| 1. |
- Abrandt Dahlgren, Madeleine, 1956-, et al.
(författare)
-
Understanding clinical reasoning : A phenomenographic study with entry-level physiotherapy students
- 2022
-
Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 38:13, s. 2817-2826
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Entry-level students' conceptualizations of clinical reasoning can provide a starting point for program planning related to clinical reasoning development with a focus on patient-centered care.OBJECTIVE: The aim of the study is to explore how physiotherapy students understand clinical reasoning midway through their education. Nine physiotherapy students were interviewed at the end of their third semester.METHODS: Semi-structured individual interviews were conducted, recorded and transcribed verbatim. A phenomenographic approach to qualitative data analysis, seeking to explore variations in students' conceptions was applied.RESULTS: The students' ways of understanding clinical reasoning could be described as: 1) the cognitive process of the physiotherapist; and 2) the relational process of the collaborative partnership between the physiotherapist and the patient. A contrastive analysis shows how the cognitive and relational perspectives are developed through the relationships among three dimensions of clinical reasoning: 1) problem-solving; 2) context of working; and 3) own learning.CONCLUSION: By identifying the critical variation in students' conceptions of clinical reasoning, focus can be placed on pedagogical arrangements to facilitate students' progression toward a person-centered approach.
|
|
| 2. |
|
|
| 3. |
- Ahn, Song-ee, 1972-, et al.
(författare)
-
Designing a virtual patient as an interprofessional enactment : lessons learnt from the process
- 2020
-
Ingår i: International Journal of Learning Technology. - : InderScience Publishers. - 1477-8386 .- 1741-8119. ; 15:3, s. 204-218
-
Tidskriftsartikel (refereegranskat)abstract
- This study is based on observations of the design process of a virtual patient (VP), which aimed to facilitate interprofessional learning. By following the design process of this particular VP, this study aimed to trace how different practices and the knowledge within these practices were enacted as a VP and to understand the design team's difficulties and challenges. Drawing upon actor-network theory (ANT), the study demonstrates how technology and various practices in healthcare and education were enrolled to build the VP and the different translations that took place during the process. We discuss the results by reflecting on the intertwined relationship among the different enactments of a patient in the different professional practices, the enactment of pedagogical intentions and the role of technology in the design process.
|
|
| 4. |
- Allvin, Renée, 1956-, et al.
(författare)
-
Assessment of interprofessional competence in undergraduate health professions education : protocol for a systematic review of self-report instruments
- 2020
-
Ingår i: Systematic Reviews. - : BioMed Central. - 2046-4053. ; 9:1
-
Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Health practitioners from different professions, and with differing competencies, need to collaborate to provide quality care. Competencies in interprofessional working need developing in undergraduate educational preparation. This paper reports the protocol for a systematic review of self-report instruments to assess interprofessional learning in undergraduate health professionals' education.METHODS: We will search PubMed, Web of Science, CINAHL and ERIC from January 2010 onwards. A combination of search terms for interprofessional learning, health professions, psychometric properties, assessment of learning and assessment tools will be used. Two reviewers will independently screen all titles, abstracts and full-texts. Potential conflicts will be resolved through discussion. Quantitative and mixed-methods studies evaluating interprofessional learning in undergraduate health professions education (e.g. medicine, nursing, occupational and physical therapy, pharmacy and psychology) will be included. Methodological quality of each reported instrument, underpinning theoretical frameworks, and the effects of reported interventions will be assessed. The overall outcome will be the effectiveness of instruments used to assess interprofessional competence. Primary outcomes will be the psychometric properties (e.g. reliability, discriminant and internal validity) of instruments used. Secondary outcomes will include time from intervention to assessment, how items relate to specific performance/competencies (or general abstract constructs) and how scores are used (e.g. to grade students, to improve courses or research purposes). Quantitative summaries in tabular format and a narrative synthesis will allow recommendations to be made on the use of self-report instruments in practice.DISCUSSION: Many studies use self-report questionnaires as tools for developing meaningful interprofessional education activities and assessing students' interprofessional competence. This systematic review will evaluate both the benefits and limitations of reported instruments and help educators and researchers (i) choose the most appropriate existing self-report instruments to assess interprofessional competence and (ii) inform the design and conduct of interprofessional competency assessment using self-report instruments.SYSTEMATIC REVIEW REGISTRATION: Open Science Framework [https://osf.io/vrfjn].
|
|
| 5. |
- Allvin, Renée, 1956-, et al.
(författare)
-
Confident but not theoretically grounded : experienced simulation educators’ perceptions of their own professional development
- 2017
-
Ingår i: Advances in Medical Education and Practice. - Macclesfield : DOVE Medical Press Ltd.. - 1179-7258. ; :8, s. 99-108
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identi ed as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature. Objectives: To explore changes in experienced simulation educators’ perceptions of their own teaching skills, practices, and understanding of teaching over time.Methods: A qualitative exploratory study. Fourteen experienced simulation educators partici- pated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis. Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identi ed: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being con dent in the role as an instructor seemed to constitute a foundation for the instructor’s pedagogical development.Conclusion: Experienced simulation educators’ pedagogical development was based on self- con dence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the rst clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.
|
|
| 6. |
- Allvin, Renée, 1956-, et al.
(författare)
-
Variations in measurement of interprofessional core competencies : a systematic review of self-report instruments in undergraduate health professions education
- 2024
-
Ingår i: Journal of Interprofessional Care. - : Taylor & Francis. - 1356-1820 .- 1469-9567. ; 38:3, s. 486-498
-
Forskningsöversikt (refereegranskat)abstract
- Educating health care professionals for working in interprofessional teams is a key preparation for roles in modern healthcare. Interprofessional teams require members who are competent in their roles. Self-assessment instruments measuring interprofessional competence (IPC) are widely used in educational preparation, but their ability to accurately and reliably measure competence is unknown. We conducted a systematic review to identify variations in the characteristics and use of self-report instruments measuring IPC. Following a systematic search of electronic databases and after applying eligibility criteria, 38 articles were included that describe 8 IPC self-report instruments. A large variation was found in the extent of coverage of IPC core competencies as articulated by the Interprofessional Education Collaborative. Each instrument's strength of evidence, psychometric performance and uses varied. Rather than measuring competency as "behaviours", they measured indirect proxies for competence, such as attitudes towards core interprofessional competencies. Educators and researchers should identify the most appropriate and highest-performing IPC instruments according to the context in which they will be used.Systematic review registration: Open Science Framework (https://archive.org/details/osf-registrations-vrfjn-v1).
|
|
| 7. |
- Edelbring, Samuel, 1969-
(författare)
-
A three-fold framework for relating to innovations and technology in education: learning from, with and about technology
- 2010
-
Ingår i: Interprofessional E-Learning and Collaborative Work. - Hershey, PA : IGI Global. - 9781615208890 - 9781615208906 ; , s. 23-33
-
Bokkapitel (refereegranskat)abstract
- In recent years computer technology has developed quickly as have cultural practices in society. However, educational practices with technology have not yet reached the point where educators and learners benefit optimally from innovative technology. In interprofessional education (IPE) there are examples of technology use that forms an integral part of education. To improve IPE there is a need for reflection on how today and tomorrow’s technology can contribute. As technology and its practices melt together this reflection is however, not easily done. A framework intended as a starting point for such reflection is presented in the following chapter which involves learning from, with and about technology. To assess the benefit of technology for learning we need research on technology integration, on outcomes from learning with technology as well as processes of learning in conjunction with technology. This research has to use different perspectives involving various scientific traditions.
