ABSTRACT

Objective: To determine the relationship between expectations and satisfaction regarding technical knowledge - empathic attitude in the clinical practices of nursing students at the Grau de EsSalud Emergency Hospital in 2019. Methods: A study with a quantitative approach, observational type, and correlational design showed 80 nursing students who carried out their clinical practices at the Hospital de Emergencias Grau participated in 2019. Results: Nursing students were characterized by an average age of 21.36 years, 75% were female, and 72.5% were single. The expectations and satisfaction regarding technical knowledge - empathic attitude in the clinical practices of nursing students were high levels in 97.5% and medium level in 60%, respectively. There was no significant relationship between expectations and satisfaction regarding technical knowledge - the empathic attitude of the clinical practices of nursing students (p = 0.661). Conclusion: There is no relationship between expectations and satisfaction regarding technical knowledge - empathic attitude in the clinical practices of nursing students at Hospital de Emergencias Grau de EsSalud in 2019.

Keywords: Expectation; Satisfaction; Clinical practice; Nursing (source: MeSH Terms).

RESUMEN

Objetivo: Determinar la relación entre expectativas y satisfacción sobre conocimiento técnico - actitud empática en las prácticas clínicas de los estudiantes de enfermería del Hospital de Emergencias Grau de EsSalud en el año 2019. Métodos: Estudio con enfoque cuantitativo, tipo observacional y con diseño correlacional, en el que participaron 80 estudiantes de enfermería que realizaban sus prácticas clínicas en el Hospital de Emergencias Grau, en el período 2019. Resultados: Los estudiantes de enfermería se caracterizaron por tener una edad promedio de 21.36 años, donde 75% eran de sexo femenino, y 72.5% solteros. Las expectativas y la satisfacción sobre conocimiento técnico - actitud empática en las prácticas clínicas de los estudiantes de enfermería fueron de nivel alto en 97.5%, y de nivel medio en 60%, respectivamente. No hubo relación significativa entre las expectativas y la satisfacción sobre conocimiento técnico - actitud empática de las prácticas clínicas de los estudiantes de enfermería (p=0.661). Conclusión: No existe relación entre las expectativas y la satisfacción sobre conocimiento técnico – actitud empática en las prácticas clínicas de los estudiantes de enfermería del Hospital de Emergencias Grau de EsSalud en el año 2019.

Palabras Clave: Expectativa; Satisfacción; Práctica clínica; Enfermería (Fuente: DeCS BIREME).

INTRODUCTION

Nursing is a scientific and humanistic career whose main role is to assume the surveillance of subjects at different levels of prevention and health care, considering the interculturality of people⁽¹⁾.

Nurses found a high level of satisfaction in patients, which is not only related to the application of professional skills and abilities. This is because society recognizes attentive, effective, sensitive, and interested experts, which makes a difference between good and bad nurses beyond their professional competence and increases greater stress due to the “emotional work” that it implies⁽²⁾.

Nursing training denotes high levels of expectations due to the complexity of the training; likewise, because an ethical norm regulates it and it unfolds through deliberative processes of understanding of the participants, that is, judgments based on the interpretation of the educational activities developed by the teacher and the student⁽³⁾.

For Levvett-Jones et al., Clinical practice is the fundamental part of the curriculum concerning the nursing career since it is the space for applying skills by students based on knowledge achieved in the university⁽⁴⁾.

Likewise, it is a social practice, that is, an activity carried out based on the social needs of each historical moment and that is composed and becomes the dynamics of relationships⁽⁵⁾.

For this reason, clinical practice is planned in health institutions that meet the necessary conditions to achieve the objectives registered in the study plan⁽⁶⁾.

Clinical practice teachers are one of the main actors in this process, since its purpose is to provide, through their technical knowledge, the necessary bases and, as well as to help the nursing student with an empathetic attitude for their professional development⁽⁷⁾.

In addition to being a capacity in itself, clinical practice is also the way to achieve higher levels of clinical competence over time, based on daily work. Suppose the student is carried away by habitual, little-involved practices. In that case, the effect will be insufficient attention, without nuances in terms of clinical understanding and that does not have to turn according to the requirements of the patient and family. But, if the student responds in a sensitive and involved way to his encounters in his practice, linking himself emotionally, he will make them become paradigmatic stored cases⁽⁸⁾.

Technical knowledge involves a series of practical and instrumental skills that favor transforming scientific knowledge into actions that seek to solve certain needs⁽⁹⁾.

The empathic attitude refers to the ability to understand the needs, emotions, and problems, placing oneself in their place and, in this way, responding correctly to their emotional reactions. According to the model, emotional empathy competence is achieved when active listening is merged at an intellectual level, at an emotional level, understanding, and, at a behavioral level, assertiveness⁽¹⁰⁾.

