“Health-Environment Integrated Panel” in Nursing Education: a Descriptive Study Online Brazilian Journal of Nursing, Vol

Online Brazilian Journal of Nursing E-ISSN: 1676-4285 [email protected] Universidade Federal Fluminense Brasil

de Abreu Moniz, Marcela; Manhães Pereira, Jaqueline; Simão Marques, Thamires An Evaluation of the use of Educational Technology, the “Health-Environment Integrated Panel” in nursing education: a descriptive study Online Brazilian Journal of Nursing, vol. 15, núm. 3, 2016, pp. 466-471 Universidade Federal Fluminense Rio de Janeiro, Brasil

Available in: http://www.redalyc.org/articulo.oa?id=361453978014

How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ISSN: 1676-4285

An Evaluation of the use of Educational Technology, the “Health- Environment Integrated Panel” in nursing education: a descriptive study

Marcela de Abreu Moniz1, Jaqueline Manhães Pereira1, Thamires Simão Marques2

1 Federal Fluminense University 2 City Hall of Rio de Janeiro

ABSTRACT Aim: To evaluate the use of educational technology, the “Health-Environment Integrated Panel” with nursing graduates. Method: This is a descriptive, evaluative research, of a qualitative approach, conducted through a questionnaire with 18 nursing students of Rio das Ostras campus, of the Federal Fluminense University in May 2015. The data received analytical treatment that included exploration, organization and interpretive synthesis. Results: The results show the usability of technology and good ability to generate reflection, interaction and motivation for learning about the dynamics of the health-disease process resulting from socioenvironmental changes in the territory, and the ethical and political attitudes of nurses front these issues. Discussion: With the use of educational technology in this scenario, it was possible to implement a creative and stimulating practice of teaching, which involved action-reflection on various aspects of observed reality, favoring significant learning on the health-environment relationship in the training space of nurses. Conclusion: We suggest adjustments and validation of the aforementioned technology.

Descriptors: Educational Technology; Environmental Health; Students, Nursing.

Moniz MA, Pereira JM, Marques TS. An Evaluation of the use of Educational Technology, the “Health-Environment Integrated 466 Panel” in nursing education: a descriptive study. Online braz j nurs [internet] 2016 Sept [cited year month day]; 15 (3):466-471. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/5421 INTRODUCTION Based on this, our study is relevant regarding the contribution to changes in educational The literature on the use of educational practices that result in student empowerment technologies in the training area in nursing for action in education and nursing care, in discusses their applicability in various situa- line with an ecological ideal, of dignity, justice tions involving teachers, monitors, and nursing and social commitment and ethics in health students(1). promotion. The objective of this study is to In the nursing education area, proponents evaluate the use of educational technology have considered educational technology as a set “Health-Environment Integrated Panel” with of mediators devices of the teaching-learning nursing students. process that must contain a logical organization, so that they can be systematically planned, observed, understood and transmitted. In addition, METHOD the technology, while material, should also be recognized as an important component in the It is evaluative, descriptive research with educational work, and should be seen as a fa- a qualitative approach. The evaluation of an cilitator, which together with other strategies, action or educational process is understood as make the most complete educational system an integrated methodology to the dynamics of in its planning and execution. Thus, educational this process, which allows us to obtain useful in- technology can be characterized as a process or formation to judge it. In this study, an evaluation product(2). of environmental health education technology However, educational technologies have was based on a dialogical and dialectic perspec- been used many times without proper syste- tive(7), implying that the understanding of the matization and evaluation(1). In the Brazilian difficulties of the students may come from the scenario on environmental health education perception and participation by those involved. in nurse training, no studies were found that The technique used was a self-report ques- use and evaluate educational technologies in tionnaire, which was developed based on the socioenvironmental teaching practices. study of Sabóia et al(8). The study participants Environmental education becomes an were 18 students enrolled in courses of the important nurse’s working instrument in the last semester of the second year of the nursing contemporary socioenvironmental problems undergraduate course at the Institute for Huma- and their impact on public health(3,4). Thus, there nities and Health, Rio das Ostras Campus/UFF, are increasing demands for nurse training with who participated in the use of this technology specific skills aimed at education, coping and risk in May 2015. management in environmental health(5). The technology, called the “Health-Environ- Following this line of thought, it is consi- ment Integrated Panel” represents a proposal dered that educational technology can be used for an active methodology of teaching and for knowledge and reflection of the complexity learning about the resonance of socioenviron- of anthropogenic environmental problems, mental changes in the health-disease process seeking to instill in students a broad and critical in a territory. understanding of environmental interrelations The methodological steps of the applica- with man, and its effects to human health(6). tion of technology are described below.