|
|
| 8. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Bodies in Simulation : Exploring Sociomaterial Theory in Collaborative Video-Analysis
- 2016
-
Ingår i: Independent Session: <em>What You See is What</em><em> You Get? Comparing Techniques of Video as a Means of Data Collection and Analysis in Research on Interprofessional Simulation</em>. - : NextMed.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The third presentation builds on practice theory. Practice theory views knowledge as being embodied and relational, intertwined with ethical reasoning and materiality. The findings show that the student teams relate to the manikin as a technical, medical and human body, and that interprofessional knowings and enactments emerge as a fluid movement between bodily positioning in synchrony, and bodily positioning out of synchrony, in relation to the sociomaterial arrangements. The findings are related to contemporary theorisations of practice comprising an integrated view of body and mind, and it is discussed how the findings can be used in simulation exercises to support participants’ learning in new ways.
|
|
| 9. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Characteristics of two questionnaires used to assess interprofessional learning : psychometrics and expert panel evaluations
- 2018
-
Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 18
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Interprofessional learning activities are included in many curricula but are difficult to assess. For languages that are not widely spoken such as Swedish, few validated questionnaires exist that relate to interprofessional outcomes. Therefore, the aim was to examine two such questionnaires in relation to interprofessional competence domains.Methods: Psychometric characteristics, such as homogeneity of items and internal consistency, were assessed for the Swedish versions of the Jefferson Scale of Attitudes Towards Physician-Nurse Collaboration (JSAPNC) and the Readiness for Interprofessional Learning Scale (RIPLS). The questionnaires were distributed directly following IPL activities. Mokken scale analysis based on Loevingers coefficient for homogeneity and Cronbachs alpha were used to evaluate the scales. Two expert panels performed a qualitative analysis of items in relation to four internationally defined interprofessional competences.Results: In total, 88 and 84 responded to the JSAPNC and RIPLS questionnaires, respectively. Estimates of homogeneity were low for both the JSAPNC (H = 0.16) and the RIPLS (H = 0.21). Reliabilities were weak (0.62 and 0.66, respectively) for the total scales. The expert panels categorised 68% of items into similar competence domains. However, their discussion revealed ambiguous wordings and imbalances in the two questionnaires in relation to domains.Conclusion: Interprofessional competence domains are defined but few validated tools exist to assess them. Examined tools relating to interprofessional learning in Swedish do not qualify for assessing overarching IPL outcomes, and summed scores from these tools should be used with caution.
|
|
| 10. |
- Edelbring, Samuel, et al.
(författare)
-
Development of a framework for a structured clinical reasoning curriculum : Outcomes from a multiprofessional European project
- 2021
-
Konferensbidrag (refereegranskat)abstract
- Background: Despite clinical reasoning standing at the core of health professions practice, it is often taught implicitly and informally within the health professions and there is a lack of its structured education. Multiple professions can gain from a supportive framework with explicit learning objectives and expressed key educational aspects. Our aim was to develop such a framework to support development of a longitudinal and adaptive clinical reasoning curriculum for students and teachers in health professions education.Summary of Work: Educators and researchers from several universities and learning institutions across Europe and the USA gathered to strengthen clinical reasoning education (DID-ACT consortium). As a part of a greater Kern-cycle of curriculum-development, participants worked in multiprofessional groups to identify resources, learning activities and assessments addressing target areas derived from a needs analysis.Summary of Results: The DID-ACT framework is based on a learner-centered and active learning pedagogical approach using contextualized patient-scenarios as point of departure. Thirty-five learning objectives were formulated regarding clinical reasoning theories, cognitive biases, about gathering, interpreting and synthesizing patient information and participation, as well as collaborative aspects of clinical reasoning. Learning activities and assessment methods were constructively aligned using a competence-based approach. Progression was described at novice, intermediate and advanced student levels, and at a teaching level.Discussion and Conclusions: Whereas competence-based learning objectives and curricular goals relating to clinical reasoning exist, DID-ACTs collaborative effort presents a novel contribution. It adds to previous work in its explicit focus on clinical reasoning and multiprofessional approach. The presented framework will be used to develop blended learning for students and educators within the consortium and can contribute to future standardized clinical reasoning curricula.Take-home Messages: Clinical reasoning is often taught implicitly and informally within the health professions. A collaborative effort has developed a curricular framework to buttress students clinical reasoning and support educators. This framework highlights key curricular aspects and presents a range of resources, learning activities and assessments.
|
|
| 11. |
|
|
| 12. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Dynamics of study strategies and teacher regulation in virtual patient learning activities : a cross sectional survey
- 2016
-
Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Students’ self-regulated learning becomes essential with increased use of exploratory web-based activities such as virtual patients (VPs). The purpose was to investigate the interplay between students’ self-regulated learning strategies and perceived benefit in VP learning activities.Method: A cross-sectional study (n = 150) comparing students’ study strategies and perceived benefit of a virtual patient learning activity in a clinical clerkship preparatory course. Teacher regulation varied among three settings and was classified from shared to strong. These settings were compared regarding their respective relations between regulation strategies and perceived benefit of the virtual patient activity.Results: Self-regulation learning strategy was generally associated with perceived benefit of the VP activities (rho 0.27, p < 0.001), but was not true in all settings. The association was higher in the two strongly regulated settings. The external regulation strategy did generally associate weakly with perceived benefit (rho 0.17, p < 0.05) with large variations between settings.Conclusions: The flexible student-autonomous appeal of virtual patients should not lead to the dismissal of guidance and related course activities. External teacher and peer regulation seem to be productive for increasing learners’ perceived benefit. Awareness of the interplay among teacher regulation (external) and various study strategies can increase the value of flexible web-based learning resources to students.
|
|
| 13. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Expectations and experiences of the collaborative aspect of virtual patient work
- 2013
-
Konferensbidrag (refereegranskat)abstract
- Background: The small group setting has proved beneficial for learning (Lou et al., 2001). Furthermore, the reasoning process is a goal in itself within an interpersonal view of learning (Crook, 2010). In medical education the use of virtual patients (VPs) has emerged as a method to train clinical reasoning which implies an increased interest for peer collaboration. The VPs are however often used individually in a self-study manner. One study reports 94% individual use (Fall et al., 2005).The aim of this study is to gain knowledge about how students perceive collaboration using VPs and the reasons for individual or collaborative VP work.Summary of work: Students worked with four VPs during clinical clerkship in Rheumatology. All students during one semester (n=30) were asked to fill in a questionnaire concerning collaborative VP work. Questionnaire responses were analysed thematically (Braun and Clarke, 2006).Summary of results: Twenty-nine students (97%) answered the questionnaire. 62% of the students worked individually with the virtual patients, 24% both individually and collaboratively, and 14% only in the collaborative setting. All of those working in the collaboratively stated learning reasons for doing so. Almost all (94%) of the reasons for working individually were of practical character. Those working in both settings stated both practical and learning reasons for doing so.Conclusions: Students clearly see educational benefits of working collaboratively with VPs. However, for practical reasons collaborative case work seems often to give way to the individual self-study approach.Take-home messages: Practical opportunities should be arranged for in order to benefit from collaborative learning when using VPs.
|
|
| 14. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Experiencing virtual patients in clinical learning : a phenomenological study
- 2011
-
Ingår i: Advances in Health Sciences Education. - : Springer. - 1382-4996 .- 1573-1677. ; 16:3, s. 331-345
-
Tidskriftsartikel (refereegranskat)abstract
- Computerised virtual patients (VPs) are increasingly being used in medical education. With more use of this technology, there is a need to increase the knowledge of students experiences with VPs. The aim of the study was to elicit the nature of virtual patients in a clinical setting, taking the students experience as a point of departure. Thirty-one students used VPs as a mandatory part of an early clinical rotation in rheumatology. Using the qualitative approach of phenomenology, we interviewed these students and then analysed data regarding their experiences of VPs as a learning activity. The result shows that students perceived VP activities in relation to actual patients, the clinical context and other learning activities. The VPs represented typical clinical cases which encouraged clinical reasoning and allowed for decision making. The students experienced the activities as integrating biomedical knowledge and clinical experience, providing structure that prepared for the unstructured clinical environment and patient encounters under unstressful conditions. However, the VPs were experienced as lacking the emotional interactivity and complexity of actual patients. Theoretical frameworks of clinical reasoning and experiential learning are suggested as foundations for further educational integration of VPs in the clinical environment. VP activities during clinical rotations provide experiences of clinical reality and allow students to solve problems actively. These features are dependent on VP technology but are also contingent on the surrounding environment.
|
|
| 15. |
- Edelbring, Samuel, PhD, Docent, 1969-, et al.
