Sairaanhoitajien opiskelijaohjausosaaminen ja ohjaajakoulutuksen vaikutus osaamiseen

Abstract The purpose of this study was to describe and explain nurse mentors’ competence in mentoring nursing students and to evaluate the effects of an educational intervention on nurse mentors’ competence in mentoring. The purpose was to also evaluate the reliability of an instrument measuring competence in mentoring nursing students. The study aimed to develop new knowledge on nurse mentors’ competence that can be used to improve mentoring education. This study included four phases. In the first phase, nurse mentors’ experiences of mentoring nursing students were described using a systematic review. Data were collected from seven electronic databases and were selected by titles, abstracts and full-texts. The quality of the included studies (n=21) was evaluated and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) extraction tool was used to extract and synthesize the studies. In the second phase, the psychometric properties of Mentor Competence Instrument (MCI) were tested. Data were collected from mentors (n=3355) at five university hospitals in Finland using an electronic version of the MCI. The construct validity and reliability of the instrument were tested using exploratory factor analysis (EFA) and Cronbach’s alpha. In the third phase, mentors’ level of competence in mentoring and distinct mentor profiles were identified using a cross-sectional study. The same data were used as in the second phase of this study and analyzed using multivariate statistical methods. In the fourth phase, the effect of mentoring education on nurse mentors’ competence in mentoring nursing students was evaluated using a quasi-experimental study. Data were collected from nurses (n=150) using the MCI instrument before and after mentoring education. Data were analyzed using statistical methods. According to the systematic review, nurse mentors’ competence in mentoring nursing students contained eight competence areas. The MCI instrument exhibited acceptable psychometric properties. Nurse mentors evaluated their level of competence in various categories from satisfactory to good. Three distinct profiles of mentor competence were identified from skilled developer, competent adapter and beginner. Mentoring education had an effect on mentoring competence.Tiivistelmä Tutkimuksen tarkoituksena oli kuvata ja selittää sairaanhoitajien opiskelijaohjausosaamista sekä arvioida ohjaajakoulutuksen vaikutuksia sairaanhoitajien opiskelijaohjausosaamiseen. Lisäksi tarkoituksena oli arvioida opiskelijaohjausosaamisen mittarin luotettavuutta. Tavoitteena oli vahvistaa hoitotieteen tietoperustaa ja tuottaa uutta tietoa opiskelijaohjaajien osaamisesta ohjaajakoulutuksen kehittämiseksi. Tutkimus oli nelivaiheinen. Ensimmäisessä vaiheessa kuvailtiin järjestelmällisen katsauksen avulla sairaanhoitajien kokemuksia opiskelijoiden ohjaamisessa tarvittavasta osaamisesta ammattitaitoa edistävän harjoittelun aikana. Tiedonhaku toteutettiin seitsemästä tietokannasta. Aineisto valittiin otsikoiden, tiivistelmien ja koko tekstien perusteella. Mukaan otettujen alkuperäistutkimusten (n=21) laatu arvioitiin sekä tulosten yhdistämisessä ja analyysissä käytettiin apuna Joanna Briggs Instituutin JBI-QARI -uuttamismenetelmää. Toisessa vaiheessa arvioitiin opiskelijaohjausosaamista arvioivan mittarin luotettavuutta. Aineisto kerättiin poikkileikkaustutkimuksena Suomen viidessä yliopistollisessa sairaalassa työskenteleviltä sairaanhoitajilta (n=3355) sähköisesti opiskelijaohjausosaamisen mittarilla. Mittarin rakennevaliditeettia arvioitiin eksploratiivisella faktorianalyysillä ja sisäistä johdonmukaisuutta Cronbachin Alfa -kertoimella. Kolmannessa vaiheessa kuvattiin sairaanhoitajien opiskelijaohjausosaamisen tasoa ja selitettiin profiileita poikkileikkaustutkimuksella. Aineisto oli sama kuin tutkimuksen toisessa vaiheessa. Aineisto analysoitiin tilastollisilla monimuuttujamenetelmillä. Neljännessä vaiheessa arvioitiin ohjaajakoulutuksen vaikutuksia sairaanhoitajien opiskelijaohjausosaamiseen kvasikokeellisella tutkimusasetelmalla. Aineisto kerättiin sairaanhoitajilta (n=150) Opiskelijaohjausosaaminen -mittarilla ennen ja jälkeen koulutuksen. Aineisto analysoitiin tilastollisin menetelmin. Järjestelmällisen katsauksen mukaan sairaanhoitajien opiskelijaohjausosaaminen muodostui seitsemästä osaamisen alueesta. Opiskelijaohjausosaamisen mittarin psykometriset ominaisuudet todettiin hyviksi. Sairaanhoitajat arvioivat opiskelijaohjausosaamisen tason tyydyttäväksi tai hyväksi. Sairaanhoitajat profiloituivat ohjausosaamisensa osalta taitavaan kehittäjään, osaavaan soveltajaan ja aloittelijaan. Ohjaajakoulutus edisti ohjausosaamista

