuring safe care for patients, staff and spectators. They highlighted the actions taken to prevent and mitigate incidents. However, they based their experiences on practice protocols and individual actions, expressing the need to improve knowledge about patient safety.
Final Considerations:
mobile pre-hospital care nurses’ experience in relation to patient safety was limited, suggesting the need for training on the subject, alignment of work processes and implementation of strategies, aiming to guarantee safe care.
- Eduardo Dias Filipe
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ORIGINAL ARTICLE12-13-2024
Stress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
Abstract
ORIGINAL ARTICLEStress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
DOI 10.1590/0034-7167-2023-0542
Views1See moreABSTRACT
Objectives:
to analyze stress from the perspective of nursing workers caring for people with COVID-19 in a public hospital in the Recôncavo region of Bahia.
Methods:
this is an exploratory qualitative study, conducted through semi-structured interviews. The data were analyzed using word clouds, similarity trees, and content analysis.
Results:
nursing workers were exposed to stress while attending to patients with COVID-19. The reported stressors in the workplace included: work overload, lack of planning, speed in performing tasks, fatigue, lack of participation in decision-making, lack of support from management, technological changes, excessive responsibility without preparation, interpersonal conflicts, and professional undervaluation.
Conclusions:
exposure to these stressors leads to emotional exhaustion and demotivation, which were intensified during the COVID-19 pandemic.
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ORIGINAL ARTICLE12-13-2024
Knowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
- Ana Carolina Macri Gaspar Vendramini ,
- Rosemeiry Capriata de Souza Azevedo ,
- Priscila Aguiar Mendes ,
- Janderson Diego Pimenta da Silva ,
- Annelita Almeida Oliveira Reiners , [ … ],
- Amanda Cristina de Souza Andrade
Abstract
ORIGINAL ARTICLEKnowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(5):e20240011
DOI 10.1590/0034-7167-2024-0011
- Ana Carolina Macri Gaspar Vendramini ,
- Rosemeiry Capriata de Souza Azevedo ,
- Priscila Aguiar Mendes ,
- Janderson Diego Pimenta da Silva ,
- Annelita Almeida Oliveira Reiners ,
- Amanda Cristina de Souza Andrade
Views0See moreABSTRACT
Objectives:
to compare the knowledge and attitudes of nursing students regarding sexual behavior and sexually transmitted infections (STIs) in older adults before and after an educational intervention.
Methods:
this quasi-experimental study involved a convenience sample of 45 nursing students from a public university, conducted in three stages: pre-intervention, intervention, and post-intervention. A questionnaire was used to assess sociodemographic characteristics, academic training, and knowledge and attitudes on the topic. The intervention was an educational web conference. Paired t-test and Wilcoxon test were used for data analysis.
Results:
there was a statistically significant difference in the knowledge and attitude scores of nursing students before and after the educational intervention (p < 0.001). A significant increase was observed in the knowledge score (from 9.3 to 12.2) and attitude score (from 108 to 117.2) in the post-intervention phase.
Conclusions:
the knowledge of nursing students regarding the sexuality of older adults increased after the educational intervention, and their attitudes on the subject became more positive.
- Ana Carolina Macri Gaspar Vendramini
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ORIGINAL ARTICLE12-13-2024
Educational booklet on labor and delivery: validity study
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Abstract
ORIGINAL ARTICLEEducational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138
DOI 10.1590/0034-7167-2024-0138
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Views2See moreABSTRACT
Objectives:
to develop and validate an educational booklet on labor and delivery for pregnant women.
Methods:
this methodological study involved constructing and validating a booklet based on Echer’s framework. We used the Content Validity Index and Cronbach’s alpha for content and face validation, selecting judges according to Fering’s criteria. We then conducted a clinical validation with the target population.
Results:
the booklet, developed based on evidence from an integrative review and validated by judges and the target audience, achieved global Content Validity Index of 0.919 and 0.913, respectively. After clinical validation with 22 pregnant women, it included 28 topics and 48 pages, with illustrations by a graphic designer.
