César Leal-Costa

Background: The SimZones model is an organizational framework for simulation-based education that structures learning across 5 progressive zones, from self-directed preparatory activities (zone 0) to team-based clinical scenarios (zones 1‐4). However, empirical evidence on the impact of zone 0 regarding procedural skill acquisition and retention remains limited. Objective: The present pilot study aimed to build on this evidence gap by examining whether the addition of a structured zone 0 self-directed preparatory phase, delivered through interactive video (IV), could enhance cardiopulmonary resuscitation (CPR) competence acquisition, skill retention, and CPR quality among nursing students when combined with conventional instructor-led zone 1 training, while also assessing the feasibility and acceptability of the intervention. Methods: A total of 52 nursing students from San Pablo CEU University (Madrid, Spain) were randomly assigned to an experimental group (n=33, SimZone 0 IV followed by SimZone 1 instructor-led seminar) or a control group (n=19, SimZone 1 instructor-led seminar only). CPR competence acquisition, skill retention, CPR quality, and feasibility were assessed immediately after zone 1 training and at 3 and 6 months. Results: In the self-directed zone 0 phase, 73% (24/33) of experimental group students achieved competence. After zone 1 training, 100% (28/28) of the experimental group achieved competence vs 84% (16/19) of the control group ( P =.06, Fisher exact test). At 3 months, competence was 96% (23/24) vs 71% (10/14; P =.05), and at 6 months, 96% (22/23) vs 62% (8/13; P =.02). Mean CPR quality scores were consistently higher in the experimental group across all time points (zone 1: 94%, SD 11.8% vs 90%, SD 16.4%; 3 months: 92%, SD 10.9% vs 90%, SD 12.1%; and 6 months: 92%, SD 10.9% vs 85%, SD 17.8%). The intervention was feasible, well accepted, and free of adverse events or technical issues. Conclusions: Self-directed IV learning as a preparatory phase before instructor-led training is feasible, acceptable, and is associated with preliminary signals of enhanced CPR skill acquisition and retention among nursing students. These findings should be interpreted with caution given the pilot nature of the study and the small sample size.

Background/Objectives: Online sexual violence is an increasingly prevalent form of gender-based harm facilitated by digital technologies, with significant consequences for the health, well-being, and rights of adult women. Despite growing attention to this phenomenon, women’s lived experiences remain underexplored, particularly regarding sexual consent and institutional responses. This study aimed to examine how adult women experience online sexual violence, how consent is negotiated or constrained in digital contexts, and how coping and institutional mechanisms are perceived. Methods: A qualitative study with a hermeneutic phenomenological approach was conducted. Data were collected through three focus groups with 23 women aged 21 to 42 years who were active users of social media. Results: Participants reported diverse forms of online sexual violence, including unsolicited sexual messages and images, persistent harassment, coercion, blackmail, and threats. Sexual consent was often undermined by emotional manipulation, social pressure, and fear, placing women in vulnerable positions. These experiences negatively affected well-being, contributing to anxiety, reduced self-esteem, fear, and difficulties in sexual and emotional relationships. Coping strategies were mainly individual, such as blocking perpetrators or reporting content, while social support was frequently perceived as insufficient. A generalized distrust of institutional responses emerged, with formal mechanisms viewed as ineffective or inaccessible. Conclusions: For the study participants, online sexual violence is increasingly normalized and concealed within digital environments, reinforced by anonymity and impunity. The findings highlight the need for continued research and the development of interventions that include early sexual and emotional education, awareness-raising initiatives, digital regulation, specialized professional training, and the strengthening of victim-centered support networks.