Moniz MA, Pereira JM, Marques TS. An Evaluation of the use of Educational Technology, the “Health-Environment Integrated Panel” in nursing education: a descriptive study. Online braz j nurs [internet] 2016 Sept [cited year month day]; 15 (3):466-471. 467 Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/5421 At first, the participants visited a territory The research project was approved by the that had experienced profound changes and Ethics Committee in Research at the Univer- socioenvironmental conflicts, as well as an ex- sity Hospital Antonio Pedro of UFF, under n ° pansion of health risks to communities arising 1,585,527. from the process of building the Petrochemical Complex of Rio de Janeiro (COMPERJ)(9). This scenario was the municipality of Itaboraí, one RESULTS of the poorest areas of the metropolitan region of the state of Rio de Janeiro, with a human de- The sample of subjects was composed of velopment index of 0.693 (9). 18 nursing students aged between 19-38 years, In a second step, the contextualization of being 16 females and two males. reality was portrayed in the classroom environ- The technology has been well evaluated by ment by participants and researchers. Therefore, the students, since 13 participants attributed the educational technology was developed from the “good” concept to it and five attributed the term construction of an integrated panel with pictures “regular”. Some limitations, which were identi- and descriptions of problem situations, which fied by the students, referred to the distance tra- were encountered during the visit carried out veled, the university vehicle, and the restriction with students in the surrounding areas of COM- on access roads to the place of the enterprise PERJ so that participants could relate them to construction during the visit to the field. the environmental and health impacts observed Among the positive aspects pointed out in the field. by all students on the usability of educational At the end of the meeting, the participants technology included: the relevance of techno- who agreed to participate in the study signed logy to stimulate interest, reflection and student the Informed Consent and completed the ques- participation in a relaxed way, allowing the use tionnaire of assessment of the technology, which of existing knowledge and the clarification of contained the following questions: Between questions of students; the opening space for very good, good, fair, poor and without opinion, the apprehension of new knowledge about the which concept would you give to educational socioenvironmental issues addressed; refer to technology? Did the technology favor reflection? other colleagues to participate in the technolo- Were the issues of interest to you? Did you feel gy; and the suggestion to reproduce it at another at ease during the group? Would you indicate to times in the academic education of nurses. other colleagues to participate in the same kind The data showed that the Health-Environ- of educational technology? What did you most ment Integrated Panel enabled the expression like about the activity? What did you like least of the students, on their own terms, of points about the activity? Suggestions. of view, beliefs, attitudes and representations, For the data analysis, an analytical inter- as well as exchanges of ideas, values and expe- pretation strategy was adopted(10), fulfilling riences, based on field observation, photos and the steps of: comprehensive reading material; interaction between participants. organization of data, following the grouping Regarding the consideration of the content logic instrument issues; identifying characte- covered, 16 academics said that the technology ristics of the material; and the development of was able to promote reflection, considering the interpretive synthesis. interactive and well prepared in its method of

