doi: 10.56294/mr202336

ORIGINAL

Image in Nursing and Simulation

Imagen en enfermería y simulación

Shirley Tumiri¹ *, Luis Duran¹ *, Johanna Lin¹ *,  Norma B. Ríos¹ *, Ana Mosca¹ *, Teresa Gómez¹ *

¹Instituto Universitario Hospital Italiano de Buenos Aires. Carrera de Licenciatura en Enfermería. Ciudad Autónoma de Buenos Aires, Argentina.

Cite as: Tumiri T, Duran L, Lin J, Ríos NB, Mosca A, Gómez T. Image in nursing and simulation. Metaverse Basic and Applied Research. 2023; 2:36. https://doi.org/10.56294/mr202336

Submitted: 03-02-2023           Revised: 02-04-2023            Accepted: 05-06-2023            Published: 06-06-2023

Editor: Dra. Patricia Alonso Galbán

ABSTRACT

Introduction: professional image is a relevant aspect in the profile of any graduate due to its external impact on society. It is projected to others based on physical aspects and consolidated with what others perceive and interpret from every action. This article describes the contributions that clinical simulation offers to the professional image of students at the University Institute of the Italian Hospital.

Method: the study was a quantitative, descriptive, cross-sectional, and prospective one.

Results: of the 90 surveyed students, 39,78 % responded that clinical simulation provided them with skills, 38,67 % reported that it provided them with security, 12,71 % reported that it improved their professional identity, and 8,84 % said that it helped them with communication. The factor that contributed the most to the formation of professional identity was the execution of techniques in the simulation center, with 69,03 %.

Conclusion: it was possible to identify in the student body that clinical simulation provided them with skills, security, and a clearer professional identity. On the other hand, students considered that the use of a complete uniform in clinical simulations contributed to the construction of their professional image, as it produced attitudinal changes that influence their dress and are subsequently projected in their image.

Keywords: Nursing; Professional Image; Clinical Simulation; Investigation.

RESUMEN

Introducción: la imagen profesional es un aspecto relevante en el perfil de cualquier egresado debido al impacto externo que tiene ante la sociedad. Se proyecta a los demás a partir de los aspectos físicos y se consolida con lo que los demás perciben e interpretan de cada acción. Este artículo describe los aportes que la simulación clínica ofrece a la imagen profesional de los estudiantes del Instituto Universitario del Hospital Italiano.

Método: el estudio realizado fue cuantitativo, descriptivo, transversal y prospectivo.

Resultados: de los 90 estudiantes encuestados, un 39,78 % respondió que la simulación clínica les aportó habilidades, un 38,67 % afirmó que les brindó seguridad, un 12,71 % mencionó que mejoró su identidad profesional y un 8,84 % dijo que les aportó en la comunicación. El factor que más contribuyó a la formación de la identidad profesional fue la ejecución de técnicas en el centro de simulación, con un 69,03 %.

Conclusión: se logró identificar en el alumnado que la simulación clínica les aportó habilidades, seguridad y una identidad profesional más clara. Por otro lado, los estudiantes consideraron que el uso del uniforme completo en las simulaciones clínicas contribuyó a la construcción de su imagen profesional, ya que produjo cambios actitudinales que influyen en la vestimenta y que, posteriormente, son proyectados en su imagen.

Palabras clave: Enfermería; Imagen Profesional; Simulación Clínica; Investigación.

INTRODUCTION

The professional image is a fundamental aspect in the profile of any graduate due to the external impact on society. This image is influenced by the contributions that clinical simulation makes to future professionals of the Nursing degree course at the University Institute of the Italian Hospital. Although it is not considered a direct tool for their training, it is a relevant activity for the development of the profession.

Professional identity is the process developed through the projection of knowledge, attitudes and mainly family, personal and teacher experiences, which influence academic development. It is relevant to mention that for students to adopt their professional identity as a nurse, they need to live a process that progressively rises from abstraction as university studies go by. They acquire experiences caring for his health or that he provides for others.

