title: The convergence process in European Higher Education and its historical cultural impact on Spanish clinical nursing training.
abstract: The objective of this study was to promote student reflection on the historical and cultural impact of the implementation of the European Higher Education Area (EHEA) on the nursing practicum course in Spain. The objective was to demonstrate the relevance of a clinical practice diary as a facilitative tool for reflection, metacognition and self-evaluation during the practicum. The theoretical framework for this study was based on the socio-critical and critical thinking and comparative education paradigms. Methodologically, we used reflection and educational, ethnography-based resources.
  
  
  RESULTS
  Theoretical and methodological competencies were perceived as requiring more time and effort (records, nursing process: 29%/35% respectively), whereas the technical skills that related to community work are perceived as involving the least amount of time and effort requiring (13%/10% respectively). The conclusion we have reached is that the primary difficulties in implementing the EHEA are in the cultural transformations that result from the new system of student-centred learning. A clinical practice diary is an effective tool with which to contextualise the nursing practicum and its impact on cultural characteristics, ways of thinking and the reflections of the students. This clinical practice diary facilitates the achievement of competences through the processes of reflection and metacognition.
authors.affiliation: Culture of Care Group, Department of Nursing, University of Alicante, 03080, Alicante, Spain. jose.siles@ua.es
authors.forename: J
authors.initials: J
authors.lastname: Siles González
authors.forename: Ma C Solano
authors.initials: MC
authors.lastname: Ruiz
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004506:Education, Nursing / Q000458:organization & administration*; D005060:Europe; D006801:Humans; D007858:Learning; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D015279:Organizational Culture; D013030:Spain; D013338:Students, Nursing / Q000523:psychology*