(författare)
-
Flexible interprofessional student encounters based on virtual patients : a contribution to an interprofessional strategy
- 2022
-
Ingår i: Journal of Interprofessional Care. - : Taylor & Francis. - 1356-1820 .- 1469-9567. ; 36:2, s. 310-317
-
Tidskriftsartikel (refereegranskat)abstract
- It is challenging to organize interprofessional activities in terms of coordinating students' various schedules. These challenges can be overcome by providing flexible online opportunities based on virtual patients (VPs). This study set out to study feasibility of using a blended approach based on virtual patients and a flexible interprofessional student encounter. The encounter was arranged in pairs or triads between nursing and medical students from two separate courses. Data were gathered through a questionnaire and followed up with group interviews. Reflective texts from the interprofessional encounters were analyzed in relation to descriptions of interprofessional competence. The great majority (86%) chose to meet online due to its flexibility. The participants gained an understanding of the other profession's roles and competences and a holistic patient awareness. Given its flexible and scalable opportunities, the blended online virtual patient approach provides a valuable contribution to an interprofessional programme.
|
|
| 16. |
|
|
| 17. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Increasing Reasoning Awareness : Video Analysis of Students' Two-Party Virtual Patient Interactions.
- 2018
-
Ingår i: JMIR Medical Education. - : JMIR Publications. - 2369-3762. ; 4:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Collaborative reasoning occurs in clinical practice but is rarely developed during education. The computerized virtual patient (VP) cases allow for a stepwise exploration of cases and thus stimulate active learning. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature.OBJECTIVE: The objective of this study was to thoroughly investigate interactions during medical students' clinical reasoning in two-party VP settings.METHODS: An in-depth exploration of students' interactions in dyad settings of VP sessions was performed. For this purpose, two prerecorded VP sessions lasting 1 hour each were observed, transcribed in full, and analyzed. The transcriptions were analyzed using thematic analysis, and short clips from the videos were selected for subsequent analysis in relation to clinical reasoning and clinical aspects.RESULTS: Four categories of interactions were identified: (1) task-related dialogue, in which students negotiated a shared understanding of the task and strategies for information gathering; (2) case-related insights and perspectives were gained, and the students consolidated and applied preexisting biomedical knowledge into a clinical setting; (3) clinical reasoning interactions were made explicit. In these, hypotheses were followed up and clinical examples were used. The researchers observed interactions not only between students and the VP but also (4) interactions with other resources, such as textbooks. The interactions are discussed in relation to theories of clinical reasoning and peer learning.CONCLUSIONS: The dyad VP setting is conducive to activities that promote analytic clinical reasoning. In this setting, components such as peer interaction, access to different resources, and reduced time constraints provided a productive situation in which the students pursued different lines of reasoning.
|
|
| 18. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Integrating virtual patients into courses: follow-up seminars and perceived benefit
- 2012
-
Ingår i: Medical Education. - : Wiley-Blackwell Publishing Inc.. - 0308-0110 .- 1365-2923. ; 46:4, s. 417-425
-
Tidskriftsartikel (refereegranskat)abstract
- Context: The use of virtual patients (VPs) suggests promising effects on student learning. However, currently empirical data on how best to use VPs in practice are scarce. More knowledge is needed regarding aspects of integrating VPs into a course, of which student acceptance is one key issue. Several authors call for looking beyond technology to see VPs in relation to the course context. The follow-up seminar is proposed as an important aspect of integration that warrants investigation.Methods: A cross-sectional explanatory study was performed in a clinical clerkship introduction course at four teaching hospitals affiliated to the same medical faculty. The VP-related activities were planned collaboratively by teachers from all four settings. However, each setting employed a different strategy to follow up the activity in the course. Sixteen questionnaire items were grouped into three scales pertaining to: perceived benefit of VPs; wish for more guidance on using VPs, and wish for assessment and feedback on VPs. Scale scores were compared across the four settings, which were ranked according to the level of intensity of students processing of cases during VP follow- up activities.Results: The perceived benefit of VPs and their usage were higher in the two intense-use settings compared with the moderate-and lowintensity settings. The wish for more guidance was high in the low-and one of the highintensity settings. Students in all settings displayed little interest in more assessment and feedback regarding VPs.Conclusions: High case processing intensity was related to positive perceptions of the benefit of VPs. However, the low interest in more assessment and feedback on the use of VPs indicates the need to clearly communicate the added value of the follow-up seminar. The findings suggest that a more intense follow-up pays off in terms of the benefit perceived by students. This study illustrates the need to consider VPs from the perspective of a holistic course design and not as isolated add‐ons.
|
|
| 19. |
- Edelbring, Samuel, PhD, Docent, 1969-, et al.
(författare)
-
Interprofessionell simulering är engagerande och relevant [Interprofessional simulation: an engaging and relevant technique for teamwork practice]
- 2019
-
Ingår i: Läkartidningen. - Stockholm, Sweden : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 116
-
Tidskriftsartikel (refereegranskat)abstract
- Stakeholders in healthcare and education find interprofessional teamwork to be crucial for todays complex healthcare. Consequently, the students need to prepare for future collaboration with other professions. Interprofessional simulation (IPS) is a technique in which several professions can engage together in clinical scenarios. Using a survey we studied the perceived relevance of two IPS settings in which last-year medical and nursing students participated in acute care scenarios. The findings showed that students perceive IPS as being highly relevant and that students from the other profession contributed to their learning. IPS holds promise as a pedagogical tool towards future interprofessional competence. However, pedagogical improvements can be made, and the professional perspectives can be better balanced. Furthermore, in order to equip students with broader interprofessional competence, scenarios should include several professions and a variety of clinical contexts.
|
|
| 20. |
|
|
| 21. |
- Edelbring, Samuel, 1969-
(författare)
-
Measuring strategies for learning regulation in medical education : Scale reliability and dimensionality in a Swedish sample
- 2012
-
Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe degree of learners’ self-regulated learning and dependence on external regulation influence learning processes in higher education. These regulation strategies are commonly measured by questionnaires developed in other settings than in which they are being used, thereby requiring renewed validation. The aim of this study was to psychometrically evaluate the learning regulation strategy scales from the Inventory of Learning Styles with Swedish medical students (N = 206).MethodsThe regulation scales were evaluated regarding their reliability, scale dimensionality and interrelations. The primary evaluation focused on dimensionality and was performed with Mokken scale analysis. To assist future scale refinement, additional item analysis, such as item-to-scale correlations, was performed.ResultsScale scores in the Swedish sample displayed good reliability in relation to published results: Cronbach’s alpha: 0.82, 0.72, and 0.65 for self-regulation, external regulation and lack of regulation scales respectively. The dimensionalities in scales were adequate for self-regulation and its subscales, whereas external regulation and lack of regulation displayed less unidimensionality. The established theoretical scales were largely replicated in the exploratory analysis. The item analysis identified two items that contributed little to their respective scales.DiscussionThe results indicate that these scales have an adequate capacity for detecting the three theoretically proposed learning regulation strategies in the medical education sample. Further construct validity should be sought by interpreting scale scores in relation to specific learning activities. Using established scales for measuring students’ regulation strategies enables a broad empirical base for increasing knowledge on regulation strategies in relation to different disciplinary settings and contributes to theoretical development.
|
|
| 22. |
- Edelbring, Samuel, et al.
(författare)
-
Medicinpedagogisk forskning krävs för utveckling av läkarutbildningen
- 2023
-
Ingår i: Lakartidningen. - 0023-7205. ; 120
-
Tidskriftsartikel (refereegranskat)abstract
- To secure high-quality education for healthcare professionals, the teaching and learning processes-the "how" in education-should be informed by a research base. Although Swedish medical education research is growing, it lacks a national strategy. This study analysed and compared Swedish and Dutch production of medical education articles over ten years in nine core journals, including the number of editorial board members. During the period 2012-2021, Swedish authors produced 217 articles, whereas Dutch authors published 1,441. The journals had 466 board members, of which 31 (7%) were Dutch and four (<1%) Swedish. The results show that medical education in Swedish medical faculties requires improvement. To ensure high-quality education opportunities, we propose a national effort to strengthen the educational research base, using the Dutch effort as inspiration.
|
|
| 23. |
- Edelbring, Samuel, PhD, Docent, 1969-
(författare)
-
Medicinsk informatik och lärande
- 2020. - 1
-
Ingår i: Medicinsk informatik. - Stockholm : Liber. - 9789147134083 ; , s. 192-203
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Detta kapitel handlar om informatikens funktioner i lärandeprocesser irela tion till studenter, professionella och patienter. Det introducerarbegrepp, syn på kunskap och några klassiska modeller för lärande för att synliggöra pedagogiska processer som läsaren känner igen i sinvardags- och yrkessituation. Exemplen hämtas från olika lärandesituationer och vårdområden.
|
|
| 24. |
- Edelbring, Samuel, PhD, Docent, 1969-, et al.
(författare)
-
Person-Centeredness in Clinical Reasoning of Interprofessional Stroke Teams
- 2023
-
Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 109:Suppl., s. 70-70
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Although person-centered care is prioritized in healthcare, challenges remain before such care is integrated in everyday communication and practice. One way to strengthen person-centered care is that health professionals’ clinical reasoning (i.e., assessment and management) is pervaded by patient participation and individualized to patient needs. Interprofessional team meetings, focusing on goals and management planning, is an opportunityt o improve person-centeredness. However, there is a lack of understanding of how person-centeredness is created in the clinical reasoning of teams. This study aims to explore how clinical reasoning is performed from a person-centered perspective in team meetings with patients with stroke and next of kin.Methods: Explorative qualitative design employing a thematic analysis of audio recorded communication at three team meetings. In total, three patients, two next of kin, and 15 professionals representing eight health professions, participated in the meetings.Findings: Four themes and eight subthemes were established: a) Emphasizing the patient’s resources; b) Struggling to find a common understanding, including subthemes: Unite the person’s narrative, the relative’s view, and the expertise of the interprofessional team, missed opportunities to clarify patient needs and wishes, and active listening and receptiveness; c) Balancing the patient’s goals and professionals’ goals, including subthemes: Shared goals, the professionals’ view of appropriate goals, and the professionals’ assessment governs achievement of goals; d) Ambiguity in decisions about the management plan, including subthemes: Initiating shared decision making and lack of clarity and consensus.Discussion: This study reveals how the patient, next of kin and team contribute to shared understanding of the patient’s problem. Goals were guided by the patient’s and professionals’ expertise. To improve person-centeredness in clinical reasoning, the team need to further put the patient’s personal goals and perception of goal-achievement in the forefront as well as improve communication skills to catch patient needs and facilitate shared decisions.
|
|
| 25. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Phenomenology as research approach in medical education : Characteristics and empirical examples
- 2010
-
Konferensbidrag (refereegranskat)abstract
- Background: In contemporary educational research learning is not necessarily determined by outcomes measured by scales or prefabricated instruments. Student learning is rather looked upon as a process where individuals learn in relation to what is meaningful to him or her (Marton & Booth). This implies that the students’ perception of their learning environment is of importance for the researcher. Phenomenology is a research approach focusing on how individuals experience their environment and thus, suitable for such investigations.Summary of work: The empirical phenomenological approach has been investigated regarding its aim and procedures. Elements of this approach will be presented illustrated by a recent study.Summary of results: Phenomenology has characteristic core elements that the researcher must acknowledge.Conclusions: Husserl’s phenomenological philosophy constitutes an excellent base for a research approach that aims at taking a subjects standpoint as a foundation for the research. A medical education researcher can be overwhelmed by philosophical literature, but contemporary psychologists have worked out empirical methods making the philosophy feasible to carry out in practice.Take-home messages: Empirical phenomenology is a research methodology highlighting individuals’ experiences, adapted from Husserl’s philosophical method. There are guidelines that break down the approach into practical procedures that make the approach possible to carry through in a medical education context.
|
|
| 26. |
|
|
| 27. |
- Edelbring, Samuel, PhD, Docent, 1969-, et al.
(författare)
-
Should the PBL tutor be present? : A cross-sectional study of group effectiveness in synchronous and asynchronous settings
- 2020
-
Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The tutorial group and its dynamics are a cornerstone of problem-based learning (PBL). The tutor's support varies according to the setting, and it is pertinent to explore group effectiveness in relation to different settings, for example online or campus-based. The PBL groups' effectiveness can partly be assessed in terms of cognitive and motivational aspects, using a self-report tool to measure PBL group effectiveness, the Tutorial Group Effectiveness Instrument (TGEI).This study's aim was to explore tutor participation in variations of online and campus-based tutorial groups in relation to group effectiveness. A secondary aim was to validate a tool for assessing tutorial group effectiveness in a Swedish context.Methods: A cross-sectional study was conducted with advanced-level nursing students studying to become specialised nurses or midwives at a Swedish university. The TGEI was used to measure motivational and cognitive aspects in addition to overall group effectiveness. The instrument's items were translated into Swedish and refined with an expert group and students. The responses were calculated descriptively and compared between groups using the Mann-Whitney U and Kruskal-Wallis tests. A psychometric evaluation was performed using the Mokken scale analysis. The subscale scores were compared between three different tutor settings: the tutor present face-to-face in the room, the tutor present online and the consultant tutor not present in the room and giving support asynchronously.Results: All the invited students (n=221) participated in the study. There were no differences in motivational or cognitive aspects between students with or without prior PBL experience, nor between men and women. Higher scores were identified on cognitive aspects (22.6, 24.6 and 21.3; p<0.001), motivational aspects (26.3, 27 and 24.5; p=002) and group effectiveness (4.1, 4.3, 3.8, p=0.02) for the two synchronously tutored groups compared to the asynchronously tutored group. The TGEI subscales showed adequate homogeneity.Conclusions: The tutor's presence is productive for PBL group effectiveness. However, the tutor need not be in the actual room but can provide support in online settings as long as the tutoring is synchronous.
|
|
| 28. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
SvalSim : field work simulation system for problem-oriented learning in petroleum geology
- 2004
-
Ingår i: International Journal of Innovation in Science and Mathematics Education. - : Institute for Innovation in Science and Mathematics Education. - 2200-4270. ; 12:1, s. 9-11
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- The Educational Technology Unit at Karolinska Institutet (KI) in Sweden has developed an on-screen simulation software, SvalSim, that simulates field work for problem-oriented learning in petroleum geology. The system is using numerous authentic geological data, takes the time aspect into account and lets users control almost all events resulting in a very realistic simulation. The educational setting for use of the simulation software is general training in geosciences and field courses in Norway e.g., at Svalbard. This article describes the system and the pedagogical objectives.
|
|
| 29. |
- Edelbring, Samuel, et al.
