ORIGINAL RESEARCH

Communication dynamics: evaluation of educational technology with college nursing students

Vera Maria Sabóia^I; Marcela de Abreu Moniz^II Donizete Vago Daher^III; Enéas Teixeira Rangel^IV; Julianna Machado Barros de Moura^V; Fernanda Corrêa de Sá ^VI

^I Post-doctoral Degree in Nursing. Full Professor, School of Nursing, Aurora de Afonso Costa, Fluminense Federal University. Niterói, Rio De Janeiro, Brazil. E-mail: verasaboia@uol.com.br
^II PhD student in Public Health and Environment of the National School of Public Health. Assistant Professor, Department of Nursing, Fluminense Federal University. Rio das Ostras, Rio de Janeiro, Brazil. E-mail: marceladeabreumoniz@gmail.com
^III PhD in Public Health. Associate Professor, School of Nursing, Aurora de Afonso Costa, Fluminense Federal University. Niterói, Rio De Janeiro, Brazil. E-mail: donizete@predialnet.com.br
^IV Post-doctoral Degree in Clinical Psychology. Full Professor. Academic Master's Coordinator of the Nursing School Aurora de Afonso Costa, Fluminense Federal University. Niterói, Rio De Janeiro, Brazil. E-mail: eneaspsi@hotmail.com
^V Master's Degree student in Health Care Sciences of the Nursing School, Aurora Afonso Costa, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil. E-mail: juliannafisio83@hotmail.com
^VI Master's Degree student in Health Care Sciences of the Nursing School, Aurora Afonso Costa, Fluminense Federal University. Niterói, Rio De Janeiro, Brazil. E-mail: nandaenfe@ig.com.br

DOI: http://dx.doi.org/10.12957/reuerj.2016.7840

ABSTRACT

Objective: analyzed the results of nursing students' assessments of the educational technology Communication facilitator on risks of drug use as a pedagogical resource. Method: in this participatory, quantitative study, evaluation questionnaires were applied after holding focus groups of 31 nursing students at Fluminense Federal University in June 2013. Results: the results showed the technology to be instrument capable of generating data that express individual and collective opinions and meanings attributed to risks of drug use, while at the same time helping prepare university students on this topic. Conclusion: this educational technology can be considered important by prompting discussion, critical reflection and learning about drugs in the nursing field in the university context.

Keywords: Educational technology; students, nursing; substance-related disorders; health communication.

INTRODUCTION

Drug use is a relevant and current concern, given the number of existing users and their social impact^{1- 4}. Drugs or psychoactive drugs alter consciousness, mood, cognition and human behavior and can bring out various benefits or harms to health, depending on individual factors and type, dosage, frequency and usage context of the drug^5,6.

According to the World Health Organization, about 10% of the populations of urban centers around the world, consuming psychoactive substances in an abusive manner, regardless of age, sex, level of education and acquisitive power⁷. However, there is a growing global trend of multiple drug use among youth^3,8,9 and college students comprise a significant portion of this univers².

The specificity of this college context must be highlighted as a relevant element in the formulation of universal preventive strategies, such as the communicational process on the health risks from abusive and multiple use of alcohol and other drugs. However, there are difficulties to develop health education practices on drugs in college environment and the use of educational technology could assist in this process¹⁰. Traditional education methodologies when applied to communicative-educational processes on drugs with college students, contribute a little to a critical general conception. There is, thus, passivity and subordination of the students for with their educator.

It is advocated that educational technologies and communicative practices in health must be problem-directed, constructive and contextualized in the social and human dimension being where they are produced and placed in practice. The interfaces of education, communication and educational technology with the health field have here a pertinent and truly necessary reasoning through the fields of cultural anthropology, education, communication and public health, in order to support processes where we look for the best knowledge, in order to intervene with the best practices in health education¹¹.

With that, we stress out the importance of elaborating new educational strategies in order to exploit and prevent the abusive use of drugs and that incorporate the socio-economic, cultural and political dimension of this phenomenon, as well as the representations and practices of the population concerning various aspects of the theme¹². This educational process should be directed for improving the process of forming the individual, through knowledge, expertise and human relations ¹³.

