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Abstracts of the 4th Nordic Nursing Forum
4th NORDIC NURSING FORUM THE 4TH NORDIC FORUM FOR NURSE EDUCATORS „IS NURSING EDUCATION UP TO DATE?“
FORUM ABSTRACTS
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ORGANISING COMMITTEE
Ireen Bruus – Chair of Organising Committee Virpi Sulosaari Reet Urban Saima Hinno Eve-Merike Sooväli Mari-Liis Timmotalo Jaanika Niinepuu Merlis Kännaste Richard Jalakas Margit Lenk-Adusoo/Airin Treiman-Kiveste – Curators of the Workshop
SCIENTIFIC COMMITTEE Abstract Review Committee:
Reet Urban, MSc Head of Abstract Review Committee Tartu Health Care College, Estonia Marit Silén, PhD University of Gävle, Gävle, Sweden Thorbjorg Jónsdóttir, PhD University of Akureyri, Iceland Johanne Alteren, PhD Nord University Mo i Rana, Norway This forum is organized in collaboration with MEDICO (Nordic Collaboration Network for Nursing Medication Educators) - a Nordplus Higher Education Network.
Leena Salminen
Department of Nursing Science, University of Turku, Finland
The competence of nurse educators is multidimensional and the roles and qualifications of the faculty have been discussed for decades. Continuous changes in society and working life highlight the need for a change in teaching nursing and nurse educators’ work and competence demands. There is no consensus on the minimum qualifications or required experience of nurse educators. It is asked, should nurse educator perform teaching, research, clinical and managerial roles. The competence of teachers is described as the capabilities that teachers need to possess in order to provide high-quality teaching and support improved student learning. The competence is not one-dimensional, but relational. Competence is the relation between individual abilities and the satisfactory completion of appropriate tasks.
It is discussed about what competences nurse educators need and on what level the competences should be described: very particularly or in a more general way. The diversity of nursing education work settings and the goal of nursing education demand an appropriate match between a nurse educator’s knowledge and skills, and the needs and goals of particular settings, either academic or clinical. Moreover, the educators should foresee what is coming in the future; the health care systems are changing, and so are also the health professions. They must also understand the new generation’s way of living and learning.
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About the nursing competence of educators it is at least required that educators need the updated knowledge and a deep interest in nursing. This improves learning and the professional development of the students. The educators need competence of the clinical nursing practice to be credible. This nursing competence means theoretical knowledge, professional nursing skills and their connection. The students can reach and adapt the real nursing competence only if research, education and the practice are combined together.
When thinking about the increasing demands of 21th century health care, there might be a need to create general minimum requirements for nurse educators or even a common EU directive to dictate a competence qualification for educators in Europe.
NURSING COMPETENCE OF NURSING STUDENTS
Virpi Sulosaari
Turku University of Applied Sciences, University of Turku, Finland
Background. Nursing education is guided by European directives and it is based on competency-based approach to education. Nursing competence of nursing students is contemporary and important issue to all nurse educators, universities and employers of graduating nursing students as it is related to professional standards, patient safety and overall quality of nursing care. It is one of the core competences of nursing education. Employers expect new nursing graduates to have adequate nursing competence to be able to provide safe patient care. However, there is variation of definitions of the competence and methods of supporting the development of the competence and assessing it in the university and in clinical practice.
Aim. The aim of this presentation is to provide an overview on nursing competence as an outcome of undergraduate nursing education.
Method. Literature review.
Results. In this presentation definitions of nursing competence as outcome of nursing education and overview of perspectives to assessment of nursing competence is provided. Nursing students are required even more highly specialized competencies due to changes in societies and more complex patient care. This challenges nurse educators to create ways to support the development of nursing competence and assessment in the university and clinical practice. Collaboration between the universities and clinical practice placements is necessary for keeping the education
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contemporary and responsive to the needs of current and future health care.
Conclusions. Nursing competence is both a professional standard and central to patient-care outcomes, yet it has proved to be a difficult concept to define and assess. For nurse educators and clinical instructors, it is important to understand the nursing competence as an outcome of education and how to support and assess it.
Keywords: nursing competence, competence, nursing student, nursing education
CLINICAL LEARNING ENVIRONMENT – THE ESSENCE OF LEARNING IN BECOMING A REGISTERED NURSE
Kristina Mikkonen
Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Finland
Background. Previous research has shown that the role of students’ mentors has significant influence upon the success and learning outcomes of nursing students in their clinical placements. Building of a safe clinical learning environment and effective mentoring are an essential part of building a well-functioning clinical learning environment for nursing students.
Aim. The aim of this study was to describe and explore the clinical learning environment and mentoring of nursing students in order to provide new evidence for developing nursing curricula.
Methodology. A cross-sectional study was conducted with nursing students and their mentors in Finland in 2015-2016. The data was collected using four psychometrically tested instruments: Cultural and Linguistic Diversity scale (CALDs) and Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T); Cultural and Linguistic Diversity in Mentoring scale (CALD+Ms) and Mentors’ Competence Instrument (MCI). The data was analyzed using a nonparametric test and a binary logistic regression analysis.
Results. The data between two groups was compared, national students and their mentors and culturally and linguistically diverse nursing students and their mentors. Students’ evaluation strongly differed from their
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mentors’ evaluation. Mentors evaluated their competence in mentoring as highly agreeable. Students perceived the pedagogical atmosphere, learning environment, role of the nurse teacher, and cultural and linguistic diversity in the clinical learning environment as more challenging. Mentors perceived students’ evaluation and linguistic diversity in the clinical learning environment as most challenging.
Conclusions: Despite mentors evaluating their competence level as high, mentoring education should be offered for staff in order to enhance their competence to mentor national and culturally and linguistically diverse nursing students. The collaboration between higher educational institutions and clinical placements should be built on evidence-based knowledge so that theoretical models are integrated into the guidelines used in the practice. National and culturally linguistic diverse nursing students should be integrated in collaborative multi-disciplinary learning environments where diversity could be further embraced.
