Using the Reflective Journal to Improve Practical Skills Integrating Affective and Self-Critical Aspects in Impoverished International Environments. A Pilot Test
2. Materials and Methods
2.1. Study Sample
2.2. Study Design
2.3. Variables and Data Collection
- 1st phase: They freely think about an aspect or category including feelings and emotions, as well as thoughts that emerged after the practices.
- 2nd phase: They deepen their knowledge and daily learning by analyzing specific situations and cases.
- 3rd phase: Discussion with the tutor on a weekly basis, where the student exposes what they have registered in the RPJ, and a critical dialogue is created to correct the aspects to improve and optimize the progression in the acquisition of knowledge.
2.4. Data Analysis
2.5. Ethical Aspects
3.1. Category “Nursing Procedures”
“It has caught my attention how they can perform procedures with everyday objects in the absence of others”, “from a plastic bottle how an air chamber is created for the administration of salbutamol. In cases of scarcity of resources, imagination is a tool to solve them” (ASJ).“Today we have treated people in their homes, pure and simple nursing, we have seen that they need a lot of help. Young people are unconcerned about their elders, and it is the neighbours who are attentive to their needs. The human quality is present in those moments” (JS).“In home visits, it is necessary to create a calm climate that allows fluidity and comfort to be more efficient.” “If at the moment it’s observed that there is little coordination, it’s necessary to change the way of doing things to be more productive” (ASJ).“I have learned that, despite the most extreme poverty, they are happy with their families”(AMG).
3.2. Category “Social Context”
“You have to adapt to their way of life, language, lifestyle, customs, everything. Not only to integrate into society, but so that the patient is comfortable when he is cared for” (ASJ).“Accustomed, possibly to a more agile health system and with much shorter response times, I believed that they would have a short wait to be transferred to a hospital” (JS).“People there are abandoned by the government, because being a less accessible area, it is not taken into account and they are displaced” (AMG).“The ease of accessing antibiotics without a prescription means that in a few years there will be multi-resistance to antibiotic therapy” (PE).“I was struck by the lack of resources, the willingness of people to attend a talk immediately. That antibiotics are sold in the market without any type of control” (AM).
3.3. Category “Motivation”
“Neither I nor any of my colleagues would be here if it weren’t for something moving inside us that makes us want to discover more and go a little further” (PE).“I feel very motivated and excited to do nursing interventions here, see the differences and learn from them” (NS).“Leaving the routine, starting to work out of the ordinary, beyond nervousness, fear and other sensations related to contact with the unknown, a new stage is usually driven by motivation” (AC).“The faces of the children and mothers motivate me to continue learning, working and fighting for what I like the most, which is nursing” (JS).“I attended a delivery and the mother asked my permission to put my name on her daughter, I can’t stop crying, I don’t fit the happiness I feel. Thank you life, thank you, Peru, thank you, Mayte, thank you to my parents for giving me the opportunity to live... and thank you WORLD” (JS).“You want to learn absolutely everything possible.” (BG)
3.4. Category “Attention to the Community”
“It has been difficult, at times, to pass scales to illiterate people since they answered yes or no without any criteria. This situation made me feel frustrated” (BG).“I consider it essential to make an effort to empathize and offer confidence to obtain more reliable data when filling in rating scales” (ASJ).“Thanks to the domiciliary, we were able to see what needs the patients had and we elaborated care plans adapted to them” (PE).“Thanks to the theoretical and practical knowledge of the 4 years of career plus acquired knowledge, I tried to explain and put into practice the healthy lifestyle to different people. Also, those who suffered from chronic diseases and vulnerable people (the elderly, children, pregnant women, etc.)” (BG).
3.5. Category “Learning”
“From the first moment I have felt autonomy, from the moment I receive the patient until I say goodbye to them” (BG).“I have filled out rating scales keeping an order. At first, I needed help due to my lack of experience, little by little I have been acquiring more practice. These records help us to know in what situation the population is and to be able to plan appropriate interventions to the needs” (JS).“Due to the shortage of material, we had to perform a slightly modified technique” (AM).“I have learned to offer recommendations, talks, to be more imaginative, more empathetic without expecting anything in return and to offer all the help that was within my reach” (NS).“We have specifically planned care, taking into account the situation of people in all areas” (AC).
