| 1. |
- Barman, Linda, 1972-, et al.
(författare)
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How education policy is made meaningful - a narrative exploration of how teachers show autonomy in the development of teaching and learning
- 2016
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Ingår i: Higher Education Resarch and Development. - : Informa UK Limited. - 0729-4360 .- 1469-8366. ; 35:6, s. 1111-1124
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Tidskriftsartikel (refereegranskat)abstract
- This study addresses how the autonomy of teachers in higher education, in relation to education policy and reform, can be understood. By taking a narrative-in-action approach, we studied health profession teachers' activities and reasoning within their ongoing practice during one year. The findings show how the teachers created their own policies and in what way these policies became meaningful. As teachers in this study continuously made changes, the joint creation of policies contributed to their sense of togetherness and the re-building of a community of practice. In parallel, they increased the evidence-based standards related to their discipline and experienced a shift in perspective concerning teaching and learning. The importance of their jointly made policies can be explained by how they learned a student-learning view together, and built on their own ideas of what educational matters needed to be developed. At the same time, their activities and reasoning mirror a debated but yet prevailing view' on the discourse of quality and a number of ideals thereof such as transparency and standardisation, effective teaching and increased academisation.
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| 2. |
- Barman, Linda, 1972-, et al.
(författare)
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Outcome based education enacted : teachers' tensions in balancing between student learning and bureaucracy.
- 2014
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Ingår i: Advances in Health Sciences Education. - : Springer Science and Business Media LLC. - 1382-4996 .- 1573-1677. ; 19:5, s. 629-643
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports on how teachers within health sciences education translate outcome-based education (OBE) into practice when they design courses. The study is an empirical contribution to the debate about outcome- and competency-based approaches in health sciences education. A qualitative method was used to study how teachers from 14 different study programmes designed courses before and after OBE was implemented. Using an interpretative approach, analysis of documents and interviews was carried out. The findings show that teachers enacted OBE either to design for more competency-oriented teaching-learning, or to further detail knowledge and thus move towards reductionism. Teachers mainly understood the outcome-based framework as useful to support students' learning, although the demand for accountability created tension and became a bureaucratic hindrance to design for development of professional competence. The paper shows variations of how teachers enacted the same outcome-based framework for instructional design. These differences can add a richer understanding of how outcome- or competency-based approaches relate to teaching-learning at a course level.
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| 3. |
- Barman, Linda, 1972-, et al.
(författare)
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Safeguarding fairness in assessments—How teachers develop joint practices
- 2022
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Ingår i: Medical Education. - : Wiley-Blackwell Publishing Inc.. - 0308-0110 .- 1365-2923. ; , s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Introduction - In light of reforms demanding increased transparency of student performance assessments, this study offers an in-depth perspective of how teachers develop their assessment practice. Much is known about factors that influence assessments, and different solutions claim to improve the validity and reliability of assessments of students' clinical competency. However, little is known about how teachers go about improving their assessment practices. This study aims to contribute empirical findings about how teachers' assessment practice may change when shared criteria for assessing students' clinical competency are developed and implemented.Methods - Using a narrative-in-action research approach grounded in narrative theory about human sense-making, one group including nine health professions teachers was studied over a period of 1 year. Drawing upon data from observations, interviews, formal documents and written reflections from these teachers, we performed a narrative analysis to reveal how these teachers made sense of experiences associated with the development and implementation of joint grading criteria for assessing students' clinical performances.Results - The findings present a narrative showing how a shared assessment practice took years to develop and was based on the teachers changed approach to scrutiny. The teachers became highly motivated to use grading criteria to ensure fairness in assessments, but more importantly, to fulfil their moral obligation towards patients. The narrative also demonstrates how these teachers reasoned about dilemmas that arose when they applied standardised assessment criteria.Discussion - The narrative analysis shows clearly how teachers' development and application of assessment standards are embedded in local practices. Our findings highlight the importance of teachers' joint discussions on how to interpret criteria applied in formative and summative assessments of students' performances. In particular, teachers' different approaches to assessing ‘pieces of skills’ versus making holistic judgements on students' performances, regardless of whether the grading criteria are clear and well-articulated on paper, should be acknowledged. Understanding the journey that these teachers made gives new perspectives as to how faculty can be supported when assessments of professionalism and clinical competency are developed.
