Studenti di infermieristica, tirocinio clinico in rianimazione e medicina narrativa: indagine qualitativa degli aspetti metacognitivi dell’apprendimento in una esperienza di assegnazione precoce in unità operative complesse

Abstract

Background. The Intensive Care Unit is a clinical setting with high technical and complex care and with high emotional impact for operators. The emotional aspects could affect the clinical practice and the learning of the students during their internship. A group of 2nd-year nursing student have been assigned to the intensive care unit, although they didn’t previously attend an intensive care course. The goal of this paper is the description of the emotional impact as experienced by students and its influence on students learning. Methodology. It was adopted a qualitative methodology within a phenomenological hermeneutic speculative approach. The authors used some tools such as reflective journals and debriefings. All collected data were transcribed, analyzed and later processed on ATLAS.ti. Results. Content analysis allowed us to highlight that the student initial reaction in front of the critically ill patient and in front of the complex clinical environment was characterized by feelings of fear and discomfort, and the knowledge gap seemed unbridgeable. Subsequently, due to the availability and support of clinical mentors, most of the students adopted a self-directed learning style to fill that gap, perceiving a personal and professional growth with an increase of satisfaction and self-efficacy feelings. Conclusions. Intensive care proved to be an effective learning clinical environment, but further studies are needed to determine both personality characteristics, allowing a student to successfully deal with complex and stressful environments, and relational and teaching skills that distinguish the most effective clinical mentors in such complex clinical environments.