Keywords: Clinical learning environment, mentoring, nursing students, nurse teacher, cultural and linguistic diversity
INNOVATIVE TEACHING AND LEARNING METHODS: 10 YEARS OF SIMULATION IN A SWISS NURSING FACULTY
Patrick Van Gele
University of Health Sciences, Lausanne, Switzerland
The University of Health Sciences in Lausanne, Switzerland developed it’s bachelor of Science in Nursing program in 2002. This radical change from vocational to academic curriculum gave us the opportunity to rethink thoroughly our educational practices. We not only adopted socioconstructivist active learning strategies inspired by Schön and Vygotski but we also created an authentic environment where students could securely experiment clinical reality using simulation.
The presentation will retrace more than 10 years of pioneering activities in the domain of simulation and it’s curriculum integration. It will also discuss successes, challenges and lessons learned and finally suggesting some recommendations for the future.
4th NORDIC NURSING FORUM NURSES’ COMPETENCES – GOING INTO TOMORROW
Gerli Liivet
Estonian Nurses Association, Tallinn, Estonia
Competence is the certified capability to use knowledge, skills and personal, social and/or methodical abilities in work or study situations and also in professional and personal growth. In Estonia there are not any national documents that define nurses’ minimum and special nurses’ competences. There used to be a nurses’ occupational standard but in 2016 it was decided that as this field is regulated by directives then there is no need for the occupational standard - now it is in agenda again.
Although nursing as a field is regulated by the European directive 2013/55/ EL, it is not enough for nurses and other healthcare specialists to fully comprehend the competences of nurses. And because nurses are insecure in their competences it endangers the safety of patients as well as the development of nursing as a whole.
The aim of the research was to describe nurse’s minimum and special nurse’s competences.
This research analysed different frameworks of competences applied in Europe, consulted with nurse managers, academics and practitioners.
As a result of the research the frameworks of nurse’s minimum and special nurse’s competences were compiled, which are the basis for further discussions with the advocacy groups and Ministry of Social Affairs’ specialists. In addition, the end result of the discussions and framework is to compile an occupational standard or some other national document that fixates the nurse’s minimum and special nurse’s competences.
THE NURSING STUDENT AS A HELPER. EMOTIONS AND ITS RELEVANCE TO NURSING COMPETENCE
Johanne Alteren
Nord University Mo I Rana, Norway
Background. Nurse education seeks to facilitate learning situations where students through practical training develop competence, enabling them to help the patient in a secure way. Central to the development of knowledge is the integration between different forms of knowledge. Theoretical background is Aristotle and Nussbaum’s attempts to move up the boundaries between the knowledge forms episteme (theoretical knowledge), techne (skill knowledge), and fronesis (practical knowledge). Integration of different forms of knowledge is still an unsolved challenge in nurse education. Central questions are therefore: What forms of knowledge do students integrate, and what could form the basis for this integration?
Aim. The aim is to explore the students’ learning process, their experiences and challenges of integrating different forms of knowledge in professional care.
Methodology. I did fieldwork at four nursing homes and followed seven nursing students while they were in practice there. After the observations, I had conversations with students about their experiences and challenges in practice. Narratives students told were analysed using the hermeneutic circle described by Gadamers.
Results. The students told of emotions that arose when and because they were going to help another human being, and the importance these
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emotions were for their decisions in the situation with the patient. The basis for the student’s actions were the emotions, and the student’s rational reflection included both the emotions and practical actions related to nursing practice. Students expressed their emotions by showing fear, uncertainty, wonder and perception.
Conclusion. There is knowledge in the emotions, knowledge that students related to the patient. The student develops knowledge based on emotions that arise in the situation. These emotions are rational and of significance to development of knowledge. Within the nursing profession, these emotions are defined as not being significant, but perceived to create blindness to see the patient. This attitude should be changed, when emotions have professional and important significance for development of knowledge and skills necessary for good caring.
Keywords: nursing students, nursing competence, integration of different forms of knowledge, development of knowledge, narrative, emotions as a helper
“IT’S ABOUT BEING AT THE FOREFRONT” - NURSES’ EXPERIENCES USING PHYSICAL EXAMINATION & HEALTH ASSESSMENT, PEHA IN MUNICIPALITY HEALTH CARE
Åsmund Didriksen, Lisbeth Nerdal, Jorunn Hov
Nord University, Helgeland, Norway
Background. On January 1, 2012, the Norwegian authorities introduced a reform for greater interaction between the municipalities and hospitals. After the introduction of the reform, the patients in the municipal health service are more ill and treatment-intensive than they have previously been when discharged from the hospital. The reform has for the nurses in the municipalities led to new and more advanced tasks than before.
In 2012, the University of Nordland, now Nord University, initiated the introduction of PEHA in the primary education of nurses. PEHA involves systematic use of inspection, percussion, palpation and auscultation, and thus an extension from previous data collections. In addition, Nord University has completed courses for nurses in municipal health care.
The purpose of the introduction of PEHA is to ensure that the nurses have enough data to make the right decisions for patients to get needed treatment and care.
Aim. The aim is to explore nurses` experiences with the use of PEHA during their working day in the municipal health care.
Methodology. In this study, the qualitative study is semi-structured one-by one interviews with nurses working in municipalities’ health care.
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Ten nurses from six municipalities in Northern Norway participated. The interviews are analyzed using qualitative content analysis by Graneheim and Lundman.
Results. The main theme, “It is about to be at the forefront”, summarizes the essence of the nurses’ experiences using PEHA in the municipal health care. The results were categorized into three themes: “Visibility of the need for new competence”, “Increased confidence in own competence” and “Systematic documentation”.
