| 1. |
- Nilsson, Maria Skyvell, 1961, et al.
(författare)
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Clinical Course Content As A Dynamic Variable In Supervision Of Medical Students
- 2010
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Ingår i: The Internet Journal of Medical Education. - 2155-6725. ; 1:2
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDuring clinical supervision, medical students are expected to gain experience through clinical work, with the support of their clinical supervisor. What each supervisor chooses to emphasize and considers important will have a decisive impact on students’ understanding of what is content necessary to master in order to gain clinical skills. Therefore, in this study, the focus of attention is on what supervisors choose to emphasise during clinical supervision of fourth year medical students during a surgical course. MethodAn ethnographic approach was used, including a selective intermittent time mode, where observation and informal interviews were conducted. Twelve supervisors and nine medical students at a teaching hospital in Sweden participated. Field notes were made during observation; these were transcribed and analysed qualitatively. ResultsThe analysis resulted in six topic areas describing what was emphasized during supervision. The topic areas were: 1) Identifying, collecting and combining information, 2) Problem-solving and decision-making, 3) Handling treatment of disease, 4) Practical skills and illustration of technical equipment, 5) Communicating with patients, and 6) Handling organisational demands.ConclusionsThe findings of this study show the existence of several areas that are focused on in supervision. In authentic clinical situations, these topic areas were intertwined and overlapped and often appeared simultaneously. The clinical situations were adjusted neither to the students’ clinical experience nor to the needs of the students. Consequently, the students may find it difficult to determine what to learn and what to achieve during supervision. They may also find it difficult to understand the situations in the same way as their supervisors, because students focus on handling situations with a more theoretical and declarative approach to a larger extent than do their supervisors. The students therefore need supervisor support to develop and integrate theoretical knowledge. One conclusion that can be made is that supervisor awareness of students’ understanding is of crucial significance for the effective supervision. Regarding the nature of the content chosen in supervised situations, research in other settings and specialties would be required to map and to determine a more general theory of what is focused during medical supervision.
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| 2. |
- Carlson, Elisabeth, et al.
(författare)
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"This is nursing": Nursing roles as mediated by precepting nurses during clinical practice
- 2010
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Ingår i: NURSE EDUCATION TODAY. - : Elsevier. - 0260-6917 .- 1532-2793. ; 30:8, s. 763-767
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Tidskriftsartikel (refereegranskat)abstract
- In nursing education, it has been argued that professional socialization is facilitated by clinical experiences where students work together with precepting nurses. However, few studies found have focused on how nurses think and act as preceptors, hence providing a base for professional socialization to occur. Therefore; this study aimed to describe how preceptors mediated nursing as a profession to undergraduate nursing students during clinical practice. This was an ethnographic study guided by symbolic interactionism. A purposeful sampling of 13 precepting nurses was observed during the field work period. In addition, 16 staff nurses, purposively selected, and experienced in precepting, participated in focus group interviews. All text from field notes and interviews were read as a whole and analyzed following the ethnographic approach. Findings illustrated how nursing was mediated as the medical–technical, the administrative, and the caring role. Preceptors aimed for professionalism in their students by teaching the students to reflect on what they can do independently as nurses. Preceptors strived to verbalise their practical knowledge to make theory explicit and contextualize to student nurses. This knowledge can guide implementation of preceptor programmes focusing on the meaning and implications of professionalism.
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| 3. |
- Carlson, Elisabeth, et al.
(författare)
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Time to precept: supportive and limiting conditions for precepting nurses.
- 2010
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Ingår i: JOURNAL OF ADVANCED NURSING. - : Blackwell Munksgaard. - 0309-2402 .- 1365-2648. ; 66:2, s. 432-441
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper is a report of a study describing conditions for precepting in a Swedish clinical context from the perspective of precepting nurses. Background. Clinical practice is a complex part of nursing education, and registered nurses who are acting as preceptors for nursing students face a number of challenges that need to be addressed during the precepting process. Method. An ethnographic approach guided by symbolic interactionism was used. Data were collected by participant observation and focus group interviews over a ten-month period in 2006–2007. Participants were selected by purposive sampling of 13 staff nurses who were preceptors during the field work period. In addition, 16 staff nurses, experienced in precepting, were purposively selected for four focus groups. Findings. Precepting was found to be a complex function for nurses, influenced by conditions that could be both supportive and limiting in nature. Three themes described these conditions: organization, comprising clinical responsibilities and routines; collaboration, focusing on professional relations and interactions; and the personal perspective, comprising preceptors’ experiences, need for feed back and notions of benefits. Time as a limiting condition reappeared through all categories. Conclusion. It is important to raise the issue of time and its impact on the precepting process. Precepting needs to be further discussed in terms of an integrated nursing competence prioritized by all stakeholders involved in clinical practice. Therefore; efforts should be made to plan nurses’ clinical work so that allocated time for precepting can be facilitated.
