TEACHER'S EDUCATIONAL CAPACITY AND ACHIEVEMENT OF COMPETENCES DURING ITS CLINICAL PRACTICES IN THE NURSING INTERNAL OF THE EMERGENCY HOSPITAL GRAU ESSALUD, 2019

Objectives: To identify the relationship between the teaching capacity of the teacher tutor and the achievement of competencies of the Nursing intern during their clinical practices at the Grau Emergency Hospital in 2019. Methods: Study with a quantitative approach, relational level and non-experimental design. Through non-probabilistic convenience sampling, a sample of 50 nursing interns from the Grau EsSalud emergency hospital was used. Results: Most were between 20 and 27 years old (56%)


INTRODUCTION
The tough work of training a high-level professional, assigned a great system of knowledge and skills to be able to carry out with high quality and efficiency the promotion, prevention, detection, cure and rehabilitation of people affected by diseases, demand for a teacher trained in the Nursing field and who at the same time possesses the necessary and sufficient professional skills to teach.With regard to higher levels: the contribution, collaboration and protagonism of the students, the teaching role development as an axis that enhances knowledge and personalized educational work, demand tutoring as one of the main points that the teacher must make in contemporary education (1) .
The tutor must adapt to new roles, judgments and strategies of the teaching-learning process, focusing on the students, in addition to regulate, guiding and providing the mentioned process (2) .
The tutor is seen as the nursing professional who freely takes the commitment of the students' clinical practical learning in their work environment, planning, regulating and evaluating; being a reference and didactic support for the student (3) .Furthermore, has the following academic peculiarities: reality perception with a critical autonomy attitude; stay updated, be able to admit its restrictions, endorse a pedagogical scenario of a democratic and humanistic nature; promote the useful use of technologies; prevent and support students and provide moral support to develop skills in them, in addition to encouraging collective effort (4) .
Tutors not only teach, but also encourage the learner to make decisions, observations, establish relationships, and work with inquiries.In this way, the educator provides the student with the impulse of skills and qualities that lead to obtaining technical and political power, in a way that they can act in favor the society (5) .
The combination of theory and practice in academic training is one of the great institutions concerns.Nursing schools are no exception and the contrast between what is preached in the classrooms and what is acquired in the care centers where clinical practices are carried out, often orienting students a great challenge (6) .Didactics encompasses those teaching conditions for which certain elements are requested: the educator (who teaches), the student (who learns) and the learning scenario.Teaching models, for its part, can be based on a theoretical or technological profile (7) .
In addition, implies the teacher role as an agent who, through the instructional processes, is in charge of guiding, directing, providing and guiding the interaction of students with culturally organized collective knowledge so they can build their own knowledge (8) .
Teaching reveals the situation developed in the educational context, from the achieved interaction between teachers and students, which is ruled by a series of explicit and implicit guidelines defined by the institution and the people in interaction9.
Therefore, tutor's teaching capacity is assumed as the discipline which responds to the teaching processes, which involves addressing what is taught for, why and how; It also attends to the organization of the preparation processes of each educator who is subject to adapt their methodology to the educational organization, the circumstances of the context, the socio-cultural aspect and any kind of conditioning that constitutes the environment and training of each student (10) .
A research developed by Huamantupa (2018) it was shown that the teaching capacity of the secondary education teacher was moderate (55.2%) to good (32.4%) (11).
The contribution of the students in the assessment process is an essential aspect to boost their autonomy.It stimulates critical capacity and qualities about the affective sphere (knowing how to be) are invigorated, such as: honesty, commitment and autonomy that incur in the personal formation of the student.Several researches mention the main utility of the learners' perception is that they gain insight into their training process, can assess the contribution of others, and make appropriate judgments for decision-making (12) .
The concept of competence, so convenient in the world of work, has been included in the university horizon as a catalyst of curricular models since 90's, obtaining different qualifications: training by competencies, study plans determined in the approach by competencies, educational approaches by competencies; all with the intention of becoming an academic training option (13) .
The term competition comes from the Latin competentia which refers to "dispute or contention Pág.380 between two or more people"; in other words, a subject is competent when he establishes a specific job to the satisfaction of the person who entrusts it or hires it for that purpose (14) .
Professional competence involves the input of the knowledge, skills and aptitudes which are essential to carry out a career and can also solve professional problems in a comprehensive and flexible way, so it is able to assist in their professional environment and in the distribution of work.It is conceived that a subject is qualified when in his work performance he obtains the expected effects, with the resources and appropriate quality level (15) .
It is classified in: (1) Basic or instrumental competences, those related to fundamental knowledge and focused on understanding and solving periodic problems for entering work.(2) Generic or transversal competences are those linked to capacities, characters, actions and qualities extended to different professional fields such as working in a team, planning or the skill to negotiate.
(3) Specific, technical or specialized competences are those concern to technical aspects directly related to the occupation or to a certain area of study, which are not so easily transferable to other work or academic contexts (16) .The student's competencies specify what must be instructed and must be valued, in addition to composing the center of the entire teaching-learning interval.The accuracy of competences is an essential task, both for the agents involved in the training of the future professional as for the institutions and general society.The practices of the Nursing degree address an essential part of the future professionals' disposition, since they establish an initial relationship with patients and families, with the hospital and with what their work will be when they finish their studies.This gives students the opportunity to tentatively locate the knowledge that they have been reaching about the different courses (17) .
In clinical practice, a relationship is founded between the student and his practice tutor in a vertical and unidirectional way, where the student assumes a lower position than his tutor, both due to his lack of knowledge, as well as his inexperience in that specific area nursing, where the tutor is the one who has the knowledge to be able to act (18) .López et al. (2017) in their work found that the professional competencies (care, management and educational) of the nursing interns reached a high level of achievement in 86%, while the generic competences (general and seal) obtained a satisfactory level of achievement, around 82%, it means the students' performance is satisfactory at the end of their internship (19) .
In the research by Jimenez and More (2016), it was evidenced that nursing interns are competent at the attitudinal level (77.1%), it means, their behaviors are the most accurate at the time of patient care, on the other hand, in the cognitive level (58.3%) and aptitude (62.5%) are not competent (20) .
On the other hand, Matos (2017) in his study published points out nursing interns consider to have achieved social skills during their training, which they apply in nursing work, thus developing basic skills, sociability, positioning, establishing links and self-regulation (21) .
Villar (2016) in his research showed that there are significant differences between the perception of the tutor and the student about the achievement of competencies during the clinical practice in the internship period of the students of health sciences (22) .
Based on what has been attributed, in the present work the evaluation of professional competences and the importance of the work at the teaching level of the teacher represent a central element in the career's development, being the key to achieving the health services quality, and by the way favoring the professional training of the nurse, orienting itself to the academic growth of the student, a high level of patient satisfaction, an adequate social recognition of Nursing, a direction clear towards care and a great motivation and professional development of Nursing.This article's objective is to identify the relationship between the tutor teaching capacity and the competencies achievement of the Nursing intern during their clinical practices at the Grau Emergency Hospital in 2019.

