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  • 1. Abdelhai, Rehab
    et al.
    Yassin, Sahar
    Ahmad, Mohamad F.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    An e-learning reproductive health module to support improved student learning and interaction: a prospective interventional study at a medical school in Egypt2012Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 12, s. 11-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The Public Health (PH) course at the medical college of Cairo University is based on traditional lectures. Large enrollment limits students' discussions and interactions with instructors. Aim: Evaluate students' learning outcomes as measured by improved knowledge acquisition and opinions of redesigning the Reproductive Health (RH) section of the PH course into e-learning and assessing e-course utilization. Methods: This prospective interventional study started with development of an e-learning course covering the RH section, with visual and interactive emphasis, to satisfy students' diverse learning styles. Two student groups participated in this study. The first group received traditional lecturing, while the second volunteered to enroll in the e-learning course, taking online course quizzes. Both groups answered knowledge and course evaluation questionnaires and were invited to group discussions. Additionally, the first group answered another questionnaire about reasons for non-participation. Results: Students participating in the e-learning course showed significantly better results, than those receiving traditional tutoring. Students who originally shunned the e-course expressed eagerness to access the course before the end of the academic year. Overall, students using the redesigned e-course reported better learning experiences. Conclusions: An online course with interactivities and interaction, can overcome many educational drawbacks of large enrolment classes, enhance student's learning and complement pit-falls of large enrollment traditional tutoring.

  • 2. Al Ansari, A.
    et al.
    Strachan, K.
    Hashim, Sumaya
    RCSI Bahrain, Adliya, Kingdom of Bahrain.
    Otoom, S.
    Analysis of psychometric properties of the modified SETQ tool in undergraduate medical education2017Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, nr 1, artikel-id 56Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Effective clinical teaching is crucially important for the future of patient care. Robust clinical training therefore is essential to produce physicians capable of delivering high quality health care. Tools used to evaluate medical faculty teaching qualities should be reliable and valid. This study investigates the psychometric properties of modification of the System for Evaluation of Teaching Qualities (SETQ) instrument in the clinical years of undergraduate medical education.

    Methods: This cross-sectional multicenter study was conducted in four teaching hospitals in the Kingdom of Bahrain. Two-hundred ninety-eight medical students were invited to evaluate 105 clinical teachers using the SETQ instrument between January 2015 and March 2015. Questionnaire feasibility was analyzed using average time required to complete the form and the number of raters required to produce reliable results. Instrument reliability (stability) was assessed by calculating the Cronbach’s alpha coefficient for the total scale and for each sub-scale (factor). To provide evidence of construct validity, an exploratory factor analysis was conducted to identify which items on the survey belonged together, which were then grouped as factors.

    Results: One-hundred twenty-five medical students completed 1161 evaluations of 105 clinical teachers. The response rates were 42% for student evaluations and 57% for clinical teacher self-evaluations. The factor analysis showed that the questionnaire was composed of six factors, explaining 76.7% of the total variance. Cronbach’s alpha was 0.94 or higher for the six factors in the student survey; for the clinical teacher survey, Cronbach’s alpha was 0.88. In both instruments, the item-total correlation was above 0.40 for all items within their respective scales.

    Conclusion: Our modified SETQ questionnaire was found to be both reliable and valid, and was implemented successfully across various departments and specialties in different hospitals in the Kingdom of Bahrain.

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  • 3.
    Andersson, Jenny
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Verdonk, Petra
    Johansson, Eva E
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Lagro-Janssen, Toine
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Comparing gender awareness in Dutch and Swedish first-year medical students: results from a questionaire2012Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 12, s. 3-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To ascertain good and appropriate healthcare for both women and men implementation of gender perspectives in medical education is needed. For a successful implementation, knowledge about students' attitudes and beliefs about men, women, and gender is crucial. The aim of this study was to compare attitudes to gender and gender stereotyping among Dutch and Swedish male and female medical students.

    Methods: In this cross-sectional study, we measured the attitudes and assumptions about gender among 1096 first year medical students (616 Dutch and 480 Swedish) with the validated Nijmegen Gender Awareness in Medicine Scale (N-GAMS). The response rate was 94% in the Netherlands and 93% in Sweden. Univariate analysis of variance (ANOVA) was used to compare the scores between Dutch and Swedish male and female students. Linear regressions were used to analyze the importance of the background variables.

    Results: There were significant differences in attitudes to gender between Dutch and Swedish students. The Swedish students expressed less stereotypical thinking about patients and doctors and the Dutch were more sensitive to gender differences. The students' sex mattered for gender stereotyping, with male students in both countries agreeing more with stereotypical statements. Students' age, father's birth country and mother's education level had some impact on the outcome.

    Conclusions: There are differences between cultures as well as between men and women in gender awareness that need to be considered when implementing gender in medical education. This study suggests that to arouse the students' interest in gender issues and make them aware of the significance of gender in medical work, the examples used in discussions need to be relevant and challenging in the context of the specific country. Due to different levels of knowledge and different attitudes within the student population it is important to create a climate for dialogue where students feel permitted to disclose their ideas and attitudes in order to become aware of what these are as well as their possible consequences on interaction and decision-making in medical work.

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  • 4.
    Aronsson, Patrik
    et al.
    Department Pharmacology, Institution of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Booth, Shirley
    Department Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden; School of Education, University of the Witwatersrand, Johannesburg, South Africa.
    Hägg, Staffan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Klinisk farmakologi.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten.
    Zetterqvist, Ann
    Department Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Tobin, Gunnar
    Department Pharmacology, Institution of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Reis, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten.
    The understanding of core pharmacological concepts among health care students in their final semester2015Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, nr 1, artikel-id 235Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The overall aim of the study was to explore health care students´ understanding of core concepts in pharmacology.

    Method

    An interview study was conducted among twelve students in their final semester of the medical program (n = 4), the nursing program (n = 4), and the specialist nursing program in primary health care (n  = 4) from two Swedish universities. The participants were individually presented with two pharmacological clinically relevant written patient cases, which they were to analyze and propose a solution to. Participants were allowed to use the Swedish national drug formulary. Immediately thereafter the students were interviewed about their assessments. The interviews were audio-recorded and transcribed verbatim. A thematic analysis was used to identify units of meaning in each interview. The units were organized into three clusters: pharmacodynamics, pharmacokinetics, and drug interactions. Subsequent procedure consisted of scoring the quality of students´ understanding of core concepts. Non-parametric statistics were employed.

    Results

    The study participants were in general able to define pharmacological concepts, but showed less ability to discuss the meaning of the concepts in depth and to implement these in a clinical context. The participants found it easier to grasp concepts related to pharmacodynamics than pharmacokinetics and drug interactions.

    Conclusion

    These results indicate that education aiming to prepare future health care professionals for understanding of more complex pharmacological reasoning and decision-making needs to be more focused and effective.

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  • 5.
    Bejerot, Susanne
    et al.
    Orebro Univ, Sch Med Sci, Orebro, Sweden;Orebro Univ, Univ Hlth Care, Fac Med & Hlth, Res Ctr, Orebro, Sweden.
    Lindgren, Ann
    Municipal Norrtalje, Cent Hlth Serv Presch, Sch & Upper Secundary Sch, Stockholm, Sweden.
    Rosén, Jörgen
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Bejerot, Eva
    Orebro Univ, Sch Business, Orebro, Sweden.
    Elwin, Marie
    Orebro Univ, Univ Hlth Care, Fac Med & Hlth, Res Ctr, Orebro, Sweden.
    Teaching psychiatry to large groups in society2019Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, artikel-id 148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is a need to educate a range of professionals in caring for individuals with long-term mental disability who reside within our communities. Empathy alone is insufficient. The Kognus 4-Step Education Program was developed to achieve this goal.

    Method: The program consisted of independent courses, including an 18-session basic course on psychiatric disability (on-site or online), advanced courses, and highly specialized training programs (Nidotherapy/Peer Consultation). Experts lectured together with clients with psychiatric disabilities. We first report Swedish reforms in which institutionalized patients were relocated to semi-independent individual households. We then describe the design and implementation of the education program. Approximately 50% of participants who were younger than 36years old lacked any healthcare education. The participants' backgrounds, perceptions, participation in the education program, and costs are presented.

