Högskolan i Skövde

OBJECTIVES:

The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses.

DESIGN AND SETTINGS:

The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design.

PARTICIPANTS:

The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study.

METHODS:

A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception.

RESULTS:

Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor.

CONCLUSIONS:

In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students.

In Europe, midwifery education has undergone a number of reforms in the past few decades. In several countries, it has shifted from vocational training to academic education. The higher education reform, known as the “Bologna process” aimed to create convergence in higher education among a number of European countries and enhance opportunities for mobility, employment and collaborative research. It also indicated a transparent and easily compared system of academic degrees, generating a new educational system in three cycles. This study explores the implementation of the process in Sweden when the midwifery education was transferred from diploma to postgraduate or master's level. The aim of this study was to analyse how the implementation of the Bologna process in the Swedish higher education system has impacted midwifery education programmes in the country. Descriptive statistics and content analysis were employed to analyse 32 questionnaire responses from teachers and the 2009–2010 curricula and syllabi of 11 postgraduate midwifery education programmes at Swedish universities and university colleges. The results revealed variations among the universities at the major subject into the three disciplines; midwifery, nursing and caring with different conceptualisations, even when the content was identical in the curricula to that of the midwifery professional knowledge base. Implementation of the new reform not only has accelerated the academisation process, but also puts higher demand on the students and requires higher competencies among teachers to involve more evidence-based knowledge, seminars, independent studies and a postgraduate degree project in the major subject. Thus the students earn not only a diploma in midwifery, but also a master's degree in the major subject, which affords the opportunity for an academic career. But still there is a tension between professional and academic education.

Aim: The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. Background: The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. Method: A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. Results: In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p < 0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. Conclusion: The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

Background: The importance of the clinical learning environment in nurse education has gained increasing attention over the last decades. However, there is a lack of research on the learning environment, its significance and meaning in specialist nurse education. Objective: The objectives of the study were to investigate specialised nursing students' experiences of supervision during clinical practice and to compare students who were satisfied with the supervision with those who were dissatisfied with respect to a)organisation of supervision and number of preceptors, as well as time allocated by preceptors for b)supervision, c)reflection, d)discussion of intended learning outcomes, and e)assessments of students' performance by preceptors. Design: This study used a cross-sectional design. Sample and settings: A convenience sample of specialised nursing students was derived from five Swedish universities in the years 2016 and 2017. Methods: Data were collected using a questionnaire. Statistical analyses and a qualitative conventional content analysis were performed. Results: While almost all specialised nursing students reported that there had been time for discussion on their performance assessment, almost half of the students reported not getting time for supervision, or time for reflections and discussions on intended learning outcomes with the preceptor. Students reporting having time allocated for supervision by preceptors were found to be more satisfied with supervision. It was described as important that the preceptor(s)acknowledged the students previous work experiences. Even though being a registered nurse, reflections and feedback were described as valuable for the students learning. Several preceptors were described as positive allowing a broader picture and different views regarding working as a specialist nurse. Conclusions: This study indicates that supervision, in terms of discussions and reflections, of specialised nursing students is significant for learning experiences and satisfaction during clinical placement. © 2019 Elsevier Ltd

Simulation has become a widely used and established pedagogy for teaching clinical nursing skills. Nevertheless, the evidence in favour of this pedagogical approach is weak, and more knowledge is needed in support of its use. The aim of this study was (a) to explore the experiences of undergraduate nursing students when examining knowledge, skills and competences in clinical simulation laboratories with high-fidelity patient simulators and (b) to analyse these students' learning experiences during the examination. A phenomenological approach was used, and qualitative interviews were conducted among 23 second-year undergraduate nursing students-17 women and 6 men. The findings revealed that, irrespective of whether they passed or failed the examination, it was experienced as a valuable assessment of the students' knowledge and skills. Even if the students felt that the examination was challenging, they described it as a learning opportunity. In the examination, the students were able to integrate theory with practice, and earlier established knowledge was scrutinised when reflecting on the scenarios. The examination added aspects to the students' learning that prepared them for the real world of nursing in a safe environment without risking patient safety. The study findings suggest that examinations in clinical simulation laboratories can be a useful teaching strategy in nursing education. The use of high-fidelity patient simulators made the examination authentic. The reflections and feedback on the scenario were described as significant for the students' learning. Undergraduate nursing students can improve their knowledge, understanding, competence and skills when such examinations are performed in the manner used in this study.

The higher education reform in Europe known as the “Bologna Process” implies further harmonisation and integration of nursing programmes into the higher education system. This study explores this process in Sweden, where the development of nursing education into an undergraduate programme started in 1977. The aim of this study was to analyse characteristics of the major subject and its relationship to other subject areas, such as medical sciences and social sciences, in Bachelor level nursing programmes in Sweden following initial implementation of the Bologna process. A constructivist approach and descriptive content analysis were employed to analyse the 2008 nursing curricula and syllabi of 27 undergraduate programmes at 26 Swedish universities and university colleges. The results revealed variation in terms and concepts used for the major subject as well as its scientific foundation, demarcation between the major subject and other subjects included in the study programmes and its relationship to the profession. These variations are linked to the variety of research orientations under debate in the Scandinavian countries: Nursing Science and Caring Science; representing different knowledge domains, focus, challenges and visions for the discipline. Potential implications of basing curricula on a major subject other than Nursing Science in a Bachelor level nursing programme are highlighted.

Aim: To describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden. Methods: Interviews (n = 17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions. Results: The analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives. Conclusion: Nursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening.