Carmen Casal Angulo

Aim(s): To explore how HEMS professionals perceive the role, competencies, training and professional development of nursing within aeromedical transport services in Spain, incorporating the perspectives of different professional profiles involved in HEMS operations. Design: An interpretative qualitative study using phenomenologically informed thematic analysis. Methods: Semi‐structured, in‐depth interviews were conducted and analysed using phenomenologically informed thematic analysis. Data were systematically coded through open coding and organised into themes and subthemes using ATLAS.ti. Data Sources: Primary qualitative data were obtained from 17 purposively selected HEMS professionals through individual interviews. Interviews lasted 45–60 min, were audio‐recorded and transcribed verbatim. Results: Four main categories emerged from the analysis: (1) access to the HEMS environment; (2) technical skills and competencies; (3) professional perspective and role development; and (4) structured professionalisation of the HEMS profile. Participants perceived that extensive prior experience in critical care settings, specialised academic training, supervised practice and advanced clinical simulation were necessary. Fully online training was widely perceived as insufficient. Participants identified core competencies, including advanced technical skills, knowledge of aerophysiology, aviation safety training, Crew Resource Management and Helicopter Underwater Escape Training. In addition, participants identified emotional resilience and physical fitness as personal attributes relevant to HEMS practice. Conclusion: According to participants, HEMS nursing in Spain was described as a complex and highly specialised professional profile, characterised by extensive critical‐care experience, advanced technical competencies and structured, practice‐oriented training. The absence of a formalised training pathway contrasts with international standards and points to a perceived need for greater professional recognition and standardisation of competencies to support safe and high‐quality care. Implications for the Profession and/or Patient Care: The findings provide qualitative evidence that may inform the future development of structured training pathways, competency frameworks and professional recognition for HEMS nurses in Spain. The findings may also inform future research on standardised education, advanced simulation and aviation safety training. Further research is needed to determine whether these educational approaches improve clinical decision‐making, patient safety and operational effectiveness in aeromedical transport. Impact: The findings highlight the lack of a clearly defined and standardised competency framework and training pathway for HEMS nursing professionals in Spain. Participants perceived effective HEMS practice as requiring extensive prior critical‐care experience, advanced technical competencies, supervised practical training and specific personal attributes, including emotional resilience and physical preparedness. These findings are relevant to HEMS nurses, educators, policymakers and healthcare managers involved in aeromedical services in Spain and may also contribute to international discussions on advanced nursing practice in air medical transport. Reporting Method: This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Patient or Public Contribution: No Patient or Public Contribution.

1. Introducción: Las habilidades psicomotoras están directamente relacionadas con la activación del sistema de neuronas espejo. 2. Objetivo: Conocer las diferencias de aprendizaje en las habilidades psicomotoras, alcanzado por alumnos y alumnas de ciencias de la salud con diferentes mensajes docentes: audio, texto, texto e imagen, vídeo manual y vídeo mecánico (robot). 3. Desarrollo: A alumnos y alumnas de medicina o enfermería reclutados por conveniencia, se les suministró aleatoriamente, uno de los mensajes precedentes, practicando a continuación las habilidades psicomotoras sobre un maniquí, siendo evaluado su desempeño por un docente. 4. Resultados: Participaron un total de 312 alumnos y alumnas de primer curso de medicina o enfermería, de 3 universidades, constituyéndose 6 grupos según el mensaje recibido; se realizó un análisis descriptivo e inferencial entre ellos con el paquete estadístico fStats-UCV. Las puntuaciones obtenidas por cada grupo mostraron diferencias estadísticamente muy significativas entre los 6 grupos en una escala incremental: sin mensaje, texto, audio, texto e imagen, vídeo robótico y vídeo manual. 5. Conclusiones: La adquisición de habilidades psicomotoras mediante simulación clínica, difiere con los mensajes didácticos suministrados a los alumnos, comprobando una superioridad del mensaje animado con participación humana, seguido por el mensaje de vídeo robótico