(författare)
-
Svensk medicinpedagogisk forskningsproduktion och förutsättningar för tillämpning för kvalitet och innovation
- 2023
-
Konferensbidrag (refereegranskat)abstract
- Bakgrund: Beslut och metoder inom hälso- och sjukvården bygger på vetenskaplig grund vilket förutsätter en forskningsbas. Inom detta område är svensk vetenskaplig produktion och tillämpning relativt stark, däremot ser vi inte motsvarande styrka i kunskapsbasen för utbildningsuppdraget. I diskussionen om utbildningens forskningsförankring är det vanligtvis innehållet som avses eller kontakt med aktiva forskare, mer sällan hur utbildningen bör utformas för att stödja lärande eller förutsättningarna för lärarskicklighet.Det saknas inte forskning inom området, på den internationella arenan ser vi en växande högskolepedagogisk forskningsproduktion med medicin och hälsa som kontext, sk. medicinsk pedagogik. Däremot finns anledning att uppmärksamma från vilken kontext forskningen kommer och förutsättningarna att omsätta den till kvalitet och innovation i utbildningarna. Merparten av fältets forskningsproduktion kommer från USA, UK, Canada och Australien (Thomas, 2019). Den internationella prägeln på kunskapsbasen är inte alltid optimal för implementering i svenska förhållanden då resultaten och slutsatser är dragna från en kontext som i flera avseenden skiljer sig från vår. Förutom tillgång till forskning behövs möjligheter att ta del av den och omsätta till godo för utbildningen. Europeiska lärare anser inte att ny forskning når deras arbetsgrupper i någon hög utsträckning (Thomas et al., 2019). Medicinskt skolade lärare är ofta ovana vid den högskolepedagogiska forskningsgenren som evidensgrund (Kneebone, 2002). Nederländerna, som är mer befolkat än Sverige men har snarligt antal läkarutbildningar samt likartade förhållanden för högre utbildning, har satsat på en medicinpedagogisk utveckling som givit avtryck i fältet.Syftet med denna studie är att undersöka svensk forskningsproduktion inom det medicinpedagogiska området samt att föreslå en förstärkning av förutsättningar för denna produktion och dess tillämpning i utbildningar för medicin och hälsa.Metod: Författarna är pedagogiska aktörer vid tre medicinska fakulteter och har granskat svensk och nederländsk kunskapsproduktion för medicinsk pedagogik och aspekter av dess tillämpning. En bibliometrisk analys genomfördes av antal svenska och nederländska publikationer i 9 etablerade medicinpedagogiska tidskrifter för åren 1995-2021. Svenska affilieringar och finansieringskällor samt antal svenskar i tidskriftsredaktionerna analyserades också. Tidskrifterna var Medical education, Medical teacher, BMC medical education, Advances in health sciences education, Academic medicine, Perspectives on medical education, Anatomical sciences education, Teaching and learning in medicine samt International journal of medical education. Förutsättningar för forskning i medicinsk pedagogik identifierades genom sökningar på medicinska fakulteternas hemsidor samt på respektive lärosätes forskningsämnen/institutioner/forskargrupper. Resultat: Under tioårsperioden 2012–2021 publicerades 17 013 artiklar i dessa tidskrifter varav 1 441 från Nederländerna och 217 från Sverige. Nederländska publikationer ökade dramatiskt i det längre perspektivet för att plana ut till en hög produktion med 117–187 årliga publikationer under perioden, medan svenska publikationer ökade makligt till 16–33 årliga publikationer. Samtliga svenska medicinska fakulteter bidrog till produktionen, men andelen från KI dominerade. Tidskrifternas redaktioner bestod sammanlagt av 466 personer varav 31 (7%) nederländare och fyra svenskar (<1%). Organisatoriskt stöd till pedagogisk forskningsanknytning finns på alla medicinska fakulteter men i de flesta fall som en del av universitetets pedagogiska utveckling, inte anpassat till professionsutbildningar inom medicin och hälsa.Diskussion och slutsats: Forskningsbaserad kunskap bör vägleda utbildningarna, och eget forskningsengagemang i fältet skapar omdöme i utveckling och strategiska beslut. Hög forskningsproduktion är inte per se ett kvalitetsmått på utbildningarna, dock är det rimligt att anta att en satsning på produktion avspeglas i högre pedagogisk medvetenhet och säkrare beslutsunderlag i såväl fakultets- och kursledningar som hos lärare och handledare. En stark produktion och engagemang skapar delaktighet i det internationella forskarsamhället som vi både kan lära av och bidra i. Nederländerna har visat att även ett europeiskt land kan göra avtryck i fältet (Doja et al., 2014). Vi föreslår specifika svenska satsningar för en hållbar kvalitetssäkring och innovationskraft.
|
|
| 30. |
- Edelbring, Samuel, 1969-
(författare)
-
Technology in education, necessary but not sufficient : understanding learning with virtual patients
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- With the rapid technological development and the broadening access to computers over recent decades, several technological innovations have emerged in medical education, including virtual patients. Students’ use of virtual patients is proposed to fill gaps in clinical exposure, and train clinical reasoning. However, higher education faculties have been slow to adopt new technology as a regular part of curricula. Virtual patients and similar technologies have either been implemented by enthusiastic teachers or by university policy directives. A possible reason for the low uptake of virtual patients in curricula is a lack of a clear understanding of how their use contributes to student learning. The four studies described in this thesis address learning with virtual patients from three perspectives: the student perspective on learning with virtual patients; the course integration perspective; and the individual study strategy perspective. A mixed methods approach was used given the overarching interest to seek understanding and clarification of student learning with virtual patients. Data were gathered by research interviews with medical students during clerkship, and by questionnaires in clerkship preparatory courses. Interview data was analysed by a phenomenological approach, and scales were formed from questionnaire responses which were analysed cross-sectionally for the four teaching hospitals affiliated with the medical programme at Karolinska Institutet. Use frequency, students’ perceived benefit of virtual patients, their wish for more guidance on using virtual patients and, wish for more assessment and feedback on virtual patient work were targeted in the questionnaires. Furthermore, the students’ preferences of study strategies were analysed in relation to the virtual patient activity using regulation strategy scales from the Inventory of Learning Styles devised by Jan Vermunt. The findings suggested that virtual patient learning activities offer possibilities of applying biomedical knowledge to clinical cases in a way that was engaging and supported decision-making. Furthermore, the virtual patient learning activities were perceived as having an intermediate function between textbook learning and learning with actual patients. The consequences of integration strategies in the course context were influential for how students perceived the benefit of learning with virtual patients. Intensity of processing of virtual patient cases, and presenting cases for other students were associated with high perceived benefit of virtual patient learning activities. Students’ self-regulation abilities were also associated with perceived benefit of the virtual patient learning activities, although to a lesser extent than the influence of the course context. The technology of virtual patients provides possibilities that enhance student learning, and should thus be a necessary part of education. However, this research show that an educational integration strategy is needed that supports students’ active processing of virtual patient cases.
|
|
| 31. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Utvärdering av IPL-simulering på Clinicum : Simuleringsdag ”Akuta situationer” för sistaårsstudenter från sjuksköterske- och läkarprogrammen HT 2016
- 2017
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En gemensam simuleringsdag för sjuksköterske- och läkarstudenter har utvärderats och diskuteras här i relation till interprofessionellt lärande och simuleringsbaserat lärande.IPL-simuleringen kännetecknas av ett starkt studentengagemang och upplevs som mycket relevant och kliniskt autentisk. Den simuleringsbaserade satsningen är alltså fortsatt aktuell och har utvecklats till en hög nivå med relevans för lärande och klinisk förberedelse. Innehållet rör såväl kliniska som teamrelaterade kunskaper och kompetenser. Simulering som undervisningsform uppskattas högt och simuleringsinstruktörens bidrag till lärandet lyfts fram. Ambitionsnivån kan ytterligare höjas på några punkter. Kurskamraternas bidrag i lärandet kan ytterligare stärkas, likaså omvårdnadsinnehållet i scenarierna.IPL-mål adresseras i aktiviteten, i synnerhet ökar teamsamverkan progressivt under dagen. Det interprofessionella lärandet kan stärkas ännu mer genom att linjera tydligare med övriga IPL-moment samt knyta an till de uttalade IPL-curriculum-målen.
|
|
| 32. |
|
|
| 33. |
- Edelbring, Samuel, 1969-, et al.