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| 4. |
- Barman, Linda, 1972-
(författare)
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Striving for Autonomy : Health sciences teachers’ enactment of policy
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Abstract This thesis explores how teachers within the health sciences enact education policy. The questions address how teachers’ choices related to the design of courses and curricula are made in the light of reforms that emphasise standardisation and transparency. Employing a hermeneutical framework teachers’ enactment were regarded as a meaning-making process shown through reason and action. In line with the interpretative approach, the two research projects were performed with qualitative methods. The first research project (study I and II) concerned how teachers’ understood and carried out changes in course design related to the implementation of outcome-based education and the European Bologna Process. For that purpose, course material and interview data was analysed. The second research project (study III and IV), was conducted to deepen the understanding of findings from the first project. A group of teachers who conducted major changes related to previous reform was chosen and studied with a narrative approach when they engaged in the development of teaching and learning. In particular, the teachers’ development of assessment criteria of students’ clinical competencies was studied over one year. A body of literature report on how teachers conceptualise teaching and learning. Based on those studies there has been an emphasis on supporting teachers’ shift in views regarding teaching and learning. Related to recent reforms in higher education, it is however suggested that teachers are less free to decide upon educational matters, and hence individual teachers’ deepened understanding are not enough for development of practice to occur. The findings in this thesis suggest that wide interpretations of education policy in combination with pedagogical knowledge may benefit educational development in practice. Teachers were found to approach outcome-based education when introduced as policy in four different ways, with outcome blind, technocratic, pragmatic or ideological approach. These approaches were related to student-centred learning to more or less extent, and to greater or lesser autonomy in the decision-making related to course design. The studies showed how teachers’ experience a tension between bureaucratic demands and what is emphasised through teaching and learning theory. For some teachers this meant that theoretical constructs were applied in instrumental ways and that pedagogy equated the bureaucratic and rational standards involved in quality control. The findings suggest however, that learning and development can be promoted through education policy but that teachers’ local practices should be supported.
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| 5. |
- Bos (Sparén), Elisabeth, 1958-
(författare)
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A good learning environment for nursing students in primary health care
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Clinical learning is a key part for developing nursingursing education. Previous studies concentrated on hospitals as placement sites. Research results reported in this dissertation identify factors that encourage good learning environments in primary health care (PHC) placements.Aims and methods: The overall aim of the present research was to identify factors that promote good clinical learning environments in PHC settings. Clinical learning environment was investigated from students 'and supervisors' perspectives and their perceptions of the clinical part of nursing education in PHC settings. The present research implemented three quantitative studies (I, II, III) and one qualitative study (IV). In study I investigated district nurses’ (DNs’) student supervision experiences in PHC units before and after implementation of a new supervision model; 98 of 133 DNs (74%) responded to a questionnaire before and 84 (65%) respondes after implementation. In study II validated the Clinical Learning Environment, Supervision, and Nurse Teacher (CLES+T) scale. In study III investigated students’ motivation, total satisfaction, and experience of professional role models associated with dimensions in clinical learning environments. In studies II and III collected data from undergraduate nursing students (n=356) using the CLES+T scale. In study IV interviewed six focus groups with 24 supervisors (DNs); these data provided understanding of student supervision in PHC units.Results: Study I revealed significant need for a new supervision model in PHC units. Supervisors had difficulties staying updated on changes in nursing curricula and experienced insufficient support from universities. They felt that they had to set aside time from their regular duties and get permission from unit managers to supervise students. The supervisors felt confident in the supervisory role, but few had formal educational and academic credentials. After the new supervision model implementation, several supervisors were more satisfied with the supervision organization. The model implementation resulted in improvements within PHC units. Study II confirmed good internal reliability in the CLES+T scale and demonstrated that the five-factor model within the scale is the best-fit model. Supervisory relationship was the most important factor and it strongly correlated with these factors: (i) pedagogical atmosphere and (ii) premises of nursing. Supervisory relationship was moderately correlated with the role of the nurse teacher, and leadership style correlated with PHC units. Study III revealed a statistically significant association between (i) students’ motivation, total satisfaction, and experiences of professional role models and (ii) five dimensions of clinical learning environments. The satisfaction factor had a statistically significant association (effect size was high) with