Parent and carer experiences of health care professionals’ communication about childhood obesity:a qualitative systematic review protocol

Abstract Objective: The objective of the systematic review is to identify, critically appraise, and synthesize the best available qualitative evidence on parent and carer experiences of health care professionals’ communication about childhood obesity. Introduction: Parents and carers play a key role in a child’s environment and healthy development, which is why they can find it confronting to discuss their child’s weight. This review will provide an insight into the experiences of parents and carers with health care professionals’ communication about their child's overweight or obesity. Inclusion criteria: This qualitative review will consider participants who are parents and carers with a child with overweight or obesity (birth to 12 years). The phenomenon of interest is parents’ and carers’ lived experiences of childhood obesity communication from a health care professional, and the context is health care settings. Communication includes verbal or written communication about a child's obesity from health care professionals received by a parent or carer. Methods: The proposed review will systematically search the following databases: MEDLINE (EBSCO), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, LILACS, and the Finnish health sciences database MEDIC. ProQuest Dissertations and Theses (ProQuest) will be searched for unpublished articles. A manual search will supplement the database searches. The quality of included studies will be assessed independently by 2 reviewers, and the qualitative data will be extracted from papers by 2 independent reviewers using the standardized JBI data extraction tool. The recommended JBI approach to critical appraisal, study selection, data extraction, and data synthesis meta-aggregation will be used

Nurses’ experiences of their competence at mentoring nursing students during clinical practice:a systematic review of qualitative studies

Abstract Aim: To identify and synthesize the best available evidence on nurse mentors’ experiences of their competence in mentoring nursing students during clinical practice. Design: The research employed a systematic literature review that followed the guidelines of the Joanna Briggs Institute (JBI). Data sources: The databases CINAHL, Medline Ovid, Scopus, Eric, Web of Science, Medic, and OATD were systemically searched from 2000 to 2017. Review methods: The identified studies were screened by title, abstract (n = 3080) and full-text (n = 91) using the following inclusion criteria: registered nurses, nurses’ experiences of competence in mentoring nursing students, acute and primary care organizations providing clinical practice for nursing students, qualitative study. Quality appraisal was performed, data extracted and findings from the included studies (n = 21) were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI). Results: A total of 92 extracted findings were aggregated into 21 categories and then further grouped into five synthesized findings: 1) creating an interactive relationship with the student; 2) developing mentor’s characteristics and cooperation with stakeholders; 3) providing goal-oriented mentoring; 4) supporting students’ development to nurse profession; 5) supporting the student’s learning process. Conclusions: This review demonstrated that multifaceted mentoring competence is essential to supporting students’ learning processes and helping them become confident professionals. For this reason, the findings suggest that healthcare organizations which provide clinical practice for students should emphasize developing the mentoring competence of nurses by offering nurse mentors adequate education, ensuring that the organizational structure affords them sufficient support, and creating a receptive learning atmosphere

Mentor experiences of international healthcare students’ learning in a clinical environment:a systematic review

Abstract Background: Globalisation has brought new possibilities for international growth in education and professional mobility among healthcare professionals. There has been a noticeable increase of international degree programmes in non-English speaking countries in Europe, creating clinical learning challenges for healthcare students. Objective: The aim of this systematic review was to describe mentors’ experiences of international healthcare students’ learning in a clinical environment. The objective of the review was to identify what influences the success or failure of mentoring international healthcare students when learning in the clinical environment, with the ultimate aim being to promote optimal mentoring practice. Design: A systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination. Data sources: Seven electronic databases were used to search for the published results of previous research: CINAHL, Medline Ovid, Scopus, the Web of Science, Academic Search Premiere, Eric, and the Cochrane Library. Review Methods: Search inclusion criteria were planned in the PICOS review format by including peer-reviewed articles published in any language between 2000 and 2014. Five peer-reviewed articles remained after the screening process. The results of the original studies were analysed using a thematic synthesis. Results: The results indicate that a positive intercultural mentor enhanced reciprocal learning by improving the experience of international healthcare students and reducing stress in the clinical environment. Integrating international healthcare students into work with domestic students was seen to be important for reciprocal learning and the avoidance of discrimination. Conclusion: Many healthcare students were found to share similar experiences of mentoring and learning irrespective of their cultural background. However, the role of a positive intercultural mentor was found to make a significant difference for international students: such mentors advocated and mediated cultural differences and created a welcoming environment for international students by helping to minimise feelings of social isolation

