In nursing schools, the contrast between what is taught in classrooms and what is practiced in healthcare centers often causes students to be very confused. The objective of this research is to know the opinion of the students and professionals of the care centers where they carry out their clinical practices about them, to detect their problems and see if there are differences between primary care and specialized care. The research was carried out during the first semester of 2015 with qualitative methodology, through four discussion groups, formed by students, alumni, primary care tutors and nursing professionals of the hospitals in which the practices are carried out. The initial intervention used was indirect. The discourse of nursing students and their tutors on the practices during the diploma shows the dissatisfaction of both groups. In all the groups the anguish appears as the protagonist of their teaching, teaching and assistance activities. The lack of social recognition determines their lack of identification as a collective, and both that the anguish are present. The recognition of the degree for their university studies and the development of the specialties would contribute to their social recognition and their identification as a professional group. Conclusions: As long as the anguish that the nursing professionals have, and that transfer the students during the realization of the internship, is not resolved, it will not be possible to reach a higher level of satisfaction with them, neither by the tutors nor by the students.

When talking about the nursing career in the performance of teaching, it is described that the nursing teacher in the development of its contents of the theoretical-practical activities establishes that in the clinical practice fields it provides the necessary bases developed or obtained in the classroom to identify the knowledge bases of the professional future. The proposed objective is to understand the experience of nursing teachers with nursing students, in the fields of practice for the clinic. The teaching and learning process in nursing has some special characteristics because it is largely based on theory and practice, as well as being developed in institutions providing health services that act as clinical practice fields.

That is why the Higher Education Institutions of Nursing in particular, in the last decade have been concerned with the quality and constant updating of the study programs, so that the training of professionals is relevant to the demands of a constantly changing world. In this sense, the university in Venezuela, in correspondence with the Nursing School, has adopted the curriculum model for Integrated Professional Competencies, which privileges the student's learning and active role. At the center of the educational process is the student, who is the one who must develop skills that facilitate his learning. The teacher ceases to be the center, to become a mediator between the student and knowledge.

According to the above, teaching is conceived as a dynamic, participatory and interactive process between the educator and the student, in which the teacher's tasks are focused on directing the student's autonomous and conscious process in the construction of their knowledge, skills and values; teaching not only implies providing information, but helping to learn and develop as people. The goal of teacher activity is to increase the competence, understanding and autonomous performance of their students (Díaz Barriga, 2010: 5). It is trained to help people, families and communities in the recovery of health and the maintenance of life (p: 6). Thus, Nursing Education is a fundamental element of the university programs of the profession. Registered nurses must be prepared to provide Nursing care, to healthy or sick people in different scenarios, and be prepared to act in rapidly changing political and economic-social scenarios that influence the provision of services and Healthcare.

Congruent with the above in the Nursing degree curriculum of these Academic Units, theoretical and practical subjects focused on the first, second and third level of care are included, including learning units such as: Community Nursing, Epidemiology, Public Health, Preventive Medicine, as well as the Community Practice from the second semester of the race. However, it is often observed that students do not show great interest in Community Care, they focus mainly on healing aspects, taking little care of health promotion and disease prevention.

Based on this problem, this research is proposed, which involves reflecting on the components that are involved in the teaching and learning process, which includes the cognitive subject, the teacher and the programmatic content. The objective of this study is: to describe and analyze the teaching/learning of Nursing, in undergraduate students of the Higher School of Nursing in Venezuela, since it is important to leave teaching models with emphasis on the contents and development of certain skills and behaviors (which can be measured) that consequently inhibit creativity and independent and critical thinking of the student (Waldow, 2008: 178-179).

In relation to Nursing training, Carvalho (2009) mentions that the teaching model should form a critical conscience, a new professional mentality in line with the meanings of the art of Nursing and health care, in the context of new vision on seeing sick or healthy people with care needs, support measures and instructions for nurses especially. The integration of theory and practice in academic training is one of the main concerns of teaching institutions. Nursing schools are no exception and the contrast between what is taught in the classrooms and what is learned in the health centers where clinical practices are carried out, usually immerses students in great confusion.