Conclusion. “It’s about beeing at the forefront” is about being able to perform a systematic examination, to document and confidently assess whether the patient needs emergency medical assistance, medical assistance the next day or if the nurse on an independent basis can take action based on nursing knowledge.
Keywords: nurses, physical examination, health assessment, municipal health services, nursing.
IMPLEMENTING A NEW POSTGRADUATE EDUCATION AND AN ADVANCED PRACTICE NURSING ROLE IN NORWEGIAN HEALTH CARE – A COLLABORATIVE PROJECT BETWEEN HIGHER EDUCATION, CLINICAL FIELD, RESEARCH AND THE USERS’ OF HEALTHCARE SERVICES
Boman, E.1,2, Bing-Jonsson, P.C.1, Levy-Malmberg, R.1,3 , Taylor, I.1, Fagerström, L.1,4
1 Department of Nursing and Health Sciences, University College of
Southeast Norway, Drammen, Norway 2 Department of Nursing, Åland University of Applied Sciences,
Mariehamn, Finland 3 Department of Nursing, University of Applied Sciences, Novia, Vaasa,
Finland 4 Faculty of Education and Welfare Studies, Åbo Akademi University,
Vaasa, Finland
Background. Nursing practice on an advanced level is asked for in a growing extent of countries. To meet this need, an action research project was introduced in 2015; putting Norway on the map of countries offering a master degree programs for advance practice nurses (APNs). The main hypotheses was, that by enhancing the clinical competence of RNs and the cooperation between healthcare professionals, patients will to a larger extent receive proper care and treatment, in the right place and timely. It requires advanced clinical competence; assessing, diagnosing and making advanced clinical decisions concerning acute health problems, as well as chronic conditions. The APN role thus enrolls task-shifting; taking on tasks that traditionally have been performed by physicians. Restructuring traditional and hierarchical systems often leads to confusion and conflicts
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amongst professional groups. A challenge is further to gain trust within the organization and among patients and significant others.
Aim. The overall aim of this project, based on cooperation between community healthcare, hospital and education, is to contribute to new models of organizing, managing and delivering high-quality healthcare services, and thereby contribute to a person-centred and effective healthcare.
Methodology. The project is based on the PEPPA framework - a participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation, and evaluation (ref). Data has been collected through workshops and interviews involving different stakeholders during different parts of the process.
Results. The project is now in the middle of the process. In total 65 students have been applied to the master program. The preliminary results show that students experience the master program as overall relevant for their work life as well as motivating for developing their clinical competence. In interviews the need nursing on advanced practice level has been confirmed. However, there are also hindering factors that need to be considered.
Conclusion. It can be challenging to be a pioneer. However there is an outspoken need of the APN role that motivates further education. The next step is to come to a stakeholder consensus on models for delivering advanced nursing practice, and to plan and collect data for evaluations.
Keywords: action research, advanced nursing practice, advanced practice nurse, collaboration, evaluation, implementation, postgraduate education
LEARNING AND PERFORMING PERSON-CENTERED CARE IN CLINICAL PRACTICE IN NURSING HOMES
Jorunn Hov, Linda Alexandra Lysfjord
Nord University, Helgeland, Norway
Background. The workday seems busier. Nevertheless, a nurse must be able to adjust to the patient’s needs and pace. This may be challenging to grasp and perform for nursing students, as well as for professional nurses. Research shows a connection between the quality of care for patients with dementia, and viewing the patient as an entire human being. This is central to person-centered care. National guidelines for future health- and nursing services emphasize a closer collaboration with the patients and their relatives to ensure and increase the patients’ influence on their daily living. This must also apply to patients with cognitive impairment.
Aim. To help students in clinical practice in nursing homes to gain insight into the importance of person-centered care and how to implement it.
Methodology. The students spent 30 minutes twice a week in one-to-one meetings with a particular patient during the practice period. They logged each meeting. We conducted the study with eight students in two different periods of practice in nursing homes. We used focus group interviews to collect qualitative data regarding how the students experienced these meetings. Student logs are analysed and included in the data material. We also interviewed the tutors.
Results. The students have showed a growing interest in the one-to-one meeting with their patient. They have developed reflected knowledge on how time spent together with a patient can be meaningful and useful for
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both the patient and the nurse. They show increased insight and creativeness into various ways of spending time together with the patient. The patients’ history has proven to be relevant for understanding the patient and performing person-centered care. In some cases, the students gained information previously unknown to the nursing personnel.
Conclusion. One-to-one meetings twice a week between students and their patient appear to be a relevant educational method to help students gain insight into and practice person-centered care. The meetings help the students in their reflections on the importance of knowing the patient’s lived history, as well as the importance of personal attention in daily care.
Keywords: Promotion of personhood, patients’ life-world, clinical training of nursing students, reflection on caring activities, validation, person-centered care.
SELF-EFFICACY OF LAST YEAR STUDENTS OF NURSE CURRICULUM IN HEALTH CARE COLLEGES IN ESTONIA IN EXPRESSING CARE TOWARDS PATIENTS: RESULTS OF “CES” SELF-ASSESSMENT SCALE
Linnik Ljudmila1, Reet Urban2, Sigrid Vorobjov3, Ere Uibu3
1 Tallinn Health Care College, Tallinn, Estonia 2 Tartu Health Care College, Tartu, Estonia 3 Tartu University, Tartu, Estonia
Backround. Students’ faith in their abilities to express care helps them establish reliable and therapeutic relationships with patients in different situations more easily and does not let an uncaring role model affect them to such a significant extent. The opportunities for improving self-efficacy include efficient action, following good examples and verbal persuasion. In learning process, it is possible to encounter situations where the opportunities for improving self-efficacy are not used adequately enough.. It is not known to which extent a student who graduates from school believes in their ability to express care towards their patients.
Aim. The aim of Master’s thesis was to describe the self-efficacy of last year students of nurse curriculum in Health Care Colleges in Estonia in expressing care towards patients and describe differences between the self-efficacy of students and background variables.
Methodology. The research used descriptive, empirical and quantitative methods. The data was collected in the period from 10.09 to 30.10. 2013 using the “Caring Efficacy Scale”. Out of the 285 questionnaires distributed to nurses, 200 (71%) were returned, of which 199 questionnaires were
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analysed. The data was analysed statistically, using descriptive statistics, t-test and the ANOVA analysis.
Results. The results of the research demonstrate that the self-efficacy rate of last year students of nurse curriculum in Health Care Colleges in Estonia in expressing care towards patients is not high, since the average CES rate was 4.69 (SD=1.15). The rate was lower than that of the students who participated in the researches of Coates (CES=5.33), Sadler (CES=5.09) and Fassetta (CES=5.02).
Conclusions. The self-efficacy rate of students in Estonia in expressing care was higher in the event of female students than in the event of male students and higher in the event of Estonians than in the event of non-Estonians. The results provide a basis for developing, in the learning process, how the students express caring by relying on the opportunities for improving self-efficacy.
Keywords: caring, student, self-efficacy, nursing.
Evelin Märtson¹, Angelika Paulin², Marika Tammaru³
1 Diagnostic Clinic, East-Tallinn Central Hospital, Estonia 2 Clinic of Medical Rehabilitation, East-
Tallinn Central Hospital, Estonia 3 Research department, East-Tallinn Central Hospital, Estonia
Background. As a practice base for a number of educational facilities, the East-Tallinn Central Hospital (ETCH) offers an opportunity to enhance clinical skills for nursing, midwifery and physiotherapy students as well as for other future health specialists. Qualitative feedback regarding students’ satisfaction with hospital practice has been regularly collected. However, there has been no instrument for quantitative assessment and monitoring of students’ satisfaction.
Aim. To develop an instrument for quantitative assessment of students’ satisfaction with hospital practice.
Methodology. Students of different specialities were interviewed in order to elucidate their perception of a satisfactory hospital practice and the factors influencing their satisfaction. The preliminary list of questionnaire items was composed on the results of the group-discussion. Another group of students assessed the validity of these items regarding their experience and discussed the possible response format. Thereafter, the version of questionnaire for reliability testing was composed and administered to students finishing their hospital practice. The respondents’ were given the possibility to comment on the questionnaire.
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Results. The developed questionnaire consists of 30 items. An item is a statement describing a satisfactory quality of hospital practice; the respondent assesses on a 5-point Likert scale the extent to which the item is in concordance with their own experience. The total score is derived by averaging all responses over the questionnaire. The scores for subscales (satisfaction with mentoring, colleagues’ attitude, department’s work environment and organisation of practice) can be calculated.
Two hundred and two students filled in the questionnaire. Cronbach’s alpha was 0.92 for the total scale and varied from 0.78 to 0.87 for the subscales. The median score for the total scale was 4.83 with 20.3% of respondents scoring the maximum. The comments of the respondents on the questionnaire, its items and response format were generally positive.
Conclusions. A new instrument for measuring and monitoring students’ satisfaction with hospital practice was developed. The instrument demonstrated good internal consistency and was well accepted by the respondents. Considerable ceiling effect indicates the necessity to develop the questionnaire further by adding items enabling to highlight the subtle differences in a generally satisfactory hospital practice experience.
Keywords: hospital practice, satisfaction, satisfaction measurement, questionnaire, questionnaire development
WHAT BENEFITS DID ACADEMIC SERVICE PARTNERSHIP PRODUCE FOR THE DEVELOPMENT OF EVIDENCE BASED PRACTICE IN SOCIAL AND HEALTH CARE SERVICES?
Hanna-Leena Melender
VAMK University of Applied Sciences, Vaasa, Finland
Background. Implementation of evidence based practice (EBP) has often proved to be a challenging task. Learning about how to develop and lead the implementation of EBP in services is an important part of the education of developers and managers for the social and health care sectors. In order to develop this teaching and to support the development of EBP in services, a Teaching Development Effort was conducted by establishing academic service partnerships (ASPs) and connecting the Master’s Degree students’ assignments with them.
Aim. To describe the experiences of working life representatives regarding the development of EBP in ASPs within the social and health care sectors.
Methodology. The data were collected by email interviews. Eight working life representatives’ participated in the study. The informants were asked to describe the usefulness of the plan that had been prepared by the students regarding the implementation of EBP, and to describe the significance of this ASP for the development of working life. A qualitative content analysis method was used when analyzing the data.
Results. Virtually all the informants stated that the plan prepared by the students, for the implementation of EBP, was entirely ready to be taken into use in the form they had finished it. The significance of the ASP was described in terms of the ASP assisting in improving the quality of the
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service. Furthermore, the workplace-based student assignment topics, external views to support the development of EBP, and the theoretical approach used by the students were valuable. The ASP provided opportunities for the practitioners to learn new things, inspiration to look to the future, and assistance in the implementation of time management practices.
Conclusion. ASPs were significant for the development of working life in many ways and the use of them is recommended.
Keywords: academic service partnerships; evidence based practice; interdisciplinary; Master’s Degree students; organizational development; social and health care; teaching development effort
INTERVENTION POSSIBILITIES TO INTIMATE PARTNER VIOLENCE DURING PREGNANCY AND POSTPARTUM PERIOD IN INTERDISCIPLINAR TEAMWORK USING SIMULATION AND E-LEARNING METHODS
Marika Merits1, Mare Tupits1, Silja Mets-Oja1 , Rauni Rohuniit2, Uno Traat2, Ülle Vanaisak2
1 Tallinn Health Care College, Estonia 2 Estonian Academy of Security Sciences, Tallinn, Estonia
Background. Intimate partner violence (IPV) is according to the World Health Organization (WHO) a public health problem of increased severity during pregnancy and postpartum period, affecting the health of the woman and the fetus. The prevalence of violence against women (incl IPV) in Estonia continues to be on high level. In Estonia the legal framework of intervention for police and the health care has been developed, but the cooperation between the institutions is weak, and therefore a victims support is too low and not effective. Necessity for common learning subject is caused by the need to offer for victims the effective complete solutions, combining the health care and police work intervention.