the dimensions; this clearly indicated that students experienced satisfaction. Supervisory relationship and pedagogical atmosphere particularly influenced students’ satisfaction and motivation. Study IV revealed three themes related to supervisors’ experiences during student supervision in PHC units: abandonment, ambivalence, and sharing the holistic approach. Supervisors felt abandoned by their managers, colleagues, and nurse teachers rom universities. They were proud to be DNs and willing to share experiences with students – yet torn between being students’ supervisors and patients’ nurses.Conclusion: This dissertation reports six main factors for good learning environments in PHC units. Supervisors must be prepared and engaged, and students must be motivated. A close, reflective supervisory relationship is one of the most important factors for learning in PHC units. Successful supervision requires clear structure and organization. Adequate support and resources from PHC units are needed for supervisors. Collaboration and liaison between universities and PHC units are needed to link theoretical and practical parts of nurse education. PHC-unit circumstances contribute to holistic nursing care, which is an important factor for student learning. Furthermore, the CLES+T scale was shown to be a reliable tool to use for evaluating PHC settings as clinical learning environment.
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| 6. |
- Bos (Sparén), Elisabeth, et al.
(författare)
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Clinical supervision in primary health care : experiences of district nurses as clinical supervisors - a qualitative study
- 2015
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Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 14:39
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Tidskriftsartikel (refereegranskat)abstract
- Background Learning in the clinical environment is an important part of nursing education. Several recent studies focusing on clinical learning have been based on hospital settings. Little is known about primary health care (PHC) as clinical environment where district nurses (DNs) or nurses supervise students. It is important to understand more about opportunities and difficulties in supervising in this area in order to develop PHC as an optimal learning environment for nursing students. The main objective of this study was to gain an understanding of supervisors’ experiences of supervising undergraduate students at PHC units.Methods A qualitative research approach was used to collect data and analyse supervisors’ experiences. Six focus groups were carried out with 24 supervisors. Focus group data were audio-taped. The data were analysed using an inductive content analysis.Results Three themes illustrated supervisors’ experiences: abandonment, ambivalence and sharing the holistic approach. Supervisors felt abandoned by their managers, colleagues and nurse teachers from universities. They experienced ambivalence due to simultaneously being supervisors for students and carrying out their daily work with patients. At the same time, they were proud to be DNs and willing to share their unique role to apply a holistic approach and continuity in patient care with students.Conclusion When supervising students in PHC, social support and communication between supervisors and their colleagues and management as well as nurse teachers need to be taken into consideration both at universities and at primary health care units.
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| 7. |
- Fjellström, Mona, 1958-
(författare)
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Utvärdering för utveckling av utbildning : Med sikte på delaktighet och deliberation
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis is to explore how evaluation can support higher education development. The thesis addresses the current use of evaluation machines (Dahler-Larsen, 2012b) in relation to the distinctive features of higher education development. Evaluation and educational change are discussed from a social constructivist perspective. Key concepts are: evaluation as a context sensitive process with the purpose of understanding and assessing the value of education (Elliott & Kushner, 2007), participation (Whitmore, 1998) and deliberation (Gutman & Thompson, 2004). The thesis rests on a collection of four articles, three of them based on data originating from a longitudinal case study. This case study explores a participative stakeholder evaluation that was employed as a strategy to support the development of an undergraduate medical programme at a Swedish university. Empirical data were gathered through a literature review, interviews with ten stakeholders, logbook notes from the evaluation and development process and lastly evaluations conducted of the study programme.By highlighting the complexity of educational work and the expectations of the medical profession, the evaluation strategy studied contributed to the creation of a qualified and nuanced development process. It also illuminated an evaluation process that is more associated with learning than with quality enhancement. The practice-near and language sensitive process supported the creation of a community of practice promoting dialogue, critical enquiry, educational conversations and enlightenment. The commitment to cooperation, dialogue and enlightenment was, however, constantly threatened by a higher education culture that is increasingly characterized by productivity and efficiency.The analysis suggests that the complex context of higher education calls for more varied evaluation strategies characterized by holistic perspectives, enlightenment and local ownership. Evaluations that provide answers to crucial questions are a prerequisite for change in higher education. Giving teachers responsibility for the process should develop both their ability to conduct educational evaluations, to work with educational development and ultimately facilitate definitions of educational quality specific to education.
