| 1. |
- Byungura, Jean Claude, 1979-, et al.
(författare)
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Online learning for continuous professional development of healthcare workers : an exploratory study on perceptions of healthcare managers in Rwanda
- 2022
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Ingår i: BMC Medical Education. - London : BioMed Central (BMC). - 1472-6920. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Due to outbreaks of new diseases, development of new treatment regimens and requirement of evidence-based practice, health professionals continuously need to acquire updated knowledge and skills. This type of learning is known as continuous professional development (CPD). The scarcity of skilled health care professionals in developing countries further increases the need of CPD. Traditionally, face-to-face approach has been preferred as the best mode of CPD. Currently, health professionals have started using online learning for continued professional growth in different parts of the world. Consequently, research studies from different settings are needed to investigate the significance of online learning for CPD. Therefore, the aim of this study was to investigate the importance and challenges attributed to online learning by the managers of health facilities in Rwanda. Moreover, the study aimed to identify the status of infrastructures that could support online CPD, and assess the perceived enhancement and barriers for implementing online CPD. Methods: The study used a convergence mixed-method design to explore quantitative and qualitative data from 42 health care managers. A descriptive analysis was conducted on quantitative data while qualitative data were thematically analyzed to inform the study findings. Results: It was revealed that 90.5% of managers, who participated in this study, consider positively the use of online learning for CPD. All managers acknowledged that online learning could improve the knowledge and practice skills of health care professionals. Nevertheless, 52.4% of health institutions who participated in this study currently do not use online for CPD. Participants demonstrated challenges such as the lack of access to digital devices, poor or lack of internet access, poor online learning design, low digital skills of healthcare professionals, lack of time dedicated to online learning, and heavy workload of staff. Conclusion: These findings indicate then that the managers of health institutions value the importance of online learning for CPD of health professionals. However, online learning should be designed to fit for the purpose and with a high consideration on needs and preferences of healthcare professionals and thereby improve information communication technology infrastructure that support online learning for CPD. Traditional in-person CPD courses are still recommended in health institutions with shortage in resources and technology. Also, the barriers of online CPD delivery such as low internet connectivity and lack of access to digital devices by healthcare professionals need to be co-creatively addressed through the pyramidal structure of the Rwandan health system. © 2022, The Author(s).
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| 2. |
- Fors, Uno, et al.
(författare)
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Can virtual patients be used to assess clinical reasoning? The effect of different grading metrics
- 2012
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Ingår i: 15th Ottawa Conference, Abstracts. - Ottawa : AMEE. ; , s. 166-166
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Konferensbidrag (refereegranskat)abstract
- BackgroundVirtual patients (VPs) can be used to assess clinical reasoning. Grading metrics applied to VP exams may include scoring for appropriate differential diagnoses, proposed therapy, and the learner’s approach to the case. The learner’s inquiry of medical history, physical exam, and lab/ancillary tests utilized during the exam can all be graded. However, the best grading metric used to assess clinical reasoning for VP examination is unresolved. Summary of WorkResults from two groups of students assessed by VP-based examination (n>300) were used as a basis to evaluate different grading metrics. These grading models were also compared with results of other traditional student examination performance. Summary of ResultsEach method of grading had both pronounced advantages and disadvantages with none considered ideal. However one grading metric was perceived to perform slightly better. None of the scoring methods had a direct correlation with four traditional exam formats to which they were compared. ConclusionsEach grading metric used in this study had advantages and disadvantages. Medical school exams employing VP-based exams need to define what should be assessed for reliable utilization.Take-home Messages Objectives of VP-based examination are essential to measure learner competency in an appropriate context. Traditional exams do not necessarily measure the same aptitude that VP-based exams measure.
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| 3. |
- Forsberg, Elenita, 1961-, et al.