Aim. The aim is to describe how students of two higher education institutions learn to intervate possibilities to IPV during pregnancy and postpartum periood ininterdisciplinar teamwork using simulation and e-learning methods. The emphasisis on common learning of midwifery students and police students.
Design. Learning subjekt volume is 4 ECTS, the participating students are from Tallinn Health Care College (midwife and nurse students) and Estonian Academy of Security Sciences (security and police students).
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Combained course design contains: e-learning in Moodle environment and contact learning – a theories of IPV, impact to pregnancy and postpartum period, the legislation in Estonia and interdisciplinar teamwork in helping targetgroup of victims; simulation practice is build up in varikus cases and intervention by combining health care and police work. Preparation lasted for one year, as a result the common learning subjekt was build up.
Findings. The subject needs some improvement. A students feedback is colleceted by the questionnaire in Moodle environment and by the instant feedback in the closing seminar. The following suggestions were brought up: to involve social workers as well victim assistance that solutions would be more effective, to add more complicated, and varikus cases and to improve the common part of Moodle environment. A satisfaction was expressed that midwifery, nurse and police students will be able to share a mutually necessary in formation and act professionally by ensuring for victims the effective komplete solutions and support.
Innovation in education including shared learning on the example of the two higher education institutions using e-learning and simulation by enhancing the interdisciplinar teamwork in the interventing of targetgroup of victims.
Keywords: intimate partner violence, ininterdisciplinar teamwork, simulation, e-learning.
INTERNATIONAL STUDENT AND TEACHER EXCHANGE AS A FORM OF DEVELOPMENT COOPERATION EXPERIENCES OF THE STUDENTS OF HEALTH CARE AND SOCIAL WORK FROM KENYA AND UGANDA
Helinä Mesiäislehto-Soukka
School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Finland
Background. From 1996 onwards, the Healthy Africa network has provided as many as 700 students and 80 teachers the possibility of an exchange from Finland to Uganda and Kenya. In turn, from Uganda and Kenya 95 students and 65 teachers have participated in the exchange, 400 persons have participated in intensive courses. One important objective of both student exchanges and teacher exchanges has been to focus social work and nursing according to the Finnish goals of cooperation development.
Aim. The objective of this study was to strengthen and extend the students’ views on nursing in developing countries. This research study is very important, and the research results ensure the significance of student exchange. The purpose of this study was to describe experiences of students of health care and social work in the autumn of 2016 in Kenya and Uganda regarding social work and nursing. Subjects of final thesis hoped to carry out.
Methodology. The study tendency was qualitative. The data, which accumulated 13 sheets, was collected by interviewing eight students, four in Uganda and four in Kenya. The researcher worked as the practice educator in both countries. The interviews had a free and open form. The material was analyzed using content analysis.
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Results. The carefully planned Finnish student guidance culture was greatly hoped for in hospitals and children’s homes. The students were grateful for the opportunity they had, and surprised at their own intellectual growth, which was made possible in a very different culture, on a foreign language, surrounded by tropical diseases in a tropical climate, in the company of kind and unhurried local students and colleagues.
Conclusions. Nursing Students’ International exchange experiences are very important just now because of many reasons like hygiene in African hospitals, immigration and global diseases.
Keywords: clinical nursing experiences in Africa, development cooperation experiences.
PARTICIPATORY E-LEARNING SOLUTIONS IN LAPLAND- LOVO
Anja Mikkola, Annette Sjöman
Lapland University of Applied Sciences, Kemi, Finland
Background. In Lapland there is a natural need for utilising and developing eLearning due to the long distances. eLearning is meant to add geographical and social equality and develop the accessibility of education. The development of eLearning and accessibility of education in Lapland has been quite organisation- and teachercentred
Aim. The aim is to develop and start using student activating and student centered learning methods. Aim is also to produce new digital contents and new digital methods for learning, guiding and evaluating. One aim is also to highlight the education qualifications and competencies in Lapland.
Methodology. There are five educational organizations of Lapland working in this project: The Blog of the project is in www.lovo.fi which is in Finnish. From the LUAS Social Services, Health and Sports´s unit there is two pilots in this project. First pilot is an electric evaluation system for studies in Acute and General Practice Nursing course. In the second pilot is produced question banks of digital exam for the studies in Medication in Nursing course and in Anatomy and Physiology both in English and in Finnish. The Authors are involved in this part of the project.
Results. As the result of the project there will be more easily achievable, flexible and student centered possibilities for developing competencies
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and qualifications. As the result in the second pilot in social Services, Health and Sport`s is the question banks of digital exams in Medication in Nursing and Anatomy and Physiology. Questions are made by students during the courses. Questions from bank can be used in the future in many ways; part of independent work, prestudies before lectures, as an exam or part of exam, evidence of competencies
Conclusion. In the end of the project the digital learning environments and practices will ”flip” from organisation- and teachercenteres into learning- and learner-centered
Keywords: net-learning, digital exam, student activating methods.
NURSING STUDENTS ASSESMENTS OF THE CLINICAL LEARNING ENVIRONMENT AND MENTORING –A COMPARATIVE DESCRIPTIVE STUDY
Lily Parm1, Marika Asberg1, Ilme Aro2
1 Tallinn Health Care College, Tallinn, Estonia 2 University of Tartu, Tartu, Estonia
Background. The learning environment affects the development of clinical skills and gives students an opportunity to apply the theory gained in practice. Students in particular need a supportive learning environment. From earlier studies in Estonia, the results revealed a number of problems during practice. The latter practice instruction and the learning environment satisfaction survey was conducted in 2007 and the followup studies have not been done.