Conclusions:
expert judges and the target audience considered this educational technology valid, deeming it a relevant tool for promoting the health of pregnant women.
- Michelle Tatiane Carvalho Gonçalves
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12-08-2024
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
Abstract
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
DOI 10.1590/0034-7167.2024770101pt
Views0Na próxima semana, acontecerão dois grandes eventos científicos em Madri e Granada (Espanha). Serão atividades internacionais, específicas e de forma muito especial, embora não exclusivas do campo ibero-americano, organizadas e desenvolvidas por duas sociedades científicas de enfermagem muito importantes, como a Associação de Enfermagem Comunitária (AEC) e a Associação Latino-Americana de Escolas e Faculdades de […]See more -
ORIGINAL ARTICLE12-08-2024
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
Abstract
ORIGINAL ARTICLEInitial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
Views0See moreABSTRACT
Objective:
to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.
Methods:
a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.
Results:
115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.
Conclusions:
assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.
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REVIEW12-08-2024
Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
- Lais Palotta Balderrama Gueroni ,
- Daniele Alcalá Pompeo ,
- Letícia Palota Eid ,
- Marcos Antonio Ferreira Júnior ,
- Carlos Alberto da Cruz Sequeira , [ … ],
- Luciano Garcia Lourenção
Abstract
REVIEWInterventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
DOI 10.1590/0034-7167-2023-0192
- Lais Palotta Balderrama Gueroni ,
- Daniele Alcalá Pompeo ,
- Letícia Palota Eid ,
- Marcos Antonio Ferreira Júnior ,
- Carlos Alberto da Cruz Sequeira ,
- Luciano Garcia Lourenção
Views0See moreABSTRACT
Objective:
To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.
Methods:
Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.
Results:
Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.
Conclusion:
The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.
- Lais Palotta Balderrama Gueroni
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REVIEW12-08-2024
Common mental disorders in hematopoietic stem cell transplant patients: a scoping review
- Ana Clara Paiva de Almeida ,
- Valéria Dantas de Azevedo ,
- Tássia Regine de Morais Alves ,
- Viviane Euzébia Pereira Santos ,
- Glauber Weder dos Santos Silva , [ … ],
- Isabelle Campos de Azevedo
Abstract
REVIEWCommon mental disorders in hematopoietic stem cell transplant patients: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20220581
DOI 10.1590/0034-7167-2022-0581
- Ana Clara Paiva de Almeida ,
- Valéria Dantas de Azevedo ,
- Tássia Regine de Morais Alves ,
- Viviane Euzébia Pereira Santos ,
- Glauber Weder dos Santos Silva ,
- Isabelle Campos de Azevedo
Views0See moreABSTRACT
Objective:
to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation.
Methods:
this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included.
Results:
the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia.
Conclusions:
the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients’ evolution.
- Ana Clara Paiva de Almeida
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ORIGINAL ARTICLE03-24-2021
Therapeutic itinerary of people with leprosy: paths, struggles, and challenges in the search for care
- Eliziane Oliveira de Lima ,
- Maria Rocineide Ferreira da Silva ,
- Mirna Neyara Alexandre de Sá Barreto Marinho ,
- Olga Maria de Alencar ,
- Thayza Miranda Pereira , [ … ],
- Saiwori de Jesus Silva Bezerra dos Anjos
Abstract
ORIGINAL ARTICLETherapeutic itinerary of people with leprosy: paths, struggles, and challenges in the search for care
Revista Brasileira de Enfermagem. 2021;74(1):e20200532
DOI 10.1590/0034-7167-2020-0532
- Eliziane Oliveira de Lima ,
- Maria Rocineide Ferreira da Silva ,
- Mirna Neyara Alexandre de Sá Barreto Marinho ,
- Olga Maria de Alencar ,
- Thayza Miranda Pereira ,
- Lúcia Conde de Oliveira ,
- Saiwori de Jesus Silva Bezerra dos Anjos
Views0See moreABSTRACT
Objectives:
to understand how the therapeutic itineraries of people affected by leprosy are processed.