The college group is heterogeneous and each area of knowledge has its peculiarity, generating situations and experiences that can promote or not abuse and multiplicity of drug use and their risks, and other extrinsic factors of this environment can also influence in the process, such as: the social network, including family, religion, other social networks, among others, would directly influence the formation of the individuals, in their perceptions and attitudes of risks, benefits and their relationships with drug use^2-4.

Thus, these individual, social and institutional factors related or not to the college context should be considered for the construction and the development of communication and investigative strategies on the theme of drugs with college students in the health area.

With the purpose of contributing to the reflections on the use of the communication on risks of drugs, such as educational technology for the reduction of vulnerability, this study had as an objective to analyze the results of the evaluation of nursing students about educational technology Communicative dynamics on the risks of drug use.

LITERATURE REVIEW

The educational process is a work process that is triggered due to the presence of subjects - educators and students - producing the process, of a state of knowledge object - to be transformed through methods and techniques. It is still emphasized, according to Freirean Pedagogy, that teaching directive is not to transfer knowledge, but to create the possibility for its proper production, on the basis of student experience ¹⁴.

We take the game example, through educative dynamics as an educational technology widely used in participatory methodologies in health on the issue of drugs and other issues with young people. When valuing the multiple dimension of the perception and apprehension of complex health phenomena, such as the use of drugs and similar themes, the game looks for incorporating one definitive critical vision on the education and autonomy in the health field. As one of the assumptions of this critical approach, we have the valuation of the training process of individuals and groups for transforming reality, replacing the persuasion on the risks of illness and injury to health or information transfer¹⁵.

In this perspective, we verify that the ludic behavior contemplates the criteria for an effective learning, in the sense that it stimulates the attention on a particular subject and its significance can be discussed among all subjects. Thus, the knowledge generated from the ludic activity can be transported to the realm of reality, featuring transcendence ¹⁶. When seen through the opinion of the subjects, the educative game is amusing, stimulant, enlightening doubts, facilitating learning, interactive, innovative and ilustrative¹⁷.

However, in health education area, the game is just a kind of dynamics that can be implemented during this process, and there may exist other features or strategies that facilitate discussion of relevant topics, such as diabetes, child respiratory infection, puerperal care, and even sensitive issues, such as drug abuse and Acquired Immunodeficiency Syndrome (AIDS) ^18,19. The dynamics are considered as pedagogical, interactive and motivating tools, able to generate learning, promote dialogue, and facilitate approach of issues and debate of everyday situations.

In Brazil, some studies have taken dynamics for approaching drug phenomenon with 20 college kids ²⁰ and, at the same time, investigate the perception of these individuals on this theme. Thus, the relevance of producing educational resources in the health area and serving, also as data-collection instruments has been increasingly recognized in the scientific world, where participatory methodologies appear as paths to the feasibility of applying these resources.

The participatory scientific methodologies on the theme of drugs with youth have favored significant learning, from the construction of transversal knowledge spaces, among investigated and investigators, when both also assume and mix the roles of educators and students through the exchange of experiences, knowledge and values made up socially^15,18.

Educational activity constitutes a participatory process through the understanding and reflection on the received information, and in the production of knowledge generating solutions for health problems.

In this context, the dynamics may be considered educational technologies, when seeking to address drug concepts and effects, in addition to generating new knowledge, meeting demands of the community, based on communication needs in health, with a view to quality of healthy life for the social actors for whom they are intended. Therefore, the purpose of the educational technology action is to produce in people and groups a critical discussion on a given reality and its repercussions on the health in general²¹.

METHODOLOGY

This evaluative investigation with quantitative analysis is an integral part of the project referred to as: Perception and communication of social and health risks associated with the abuse of alcohol and other drugs among nursing students of Fluminense Federal University (UFF), which was implemented after being approved by the Research Ethics Committee of the University Hospital Antônio Pedro (HUAP)/UFF under the Certificate of Introduction to Ethics Assessment (CAAE) n° 02733312.3.0000.5243, that is based on the guidelines on investigations involving humans.

The methodological procedures adopted were: the technique of focus groups, complemented with the self-application technique of a semi-structured questionnaire and the observation, which were selected on the basis of investigation fundamentals and objectives.

