Interprofessional training for nursing and medical students in Norway : exploring different professional perspectives.

This article presents an explorative case study focusing on interprofessional training for medical and nursing students in Norway. Based on interviews with, and observations of, multiple stakeholder groups-students, university faculty, and hospital staff-content analysis was applied to investigate their perspectives regarding the design of such educational training. The findings revealed a positive perspective amongst stakeholders while voicing some concerns related to how communication issues, collaboration, workflow, and professional role patterns should be reflected in such training. Based on our data analysis we derive three themes that must be considered for successful interprofessional training of nursing and medical students: clinical professionalism, team performance, and patient-centered perspective. These themes must be balanced contingent on the students' background and the learning objectives of future interprofessional training efforts

Influence of Lithium ions on conidiophore size in Neurospora crassa

Lithium (Li) ions are known to affect Neurospora crassa’s growth speed and circadian clock period, while elevated temperatures abolish these influences. We wondered whether Li has also an effect on conidia size. We used cryo-SEM to investigate this question and report here the results of 1720 measurements showing that at 20°C the long and short conidial axes are significantly reduced at high Li concentrations (10-15 mM), while the ratio between the long and short axes remains approximately constant. An increased temperature (30°C) appears to abolish the Li effect on conidia size

To what degree and how do healthcare professionals in nursing homes and homecare practice user involvement? A mixed methods study

Background: Involving patients and users may contribute to sound quality and safety in healthcare services. We examined the degree to which and how user involvement is practiced in daily work and in quality improvement in nursing homes and homecare. Methods: Mixed methods design. Focus groups and individual interviews with managers (n=45), and employees (n= 40) from 15 Norwegian care settings were conducted. Data were analyzed via systematic text condensation. Survey data from four homecare services (N=139) and four nursing homes (N=165) were analyzed using descriptive statistics and t-tests. Results: Participants focused on supporting independence in users and involved them in activities that increased coping. Knowing users was an important prerequisite. Challenges related to poor communication leading to several cross-pressures between users, relatives and healthcare professionals. There were no differences between nursing homes and homecare on the degree of user involvement in daily work and in quality improvement; both scored significantly lower on the latter. Conclusion: User involvement is an important part of the daily work of healthcare professionals in care settings. Participants seemed to lack knowledge on how to use patients’ experience to inform quality improvement. A key remedial strategy is training healthcare professionals in involving users in quality improvement.publishedVersio

Lessons learnt from nursing home and homecare managers’ experiences with using the SAFE-LEAD guide

Background: In the SAFE-LEAD intervention we implemented a research-based guide (paper- and web-version) for managers to support their quality improvement work. This paper explores managers’ experiences with the SAFE-LEAD guide, and key factors of relevance for sustainability. Methods: Four Norwegian nursing homes and four homecare services participated, and 36 workshops with managers working together with researchers on the guide were conducted. After the intervention, nine focus groups with managers were conducted. Systematic text condensation was used for analysis. Results: Managers perceived the guide as useful in their quality improvement work. It helped create a systematic approach and overview of improvement activities. The guide supported collaborative reflections, awareness and fitted with their daily work. Most preferred the web-version, but technical adjustments were required to ease its use. Prioritization, anchoring, super users, and local adjustments were key factors for sustainability. Conclusion: Key factors for successful implementation were adapting the guide to the local context, access to supporting learning tools, thorough anchoring, acknowledging its benefits, and prioritizing. Further implementation studies should take technological maturity, ongoing changes and reorganizations in the sector and units into account. Careful planning and timing of the intervention, involving all relevant stakeholders at an early stage, is important.publishedVersio

Exploring stakeholders’ experiences in co-creation initiatives for clinical nursing education: a qualitative study

Background Co-creation is an emerging approach in nursing education, wherein academics engage in multi-stakeholder collaborations to generate knowledge, ideate solutions, promote sustainability, and enhance educational quality. However, knowledge on stakeholders’ experiences in participation in co-creation initiatives for nursing education is scarce. This study aimed to explore the experiences of student nurses, nurse educators, and e-learning designers in co-creation initiatives to design and develop a digital educational resource for clinical nursing education. Methods The study adopted an exploratory qualitative design. Data were collected via three separate semi-structured focus group interviews with student nurses (n = 7), nurse educators (n = 8), and e-learning designers (n = 3) who participated in co-creation workshops. Collected data were then thematically analyzed. Results Three themes related to the participants’ experiences emerged: (1) The co-creation workshops were enjoyable, useful, and instructive; (2) power imbalances influenced the students’ engagement; and (3) contextual factors influenced the participants’ overall engagement. Conclusions This study shows that co-creation through workshops is a novel, enjoyable, and instructive approach that facilitates knowledge exchange. It also highlights the needs and experiences of stakeholders, especially student nurses. However, the use of co-creation in nursing education presents some challenges. Recognizing and managing power differentials are essential for successful co-creation in clinical nursing education, alongside a mindset of collaboration and mutuality. Future research is required to systematize knowledge about the benefits and impacts of the processes and outcomes of co-creation initiatives, including stakeholders’ motivation, barriers, and facilitators to participation in co-creation, to improve the quality of clinical nursing education.publishedVersio

A digital educational resource to support and enhance effective mentorship practices of nursing students in nursing homes: a qualitative study

