Comparison of the Diagnostic Accuracy of Undergraduate Students and Nurses in Residency Programs

Abstract

Objetivos: comparar o grau de acurácia diagnóstica entre estudantes do último ano de graduação em ENFERMAGEM e de enfermeiros residentes, e estimar a associação entre o grau de acurácia diagnóstica e o grau de contato com processo de enfermagem, diagnóstico de enfermagem, raciocínio clínico e o grau de habilidade em estabelecer diagnósticos de enfermagem. Método: trata-se de estudo descritivoexploratório transversal. Participaram 65 sujeitos, dos quais: 27 graduandos do último ano de Enfermagem, 19 enfermeiros residentes do primeiro ano e 19 do segundo ano. Utilizaram-se dois instrumentos: caracterização dos participantes e caso clínico. O grau de acurácia diagnóstica foi avaliado por meio da Escala de Acurácia de Diagnósticos de Enfermagem -versão 2. Os dados foram analisados por meio de estatística descritiva e inferencial. Resultados: os participantes tinham idade média entre 22 e 26 anos e a maioria era do sexo feminino. Não houve diferença estatisticamente significativa quanto à habilidade autorreferida para estabelecer diagnósticos de enfermagem e grau de contato com processo de enfermagem, diagnósticos de enfermagem e raciocínio clínico nos âmbitos teórico e prático. Verificou-se que os residentes do segundo ano identificaram número significativamente menor de diagnósticos de baixa acurácia. Conclusão: os resultados sugerem que os programas de residência contribuem para melhorar a acurácia diagnóstica. Palavras-chave: Diagnóstico de Enfermagem; Enfermagem; Capacitação em Serviço. ABSTR ACTObjectives: to compare the level of diagnostic accuracy between students attending the last undergraduate year in Nursing and nursing residents, and to estimate the association between the level of diagnostic accuracy and the degree of familiarity with the nursing process, diagnosis, clinical reasoning, and the ability degree to establish nursing diagnoses. Method: this was a cross-sectional descriptive and exploratory study. The 65 participating subjects were 27 undergraduates attending the last year of nursing school, 19 first year resident nurses, and 19 second year resident nurses. Two instruments were used: characterization of participants and clinical case. The degree of diagnostic accuracy was evaluated by the Escala de Acurácia de Diagnósticos de Enfermagem (Accuracy Scale of Nursing Diagnoses) -Version 2. Data were analyzed through descriptive and inferential statistics. Results: the mean age of participants varied from 22 to 26 years and most were females. There was no statistically significant difference regarding the self-reported ability to establish nursing diagnoses and the degree of clinical contact with the nursing process, diagnoses, and clinical reasoning in the theoretical and practical contexts. It was observed that the second year residents identified a significantly smaller number of low accuracy diagnoses compared to the other participants. Conclusion: the results suggest that the residency programs contribute to improving diagnostic accuracy.

Acurácia dos diagnósticos de enfermagem de uma instituição de cardiologia

“…A similar result was found in a study that evaluated the Nursing diagnoses of undergraduates and Nursing residents where the students enrolled significantly more number of ND than the residents. 10 It was also verified that, the greater the number of participation in Clinical Visit, the smaller number of diagnoses are raised and less diagnoses of low or zero accuracy are listed.…”

“…2,10-11-12 A study conducted with undergraduate students and Nursing residents of the first and second years of Nursing residency at a public university in São Paulo showed that Nursing residents of the 2nd year registered a lower number of ND with low accuracy due to the longer inservice training. 10 A study was conducted by researchers with the objective of evaluating the accuracy of the diagnosis of acute pain in hospitalized children in the period before and after the implementation of an inservice training program. The Nursing diagnosis investigated showed moderate / high accuracy during the study period, but four months later the accuracy became prevalent low / null.…”

“…Knowledge about the diagnostic process is improved and the reliability of clinical studies on Nursing diagnoses is increased by the use of reliable and validated methods to measure the accuracy of Nursing diagnoses. 15 NDAS-2 is used in several studies 1,[10][11]15 showing the efficacy in determining the degree of accuracy of the nursing diagnoses. In-service training is a strategy that is effective in improving nurses' performance.…”

Evaluation of the Accuracy of Nursing Diagnoses Determined by Users of a Clinical Decision Support System

“…Benner (2001) emphasized that educational level and years of professional experience may influence nurses’ ability to make clinical judgments. In fact, as evidenced by other researchers, second‐year resident nurses identified a lower number of diagnoses with low accuracy in comparison with first‐year resident nurses and undergraduate nursing students (Oliveira & Silva, 2016).…”

“…These skills may be learned and developed, so that the ability to make judgments with accuracy may be enhanced by means of teaching and practice (Carvalho et al, 2017; Oliveira & Silva, 2016). Benner (2001) emphasized that educational level and years of professional experience may influence nurses’ ability to make clinical judgments.…”