Professional Image develops from the recognition or inclination towards a professional career. It is there where the individual becomes aware of the relationship between their aptitudes, affinities, ideals, and characteristics, adding to the activities carried out in their future professional roles. In this way, the student strengthens and creates new concepts that contribute to forming a professional identity, acquiring new communication skills and developing a profile, which is formed and modified in the expression of his clothing, attitude and behavior.

The most representative contributions of clinical simulation are the skills and confidence in the skills, but also constitute to their identity in terms of the professional activities they perform, to later assume their belonging to the group of professionals.⁽¹⁾ In this way, they can later assume their belonging to the group of professionals, since it is in the confrontation with the work space or in the imitation of the same in simulated environments that they recognize their profession.⁽²⁾

The aim of this research was to disseminate the contributions of clinical simulation in order to strengthen the professional image in the nursing career in the Autonomous City of Buenos Aires in 2019.

METHODS

The study was quantitative, descriptive, cross-sectional and prospective.

The variable contributions in the clinical simulation were broken down into the professional image dimension with three indicators: professional identity, communication, and profile. These three indicators were subdivided into clothing, behavior, and attitude.

Inclusion, exclusion, elimination, spatial time, and ethical repair were considered for the population's selection. Independently, each author completed the course on good clinical practices and the protocol presentation to be evaluated by the institutional ethics committee before collecting data.

The pilot test of the instrument was applied to five recent graduates of the University Institute of the Italian Hospital by email, with no suggestions for correction. It consisted of seven multiple-choice questions with four possibilities with a filling time that did not exceed five minutes.

Once this stage was closed, the paper questionnaires were delivered in person to 90 students from different years. For its application, authorization was requested from the career’s direction and the list of students and coordinators responsible by year from the secretariat. The meeting date and time were consulted.

Even though each instrument considered prior consent to respond, the voluntary and anonymous nature was once again reinforced.

The protocol of this study was approved by the Institutional Ethics Committee and was conducted following the guidelines established by the modified Declaration of Helsinki.

RESULTS AND DISCUSSION

The results obtained for the variable contributions of clinical simulation in the professional image dimension showed that, of the 90 nursing students surveyed, 39,78 % responded that clinical simulation provided them with skills, followed by 38,67 % who provided security, 12,71 % expressed that it improved professional identity and 8,84 % that it contributed to communication.

The most representative contributions of clinical simulation are abilities and security in skills. But it also constitutes their identity based on the professional activities they perform, to later assume their belonging to the group of professionals, since it is in the confrontation with the workspace or in the imitation of the same in simulated environments where they recognize their profession.⁽²⁾

Although resolving the clinical situation is the fundamental objective, Costa⁽³⁾ considered the attitude in the simulation beneficial since it could condition learning and the entire ambo. Other authors⁽⁴⁾ state that attitudinal changes are caused that influence their clothing, which is later developed in the projection of the professional image.

Regarding the identity indicator, 69,03 % responded that the contributing factors are the execution of techniques before hospital practice in the simulation centre, followed by 26,55 % who expressed that attending the clinical simulation centre collaborates in the construct of professional identity. 3,54 % do not know, and 0,88 % prefer not to answer.

Professional identity manifests when the role is assumed and can be exercised in a personalized way, with personal commitment and creativity.⁽⁵⁾ It begins when the subject comes into contact with higher education institutions and is related to recognized members within the professional field.⁽²⁾

For the communication indicator, the students surveyed responded that the clinical simulation contributed to having proprietary communication in 51,72 %, followed by 43,97 % who provided scientific terminology to their communication, 2,59 % who did not know and 1,72 % who preferred not to answer.

Martinez Martillo et al.⁽⁶⁾ considered it beneficial since the clinical simulation is critical to developing their interrelationships with the rest of the professionals and as an experience for correctly using well-founded terms. Authors⁽⁷⁾ considered it an indicator to determine the professional image perceived by third parties since it expresses the health team's ways of acting and thinking, according to gestures, tone of voice and manners.

Finally, for the profile indicator and its clothing sub-indicator, 52,63 % responded that it is important to resolve a clinical situation in the simulation. 31,58 % expressed that the fundamental thing is to have initiative, and 15,79 %, considered it important to use the full ambo during clinical simulation.