There is a grooving body of evidence emphasising the need to support and enhance effective mentorship practices for nursing students in nursing home placements, including strengthening of the pedagogical competence of registered nurse mentors. Owing to the necessity for multifaceted mentoring competence and the challenges of workload registered nurses are facing, the use of flexible digital educational resources has been suggested. However, current knowledge on the effectiveness of digital educational resources in enhancing mentorship practices in nursing homes is scarce. This study aimed to explore the perception of registered nurse mentors regarding the effectiveness of a digital educational resource, particular its usability and value-in-use in supporting and enhancing mentorship practices in nursing homes. The study applied an exploratory descriptive qualitative design. Pre- and post-mentoring semi-structured focus group interviews were conducted among a total of 23 registered nurse mentors across three Norwegian nursing homes. The transcribed interviews were thematically analysed. Standards for reporting qualitative research were followed. The analysis yielded one pre-mentoring theme: (1) predominant enthusiasm and satisfaction and three post-mentoring themes: (2) enhanced confidence and motivation, (3) enhanced mentoring competence in supporting the nursing students’ learning process, and (4) factors influencing the value-in-use of the digital educational resource. Digital educational resources support effective mentorship practices by enhancing the confidence and motivation in the mentor role and by enabling more goal-oriented supervision and assessment tailored to the learning goals of students. The implementation of digital educational resources to support and enhance effective mentorship practices is an important avenue for further research towards achieving high-quality learning environments in clinical nursing education in general and nursing homes. Based on the study findings, nursing educational institutions should consider offering digital educational resources to develop, support, and advance mentorship training, which may more effectively impact and improvepublishedVersio

Psychometric properties of the Norwegian version of the clinical learning environment comparison survey

Aim: To translate The Clinical Learning Environment Comparison Survey (CLECS) into Norwegian and to evaluate the psychometric properties of the Norwegian version. Design: A cross-sectional survey including a longitudinal component. Methods: The CLECS was translated into Norwegian following the World Health Organization guidelines, including forward translation, expert panel, back-translation, pre-testing and cognitive interviewing. Nursing students at a Norwegian university college were invited to participate in the study (psychometrical testing) based on informed consent. Reliability and validity of the translated version of CLECS were investigated using a confirmatory factor analysis (CFA), Cronbach's alpha and test–retest analysis. Results: A total of 122 nursing students completed the questionnaire and Cronbach alphas for the CLECS subscales ranged from 0.69 to 0.89. CFA goodness-of-fit indices (χ2/df = 1.409, CFI = 0.915, RMSEA = 0.058) showed acceptable model fit. Test–retest ICC ranged from 0.55 to 0.75, except for two subscales with values below 0.5.publishedVersio

Supporting the nurse educator in clinical education – A qualitative evaluation of a digital educational resource DigiVIS

Despite the increased use of technology for teaching and learning in clinical nursing education, relatively little attention seems to be directed toward the usefulness of digital educational resources (DERs) to support nurse educators’ educational role in clinical nursing education. An interpretive descriptive qualitative study design was conducted to evaluate the usefulness of a DER to support nurse educators in clinical nursing education. Data were collected through two focus group interviews with part-time and novice educators (n = 5) and full-time, more experienced educators (n = 5), after they had overseen student nurses in nursing home placements. Data were analyzed using thematic analysis and Standards for Reporting Qualitative Research guidelines were used for this study. The analysis identified three themes related to nurse educators’ experiences of the usefulness of a DER to support their educational role while overseeing first-year students on clinical placements in nursing homes: (1) Provides academic support and a sense of security (2) promotes pedagogical efficacy, and (3) represents a flexible resource for educational planning. This study shows that a digital educational resource can be an efficient and useful supplementary strategy to support the nurse educator’s role in clinical nursing education. Future research is required to systematize knowledge about the impact of DERs on orientation and training, as well as motivation and facilitators for, and barriers to, their use to enhance quality and strengthen the nurse educator’s role in clinical nursing education.publishedVersio

Integrating simulation training during clinical practice in nursing homes: An experimental study of nursing students´ knowledge acquisition, self-efficacy and learning needs

Background Limited access to supervision, feedback and quality learning experiences pose challenges to learning in the clinical setting for first-year nursing students who are beginning their clinical experiences. Prior studies have indicated that simulation training, as a partial replacement of clinical practice hours, may improve learning. However, there has been little research on simulation training integrated as a partial replacement during first-year students’ clinical practice in nursing homes. The primary aim of this study was to examine first-year nursing students’ knowledge acquisition and self-efficacy in integrating a partial replacement of clinical hours in nursing homes with simulation training. Its secondary aim was to examine perceptions of how learning needs were met in the simulated environment compared with the clinical environment. Design The primary aim was addressed using an experimental design that included pre- and post-tests. The secondary aim was investigated using a descriptive survey-based comparison. Methods First-year students at a Norwegian university college (n = 116) were asked to participate. Those who agreed (n = 103) were randomly assigned to the intervention group (n = 52) or the control group (n = 51). A knowledge test, the General Self-efficacy Scale and the Clinical Learning Environment Comparison Survey were used to measure students’ outcomes and perceptions. The data were analysed using independent samples t-tests, chi-square tests and paired samples t-tests. Results Knowledge scores from pre- to post-tests were significantly higher in the intervention group than in the control group with a medium to large effect size (p < 0.01, Hedges’ g = 0.6). No significant differences in self-efficacy were identified. Significant differences (p <  0.05) were observed between the simulated and the clinical environment with regard to meeting learning needs; effect sizes ranged from small and medium to large (Cohen’s d from 0.3 to 1.0). Conclusion Integrating the partial replacement of clinical hours in nursing homes with simulation training for first-year nursing students was positively associated with knowledge acquisition and meeting learning needs. These findings are promising with regard to simulation as a viable partial replacement for traditional clinical practice in nursing homes to improve learning.publishedVersio