Contribution of an instructional module in the development of lymph node assessment skills: an experiment

The data colleta through anamnesis and physical examination is an indispensable step for the implementation of the Nursing Process; to perform the physical examination are used the techniques of inspection, palpation, percussion and auscultation, which allow to confirm patterns of normality or the presence of changes. It is of interest, in this study, the examination of the lymph nodes, components that can, from their alterations, guide the therapeutics and the nursing actions to be performed. Such structures are evaluated by the techniques of inspection and palpation, in addition to anamnesis. Considering the need to create increasingly interactive strategies based on the proposal of experiential learning, this experimental, randomized, controlled and double blind study aims to evaluate the contribution of an Instructional Module in the acquisition of knowledge about the evaluation of lymph node characteristics, by nursing students. The educational intervention was composed by the use of an instructional module, formed by a prototype of palpation and a guide instrument of registration. The participants of the study were 68 undergraduate nursing students from a public institution in São Paulo who were attending the discipline of semiology and semitechnical. In both groups (experiment and control) the palpation of the lymph nodes was initially performed in a prototype (A) followed by the free registration of the characteristics and number of the structures evaluated. The control group followed for final evaluation, similar to the initial one, in another prototype (C) using the free registry instrument. The experimental group was submitted to the educational intervention, which consisted in the management of the instructional module (prototype B and instrument guide of data recording) and, afterwards, made the final evaluation, similar to that of the control group. After the final evaluation, the control group was presented to the educational intervention. Finally, in both groups, the students recorded their opinion about the educational activity performed. We used for analysis the records made in the initial and final phases; the data were categorized and, to evaluate age, course and sex, we used frequency, mean, median and standard deviation; to verify the interaction between the correctness of the variables by the groups in the times, we opted for the mixed linear regression model. The analysis of interaction between the groups allows to conclude that the experiment group presented a significant difference in relation to the control group in the variables size of the lymph node (P <= 0.0001), consistency (p <= 0.0001), mobility (p <= 0.0001) and coalescence (p = 0.0021). Still, the students positively evaluated the activity, highlighting their ability to relate theory to practice, its easy and good representation of reality. The positive results of the experiment group as well as the acceptance reported by the target public reinforce the use of the instructional module as a complementary teaching strategy to the semiology and semi-technical classes in teaching the evaluation of lymph node characteristics