    Results: Between 2009 and 2014, 8959 participants attended the Kognus psychiatry courses online or on-site in Stockholm (basic on-site course, n=2111; online course, n=4480; advanced courses, n=2322; highly specialized programs, n=46). A total of 73% of the participants satisfactorily attended the basic sessions on-site compared with 11% of the online participants. The developers conducted the education program for the first 3years. Thereafter, another course provider continued the program with other types of participants. The program was perceived to be equally interesting and meaningful to participants with low and high levels of education, demonstrating the generalizability of the program. The quality of the basic and advanced courses was rated as 4.4 and 4.3, respectively, on a 5-point Likert scale.

    Conclusions: Personnel without appropriate education who work with people with psychiatric/intellectual disabilities can be educated in large numbers. The Kognus program represents a novel and successful way of training people who have no formal education about some essentials of good mental healthcare. Moreover, the model can be easily implemented elsewhere.

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  • 6.
    Bejerot, Susanne
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. University Health Care Research Center.
    Lindgren, Ann
    Central Health Services in pre-schools, schools and upper secundary schools, Municipality of Norrtälje, Stockholm, Sweden.
    Rosén, Jörgen
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Bejerot, Eva
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Elwin, Marie
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. University Health Care Research Center.
    Teaching psychiatry to large groups in society2019Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, nr 1, artikel-id 148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: There is a need to educate a range of professionals in caring for individuals with long-term mental disability who reside within our communities. Empathy alone is insufficient. The Kognus 4-Step Education Program was developed to achieve this goal.

    METHOD: The program consisted of independent courses, including an 18-session basic course on psychiatric disability (on-site or online), advanced courses, and highly specialized training programs (Nidotherapy/Peer Consultation). Experts lectured together with clients with psychiatric disabilities. We first report Swedish reforms in which institutionalized patients were relocated to semi-independent individual households. We then describe the design and implementation of the education program. Approximately 50% of participants who were younger than 36 years old lacked any healthcare education. The participants' backgrounds, perceptions, participation in the education program, and costs are presented.

    RESULTS: Between 2009 and 2014, 8959 participants attended the Kognus psychiatry courses online or on-site in Stockholm (basic on-site course, n = 2111; online course, n = 4480; advanced courses, n = 2322; highly specialized programs, n = 46). A total of 73% of the participants satisfactorily attended the basic sessions on-site compared with 11% of the online participants. The developers conducted the education program for the first 3 years. Thereafter, another course provider continued the program with other types of participants. The program was perceived to be equally interesting and meaningful to participants with low and high levels of education, demonstrating the generalizability of the program. The quality of the basic and advanced courses was rated as 4.4 and 4.3, respectively, on a 5-point Likert scale.

    CONCLUSIONS: Personnel without appropriate education who work with people with psychiatric/intellectual disabilities can be educated in large numbers. The Kognus program represents a novel and successful way of training people who have no formal education about some essentials of good mental healthcare. Moreover, the model can be easily implemented elsewhere.

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    Teaching psychiatry to large groups in society
  • 7. Botezatu, Mihaela
    et al.
    Hult, Håkan
    Tessma, Mesfin
    Dahlgren, Lars Owe
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Virtual Patient Simulation: what do students make of it?: A focus group study2010Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 10, nr 91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The learners' perspectives on Virtual Patient Simulation systems (VPS) are quintessential to their successful development and implementation. Focus group interviews were conducted in order to explore the opinions of medical students on the educational use of a VPS, the Web-based Simulation of Patients application (Web-SP).

    Methods

    Two focus group interviews-each with 8 undergraduate students who had used Web-SP cases for learning and/or assessment as part of their Internal Medicine curriculum in 2007-were performed at the Faculty of Medicine of Universidad el Bosque (Bogota), in January 2008. The interviews were conducted in Spanish, transcribed by the main researcher and translated into English. The resulting transcripts were independently coded by two authors, who also performed the content analysis. Each coder analyzed the data separately, arriving to categories and themes, whose final form was reached after a consensus discussion.

    Results

    Eighteen categories were identified and clustered into five main themes: learning, teaching, assessment, authenticity and implementation. In agreement with the literature, clinical reasoning development is envisaged by students to be the main scope of VPS use; transferable skills, retention enhancement and the importance of making mistakes are other categories circumscribed to this theme. VPS should enjoy a broad use across clinical specialties and support learning of topics not seen during clinical rotations; they are thought to have a regulatory effect at individual level, helping the students to plan their learning. The participants believe that assessment with VPS should be relevant for their future clinical practice; it is deemed to be qualitatively different from regular exams and to increase student motivation. The VPS design and content, the localization of the socio-cultural context, the realism of the cases, as well as the presence and quality of feedback are intrinsic features contributing to VPS authenticity.

    Conclusions

    Five main themes were found to be associated with successful VPS use in medical curriculum: Learning, Teaching, Assessment, Authenticity and Implementation. Medical students perceive Virtual Patients as important learning and assessment tools, fostering clinical reasoning, in preparation for the future clinical practice as young doctors. However, a number of issues regarding VPS design, authenticity and implementation need to be fulfilled, in order to reach the potential educational goals of such applications.

  • 8. Brodin, Ulf
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Bolander Laksov, Klara
    The application of Item Response Theory on a teaching strategy profile questionnaire2010Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 10, nr 14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    In medical education research, various questionnaires are often used to study possible relationships between strategies and approaches to teaching and learning and the outcome of these. However, judging the applicability of such questionnaires or the interpretation of the results is not trivial.

    Methods

    As a way to develop teacher thinking, teaching strategy profiles were calculated for teachers in a research intensive department at Karolinska Institutet. This study compares the sum score, that was inherent in the questionnaire used, with an Item Response Theory (IRT) approach. Three teaching dimensions were investigated and the intended sum scores were investigated by IRT analysis.

    Results

    Agreements as well as important differences were found. The use of the sum score seemed to agree reasonably with an IRT approach for two of the dimensions, while the third dimension could not be identified neither by a the sum score, nor by an IRT approach, as the items included showed conflicting messages.

    Conclusions

    This study emphasizes the possibilities to gain better insight and more relevant interpretation of a questionnaire by use of IRT. A sum score approach should not be taken for granted. Its use has to be thoroughly evaluated.

  • 9. Charandabi, Sakineh Mohammad-Alizadeh
    et al.
    Vahidi, Rezagoli
    Marions, Lena
    Wahlström, Rolf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Effect of a peer-educational intervention on provider knowledge and reported performance in family planning services: a cluster randomized trial2010Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Peer education is an interactive method of teaching or learning which is widely used for educating school and college students, in a variety of different forms. However, there are few studies on its effectiveness for in-service education. The aim of this study was to evaluate the effect of an educational programme including peer discussions, based on a needs assessment, on the providers' knowledge and reported performance in family planning services. Methods: An educational programme was designed and applied in a random selection of half of in-charges of the 74 family health units (intervention group) in Tabriz at a regular monthly meeting. The other half constituted the control group. The programme included eight pages of written material and a two-hour, face-to-face discussion session with emphasis on the weak areas identified through a needs assessment questionnaire. The educated incharges were requested to carry out a similar kind of programme with all peers at their health facilities within one month. All in-charges received one self-administered questionnaire containing knowledge questions one month after the in-charge education (follow-up I: 61 responses), and another one containing knowledge and self-reported performance questions 26 months later (follow-up II: 61 responses). Also, such tests were done for the peers facilitated by the in-charges one (105 responses) and 27 months (114 responses) after the peer discussions. Multiple linear regression was used for comparing mean total scores, and Chi square for comparing proportions between control and intervention groups, after defining facility as the unit of randomization. Results: The mean total percentage scores of knowledge (percent of maximal possible score) in the intervention group were significantly higher than in the control group, both at follow-up I (63%) and at follow-up II (57%); with a difference of 16 (95% CI: 11, 22) and 5 (95% CI: 0.4, 11) percentage units, respectively. Only two of the nine reported performance items were significantly different among the non in-charges in the intervention group at follow-up II. Conclusions: The educational programme including peer discussions using existing opportunities with no need for additional absence from the workplace might be a useful complement to formal large group education for the providers.