METHODS
A study with a quantitative, correlational approach and a non-experimental design was carried out.In order to select the sample, a non-probabilistic convenience sampling was used, due to the small size of the population, the sample being made up of 50 nursing interns of the Grau EsSalud emergency Hospital during 2019, who agreed to participate in the study through informed consent and also met Rev. Fac.Med.Hum.2021;21(2):378-386.

ORIGINAL PAPER
Pág. 381 the inclusion and exclusion criteria.
Inclusion criteria: • Nursing interns who agreed to participate in the research.
• Nursing intern who had stay more than one month in the hospital.
• Intern who signs the informed consent.
Exclusion criteria: • Interns from other undergraduate specialties.
• Intern who does not agree to participate in the study.
The technique used was the personalized survey and direct observation.Two instruments were used: A Perception Scale of the teaching capacity of the teacher tutor issued by the nursing interns, which is divided into the communication and didactic dimension, consisting of 10 questions, being the Likert type of response with 5 response alternatives (Strongly agree = 5, Agree = 4, Neither agree nor disagree = 3, Disagree = 2, Strongly disagree = 1).
The other instrument was a competences Checklist of nursing intern, made up of 50 items, whose type of response is as follows: (1) Never, (2) Sometimes and (3) Always.Both instruments were validated through expert judgment, obtaining agreement between their assessments (p <0.05).Likewise, both instruments were made reliable by a pilot test, obtaining a Cronbach's alpha coefficient of 0.96 for the Perception Scale of the tutor teaching capacity, and a Cronbach's alpha of 0.96 for the Intern's Competencies Checklist, in other words, a very high reliability for both, being suitable for its application.
To categorize the perception of the teaching didactic capacity, a total score of 10 to 50 points was obtained, and a scale was made as follows: K= ((number of Items x higher score)-number of Items) ÷ 3) K= ((10 x 5)-10) ÷ 3) = 13 The value of the constant (K) it is used to obtain the categories: • Good teaching capacity of the educator: 38 -50 points.
• Regular teaching capacity of the teacher: 24 -37 points.
• Level of Competence in the process of achievement: 84 -117 points.
For the descriptive analysis, the distribution of absolute and relative frequencies and for the quantitative variables the measures of central tendency (average) and dispersion (standard deviation) were used.In addition, Spearman's Rho correlation test was utilized to obtain the relationship between the variables.
The study was carried out with the authorization of the Ethics Committee of the Grau Essalud Emergency Hospital, and the bioethical principles were met, applying the respective informed consent to the nursing interns, protecting the confidentiality of their data.