Aim. The aim was to describe the Tallinn Health College and Tartu Health College nursing students’ assessment of the learning environment and guidance for clinical practice and to compare the results to a survey conducted by Asberg (2007) results.
Methodology. Data was collected 2012 spring and autumn semester using the questionnaire of Clinical Learning Environment and Supervision Instrument (CLES). The sample consisted of all nursing students from courses II and III from Tallinn and Tartu Health Colleges (n = 302), who had undergone at least one of the clinical practices. A total of 291 completed questionnaires, which were filled correctly, were analyzed. Statistics analysis was carried out in the statistics programm SPSS 20.0. The used statistical methods were descriptive statistics, χ2 test, t-test, and Spearman correlation analysis.
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Results. Students rated the mentoring of clinical practice as good. The most highly was evaluated the guidance, which was based on mutual trust and the positive attitude of the mentor. The lowest levels were assessed individual coaching experiences, and it arises from the fact that only half of the subjects had an individual mentor.
Conclusions. Assessing clinical learning environment the most highly was rated the head nurse`s management style and the lowest rating had the atmosphere of the department. A higher estimate of mentoring was given by students who had an individual mentor. Compared with 2007 and 2012 results of the research, there was an increase in satisfaction with clinical practice.
Keywords: mentor, clinical learning environment, mentoring, clinical nursing practice, nursing students.
STUDENTS’ SATISFACTION WITH HOSPITAL PRACTICE
Angela Paulin1, Evelin Märtson2, Marika Tammaru³
Tallinn, Estonia 2 Clinic, East-Tallinn Central Hospital, Tallinn, Estonia 3 Research Department, East-Tallinn Central Hospital, Tallinn, Estonia
Background. In 2016, 365 students of nursing, midwifery and other health professions underwent their clinical practice in the East-Tallinn Central Hospital (ETCH). For a hospital, the feedback from students regarding their experience is essential for further self-development as a practice base.
Aim. To describe the feedback from students regarding their satisfaction with their practice in ETCH, including mentoring, colleagues’ attitudes, working environment and organisation of the practice.
Methodology. The anonymous unstructured written feedback was collected from the students at the end of their clinical practice. The expressions were restructured in order to group, compare and contrast the opinions regarding similar practice aspects.
Results. Altogether, the feedback was gathered from 227 students. According to the respondents, most mentors dedicated sufficient time to their trainees. However, there were some examples where the mentoring responsibility was passed on to colleagues. Mentors had the training process prepared on a daily basis and they gave constant feedback on students’ performance. Mentors’ attitude towards students and their knowledge was respectful. Some mentors pointed out the differences of “theoretical
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knowledge” and “practical life” (eg when using NANDA). In general, coworkers were rated highly by the respondents. However, some incidents were described when nurses were so occupied with their own activities and the students felt as being left aside.
The respondents were satisfied with the overall social atmosphere at the departments and a wide variety of opportunities for successful performance during the practice. On the negative side, students mentioned some department workers’ lack of interest in trainees. Suggestions were made about improving Wi-Fi quality and resting conditions.
Some students had sufficient information about the practice organisation whereas the others felt under informed. Information exchange between the hospital and school was also mentioned as having room for improvement. It was often mentioned that while the department head nurse was informed about the students’ arrival, the other workers of the department (including even the mentor) were unaware about the newcomers.
Conclusions. Students are generally satisfied with their clinical practice in ETCH, however major improvements in communication between the educational facilities and hospital as well as inside the hospital are required.
Keywords: hospital practice, mentoring, co-worker, department, communication
Margrét Hrönn Svavarsdóttir1,2, Hafdís Skúladóttir1
1 School of Health Sciences, University of Akureyri, Iceland
2 Department of Nursing, Faculty of Health, Care and Nursing, NTNU,
Norwegian University of Science and Technology, Gjøvik, Norway
Background. Evaluation of clinical competence is complicated, as it is not simply a measure of psychomotor skills, but also involves a measure of utilization of theoretical knowledge, judgment, and ability to respond to a changing environment and informs students about their achievement. Difficulty in clinical evaluation can be partly explained by the limited connections of available evaluation tools to measure actual specific clinical behavior and the lack of measures of required clinical outcomes. In addition, some degree of subjectivity will always be present in clinical evaluation. One way to overcome this is to integrate the use of aassessment tool with a rating scale, clearly defined performance criteria, and a detailed description of performance at each level.
Aim. The aim of this study was to develop a valid assessment tool to guide clinical education and evaluate students’ performance in clinical nursing education at University of Akureyri, Iceland.
Methodology. The development of the Clinical Assessment Tool for Nursing Education (CAT-NE) was based on the Theory of nursing as professional caring and the Bologna learning outcomes. Benson & Clark’s four steps of instrument development and validation guided the development and assessment of the tool. Mixed method with individual structured
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cognitive interviewing and quantitative assessments were used to validate the tool. Supervisory teachers, pedagogical consultant, clinical expert teachers, clinical teachers, and nursing students at University of Akureyri in Iceland participated in the process.
Results. According to the students and their clinical teachers, the assessment tool has clarified the learning objectives, enhanced the focus of the assessment process, and made the evaluation more objective. Training the clinical teachers how to assess the students’ performances in clinical studies and use the tool has enhanced the quality of clinical assessment in nursing education.
Conclusion. This assessment tool is a valid tool to assess clinical performance of nursing students andconsists of rubrics that list the criteria for the students’ expected performance.Even though the assessment tool has been developed within a specific nursing program, the findings might be transferable to other settings, and the assessment tool could be adjusted to suit other nursing programs.
Keywords: educational measurement; students; nursing; nursing theory; teachers; clinical competence.
