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1.
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2.
  • 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. 
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3.
  • 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.
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4.
  • 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.
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5.
  • 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.
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6.
  • 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.
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7.
  • 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.
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9.
  • 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.
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10.
  • 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.
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11.
  • 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.
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12.
  • 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.
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15.
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16.
  • 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.
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17.
  • 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.
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18.
  • Hodza-Beganovic, Ruhija, 1968-, et al. (författare)
  • Survey-based experiential learning - means of raising professional awareness in developing countries
  • 2019
  • Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 29:Suppl. 4, s. 586-586
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Healthcare in post-war Balkans is still under development. Healthcare changes towards more complex clinical scenarios that need different competencies around patients. This study reports on survey based learning to increasing professional awareness for developing sustainable healthcare settings using an experiential learning approach.Methods: In this study, researchers and educators identified non-technical skills concepts on individual, team, and organizational levels. These concepts were contextualized into the local setting through interactive workshops. Two pediatric surgery clinics in Kosovo and Bosnia and Herzegovina participated who were part of an international clinical skills training project. The tools and surveys were: Johari window, Kolb’s learning style questionnaire, team members exchange quality scale, the IPEC framework for interprofessional competence, Team STEPPS observation tool and organizational models.Results: A model is developed for contextualizing core concepts on professional awareness into a local developing healthcare setting. It entails three steps conducted in consecutive workshops: Identifying research-based concepts on professional compe-tence on individual, team and organizational levels. Facilitating local contextualization of these concepts by using surveys in interactive workshops. Agreeing on indicators to maintain high professional awareness.Conclusions: Capacity-building in public health can be conducted through increasing professional awareness. Professional awareness can be approached in individual, team and organizational dimensions. Established core concepts of non-technical skills can be contextualized in other cultures through a survey-based experiential learning approach.Key messages:Professional individual, team and organizational awareness is a vital part of conducting efficient healthcare.The professional awareness can be enhanced through processing core concepts in a local context through facilitated workshops.
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19.
  • Kononowicz, A. A., et al. (författare)
  • Virtual patient simulations for health professional education
  • 2016
  • Ingår i: Cochrane Database of Systematic Reviews. - : John Wiley & Sons. - 1469-493X. ; :5
  • Forskningsöversikt (refereegranskat)abstract
    • The objective of this review is to evaluate the effectiveness of virtual patient simulation as an educational intervention versus traditional learning, other types of e‐Learning interventions and other forms of virtual patient simulation interventions for delivering pre‐registration and post‐registration healthcare professional education. We will primarily assess the impact of these interventions on learners’ knowledge, skills and attitudes. Our secondary objective is to assess the cost‐effectiveness of these interventions.
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20.
  • Kononowicz, Andrzej A., et al. (författare)
  • Virtual Patient Simulations in Health Professions Education : Systematic Review and Meta-Analysis by the Digital Health Education Collaboration
  • 2019
  • Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 21:7
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education.Objective: The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction.Methods: We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models.Results: A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI -0.17 to 0.39, I-2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I-2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence.Conclusions: Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low-and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.
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21.
  • Kononowicz, Andrzej, et al. (författare)
  • Virtual patients - what are we talking about? : A framework to classify the meanings of the term in healthcare education
  • 2015
  • Ingår i: BMC Medical Education. - : BioMed Central (BMC). - 1472-6920. ; 15
  • Forskningsöversikt (refereegranskat)abstract
    • BackgroundThe term "virtual patients" (VPs) has been used for many years in academic publications, but its meaning varies, leading to confusion. Our aim was to investigate and categorize the use of the term "virtual patient" and then classify its use in healthcare education.MethodsA literature review was conducted to determine all articles using the term "virtual patient" in the title or abstract. These articles were categorized into: Education, Clinical Procedures, Clinical Research and E-Health. All educational articles were further classified based on a framework published by Talbot et al. which was further developed using a deductive content analysis approach.Results536 articles published between 1991 and December 2013 were included in the study. From these, 330 were categorized as educational. Classifying these showed that 37% articles used VPs in the form of Interactive Patient Scenarios. VPs in form of High Fidelity Software Simulations (19%) and Virtual Standardized Patients (16%) were also frequent. Less frequent were other forms, such as VP Games.Analyzing the literature across time shows an overall trend towards the use of Interactive Patient Scenarios as the predominant form of VPs in healthcare education.ConclusionsThe main form of educational VPs in the literature are Interactive Patient Scenarios despite rapid technical advances that would support more complex applications. The adapted classification provides a valuable model for VP developers and researchers in healthcare education to more clearly communicate the type of VP they are addressing avoiding misunderstandings.