Objective: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence‐based practice (EBP) and identified factors that affect its implementation in clinical environments. Background: EBP is essential for enhancing healthcare quality; however, there are still gaps between theoretical knowledge and its practical application. Nursing leaders are crucial in promoting EBP, yet their competence levels and obstacles have not been thoroughly examined in Spain. Material and methods: A cross‐sectional study surveyed 159 nurse managers across 16 autonomous communities in Spain, utilizing the validated EBP‐COQ Prof tool. The questionnaire assessed four competency domains—attitude, knowledge, skills, and utilization—using a 1 to 5 Likert scale. Predictors of EBP competency, including training, mentorship, and organizational affiliation, were analyzed using multivariate linear regression. Results: Participants demonstrated a strong overall EBP competence, with an average total score of 143.77 out of 175. The highest scores were in the attitude domain (36.26/40) and knowledge (43.09/55), whereas utilization scores were relatively lower (37.57/50). This indicates that applying EBP in practice still lags behind positive attitudes and knowledge. Key factors predicting higher EBP competence included EBP training, consistent reading of scientific literature, mentoring nursing students, and working in a BPSO center. These results also imply that organizational constraints may continue to impede the integration of EBP competence into routine managerial practice. Conclusions: Spanish nurse managers possess strong EBP knowledge but continue to encounter difficulties in applying it clinically. The study highlights four adjustable factors of EBP competency that could guide focused interventions. Implications for Nursing Management: Healthcare institutions should implement (1) training programs for addressing knowledge‐to‐practice gaps, especially for nonspecialist managers; (2) mentorship systems pairing EBP‐competent leaders with novices; (3) protected time for EBP activities; and (4) expanded BPSO accreditation to institutionalize evidence‐based care. Future initiatives should include EBP metrics in performance evaluations, and research should explore factors such as leadership styles and the impact of resource allocation on patient outcomes through longitudinal designs.

Introduction: Interprofessional simulation enhances both technical and nontechnical skills among healthcare professionals, improving their clinical practice. Co‐debriefing, where two facilitators lead debriefing sessions, is a common approach in these trainings. This study aims to assess educational aspects of interprofessional simulation and co‐debriefing in postgraduate medical and emergency nursing students. Methods: A descriptive cross‐sectional study with a mixed‐methods approach was conducted among postgraduate students ( n = 46). A mixed‐methods design was used, combining quantitative questionnaire data with qualitative content analysis of open‐ended responses, allowing integration of numerical trends with in‐depth learner perspectives. A valid and reliable ad hoc questionnaire was designed, and qualitative content analysis was used to examine participants’ free‐text responses. Results: Students’ perceptions were evaluated across six dimensions: applicability, satisfaction, motivation, safe environment, organization, and co‐debriefing. Significant differences were found between medical and nursing students in all dimensions except applicability and organization. Overall, students rated interdisciplinary sessions and co‐debriefing positively, though nurses highlighted areas for improvement, such as icebreaker activities, more dynamic simulations, and equal representation of both professions. Conclusions: While interprofessional simulation and co‐debriefing were well received, participants—especially nurses—identified areas for enhancement to ensure a more balanced and engaging learning experience. By integrating quantitative outcomes with qualitative insights, the study highlights when co‐debriefing adds value in interprofessional simulation and when single‐facilitator approaches may be sufficient.

Background/Objectives: Loneliness is a significant public health issue among older adults, especially in rural and socioeconomically vulnerable groups. Telephone-based interventions have become a scalable, cost-effective way to reduce social isolation, although evidence of their long-term effects on various health outcomes remains limited. This study aimed to assess how effective HELPeN, a structured telephone program delivered by trained nursing students, is in decreasing loneliness and enhancing psychosocial and cognitive health in community-living older adults. Methods: A randomized controlled trial was conducted with 119 older adults (≥65 years) residing in the community. Participants were allocated to either an intervention group (n = 65), which received weekly structured telephone calls over 9 months, or a control group (n = 54), which received standard care. Outcomes were evaluated at baseline (M0), mid-intervention (M1–M3), and 3 months after the intervention (M4). The primary outcomes measured included loneliness and perceived social support. Secondary outcomes comprised functional status, comorbidities, depressive symptoms, quality of life, sleep quality, and cognitive function. The data were analyzed using repeated-measures ANOVA with Greenhouse–Geisser correction. Results: Significant group interactions over time were identified for loneliness (F = 5.92, p = 0.001, η² = 0.067), social support (F = 3.39, p = 0.023, η² = 0.043), depressive symptoms (F = 3.87, p = 0.019, η² = 0.046), and cognitive status (F = 5.35, p = 0.002, η² = 0.063). No significant differences were found for functional status, comorbidity, sleep quality, or quality of life. Conclusions: The HELPeN program demonstrated significant effectiveness in reducing loneliness and social isolation, and in improving emotional, cognitive, and sleep-related outcomes in older adults. As a low-cost and scalable model, this intervention strengthens the role of nursing students in addressing social determinants of health and may be integrated into community and public health strategies targeting vulnerable aging populations.