RESULTS
There were 50 nursing interns during their clinical practices at the Grau Emergency Hospital during 2019, who participated in the study, with the most frequent age being between 20 to 27 years in 56%, and female in 98%.(Graphic 1) Table 1 shows the teaching capacity of the teacher according to the perception of the nursing intern,it was 62% of regular level, 34% of good level, and 4% of bad level; Regarding its communication dimension, it was 62% of regular level, and 34% of good level, and for didactics, it was 54% of good level, and 44% of regular level.
Table 2 shows the achievement of competencies of the nursing intern during their clinical practices Pág. 382 ,it was 46% achieved, 32% in process, and 24% not achieved.And the dimensions of the intern's competencies: administration of medications, obtained 50% achieved, preoperative care, obtained 52% in process, hospital admission, obtained 70% in process, canalization of Peripheral intravenous route, obtained 60% not achieved; placement of Nasogastric Tube and Foley Tube, obtained 46% achieved, electrocardiogram taking, obtained 38% achieved, and interpersonal skills, obtained 62% not achieved.
A considerable direct relationship was also demonstrated between the tutor teaching capacity and the achievement of competencies of the nursing intern during their clinical practices, since it reached a Spearman correlation coefficient of 0.793, being significant (p = 0.000).Likewise, a considerable direct relationship was also found between the achievement of competencies of the nursing intern and the educator teaching capacity in its communication dimensions (rho = 0.785; p = 0.000), and didactics (rho = 0.806; p = 0.000).(See Tables 3, 4 and 5

DISCUSSION
Nursing professionals need to achieve many capacities and a values structure and attitudes that make it easier for them to offer a quality service that basically shows respect for life and human dignity, an understanding of the environment and culture, characteristics that are acquired through of academic preparation and are sensitized in the daily work of clinical practices.
Having good professionals does not depend exclusively on an adequate curricular structure, or on a modernized curriculum, but it must be essential an excellent teaching staff throughout the educational process both in university classrooms and in clinical practices.
However, the university training problem is formed from the achievement of educational objectives taking as a basis not only the nursing internship but also the teaching capacity, which arises that, within the current demands of society it is necessary train professional citizens not only with scientific knowledge, but also with skills for innovation and research, as well as for social and ethical projection.
Regarding the general results in the study by Hernández R. (2018), they showed 54% of students considered the teacher performed regularly, 26% Pág. 385 indicated that it was good, 10% that it was very good; and 10% thought it was bad (23) .
However, in the present study, the nursing interns considered the educator teaching capacity was 62% regular and 34% good, which reflects an intermediate result in terms of communication and didactics by the clinical practice teachers of the Grau-Essalud Emergency Hospital.
Regarding the competence of the tutor, the results of the research by Chávarry P (2016) showed, according to the dimension of didactics, 82.9% of teachers have a moderately satisfactory and refering the dimension relational aspects 45 7% of teachers have a moderately satisfactory performance (24) .
Mean while, in the present research, the results reveal in the didactic dimension, the majority of the teachers (54%) were qualified with a good level and 44% a regular level, the most outstanding being the explanation of the procedures in a way.clear and precise, as well as shared experiences and clinical cases in clinical practices.In summary, the tutor teacher shows an intermediate development, however, he uses many materials that make it possible to be didactic and achieve student learning.On the other hand, in terms of teacher communication, the weakest aspect was not identifying the inmates by name.
Regarding the achievement of competencies of the nursing intern, in the present work it was found that most reached a level achieved (46%), followed by in process (32%), which shows that the instruction provided by the teacher is good both on a theoretical and practical level, being reflected in the actions of the intern.
The finding of a direct relationship between the teaching capacity of the teacher and the achievement of competencies of nursing interns shows that it is essential to have adequate teachers who positively influence the acquisition of competences by students, at the health level.Moreover, didactic methods are an important piece to reach the nursing intern more effectively.

CONCLUSION
According to this research results, it is concluded there is a considerable direct relationship between the teacher's educational capacity and the achievement of competencies of the Nursing intern during their clinical practices at the Hospital de Emergencias Grau EsSalud 2019.

Table 1 .
Age and gender of nursing interns of the grau essalud emergency hospital, 2019.Didactic capacity of the teacher and its dimensions during their clinical practices in the nursing promotion of the Grau EsSalud Emergency hospital, 2019.

Table 2 .
Achievement of competences and their dimensions during their clinical practices in the nursing promotion of the Grau EsSalud Emergency hospital, 2019.

Table 3 .
Relationship between the teacher's didactic capacity and the achievement of competences during their clinical practices in the nursing promotion of the Grau EsSalud Emergency hospital, 2019.

Table 4 .
Relationship between the teacher's didactic capacity in their communication dimension and the achievement of competences during their clinical practice in the nursing promotion of the grau essalud emergency hospital, 2019.

Table 5 .
Relationship between the teacher's didactic capacity in their didactic dimension and the achievement of competences during their clinical practices in the nursing practice of the Grau EsSalud Emergency hospital, 2019.