| 1. |
- Fredholm, Angelica, et al.
(författare)
-
Authenticity made visible in medical students' experiences of feeling like a doctor
- 2019
-
Ingår i: International Journal of Medical Education. - : International Journal of Medical Education. - 2042-6372. ; 10, s. 113-121
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To interpret the phenomenon of authenticity made visible in medical students' experiences of feeling like a doctor, i.e., how authenticity took shape in narratives about feeling like a doctor in clinical situations where students were challenged to be independent and to a high degree make choices and clinical decisions.Methods: The conducted research was positioned within phenomenological hermeneutic research tradition, interpreting participants' experiences in a life-world perspective using narrative inquiry. Fifteen medical students in their fifth year were interviewed focusing on clinical situations. An abductive analysis approach was used to discover patterns and to interpret data following a phenomenological hermeneutic research method for textual interpretation.Results: The analysis resulted in a thematic structure of findings: Opportunity to experience authenticity through creating relationships; Opportunity to experience authenticity through responsibility; Opportunity to experience authenticity through independence, managing wholeness, and follow-up processes; Opportunity to experience authenticity through being able to reason and discern. Overarching the four themes was the perceived need for attachment, i.e. attachment to patients, to supervisors, to the workplace, to the situation and reasoning and knowledge.Conclusions: Essential for the experience of feeling like a doctor was authentic situations that resulted in the experienced members of a community of practice and the perceived development of a professional identity. These findings can advance the understanding of how clinical education should be organized to facilitate professional identity development.
|
|
| 2. |
- Junninen, Heikki, et al.
(författare)
-
Terpene emissions from boreal wetlands can initiate stronger atmospheric new particle formation than boreal forests
- 2022
-
Ingår i: Communications Earth and Environment. - : Springer Science and Business Media LLC. - 2662-4435. ; 3:1
-
Tidskriftsartikel (refereegranskat)abstract
- Aerosols and their interaction with clouds constitute the largest uncertainty in estimating the radiative forcing affecting the climate system. Secondary aerosol formation is responsible for a large fraction of the cloud condensation nuclei in the global atmosphere. Wetlands are important to the budgets of methane and carbon dioxide, but the potential role of wetlands in aerosol formation has not been investigated. Here we use direct atmospheric sampling at the Siikaneva wetland in Finland to investigate the emission of methane and volatile organic compounds, and subsequently formed atmospheric clusters and aerosols. We find that terpenes initiate stronger atmospheric new particle formation than is typically observed over boreal forests and that, in addition to large emissions of methane which cause a warming effect, wetlands also have a cooling effect through emissions of these terpenes. We suggest that new wetlands produced by melting permafrost need to be taken into consideration as sources of secondary aerosol particles when estimating the role of increasing wetland extent in future climate change.
|
|
| 3. |
- Kangas-Niemi, Annina, et al.
(författare)
-
Facilitating affective elements in learning - In a palliative care context
- 2018
-
Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 33, s. 148-153
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore ways clinical supervisors facilitate the learning of the affective elements of professional competence in a clinical palliative care environment. The secondary aim was to advocate for and raise awareness of the importance of the affective domain in medical education.A clinical palliative care learning environment has been reported to be emotionally challenging. The affective and transformative learning processes taking place requires special support. However, little is known about how clinical supervisors facilitate this learning processes. A qualitative, explorative study was designed to capture supervisors' perceptions of their supervision using semi-structured interviews. Six experienced clinical supervisors working within a palliative care context were recruited using convenience sampling. Data were analyzed using inductive content analysis. The affective elements were viewed as essential for learning, clinical supervision, and professional competency. Supervisors use a variety of different ways of facilitation. Four main themes were identified; building a relationship, creating space for learning, creating a pedagogical environment, and Mirroring.
|
|
| 4. |
- Koufidis, Charilaos, et al.