  • 10. Conte, Helen
    et al.
    Scheja, Max
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för pedagogik och didaktik.
    Hjelmqvist, Hans
    Jirwe, Maria
    Exploring teams of learners becoming WE in the Intensive Care Unit - a focused ethnographic study2015Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, artikel-id 131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Research about collaboration within teams of learners in intensive care is sparse, as is research on how the learners in a group develop into a team. The aim of this study was to explore the collaboration in teams of learners during a rotation in an interprofessional education unit in intensive care from a sociocultural learning perspective. Methods: Focused Ethnographic methods were used to collect data following eight teams of learners in 2009 and 2010. Each team consisted of one resident, one specialist nurse student and their supervisors (n = 28). The material consisted of 100 hours of observations, interviews, and four hours of sound recordings. A qualitative analysis explored changing patterns of interplay through a constant comparative approach. Results: The learners' collaboration progressed along a pattern of participation common to all eight groups with a chronological starting point and an end point. The progress consisted of three main steps where the learners' groups developed into teams during a week's training. The supervisors' guided the progress by gradually stepping back to provide latitude for critical reflection and action. Conclusion: Our main conclusion in training teams of learners how to collaborate in the intensive care is the crucial understanding of how to guide them to act like a team, feel like a team and having the authority to act as a team.

  • 11.
    Diderichsen, Saima
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Johansson, Eva E.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Verdonk, Petra
    Lagro-Janssen, Toine
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Few gender differences in specialty preferences and motivational factors: a cross-sectional Swedish study on last-year medical students2013Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 13, artikel-id 39Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Today, women constitute about half of medical students in several Western societies, yet women physicians are still underrepresented in surgical specialties and clustered in other branches of medicine. Gender segregation in specialty preference has been found already in medical school. It is important to study the career preferences of our future physicians, as they will influence the maintenance of an adequate supply of physicians in all specialties and the future provision of health care. American and British studies dominate the area of gender and medical careers whereas Swedish studies on medical students' reasons for specialty preference are scarce. The aim of this study is to investigate and compare Swedish male and female medical students' specialty preferences and the motives behind them. Methods: Between 2006 and 2009, all last-year medical students at Umea University, Sweden (N = 421), were invited to answer a questionnaire about their future career and family plans. They were asked about their specialty preference and how they rated the impact that the motivational factors had for their choice. The response rate was 89% (N = 372); 58% were women (N = 215) and 42% were men (N = 157). Logistic regression was used to evaluate the independent impact of each motivational factor for specialty preference. Results: On the whole, male and female last-year students opted for similar specialties. Men and women had an almost identical ranking order of the motivational factors. When analyzed separately, male and female students showed both similarities and differences in the motivational factors that were associated with their specialty preference. A majority of the women and a good third of the men intended to work part-time. The motivational factor combining work with family correlated with number of working hours for women, but not for men. Conclusions: The gender similarities in the medical students' specialty preferences are striking and contrast with research from other Western countries where male and female students show more differences in career aspirations. These similarities should be seized by the health care system in order to counteract the horizontal gender segregation in the physician workforce of today.

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  • 12. Dieden, Anna
    et al.
    Carlson, Elisabeth
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Gudmundsson, Petri
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Learning echocardiography- what are the challenges and what may favour learning? A qualitative study.2019Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, nr 1, artikel-id 212Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Echocardiography is a frequently used imaging modality requiring extensive training to master. In order to develop curriculums and teaching material fully favouring students learning within echocardiography, this study aims to investigate students’ experiences of learning echocardiography, focusing on that which is perceived as the main challenges as well as what might aid learning within the area. The findings could serve as a foundation in the development of new teaching material or curriculums. Methods: A qualitative study was performed with data gathered through two audio-recorded focus group interviews with four third year students from the biomedical laboratory programme at Malmö University in each group. Data was analysed by manifest content analysis. Results: Findings were clustered into two categories reflecting the main findings in the text – practical skills and bridging the theory-practice-gap. Students expressed that main challenges when initially learning echocardiography were the projections and handling the probe as well as connecting ultrasound physics and measurements to practical application. Things that aided their learning were immediate feedback, “playing” with the ultrasound machine, video lectures, the possibility to swiftly alternate between practice and theory as well as the learning by their mistakes in a risk-free environment. Conclusions: This study shows the main challenges when initially learning echocardiography and what might be helpful during the learning process. These findings may be useful when developing curriculums or new teaching material within echocardiography. One suggestion might be to develop digital resources such as virtual laboratories (vLABs).

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    FULLTEXT01
  • 13.
    Edelbring, Samuel
    Karolinska Institutet.
    Measuring strategies for learning regulation in medical education: Scale reliability and dimensionality in a Swedish sample.2012Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 12, nr 76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The 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).

    Methods

    The 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.

    Results

    Scale 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.

    Discussion

    The 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

  • 14.
    Edelbring, Samuel
    Centre for Medical Education, Department LIME, Karolinska Institutet, Stockholm, Sweden.
    Measuring strategies for learning regulation in medical education: Scale reliability and dimensionality in a Swedish sample2012Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 12, artikel-id 76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The 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).

    Methods

    The 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.

    Results

    Scale 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.

    Discussion

    The 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.

  • 15.
    Edelbring, Samuel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Abrandt Dahlgren, Madeleine
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Edstrom, Desiree Wiegleb
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Characteristics of two questionnaires used to assess interprofessional learning: psychometrics and expert panel evaluations2018Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, artikel-id 40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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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  • 16.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Abrandt Dahlgren, Madeleine
    Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Wiegleb Edström, Desirée
    Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Stockholm, Sweden; Department of Dermatology, Karolinska University Hospital, Stockholm, Stockholm, Sweden.
    Characteristics of two questionnaires used to assess interprofessional learning: psychometrics and expert panel evaluations2018Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, artikel-id 40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

    Ladda ner fulltext (pdf)
    Characteristics of two questionnaires used to assess interprofessional learning: Psychometrics and expert panel evaluations
  • 17.
    Edelbring, Samuel
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten. Orebro Univ, Sweden.
    Alehagen, Siw
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Mörelius, Evalotte
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus Linköping/Motala. Edith Cowan Univ, Australia.
    Johansson, AnnaKarin
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Rytterström, Patrik
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Should the PBL tutor be present?: A cross-sectional study of group effectiveness in synchronous and asynchronous settings2020Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, BMC MEDICAL EDUCATION, Vol. 20, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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  • 18.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Alehagen, Siw
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Mörelius, Evalotte
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden; School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
    Johansson, AnnaKarin
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Rytterström, Patrik
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Should the PBL tutor be present?: A cross-sectional study of group effectiveness in synchronous and asynchronous settings2020Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 20, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 19.
    Edelbring, Samuel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Institutet, Stockholm, Sweden.
    Wahlström, Rolf
    Karolinska Institutet, Stockholm, Sweden.
    Dynamics of study strategies and teacher regulation in virtual patient learning activities: a cross sectional survey2016Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, nr 1, s. 122-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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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  • 20.
    Edelbring, Samuel
    et al.
    Department of Medical and Health Sciences, Division of Community Medicine, unit of Medical Education, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Wahlström, Rolf
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Dynamics of study strategies and teacher regulation in virtual patient learning activities: a cross sectional survey2016Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, nr 1, artikel-id 122Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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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    Dynamics of study strategies and teacher regulation in virtual patient learning activities: a cross sectional survey
  • 21. Ekblad, Solvig
    et al.
    Mollica, Richard F.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Pantziaras, Ioannis
    Lavelle, James
    Educational potential of a virtual patient system for caring for traumatized patients in primary care2013Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 13, s. 110-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Virtual Patients (VPs) have been used in undergraduate healthcare education for many years. This project is focused on using VPs for training professionals to care for highly vulnerable patient populations. The aim of the study was to evaluate if Refugee Trauma VPs was perceived as an effective and engaging learning tool by primary care professionals (PCPs) in a Primary Health Care Centre (PHC). Methods: A VP system was designed to create realistic and engaging VP cases for Refugee Trauma for training refugee patient interview, use of established trauma and mental health instruments as well as to give feedback to the learners. The patient interview section was based on video clips with a Bosnian actor with a trauma story and mental health problems. The video clips were recorded in Bosnian language to further increase the realism, but also subtitled in English. The system was evaluated by 11 volunteering primary health clinicians at the Lynn Community Health Centre, Lynn, Massachusetts, USA. The participants were invited to provide insights/feedback about the system's usefulness and educational value. A mixed methodological approach was used, generating both quantitative and qualitative data. Results: Self-reported dimensions of clinical care, pre and post questionnaire questions on the PCPs clinical worldview, motivation to use the VP, and IT Proficiency. Construct items used in these questionnaires had previously demonstrated high face and construct validity. The participants ranked the mental status examination more positively after the simulation exercise compared to before the simulation. Follow up interviews supported the results. Conclusions: Even though virtual clinical encounters are quite a new paradigm in PHC, the participants in the present study considered our VP case to be a relevant and promising educational tool. Next phase of our project will be a RCT study including comparison with specially prepared paper-cases and determinative input on improving clinical diagnosis and treatment of the traumatized refugee patient.