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22.
  • Malin, Södling, et al. (författare)
  • Färdighetsträning i simulerad miljö : Undervisning av praktiska färdigheter på Clinicum, Läkarutbildning, Stadium III, Termin 9
  • 2018
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Från och med 2009 erbjuds praktiska färdighetsövningar på Clinicum där läkarstudenter under handledning går genom teoretisk bakgrund och övar genomförande av praktiska färdigheter kopplade till mål inom cirkulation, respiration och ortopedi på anatomiska modeller. En observationsstudie genomfördes med fokus på studentcentrerat lärande, meningsfullhet och relevans, samt lärande i samarbete med andra. Det konstaterades att lärmomentet genomförs i enlighet med grundläggande principer för PBL, är stark kopplat till den kliniska praktiken, samt att det bjuder in till att lära i samarbete med andra.Förbättringsmöjligheter identifierades i tillgänglighet av referensmaterial om teoretisk bakgrund före utbildningsmomentet för att underlätta undervisningens anpassning till studenternas aktuella kunskaper. Att dessutom göra det möjligt att skicka frågor till lärarna som förberedelse skulle bidra till ökad individualisering och effektivisering av utbildningsmomenten.
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23.
  • Nilsson, Mikael, et al. (författare)
  • Why Medical Students Choose to Use or Not to Use a Web-Based Electrocardiogram Learning Resource : Mixed Methods Study
  • 2019
  • Ingår i: JMIR Medical Education. - : JMIR Publications Inc.. - 2369-3762. ; 5:2, s. e12791:1-e12791:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Electrocardiogram (ECG) interpretation is a core competence and can make a significant difference to patient outcomes. However, ECG interpretation is a complex skill to learn, and research has showed that students often lack enough competence. Web-based learning has been shown to be effective. However, little is known regarding why and how students use Web-based learning when offered in a blended learning situation.Objective: The aim of this paper was to study students’ use of Web-based ECG learning resources which has not previously been studied in relation to study strategies.Methods: A qualitative explanatory design using mixed methods was adopted to explore how medical students reason around their choice to use or not to use a Web-based ECG learning resource. Overall, 15 of 33 undergraduate medical students attending a course in clinical medicine were interviewed. Data on usage of the resource were obtained via the learning management system for all students. At the final examination, all the students answered a questionnaire on study strategies and questions about internet access and estimated their own skills in ECG interpretation. Furthermore, study strategies and use patterns were correlated with results from an ECG Objective Structured Clinical Examination (OSCE) and a written course examination.Results: In total, 2 themes were central in the students’ reasoning about usage of Web-based ECG: assessment of learning needs and planning according to learning goals. Reasons for using the Web resource were to train in skills, regarding it as a valuable complement to books and lectures. The main reasons for not using the resource were believing they already had good enough skills and a lack of awareness of its availability. Usage data showed that 21 students (63%) used the Web resource. Of these, 11 were minimal users and 10 were major users based on usage activity. Large variations were found in the time spent in different functional parts of the resource. No differences were found between users and nonusers regarding the OSCE score, final examination score, self-estimate of knowledge, or favoring self-regulated learning.Conclusions: To use or not to use a Web-based ECG learning resource is largely based on self-regulated learning aspects. Decisions to use such a resource are based on multifactorial aspects such as experiences during clinical rotations, former study experiences, and perceived learning needs. The students’ own judgment of whether there was a need for a Web-based resource to achieve the learning goals and to pass the examination was crucial for their decisions to use it or not. An increased understanding of students’ regulation of learning and awareness of variations in their ECG learning needs can contribute to the improvement of course design for blended learning of ECG contexts for medical students.
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24.