Methods:
this is a descriptive, qualitative study, conducted in April 2018 in Barão de Grajaú in Maranhão, with interviews in the form of narratives of seven patients who had a late leprosy diagnosis.
Results:
the search for diagnosis is a major difficulty in accessing health services, resulting in a late diagnosis and, consequently, with the presence of visible deformities. It was noticed that the health units do not have a flow, nor protocols for comprehensive treatment, and these people are referred to a referral unit in another state to perform sputum smear microscopy.
Final Considerations:
leprosy control actions need reformulations that seek the relationship between operational activities, epidemiological indicators and risk factors, in accordance with the real needs of each region, thus highlighting the gaps evidenced in the therapeutic itineraries.
- Eliziane Oliveira de Lima
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ORIGINAL ARTICLE04-09-2021
Perceptions of senior nursing students regarding clinical decision-making
- Maria de Fátima Mendes Marques ,
- Carlos Lopes Alves Henriques Pina David ,
- Maria Anabela Ferreira dos Santos ,
- Sandra Cristina da Silva Neves ,
- Maria Jose Fonseca Pinheiro , [ … ],
- Maria Teresa Sarreira Leal
Abstract
ORIGINAL ARTICLEPerceptions of senior nursing students regarding clinical decision-making
Revista Brasileira de Enfermagem. 2021;74(1):e20200921
DOI 10.1590/0034-7167-2020-0921
- Maria de Fátima Mendes Marques ,
- Carlos Lopes Alves Henriques Pina David ,
- Maria Anabela Ferreira dos Santos ,
- Sandra Cristina da Silva Neves ,
- Maria Jose Fonseca Pinheiro ,
- Maria Teresa Sarreira Leal
Views0See moreABSTRACT
Objectives:
to understand the perceptions of senior students in an undergraduate nursing course at a nursing college in Lisbon regarding skills related to clinical decision-making learned during their initial training.
Methods:
qualitative study, of an exploratory and descriptive nature. Data collection occurred by carrying out a focus group with eight senior students in an undergraduate nursing course. Data treatment applied content analysis, performed with twebQDA® software.
Results:
data were analyzed according to the four dimensions of Tanner’s model of clinical judgment, and noticing and interpreting stood out as the most influential in clinical decision-making. Theoretical and clinical knowledge, validation of care planning, prioritization, and capacity to discuss and debate about situations emerged as the most representative skills.
Final considerations:
students make decisions by means of a complex process by using the knowledge and skills learned during their training.
- Maria de Fátima Mendes Marques
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ORIGINAL ARTICLE04-16-2021
Computerization of primary health care: the manager as a change agent
- Tarcísio Laerte Gontijo ,
- Paola Karol Martins Lima ,
- Eliete Albano de Azevedo Guimarães ,
- Valéria Conceição de Oliveira ,
- Humberto Ferreira de Oliveira Quites , [ … ],
- Ricardo Bezerra Cavancante
Abstract
ORIGINAL ARTICLEComputerization of primary health care: the manager as a change agent
Revista Brasileira de Enfermagem. 2021;74(2):e20180855
DOI 10.1590/0034-7167-2018-0855
- Tarcísio Laerte Gontijo ,
- Paola Karol Martins Lima ,
- Eliete Albano de Azevedo Guimarães ,
- Valéria Conceição de Oliveira ,
- Humberto Ferreira de Oliveira Quites ,
- Vinícius Silva Belo ,
- Ricardo Bezerra Cavancante
Views0See moreABSTRACT
Objective:
To analyze factors associated with the implementation of software systems of the e-SUS Primary Care strategy in municipalities of Minas Gerais.
Methods:
This is a cross-sectional study conducted with municipal managers of the e-SUS Primary Care strategy. A sample of cities stratified according to population size was selected. Descriptive, bivariate, and multivariate analyzes were performed to identify factors associated with the implementation of the systems.
Results:
In 49.1% (95%CI: 39.5-58.8) of the municipalities investigated, some of the e-SUS Primary Care systems were implemented. Time working as a strategy manager (OR: 3.03) and training for Primary Care professionals in the municipality (OR: 2.28) were associated with the implementation of the systems.