Moniz MA, Pereira JM, Marques TS. An Evaluation of the use of Educational Technology, the “Health-Environment Integrated 468 Panel” in nursing education: a descriptive study. Online braz j nurs [internet] 2016 Sept [cited year month day]; 15 (3):466-471. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/5421 teaching because it was able to stimulate the in environmental health, given the identi- autonomy and motivate the learning of specific fied difficulties and gaps in other studies to content and other transversal to the various overcome a fragmented socioenvironmental disciplines of the course curriculum in question, approach, reductionist, dichotomous and dis- such as the ethical and political attitudes of continuous in undergraduate nursing curricula nurses and social participation in deliberative in Brazil (4,12). spaces on health and the environment. In this sense, technology encouraged the students to reflect on local environmental issues and its association with health risks DISCUSSION and, moreover, facilitated the deepening of discussions on the ethical-political positioning The dynamic and creative nature of the of the population and the nurse as a essential technology “Health-Environment Integrated assumption for the change of these issues Panel” encouraged the participation of young because it was identified strong interest of students in an intense way, relaxed and interac- students to share and discuss social and en- tive in the action-reflection steps on different vironmental values. aspects of the observed reality, favoring ex- Thus, the educational process has collabo- changes of knowledge about the relationship rated in the development of professional skills health-environment. based on the increasing exercise of autonomy, Within the training scenarios of the nurses, citizenship and social commitment (13). the characteristic of promoting students’ active One study(14) found that the healthca- participation is seen as essential to problemati- re students did not realize that it is health zing pedagogical practice, since it provides the professional’s responsibility to search for healthy dialogue, meaningful learning and empowering environments, urging a discussion on this topic of the student (11). in the training areas of these professionals. The data shows also that the use of the In occasion of an environmental education Health-Environment Integrated Panel allowed that changes attitudes and behavior, we must the approach from theory to practice, from the expand the academic spaces to the interior of questioning of everyday socioenvironmental the communities and seek pedagogical practices and health situations of the nurse’s work, which which encourage students’ understanding of require these professional, management and how different social groups and classes produce, care competencies for care under the new pa- organize and transform the living environments radigm ecosystemic in health(9). according to their interests, positions and power The current problems of the reality expe- relations (15). rienced by students can be used as elements It appeared that the understanding of the constituting innovative teaching strategies, socio-political organization of individuals and optimizing the teaching-learning process on population groups by the students, and how environmental health in nurse training(5). they face the socioenvironmental complex si- Arise in this study, the active methodolo- tuations in the territories, are premises for the gy of problematization, substantiated by the discussion of values and the ethical and social theoretical-philosophical framework of Paulo commitment of nurses related to health promo- Freire, as a promising pedagogical practice tion and sustainability of life (5).

Moniz MA, Pereira JM, Marques TS. An Evaluation of the use of Educational Technology, the “Health-Environment Integrated Panel” in nursing education: a descriptive study. Online braz j nurs [internet] 2016 Sept [cited year month day]; 15 (3):466-471. 469 Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/5421 CONCLUSION 3. Lopes M, Ximenes L. Enfermagem e saúde ambiental: possibilidades de atuação para a promoção da saúde. Rev Bras Enferm [Inter- We conclude that the main objectives of net]. 2011 Feb [cited 2016 Aug 03] ; 64( 1 the technology “Health-Environment Integrated ): 72-77. Available from: http://www.scielo. Panel” were achieved, since the results showed a br/scielo.php?script=sci_arttext&pid=S0034- positive evaluation of the educational process, -71672011000100011&lng=en. usability and a good ability to generate reflec- 4. Bruzos GAS, Kamimura HM, Rocha AS, Jor- tion, autonomization and motivation of the getto TAC, Patrício KP. Meio ambiente e en- nursing student for learning about socioenviron- fermagem: suas interfaces e inserção no ensino de graduação. Saude soc [Internet]. mental and health issues, skills and ethical values 2011 June [cited 2016 Aug 03]; 20(2):462- of the nurse for ecological care and health care. 469. Available from: http://www.scielo.br/ However, it was identified that the tech- scielo.php?script=sci_arttext&pid=S0104- nology needs adjustments in the first step of -12902011000200017&lng=en. explanation to the target audience on all stages 5. Leffers JM, Smith CM, McDermott-Levy R, Resick of the process, considering objectives, questions LK, Hanson MJ, Jordan LC et al. Developing cur- and expectations of the field visit, including the riculum recommendations for environmental health in nursing. Nurse Educ. 2015; 40(3): 139-43. logistics of this activity. 6. Stanley MJ, Rojas D. Teaching undergraduate Thus, considering the limitations of this nursing students about environmental health: evaluative research in terms of the development addressing public health issues through simula- of an experimental methodological process for tion. J Nurs Educ. 2014; 53(1): 58-51. environmental health education with nursing 7. Minayo MCS, Assis SG, Souza ER. Avaliação graduates and techniques of survey and data por triangulação de métodos: Abordagem de analysis, it is suggested that the validation of the Programas Sociais. 4 ed. Rio de Janeiro: Editora Fiocruz; 2014. relevant technology, glimpsing the reproducibi- 8. Sabóia VM, Moniz MA, Daher DV, Rangel ET, lity of this resource in theoretical and practical Moura JMB, Sá FC. Communication dynamics: teaching practices on the health-environment evaluation of educational technology with col- relationship in nurse formative scenarios. lege nursing students. Rev Enferm UERJ. 2016; 24(1): e7849. 9. Moniz MA, Carmo CN, Hacon SS. Perception of REFERENCES environmental quality of nearby localities to the Petrochemical Complex of Rio de Janeiro, Brazil. Ciênc saúde coletiva. 2016; 21(6): 1871-1878. 1. Braga CSR, Andrade EMLR, Luz MHBA, Monteiro 10. Gomes R, Souza ER, Minayo MCS, Malaquias JV, AKC, Campos MOB, Silva FMS, et al. Construction Silva CFR. Organização, processamento, análise and validation of a virtual learning object on e interpretação de dados: o desafio da triangula- intestinal elimination stoma. Invest Educ Enferm ção. In: Minayo MCS, Assis SG, Souza ER. Avaliação [Internet]. 2016 Apr [cited 2016 jul 03]; 34(1), por triangulação de métodos: Abordagem de 120-127. Available from: http://www.scielo.org. Programas Sociais. 4 ed. Rio de Janeiro: Editora co/scielo.php?script=sci_arttext&pid=S0120- Fiocruz; 2014. -53072016000100014&lng=en&nrm=iso 11. Sobral FR, Campos CJG. The use of active metho- 2. Nietsche EA, Teixeira E, Medeiros HP. Tecnologias dology in nursing care and teaching in national cuidativo-educacionais: Uma possibilidade para productions: an integrative review. Rev esc enferm o empoderamento do enfermeiro?. Porto Alegre: USP [Internet]. 2012 Feb [cited 2016 Aug 02] ; Moriá Editora; 2014. 46( 1 ): 208-218. Available from: http://www.scie-