(författare)
-
Grounding judgement in context : A conceptual learning model of clinical reasoning
- 2020
-
Ingår i: Medical Education. - : Wiley. - 0308-0110 .- 1365-2923. ; 54:11, s. 1019-1028
-
Tidskriftsartikel (refereegranskat)abstract
- ContextContemporary research on clinical reasoning focuses on cognitive problem‐solving processes. However, the decisive role that clinical context plays in clinical reasoning is often overlooked. We explored how novice learners make sense of the patient encounter in the clinical situation. In particular, we examined medical students' own judgements concerning diagnostic and management decisions and how the clinical context impacts on this. We aimed to produce a conceptual model of how students learn clinical reasoning in the clinical environment.MethodWe used grounded theory methodology to develop a conceptual learning model. A total of 23 medical students in their third academic year were recruited. Qualitative data were gathered from semi‐structured interviews, participant observations and field interviews, during clinical clerkships.ResultsLearners participating in the clinical environment experienced tensions, called ‘Disjunctions.’ These disjunctions emerged in the context of the student–patient encounter and in particular in situations where an element from the interaction with the patient was perceived as being inconsistent with existing frames of reference. We categorised the sources of disjunctions into four subcategories: (a) observing the manifestations of clinical signs in reality; (b) fitting the symptoms to a diagnosis; (c) considering management decisions, and (d) communicating a medical decision to the patient. Disjunctions involved an affective component and were associated with feelings of uncertainty. These tensions provoked reactions from the learners, leading them to reassess and modify held assumptions in order to accommodate the encountered inconsistent elements. This facilitated changes in judgement. When making a judgement, participants learned to take into consideration situational elements.ConclusionsStudents experience disjunctions in the clinical environment as they encounter situations that challenge their frames of reference. These disjunctions carry significant learning potential. This study can contribute to knowledge concerning the role of the patient encounter in advancing clinical reasoning by transforming problematic habits of the mind.
|
|
| 5. |
- Koufidis, Charilaos, et al.
(författare)
-
Representation, interaction and interpretation : Making sense of the context in clinical reasoning
- 2022
-
Ingår i: Medical Education. - : John Wiley & Sons. - 0308-0110 .- 1365-2923. ; 56:1, s. 98-109
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundAll thinking occurs in some sort of context, rendering the relation between context and clinical reasoning a matter of significant interest. Context, however, has a notoriously vague and contested meaning. A profound disagreement exists between different research traditions studying clinical reasoning in how context is understood. However, empirical evidence examining the impact (or not) of context on clinical reasoning cannot be interpreted without reference to the meaning ascribed to context. Such meaning is invariably determined by assumptions concerning the nature of knowledge and knowing. The epistemology of clinical reasoning determines in essence how context is conceptualised.AimsOur intention is to provide a sound epistemological framework of clinical reasoning that puts context into perspective and demonstrates how context is understood and researched in relation to clinical reasoning.DiscussionWe identify three main epistemological dimensions of clinical reasoning research, each of them corresponding to fundamental patterns of knowing: the representational dimension views clinical reasoning as an act of categorisation, the interactional dimension as a cognitive state emergent from the interactions in a system, while the interpretative dimension as an act of intersubjectivity and socialisation. We discuss the main theories of clinical reasoning under each dimension and consider how the implicit epistemological assumptions of these theories determine the way context is conceptualised. These different conceptualisations of context carry important implications for the phenomenon of context specificity and for learning of clinical reasoning.ConclusionThe study of context may be viewed as the study of the epistemology of clinical reasoning. Making sense of ‘what is going on with this patient’ necessitates reading the context in which the encounter is unfolding and deliberating a path of response justified in that specific context. Mastery of the context in this respect becomes a core activity of medical practice.
|
|
| 6. |
- Koufidis, Charilaos, et al.
