CICLO DE CREACIÓN Y EVALUACIÓN DE UN MÓDULO A DISTANCIA, PARA ESTUDIANTES DE ENFERMERÍA, TITULADO “ADMINISTRACIÓN DE MEDICAMENTOS”

1 Trabajo extraído de la Tesis de Doctorado; 2 Enfermero, Doctorando, Docente de la Universidad Federal de los Vales do Jequitinhonha e Mucuri, Brasil, email: ppradotelles@yahoo.com.br; 3 Orientadora, Profesor Titular, e-mail: shbcassi@eerp.usp.br. Escuela de Enfermería de Ribeirão Preto, de la Universidad de São Paulo, Centro Colaborador de la OMS para el Desarrollo de la Investigación en Enfermería, Brasil Artigo Original


INTRODUCTION
The contemporary society demands individuals to develop their abilities of raising theories, reflecting, analyzing and organizing, which validate conscious decision making.It is necessary to develop talents that allow for autonomous ways of creation, communication and expression, generating attitudes of cooperation and reciprocity.
In this perspective, distance education stands out as an educative process in which learning occurs through a physical separation between the students and the teachers.Communication and learning take place through technological resources that go beyond oral exposition.
In this kind of process, both the student who will use it, and the teacher who develops the material need to be capable.Both these parties' motivation for learning is the accelerated scientific and technological development of the current world, which brings about constant changes in work places, demanding professionals able to adapt themselves to the changes and who are equipped and motivated for continuous learning.
A study cited in this research focused on the learning environment, with the use of the Internet, addressing intravenous therapy teaching.It aimed at developing educational material on this therapy, using the Internet and evaluating its use by the students.
The latter positively evaluated the learning opportunity through the Internet, mentioning the interaction with the instructor, space-time flexibility, access to technical resources and aspects related to course content organization (2) .Therefore, based on the idea that distance education resources are very useful, efforts were made to conduct and use it in the nursing area.
A study that revealed the educational needs of hospital nurses in terms of medication administration exposed the need for knowledge on contents like: action mechanisms, medication preparation and administration, medication interactions, stability, adverse effects of the medication and other aspects (3)   .This data indicated the existence of knowledge deficits on essential questions for safe and correct medication administration.
In view of these considerations and aware of the challenge of extending knowledge on medication administration, the researcher aimed to carry out a study that would present the contribution related to the subject: teaching medication administration, using distance education as a possibility of development in professional education of nursing undergraduates.
Therefore, the development of this study was proposed, which intended to describe the creation cycle of a distance module called "Medication Administration", as well as to evaluate it for its later implementation in undergraduate Nursing courses.

OBJECTIVES
This article aimed at: -Describing the creation cycle of a distance module in the Teleduc environment, called "Medication Administration".
-Proceeding to the evaluation of the module mentioned by specialists in content, informatics and undergraduates in nursing, through an instrument based on the Analytical Appreciation Model of Hypermedia Systems.

First Phase
The first phase of the work is an evaluation research, aimed at discovering how well a practice or program is working out when used to search for answers to practical questions (4)   .In nursing education, there is usually a need to evaluate the range of goals and the efficiency of the means used to achieve a goal (4)   .This study aimed at describing the development and evaluation of a module in a virtual learning environment, through information and communication technologies available on the web.The main characteristics of this theory are related to collaboration (students working together); connectivity (all students connected to each other all of the time); community (groups are defined according to common interests) and multisensoriality (the information can involve sound, graphs and figures) (5) .Therefore, its fundamental idea is the interaction among students engaged in learning activities.Such theory differs from others because it promotes human interaction in the context of group activities and not in the individual's interaction with the instructional program only (6) .
Important determinants that stand out in the quality of the instructional material are: little quantity of information on each screen and the use of different styles, font sizes and colors to highlight ideas, using figures to transmit them (7) .
The below figure presents the module development cycle.

Evaluation Instrument
The evaluation was performed through an instrument based on the Analytical Appreciation Model of Hypermedia Systems (8) , which was adapted and validated (9) to evaluate educational software.

Ethical Aspects
The study was authorized by the General

First Phase
The steps of the development cycle of the "Medication Administration" module are described below.

Gathering the objectives of the module
The objectives were raised based on the program content of the subject "Fundamentals for the Care Process II", taught at the institution where the researcher was a professor; on his experience in courses about the theme, taught to undergraduates and postgraduates in the health area in general and in nursing in particular; on his participation in scientific events where the theme has been discussed with specialists in the area.
The objectives of the module are presented as follows.