The methodological steps were characterized by the following timeline: First, we built a roadmap to guide the focus groups that covered the educational technology referred to as Communicative dynamics on the risks of drug use^15,18. This technology aimed to both describe the opinion of students individually, as well as to promote a collective problem discussion on the theme. Then, group activities were developed with the introduction of the risk communication related to drug abuse, based on the priority themes, questions and discussions raised before by the study subjects. Later on, there was the completion of the data through the self-completion of an evaluation questionnaire on the dynamics.

Regarding the choice of the technique referred to as focus group, this was due to the close interrelation with the applicability of participatory methodologies in health. The focus groups, as well as investigation technique, are made up as means of reflection and expression of the subjects, in their own terms, experiences, beliefs, values and representations. The data produced are based on the human trend to form opinions on interaction with other individuals. This technique allowed for analyzing the use of the Communicative dynamics on the risks of drug use, limitations and advantages.

The focus groups were developed during the month of June 2013, with 31 students of periods 1, 2, 8, and 9, of the undergraduate program in nursing, at the Niterói Campus of the Fluminense Federal University, representative of entering and exiting the undergraduate program. The selection of students came after interest shown in participating voluntarily, after a brief presentation of the proposal and its objectives. The intended sample was 10 subjects in each group, however, the number reached ranged from six to 10 subjects. Literature recommends the focus group to have six to 10 subjects, depending on issues related to the objective, purposes, time and costs¹⁸.

For accomplishing these groups, the subjects were identified through numbers, in accordance with the order of their positioning in the chairs that were located in form of a semicircle with a Bristol board placed in the center of the room on a table. After presenting the moderator and the helpers, adhesives with the respective numbering were delivered to all subjects, in order to facilitate identification and group interaction. In each focus group, a moderating investigator and one or two research assistants took part, who mediated the action, from topics provided by a script. The research assistants observed the conducts of students, made notes on problem situations, and eventually interacted with the groups.

The main investigator submitted the research project, its objectives and benefits for the ends of obtaining the Free and Clarified Consent Form (FCCF). The ethical questions on the commitment to anonymity of the given depositions, the relationship of trust and credibility as well as the information that the group was opinionative were highlighted to minimize possible difficulties when addressing issues related to drug use.

At the end of each meeting, the youth reported the experience on participating in focus groups, completing an evaluation questionnaire on the dynamics, with the following questions: Between Very Good, Good, Regular, Bad and without opinion, what concept would you give for educational technology? The technology favored the reflection? The issues addressed were of your interest? You changed your mind about any question? Did you feel at ease during the game? Would you indicate other colleagues to participate in the same type of educational technology? What do you most like on the activity? What do you least like on the activity? Suggestions.

The speeches were recorded and transcribed, and we also considered for the analysis the remarks of the investigators on the sheet.

RESULTS AND DISCUSSION

The sample was made up of 31 college students, aged from 18 to 27 years, and 26 (84%) were female and 5 (16%) male, enrolled in the first and last year of the undergraduate program in nursing at UFF, totaling four focus groups. The number of subjects per group ranged from 6 to 10, with an average: 7.75. We tried to avoid the participation of more than 10 members per group and dynamics so that the conduct shall not become difficult and factors such as time, tiredness and other activities might interfere with the final result¹⁸. The groups had an average time duration: 90 minutes.

The Communicative dynamics on the risks of drug use has been well evaluated by college students, since 18 (58%) attributed to this educational technology the concept of Very Good and 13 (42%) Good, and no study subject conceptualized this as Regular or bad. A similar result was found in another study that used an educational technology to address themes related to drug use, where most of the subjects assessed the resource as Very Good¹².

In relation to the reflection of the issues addressed, 29 (93%) of the students stated that the dynamics was a method able to promote reflection, considering it the informative, interactive, able to stimulate debate and promote reflection on the risks related to the use of drugs. The subjects also reported that through the material used in the dynamics it was possible to know better the opinion of the colleagues, apart from expressing their own opinions. Another study also found that teenage subjects valued the dynamic educational interactive approach on drugs, once that this favored the dialogue, encouraged the sharing of problems and solutions and promoted participation¹⁵. This characteristic is perceived as essential to effective pedagogical practice, since it promotes dialogue and learning.

All students have stated that the issues addressed were of interest and that they would indicate other colleagues to participate in the same type of educational technology, if the same were reproduced in other instances of academic life.