(författare)
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An Academic Reflection as an Examination after High-fidelity Simulation in Nursing Education
- 2020
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Ingår i: Creative Education. - Irvine, CA : Scientific Research Publishing. - 2151-4755 .- 2151-4771. ; 11:12, s. 2806-2821
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Today’s healthcare is complex and the need for quick decisions and care can be crucial for the patient’s well-being. For the students, it is essential to develop clinical competence during their nursing education. Aim: The aim of the study was to explore how an individual written academic reflection as an examination after high-fidelity simulation can support student nurses’ learning experiences of clinical competence when a developed questionnaire was used to stimulate in-depth reflection. Method: After the intervention of using an academic reflection as an examination after high-fidelity simulation during the fourth semester of the nursing programme, 107 individually written academic reflections were collected from students during 2017-18. A questionnaire with seven open-ended questions was developed to stimulate the reflection of students’ learning experiences of clinical competence. Based on Kolb’s experiential learning cycle, a deductive content analysis was used with focus on the students’ learning experiences. Results: The students expressed that the performed simulated scenario in connection with the individual written academic reflection made them aware of the strengths and weaknesses in their ability to clinical reasoning and patient safety. Furthermore, the importance of communications skills emerged. The students highlighted the use of the closed loop structure for communication in the team, and the necessity to involve the patient more in clinical situations. During the simulation scenarios, the students appreciated in having the opportunity to be an observer for developing knowledge concerning clinical competence. Conclusion: By implementing an examination that provides an opportunity for time for an in depth-reflection, creates effectively professional development. The academic reflection as an examination appears to be a good learning experience such as the clinical competence became visible for the students. Integrating reflective writing continuously during the nursing education can contribute progression of students’ skills to write an academic reflection. Copyright © 2020 by authors and Scientific Research Publishing Inc.
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| 4. |
- Forsberg, Elenita, 1961-, et al.
(författare)
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Assessing clinical reasoning among experienced nurses as a base for a new assessment method for nursing students
- 2011
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Ingår i: AMEE 2011: Vienna, Austria, Reed Messe Wien, 27-31 August 2011. - Dundee, UK : AMEE. ; , s. 313-313
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Konferensbidrag (refereegranskat)abstract
- Background: Postgraduate nursing education is a program which require knowledge and skills that guarantee the quality of professional competence. Many courses in nursing have learning outcomes including clinical reasoning (CR). Assessment is an important part of the learning process and should assess clinically relevant performance. Virtual Patients (VPs), have successfully been used in nursing education to promote learning and also been piloted for assessment of CR. Summary of work: However, it remains to solve how to score and grade VPs for assessment. Therefore, we need to determine the best practises that the assessment should be based on. This study investigates how clinically experienced specialist nurses apply CR for clinical decision making, to create the basis for a holistic assessment method based on VPs. Summary of results: VP cases representing different subdisciplines in paediatrics are implemented in a VP-system. 40 experienced nurses will work in pairs to solve the VP-cases, and their actions are logged in terms of what they do and in what order. Think Aloud is used to capture their thinking process. Conclusions: This study will give information about how experienced nurses solve clinical cases and thus which issues that should be assessed in VP-based assessment for nursing. Take-home messages: VP-based assessment for specialist nursing education is being developed.
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| 5. |
- Forsberg, Elenita, et al.
(författare)
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Assessing Clinical Reasoning skills in Nursing using Virtual Patients
- 2010
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Ingår i: Proceeding of AMEE 2010.
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Konferensbidrag (refereegranskat)abstract
- Clinical reasoning (CR) in nursing covers many aspects of problem solving and decision making regarding the well-being and care of patients. CR is seldom a specific topic in nursing curricula and is usually informally trained during clinical rotations. CR in nursing is different from medicine, and besides a different vocabulary, decisions in nursing seldom are focused on medical diagnosis, laboratory/imaging data or therapy, but more on the caring process and well-being of the patient. This has led to problems finding good methods for assessing nursing students’ clinical reasoning skills. In this study, Virtual patients (VPs) were introduced as an assessment tool for CR in three different nursing courses at two universities comprising 64 students in total. Students’ opinions about this assessment method were investigated using questionnaires regarding students’ acceptance, adaptation to nursing procedures and the potential of the VP-based assessment as a learning experience. A vast majority of the students reported positive attitudes to the VP-based assessment. Many students thought that the VP cases were well adapted to nursing, but some wanted the VP system to be less “medical” and asked for more focus on nursing. Almost all students identified the VP-based assessment as a good learning experience.
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| 6. |
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| 7. |
- Forsberg, Elenita, 1961-, et al.