(författare)
-
Virtual Patients in clinical education from a phenomenological perspective
- 2009
-
Konferensbidrag (refereegranskat)abstract
- Background: Although Virtual Patients (VPs) are more commonly used today there is no clear-cut picture of the nature of VPs as a learning tool. This means that educators hesitate in further curricular integration of VPs. Students and educators need examples of how this innovation can support student learning in practice.Summary of work: We have analysed the use of VPs in a clinical rotation of medical students of rheumatology lasting 2-4 weeks. The phenomenological approach was used in order to maximise the student perspective. Focus lied with the character of VP learning and the immediate framework supporting meaningful learning with VPs at the clinic. We interviewed31 students followed by a phenomenological analysis of the transcriptions. This resulted inincreased knowledge of the value of VPs in this setting.Summary of results: VPs as a learning tool play a role of enhancing the value of other learning activities at the clinic. The immediate framework affects the way that students approach VPs. When students work in pairs, reflection and argumentation strengthen the learning experience.Conclusions: The study approach provided a way to characterise learning with VPs as enhancing the value of clinical education.Take-home messages: Phenomenological research interviews provide a way of discovering the value of innovations in medical education.
|
|
| 34. |
- Eikeland Husebø, Sissel, et al.
(författare)
-
Reflecting on Interprofessional Simulation
- 2019
-
Ingår i: Interprofessional Simulation in Health Care. - Cham : Springer Publishing Company. - 2210-5549 .- 2210-5557. - 9783030195410 - 9783030195427 ; , s. 139-171
-
Bokkapitel (refereegranskat)abstract
- This chapter explores and discusses how models of debriefing can support interprofessional learning in simulation-based education activities. The role of video as a tool for feedback and reflection is described and the ways video can be integrated in the learning environment to optimize opportunities for learning.
|
|
| 35. |
- Elvén, Maria, 1973-, et al.
(författare)
-
A tension between surrendering and being involved : An interview study on person-centeredness in clinical reasoning in the acute stroke setting
- 2023
-
Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 112
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore how stroke survivors experience and prefer to participate in clinical reasoning processes in the acute phase of stroke care.METHODS: An explorative qualitative design was used. Individual interviews were conducted with 11 stroke survivors in the acute phase of care and analyzed using reflexive thematic analysis.RESULTS: The analysis identified five themes: What's going on with me?; Being a recipient of care and treatment; The need to be supported to participate; To be seen and strengthened; and Collaboration and joint understanding.CONCLUSION: Stroke survivors experience many attributes of person-centeredness in the acute phase of care but, according to their stories, their participation in clinical reasoning can be further supported. The tension between surrendering and the desire to be more actively involved in the care needs to be considered to facilitate participation in clinical reasoning.PRACTICE IMPLICATIONS: Stroke survivors' participation in clinical reasoning in the acute phase can be facilitated by health professionals noticing signs prompting a shift towards increased willingness to participate. Furthermore, health professionals need to take an active role, sharing their expertise and inviting the stroke survivors to share their perspective. The findings can contribute to further develop person-centered care in acute settings.
|
|
| 36. |
- Elvén, Maria, 1973-, et al.
(författare)
-
Clinical Reasoning Curricula in Health Professions Education : A Scoping Review
- 2023
-
Ingår i: Journal of medical education and curricular development. - : Sage Publications. - 2382-1205. ; 10
-
Forskningsöversikt (refereegranskat)abstract
- OBJECTIVES: This scoping review aimed to explore and synthesize current literature to advance the understanding of how to design clinical reasoning (CR) curricula for students in health professions education.METHODS: Arksey and O'Malley's 6-stage framework was applied. Peer-reviewed articles were searched in PubMed, Web of Science, CINAHL, and manual searches, resulting in the identification of 2932 studies.RESULTS: Twenty-six articles were included on CR in medical, nursing, physical therapy, occupational therapy, midwifery, dentistry, and speech language therapy education. The results describe: features of CR curriculum design; CR theories, models, and frameworks that inform curricula; and teaching content, methods, and assessments that inform CR curricula.CONCLUSIONS: Several CR theories, teaching, and assessment methods are integrated into CR curricula, reflecting the multidimensionality of CR among professions. Specific CR elements are addressed in several curricula; however, no all-encompassing CR curriculum design has been identified. These findings offer useful insights for educators into how CR can be taught and assessed, but they also suggest the need for further guidance on educational strategies and assessments while learners progress through an educational program.
|
|
| 37. |
- Elvén, Maria, 1973-, et al.
(författare)
-
How can clinical reasoning teaching change from a ‘black-box phenomenon’ to a structured clinical reasoning curriculum? Insights from a scoping review.
- 2022
-
Ingår i: Textes de la 5e Conférence internationale de Montréal sur le raisonnement clinique. - 9782897994099 ; , s. 56-57
-
Konferensbidrag (refereegranskat)abstract
- IntroductionClinical reasoning (CR) is scarcely explicitly taught in health profes- sions education. Barriers to teach CR include lack of awareness of teaching methods and a change-resistant teaching culture. Thus, CR often becomes a ‘black-box phenomenon’ that students need to develop informally. To advance our understanding of structured CR curriculum design in health professions education a scoping review was conducted. MethodologyArksey and O’Malley’s six-stage framework (1) was applied. Peer- reviewed articles were searched in PubMed, Web of Science, CINAHL, and manual searches, resulting in the identification of 2932 studies, which were screened by the team.ResultsTwenty-six articles were selected from medical, nursing, physical ther- apy, occupational therapy, midwifery, dentistry, and speech language therapy education. The analysis identified three themes: Features of CR curriculum design; CR theories informing curricula; and CR teaching content and methods.DiscussionNo all-encompassing CR curriculum design was identified. However, several theories and specific methods were described supporting CR development. Dual-process theory was the most prevalent theory and active learning approaches were emphasized. Patient centeredness in CR teaching was scarcely described. The diversity of methods stresses that educators need to make the intended meaning of CR explicit in their curricular work.ConclusionSpecific theories and teaching methods can support curriculum devel- opment. Lack of overall CR curriculum strategy in the literature stresses further guidance on a longitudinal CR curriculum that support stu- dents’ CR progression throughout study programs.
|
|
| 38. |
- Elvén, Maria, 1973-, et al.