Moniz MA, Pereira JM, Marques TS. An Evaluation of the use of Educational Technology, the “Health-Environment Integrated 470 Panel” in nursing education: a descriptive study. Online braz j nurs [internet] 2016 Sept [cited year month day]; 15 (3):466-471. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/5421 lo.br/scielo.php?script=sci_arttext&pid=S0080- All authors participated in the phases of this publication -62342012000100028&lng=en. http://dx.doi. in one or more of the following steps, in According to org/10.1590/S0080-62342012000100028. the recommendations of the International Committee 12. Peres RR, Camponogara S, Costa VZ, Terra MG, of Medical Journal Editors (ICMJE, 2013): (a) substantial Nietsche EA. Health and environment: (in) involvement in the planning or preparation of the visibilities and (dis) continuation in nursing manuscript or in the collection, analysis or interpretation professional training. Esc. Anna Nery [Inter- of data; (b) preparation of the manuscript or conducting net]. 2016 Mar [cited 2016 Aug 03] ; 20( 1 critical revision of intellectual content; (c) approval of the ): 25-32. Available from: http://www.scielo. versión submitted of this manuscript. All authors declare for br/scielo.php?script=sci_arttext&pid=S1414- the appropriate purposes that the responsibilities related to -81452016000100025&lng=en. all aspects of the manuscript submitted to OBJN are yours. 13. Burgatti JC, Leonello VM, Bracialli LAD, Oliveira They ensure that issues related to the accuracy or integrity MAC. Estratégias pedagógicas para o desenvol- of any part of the article were properly investigated vimento da competência ético-política na for- and resolved. Therefore, they exempt the OBJN of any mação inicial em Enfermagem. Rev bras enferm participation whatsoever in any imbroglios concerning [Internet]. 2013 Apr [cited 2016 Aug 02] ; 66( the content under consideration. All authors declare that 2 ): 282-286. Available from: http://www.scielo. they have no conflict of interest of financial or personal br/scielo.php?script=sci_arttext&pid=S0034- nature concerning this manuscript which may influence the -71672013000200020&lng=en. writing and/or interpretation of the findings. This statement 14. Camponogara S, Erthal G, Viero CM, Diaz PS, has been digitally signed by all authors as recommended Soares SGA, Peres RR. The perception of students by the ICMJE, whose model is available in http://www. of the area of health about the environmental objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf problems: a descriptive study. Online braz j nurs [Internet]. 2012 Aug [cited 2016 mar 03]; 11(2): Received: 12/04/2015 376-91. Available from: http://www.objnursing. Revised: 08/04/2016 uff.br/index.php/nursing/article/view/3767 Approved: 08/15/2016 15. Sendall MC, Lidstone J, Fleming ML, Domocol M. Nurses and teachers: partnerships for gre- en health promotion. J Sch Health [Internet]. 2013 Jul; [cited 2015 Nov 15]; 83 (7):508–513. Available from: http://onlinelibrary.wiley.com/ doi/10.1111/josh.12059/full