  • Nyström, Sofia, 1977-, et al. (författare)
  • Continuing professional development : pedagogical practices of interprofessional simulation in health care
  • 2017
  • Ingår i: Studies in Continuing Education. - : Routledge. - 0158-037X .- 1470-126X. ; 39:3, s. 303-319
  • Tidskriftsartikel (refereegranskat)abstract
    • The increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for the CPD of health care professionals. Specifically, the study focuses on how a professional development activity, the simulation, is enacted to support interprofessional collaboration and learning. A practice theory perspective is used as the theoretical framework. In this, the professional practice is conceptualised as being embodied, relational and situated in sociomaterial arrangements. Ten introduction and reflection sessions following interprofessional full-scale manikin-based simulations with professionals were video-recorded. The recordings were analysed following a stepwise qualitative collaborative approach developed for the purpose. The key findings suggest that the professional competence activity is enacted and interconnected with and governed by historical traditions of institutional teaching practices as well as simulation practices. Despite the intentions of team and interprofessional training, the institutional teaching and simulation practices constrain and hinder the intended outcomes of professional development in interprofessional collaboration.
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25.
  • Nyström, Sofia, et al. (författare)
  • Debriefing practices in interprofessional simulation with students : A sociomaterial perspective
  • 2016
  • Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 16:148, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The debriefing phase is an important feature of simulation activities for learning. This study applies a sociomaterial perspective on debriefing in interprofessional simulation with medical and nursing students. Sociomaterial perspectives are increasingly being used in order to understand professional practice and learning in new ways, conceptualising professional practice as being embodied, relational and situated in sociomaterial relations. The aim of the study is to explore how debriefing is carried out as a practice supporting students’ interprofessional learning.Methods: Eighteen debriefing sessions following interprofessional full-scale manikin-based simulation with nursing and medical students from two different universities were video-recorded and analysed collaboratively by a team of researchers, applying a structured scheme for constant comparative analysis.Results: The findings show how debriefing is intertwined with, and shaped by social and material relationships. Two patterns of enacting debriefing emerged. Debriefing as algorithm was enacted as a protocol-based, closed inquiry approach. Debriefing as laissez-faire was enacted as a loosely structured collegial conversation with an open inquiry approach.Conclusion: The findings indicate that neither an imposed structure of the debriefing, nor the lack of structure assured interprofessional collaboration to emerge as a salient topic for reflection, even though that was an explicit learning objective for the simulation. 
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26.
  • Tamás, Éva, 1968-, et al. (författare)
  • Gender and Assigned Role Influences Medical Students´ Learning Experience in Interprofessional Team Training Simulations
  • 2017
  • Ingår i: MedEdPublish. - Dundee, UK : Association for Medical Education in Europe. - 2312-7996. ; 6:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The advantages of providing standardized education avoiding exposure of real patients to interventions by novices are appealing both from patient safety and teaching aspects, thus medical simulation has become an integrated part of the healthcare curriculum.We explored the impact of gender and an acting vs. an observing role in simulation on students’ perceptions of learning outcomes, and of simulation as a learning activity.A prospective survey for graduating medical students participating in a full day simulated team training session was conducted over three terms. The questionnaire addressed issues related to the session, teamwork and simulation training in general. Participation was voluntary and the study was approved by the regional ethics committee.The overall response rate was 90.8 %. Authenticity and relevance were considered to be high, though male students scored significantly higher both for authenticity and for relevance.  Communication and teamwork were considered to be different, depending on gender and assigned role. Female students and students in an acting role were more ready to discuss knowledge gaps, experienced “good” communication significantly more often, and defined their work as teamwork more frequently.  The scenarios were found to be more stimulating and motivating by female students and acting individuals. Self-confidence and self-awareness were declared to be more enhanced for male students and for those who were acting during the simulation sessions. Observers and female students scored significantly lower as regards satisfaction with both the extent of the reflection and the individual feedback.The perceptions of authenticity and relevance of simulation sessions and students’ readiness to discuss knowledge gaps differed between genders. Furthermore, perceived changes in self-confidence and self-awareness seemed to be different. The observing role implies a different kind of learning process, which is not necessarily inferior to learning by acting.
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27.