3.6. Category “Teamwork”
“They began to trust us when they saw that we were asserting ourselves. With the staff of the health centre, the work and communication have been very good, we were a team, without distinctions” (PE).“I have tried to make an effort to work as a team by maintaining adequate communication. I have to try harder, because the irrational fear of not doing the job correctly prevents me at times” (ASJ).“Throughout the trip, I was improving communication both with colleagues and patients, their families and various social groups. Thanks to the help of my classmates, I increased my social skills” (BG).“Teamwork and collaboration of all health personnel in the different activities carried out at the health post is very important. The work of each one of us is fundamental in the service to the community” (JS).
3.7. Category “Suggestions for Improvement”
“It would be convenient to work on women’s health issues with the general population and not only with the midwives of each community, although it is a taboo subject in that area of Peru” (ASJ).“This practicum would improve only by increasing the hours, if possible, of home care, which could allow covering a greater number of elderly people, in our case, for the study of their situation in the Requena community; in addition to trying to promote health education through health campaigns in a greater number of areas, mainly in those that are furthest from civilization” (AC).“Improve communication prior to mobility with the personnel responsible for the health centre, due to the complexity and ignorance and the needs of the population” (ASJ).“In the tutorials that take place before the next trip with the students, I would invite some (or all) of us who have gone this year to have student-to-student referrals. I think it is beneficial” (JS).“Eliminate the memory of practices and keep only the reflective diary since it consists of the daily monitoring of our practices and implies constancy and shows aspects beyond the usual ones of a memory, such as personal evolution, feelings that arise in this experience. The value of the newspaper is much higher since it allows us to fully assess this experience and not in a general way” (NS).
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Nursing procedures||Mastery of nursing procedures|
Acquisition of new concepts
Demand for information
Deficiencies found in oneself
|Social context||Observation of the international context of internships|
Proactive attitude to learn
|Attention to the community||Communication with the individual and his family. Comprehensive care for the community|
Promoting community health through interventions
Control of health risks through detection and prevention
|Learning||Continuous ability to learn autonomously|
Problems encountered and ability to solve them
Skills and knowledge
Make nursing records
Forecast of the necessary material prior to the practice
|Teamwork||Effort to work as a team|
Active participation in tasks
Skills for interpersonal relationships
Acceptance of criticism
|Suggestions for improvement||Proposals|
|Name of Evaluated Student: ____________________________________________________________Date: __/__/__|
|Evaluating Student Name:|
|Knowledge and Skills||Strongly Agree||Agree||Neutral||Disagree||Strongly Disagree||Total Score|
|Provides technical and professional health care appropriate to the health needs of the people served|
|Is capable of planning and providing nursing care directed to individuals, families, or groups, oriented towards health outcomes|
|Is able to understand the interactive behavior of the person based on gender, group, or community, within their impoverished and multicultural social context|
|Designs care plans directed at individuals, families, or groups, evaluating their impact and establishing the appropriate modifications in real time|
|Promotes healthy lifestyles, self-care, supporting the maintenance of preventive and therapeutic behaviors|
|Establish effective communication with patients, family, social groups, and colleagues, and promote health education fluently|
|Make good use of available resources|
|I have observed if there is collaboration between the different sectors of the health community and the social environment|
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Murillo-Llorente, M.T.; Navarro-Martínez, O.; Valle, V.I.-d.; Pérez-Bermejo, M. Using the Reflective Journal to Improve Practical Skills Integrating Affective and Self-Critical Aspects in Impoverished International Environments. A Pilot Test. Int. J. Environ. Res. Public Health 2021, 18, 8876. https://doi.org/10.3390/ijerph18168876
Murillo-Llorente MT, Navarro-Martínez O, Valle VI-d, Pérez-Bermejo M. Using the Reflective Journal to Improve Practical Skills Integrating Affective and Self-Critical Aspects in Impoverished International Environments. A Pilot Test. International Journal of Environmental Research and Public Health. 2021; 18(16):8876. https://doi.org/10.3390/ijerph18168876Chicago/Turabian Style
Murillo-Llorente, María Teresa, Olga Navarro-Martínez, Vanessa Ibáñez-del Valle, and Marcelino Pérez-Bermejo. 2021. "Using the Reflective Journal to Improve Practical Skills Integrating Affective and Self-Critical Aspects in Impoverished International Environments. A Pilot Test" International Journal of Environmental Research and Public Health 18, no. 16: 8876. https://doi.org/10.3390/ijerph18168876