(författare)
-
Unravelling the polyphony in clinical reasoning research in medical education
- 2021
-
Ingår i: Journal of Evaluation In Clinical Practice. - : John Wiley & Sons. - 1356-1294 .- 1365-2753. ; 27:2, s. 438-450
-
Forskningsöversikt (refereegranskat)abstract
- Rationale Clinical reasoning lies at the heart of medical practice and has a long research tradition. Nevertheless, research is scattered across diverse academic disciplines with different research traditions in a wide range of scientific journals. This polyphony is a source of conceptual confusion. Aims and objectives We sought to explore the underlying theoretical assumptions of clinical reasoning aiming to promote a comprehensive conceptual and theoretical understanding of the subject area. In particular, we asked how clinical reasoning is defined and researched and what conceptualizations are relevant to such uses. Methods A scoping review of the clinical reasoning literature was undertaken. Using a "snowball" search strategy, the wider scientific literature on clinical reasoning was reviewed in order to clarify the different underlying conceptual assumptions underlying research in clinical reasoning, particularly to the field of medical education. This literature included both medical education, as well as reasoning research in other academic disciplines outside medical education, that is relevant to clinical reasoning. A total of 124 publications were included in the review. Results A detailed account of the research traditions in clinical reasoning research is presented. In reviewing this research, we identified three main conceptualisations of clinical reasoning: "reasoning as cognitive activity," "reasoning as contextually situated activity," and "reasoning as socially mediated activity." These conceptualisations reflected different theoretical understandings of clinical reasoning. Each conceptualisation was defined by its own set of epistemological assumptions, which we have identified and described. Conclusions Our work seeks to bring into awareness implicit assumptions of the ongoing clinical reasoning research and to hopefully open much needed channels of communication between the different research communities involved in clinical reasoning research in the field.
|
|
| 7. |
- Lampilahti, Janne, et al.
(författare)
-
Zeppelin-led study on the onset of new particle formation in the planetary boundary layer
- 2021
-
Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 21:16, s. 12649-12663
-
Tidskriftsartikel (refereegranskat)abstract
- We compared observations of aerosol particle formation and growth in different parts of the planetary boundary layer at two different environments that have frequent new particle formation (NPF) events. In summer 2012 we had a campaign in Po Valley, Italy (urban background), and in spring 2013 a similar campaign took place in Hyytiälä, Finland (rural background). Our study consists of three case studies of airborne and ground-based measurements of ion and particle size distribution from ∼1 nm. The airborne measurements were performed using a Zeppelin inside the boundary layer up to 1000 m altitude. Our observations show the onset of regional NPF and the subsequent growth of the aerosol particles happening almost uniformly inside the mixed layer (ML) in both locations. However, in Hyytiälä we noticed local enhancement in the intensity of NPF caused by mesoscale boundary layer (BL) dynamics. Additionally, our observations indicate that in Hyytiälä NPF was probably also taking place above the ML. In Po Valley we observed NPF that was limited to a specific air mass.
|
|
| 8. |
- Manninen, Katri, et al.
(författare)
-
Authenticity in learning : nursing students' experiences at a clinical education ward
- 2013
-
Ingår i: Health Education. - : Emerald Group Publishing Limited. - 0965-4283 .- 1758-714X. ; 113:2, s. 132-143
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aims to explore and understand first year nursing students' experiences of learning at a clinical education ward.Design/methodology/approach: The setting is a clinical education ward for nursing students at a department of infectious diseases. A qualitative study was carried out exploring students' encounters with patients, supervisors, students and other health care professionals. A total of 19 students were interviewed. Data were analyzed using qualitative content analysis investigating both the manifest and the latent content.Findings: The most important components in students' learning are mutual relationships and a sense of belongingness. A mutual relationship between the students and the patients is created and becomes the basis of students' learning. Belongingness means the students' experience of being for real a part of the team taking care of the patients.Research limitations/implications: The study, while linked to a particular teaching hospital, offers insights of more general nature by linking the findings to a theory of transformative learning.Originality/value: This study adds a deeper understanding of students' perspectives of significant characteristics to take into account when organizing clinical practice in health care education. Being entrusted and supported by a team of supervisors to take care of patients at a clinical education ward early in the education program provides an experience of internal and external authenticity. The students learn from, with and through the patients, which contributes to meaningful learning, understanding nursing, and professional development.
|
|
| 9. |
- Manninen, Katri, et al.
