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Lärande av praktiska färdigheter inom sjuksköterskeprofessionen: studier av lärande i olika arenor
Örebro University, School of Health Sciences.
2017 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A central part of the nursing profession is the performance of practical skills. In order to provide adequate care, maintain patient-safety, and feel comfortable in the profession, registered nurses (RNs) need to be equipped with requisite skills. Overall aim: To explore and describe how learning and development of practical skills occurs during the preparatory phases and within the nursing profession. Method: Qualitative (I, III, IV) and quantitative methods (II) were used. Data were collected through individual interviews (I, IV), questionnaires (II) and participant observations, including informal talks (III, IV). Results: Both students and new RNs expressed a need to learn and develop practical skills (I, II, III, IV). Less than half of the new RNs had access to a clinical skill laboratory (CSL), where they could learn and practice practical skills (II). The students described that learning at a CSL had been meaning for their clinical practice. They also expressed a great need for continuing learning in real patient situations (I, III, IV). During clinical practice, preceptors and students took different approaches which affected student’s learning processesö (I, III, IV). There was a tension between learning at a CSL and learning in clinical practice sites because students perceived differences in the performance of skills. Students described that they understood that performance of skills could be done in different ways without injuring patients. However, the data also showed deviations in performances that could jeopardize patientsafety. In these situations, student’s behavior differed (I, IV). One third of new RNs deviated from evidence based guidelines when they performed practical skills which they were unfamiliar with (II). Both students and new RNs reported that reflection in connection with the performance of practical skills was not common (I, II III, IV). Conclusions: Cooperation between university CSLs and clinical settings must be intensified in order to enhance the understanding of learning processes regarding practical skills. A consensus regarding academic approaches should be reached. Universities need to support preceptors in educational issues where the importance of reflection is clarified and exemplified. Increasing patient-safety requires that new RNs receive opportunities for training in artificial environments, and that a culture that reinforces the use of guidelines and a reflective stance is cultivated.

Place, publisher, year, edition, pages
Örebro: Örebro University , 2017. , p. 74
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 70
Keyword [en]
clinical skill laboratories, learning, new registered nurses, nurse education, nurse student, practical skills, simulation, socialization
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-55828ISBN: 978-91-7529-186-4 (print)OAI: oai:DiVA.org:oru-55828DiVA, id: diva2:1075164
Public defence
2017-04-21, Örebro universitet, Prismahuset, Hörsal 2, Fakultetsgatan 1, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2017-02-17 Created: 2017-02-17 Last updated: 2017-10-18Bibliographically approved
List of papers
1. Walking the bridge: Nursing students' learning in clinical skill laboratories
Open this publication in new window or tab >>Walking the bridge: Nursing students' learning in clinical skill laboratories
2015 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 15, no 4, p. 277-283Article in journal (Refereed) Published
Abstract [en]

Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified walking the bridge in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking.

Keyword
Clinical skills laboratory, Learning, Nursing education, Nursing students, Practical skills, Simulation
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-45675 (URN)10.1016/j.nepr.2015.03.006 (DOI)000358807100005 ()25892366 (PubMedID)
Available from: 2015-08-28 Created: 2015-08-28 Last updated: 2017-12-04Bibliographically approved
2. Use of technical skills and medical devices among new registered nurses: A questionnaire study
Open this publication in new window or tab >>Use of technical skills and medical devices among new registered nurses: A questionnaire study
Show others...
2015 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1169-1174Article in journal (Refereed) Published
Abstract [en]

Background: One comprehensive part of nursing practice is performing technical skills and handling of medical equipment. This might be challenging for new registered nurses (RNs) to do in patient-safe way.

Objectives: The aim of this study was to describe and compare the extent to which new RNs perform various technical skills and handle medical devices in different settings, and to investigate their possibility for continued learning in this respect. A further aim was to describe their perceptions of incident reporting related to technical skills and medical devices.

Design: A cross-sectional study with descriptive and comparative design.

Participants: RNs who recently graduated from a nursing programme at three Swedish universities and had worked as a RN for up to 1year were included in the study (n=113, response rate 57%).

Method: Data were collected by means of a postal questionnaire.

Results: Half of the RNs reported that they performed several of the listed tasks every day or every week, regardless of workplace. These tasks were most frequently performed in surgical departments. The majority of the participants (76%) stated a need of continued practical training. However, less than half of them (48%) had access to a training environment. Several participants (43%) had been involved in incidents related to technical skills or medical devices, which were not always reported. Nearly a third of the participants (31%) did not use the existing guidelines when performing technical skills, and reflection on performance was uncommon.

Conclusions: This study highlights the importance of shared responsibilities between nurse educators and health care employers to provide learning opportunities for new RNs in technical skills, to maintain patient safety. To increase the safety culture where nursing students and new RNs understand the importance of using evidence-based guidelines and taking a reflective approach in the performance of technical tasks is needed.

Place, publisher, year, edition, pages
Churchill Livingstone, 2015
Keyword
Clinical competence, Clinical laboratory, Equipment and supplies, Incident reports, Medical devices, New registered nurses, Nursing skills, Patient safety
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-47060 (URN)10.1016/j.nedt.2015.05.006 (DOI)000365372700007 ()26059922 (PubMedID)2-s2.0-84946492078 (Scopus ID)
Available from: 2015-12-11 Created: 2015-12-11 Last updated: 2017-12-01Bibliographically approved
3. Nursing students’ socialisation into practical skills
Open this publication in new window or tab >>Nursing students’ socialisation into practical skills
(English)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-56895 (URN)
Available from: 2017-03-29 Created: 2017-03-29 Last updated: 2017-10-18Bibliographically approved
4. Tensions in learning professional identities: nursing students narratives and participation in practical skills during their clinical practice
Open this publication in new window or tab >>Tensions in learning professional identities: nursing students narratives and participation in practical skills during their clinical practice
(English)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-56896 (URN)
Available from: 2017-03-29 Created: 2017-03-29 Last updated: 2017-10-18Bibliographically approved

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