Likewise, it is an emotional response to the contingent scenarios of others and a predisposition to act in a certain way in the face of certain emotional contexts experienced by others. To that extent, it is susceptible to being learned and taught⁽¹¹⁾.

Expectations are psychic categories that symbolize the subjects’ strength, power, and desire to acquire their purposes and goals on a personal and/or group level⁽¹²⁾.

A person may have expectations regarding a specific service or professional, which may be circumstantial and related to a moment in time⁽¹³⁾.

Expectations are presented as standards for what should happen. In this sense, having an expectation represents expecting something⁽¹⁴⁾.

On the other hand, satisfaction is conceived as an emotional response that comes from cognitive judgment⁽¹⁵⁾.

Student satisfaction shows the well-being that students feel for having their academic expectations (clinical practices) met as a result of the activities carried out by the institution to meet their educational needs⁽¹⁶⁾.

The aforementioned has been found in different works. For example, Nebot (2017) showed that the expectations of students, before any beginning of practices, are delimited by enthusiasm and motivation, which contrast with indecision and concern about the unprecedented, even more so in the first rotation. The preparation classes for the practices forge a high degree of satisfaction among the students since they favor a first approach to the patient. However, fear and insecurity are still present at the beginning of the practices⁽¹⁷⁾.

Pérez (2017), in his research, found a global satisfaction from high to very high in nursing students with respect to simulated practices⁽¹⁸⁾.

For his part, Val (2016) found that students show notable satisfaction with clinical practices in the health institution, especially with interest shown by the professionals in charge of their training. However, they perceive that teachers should increase their knowledge about the training project to direct learners⁽¹⁹⁾.

Chaina (2015) revealed that the majority of nursing students are moderately satisfied with their academic training in terms of practice⁽²⁰⁾.

Duringtraining in university classrooms, the theory learned gains greater strength through the practice that students develop. However, it is common to observe that there is demotivation in the practical training activities or that they are not prepared to assume some hospital activity, this being one of the greatest concerns of training institutions and teachers since it is frequent to appreciate that the application of the knowledge obtained in the classrooms for the care of the patient and the family, the management of real situations and the use of the tools available to improve the health of the patients, is inefficient. For this reason, this work is presented in such a way that the reality that nursing students face, the difficulties and the alternative solutions that lead to the correct performance of the practices during their stay in the hospital can be known. In addition, an analysis will be carried out on the problems that occur when an intern carries out their clinical practices so that the personnel involved can make progress and improve situations in favor of the profession, educational institutions, and people's health.

This article aims to determine the relationship between expectations and satisfaction regarding technical knowledge and empathic attitude in the clinical practices of nursing students at Hospital de Emergencias Grau Essalud, 2019.

METHODS

Design and study area

It was a quantitative study approach, observational type, and with correlational design. The study area was the Grau Es Salud Emergency Hospital, which is located at Av. Grau 351 in the Cercado de Lima district and has different specialties.

Population and sample

The population was 110 nursing students carrying out their clinical practices at the Grau Emergency Hospital in the period 2019. Regarding the sample, we worked with 80 nursing students, taking into account a non-sampling probabilistic sample for convenience, given that some did not meet the selection criteria.

Variable and instruments

The variables were expectations about technical knowledge - empathic attitude and satisfaction with technical knowledge - empathic attitude.

The technique was the survey and the instruments: a scale of expectations and satisfaction on clinical practices, which were validated and trusted prior to their application.

The Expectations and Satisfaction scales on technical knowledge - the empathic attitude of clinical practices were constructed by the researcher based on antecedents and bibliographic information. Each scale was made up of 10 items that evaluate the expectations and satisfaction of nursing students on clinical practices. These scales are classified into the teachers' technical knowledge dimension (5 items) and the empathic attitude dimension (5 items). The items on these scales have Likert-type response levels and a score ranging from 1 to 3 points (Always = 3, Sometimes = 2, Never = 1). Both scales were validated through expert judgment, so that agreement was obtained between their appraisals. They were also made reliable through a pilot test; the reliability being very high (Cronbach's alpha = 0.89) for the expectations scale, and the reliability (Cronbach's alpha = 0.75) for the satisfaction scale.

To categorize the levels of expectations and satisfaction, the Baremation was used using the formula:

K= ((No. of items x highest score) - No. of items) ÷ 3

In this way, it was obtained that, for both Expectation and Satisfaction on technical knowledge - an empathic attitude of clinical practices, it was low level (10 - 16 points), medium level (17 - 23 points), and high level (24 - 30 points). And for each of the dimensions, it was considered as low level (5 - 8 points), medium level (9 - 12 points), and high level (13 - 15 points).

