
Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
INTRODUCTION. Assertiveness is one of the important skills, with specific characteristics that can prevent burnout, increase job satisfaction, resolve workplace conflicts, reduce depression, improve patient treatment, and improve the quality of care. OBJETIVE. to determine the importance of assertiveness and its applicability as part of the teaching and learning method in Health Sciences education in Ecuador. METHODOLOGY. A bibliographic review was conducted using the search term "Assertiveness" [MeSH] between 2017 and 2024, in English. The database used was PubMed. Twelve out of 135 scientific articles related to Health Sciences education were included. Paid articles and articles not related to medical training will be excluded. RESULTS. Assertiveness and the ability to express concerns about unsafe practices are fundamental to establishing a culture of patient safety. This is strengthened when healthcare professionals not only defend their rights, but also those of the patient. In several countries, assertive communication training programs have proven effective for various healthcare professionals when used in clinical practice. CONCLUSION. Coordination between universities and healthcare facilities is suggested for learning programs that utilize assertive communication strategies such as role-playing, group work, and ongoing clinical scenario discussions, with immediate feedback. These programs are based on planned, culturally appropriate workshops, focused on patient safety and quality, and on resolving bioethical conflicts in healthcare practice
1. Carona C, Ramos K, Salvador C. Psychotherapy by Reciprocal Inhibition: Wolpe’s unique legacy to the evolution of cognitive–behavioural therapy. BJPsych Advances. 2023;29(3):218-
222. DOI: 10.1192/bja.2022.75. Disponible en: https://www.cambridge.org/core/journals/bjpsych-advances/article/psychotherapy-by-reciprocal-inhibition-wolpes-unique-legacy-to-t
he-evolution-of-cognitivebehavioural-therapy/A34DE39AC4C20EA598209C8150F9117F
2. Mansour M, Jamama A, Al-Madani M, Mattukoyya R, Al-Anati A. Reconciling assertive communication skills with undergraduate nursing education: Qualitative perspectives from
British and Saudi newly-graduated nurses. Health Professions Education. 2020;6(2):176-186. Disponible en: https://www.academia.edu/107777933/Reconciling_Assertive_Communication_Skills_With_Undergraduate_Nursing_Education_Qualitative_Perspectives_From_British_and_Saudi_Newly_Graduated_Nurses
3. Alonso Mosquera L, & Prieto Lozano D. Simulación interprofesional en salud y el desarrollo de competencias. Revisión de literatura. 2024. https://hdl.handle.net/20.500.12495/13460.
Disponible en: https://redcol.minciencias.gov.co/Record/UNBOSQUE2_fa93ddfe402a39979741405a4c92de64/Details
4. Sinchiguano D. La comunicación asertiva como herramienta para la satisfacción en la atención a los pacientes que acuden al área de emergencia del Hospital IESS Ibarra. Pontificia Universidad del Ecuador. 2024. Disponible en: https://repositorio.puce.edu.ec/items/cdef8b51-3e9c-4ad0-8e05-cf30dae87b7f
5. Azizi S, Heidarzadi E, Soroush A, Janatolmakan M, & Khatony A. Investigation the correlation between psychological empowerment and assertiveness in nursing and midwifery students
in Iran. Nurse education in practice. 2020; 4:102667. https://doi.org/10.1016/j.nepr.2019.102667. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1471595318308539?via%3Dihub
6. Omura M, Levett-Jones T, & Stone T. Design and evaluation of an assertiveness communication training programme for nursing students. Journal of clinical nursing. 2019; 28(9-10): 1990–1998. https://doi.org/10.1111/jocn.14813. Disponible en:
https://onlinelibrary.wiley.com/doi/10.1111/jocn.14813
7. Pérez-Caldevilla M, Mesa I, Herrera I, & Reyna I. Instrumentos para medir la habilidad de comunicación en estudiantes de ciencias médicas: revisión sistemática. Revista Cubana
de Medicina Militar. 2024; 53(3): 024044901. https://revmedmilitar.sld.cu/index.php/mil/article/view/44901
8. Hernández-Xumet J, García-Hernández A, Fernández-González J, & Marrero-González C. Exploring levels of empathy and assertiveness in final year physiotherapy students during
clinical placements. Scientific reports. 2024; 14(1): 13349. https://doi.org/10.1038/s41598-024-64148-8. Disponible en: https://www.nature.com/articles/s41598-024-64148-8
9. Al-Hawaiti M, Sharif L, & Elsayes H. Assertiveness in Nursing: A Systematic Review of Its Role and Impact in Healthcare Settings. Nursing Reports (Pavia, Italy). 2025; 15(3): 102.