Practical nursing students’ learning and assessment during work-based placement:a qualitative study

Abstract Aim: To describe practical nursing students’, mentors’ and educators’ perceptions of student learning and assessment of learning progress during work-based learning. Design: A qualitative descriptive study. Methods: The research data were collected by interviewing eight practical nursing students, 12 mentors and eight educators (total n = 28) from three vocational institutions and four social- and health care organizations in Finland during November 2019–September 2020. The interviews were conducted as focus group interviews, after which the collected material was subjected to content analysis. The researchers had received appropriate research permits from the target organizations. Results: Work-based learning depends on the student, who must be goal-oriented and responsible for their own learning. The mentor also plays a key role in the learning process as the supporter and enabler of a student’s goal-oriented learning process. The educator is responsible for instructing both students and mentors, and supporting a student’s goal-oriented learning process. The vocational institution also has a role in successful learning among practical nursing students as an enabler of students’ individual learning process. The participants shared that the workplace is responsible for ensuring a secure learning environment

Effectiveness of technology-based interventions compared with other non-pharmacological interventions for relieving procedural pain in hospitalized neonates:a systematic review protocol

Abstract Objectives: The objective of this review is to evaluate the effectiveness of technology-based interventions in relieving procedural pain in hospitalized neonates compared with other non-pharmacological interventions. Introduction: Neonates requiring hospital care often experience acute pain during medical procedures. The current best practice for relieving pain in neonates is the use of non-pharmacological interventions, such as oral solutions or intervention-based human touch. Technological solutions (such as games, eHealth applications, and mechanical vibrators) have become more commonplace in pediatric pain management over recent years. However, there is a knowledge gap about how effective technology-based interventions are at relieving pain in neonates. Inclusion criteria: This review will consider experimental trials that include technology-based non-pharmacological interventions for relieving procedural pain in hospitalized neonates. Primary outcomes of interest include pain response to a procedure measured by a validated pain assessment scale for neonates, behavioral indicators, and/or changes in physiological indicators. Methods: MEDLINE (Ovid), CINAHL (EBSCO), Scopus (Elsevier), Cochrane Central Register of Controlled Trials, and the MEDIC databases will be searched for studies published in English, Finnish, and Swedish. Critical appraisal and data extraction will be conducted by two independent researchers following JBI methodology. Quantitative data will be pooled in statistical meta-analyses. If statistical analysis is not possible, the findings will be reported narratively. Systematic review registration: PROSPERO CRD4202125421

Frequent attenders’ experiences of encounters with healthcare personnel:a systematic review of qualitative studies

Abstract Rather than measure demographic factors such as socioeconomics, the aim of this study was to examine the lived experience of frequent attenders by synthesizing findings on their encounters with healthcare personnel. The Scopus, CINAHL, PsycARTICLES, and PubMed (Medline) databases were searched in May 2020 in order to screen studies by title and abstract (n = 1794) and full‐text (n = 20). Findings from the included studies (n = 6) were then pooled using meta‐aggregation, yielding the following results: difficulties in resolving frequent attenders’ situations may create “service circles,” frustrating patients with their situation; frequent attenders’ own expertise regarding their condition should be recognized and valued alongside that of healthcare professionals when performing collaborative care; a lack of empathy and disparagement may make frequent attenders feel misunderstood and unappreciated; frequent attenders should be recognized as individuals by taking their circumstances into account and providing support accordingly. Frequent attenders’ experiences demonstrate the importance of shared decision‐making, continuity of care, and acknowledging these patients’ individual circumstances. Identifying the variety of frequent attenders’ service needs by synthesizing their experiences is a practical way of organizing patient‐centered healthcare services

Registered nurses’ and medical doctors’ experiences of patient safety in health information exchange during interorganizational care transitions:a qualitative review