Procedures

Permission for data collection was obtained at the Grau de Essalud Emergency Hospital through a permit document; then, the survey was applied to the target population (nursing students). Finally, the quality of the data collected was verified.

Statistical analysis

For the statistical analysis, the SPSS version 25 program was used. The descriptive statistics of qualitative variables were given through frequency distribution (relative:% and absolute: N) and quantitative variables through central tendency and dispersion measures. The inferential statistics to relate Expectations and satisfaction on technical knowledge - an empathic attitude of clinical practices, the non-parametric statistic, Spearman's Rho, was used since the evaluation was through quantitative data analysis.

Ethical aspects

The ethical aspects of the research were considered since it had the approval of the Ethics Committee of the Grau de Essalud Emergency Hospital, respecting the confidentiality of the respondents’ information after signing the informed consent.

RESULTS

Figure 1 and Table 1 show the characteristics of the 80 nursing students who carried out their clinical practices at the Grau Emergency Hospital during 2019, whose average age was 21.36 years, 75% female and 72.5% single.

The expectations about technical knowledge - an empathic attitude of the clinical practices of nursing students were of a high level of 97.5% and 2.5% of a medium level. Regarding its technical knowledge dimension, it was 86.3% of high level and 13.8% of medium level; and for the empathic attitude dimension, it was 86.3% of high level and 13.8% of medium level. (See table 2)

Satisfaction on technical knowledge - an empathic attitude of the clinical practices of nursing students was of medium level in 60% and 40% of high level. Regarding its technical knowledge dimension, it was 75% of medium level and 22.5% of high level; and for the empathic attitude dimension, it was 73.8% of medium level and 23.8% of high level. (See table 3)

On the other hand, in table 4, it is observed that there was no significant relationship between expectations and satisfaction regarding technical knowledge - an empathic attitude of the clinical practices of nursing students (p = 0.661). In turn, it was shown that there is no significant relationship between expectation and satisfaction in the technical knowledge dimension (p = 0.653) and the empathic attitude dimension (p = 0.653) of the clinical practices of nursing students. (See table 5 and table 6)

DISCUSSION

It is important to highlight that clinical practice guides how better levels of clinical competence can be achieved over time, based on daily work. Suppose the student gets carried away by traditional practices with little involvement. In that case, the consequence will be little attention, without nuances in terms of clinical understanding, and that does not depend on the requirements of the patient and the family. Considering what has been attributed, it is essential to know the opinion of nursing students regarding clinical practices to know the situation faced in rotations.

Regarding the findings of this article, the expectations of nursing students regarding technical knowledge - The empathic attitude of clinical practices obtained a high level (97.5%) with greater emphasis on aspects of the teacher that evaluate and reinforce their knowledge and that allow them to exchange opinions with other students, as well as identifying the psychosocial needs of the family, among others. On the other hand, Nebot, in his research, showed that the illusion and motivation delimit the expectations of the students before any beginning of practices. However, sometimes they feel uncertain and concern about the unknown, especially in the first rotation⁽¹⁷⁾. This reveals that the students had a great predisposition and encouragement to start their clinical practices and take on challenges that allow them to achieve their skills; they also expected high standards as their prospects were high.

Regarding the satisfaction of nursing students regarding technical knowledge - an empathic attitude of clinical practices, a medium level (60%) to high (40%) was obtained, since they indicated that sometimes the clinical practice teachers were careful in the follow-up of clinical cases or taught them to identify the needs and care of each patient. These results reflect the contrast between what is desired (expectations) and what they come to experience during their clinical practices. These results differ from Pérez's work, where it was observed that the overall satisfaction of nursing students from the Faculty of Valladolid regarding their clinical practices is high or very high.⁽¹⁸⁾; while Ruiz et al. showed that Health Sciences students are delighted with the practical knowledge and acquired competencies, stating that clinical practices have favored their learning while expressing high satisfaction in the centers’ reception the integration into work teams⁽²¹⁾. On the other hand, Chaina found that nursing students are moderately satisfied with their practical training⁽²⁰⁾. The Bustamante study showed that 55.2% of the students have a moderately favorable perception of clinical practices, 41.4% have a favorable perception, and 3.4% an unfavorable perception⁽²²⁾.

There was no relationship between expectations and satisfaction of nursing students regarding technical knowledge - an empathic attitude of their clinical practices, which could be because they already knew about the situations to be faced in their practices and were not so influential in the level of their practice of satisfaction.

CONCLUSION

According to this research, there is no relationship between expectations and satisfaction regarding technical knowledge - empathic attitude in the clinical practices of nursing students at Hospital de Emergencias Grau de EsSalud in 2019.

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