Objective: to construct and validate a high fidelity clinical simulation scenario on nursing care to colostomy patients. Method: descriptive study of construction and validation of the appearance and content of a high fidelity clinical simulation scenario referring to nursing care for colostomy patients. To guide the elaboration of the scenario, a study was carried out in the literature on nursing care for the colostomy patient in the hospital environment. The scenario was constructed according to the items proposed by Fabri, based on the Bloom’s Taxonomy. For the selection of the nine experts, the criteria proposed by Fehring were used. The scenario, after being structured, was tested by a group of students from the 3rd and 4th years of graduation in nursing in a clinical simulation laboratory of a public university. It was considered 80% level of agreement. Results: in the validation of the scenario, all the experts agreed with the proposed items, suggesting the inclusion of some references, book chapters, skills training, preparation of reading material and checklist follow-up of participants. This scenario test allowed the identification of relevant contributions for adjustments of the simulated activity and allowed to test the debriefing with the support of the checklist. It was also evidenced the need to include information in the patient medical record and to increase the time of development of the scenario to solve the proposed objectives. Conclusion: the results show that for practical simulated well defined and successful are required to careful preparation, validation and prior testing of the planned activities.

AIMS: To compare the satisfaction and self-confidence of nursing students in simulated clinical activities with and without the presence of odors.METHODS: A randomized clinical trial enrolled undergraduate nursing students 18 years of age or older randomly allocated to Intervention Group (participation in simulated scenarios with odors) or Control Group (participation in simulated scenarios with the same themes, but without odors). The odors were obtained with fermented foods. Students who already had professional practice in nursing were excluded. Data were collected using an Instrument for Characterization and Perception of Subjects, the Satisfaction with Simulated Clinical Experiences Scale and the Student Satisfaction and Self-confidence in Learning Scale. For analysis of the data, we performed an exploratory statistic, with frequency, percentage, and Cronbach Alpha reliability test for the scales, and after sample analysis by the Kolmogorov-Smirnov test, Student's t-test was used to compare means.RESULTS: A total of 100 nursing students, 55 of the intervention group (scenario with presence of odors) and 45 of the control group (scenario without odors) participated in the study. High Cronbach's alpha values were found for both the Satisfaction with Simulated Clinical Experiences Scale (0.862) and the Student Satisfaction and Self-confidence in Learning Scale (0.842) and high scores for satisfaction and self-confidence in learning in both groups. In the comparison of means there were no significant differences between the values attributed to satisfaction and self-confidence, in the intervention group and in the control group.CONCLUSIONS: There were high scores attributed to satisfaction and self-confidence among the participants, however, when compared, in this sample, there was no difference in satisfaction and self-confidence between groups that used simulated scenarios with and without the presence of unpleasant odors. However, the use of odors in the scenarios was highlighted by the participants as stimulating elements to the use of personal protection equipment and also to stimulating the learning of nonverbal communication.

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Clinical simulation allows discussions about improving the quality on the patient’s care. This method have effectiveness on what concerns to satisfaction, self-confidence and student motivation. However, during the assessment, the students have emotional reactions that have tended to be overlooked. In view of this, this article seeks to identify and describe the relationship of the emotions observed by facial expressions and assess their degree of satisfaction and self-confidence by carrying out simulated practices among the nursing students. The analysis based on the scales showed high satisfaction and self-confidence levels, and it was found that the predominant basic emotion was anger, which is caused by other correlated emotions like tension and stress. This divergence between the identified emotions opens up space for further investigations about the level of motivation and the stimulus tolearning that these emotions can provide, and the extent to which they can lead to satisfaction and self-confidence.

Can low‐fidelity simulation improve the knowledge and skills of patients undergoing clean intermittent catheterization (CIC) and their caregivers to prevent complications? Patients undergoing CIC are exposed to risks, such as urethral trauma and urinary tract infections. Objective of this paper was to assess the implications of low‐fidelity simulations for patients and caregivers in the use of clean intermittent catheterization in the event of urethral trauma and for its prevention. A quasi‐experimental study carried out between November 2015 and February 2016 in the rehabilitation centre of a university hospital, with patients undergoing CIC and/or their caregivers. Following the ethical precepts, data collection was performed during nursing consultations by means of interviews, structured observation, and a knowledge test applied before and after the low‐fidelity simulation. Patients undergoing CIC and/or caregivers underwent a low‐fidelity simulation of CIC with urethral trauma and then they were guided by the researchers following the protocol established in the department. They then underwent another simulation with the same characteristics. Fifty‐five patients participated in this study, in which most of them (33 [60·0%]) were men, with an average age of 31·7 years. Bleeding was reported by 19 patients (34·5%), of which 18 were men. The performance of low‐fidelity simulations proved to be effective for patients or caregivers in adverse situations, such as bleeding, resistance to the introduction of the catheter and negative urine drainage. The performance of low‐fidelity simulation is easily accessible and shows efficiency when used in teaching‐learning processes of health education and development of skills and competencies.

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Erectile dysfunction (ED) is a common male disorder, often associated with cardiovascular disease and ageing. The Sildenafil, a PDE5 inhibitor, can improve the erectile function by prolonging the nitric oxide (NO) downstream effect. NO is a molecule of pivotal importance in erection physiology and is mainly produced by neuronal nitric oxide synthase (nNOS) and endothelial NO synthase (eNOS). While it has been shown that eNOS and nNOS genetic polymorphisms could be associated with Sildenafil responsiveness in ED, no study so far has assessed whether nNOS polymorphisms and PDE5A polymorphism could be associated with increased risk to ED or with intensity of symptoms. A total of 119 ED patients and 114 controls were studied, with evaluation of the clinical disability by the International Index for Erectile Function instrument, plasma assessment of nitrite levels and genomic DNA analysis regarding the rs41279104 and rs2682826 polymorphisms of the NOS1 gene and the rs2389866, rs3733526 and rs13124532 polymorphisms of the PDE5A gene. We have found a significant association of the rs2682826 with lower IIEF scores in the clinical ED group. While this result should be confirmed in other populations, it may be helpful in establishing a genetic panel to better assess disease risk and prognosis on ED therapy.