(författare)
-
Ethical Coffee Room : ett EU-projekt om etiska frågor och diskussioner i verksamhetsförlagd utbildning för sjuksköterskestudenter
- 2019
-
Annan publikation (populärvet., debatt m.m.)abstract
- Projektet Simulation in Ethics, SimE, syftar till att öka den etiska kompetensen hos sjuksköterskestudenter i Norden och Baltikum. Projektet pågår under åren 2017-2019 i samarbete mellan Röda Korsets Högskola, Turku University of Applied Sciences (Finland) och Riga Medical College of the University of Latvia (Lettland) och är finansierat av EU och Interregional Central Baltic Programme.I projektet ingår att planera och genomföra tre kurser: Basic Theories of Ethics (2 ECTS), Ethical Coffee Room (1 ETCS) and Simulation in Ethics (3ECTS) som görs gemensamt av de tre partnerorganisationer. Kurserna finns på en digital plattform med web-seminarier och diskussionsforum som resurs för studenterna. Språket är engelska. I kurs 1 ges grunderna i etik och etiska teorier och begrepp. Kurs 2 handlar om att tillämpa och diskutera teoretiska kunskaper och erfarenheter i etik i en autentisk miljö i den verksamhetsförlagda utbildningen. I kurs 3 genomförs simuleringar där studenterna aktivt medverkar i simuleringsscenarier med efterföljande etisk reflektion. Gemensamma kurser i etik bidrar till en mer harmoniserad utbildning och kompetens inom regionen och främjar mobilitet av arbetskraft och bättre patientvård. Efter avslutat projekt kommer allt kursmaterial inklusive en handbok att finnas fritt tillgängligt och kunna användas av alla utbildningar inom hälso- och sjukvård. Röda Korsets Högskola har huvudansvaret för kurs 2 och vi har under våren genomfört en pilot-testning av den, Ehtical Coffee Room, i termin 3 med gott resultat.
|
|
| 10. |
- Manninen, Katri, et al.
(författare)
-
Ethical Coffee Room : An international collaboration in learning ethics digitally
- 2020
-
Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:8, s. 1655-1668
-
Tidskriftsartikel (refereegranskat)abstract
- Background:Ethics is a fundamental part of health care professionals’ competence and one of the major quality factors in good nursing care. Research shows challenges in learning and applying ethics. Ethical Coffee Room is an electronic platform, where the students, nurses and teachers discuss anonymously ethical issues during students’ clinical practice. ECR offers 1 credit (27 working hours) for the students. This work included reading theoretical material, contributions for discussion of ethical dilemmas and reflection of one’s own learning. Every user – student, nurse supervisor or teacher – could choose her or his own pseudonym.Aim:The aim of this study was to describe how nursing students experience learning ethics with digital learning activity during clinical practice, how usable the Ethical Coffee Room platform is and how this learning activity should be developed further.Research design, participants and context:The study employed a qualitative descriptive design and was an EU project between Finland, Sweden and Latvia. In total, 34 second-year nursing students participated in the study. The data collection methods were semi-structured interviews and written comments in the discussion forum Ethical Coffee Room. The data were analysed using content analysis.Ethical considerations:Ethical approval and research permission were obtained from each partner organization, according to their national standards.Findings:The results are presented under three themes: positive learning experiences of Ethical Coffee Room, challenges in learning during Ethical Coffee Room and practical suggestions for future development of Ethical Coffee Room. The results showed that the Ethical Coffee Room was experienced as a novel type of learning activity and an interesting way to learn ethics.Discussion and conclusion:Ethical Coffee Room seems to be a promising learning activity enhancing students’ ethical competence in clinical practice. However, active participation of the mentor nurses and teachers is essential. Therefore, mentor nurses and teachers need in-depth knowledge of ethical theories and concepts and how to apply them in clinical context.
|
|