  • 22.
    Eriksson, Elisabet
    et al.
    Univ Gavle, Sweden.
    Berg, Sören
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Engstrom, Maria
    Univ Gavle, Sweden; Uppsala Univ, Sweden; Lishui Univ, Peoples R China.
    Internationally educated nurses and medical graduates experiences of getting a license and practicing in Sweden - a qualitative interview study2018Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, artikel-id 296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The Swedish healthcare system has an increased need for nurses and physicians, and the number of International Educated Nurses (IENs) and International Medical Graduates (IMGs) seeking job opportunities and a license to practice in Sweden is rising. This study explored how IENs and IMGs describe their experience of getting a license to practice, their perceptions of working in Sweden and of how their intercultural competence is utilized. Method: A qualitative study based on semi-structured interviews with 11 IENs and 11 IMGs. The interviews were conducted between 2015 and 2017. The data were analyzed using qualitative content analysis. Results: Three main themes were identified: Getting a license - a different story, The work is familiar, yet a lot is new, Trying to master a new language. The time to obtain a license to practice and finding a job was shorter for IENs and IMGs coming from European countries than for those from non-European countries. Some of the experiences of getting a license to practice and of entering a new workplace in another country were the same for nurses and physicians. In general, both IENs and IMGs felt welcomed and used their intercultural competence at work. Lack of language skills was regarded as the main problem for both professions, while workplace introduction was shorter for IMGs than for IENs. Conclusions: Problems related to language and culture are often underestimated, therefore organizations and managers employing IENs and IMGs should provide longer workplace introduction to facilitate the acculturation process. More time-efficient language courses specifically adapted to IENs and IMGs could make the transition easier and shorten the time to obtain a license to practice for both professions.

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  • 23.
    Eriksson, Elisabet
    et al.
    Univ Gävle, Dept Hlth & Caring Sci, Gävle, Sweden.
    Berg, Sören
    Linköping Univ, Cty Council Östergötland, Dept Cardiothorac Surg, Dept Med & Hlth Sci, Linköping, Sweden.
    Engström, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Univ Gävle, Dept Hlth & Caring Sci, Gävle, Sweden; Lishui Univ, Med & Hlth Coll, Nursing Dept, Lishui, Peoples R China.
    Internationally educated nurses' and medical graduates' experiences of getting a license and practicing in Sweden - a qualitative interview study.2018Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, artikel-id 296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The Swedish healthcare system has an increased need for nurses and physicians, and the number of International Educated Nurses (IENs) and International Medical Graduates (IMGs) seeking job opportunities and a license to practice in Sweden is rising. This study explored how IENs and IMGs describe their experience of getting a license to practice, their perceptions of working in Sweden and of how their intercultural competence is utilized.

    Method: A qualitative study based on semi-structured interviews with 11 IENs and 11 IMGs. The interviews were conducted between 2015 and 2017. The data were analyzed using qualitative content analysis.

    Results: Three main themes were identified: ‘Getting a license – a different story,’ ‘The work is familiar, yet a lot is new,’ ‘Trying to master a new language.’ The time to obtain a license to practice and finding a job was shorter for IENs and IMGs coming from European countries than for those from non-European countries. Some of the experiences of getting a license to practice and of entering a new workplace in another country were the same for nurses and physicians. In general, both IENs and IMGs felt welcomed and used their intercultural competence at work. Lack of language skills was regarded as the main problem for both professions, while workplace introduction was shorter for IMGs than for IENs.

    Conclusions: Problems related to language and culture are often underestimated, therefore organizations and managers employing IENs and IMGs should provide longer workplace introduction to facilitate the acculturation process. More time-efficient language courses specifically adapted to IENs and IMGs could make the transition easier and shorten the time to obtain a license to practice for both professions.

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  • 24.
    Eriksson, Elisabet
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Berg, Sören
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Internationally educated nurses' and medical graduates' experiences of getting a license and practicing in Sweden - a qualitative interview study2018Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, nr 1, artikel-id 296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The Swedish healthcare system has an increased need for nurses and physicians, and the number of International Educated Nurses (IENs) and International Medical Graduates (IMGs) seeking job opportunities and a license to practice in Sweden is rising. This study explored how IENs and IMGs describe their experience of getting a license to practice, their perceptions of working in Sweden and of how their intercultural competence is utilized.

    METHOD: A qualitative study based on semi-structured interviews with 11 IENs and 11 IMGs. The interviews were conducted between 2015 and 2017. The data were analyzed using qualitative content analysis.

    RESULTS: Three main themes were identified: 'Getting a license - a different story,' 'The work is familiar, yet a lot is new,' 'Trying to master a new language.' The time to obtain a license to practice and finding a job was shorter for IENs and IMGs coming from European countries than for those from non-European countries. Some of the experiences of getting a license to practice and of entering a new workplace in another country were the same for nurses and physicians. In general, both IENs and IMGs felt welcomed and used their intercultural competence at work. Lack of language skills was regarded as the main problem for both professions, while workplace introduction was shorter for IMGs than for IENs.

    CONCLUSIONS: Problems related to language and culture are often underestimated, therefore organizations and managers employing IENs and IMGs should provide longer workplace introduction to facilitate the acculturation process. More time-efficient language courses specifically adapted to IENs and IMGs could make the transition easier and shorten the time to obtain a license to practice for both professions.

  • 25. Escher, Cecilia
    et al.
    Creutzfeldt, Johan
    Meurling, Lisbet
    Hedman, Leif
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.
    Kjellin, Ann
    Fellaender-Tsai, Li
    Medical students' situational motivation to participate in simulation based team training is predicted by attitudes to patient safety2017Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, artikel-id 37Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training.

    Methods: In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ).

    Results: We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples.

    Conclusion: In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.

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  • 26. Esmaily, Hamideh M.
    et al.
    Savage, Carl
    Vahidi, Rezagoli
    Amini, Abolghasem
    Zarrintan, Mohammad Hossein
    Wahlström, Rolf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Identifying outcome-based indicators and developing a curriculum for a continuing medical education programme on rational prescribing using a modified Delphi process.2008Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 8, s. 33-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND

    Continuing medical education (CME) is compulsory for physicians in Iran. Recent studies in Iran show that modifications of CME elements are necessary to improve the effectiveness of the educational programmes. Other studies point to an inappropriate, even irrational drug prescribing. Based on a needs assessment study regarding CME for general physicians in the East Azerbaijan province in Iran, rational prescribing practice was recognized as a high priority issue. Considering different educational methods, outcome-based education has been proposed as a suitable approach for CME. The purpose of the study was to obtain experts' consensus about appropriate educational outcomes of rational prescribing for general physicians in CME and developing curricular contents for this education.

    METHODS

    The study consisted of two phases: The first phase was conducted using a two-round Delphi consensus process to identify the outcome-based educational indicators regarding rational prescribing for general physicians in primary care (GPs). In the second phase the agreed indicators were submitted to panels of experts for assessment and determination of content for a CME program in the field.

    RESULTS

    Twenty one learning outcomes were identified through a modified Delphi process. The indicators were used by the panels of experts and six educational topics were determined for the CME programme and the curricular content of each was defined. The topics were 1) Principles of prescription writing, 2) Adverse drug reactions, 3) Drug interactions, 4) Injections, 5) Antibiotic therapy, and 6) Anti-inflammatory agents therapy. One of the topics was not directly related to any outcome, raising a question about the need for a discussion on constructive alignment.

    CONCLUSIONS

    Consensus on learning outcomes was achieved and an educational guideline was designed. Before suggesting widespread use in the country the educational package should be tested in the CME context.

  • 27.
    Fridner, Ann
    et al.
    Stockholm University / Karolinska Institutet.
    Norell, Alexandra
    Stockholm University.
    Åkesson, Gertrud
    Stockholm University.
    Gustafsson Sendén, Marie
    Stockholm University.
    Lovseth, Lise Tevik
    St. Olav’s University Hospital, NTNU, Trondheim, Norway.
    Schenck-Gustafsson, Karin
    Stockholm University / Karolinska Institutet.
    Possible reasons why female physicians publish fewer scientific articles than male physicians - a cross-sectional study2015Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, artikel-id 67Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine. Methods: Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles. Results: Male physicians published significantly more articles than female physicians p<.001. In respective multivariate models for female and male physicians, age and academic positions were significantly related to a higher number of published articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22-7.20) and male physicians (OR = 2.10; 95% CI 1.08-4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08-2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12-0.70) whilst the publishing rate among male physicians was not affected by exhaustion. Conclusions: Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.