(författare)
-
Person-Centeredness in Clinical Reasoning of Interprofessional Stroke Teams
- 2022
-
Ingår i: ICCH2022. International Conference on communication in Healthcare 2022. Abtract book.. ; , s. 125-126
-
Konferensbidrag (refereegranskat)abstract
- Background: Although person-centered care is prioritized in healthcare, challenges remain before such care is integrated in everyday communication and practice. One way to strengthen person-centered care is that health professionals’ clinical reasoning (i.e., assessment and management) is pervaded by patient participation and individualized to patient needs. Interprofessional team meetings, focusing on goals and management planning, is an opportunity to improve person-centeredness. However, there is a lack of understanding of how person-centeredness is created in the clinical reasoning of teams. This study aims to explore how clinical reasoning is performed from a person-centered perspective in team meetings with patients with stroke and next of kin.Methods: Explorative qualitative design employing a thematic analysis of audio recorded communication at three team meetings. In total, three patients, two next of kin, and 15 professionals representing eight health professions, participated in the meetings.Findings: Four themes and eight subthemes were established: a) Emphasizing the patient’s resources; b) Struggling to find a common understanding, including subthemes: Unite the person’s narrative, the relative’s view, and the expertise of the interprofessional team, missed opportunities to clarify patient needs and wishes, and active listening and receptiveness; c) Balancing the patient’s goals and professionals’ goals, including subthemes: Shared goals, the professionals’ view of appropriate goals, and the professionals’ assessment governs achievement of goals; d) Ambiguity in decisions about the management plan, including subthemes: Initiating shared decision making and lack of clarity and consensus.Discussion: This study reveals how the patient, next of kin and team contribute to shared understanding of the patient’s problem. Goals were guided by the patient’s and professionals’ expertise. To improve person- centeredness in clinical reasoning, the team need to further put the patient’s personal goals and perception of goal-achievement in the forefront as well as improve communication skills to catch patient needs and facilitate shared decisions.
|
|
| 39. |
- Elvén, Maria, 1973-, et al.
(författare)
-
Reasoning about reasoning : using recall to unveil clinical reasoning in stroke rehabilitation teams
- 2024
-
Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165.
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The study objective was to investigate how health care providers in stroke teams reason about their clinical reasoning process in collaboration with the patient and next of kin.Materials and methods: An explorative qualitative design using stimulated recall was employed. Audio-recordings from three rehabilitation dialogs were used as prompts in interviews with the involved staff about their clinical reasoning. A thematic analysis approach was employed.Results: A main finding was the apparent friction between profession-centered and person-centered clinical reasoning, which was salient in the data. Five themes were identified: the importance of different perspectives for a rich picture and well-informed decisions; shared understanding in analysis and decision-making - good intentions but difficult to achieve; the health care providers' expertise directs the dialog; the context's impact on the rehabilitation dialog; and insights about missed opportunities to grasp the patient perspective and arrive at decisions.Conclusions: Interprofessional stroke teams consider clinical reasoning as a process valuing patient and next of kin perspectives; however, their professional expertise risks preventing individual needs from surfacing. There is a discrepancy between professionals' intentions for person-centeredness and how clinical reasoning plays out. Stimulated recall can unveil person-centered practice and enhance professionals' awareness of their clinical reasoning.
|
|
| 40. |
- Escher, Cecilia, et al.
(författare)
-
Method matters: impact of in-scenario instruction on simulation-based teamwork training
- 2017
-
Ingår i: Advances in Simulation. - : Springer Science and Business Media LLC. - 2059-0628 .- 2364-3277. ; 2:25
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The rationale for introducing full-scale patient simulators in training to improve patient safety is to recreate clinical situations in a realistic setting. Although high-fidelity simulators mimic a wide range of human features, simulators differ from the body of a sick patient. The gap between the simulator and the human body implies a need for facilitators to provide information to help participants understand scenarios. The authors aimed at describing different methods that facilitators in our dataset used to provide such extra scenario information and how the different methods to convey information affected how scenarios played out. Method: A descriptive qualitative study was conducted to examine the variation of methods to deliver extra scenario information to participants. A multistage approach was employed. The authors selected film clips from a shared database of 31 scenarios from three participating simulation centers. A multidisciplinary research team performed a collaborative analysis of representative film clips focusing on the interplay between participants, facilitators and the physical environment. After that the entire material was revisited to further examine and elaborate the initial findings. Results: The material displayed four distinct methods for facilitators to convey information to participants in simulation based teamwork training. The choice of method had impact on the participating teams regarding flow of work, tempo and team communication. Facilitators’ close access to the teams’ activities when present in the simulation suite, either embodied or disembodied in the simulation, facilitated the timing for providing information, which was critical for maintaining the flow of activities and learner engagement in the scenario. The mediation of information by a loudspeaker or an earpiece from the adjacent operator room could be disturbing for team communication when information was not well timed. Conclusions: In-scenario instruction is an essential component of simulation based teamwork training that has been largely overlooked in previous research. The ways in which facilitators convey information about the simulated patient have the potential to shape the simulation activities and thereby serve different learning goals. Although immediate timing to maintain an adequate tempo is necessary for professionals to engage in training of acute situations, novices may gain from a slower tempo to train complex clinical team tasks systematically.
|
|
| 41. |
- Friman, Anne, et al.
(författare)
-
A mixed methods approach to nursing and medicine students’ attitudes towards collaboration
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Background: Lack of physician-nurse collaboration in wound management may result in prolonged healing process for the patients (Apelqvist, 2012). In order to facilitate future professional collaboration interprofessional undergraduate learning activities has been proposed (Barr et al., 2005). The aim of this study is to investigate changes and characteristics of nursing and medical students’ attitudes towards each other’s future professions in relation to a joint learning activity.Summary of Work: Medical (n=38) and nursing (n=30) students were jointly trained in compression therapy, Doppler assessment and wound case studies. Students were measured by the Jefferson scale on attitudes toward Physician-Nurse Collaboration (Hojat, et al., 1999) and compared to previously gathered baseline scores. Focus group interviews were held to deepen the knowledge about characteristics of attitudes towards both the others’ profession and towards collaboration.Summary of Results: Attitudes towards the other profession increased after interprofessional learning activity. This kind of learning activities may increase future professional collaboration and thus improve wound management.Discussion and Conclusions: Attitudes towards the other profession increased after interprofessional learning activity. This kind of learning activities may increase future professional collaboration and thus improve wound management.Take-home messages: Efforts should be made to find strategies for structures facilitating collaboration in clinical practice. Joint learning activities are appreciated by the students. These may result in better collaboration in students future professionals and may ultimately benefit patient care with better wound healing.
|
|
| 42. |
- Friman, Anne, et al.
(författare)
-
An effort to winding future nurses and physicians together : Students’ joint learning about wound management
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Background: Lack of physician-nurse collaboration in wound management may result in prolonged healing process for the patients (Apelqvist, 2012). In order to facilitate future professional collaboration interprofessional undergraduate learning activities has been proposed (Barr et al., 2005).Objectives: The aim of this study is to investigate changes and characteristics of nursing and medical students’ attitudes towards each other’s future professions in relation to a joint learning activity in wound management. Methods Medical (n=40) and nursing (n=50) students were jointly trained in compression therapy, Doppler assessment and wound case studies. Students were measured by the Jefferson scale on attitudes toward Physician-Nurse Collaboration (Hojat, et al., 1999) and compared to previously gathered baseline scores. Focus group interviews were held to deepen the knowledge about characteristics of attitudes towards both the others’ profession and towards collaboration.Results: Students scored high on the Jefferson scale in conjunction to the IPE activity. However, since also the baseline group scored high, no differences were detected after joint training. Preliminary analysis of qualitative data shows that medical students’ consider the nursing role as practically oriented with focus on the patients’ different needs of care, while nursing students sees the role of physicians as generation bound pointing to elderly physicians’ dominance and younger physicians’ flexibility but also to variations between organizational levels of care. Students experienced a lack of structural support for collaboration in their clinical practice. Interprofessional training was considered as important to gain insight into each other’s complementing knowledge area. Furthermore joint training was considered providing wider perspectives of patient care.Implications: The joint learning activity provided new insight into the other profession’s competence, and was appreciated by the students. This kind of learning activity may increase future professional collaboration and thus improve wound management. Efforts should be made to find strategies for structures facilitating collaboration in clinical practice.
|
|
| 43. |
- Friman, Anne, et al.