1. Introducción: La mayor dificultad para la enseñanza-aprendizaje del pensamiento crítico y razonamiento clínico es la de encontrar consistencia entre las perspectivas teóricas, las metodologías y los procedimientos para su implementación. 2. Objetivo: Conocer si el empleo de las funciones ejecutivas mejora la enseñanza de pensamiento crítico y razonamiento clínico en alumnos y alumnas de cursos superiores en ciencias de la salud. 3. Desarrollo: A alumnos y alumnas de medicina reclutados por conveniencia, se les informó, en una sesión grupal de simulación clínica, sobre el pensamiento crítico, el razonamiento clínico, y su relación con las funciones ejecutivas, siendo evaluado su desempeño por un docente con un modelo pre-post, con la misma rúbrica “ad hoc”. 4. Resultados: Participaron un total de 81 alumnos en 11 sesiones de formación grupal por equipos mediante simulación clínica de alta fidelidad; se realizó un análisis descriptivo e inferencial entre ellos con el paquete estadístico fStats-UCV. Se comprobó que el empleo de las funciones ejecutivas tras su implementación en la sesión es capaz de mejorar su capacidad de razonamiento clínico. 5. Conclusiones: La adquisición de pensamiento crítico mejora mediante el empleo de las funciones ejecutivas en simulación clínica grupal por equipos, y aporta seguridad en los participantes para su actuación profesional futura

Background: Trauma is the most common cause of death and disability in the paediatric population. There are a huge number of variables involved in the care they receive from health care professionals.Aim: The aim of this study was to review the available evidence of initial paediatric trauma care throughout the health care process with a view to create quality indicators (QIs).Study Design: A systematic review was performed from Cochrane Library, Medline, Scopus and SciELO between 2010 and 2020. Studies and guidelines that examined quality or suggested QI were included. Indicators were classified by health care setting, Donabedian's model, risk of bias and the quality of the publication with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment.Results: The initial search included 686 articles, which were reduced to 22, with 15 primary and 7 secondary research articles. The snowball sampling technique was used to add a further seven guidelines and two articles. From these, 534 possible indicators were extracted, summarizing them into 39 and grouping the prehospital care indicators as structure (N = 5), process (N = 12) and outcome (N = 3) indicators and the hospital care indicators as structure (N = 4), process (N = 10) and outcome (N = 6) indicators. Most of the QIs have been extracted from US studies. They are multidisciplinary and in some cases are based on an adaptation of the QIs of adult trauma care.Conclusions: There was a clear gap and large variability between the indicators, as well as low‐quality evidence. Future studies will validate indicators using the Delphi method.Relevance to Clinical Practice: Design a QI framework that may be used by the health system throughout the process. Indicators framework will get nurses, to assess the quality of health care, detect deficient areas and implement improvement measures.

Aprendizaje de las habilidades psicomotoras en simulación clínica: Metodología docente y resultados preliminares

Formación clínica grupal, pensamiento crítico y funciones ejecutivas

Introduction: A lack of professional communication and collaboration may be one of the main causes of medication errors. The objective was to evaluate the results of the implementation of ISBAR as a communication and safety tool in a Lithotripsy and Endourologic Unit of a tertiary public hospital. Methods: A total of 457 patients were included in a retrospective study from 2014 to 2019. Patients were divided into two groups: group A (357 patients) in which an endourological procedure was performed before march of 2018 (without the implementation of ISBAR tool) and Group B (100 patients) with the implementation of ISBAR tool. The inclusion criteria were patients accepted for surgical intervention by anaesthesiology Department and operated in the period of the study. The variables analysed included number of procedures, global, intraoperative and postoperative complications rate, urinary infection or sepsis, NPR (FMEA), percentage of suspended surgical patients and hospital stay. Results: The postoperative complications showed no significant differences between groups, but a trend to diminishing was seen in the complication in the group B. The sepsis reduced its incidence and it was close to significant difference. The operative time was shorter in group B 119,11min (114,63–123,59) vs 115,11min (109,63–121,67) p = 0,3. The reduction in the main postoperative complication (sepsis) explained the lower hospital stay for group B. The severe adverse events detected were reduced completely. Conclusions: ISBAR tool was an effective patient safety tool improving quality care. To provide safe patient care and improving quality is indispensable an effective communication flow.