Abstract Objective: This systematic review aimed to identify, critically appraise, and synthesize the best available literature on registered nurses’ and medical doctors’ experiences of patient safety in health information exchange (HIE) during interorganizational care transitions. Methods: The review was conducted according to the JBI methodology for systematic reviews of qualitative evidence. A total of 5 multidisciplinary databases were searched from January 2010 to September 2020 to identify qualitative or mixed methods studies. The qualitative findings were pooled using JBI SUMARI with the meta-aggregation approach. Results: The final review included 6 original studies. The 53 distinct findings were aggregated into 9 categories, which were further merged into 3 synthesized findings: (1) HIE efficiency and accuracy support patient safety during interorganizational care transitions; (2) inaccuracies in content and structure, along with poor HIE usability, jeopardize patient safety during interorganizational care transitions; and (3) health care professionals’ (HCP) actions in HIE are associated with patient safety during interorganizational care transitions. Conclusions: The results of this review identified several advantages of HIE, namely, improvements in patient safety based on reduced human error. Nevertheless, a lack of usability and functionality can amplify the effects of human error and increase the risk of adverse events. In addition, HCPs’ individual actions in HIE were found to influence patient safety. Hence, the cognitive and sociotechnical perspectives of work related to HIE should be studied. In addition, HCPs’ experiences of each stage of HIE deployment should be clarified to ensure a high standard of patient safety. Registration: PROSPERO CRD42020220631, registered on November 13, 2020

Adult patients’ experiences of patient-professional communication in patient portals:a qualitative systematic review protocol

Abstract Objective: The objective of the review is to identify, critically appraise, and synthesize the best available evidence on adult patients’ experiences of patient-professional communication in patient portals. Introduction: Alongside face-to-face communication, patient portals can improve care quality and patients’ self-management of chronic diseases. It is important to examine how patients experience patient-professional communication in patient portals because this digital environment inherently lacks non-verbal messages, which can lead to misunderstandings. Inclusion criteria: Qualitative studies that describe patients’ experiences of reciprocal patient-professional communication in patient portals will be included. Patients must be over the age of 18 years and have a need for long-term care delivered by a health care professional (eg, patients with chronic diseases, such as cancer or diabetes). The health care professionals considered for inclusion are the members of the patient’s health care team who communicate with the patient using patient portals. A patient portal is defined as a personal health record, which is either an independent webpage or interconnected with an electronic health record. Methods: The following databases will be searched: MEDLINE (PubMed), CINAHL (EBSCO), ProQuest (Abi/Inform), Scopus, Medic, Google Scholar, Science Direct and Cochrane CENTRAL. Gray literature will be searched in MedNar. Studies published in English, Finnish, or Swedish will be considered, and there is no date limitation. Studies will be screened and critically appraised for methodological quality by two independent researchers. Data will be extracted using a standardized tool from JBI SUMARI. Data synthesis will be conducted according to the meta-aggregation approach. Confidence in the evidence will be assessed using the ConQual approach. Systematic review registration number: PROSPERO CRD42021286177

Development and psychometric testing of the nursing student mentors' competence instrument (MCI):a cross-sectional study

Abstract Background: Mentors require competence at a diverse array of skills to mentor students during clinical practice. According to the latest evidence, competence at mentoring includes: knowledge, skills and attributes of individual students’ learning objectives, core elements of nursing, learning processes, a reciprocal and trustful relationship, feedback, evaluation, cooperation with stakeholders, and the mentor’s personal qualities. Objective: The purpose of the study was to test psychometric properties of a mentor’s competence instrument developed to self-evaluate mentors’ competence at mentoring nursing students in clinical practice. Design: A cross-sectional, descriptive, explorative study design was used. Settings: Data were collected from mentors at five university hospitals in Finland in 2016. Participants: A total of 576 mentors participated in this study. Methods: The instrument was developed through systematic review, experts’ evaluations, and pilot versions of the instrument tested in previous studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis (EFA) with promax rotation and Cronbach’s alpha. Results: A 10-factor model showed that the instrument has acceptable construct validity. Cronbach’s alpha values for the subscales observed ranged from 0.76 to 0.90. Conclusions: The instrument exhibited acceptable psychometric properties, thereby proving itself a valuable tool for evaluating mentors’ competence at mentoring students. Further assessments of its reliability, validity and generality for measuring mentor’s competence for mentoring students in different contexts and cultures are recommended