(författare)
-
An effort to winding future nurses and physicians together. Students’ joint learning about wound management.
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Background Lack of physician-nurse collaboration in wound management may result in prolonged healing process for the patients (Apelqvist, 2012). In order to facilitate future professional collaboration interprofessional undergraduate learning activities has been proposed (Barr et al., 2005).Objectives The aim of this study is to investigate changes and characteristics of nursing and medical students’ attitudes towards each other’s future professions in relation to a joint learning activity in wound management. Methods Medical (n=40) and nursing (n=50) students were jointly trained in compression therapy, Doppler assessment and wound case studies. Students were measured by the Jefferson scale on attitudes toward Physician-Nurse Collaboration (Hojat, et al., 1999) and compared to previously gathered baseline scores. Focus group interviews were held to deepen the knowledge about characteristics of attitudes towards both the others’ profession and towards collaboration.Results Students scored high on the Jefferson scale in conjunction to the IPE activity. However, since also the baseline group scored high, no differences were detected after joint training. Preliminary analysis of qualitative data shows that medical students’ consider the nursing role as practically oriented with focus on the patients’ different needs of care, while nursing students sees the role of physicians as generation bound pointing to elderly physicians’ dominance and younger physicians’ flexibility but also to variations between organizational levels of care. Students experienced a lack of structural support for collaboration in their clinical practice. Interprofessional training was considered as important to gain insight into each other’s complementing knowledge area. Furthermore joint training was considered providing wider perspectives of patient care.Implications The joint learning activity provided new insight into the other profession’s competence, and was appreciated by the students. This kind of learning activity may increase future professional collaboration and thus improve wound management. Efforts should be made to find strategies for structures facilitating collaboration in clinical practice.Keywordsnurse-physician student, collaboration, wound management
|
|
| 44. |
- Friman, Anne, et al.
(författare)
-
Attitudes and perceptions from nursing and medical students towards the other profession in relation to wound care
- 2017
-
Ingår i: Journal of Interprofessional Care. - : Taylor & Francis. - 1356-1820 .- 1469-9567. ; 31:5, s. 620-627
-
Tidskriftsartikel (refereegranskat)abstract
- Lack of nurse‒physician collaboration in wound care may result in prolonged healing times for patients. In order to facilitate future professional collaboration, undergraduate learning activities in interprofessional education (IPE) have been proposed. The aim of this study was to investigate nursing and medical students’ attitudes and perceptions towards each other’s future professions and interprofessional collaboration in wound care. Nursing and medical students took part in an interprofessional learning activity about wound care. Data were collected using the Jefferson Scale of Attitudes towards Physician‒Nurse Collaboration questionnaire to student groups before and after an IPE activity (pooled n = 221). Focus groups were conducted to deepen the knowledge about students’ attitudes and perceptions. The results showed high scores on the attitude scale (mean 53.2, possible maximum = 60) both before and after IPE, indicating positive attitudes towards nurse‒physician collaboration. Nursing students scored higher than medical students both pre-IPE (p < 0.001) and post-IPE (p = 0.006). However, no difference on scale scores could be identified between pre- and post-IPE. The following themes emerged in the analysis of focus group discussions: “Approaching patient care from different perspectives,” “Need for collaboration and clear professional roles in practice,” “Structures hindering future collaboration,” and “IPE as a tool for professional practice and roles.” The shared learning activity provided insights into the other profession’s competence. This kind of learning activity may increase future interprofessional collaboration, and thus, improve wound care.
|
|
| 45. |
|
|
| 46. |
|
|
| 47. |
- Friman, Anne, et al.
(författare)
-
General practitioners' knowledge of leg ulcer treatment in primary healthcare : an interview study
- 2020
-
Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 21
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe general practitioners' (GPs') knowledge and the development of their knowledge regarding leg ulcer treatment when treating patients with leg ulceration at primary healthcare centers.BACKGROUND: Earlier research regarding GPs' knowledge of leg ulcer treatment in a primary healthcare context has focused primarily on the assessment of wounds and knowledge of wound care products. Less is known about GPs' understandings of their own knowledge and knowledge development regarding leg ulceration in the everyday clinical context. This study, therefore, sets out to highlight these aspects from the GPs' perspective.METHODS: Semi-structured interviews were conducted with 16 individual GPs working at both private and county council run healthcare centers. The data were analyzed inductively using a thematic analysis.RESULTS: Four themes were identified. 'Education and training' describe the GPs' views regarding their knowledge and knowledge development in relation to leg ulcer treatment. 'Experience' refers to GPs' thoughts about the importance of clinical experience when treating leg ulcers. 'Prioritization' describes the issues GPs raised around managing the different knowledge areas in their clinical work. 'Time constraints' explore the relationship between GPs' sense of time pressure and their opportunities to participate in professional development courses.CONCLUSIONS: The study shows that the GPs working in primary healthcare are aware of the need for ongoing competence development concerning leg ulceration. They describe their current knowledge of leg ulcer treatment as insufficient and point to the lack of relevant courses that are adapted for their level of knowledge and the limited opportunities for clinical training.
|
|
| 48. |
|
|
| 49. |
- Friman, Anne, et al.
(författare)
-
General practitioners’ perceptions of their role and their collaboration with district nurses in wound care
- 2019
-
Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 20
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore the perceptions of general practitioners (GPs) regarding their role and their collaboration with district nurses (DNs) in the management of leg ulcers in primary healthcare.Background: Earlier research regarding the treatment of leg ulcers in a primary care context has focussed primarily on wound healing. Less is known about GPs’ understandings of their role and their collaboration with DNs in the management of leg ulcers. Since the structured care of patients with leg ulcers involving both GP and DN is currently rather uncommon in Swedish primary care, this study sets out to highlight these aspects from the GP’s perspective.Methods: Semi-structured individual interviews with 16 GPs including both private and county council run healthcare centres. Thematic analysis was used to analyse the data.Results: Four themes were identified. The first theme: ‘role as consultant and coordinator’ shows how the GPs perceived their role in wound care. In the second theme: ‘responsibility for diagnosis’ the GPs’ views on responsibility for wound diagnosis is presented. The third theme: ‘desire for continuity’ is based on the GPs’ desire for continuity concerning various aspects. In the fourth theme: ‘collaboration within the organisation’ the importance of the organisation for collaboration between GPs and DNs is presented.Conclusions: The GP’s often work on a consultation-like basis and feel that they become involved late in the patients’ wound treatment. This can have negative consequences for the medical diagnosis and, thereby, lead to a prolonged healing time for the patient. Shortcomings regarding collaboration are mainly attributed to organisational factors.
|
|
| 50. |
- Hege, Inga, et al.
(författare)
-
A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review
- 2016
-
Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 16
-
Forskningsöversikt (refereegranskat)abstract
- Background: Virtual Patients (VPs) have been in the focus of research in healthcare education for many years. The aim of our study was to analyze how virtual patients are described in the healthcare education literature, and how the identified concepts relate to each other.Methods: We performed a literature review and extracted 185 descriptions of virtual patients from the articles. In a qualitative content analysis approach we inductively-deductively developed categories and deducted subcategories. We constructed a concept map to illustrate these concepts and their interrelations.Results: We developed the following five main categories: Patient, Teacher, Virtual Patient, Curriculum, and Learner. The concept map includes these categories and highlights aspects such as the under-valued role of patients in shaping their virtual representation and opposing concepts, such as standardization of learner activity versus learner-centeredness.Conclusions: The presented concept map synthesizes VP descriptions and serves as a basis for both, VP use and discussions of research topics related to virtual patients.
|
|