-General Objective
Develop competences related to several contents about medication administration and to the execution of its techniques, to motivate students for the development.
-Specific Objective

Content organization
After the module objectives were determined, the content was organized.Therefore, all material was joined to be organized in a logical sequence for its broad and clear presentation.
Scientific articles, several materials prepared as content for the classes, materials presented in scientific events and books were part of this material.
The content was organized as presented in Table 1.It also stands out that this content went through a language adaptation process, in order to become appropriate for the interactive communication means of the Internet.For this purpose, some points were observed, such as the recommendation that the style should be simple and used in the habitual sense, that the images should be subtitled, the paragraphs should be short and that competent sources of quotation and reference should be used, as well as the fact that hyperlinks at the end of each screen should be stimulated and the quantity of text should be reduced, but not of information (10) .

Media selection
After determining the objectives and organizing the content, the media selection proceeded, which is a crucial moment for the professor, because it is the time to decide on the best way to present the content to the students (11)   .
After the long bibliographic material reading, the discussion with postgraduate colleagues, pedagogues and systems analysts, the whole content was made available in the Teleduc environment.
Teleduc was considered a support environment for the distance education on the web that has been developed since 1997 by the Center of Informatics Applied to Education -NIED, in partnership with the Institute for Computer Sciences Institute -IC, both from the State University of Campinas (UNICAMP).This environment was developed in a continuous and participative way, having all of its tools idealized and projected according to the needs related by its users (12) .
The architecture of this platform was developed based on the activities.Several tools were arranged for the student, such as support and reading material and frequent questions.These tools promote both teacher-student and student-student interaction and, consequently, collective work.

Creation of classes
The creation of classes followed the determination of the module objectives, as well as the content organization and media selection, which were already presented.
A fact that stands out is that 120 photographs were taken, especially produced for the module.
After the association of the objectives, contents and possibilities established for the media, the classes were creation as shown in the following conceptual maps.After all modifications were completed, it is believed that the module is appropriate to be implemented in undergraduate nursing courses.

FINAL CONSIDERATIONS
This study described the creation cycle of the "Medication Administration" module, developed in the educational environment Teleduc, based on up-to-date bibliography.For this purpose, Engagement Theory was used, which seeks the union of individuals with common interests, collaboration and connectivity.
The following sequence was adopted for the description: determining the objectives of the module, content organization, media selection, creation of classes and activation of the learning process.
The "Medication Administration" module was created in the Teleduc environment, based on up-to-date bibliography and with practical examples.It is a resource integrated to the pedagogical process as one of its mediators, providing the participants with knowledge construction on medication administration, to be built in constant interaction between students and teacher.
The engagement theory developed by Greg Kearsley, a consultant specialized in on-line and distance education, Assistant Professor of the Distance Education Program at the University of Maryland -USA, was used as a theoretical/methodological reference framework.The option to use the latter is justified because the intention was to develop a distance module for medication administration teaching which would reflect the current and innovative learning focus that unites individuals with common interests and seeks collaboration and connectivity.

Figure 1 -
Figure 1 -Development cycle of the module: "Medication Administration" Board of the research institution.It started after the approval by the Research Ethics Committee at the University of São Paulo College of Nursing, registered under number 0304/2002.Each participant was aware of the Free and Informed Consent Term for Participation in Research and issued a written record with the approval to participate in the research.

Class 1 :
develop competences related to pharmacological aspects, nursing orientations and information sources for safe medication administration.Class 2: develop competences related to the preparation of the material for medication administration.Class 3: develop competences related to intradermal medication administration.Class 4: develop competences related to subcutaneous medication administration.Class 5: develop competences related to intramuscular medication administration.Class 6: develop competences related to endovenous medications administration.

Figure 4 -
Figure 4 -Conceptual mapping of class 3 It was positively evaluated by specialists in content, informatics and undergraduates in nursing in terms of content distribution and accessibility, explicitness of its presentation, information structure and accuracy, image utilization and its relation to the text information, presentation of diverse texts, relevance of the exercises for content reinforcement, explicitness and visualization of main menu presentation, logical and pleasant sequence of the classes, suitability of visual presentation, easy execution of the program and interaction and communication provided by the environment.The module was then considered appropriate for use with nursing undergraduates.

Table 1 -
Content distribution of the "Medication A fact that stands out is that each class mentioned above has specific exercises and that the