Among those who took part, 30 (97%) responded that they felt at ease during the activity. In group discussions, the internal influences of cultural factors and structures of social group to which the subjects belong and in which they have modeled their visions are manifested promptly ²² .

The promotion of dialogue and debate on current themes, through educational technologies can facilitate the approach and the inclusion of these themes in social institutions and in the family, since that there is some difficulty to deal with such matters, considered important for the formation of individuals. The dynamic character disinhibits, stimulating the subjects to propose, justify and defend something they believe in, besides enabling exchange of experiences, based on thematic contents on the matter to be worked, in searching proximity to the reality experienced by the subjects¹⁸.

As for the change of opinion regarding any questions, 7 (32%) of students reported that there has been a change of position after taking part in the Communicative dynamics on the risks of drug use, while 24 (68%), reported not having a change of heart during the implementation of the instrument. Among the subjects that have not changed their opinion, some stated that the knowledge produced at the time of the dynamics reaffirmed their views on the risks of drug use. This fact can be assigned by previous knowledge of the nursing area students on this thematic area, acquired during under-graduation. Most subjects reported the importance of hearing colleagues' opinions, in order to consolidate their own opinions.

The positive points, highlighted by the investigation subjects, were the interactive, relaxed and educative nature of the used technology, generating discussion on the discussed matters, promoting reflection and construction of new knowledge. The subjects also stressed out the freedom to express their opinions and to be able to hear the opinions of other subjects on the issue. Only four students reported negative points on the Communicative dynamics, and that were related to time, because one subject stated that time was extended and three that time was short for the generated discussions.

An intervention is effective when it reaches the expected results. In this study, the Communicative dynamics on the risks of drug use proved to be effective as an educational practice in health, by promoting an enabling a propitious and pleasant environment for establishing a critical teaching-learning process, evidenced by the increased level of reflective capacity and autonomy on broader aspects, such as quest for improvement in quality of life.

Therefore, one should not consider the objective of education in health a behavior change, once that, the individuals may have a different value from that of the educator and, therefore, they may can choose other means in order to develop and redirect their daily practices of health and life ¹⁶.

The use of educational technologies facilitates the understanding of specific themes, arousing curiosity, promoting dialogue, interaction and motivation for learning¹¹. The use of ludic and interactive materials encourages the deflagration of a cognitive questioning process, favoring reflection and acquisition of knowledgs¹⁵. This learning process involves, on the one hand, a change in the response ability within the cognitive scope, either in the acquisition of new knowledge, new skills or in reorganizing the ideas. On the other hand, learning can be a movement to the subject's involvement with health and life, with accountability for the situations, generating greater awarenes ²³.

Educational activity constitutes an active participatory process of the people, through the understanding and reflection on the received information, and in the production of knowledge generating solutions for health problems. Therefore, the purpose of the educational action is to produce in people a critical discussion about a given reality and its repercussions on the health in general21.

A study used an educational technology referred to as Game wav, through focus groups and questions of differentiated matters in order to verify the acceptance of students and educators with the chosen methodology. It was concluded that this educational technology favored the dialogue, being essential the effective teaching practice, providing interaction and learning¹⁵.

CONCLUSION

The educational technology Communicative dynamics on the risks of drug use proved to be a useful tool and with good receptivity for a large part of the study subjects. Through the results, it was observed that the technology used for health education with nursing college students spurred the expansion of knowledge and enabled reflections on the risks of drug use. Thus, in the nursing college context, using interactive materials in line with the principles of an educational technology seems to provide the outbreak of a questioning and participatory cognitive process, because, they may facilitate the teaching-learning process and still be enjoyable, interesting and challenging.

The evaluation showed that Communicative dynamics reached its goals, allowed for the opening of a crosses and democratic space for instrumentation and construction of knowledge on the health risks of drug use at college, once that it produced information, generated problem discussion, and collectively consubstantiated opinions, clearing doubts in a satisfactory manner.

Thus, it is suggested that this technology can be used, in addition to an investigative tool qualitatively, but in educational activities with nursing college groups, addressing current themes, which are situated as problems experienced by subjects in their social reality, and reverberate with impact on their health, such as drug phenomenon. There is a great need for expansion of academic spaces that address drugs and health risks and that this pedagogic resource may be exploited in different ways, according to the situations and desired goals, favoring the communicative processes within the nursing college scope.

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