Therefore it would be too pretentious, even utopian, to want to reach a level of perfect agreement between the theory and practice of a subject. It is the subject involved in the learning process that uses the means at its disposal to integrate theory and practice in a dynamic way. Despite this reality, from the teaching point of view, we must always ensure that there is coherence between theoretical and practical training, to avoid the appearance of what some authors have called "reality shock". This would be caused by the disharmony between how things are believed to be and how they really are, and their main consequences are the intense disorientation and anguish of the student.

Some authors have introduced concepts such as praxis or reflective practice in the field of nursing teaching. These terms speak to us of a pedagogical and methodological philosophy of formation; in it, the central axis is the practice. But this is much more than a mere instrumentalized application of what the student learns in the classroom or a repetition of what was observed during the periods spent in the care centers. It consists of a much broader vision of nursing work, in which each problem is unique, immersed in a certain reality, and whose resolution lies in the action from the reflection. From this point of view, clinical practices take on great relevance and the need for rigorous learning in this area becomes irrevocable.

Among the nursing professionals we find three sectors: the care, the teacher and the manager. This division, instead of supposing an enrichment of the entire nursing group, causes rather a state of permanent conflict, since each one projects a different image marked by its particular objectives, which, in terms of Student training seems to go in different directions. The assistants think that teachers do not prepare students to face reality; Teachers, in turn, maintain that caregivers do not assume their teaching commitment and that they are reluctant to open up to new trends that mark nursing professional performance. With this situation it is really very difficult to convey to students a unified and complementary image about theory and practice.

Theoretical fundament
According to the author Carvalho (2009) To build the appropriate teaching method for the nursing chair, you must know the institutional context, its mission, vision and principles that underlie it, the Aulic context, both physical and virtual where the Teaching process, quality and convenience of the materials to be used. The methodological construction is not absolute but relative. It is formed from the conceptual structure (syntactic and semantic) of the discipline and cognitive structure of the subjects in a position to appropriate it. Construction, therefore, of a singular nature, which is generated in relation to a particular object of study and with particular subjects. As an expression of its singular character, it is also relevant to recognize that the methodological construction of education is shaped within the framework of situations or areas that are also particular.

This in the nursing chair, establishes that education is casuistically constructed in relation to the context (aulic, institutional, social and cultural). Therefore, the educational practice in nursing is carried out in different institutional settings with diverse contexts, characteristics and elements that the teacher should always consider when planning their teaching method, the objectives or purposes of the subject or subject to be taught are significant for the structure of the disciplinary contents and the projected activities with the students. In particular, the socio-economic and cultural context of the population in formation, their customs, beliefs and interactions between the subjects, their motivation towards the subject and their mental processes, to identify the strategies and techniques by which they must be analyzed Learning will develop.

It is pertinent to understand that the reflection on the aptitudes, personal, academic and work experiences, skills and abilities of the teacher, lead him to create his own style. Since more and more teaching is learned every day, as more experience is gained, more knowledge and bases for acting are also acquired. That is why constant reflection in practice is indispensable for personal, professional and intellectual growth. Knowledge in pedagogy is important, but the experience of that knowledge enriches teaching, consolidates knowledge, teaching practice, facilitates the delivery of knowledge and gives greater security to both the teacher and the student. At the same time, the maturity in the mental processes that the experience gives, the group management, the interactions with others, help the nursing professional to consider new educational challenges.

It is significant to note that the adoption of a methodological perspective in teaching projects a unique style of training. Perspective that brings into play principles and procedures of a theoretical nature and derivatives of practice. Style that, consequently, in its complex framework also expresses its trajectory (life, academic, work), even when it may not be objectified, as long as it is played in practice.

Barriga, 2010 on the other hand determines that some strategies, techniques and activities in the teaching process by identifying that in the nursing teaching process in its practical theoretical basis it is proposed to reinforce cooperative learning as a method and strategy, in which the student participates actively in the search for knowledge, not only investigating and discovering theory, but applying knowledge in simulation laboratories, in practice and in real life. This learning is a precise strategy for the higher level where students arrive cognitively prepared to build new ideas and knowledge that also facilitates interaction and participation. Here, the teacher must establish norms that allow guiding the actions and acquiring a commitment and responsibility with the group.