  • 28.
    Fridner, Ann
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen. Karolinska Institutet, Sweden.
    Norell, Alexandra
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Åkesson, Gertrud
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Gustafsson Sendén, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Løvseth, Lise Tevik
    Schenck-Gustafsson, Karin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen. Karolinska Institutet, Sweden.
    Possible reasons why female physicians publish fewer scientific articles than male physicians: A cross-sectional study2015Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, artikel-id 67Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine.

    Methods: Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles.

    Results: Male physicians published significantly more articles than female physicians p <. 001. In respective multivariate models for female and male physicians, age and academic positions were significantly related to a higher number of published articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22–7.20) and male physicians (OR = 2.10; 95% CI 1.08–4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08–2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12–0.70) whilst the publishing rate among male physicians was not affected by exhaustion.

    Conclusions: Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.

  • 29.
    Hadadgar, Arash
    et al.
    Karolinska Institutet, Sweden;Isfahan Univ Med Sci, Iran.
    Changiz, Tahereh
    Isfahan Univ Med Sci, Iran.
    Masiello, Italo
    Karolinska Institutet, Sweden.
    Dehghani, Zahra
    Isfahan Univ Med Sci, Iran.
    Mirshahzadeh, Nahidossadat
    Isfahan Univ Med Sci, Iran.
    Zary, Nabil
    Karolinska Institutet, Sweden.
    Applicability of the theory of planned behavior in explaining the general practitioners eLearning use in continuing medical education2016Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, artikel-id 215Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: General practitioners (GP) update their knowledge and skills by participating in continuing medical education (CME) programs either in a traditional or an e-Learning format. GPs' beliefs about electronic format of CME have been studied but without an explicit theoretical framework which makes the findings difficult to interpret. In other health disciplines, researchers used theory of planned behavior (TPB) to predict user's behavior. Methods: In this study, an instrument was developed to investigate GPs' intention to use e-Learning in CME based on TPB. The goodness of fit of TPB was measured using confirmatory factor analysis and the relationship between latent variables was assessed using structural equation modeling. Results: A total of 148 GPs participated in the study. Most of the items in the questionnaire related well to the TPB theoretical constructs, and the model had good fitness. The perceived behavioral control and attitudinal constructs were included, and the subjective norms construct was excluded from the structural model. The developed questionnaire could explain 66 % of the GPs' intention variance. Conclusions: The TPB could be used as a model to construct instruments that investigate GPs' intention to participate in e-Learning programs in CME. The findings from the study will encourage CME managers and researchers to explore the developed instrument as a mean to explain and improve the GPs' intentions to use eLearning in CME.

  • 30.
    Harries, Priscilla
    et al.
    Brunel University London, London, UK.
    Unsworth, Carolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Central Queensland University, Melbourne, Australia.
    Gokalp, Hulya
    Brunel University London, London, UK.
    Davies, Miranda
    Nuffield Trust, London, UK.
    Tomlinson, Christopher
    Imperial College London, London, UK.
    Harries, Luke
    University of Cambridge, Cambridge, UK.
    A randomised controlled trial to test the effectiveness of decision training on assessors' ability to determine optimal fitness-to-drive recommendations for older or disabled drivers.2018Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, nr 1, artikel-id 27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Driving licensing jurisdictions require detailed assessments of fitness-to-drive from occupational therapy driver assessors (OTDAs). We developed decision training based on the recommendations of expert OTDAs, to enhance novices' capacity to make optimal fitness-to-drive decisions. The aim of this research was to determine effectiveness of training on novice occupational therapists' ability to make fitness-to-drive decisions.

    METHODS: A double blind, parallel, randomised controlled trial was conducted to test the effectiveness of decision training on novices' fitness-to-drive recommendations. Both groups made recommendations on a series of 64 case scenarios with the intervention group receiving training after reviewing two thirds of the cases; the control group, at this same point, just received a message of encouragement to continue. Participants were occupational therapy students on UK and Australian pre-registration programmes who individually took part online, following the website instructions. The main outcome of training was the reduction in mean difference between novice and expert recommendations on the cases.

    RESULTS: Two hundred eighty-nine novices were randomised into intervention; 166 completed the trial (70 in intervention; 96 in control). No statistical differences in scores were found pre-training. Post training, the control group showed no significant change in recommendations compared to the experts (t(96) = -.69; p = .5), whereas the intervention group exhibited a significant change (t(69) = 6.89; p < 0.001). For the intervention group, the mean difference compared with the experts' recommendations reduced with 95% CI from -.13 to .09. Effect size calculated at the post-training demonstrated a moderate effect (d = .69, r = .32).

    CONCLUSIONS: Novices who received the decision training were able to change their recommendations whereas those who did not receive training did not. Those receiving training became more able to identify drivers who were not fit-to-drive, as measured against experts' decisions on the same cases. This research demonstrated that novice occupational therapists can be trained to make decisions more aligned to those of expert OTDAs. The decision training and cases have been launched as a free training resource at www.fitnesstodrive.com . This can be used by novice driver assessors to increase their skill to identify drivers who are, and are not fit-to-drive, potentially increasing international workforce capacity in this growing field of practice.

  • 31.
    Hege, Inga
    et al.
    University of Munich, Germany; Geisel School Medical Dartmouth, NH USA.
    Kononowicz, Andrzej A.
    Jagiellonian University, Poland; Karolinska Institute, Sweden.
    Tolks, Daniel
    University of Munich, Germany.
    Edelbring, Samuel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Kuehlmeyer, Katja
    University of Munich, Germany.
    A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review2016Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, nr 146Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    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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  • 32.
    Hege, Inga
    et al.
    Institute for Medical Education, Ludwig-Maximilians-Universität München, München, Germany; Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
    Kononowicz, Andrzej A.
    Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University, Krakow, Poland; Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Tolks, Daniel
    Institute for Medical Education, Ludwig-Maximilians-Universität München, München, Germany.
    Edelbring, Samuel
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Kuehlmeyer, Katja
    Institute for Ethics, History and Theory of Medicine, Ludwig-Maximilians-Universität München, München, Germany.
    A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review2016Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, artikel-id 146Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    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.

    Ladda ner fulltext (pdf)
    A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review
  • 33.
    Holmgren, Daniel
    et al.
    Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden / Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Skyvell Nilsson, Maria
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Wekell, Per
    Department of Pediatrics, NU-Hospital Group, Uddevalla, Sweden / Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
    Combining learning for educators and participants in a paediatric CPD programme2019Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, artikel-id 28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Most continuing professional development (CPD) programmes do not include an educational training module. In our country, educational practice in the areas of CPD and continuing medical education relies traditionally on conventional lectures. This is in sharp contrast to the educational research that clearly demonstrates that educational programmes emphasising adult learning methods have greater potential to change physicians'clinical practice. To investigate whether lecture-oriented educators were prepared to change their educational practice towards principles of adult learning, we decided to combine learning for educators and participants in a paediatric CPD programme.The aim of the study was to investigate educators' reflections on their learning and educational practice after they have undergone an educational skills component integrated in the implementation of a CPD learning module for paediatricians and evaluate the results from the participants' perspective.

    Methods: The objectives of the educational skills component of the learning module were developed according to adult learning theories. The learning objectives for the CPD learning module were based on a pre-course needs assessment. Evaluations were made using questionnaires.

    Results: Seven of 10 participants in the educational skills component of the learning module and all the participants, 13 paediatricians and 14 nurses, who participated in the learning module, answered the questionnaires.The results of this pilot study show that educators whose main experience of teaching was based on lectures were strengthened in their practice; they defined their competence and were prepared to move towards adult learning principles. The participants in the learning module expressed a high degree of satisfaction.

    Conclusions: We conclude that it is feasible to combine learning for educators and participants in a paediatric CPD programme and that lecture-oriented educators are prepared to change their educational practice towards principles of adult learning.