La Guía para la Elaboración de la Historia Clínica en los Prácticum del Grado en Enfermería es un recurso esencial desarrollado por el profesorado de la Universidad de Murcia, fruto de la colaboración entre las sedes de El Palmar y Cartagena de la Facultad de Enfermería. Diseñada para apoyar a los estudiantes de segundo y tercer curso, esta herramienta facilita la integración de conocimientos teóricos y prácticos durante los Prácticum I (Cuidados Básicos) y Prácticum II (Cuidados Hospitalarios y Quirúrgicos). La guía estructura el proceso de atención enfermera, desde la valoración inicial hasta la evaluación de resultados, utilizando taxonomías estandarizadas como NANDA, NOC y NIC. Su enfoque práctico ayuda a los estudiantes a desarrollar habilidades clave, como el juicio clínico, la priorización de diagnósticos y la planificación de cuidados, siempre centrados en las necesidades de los y las pacientes. Incluye plantillas, ejemplos clínicos detallados y rúbricas de evaluación, lo que garantiza un aprendizaje homogéneo y de calidad. Además, fomenta el razonamiento crítico y la toma de decisiones basada en evidencia, preparando a los y las futuros/as profesionales para enfrentar desafíos reales en entornos asistenciales. Este trabajo refleja el compromiso de la Universidad de Murcia con una formación enfermera excelente, humanizada y adaptada a las demandas actuales de la profesión. La guía no solo es un apoyo académico, sino también un puente hacia la práctica clínica segura y eficaz. Un proyecto colaborativo que une teoría y práctica para formar enfermeras/os competentes y comprometidos.

Introduction: Smoking is the leading cause of preventable deaths. The training of professionals on brief tobacco interventions ( BTIs ) increases the effectiveness of these interventions. Objective: To assess the effectiveness of an online training program on BTI based on the 5As and 5Rs model in acquiring anti‐tobacco brief advice competencies among nurses. Method: Quasi‐experimental study with a pre‐test and post‐test design, with a control group and without random assignment. In the experimental group ( EG ), online training was provided in three sections: BTI theoretical content and methodology, clinical scenario videos, and feedback. Each scenario assessed the 5As and 5Rs as a validated instrument ( BTI ‐Prof ^(C) ). The control group ( CG ) only assessed the three videos of clinical scenarios. In both groups, competence was measured at the following points in time: T0 (before the training), T1 (at the end of the training), and T2 (after 90 days). The efficacy of the intervention was measured through a two‐way ANOVA , and the variation rate was calculated from T0 to T1 and from T0 to T2 . Results: 236 nurses participated (157 EG ; 79 CG ). The mean age was 42.9 years, and 76.7% were women. There was a significant group*time interaction in the three cases, indicating that the online BTI training increases the competence of these professionals in clinical scenario 1 ( F = 10.210; p ≤ 0.001; η ² = 0.081), clinical scenario 2 ( F = 6.235; p = 0.002; η ² = 0.051), and clinical scenario 3 ( F = 11.271; p ≤ 0.001; η ² = 0.090). Conclusion: A brief, asynchronous, and online intervention using standardized video‐based cases is effective in improving nurses' BTI competence. This type of training can be a useful option for the National Health System as part of a global and continuous strategy for nurses to perform BTI . Clinical Relevance: An asynchronous online training program provides nurses with standardized, evidence‐based tools to implement brief tobacco interventions in routine care, offering a scalable and practical solution to strengthen preventive strategies in health systems.