Conclusion:
The presence of a trained manager leading the implementation process impacted the implementation of the e-SUS AB strategy software systems in the municipalities of Minas Gerais. It is also essential to highlight the need to improve the technological infrastructure for the computerization of Primary Care.
- Tarcísio Laerte Gontijo
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ORIGINAL ARTICLE05-28-2021
The work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
Abstract
ORIGINAL ARTICLEThe work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
DOI 10.1590/0034-7167-2020-0116
Views0See moreABSTRACT
Objective:
To identify the potential and the limits of the actions of the nursing team in the Primary Health Care for the Health of the Indigenous.
Methods:
This is a quantitative study guided by the Theory of Practical Intervention of Nursing and Collective Health. 230 nursing professionals participated, responding to an instrument about the frequency of the actions carried out in assistance, management, teaching, and research.
Results:
168 nursing technicians and 62 nurses participated. As strengths, 80% participated in the assistance most of the time. Stand out: 90.3% and 71% of nurses carried out nursing consultations and house visits, respectively. As a limitation, the involvement in education and research is small. Only 2% of the interviewees carried out scientific researches, reflecting the need to broaden and qualify care and improve the use of traditional practices, overcoming the biomedical model.
Final considerations:
Nursing assistance is essential in the modification and monitoring of the epidemiological profile of indigenous populations, and its results allow for the planning of quality actions.
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ORIGINAL ARTICLE06-16-2021
Self-care among people with Diabetes Mellitus and quality of care in Primary Health Care
- Samara Eliane Rabelo Suplici ,
- Betina Hörner Schlindwein Meirelles ,
- Josimari Telino de Lacerda ,
- Denise Maria Guerreiro Vieira da Silva
Abstract
ORIGINAL ARTICLESelf-care among people with Diabetes Mellitus and quality of care in Primary Health Care
Revista Brasileira de Enfermagem. 2021;74(2):e20200351
DOI 10.1590/0034-7167-2020-0351
- Samara Eliane Rabelo Suplici ,
- Betina Hörner Schlindwein Meirelles ,
- Josimari Telino de Lacerda ,
- Denise Maria Guerreiro Vieira da Silva
Views0See moreABSTRACT
Objectives:
to verify the adherence to self-care activities among people with diabetes mellitus and its association with quality of care received in Primary Care.
Methods:
a cross-sectional study with 329 people with diabetes assisted in Primary Care. Sociodemographic and self-care data were collected. To assess quality of care in Primary Care, secondary data from the Access and Quality Improvement Program were used. For comparisons between adherence to self-care activities and quality of care received in Primary Care, the Kruskal-Wallis Test was used.
Results:
better adherence to the diet, blood glucose monitoring and medication use were observed among people with diabetes treated in Primary Care with better coordination of care, agenda organization, and equipment. Foot examination, despite the inverse relationship with quality of care, proved to be desirable.
Conclusions:
adherence to self-care among people with diabetes was associated with quality of care received in Primary Care.
- Samara Eliane Rabelo Suplici
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ORIGINAL ARTICLE05-21-2021
Good Practices in Transitional Care: continuity of care for patients undergoing liver transplantation
- Laísa Fischer Wachholz ,
- Neide da Silva Knihs ,
- Suyan Sens ,
- Sibele Maria Schuantes Paim ,
- Aline Lima Pestana Magalhães , [ … ],
- Bartira de Aguiar Roza
Abstract
ORIGINAL ARTICLEGood Practices in Transitional Care: continuity of care for patients undergoing liver transplantation
Revista Brasileira de Enfermagem. 2021;74(2):e20200746
DOI 10.1590/0034-7167-2020-0746
- Laísa Fischer Wachholz ,
- Neide da Silva Knihs ,
- Suyan Sens ,
- Sibele Maria Schuantes Paim ,
- Aline Lima Pestana Magalhães ,
- Bartira de Aguiar Roza
Views0See moreABSTRACT
Objectives:
to develop a guide of care recommendations for good practices in care transition for adult patients undergoing liver transplantation.