ASSESSMENT OF CARE NEED AND CLINICAL EXAMINATION SKILLS IN NURSE EDUCATION
Hannele Tyrväinen, Jaana Perttunen
School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
Background and aim. The nurses’ professionis going to developmore independentin the future, and remarkable part of it is supportingpatient’s self-care.The aim of the course is to develop independent decision-making skills in assessing the need for care and clinical examination in nurse’s appointment, home care and in-patient care.
Methodology. The course for Patient clinical examination (5 ECTS) during the third study year has been in the curriculum of the JAMKUASsince2013. After the theoretical studies and simulations,the students have 4 weeks clinical practice in nurse’s appointment.
Learning outcomes: The students knowthe methods of the clinical examination and assessment of care need and are able to separate pathological findings from normal. Theyare able to make nursing diagnosis and care plan using evidence-based clinical decision-making skills and consulting physicians and other professionals.
The course focuses on history taking, examination of cardiovascular and respiratory system, ENT, abdominal area and basics of neurological, psychiatric and musculoskeletal examination. In addition, identification and treatment of the most common infectious diseases are also included as well as monitoring and follow-up of long-term illnesses.
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Theoretical and practical skills are assessedby a written exam, top to toe -examination and Objective Structured Clinical Examination(OSCE;a simulated standardized appointment situationusing actor patients). Each student solves one patient case and evaluates one fellow student.
In this study the students (n=50) wrote an essay how they could utilize the learning outcomes during their practical training. Thematic methodwas used for the data analyses.
Results. According to the students the course hadstrengthentheirclinical examination skills, especially acquirements for careful history taking. During clinical practicethe students were able to use the new skills in following areas:assessment of care need and clinical examination of patients with common respiratory infections, otitis, abdominal disorders as well as neurological and psychiatric patients.
Conclusion. The course was successful according to the teachers and students. Positive feedback from students and clinical practice mentors encourages continuing the course.Therefore, clinical examination and assessment of care need should be included as an independent course in the bachelor level nurse education.
Keywords: history taking, clinical examination, OSCE, nurse education
TRANSPARENCY IN TEACHING – TIMELINE OF LEARNING ACTIVITIES
Ere Uibu
Institute of Family Medicine and Public Health, University of Tartu, Estonia
Background. The University of Tartu is the only institution of higher education in Estonia which offers a graduate level curriculum in Nursing Science. The study form offered by the university is open university parttime studies, because the student of nursing science is often a working nurse/midwife, a nurse manager or a teacher of a health care college, often married, with children or about to start a family. This background makes the students more apt to be under risk of poor commitment to the studies, for dropouts and for an unreasonable delay of studies. However, based on that knowledge, additional supervision to support students’ progress is required.
Aim. The main focus of this development project was to map all independent work assignments and deadlines, to divide all of them evenly throughout the semester, to construct so-called learning timelines and to encourage students to use them for constructing their personal learning timelines. In addition, we asked the students to evaluate the usefulness of this activity.
Methodology. Cooperative computer-supported meetings were held to summon all learning activities into two learning timelines, one for the first study year, other for the second study year. Learning timelines were made available for the students in Moodle environment and at the opening seminars students were informed about them. At the end of
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the semester an electronically self-reported questionnaire was used for data collection. The sample comprised of 40 first to third year students. A total 29 students filled the questionnaire.
Results. 22 students confirmed they were well informed about the timelines and they knew where to find them, 20 students assessed them to be useful tools for keeping in mind deadlines, 18 students used them for creating their own learning timelines. Students advised to continue teachers to compile such timelines and recommended to make them available also in study information system.
Conclusions. The timeline is a useful tool to make students responsible for their own studies, to improve cooperation with teachers and to make teaching more transparent.
Keywords: postgraduate education, transparency in teaching, timeline.
CLINICAL REASONING SKILLS AS PART OF THE LEARNING SKILLS IN NURSING STUDENT SELECTION
Jonna Vierula, Elina Haavisto, Maija Hupli, Kirsi Talman
Department of Nursing Science, University of Turku, Finland
Background. Nursing schools aim to select the most suitable applicants that are able to achieve the learning requirements set for the education and competence requirements set for the profession. Learning skills are required to pass the formal education. Thus, many higher education institutions assess learning skills such as language and communication, and mathematical skills as part of their admission process. Clinical reasoning skills are required to make solid decisions in various nursing environments. However, a systematic analysis regarding the nursing applicants` learning skills or clinical reasoning skills assessed as part of nursing student selection is missing.
Aim. The purpose of this study was to describe what clinical reasoning skills as part of the learning skills have been assessed in the bachelorlevel nursing student selections. This study is part of a larger Reforming Student Selections in Nursing Education (ReSSNE) -project which aims to develop a new national selection method in nursing education that is evidence-based, cost-effective and reliable.
Methodology. A scoping review was conducted to gather relevant knowledge and to identify nature and extent of the current research. After setting the inclusion criteria, a computerized systematic search to Cinahl, Eric, PsycINFO, Pubmed and Scopus databases was performed with various search terms and the limitations of English or Finnish language, abstract available and publication year 2006–2017.
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Results. All in all, 28 studies were included in the review. These studies wereresearch articles (n=22) and doctoral dissertations (n=6) published between 2006–2016 in Australia, Italy, UK, USA and New Zealand. The results indicated that learning skills have been assessed in the areas of 1) Language and Communication skills, 2) Clinical reasoning skills, 3) Mathematical skills, and 4) Natural sciences skills. Factors of decisionmaking skills and reasoning skills have been assessed as part of the clinical reasoning skills.
Conclusions. This review confirmed clinical reasoning skills being an important part of the wide assessment of learning skills in the nursing student selection. This study has implications forfuture nursing education research and especially for the development of nursing student selection processes.