https://doi.org/10.3390/nursrep15030102. Disponible en: https://www.mdpi.com/2039-4403/15/3/102
10. Mansour M, Hasan A, & Alafafsheh A. Psychometric evaluation of the Arabic version of the Irish Assertiveness Scale among Saudi undergraduate nursing students and interns. PloS
one. 2021; 16(8): e0255159. https://doi.org/10.1371/journal.pone.0255159. Disponible en: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255159
11. Aul K, Ferguson L, & Russo B. Strategy to Enhance Undergraduate Nursing Students’ Assertiveness. The Journal of nursing education. 2023; 62(4): 263–264. https://doi.org/
10.3928/01484834-20230208-09. Disponible en: https://journals.healio.com/doi/10.3928/01484834-20230208-09
12. Lechon Tarabata I, & Pacheco Carabajo G. Relación Afectiva entre Paciente Pediátrico y Personal de Enfermería durante el proceso Hospitalario. Revisión Sistemática. Ciencia Latina
Revista Científica Multidisciplinar. 2025; 8(6): 9719-9741. https://doi.org/10.37811/cl_rcm.v8i6.15639. Disponible en: https://www.researchgate.net/publication/388278691_Relac
ion_Afectiva_entre_Paciente_Pediatrico_y_Personal_de_Enfermeria_durante_el_proceso_Hospitalario_Revision_Sistematica
13. Omura M, Maguire J, Levett-Jones T, & Stone T. The effectiveness of assertiveness communication training programs for healthcare professionals and students: A systematic review. International journal of nursing studies. 2017; 76: 120–128. https://doi.org/10.1016/j.ijnurstu.2017.09.001. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0020748917302006?via%3Dihub
14. Kılıç S, & Sevinç S. The Relationship Between Cultural Sensitivity and Assertiveness in Nursing Students from Turkey. Journal of transcultural nursing: official journal of the
Transcultural Nursing Society. 2018; 29(4): 379–386. https: //doi.org/10.1177/1043659617716518. Disponible en: https://journals.sagepub.com/doi/10.1177/1043659617716518
15. Ayhan D, & Seki Öz H. Effect of assertiveness training on the nursing students’ assertiveness and self-esteem levels: Application of hybrid education in COVID-19 pandemic. Nursing forum. 2021; 56(4): 807–815. https://doi.org/10.1111/nuf.12610. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34028042/
16. Pades Jiménez A, García-Buades M, & Riquelme I. Development of emotional intelligence and assertiveness in physiotherapy students and effects of clinical placements. Physiotherapy
theory and practice. 2023; 39(1): 72–79. https://doi.org/10.1080/09593985.2021.2005200. Disponible en:https://www.tandfonline.com/doi/full/10.1080/09593985.2021
.2005200
17. Mosquera L, Lozano D, Rodríguez A, & Ortiz W. Simulación interprofesional en salud y el desarrollo de competencias. Revisión de literatura. Revista Boletín Redipe. 2024; 13(10):
85-104. https://doi.org/10.36260/k8dc0n24. Disponible en: https://revista.redipe.org/index.php/1/article/view/2177
18. Keates C. Students’ experience of the challenges of using assertive communication. British journal of nursing (Mark Allen Publishing). 2022; 31(15): 790–798. https://doi.org/10.129
68/bjon.2022.31.15.790 PMID: 35980922. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35980922/
19. Maza-de la Torre G, Motta-Ramírez G, Motta-Ramírez G, & Jarquin-Hernández P. La empatía, la comunicación efectiva y la asertividad en la práctica médica actual. Revista de sanidad militar. 2023; 77(1): e01. Epub 02 de junio de 2023. https://doi.org/10.56443/rsm.v77i1.371. Disponible en: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=
S0301-696X2023000100001
20. Hanson J, Walsh S, Mason M, Wadsworth D, Framp A, & Watson K. ’Speaking up for safety’: A graded assertiveness intervention for first year nursing students in preparation for
clinical placement: Thematic analysis. Nurse education today. 2020; 84: 104252. https://doi.org/10.1016/j.nedt.2019.104252. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31698289/
21. Rohsig V, & de Souza A. Assertiveness training during early undergraduate years has the potential to increase students’ confidence and ability to act as patient advocates. Evidence-based nursing. 2021; 24(2): 40. https://doi.org/10.1136/ebnurs-2019-103235
22. Chugcho E. Estrategias de comunicación asertiva de los profesionales de enfermería en la atención del usuario. Universidad Técnica de Ambato. 2023: https://repositorio.uta.edu.ec/server/api/core/bitstreams/369c5b36-24ed-47c3-a44a-b3185e89edcf/content
23. Brito Guerrero N, Zurita Soria M, Padrón Fernández L, & Pérez Reyes J. Comunicación asertiva de malas noticias a pacientes y familiares de cuidados paliativos. Revista Qualitas.
2024; 28(28): 108 - 137. https://doi.org/10.55867/qual28.07. Disponible en: https://revistas.unibe.edu.ec/index.php/qualitas/article/view/243
24. Ochoa Andrade M, Moreno Jaramillo O, Saldarriaga Mera F, Santana López M, Toala Mora A, & Yacelga Marcillo J. Perfil de competencias del docente universitario en el campo de las
ciencias de la salud. Revista Médica-Científica CAMbios HECAM. 2024; 23(1): 946. https://doi.org/10.36015/cambios.v23.n1.2024.946. Disponible en: https://revistahcam.iess.gob.ec/index.php/cambios/article/view/946

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2026 Medical-Scientific Journal CAMbios HECAM