Script concordance test: uma proposta de avaliação do raciocínio gerencial da enfermagem em situações de incertezas
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Data
2016-03-02
Autores
Borges, Paulo Fernando Barcelos [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os enfermeiros integram a equipe de saúde, e como tal lidam com situações que exigem do profissional a necessidade de raciocínio clínico e tomada de decisões clínicas e gerenciais com o propósito de prevenir, minimizar e estabilizar situações. Neste contexto, o raciocínio clínico surge como um processo contínuo onde o profissional age com a intencionalidade de alcançar melhores resultados e melhoria da assistência de enfermagem. A falta de instrução e instrumentalização do raciocínio clínico na graduação contribui de forma efetiva para a deficiência de instrumentos de avaliação desta competência. Sendo assim, existe a necessidade de instrumentos capazes de avaliá-la em situações de incertezas. O método de concordância de scripts trouxe uma nova perspectiva para avaliar as tomadas de decisões nestas situações, utilizando o Script Concordance Test (SCT). O SCT é um teste escrito, que apresenta cenários clínicos da vida profissional, com circunstâncias permeadas de informações incompletas, complexas, com lacunas e um alto grau de incerteza. Mediante levantamento literário identificou-se uma lacuna nos aspectos de eficiência na avaliação tanto do raciocínio clínico quanto do raciocínio para o processo decisório gerencial. Essa lacuna aliada à vivência do pesquisador na docência do curso de graduação em enfermagem despertou o interesse em responder o seguinte questionamento: O SCT pode contribuir para a instrumentalização do raciocínio na dimensão do gerenciamento na graduação em enfermagem? O objetivo deste estudo foi desenvolver, aplicar e analisar um instrumento de avaliação do raciocínio gerencial em situações de incerteza, em língua portuguesa, baseado no teste de concordância de scripts (SCT). Trata-se de um estudo transversal com análise quantitativa por meio da estatística descritiva e analítica. Foi elaborado, com apoio de especialistas (painel de questões), um instrumento baseado na teoria de concordância de scripts, em forma de casos reais na dimensão do gerenciamento em enfermagem. O instrumento foi aplicado a estudantes de um centro universitário no interior do Estado de São Paulo e para especialistas em gerenciamento em enfermagem (painel de referência). Os resultados demonstraram a construção do instrumento do SCT para o gerenciamento de Enfermagem com 20 cenários e 100 situações que constituem o produto dessa dissertação. A aplicação do instrumento aos especialistas gerou um painel de referência que foi norteador para comparação das respostas obtidas pelos estudantes. A análise estatística evidenciou a confiabilidade dos dados, com alfa de Cronbach de 0,95. O SCT mostrou-se com boa aplicabilidade para avaliar o raciocínio gerencial da enfermagem no contexto de incertezas, sendo o instrumento construído uma importante ferramenta para incorporar o estudante às situações práticas e reais das dinâmicas gerenciais pertinentes a atuação profissional do enfermeiro.
Nurses are part of the health team, and as such deal with situations that require professional the need for clinical reasoning and making clinical and managerial decisions in order to prevent, minimize and stabilize situations. In this context, clinical reasoning appears to be an ongoing process where the professional acts with the intention to achieve better results and improved nursing care. The lack of education and instrumentalization of clinical reasoning in graduation contributes effectively to the disability evaluation that power tools. Thus, there is a need for instruments to evaluate it uncertainties situations. The Script Concordance method brought a new perspective to assess decision making in these situations, using the Script Concordance Test (SCT). The SCT is a written test that has clinical scenarios of working life, permeated with circumstances of incomplete, complex information with gaps and a high degree of uncertainty. By literary survey identified a gap in the aspects of efficiency in evaluating both the clinical reasoning as the rationale for management decision making. This gap coupled with the experience of the researcher in teaching the undergraduate nursing course sparked interest in answering the question: The SCT can contribute to the exploitation of the reasoning in the dimension of management in nursing graduation? The objective of this study was to develop, implement and analyze an evaluation tool of managerial reasoning under uncertainty, in English, based on the script concordance test (SCT). It is a cross-sectional study with quantitative analysis using descriptive and analytical statistics. It was developed with the support of experts (issues panel), an instrument based on the agreement of theory of scripts in the form of real cases in the dimension of management in nursing. The instrument was applied to students of a university in the State of São Paulo and nursing management experts (reference panel). The results demonstrated the construction of the SCT tool for nursing management with 20 sets and 100 situations that are the product of this dissertation. The application of the instrument to specialists generated a reference panel that was guiding to compare the responses obtained by the students. Statistical analysis showed the reliability of the data, with Cronbach's alpha of 0.95. The SCT showed up with good applicability to assess the managerial reasoning of nursing in the context of uncertainty, and the instrument built an important tool to incorporate the student to practical and real situations of management dynamics relevant professional work of nurses.
Nurses are part of the health team, and as such deal with situations that require professional the need for clinical reasoning and making clinical and managerial decisions in order to prevent, minimize and stabilize situations. In this context, clinical reasoning appears to be an ongoing process where the professional acts with the intention to achieve better results and improved nursing care. The lack of education and instrumentalization of clinical reasoning in graduation contributes effectively to the disability evaluation that power tools. Thus, there is a need for instruments to evaluate it uncertainties situations. The Script Concordance method brought a new perspective to assess decision making in these situations, using the Script Concordance Test (SCT). The SCT is a written test that has clinical scenarios of working life, permeated with circumstances of incomplete, complex information with gaps and a high degree of uncertainty. By literary survey identified a gap in the aspects of efficiency in evaluating both the clinical reasoning as the rationale for management decision making. This gap coupled with the experience of the researcher in teaching the undergraduate nursing course sparked interest in answering the question: The SCT can contribute to the exploitation of the reasoning in the dimension of management in nursing graduation? The objective of this study was to develop, implement and analyze an evaluation tool of managerial reasoning under uncertainty, in English, based on the script concordance test (SCT). It is a cross-sectional study with quantitative analysis using descriptive and analytical statistics. It was developed with the support of experts (issues panel), an instrument based on the agreement of theory of scripts in the form of real cases in the dimension of management in nursing. The instrument was applied to students of a university in the State of São Paulo and nursing management experts (reference panel). The results demonstrated the construction of the SCT tool for nursing management with 20 sets and 100 situations that are the product of this dissertation. The application of the instrument to specialists generated a reference panel that was guiding to compare the responses obtained by the students. Statistical analysis showed the reliability of the data, with Cronbach's alpha of 0.95. The SCT showed up with good applicability to assess the managerial reasoning of nursing in the context of uncertainty, and the instrument built an important tool to incorporate the student to practical and real situations of management dynamics relevant professional work of nurses.
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Palavras-chave
Educação superior, Avaliação em enfermagem, Gestão em saúde, Tomada de decisões gerenciais, Higher education, Nursing assessment, Health management, Making management decisions