Abstract
Background: As part of a Volunteer Project, which is developed in a High Complexity Emergency Hospital (HUAP), an institutional strategy is developed to improve the proactive orientation of the consulting population in the waiting room, especially at times of high demand. To address the low quality perceived by users, the strategy considers a support and orientation service for users in the waiting room, with roles and functions of facilitators and navigators for patients, families, and the community. This project involves 4th and 5th year students of the nursing career, since these students have as part of their graduation profile, the development of competencies of humanization of health care.
Approach: A Volunteer Program was designed and implemented with the characteristics of service learning, allowing students to have experiential learning as an educational methodology based on the idea that students learn best through direct experience and reflection on user satisfaction, as a dimension of the quality of the service provided, which is the result of multiple interactions that significantly distinguish a person, from the moment he/she enters our health care center until the moment he/she leaves, whether it is a patient who comes for an emergency medical service or his/her companion who assists him/her in the care process. The project will formulate an explicit model of care, support, and coordination, which will provide an innovative scheme of action and roles associated with the functions of facilitator and guide for networked, person-centered, and humanized care. The framework of professional competence in the field of health humanization is based on those formulated by the Center for Humanization in Health of Spain. The competencies evaluated at the beginning and at the end were: Relational, Emotional, Ethical, Spiritual, Cultural and Management.
Results: Both the exercise of the facilitating role and the guiding role have made it evident that user satisfaction is fundamentally based on personal perception (of the patient, family members or companions), as well as on the explicit or implicit recognition of the influence of psychological, social, economic and political conditions present, which directly or indirectly influence their way of classifying the experience. The relational domains with active listening, ability in the empathic response, capacity to personalize, adequate use of confrontation, prudent and ethical management of persuasion, and assertiveness, and the Emotional domain is adequate management of own and others' feelings, assertive management of feelings and their expression, temperance and tolerance to stress, are those that have been identified as having greater deficits and therefore greater needs for additional training for undergraduate students.
Implications: This project has highlighted the need for training in skills and abilities that foster humanization in the relational, emotional, ethical and cultural dimensions of care. The skills of active listening, empathic response, ability to personalize, appropriate use of confrontation, prudent and ethical management of persuasion, and assertiveness, are key to the function and roles of healthcare navigators. The participation of students in these functions and roles provides them with key experiential learning to bring about change in their future professional behaviors.