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| 4. |
- Jansson, Inger, 1964-, et al.
(författare)
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Evaluation of documented nursing care plans by the use of nursing-sensitive outcome indicators
- 2010
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Ingår i: Journal of Evaluation In Clinical Practice. - Oxford : Blackwell Publishing. - 1356-1294 .- 1365-2753. ; 16:3, s. 611-618
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Rationale and aim: There is a lack of evidence that nursing care plans affect patient outcomes. The aim of the present study was to evaluate whether documented nursing care plans affect patient outcomes by the use of nursing-sensitive outcome indicators. Method: A retrospective, cross-sectional design with patients surveyed at time of discharge from two hospital units for patients with stroke and after 2-3 weeks at home. The control unit (A) did not employ care plans. The intervention unit (B) used care plans on a daily basis. Outcome was measured by 'the National Stroke Register' and the two questionnaires: 'Quality of patients' perspective' and 'Euroquol five dimensions'. Data were collected over a 5-month period (October 2007-February 2008). Results: In total, 87 patients were included in the study. Patient characteristics in the two groups at admission and the health-related quality of life 2 to 3 weeks after discharge were similar. The patients from unit B were more satisfied with individual care (P = 0.03) and participation (P = 0.007). Unit B also had a shorter length of stay (P = 0.004). Conclusions: The effects of documented care plans are difficult to evaluate from a patient perspective, as many factors can improve the outcome. However, documentation of care plans is a prerequisite for measuring the quality and outcome of the care provided. This small study indicates that documented care plans may affect patient satisfaction regarding individual care, participation and length of hospital stay.
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| 5. |
- Pennbrant, Sandra, 1967-, et al.
(författare)
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Elderly patients' experiences of meeting with the doctor : A sociocultural study in a hospital setting in Sweden
- 2013
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Ingår i: Research on Aging. - : SAGE Publications. - 0164-0275 .- 1552-7573. ; 35:2, s. 163-181
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Tidskriftsartikel (refereegranskat)abstract
- Previous research has provided contradictory findings on how important it is for elderly patients to actively participate in the meeting with their doctors. Using descriptive and exploratory interview study with 20 elderly patients discharged from medicine and geriatric hospital care in Sweden, the authors describe how elderly patients experience their meetings with their doctor in the hospital setting. The results indicate that the meetings between elderly patients and doctors are influenced by the nature and shape of the conversation, which are influenced by power and interaction. A good relationship between an elderly patient and his or her doctor leads to reduced apprehension and increased faith in the health care system. This study was inspired by the sociocultural perspective and highlights the importance of the health care sector becoming a learning organization in which doctors are trained to prevent misunderstandings in their meetings with elderly patients.
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| 6. |
- Skyvell Nilsson, Maria, 1961-, et al.
(författare)
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Attitudes Emphasizing in the Clinical Supervision of Medical Students : An Ethnographic Study in Sweden
- 2012
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Ingår i: The Open Medical Education Journal. - 1876-519X. ; 5, s. 5-11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Medical student's professional attitudes are expected to be developed in medical school, and particularly during clinical education. In this study we focus on supervision in order to describe the attitudes emphasized in the clinical education of fourth-year medical students taking a surgical course.Methods: An ethnographic approach was applied where observation and interviews were conducted. Nine medical students and twelve supervisors at a teaching hospital in Sweden participated. Field notes were made during observation as well as interviews; these were transcribed and analysed qualitatively.Result: The analysis resulted in six topic areas describing the attitudes emphasized. The medical students were expected to be: 1) Informed and effective decision makers, 2) Sensitive to patients' needs and expectations, 3) Communicative, 4) Authoritative and patriarchal, 5) Adaptable to organizational demands, and 6) Mindful of nurse's knowledge and requests.Conclusions: This study reveals that the attitudes emphasised during supervision are: dualistic and complex to learn, developed by a former generation and influence student learning. Students need support in order to handle the state of tension that exists in the attitudes emphasized. Medical students might experience difficulties in adopting some attitudes belonging to a former generation. There is a need for competence development among supervisors concerning how students may experience the attitudes emphasized in supervision.
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