Methods:
a methodological study, based on the Appraisal of Guidelines for Research & Evaluation in the updated version, II. Care recommendations were sustained by conducting an integrative literature review and qualitative research.
Results:
from evidence, three topics emerged: Care Transition Planning; Health Education for Self-Care; Care Management. Each of the central topics has respective subtopics, totaling six, giving rise to 30 care recommendations. Concerning evaluators’ scores, in all domains the scores were higher than 90%.
Final Considerations:
the proposed guide assists professionals in conducting care transition in liver transplantation, ensuring greater safety for patients in continuity of home care.
- Laísa Fischer Wachholz
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REVIEW05-21-2021
Integrative review on the incidence of HIV infection and its socio-spatial determinants
- Bruna Rafaela Leite Dias ,
- Taymara Barbosa Rodrigues ,
- Eliã Pinheiro Botelho ,
- Marília de Fátima Vieira de Oliveira ,
- Alexsandra Rodrigues Feijão , [ … ],
- Sandra Helena Isse Polaro
Abstract
REVIEWIntegrative review on the incidence of HIV infection and its socio-spatial determinants
Revista Brasileira de Enfermagem. 2021;74(2):e20200905
DOI 10.1590/0034-7167-2020-0905
- Bruna Rafaela Leite Dias ,
- Taymara Barbosa Rodrigues ,
- Eliã Pinheiro Botelho ,
- Marília de Fátima Vieira de Oliveira ,
- Alexsandra Rodrigues Feijão ,
- Sandra Helena Isse Polaro
Views0See moreABSTRACT
Objectives:
to identify the socio-spatial determinants associated with the incidence of infection by the human immunodeficiency virus (HIV) described in national and international literature.
Methods:
integrative literature review that included original articles indexed in the LILACS, PUBMED, CINAHL, and Scopus databases, from 2015 to 2019. The synthesis of the articles was done in a descriptive manner in two categories according to the type of approach.
Results:
13 articles were selected, with a predominance of ecological studies. Regions with deficient access to health services, high population density, higher rates of poverty, intense migratory flow, border areas, as well as precarious socioeconomic conditions, and risk behaviors are associated with higher rates of infection.
Final Considerations:
the influence of regional inequalities on the incidence of HIV infection is revealed, confirming the relevance of spatial analysis techniques for mapping the distribution of diseases and identifying risk areas.
- Bruna Rafaela Leite Dias
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REVIEW05-21-2021
Evaluation strategies in active learning in higher education in health: integrative review
- Monike Alves Lemes ,
- Maria José Sanches Marin ,
- Carlos Alberto Lazarini ,
- Silvia Cristina Mangini Bocchi ,
- Elza de Fátima Ribeiro Higa
Abstract
REVIEWEvaluation strategies in active learning in higher education in health: integrative review
Revista Brasileira de Enfermagem. 2021;74(2):e20201055
DOI 10.1590/0034-7167-2020-1055
- Monike Alves Lemes ,
- Maria José Sanches Marin ,
- Carlos Alberto Lazarini ,
- Silvia Cristina Mangini Bocchi ,
- Elza de Fátima Ribeiro Higa
Views0See moreABSTRACT
Objectives:
to analyze scientific evidence on evaluation strategies for active learning methods in health undergraduate programs.
Methods:
integrative literature review in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases.
Results:
different evaluation strategies are used: Presentation of seminars, Self-evaluation, Evaluation of student performance in Tutotest-Lite tutoring, Peer Evaluation, Active Learning and Critical Thinking Self-evaluation Scale, Objective and Structured Clinical Exam, Portfolio, Progressive Disclosure Questions, Modified Dissertation Questions, Progression Test, Dissertation Test, Objective Test, Immediate Learning Checks, Clinical Case Resolution and Cumulative Test.
Final Considerations:
evaluation strategies in active learning are used in combination, aiming at the affective, cognitive and psychomotor development of the student. However, studies with greater power of scientific evidence would be needed.
- Monike Alves Lemes
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