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| 8. |
- Fredholm, Angelica, et al.
(författare)
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Authenticity made visible in medical students' experiences of feeling like a doctor
- 2019
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Ingår i: International Journal of Medical Education. - : International Journal of Medical Education. - 2042-6372. ; 10, s. 113-121
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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.
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| 9. |
- Fredholm, Angelica, et al.
(författare)
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The practice of thresholds : Autonomy in clinical education explored through variation theory and the threshold concepts framework
- 2020
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Ingår i: Teaching in Higher Education. - : Taylor & Francis. - 1356-2517 .- 1470-1294. ; 25:3, s. 305-320
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Tidskriftsartikel (refereegranskat)abstract
- This paper demonstrates a practical dimension to the discussion about threshold concepts. Threshold concepts have thus far mostly been acknowledged to elucidate learning processes mainly connected to theoretical concepts. By exploring situations that prompted experiences of autonomy and authenticity in clinical learning, findings showed how a practical experience could have the same power to transform thinking and identity as theoretical thresholds and serve as a trigger for transformational learning, therefore making the discussion about ‘practical thresholds' or thresholds in practice possible. The present study explores situations that prompted autonomy and authenticity, and offers context for and substance to these situations by adopting variation theory and the threshold concept framework. In order to learn more about situations that prompt experiences of autonomy and authenticity, and create prerequisites for such experiences, this paper examines how students discern and interpret these situations by analysing them through variation theory and the threshold concept framework.
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| 10. |
- Fyrenius, Anna, 1969-
(författare)
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Dynamiskt lärande : En ämnesdidaktisk avhandling om fysiologiska fenomen och läkarstudentens lärande
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- It is well known that the outcome of teaching and learning in higher education is often unsatisfactory. Earlier studies have shown that medical students often have a surface approach to their studies and that misconceptions of fundamental physiological phenomena are common. The aim of this thesis is to support educational practice in medicine, particularly in medical physiology. The thesis can be categorised as subject matter-specific education research, which means that questions about teaching and learning are closely linked to the subject studied. The researcher should be well acquainted with the subject in question. The subject area dealt with in this thesis is physiological phenomena related to cardiovascular pressure-flow relations.The thesis consists of studies of 3-dimensional intra cardiac pressure-flow phenomena in the heart (studies 1 and 2) and studies of how students conceive of and develop an understanding of physiological phenomena related to blood pressure and blood pressure regulation (studies 3 and 4).Flow in the left atrium as well as inflow-patterns to the left ventricle were studied. The 3-dimensional method elucidates vortical flow phenomena which were previously unknown. The findings could contribute to increasing physicians and technicians understanding of flow phenomena in the diagnosis and assessment of heart disease and to the further development of diagnostic methods. In the studies of learning and understanding of physiological phenomena, the findings point to new aspects of a deep approach to learning, which have to do with the students’ ability to change perspective and adopt a variety of learning strategies to a phenomenon (Moving) versus a tendency to hold on to one explanatory model (Holding). The study also investigates the students’ ability to identify and apply fundamental physiological principles as well as how they conceive of the importance of detailed knowledge for understanding of physiology. The findings point to differences in the students’ conceptions of physiological principles. A problemising approach, which includes not only causally described relations, indicates a more complex conception of physiological phenomena. The study shows aspects of understanding which are seldom assessed in examinations.The findings indicate a connection between the students’ approaches to learning and the quality of their understanding of fundamental physiological principles. In the thesis, teaching interventions are proposed in order to stimulate dynamic learning and a learning environment where students are not afraid to challenge their conceptions in order to acquire a rich and nuanced picture of physiological phenomena.
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