  • 34. Jensen, Ulf J.
    et al.
    Jensen, Jens
    Olivecrona, Goran
    Ahlberg, Gunnar
    Lagerquist, Bo
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Tornvall, Per
    The role of a simulator-based course in coronary angiography on performance in real life cath lab2014Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, s. 49-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of this study was to explore if a course consisting of lectures combined with simulator training in coronary angiography (CA) could accelerate the early learning curve when performing CA on patients. Knowledge in performing CA is included in the curriculum for the general cardiologist. The method, according to American College of Cardiology and European Society of Cardiology guidelines, for this training is not well defined but simulator training is proposed to be an option. However, the transfer effect from a CA simulator to performance in real world cath lab is not validated. Methods: Fifty-four residents without practical skills in CA completed the course and 12 continued to training in invasive cardiology. These residents were tracked in the Swedish Coronary Angiography and Angioplasty Registry and compared to a control group of 46 novel operators for evaluation of performance metrics. A total of 4472 CAs were analyzed. Results: Course participants demonstrated no consistent acceleration in the early learning curve in real world cath lab. They had longer fluoroscopy time compared to controls (median 360 seconds (IQR 245-557) vs. 289 seconds (IQR 179-468), p < 0.001). Safety measures also indicated more complications appearing at the ward, in particular when using the femoral approach (6.25% vs. 2.53%, p < 0.001). Conclusions: Since the results of this retrospective non-randomized study were negative, the role of a structured course including simulator training for skills acquisition in CA is still uncertain. Randomized transfer studies are warranted to justify further use of simulators for training in CA

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  • 35.
    Kalén, Susanne
    et al.
    Karolinska Institutet.
    Lachmann, Hanna
    Karolinska Institutet / Sophiahemmet Högskola.
    Varttinen, Maria
    Karolinska Institutet.
    Möller, Riitta
    Karolinska Institutet.
    Bexelius, Tomas S
    Karolinska Institutet.
    Ponzer, Sari
    Karolinska Institutet.
    Medical students' experiences of their own professional development during three clinical terms: a prospective follow-up study2017Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, nr 1, artikel-id 47Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: A modern competency-based medical education is well implemented globally, but less is known about how the included learning activities contribute to medical students' professional development. The aim of this study was to explore Swedish medical students' perceptions of the offered learning activities and their experiences of how these activities were connected to their professional development as defined by the CanMEDS framework.

    METHODS: A prospective mixed method questionnaire study during three terms (internal medicine, scientific project, and surgery) in which data were collected by using contextual activity sampling system, i.e., the students were sent a questionnaire via their mobile phones every third week. All 136 medical students in the 6th of 11 terms in the autumn of 2012 were invited to participate. Seventy-four students (54%) filled in all of the required questionnaires (4 per term) for inclusion, the total number of questionnaires being 1335. The questionnaires focused on the students' experiences of learning activities, especially in relation to the CanMEDS Roles, collaboration with others and emotions (positive, negative, optimal experiences, i.e., "flow") related to the studies. The quantitative data was analysed statistically and, for the open-ended questions, manifest inductive content analysis was used.

    RESULTS: Three of the CanMEDs Roles, Medical Expert, Scholar, and Communicator, were most frequently reported while the four others, e.g., the role Health Advocate, were less common. Collaboration with students from other professions was most usual during the 8th term. Positive emotions and experience of "flow" were most often reported during clinical learning activities while the scientific project term was connected with more negative emotions.

    CONCLUSIONS: Our results showed that it is possible, even during clinical courses, to visualise the different areas of professional competence defined in the curriculum and connect these competences to the actual learning activities. Students halfway through their medical education considered the most important learning activities for their professional development to be connected with the Roles of Medical Expert, Scholar, and Communicator. Given that each of the CanMEDS Roles is at least moderately important during undergraduate medical education, the entire spectrum of the Roles should be emphasised and developed during the clinical years.

  • 36. Kalén, Susanne
    et al.
    Lachmann, Hanna
    Sophiahemmet Högskola.
    Varttinen, Maria
    Möller, Riitta
    Bexelius, Tomas S
    Ponzer, Sari
    Medical students' experiences of their own professional development during three clinical terms: a prospective follow-up study.2017Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: A modern competency-based medical education is well implemented globally, but less is known about how the included learning activities contribute to medical students' professional development. The aim of this study was to explore Swedish medical students' perceptions of the offered learning activities and their experiences of how these activities were connected to their professional development as defined by the CanMEDS framework.

    METHODS: A prospective mixed method questionnaire study during three terms (internal medicine, scientific project, and surgery) in which data were collected by using contextual activity sampling system, i.e., the students were sent a questionnaire via their mobile phones every third week. All 136 medical students in the 6th of 11 terms in the autumn of 2012 were invited to participate. Seventy-four students (54%) filled in all of the required questionnaires (4 per term) for inclusion, the total number of questionnaires being 1335. The questionnaires focused on the students' experiences of learning activities, especially in relation to the CanMEDS Roles, collaboration with others and emotions (positive, negative, optimal experiences, i.e., "flow") related to the studies. The quantitative data was analysed statistically and, for the open-ended questions, manifest inductive content analysis was used.

    RESULTS: Three of the CanMEDs Roles, Medical Expert, Scholar, and Communicator, were most frequently reported while the four others, e.g., the role Health Advocate, were less common. Collaboration with students from other professions was most usual during the 8th term. Positive emotions and experience of "flow" were most often reported during clinical learning activities while the scientific project term was connected with more negative emotions.

    CONCLUSIONS: Our results showed that it is possible, even during clinical courses, to visualise the different areas of professional competence defined in the curriculum and connect these competences to the actual learning activities. Students halfway through their medical education considered the most important learning activities for their professional development to be connected with the Roles of Medical Expert, Scholar, and Communicator. Given that each of the CanMEDS Roles is at least moderately important during undergraduate medical education, the entire spectrum of the Roles should be emphasised and developed during the clinical years.

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  • 37.
    Kononowicz, Andrzej
    et al.
    Karolinska Institutet.
    Zary, Nabil
    Karolinska Institutet.
    Edelbring, Samuel
    Karolinska Institutet.
    Corral, Janet
    University of Colorado.
    Hege, Inga
    University of Munchen.
    Virtual patients - what are we talking about? A framework to classify the meanings of the term in healthcare education2015Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, nr 11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The 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.

    Methods

    A 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.

    Results

    536 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.

    Conclusions

    The 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.

  • 38.
    Kononowicz, Andrzej
    et al.
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland.
    Zary, Nabil
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Edelbring, Samuel
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Corral, Janet
    School of Medicine at the University of Colorado Denver, Denver, Colorado, USA.
    Hege, Inga
    Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, München, Germany.
    Virtual patients - what are we talking about?: A framework to classify the meanings of the term in healthcare education2015Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, artikel-id 11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The 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.

    Methods

    A 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.

    Results

    536 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.

    Conclusions

    The 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.

  • 39.
    Kristoffersson, Emelie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Andersson, Jenny
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Bengs, Carita
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Experiences of the gender climate in clinical training: a focus group study among Swedish medical students2016Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, artikel-id 283Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Research shows that medical education is characterized by unequal conditions for women and men, but there is a lack of qualitative studies investigating the social processes that enable and maintain gender inequalities that include both male and female students. In this focus group study, we therefore explored male aswell as female medical students’ experiences of the gender climate – i.e., how beliefs, values, and norms about gender were communicated – during clinical training and how the students dealt with these experiences.

    Methods: Focus group interviews were conducted with 24 medical students (nine men) at Umeå University, Sweden. The interviews were structured around personal experiences in clinical training where the participants perceived that gender had mattered. Data were analysed using qualitative content analysis.

    Results: The students described gender-stereotyped expectations, discriminatory treatment, compliments, comments, and demeaning jargon. Female students gave more personal and varied examples than the men.The students’ ways of handling their experiences were marked by efforts to fit in, for example, by adapting their appearance and partaking in the prevailing jargon. They felt dependent on supervisors and staff, and due to fear of repercussions they kept silent and avoided unpleasant situations and people rather than challenging humiliating jargon or supervisors who were behaving badly.

    Conclusions: Everyday communication of gender beliefs combined with students’ adaptation to stereotyped expectations and discrimination came across as fundamental features through which unequal conditions for male and female students are reproduced and maintained in the clinic. Because they are in a dependent position, it is often difficult for students to challenge problematic gender attitudes. The main responsibility for improvements, therefore, lies with medical school leadership who need to provide students and supervisors with knowledge about gendered processes, discrimination, and sexism and to organize reflection groups about the gender climate in order to improve students’ opportunities to discuss their experiences, and hopefully find ways to protest and actively demand change.