Although the resolution of the clinical situation is the fundamental objective to achieve, Cesar Costa⁸ considered the attitude in the simulation beneficial since it could condition the learning and the complete ambo. Authors⁽⁹⁾ considered that they produce attitudinal changes that influence their clothing, which are later developed in the projection of the professional image.

For the behavior sub-indicator, 63,33 % considered that the clinical situation presented in the simulation does condition their way of acting, followed by 26,67 % who do not, 6,67 % who do not know and 3,33 % who preferred not to answer.

Developing this practice helps the participants achieve or maintain good performance in the future, a permanent change in their behavior.⁽¹⁰⁾ The professional's work conditions and behaviour significantly affect their professional image.⁽¹¹⁾ Coinciding with Maestre⁽¹²⁾, who assures that she gave him security when making decisions and carrying out procedures both in calm and stressful situations.

Regarding the last sub-indicator, attitude, 61,11 % of respondents answered that sometimes they have the initiative to participate in the clinical simulation, followed by 37,78 % who always do and 1,11 % who do not know.

Rodríguez et al.⁽¹³⁾ affirmed that the student develops and demonstrates punctuality, initiative, participation, respect and uniformity to the extent that these simulations are carried out. Coincidently, Mejías⁽¹⁴⁾ considers the simulation beneficial for producing positive attitudinal changes due to the students' proactivity, enthusiasm and interest.

This study aimed to disseminate the contributions of clinical simulation that strengthen the professional image in the Instituto Universitario Hospital Italiano de Buenos Aires nursing career.

Although the sample consisted of 90 students and the method was descriptive, the results showed that it gave them 38,67 % ability and 39,78 % security. These results are close to a quasi-experimental study conducted at the Hermilio Valdizan National University (Peru) in 2016 with 126 nursing students, demonstrating significant results in the simulator group. The above resulted in benefits for the patient’s development of skills and strengthening of safety procedures.

Both results align with what George Miller points out when discussing the four competence acquisition dimensions. The first two levels of the pyramid's base are knowledge (know) and how to apply it (know-how) to move on to the higher level of showing how in a simulated environment.

CONCLUSIONS

It was possible to identify in the students that the clinical simulation in the simulation center provided them with skill, security and professional identity.

Using the complete uniform in the simulations added to the construction of the professional image since it produced attitudinal changes that influence the clothing and that a posteriori are projected by the image.

It is considered that carrying out these activities contributes to the formation of the students' professional identity since it produces improvements in the way of communicating and in the resolution of clinical situations, thus improving their profile and, subsequently, image.

In this attitude, simulation improves the initiative and encourages interest and desire to participate. Finally, the correctly equipped areas have achieved weight changes in the student's abilities, from technical skills to the projection of their image as future professionals, allowing them to participate in areas similar to jobs.

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FINANCING

None.

CONFLICT OF INTEREST

There are no conflicts of interest.

AUTHORSHIP CONTRIBUTION

Conceptualization: Shirley Tumiri, Luis Duran, Johanna Lin, Norma B. Ríos, Ana Mosca, Teresa Gómez.

Research: Shirley Tumiri, Luis Duran, Johanna Lin, Norma B. Ríos, Ana Mosca, Teresa Gómez. Ríos, Ana Mosca, Teresa Gómez.

Methodology: Shirley Tumiri, Luis Duran, Johanna Lin, Norma B. Ríos, Ana Mosca, Teresa Gómez. Ríos, Ana Mosca, Teresa Gómez.

Formal analysis: Shirley Tumiri, Luis Duran, Johanna Lin, Norma B. Ríos, Ana Mosca, Teresa Gómez. Ríos, Ana Mosca, Teresa Gómez.

Writing - original draft: Shirley Tumiri, Luis Duran, Johanna Lin, Norma B. Ríos, Ana Mosca, Teresa Gómez. Ríos, Ana Mosca, Teresa Gómez.

Writing - proofreading and editing: Shirley Tumiri, Luis Duran, Johanna Lin, Norma B. Ríos, Ana Mosca, Teresa Gómez. Ríos, Ana Mosca, Teresa Gómez.