Collaborative learning in the nursing profession represents another teaching strategy that develops personal, social and coexistence skills, in which values such as respect, responsibility and will allow to create consensus in the team members for the collective construction of the new knowledge. It develops through a gradual process in which each member and everyone feels mutually committed to the learning of others, which generates positive interdependence that does not imply competition.

It is noteworthy that, in collaborative groups, respect for individual contributions and skills is a fundamental requirement, there is a shared authority, relationships of equality and acceptance of responsibilities in actions and decisions, which forms the student so that in the future Know how to share and work as a team. Since the role of the teacher in this case is to intervene to clarify concepts or ideas, complement the information related to the topic, simulate problem situations and during the resolution process facilitate the student to assimilate the respective information and organize their ideas.

Within the teaching strategies, “The use of individual and collective work is considered, considering that learning occurs in the relationship between subjects although it has an individual aspect, since activities are contemplated that contemplate both the collective and individual aspects. The use of action-reflection-action, which implies taking the action itself as an object of questioning, then, to act again. The dialogue as mediator of the process, of the theoretical teaching practice establishing if the learning takes place in the relationship between the subjects, the dialogue is formed in an indispensable way because it is the one that can ensure the sharing of experiences, the discussion on the object of study, that is, learning itself with the other. The integration of personal objectives in the groups, although the discipline presents its own objectives”.

Theories of learning in teaching practices the learning theories Gimeno Sacristán and Pérez Gómez 2010. It states that during the practical theoretical teaching process one must constantly reflect on each step that happens, when the educational activity is being planned, during its development and when it has finished. Therefore, based on the reasons given by the author "For the instructive and formative process of the person, learning theories, according to their model and proposal, are supported with different emphasis and strategies on motivation, attention, assimilation, organization, recovery and transfer of knowledge as an object, in its relation to the subject that learns and in the context where learning is required. Each of these strategies used in the teaching process can generate different effects or results, so it is necessary an analysis regarding what was planned in the planning, what was observed in the action, the criteria used in the evaluation and the criticism regarding the effectiveness in the learning process”.

In the nursing profession, the initial motivation that the student brings with respect to the subjects is specifically concerned. Since within them, theoretical subjects and practical theoretical matters are established. That is why there are students and teachers who want to know about the subject, as well as those who only want to meet a requirement in their curriculum. It is a challenge for the teacher to plan proposals or activities that motivate them all and involve them during the course of the semester to develop and present their products. In the end you can find that many of the students who were not motivated, have been satisfied and wanting to know more about it. By applying various strategies and techniques, information and knowledge can be fed back with the active participation of students.

Teaching as a practice and research challenge in nursing
Ferstermacher and Soltis, 1999, Identifies that Teaching is to inspire, is to promote discussion about the problems raised, is to provide the opportunity to coordinate different points of view, starting with the purpose of guiding towards the cooperative resolution of problem situations. In a profession as a nurse whose mission is based on an ethic, techniques and procedures of caring for other people, sometimes in a vulnerable state, the responsibility of forming and recognizing the growth of people who play a leading role in the society we dream of is palpable. . “Teaching not only has consequences on the lives of people, but also on the future of societies and the destiny of nations. Teaching helps to form a type of man and a type of society. A more or less explicit ideal of “educated person” gives direction and form to teaching practices (Ferstermacher and Soltis, 1999) and is expressed in educational purposes, which can be reconstructed through the curricular texts in force in each historical context”.

So, if you take into account that one of the priority factors involved in the development of health education nations, forming the university community corroborates or transforms beliefs and renews knowledge. Therefore, it is necessary to look at how teachers transform the teaching process, aware that it is not only to transmit or report data, but to train citizens capable of building society. Building society is creating new knowledge and thoughts, consolidating the structure of the individual, his personality, making him participate in the solutions of the problems that afflict society, in a clear, honest and open way.