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  • 40.
    Kristoffersson, Emelie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Diderichsen, Saima
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Verdonk, Petra
    Lagro-Janssen, Toine
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Andersson, Jenny
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    To select or be selected - gendered experiences in clinical training affect medical students' specialty preferences2018Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, artikel-id 268Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The literature investigating female and male medical students' differing career intentions is extensive. However, medical school experiences and their implications for professional identity formation and specialty choice have attracted less attention. In this study we explore the impact of medical school experiences on students' specialty preferences, investigate gender similarities and differences, and discuss how both might be related to gender segregation in specialty preference.

    Methods: In a questionnaire, 250 Swedish final-year medical students described experiences that made them interested and uninterested in a specialty. Utilizing a sequential mixed methods design, their responses were analyzed qualitatively to create categories that were compared quantitatively.

    Results: Similar proportions of women and men became interested in a specialty based on its knowledge area, patient characteristics, and potential for work-life balance. These aspects, however, often became secondary to whether they felt included or excluded in clinical settings. More women than men had been deterred by specialties with excluding, hostile, or sexist workplace climates (W = 44%, M = 16%). In contrast, more men had been discouraged by specialties' knowledge areas (W = 27%, M = 47%).

    Conclusions: Male and female undergraduates have similar incentives and concerns regarding their career. However, the prevalence of hostility and sexism in the learning environment discourages especially women from some specialties. To reduce gender segregation in specialty choice, energy should be directed towards counteracting hostile workplace climates that explain apparent stereotypical assumptions about career preferences of men and women.

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  • 41.
    Laksov, Klara Bolander
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för pedagogik och didaktik. Karolinska Institutet, Sweden.
    Dornan, Tim
    Teunissen, Pim W.
    Making theory explicit - An analysis of how medical education research(ers) describe how they connect to theory2017Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, artikel-id 18Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: As medical education develops into a varied and well-developed field of research, the issue of quality research anchored in or generating theory has gained increasing importance. Medical education researchers have been criticized of not connecting their work to relevant theory. This paper set out to analyse how researchers can connect to theory in medical education. The goal of this paper is to provide an accessible framework for those entering medical education research, regarding how theory may become an integral part of one's work. Methods: Fifteen purposefully selected researchers in medical education were asked to nominate papers they considered influential in medical education. Through this process 41 papers were identified and included in the study. Results: The papers were analysed with thematic content analysis, which resulted in three approaches to the use of theory: as close-up exploration; as a specific perspective; and as an overview. The approaches are exemplified by quotes from the papers included in our dataset and further illuminated by a metaphoric story. Conclusions: We conclude by pointing at the importance of making explicit how theory is used in medical education as a way to collaboratively take responsibility for the quality of medical education research.

  • 42. Liljedahl, Matilda
    et al.
    Björck, Erik
    Kalén, Susanne
    Ponzer, Sari
    Bolander Laksov, Klara
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för pedagogik och didaktik. Karolinska Institutet, Sweden.
    To belong or not to belong: nursing students' interactions with clinical learning environments - an observational study2016Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, artikel-id 197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Belongingness has been argued to be a prerequisite for students' learning in the clinical setting but making students feel like they belong to the workplace is a challenge. From a sociocultural perspective, workplace participatory practices is a framework that views clinical learning environments to be created in interaction between students and the workplace and hence, are dependent on them both. The aim of this study was to explore the interdependence between affordances and engagement in clinical learning environments. The research question was: How are nursing students influenced in their interactions with clinical learning environments? Methods: An observational study with field observations and follow-up interviews was performed. The study setting comprised three academic teaching hospitals. Field observations included shadowing undergraduate nursing students during entire shifts. Fifty-five hours of field observations and ten follow-up interviews with students, supervisors and clinical managers formed the study data. A thematic approach to the analysis was taken and performed iteratively with the data collection. Results: The results revealed that students strived to fill out the role they were offered in an aspirational way but that they became overwhelmed when given the responsibility of care. When students' basic values did not align with those enacted by the workplace, they were not willing to compromise their own values. Workplaces succeeded in inviting students into the community of nurses and the practice of care. Students demonstrated hesitance regarding their desire to belong to the workplace community. Conclusion: The results imply that the challenge for clinical education is not to increase the experience of belongingness but to maintain students' critical and reflective approach to health care practice. Additionally, results suggest students to be included as an important stakeholder in creating clinical learning environments rather than being viewed as consumer of clinical education.

  • 43.
    Lund, Bodil
    et al.
    Karolinska Inst, Dept Dent Med.
    Fors, Uno
    Stockholm Univ, Dept Comp & Syst Sci,.
    Sejersen, Ronny
    Karolinska Institutet, Stockholm.
    Sallnäs Pysander, Eva-Lotta
    KTH, Skolan för datavetenskap och kommunikation (CSC), Människa-datorinteraktion, MDI.
    Rosén, Annika
    Karolinska Institutet, Stockholm.
    Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training2011Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 11, nr 1, s. 82-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Methods: Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP) Simulation system (Web-SP) and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. Results: The response rate was 91.5% (43/47). The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. Conclusions: The two tested simulation methods were well accepted and most students agreed that the future curriculum would benefit from permanent inclusion of these exercises, especially when used in combination. The results also stress the importance of teaching technical skills and clinical reasoning in concert.

  • 44. Lund, Bodil
    et al.
    Fors, Uno
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Sejersen, Ronny
    Sällnäs, EvaLotta
    Rosén, Annika
    Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training2011Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 11, s. 82-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Methods: Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP) Simulation system (Web-SP) and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. Results: The response rate was 91.5% (43/47). The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. Conclusions: The two tested simulation methods were well accepted and most students agreed that the future curriculum would benefit from permanent inclusion of these exercises, especially when used in combination. The results also stress the importance of teaching technical skills and clinical reasoning in concert.

  • 45.
    Manninen, Katri
    et al.
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics, Stockholm, Sweden.
    Henriksson, Elisabet Welin
    Department of Neurobiology, Karolinska Institutet; Care Sciences and Society, Stockholm, Sweden.
    Scheja, Max
    Department of Education, Stockholm University, Stockholm, Sweden.
    Silén, Charlotte
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics, Stockholm, Sweden.
    Patients' approaches to students' learning at a clinical education ward: an ethnographic study2014Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, artikel-id 131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: It is well known that patients' involvement in health care students' learning is essential and gives students opportunities to experience clinical reasoning and practice clinical skills when interacting with patients. Students encounter patients in different contexts throughout their education. However, looking across the research providing evidence about learning related to patient-student encounters reveals a lack of knowledge about the actual learning process that occurs in encounters between patients and students. The aim of this study was to explore patient-student encounters in relation to students' learning in a patient-centered health-care setting.

    METHODS: An ethnographic approach was used to study the encounters between patients and students. The setting was a clinical education ward for nursing students at a university hospital with eight beds. The study included 10 observations with 11 students and 10 patients. The observer followed one or two students taking care of one patient. During the fieldwork observational and reflective notes were taken. After each observation follow-up interviews were conducted with each patient and student separately. Data were analyzed using an ethnographic approach.

    RESULTS: The most striking results showed that patients took different approaches in the encounters with students. When the students managed to create a good atmosphere and a mutual relationship, the patients were active participants in the students' learning. If the students did not manage to create a good atmosphere, the relationship became one-way and the patients were passive participants, letting the students practice on their bodies but without engaging in a dialogue with the students.

    CONCLUSIONS: Patient-student encounters, at a clinical education ward with a patient-centred pedagogical framework, can develop into either a learning relationship or an attending relationship. A learning relationship is based on a mutual relationship between patients and students resulting in patients actively participating in students' learning and they both experience it as a joint action. An attending relationship is based on a one-way relationship between patients and students resulting in patients passively participating by letting students to practice on their bodies but without engaging in a learning dialogue with the students.

  • 46.
    Manninen, Katri
    et al.
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics.
    Welin Henriksson, Elisabet
    Department of Neurobiology, Karolinska Institutet; Care Sciences and Society.
    Scheja, Max
    Department of Education, Stockholm University.
    Silén, Charlotte
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics.
    Patients' approaches to students' learning at a clinical education ward: an ethnographic study2014Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, artikel-id 131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: It is well known that patients' involvement in health care students' learning is essential and gives students opportunities to experience clinical reasoning and practice clinical skills when interacting with patients. Students encounter patients in different contexts throughout their education. However, looking across the research providing evidence about learning related to patient-student encounters reveals a lack of knowledge about the actual learning process that occurs in encounters between patients and students. The aim of this study was to explore patient-student encounters in relation to students' learning in a patient-centered health-care setting.