Keywords: nursing student selection, clinical reasoning, clinical reasoning skills, learning skills, scoping review
Maija Hupli1, Kirsi Talman1, Nina Hahtela2, Pirjo Huovila3 , Asta Heikkilä1,4, Elina Haavisto1,5
1 University of Turku, Department of Nursing Science, Turku, Finland 2 Finnish Nurses Association, Helsinki, Finland 3 Faculty of Health Care and Social Service, Saimaa University of Applied
Sciences, Lappeenranta, Finland 4 School of Health Care and Social Work, Seinäjoki University of Applied
Sciences, Seinäjoki, Finland 5 Hospital District of Satakunta, Pori, Finland
Background. Selection methods and practices of nursing education vary from one country to another. The aim is to develop a student selection method to be implemented nationally, to ensure that motivated students, who will succeed in both theoretical studies and clinical practice, who are suitable for the profession and have a realistic perception of it will be selected. This study is a part of a larger Reforming Student Selections in Nursing Education (ReSSNE) -project which aims to develop a new national selection method to nursing education that is evidence-based, cost-effective, objective and reliable. After literature review and focus group interviews, three categories of selection methods were defined: learning skills, social skills and certainty of career choice. The last one consists of three sum-categories: realistic perceptions of the nursing profession, willingness to be a nurse and willingness to study nursing. This study focused on realistic perceptions of the nursing profession.
Aim. The aim of this study was to examine perceptions of the nursing profession among applicants to nursing education. The ultimate aim is
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to produce knowledge which can be utilized in developing selection methods for nursing education. The research questions were: 1) what kind of perception do the applicants have of the nursing profession?; 2) which factors are related to the applicants´ perception of the nursing profession?
Methodology. The data have been collected using a questionnaire developed for this study. All voluntary applicants Altogether 429 applicant who participated in the on-site selection test to nursing education in November 2016 in four Universities of Applied Sciences were participated. The questionnaire consists of a three-point knowledge test scale (1= right, 2= wrong, = cannot say) and ten background questions. The statistical analysis of the data is going on.
Results. The results will be available at the conference.
Conclusions. The conclusions will be presented in the Nordic Forum in November 2017.
Keywords: nursing student selection, perception of nursing profession.
FACTORS AFFECTING PROFESSIONAL PRACTICE OF STUDENTS OF THE CURRICULUM OF MIDWIFERY (Based on the example of Tallinn Health Care College)
Kaire Sildver , Silja Mets-Oja, Katrin Klein
Tallinn Health Care College, Tallinn, Estonia
Background. The importance of the research is to find out the factors that affect the quality of professional practice of the midwives. Practice in working environment has an important part in student’s studies. A learning foundation is based on the relationship between the student and the mentor and the success of completion the practice depends on it. The quality of the cooperation between the student and the mentor significantly influences the reputation and the experience of study practice. Personality features of the supervisor also have an important role. Midwifery students will develop theoretical and practical skills in the work environment during practice, they will also develop their professional competences, personal values, communication skills and ethical attitudes. Practical experience is very important for the students, the lack of it in the practice base could indicate negative influence on the acquisition of knowledge and practice for the students. Lack of it can also affect students work results as a future midwife. During the practice students inevitably experience negative feelings. In the practice environment midwifery students have experienced mental violence and exclusion by the employees of the practice base and have even had fear towards them.
Aim. The purpose of the research is to find out what affects the satisfaction with professional practice of students of the midwifery curriculum.
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Methodology. Current research is quantitative. Students of midwifery of Tallinn Health Care College constitute the sample. Feedback of the practice is collected from students after the practice in a form of a questionnaire. The questionnaire consists partly of enclosed multiple-choice questions and partly of open questions. Statistic analysis was carried out in the statistics program STATA12.
Results. Satisfaction with professional practice of the students of Tallinn Health Care College Midwifery Curriculum was affected by: supervisor’s interest towards the student (p<0,05); practice management (p<0,05); indoor climate of the practice placement (p<0,05).
Conclusion. Satisfaction with professional practice of the curriculum of midwifery was strongly affected by the supervisor’s interest towards the student, practice management and inner climate of the practice base. As a result Tallinn Health Care College can implement changes in organizing the practice and in planning future practices based on the results.
Keywords: professional practice, students, midwifery, satisfaction, mentor.
FURTHER EDUCATION PROJECT FOR NURSES INVOLVED WITH ACUTE CARE OF DISABLED CHILDREN AND ADULTS
Virpi Sulosaari, Riikka Teuri
Turku University of Applied Scienes, Turku, Finland
Background. The care of children and adults having severe developmental disability requires special competencies from the nurses. In the acute inpatient clinics nursing staff have a lack of the special skills needed and they often experience behavior and care of these patients challenging. Disabled children and adults are discharged from acute care soon as possible, and continuing the most effective care may be shorten. Therefore, there was a need to establish special unit for continuing the acute care in environment known by the patients and delivered by nurses specialized into disability care.
Aim. The aim of this education project is to increase the competences of registered nurses working with disability patients is relation to intravenous care. The goal of the collaboration between the unit and university is to support the establishment of special medical unit.
Methodology. Further education program was planned together with the nurse director and chief physician of the future unit. One day education was based on the assumption of basic registered nurses education, and concentrated on the safety delivery of intravenous medication care in theory and in practice. During the day, equipment list for the future unit was made and material tool kit for the nurses. One day education will be held twice. Before the education participants had preassignments and were asked to tell their expectations for the education. Education day was
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held two times and after both days participants evaluated development of their competencies in this field.
Results. Participants’ expectations were focused on updating their knowledge and skills in intravenous care and aseptics. They also wanted to increase understanding how to ensure patient safety in intravenous care. The results of the education project will be presented in poster.
Conclusions. The possibility to ensure the quality and continuity of care as well as more optimal outcomes of care are is important for patients with special needs. This projects is a good example on how to prepare unit staff to a new role by education and good planning before starting the new unit. In this poster we will describe the education and the experiences of the nurses.
Keywords: disabled children and adults, intravenous infusion, medication administration, further education
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