  • Viking, Tuija (författare)
  • En studie om interprofessionellt lärande i teamarbete : Fallet med en 'best practice´ för tvångsvård
  • 2019
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Det interprofessionella lärandet, IPL, i team har blivit ett populärt medel för att öka samarbete och kvalité i den sociala sektorn och hälso- och sjukvård. En alltmer specialiserad och fragmentiserad vård, som ofta genomförs i team, har lett till stor spridning av interprofessionell utbildning, IPE. Studerande och/eller medlemmar från olika professioner lär sig därmed, med, från och om varandra. Sådant lärande antas ske vid utbyte av och reflektion över varandras olika erfarenheter, perspektiv och kunskaper, d.v.s. professionella skillnader, och leda till förbättrad effektivitet och kvalitet i vården.Inom hälso- och sjukvårdsområdet har man dock bara i mindre skala undersökt vad IPL i etablerade team innebär och hur professionella skillnader påverkar lärandet. Denna licentiatuppsats hade som övergripande syfte att bidra med ökad kunskap inom detta område. Här studerades ett arbete, med kliniska riktlinjer för psykiatrisk tvångsvård, som skulle genomföras av ett interprofessionellt team. Huvudfrågan var hur teamet arbetade med riktlinjerna och hur professionella skillnader kom till uttryck och gav implikationer för IPL. Licentiatuppsatsen är en fallstudie. Undersökningen baseras dels på material (mötesprotokoll, mejlkommunikation, dokument och mediarapporter) från teamets tre-åriga arbete, dels nio intervjuer och en observation av seminariet där teammedlemmar presenterade de färdiga riktlinjerna. Studie 1 syftade till att undersöka hur teamet hanterade en kontrovers och hur de strategier som användes gav konsekvenser för interprofessionellt lärande. Studie 2 syftade till att studera hur teamet granskade kön/genus i arbetet med riktlinjerna och vilka implikationer det blev för riktlinjerna och för interprofessionellt lärande. Fokus här är därmed på ett lärande i ett "färdigt" team. Resultaten i studierna baseras på fallbeskrivning och narrativ analys. Fynden i studierna tolkades huvudsakligen utifrån sociokulturell teori och idéer och insikter från kontroversstudier (studie 1) och det genusvetenskapliga fältet (studie 2).Resultatet i studie 1 visade att kontroversen hanterades främst genom en kompromiss. Resultatet visar också hur lärandestrategier nyttjades vid användning av texter. Lärandet utmanades dock när maktstrategier användes genom hävdande av auktoritet snarare än utforskande av kunskapsläget.Resultatet i studie 2 visade hur kön/genus aktualiserades i en diskussion om könsskillnader i användning av tvångsbälten. I diskussionen användes professionsspecifika erfarenheter och kunskaper om kön/genus, vilket kan antas främjade IPL. Teamets lärande om komplexiteten kring kön/genus resulterade i riktlinjer som betonar makt och med fokus på den individuella patienten. Därmed ledde teamets analys och lärande relaterat till kön/genus paradoxalt till könsneutrala riktlinjer. Slutsatsen är att studierna, på olika sätt, visade förekomst av IPL och hur detta påverkades både positivt och negativt av professionella skillnader.
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28.
  • Wiegleb Edström, Desirée, et al. (författare)
  • Reality check : validating virtual patients for interprofessional wound care education
  • 2016
  • Konferensbidrag (refereegranskat)abstract
    • Background: Interprofessional collaboration is important for successful healing of leg ulcers, but studies have demonstrated a lack of collaboration in practice. The education can contribute to establish conditions for interprofessional collaboration and an understanding for the other profession’s perspective on patents. We intended to use web based virtual patients (VPs) to implement shared learning between nursing and medical students. These VPs need thus to reflect different aspects. The question guiding this research was: How should VP cases be designed to reflect authentic situations in wound care in order to improve interprofessional education (IPE)?Summary of Work: Observations and interviews were conducted with physicians and nurses in both primary care and at a university hospital. Interview data underwent thematic analysis in relation to the research question and the VPs were then discussed regarding these.Summary of Results: Two themes emerged; 1) organization of management, and 2) direct clinical care. The 1st theme indicated a lack of teamwork, competence and responsibility with ambiguous professional roles. The 2nd theme revealed the importance of initial handling, aspects of nursing and follow-up. Observation data supported the findings in the interviews. The themes exposed weaknesses in our VP cases in which the lack of nursing perspectives was particularly apparent.Discussion: The interviews revealed the importance of increased knowledge of leg ulcer management, nursing and follow-up. The VP cases need to be enriched by reflecting these aspects to improve future interprofessional collaboration. Furthermore, VP activity should be followed-up by discussing the cases with students and facilitators from the "other" profession.
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