(författare)
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Assessing progression of clinical reasoning through Virtual Patients
- 2014
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Ingår i: Ottawa Conference Abstracts. ; , s. 71-72
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Konferensbidrag (refereegranskat)abstract
- BackgroundThere have been discussions to use more formative assessments in health care education to contribute to students’ deep learning. Feedback is important, but a lot of student’s do not do anything with it. Thus, interventions which force students to reflect the new knowledge need to be introduced.In order to explore if formative VP-based exams had an impact on development of clinical reasoning ability and achievement of clinical decision making, we let postgraduate pediatric nurse students complete self-evaluation forms in connection with three VP- based assessments to follow their progress.Summary of WorkAfter performed assessment and before answering the self-evaluation form, the students’ were asked to take part of the feedback section of the VP-system and the recommended interactions in the VP system. Data was conducted using content analysis with a deductive approach. Kolb’s’ model of Learning Cycle guided the analysis.Summary of ResultsThe result showed a perceived progression of clinical reasoning skills by the students. After the first assessment the students described uncertainty and that knowledge gaps were exposed, at the second exam the awareness of clinical reasoning was obvious and the students were more certain of knowing how. Finally, self-efficacy in patient solving was expressed.ConclusionsVP-based assessments with self-evaluation early in the education resulted in a gain of students’ own identification of the concept of clinical reasoning, awareness of what to focus on, and pay attention to during clinical practice.Take-home Messages VP with reflective tools is excellent to use in formative assessments to identify progress and to visualize the expected clinical competence.
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| 8. |
- Forsberg, Elenita, 1961-, et al.
(författare)
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Assessing progression of clinical reasoning through virtual patients : An exploratory study
- 2016
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Ingår i: Nurse Education in Practice. - Kidlington : Elsevier BV. - 1471-5953 .- 1873-5223. ; 16:1, s. 97-103
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Tidskriftsartikel (refereegranskat)abstract
- To avoid test-driven learning, there have been discussions regarding the use of more formative assessments in health care education to promote students' deep learning. Feedback is important in formative assessment, but many students ignore it; therefore, interventions should be introduced which stimulate them to reflect on the new knowledge. The aim for this study was to explore if Virtual Patient (VP)-based formative assessments, in connection with self-evaluations, had an impact on postgraduate pediatric nursing students' development of clinical reasoning abilities. Students' self-evaluations served as the basis for measuring progress. Data was analysed using deductive content analysis. The findings showed a clear progression of the clinical reasoning ability of the students. After the first assessment, the students described feelings of uncertainty and that their knowledge gaps were exposed. At the mid-course assessment the awareness of improved clinical reasoning was obvious and the students were more certain of knowing how to solve the VP cases. In the final assessment, self-efficacy was expressed. VP -based assessments, in connection with self-evaluations, early in the education resulted in a gain of students' own identification of the concept of clinical reasoning, awareness of what to focus on during clinical practice and visualised expected clinical competence.
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| 9. |
- Forsberg, Elenita, 1961-, et al.
(författare)
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Att leda i pediatrisk omvårdnad
- 2022. - 1
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Ingår i: Våga leda omvårdnad. - Stockholm : Liber. - 9789147128396 ; , s. 129-151
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Forsberg, Elenita, 1961-, et al.
(författare)
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Clinical reasoning in nursing, a think-aloud study using virtual patients – A base for an innovative assessment
- 2013
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Ingår i: Nurse Education Today. - Amsterdam : Elsevier. - 0260-6917 .- 1532-2793. ; 34:4, s. 538-542
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Tidskriftsartikel (refereegranskat)abstract
- In health-care education, it is important to assess the competencies that are essential for the professional role. To develop clinical reasoning skills is crucial fornursing practice and therefore an important learning outcome in nursing education programmes. Virtual patients (VPs) are interactive computer simulations of real-life clinical scenarios and have been suggested for use not only for learning, but also for assessment of clinical reasoning. The aim of this study was to investigate how experienced paediatric nurses reason regarding complex VP cases and how they make clinical decisions. The study was also aimed to give information about possible issues that should be assessed in clinical reasoning exams for post-graduate students in diploma specialist paediatric nursing education. The information from this study is believed to be of high value when developing scoring and grading models for a VP-based examination for the specialist diploma in paediatricnursing education. Using the think-aloud method, data were collected from 30 RNs working in Swedish paediatric departments, and child or school health-care centres. Content analysis was used to analyse the data. The results indicate that experienced nurses try to consolidate their hypotheses by seeing a pattern and judging the value of signs, symptoms, physical examinations, laboratory tests and radiology. They show high specific competence but earlier experience of similar cases was also of importance for the decision making. The nurses thought it was an innovative assessment focusing on clinical reasoning and clinical decision making. They thought it was an enjoyable way to be assessed and that all three main issues could be assessed using VPs. In conclusion, VPs seem to be a possible model for assessing the clinical reasoning process and clinical decision making, but how to score and grade such exams needs further research. © 2013 Elsevier Ltd. All rights reserved.
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