    METHODS: An ethnographic approach was used to study the encounters between patients and students. The setting was a clinical education ward for nursing students at a university hospital with eight beds. The study included 10 observations with 11 students and 10 patients. The observer followed one or two students taking care of one patient. During the fieldwork observational and reflective notes were taken. After each observation follow-up interviews were conducted with each patient and student separately. Data were analyzed using an ethnographic approach.

    RESULTS: The most striking results showed that patients took different approaches in the encounters with students. When the students managed to create a good atmosphere and a mutual relationship, the patients were active participants in the students' learning. If the students did not manage to create a good atmosphere, the relationship became one-way and the patients were passive participants, letting the students practice on their bodies but without engaging in a dialogue with the students.

    CONCLUSIONS: Patient-student encounters, at a clinical education ward with a patient-centred pedagogical framework, can develop into either a learning relationship or an attending relationship. A learning relationship is based on a mutual relationship between patients and students resulting in patients actively participating in students' learning and they both experience it as a joint action. An attending relationship is based on a one-way relationship between patients and students resulting in patients passively participating by letting students to practice on their bodies but without engaging in a learning dialogue with the students.

  • 47.
    Meurling, Lisbet
    et al.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Anaesthesia & Intens Care, SE-14186 Stockholm, Sweden.
    Hedman, Leif
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Orthopaed & Biotechnol, SE-14186 Stockholm, Sweden.
    Lidefelt, Karl-Johan
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Paediat, SE-14186 Stockholm, Sweden.
    Escher, Cecilia
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Anaesthesia & Intens Care, SE-14186 Stockholm, Sweden.
    Fellander-Tsai, Li
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Orthopaed & Biotechnol, SE-14186 Stockholm, Sweden.
    Wallin, Carl-Johan
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Anaesthesia & Intens Care, SE-14186 Stockholm, Sweden.
    Comparison of high- and low equipment fidelity during paediatric simulation team training: a case control study2014Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, s. 221-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: High-fidelity patient simulators in team training are becoming popular, though research showing benefits of the training process compared to low-fidelity models is rare. We explored in situ training for paediatric teams in an emergency department using a low-fidelity model (plastic doll) and a high-fidelity paediatric simulator, keeping other contextual factors constant. The goal was to study differences in trainees' and trainers' performance along with their individual experiences, during in situ training, using either a low-fidelity model or a high-fidelity paediatric simulator.

    Methods: During a two-year period, teams involved in paediatric emergency care were trained in groups of five to nine. Each team performed one video-recorded paediatric emergency scenario. A case control study was undertaken in which 34 teams used either a low-fidelity model (n = 17) or a high-fidelity paediatric simulator (n = 17). The teams' clinical performances during the scenarios were measured as the time elapsed to prescribe as well as deliver oxygen. The trainers were monitored regarding frequency of their interventions. We also registered trainees' and trainers' mental strain and flow experience.

    Results: Of 225 trainees' occasions during 34 sessions, 34 trainer questionnaires, 163 trainee questionnaires, and 28 videos, could be analyzed. Time to deliver oxygen was significantly longer (p = 0.014) when a high-fidelity simulator was used. The trainees' mental strain and flow did not differ between the two types of training. The frequency of trainers interventions was lower (p < 0.001) when trainees used a high-fidelity simulator; trainers' perceived mental strain was lower (< 0.001) and their flow experience higher (p = 0.004) when using high-fidelity simulator.

    Conclusions: Levels of equipment fidelity affect measurable performance variables in simulation-based team training, but trainee s' individual experiences are similar. We also note a reduction in the frequency of trainers' interventions in the scenarios as well as their mental strain, when trainees used a high-fidelity simulator.

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  • 48. Muntean, Valentin
    et al.
    Calinici, Tudor
    Tigan, Stefan
    Fors, Uno G. H.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för data- och systemvetenskap.
    Language, culture and international exchange of virtual patients2013Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 13, s. 21-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Language and cultural differences could be a limiting factor for the international exchange of Virtual Patients (VPs), especially for small countries and languages of limited circulation. Our research evaluated whether it would be feasible to develop a VP based educational program in our Romanian institution, with cases in English and developed in a non-Romanian setting. Method: The participants in the research comprised 4th year Romanian medical students from the Faculty of Medicine in Cluj-Napoca, Romania, with previous training exclusively in Romanian, good English proficiency and no experience with VPs. The students worked on eight VPs in two identical versions, Romanian and English. The first group (2010) of 136 students worked with four VPs developed in Cluj and the second group (2011) of 144 students with four VPs originally developed at an US University. Every student was randomly assigned two different VPs, one in Romanian and another in English. Student activity throughout the case, the diagnosis, therapeutic plan and diagnosis justification were recorded. We also compared student performance on the two VPs versions, Romanian and English and the student performance on the two sets of cases, originally developed in Romania, respectively USA. Results: We found no significant differences between the students' performance on the Romanian vs. English version of VPs. Regarding the students' performance on the two sets of cases, in those originally developed in Romania, respectively in the USA, we found a number of statistically significant differences in the students' activity through the cases. There were no statistically significant differences in the students' ability to reach the correct diagnosis and therapeutic plan. Conclusion: The development of our program with VPs in English would be feasible, cost-effective and in accordance with the globalization of medical education.

  • 49.
    Nesterowicz, Krzysztof
    et al.
    Jagiellonian University.
    Librowski, Tadeusz
    Jagiellonian University.
    Edelbring, Samuel
    Karolinska Institutet.
    Validating e-learning in continuing pharmacy education: user acceptance and knowledge change2014Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, nr 33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Continuing pharmacy education is becoming mandatory in most countries in order to keep the professional license valid. Increasing number of pharmacists are now using e-learning as part of their continuing education. Consequently, the increasing popularity of this method of education calls for standardization and validation practices. The conducted research explored validation aspects of e-learning in terms of knowledge increase and user acceptance.

    Methods

    Two e-courses were conducted as e-based continuing pharmacy education for graduated pharmacists. Knowledge increase and user acceptance were the two outcome measured. The change of knowledge in the first e-course was measured by a pre- and post-test and results analysed by the Wilcoxon signed–rank test. The acceptance of e-learning in the second e-course was investigated by a questionnaire and the results analysed using descriptive statistics.

    Results

    Results showed that knowledge increased significantly (p < 0.001) by 16 pp after participation in the first e-course. Among the participants who responded to the survey in the second course, 92% stated that e-courses were effective and 91% stated that they enjoyed the course.

    Conclusions

    The study shows that e-learning is a viable medium of conducting continuing pharmacy education; e-learning is effective in increasing knowledge and highly accepted by pharmacists from various working environments such as community and hospital pharmacies, faculties of pharmacy or wholesales.

  • 50.
    Nesterowicz, Krzysztof
    et al.
    Department of Radioligands, Medical College, Faculty of Pharmacy, Jagiellonian University, Poland.
    Librowski, Tadeusz
    Department of Radioligands, Medical College, Faculty of Pharmacy, Jagiellonian University, Poland.
    Edelbring, Samuel
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Validating e-learning in continuing pharmacy education: user acceptance and knowledge change2014Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, nr 33, artikel-id 33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Continuing pharmacy education is becoming mandatory in most countries in order to keep the professional license valid. Increasing number of pharmacists are now using e-learning as part of their continuing education. Consequently, the increasing popularity of this method of education calls for standardization and validation practices. The conducted research explored validation aspects of e-learning in terms of knowledge increase and user acceptance.

    Methods

    Two e-courses were conducted as e-based continuing pharmacy education for graduated pharmacists. Knowledge increase and user acceptance were the two outcome measured. The change of knowledge in the first e-course was measured by a pre- and post-test and results analysed by the Wilcoxon signed–rank test. The acceptance of e-learning in the second e-course was investigated by a questionnaire and the results analysed using descriptive statistics.

    Results

    Results showed that knowledge increased significantly (p < 0.001) by 16 pp after participation in the first e-course. Among the participants who responded to the survey in the second course, 92% stated that e-courses were effective and 91% stated that they enjoyed the course.

    Conclusions

    The study shows that e-learning is a viable medium of conducting continuing pharmacy education; e-learning is effective in increasing knowledge and highly accepted by pharmacists from various working environments such as community and hospital pharmacies, faculties of pharmacy or wholesales.

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