At the end of the 20th century, the concepts of health and care were an important part of the curricular proposals of the nursing profession. From these components, the infirmary was inclined to assist people so that they themselves would take care of themselves. Thus, he educated, motivated and guided them, and became involved with them in the care and decisions they made regarding their health. For this, it was conceptualized that the person was an indivisible whole that oriented their care according to their priorities. In turn, by this end of the century, pedagogical models began to privilege the teacher-student relationship, in which the teacher, with his mastery of the content, led to the autonomy and self-learning of the students.

From the nursing profession, the emphasis on self-care causes the individual to be empowered of his health and actively participate in the solution of the problems that afflict him as an individual or the collective, so the student must be accompanied in the identification and approach to solutions to health problems found in the community from interdisciplinary work and with other sectors of society. As students grow and learn, one as a teacher also learns from them and improves the teaching work every day.

In the interaction between teachers and students, the use of norms that are the result of agreements that seek quality of life and development of the educational community is encouraged. In this sense, it is about the students living the democratic use of power (the value and importance that implies the fact that knowledge circulates socially), fulfill functions of common benefit and recognize health and the disease not as a matter of "powerful specialists", but as part of the reality of all people and groups. Together, the participation of the teacher in those social or political groups involved in the preparation of the curricula is fundamental, since from there the educational policies that will support the system are formulated; It is the teachers who ultimately live and know the problem of teaching and their opinion should be valued within the framework of Venezuelan educational legislation.

Information and communication technologies in teaching another unavoidable element are the assimilation of Information and Communication Technologies (ICT). Litwin clarifies that: “Just as the chosen strategy does not structure the educational proposal alone, neither does the selected technological support. The familiarity with the technologies makes them invisible, that is, we are not aware of the changes caused by their use and it does not allow us to identify how they condition or impact the practices. We stop recognizing the reasons that underlie your choice: they provide better explanations, they allow you to bring images that favor understanding to the classroom, and they are provocative because of the type of relationships they create, among many others”

New technological developments have forced progress in the educational area for nursing education to implement programs. This requires the construction and implementation of new pedagogical models in information and communication technologies that stimulate the creation of learning communities and that seek the consolidation of collaborative methodologies, where the participation of the actors of the educational plot is equal in the process of teaching and learning The teacher is immersed and he feels the demand for the use of ICT when working with young university students, who increasingly demand this type of technology, which are close to them. Learning the management of these tools allows to introduce the topic to be treated, clarify information, question or develop thinking, give importance to those relevant or outstanding activities and leave written record of the above. And students must discern the information they obtain online, not everything is important, nor true, not all sources are reliable and not all content is sufficiently argumentative. But, it is also not true to generalize that all the information extracted from the internet does not work, is harmful or superfluous. Since “There are no equal subjects, there are no equal teachers and there are no equal student groups. It is difficult to recognize that in this time of innovations, the didactic, the old didactic founded in the 17th century, still has many things to say”

Within this teaching and learning process, it is clear that the reflection on the teaching experience in nursing is the way to continually research, innovate and create not only knowledge, but also citizens of the future. Although the designers of teacher training policies have opted for the death of didactics, more because of ignorance of this discipline than because of a recognition of the role they have in the structuring of the teaching profession, we could almost say that without didactics there is no way that a person do their teaching work.

Based on this problem, this research is proposed, which involves reflecting on the components that are involved in the teaching and learning process, which includes the cognitive subject, the teacher and the programmatic content. The objective of this study is: to describe and analyze the teaching/learning of Nursing, in undergraduate students of the Higher School of Nursing it is also important to leave the teaching models with emphasis on the contents and the development of certain skills and behaviors (which can be measured) that consequently inhibit the creativity and independent and critical thinking of the student (Waldow, 2008: 178-179).

In relation to Nursing training, Carvalho (2009) mentions that the teaching model should form a critical conscience, a new professional mentality in line with the meanings of the art of Nursing and health care, in the context of new vision on seeing sick or healthy people with care needs, support measures and instructions for nurses especially.

The evaluation and control of education systems in higher education in general and in particular those of nursing, imply the appreciation of constant pressures of varied order (social, economic and technological demands), for whose attention they need to have educational methods, of adequate research and evaluations, which allow it to improve the urgent requirements to update the training of its professionals. That is how teaching should transcend the teaching-learning process, favoring a renewal that considers: scientific progress, the versatility of the contents to teach, the incorporation of varied methodologies that replace the insufficiency of the exhibition classes, the establishment of permanent education processes that open possibilities for continuing education, the expectations of new professional, social and interdisciplinary roles, among others.

However, reforms in higher education often offer resistance, uncertainty, insecurity, which is based fundamentally on the tradition of years and on rigid and routine university positions. This implies, maintaining a constant attitude of alertness, motivation, knowledge and teamwork that lead to overcome them. According to the aforementioned problem, this article raises the need to innovate in nursing education, as a way of optimize and improve in a broad and deep way the quality and effectiveness of it, using as an alternative the contributions of instructional design. To achieve the purpose, some antecedents that affect the university system in general are presented, which in particular can also be focused on the nursing situation.

Standing out in this way, the active and responsible role that corresponds to it, compared to the improvement of the teaching provided. Some educational methodologies and the main properties and characteristics of instructional design are described. It should be noted that nursing education must be assumed by estimating an institutional team work, which allows the use and development of learning resources in accordance with the current requirements of society, taking advantage of scientific and technological activity and using existing means in all their potential. What involves the creation of environments conducive to the individual growth of students and academic development, favoring an active, creative and questioning professional training?

Reflections
The general problems faced by nursing professionals and the particularities of the health context, determine the need for a more coherent relationship between the lack of work context and professional performance. In this article the performance of the nursing professional is based as a response to that need in the exercise of the profession, and an evaluative analysis of concepts, conceptions and approaches for its formation is made from diverse references in the international context and its implications in The performance of this professional. Relations related to performance are determined from the practice of nursing and the current conditions of their knowledge in the field of health.

Various experiences are debated in the international and national context, but it is necessary to reason the most up-to-date conceptions on the subject, and analyze whether they meet the needs of nursing in terms of practical theoretical teaching. This research was aimed at systematize the definition of nursing professional performance, taking into account its relationship with the current conditions of nursing practice. Nursing professional performance is an object of research that is usually not addressed much during the fulfillment of the investigative functions. Nursing models and theories are guidelines for the continuous development of nursing practice from the improvement of professional performance. The contributions as a result of the systematization favor the clarification of the operational definitions, necessary to contextualize the research objectives.

Comparisons To reveal the phenomenon of the experience of being a teacher/Nursing Facilitator, who in the fields of Theory and practice sometimes acts with graduating students, allowed us to understand the relevance of the educational process in the attributes of modes of being, communication, affection, language, time and space, among others. The teaching nurse/Facilitator as being there has the possibility of transcending being with the other in the world, understanding the other in their existence and their world, and at the same time, having the possibility of transforming that world, because it is permanently being changed with updated techniques and procedures. Training a new nursing professional is a complex task that requires the teacher skills related not only to their knowledge, but also to the skills acquired from their own experience in terms of being. These skills that will be applied in real time, in a complex environment such as the clinical field, an environment that necessarily involves the relationship with the patient, student, clinical nurse and health team. As nursing teachers we consider that the production of knowledge is generated from education. In this educational process we must consider the creative gesture that results from man being in the world and interacting with him, which allows him to transform and, in this process, transform.

On the other hand, the dissemination of knowledge favors the reflection of the teaching team and the nurse on the educational meaning of their function, identifying issues to be improved in the process of caring for students and patients. It is necessary to expand research in this area, since as we saw, this is an important part of the learning process of the future nursing professional. In addition, when reviewing the production available at the South American level on the subject presented, we face difficulties in finding similar research to enrich the discussion presented.

In the same way, we understand that it is the task of universities to constantly search for the teaching / assistance approach, as a construction and facilitator element of the teaching process, with the objective of training new nursing professionals who, in their actions, bring with them the foundations of authentic care, and involve in this care the teacher, the nursing student and the patient, as active members of their important function.