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Forsman, H., Inger, J., Leksell, J., Lepp, M., Sundin Andersson, C., Engström, M. & Nilsson, J. (2020). Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students. Journal of Advanced Nursing, 76(1), 199-208
Open this publication in new window or tab >>Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students
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2020 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, no 1, p. 199-208Article in journal (Refereed) Published
Abstract [en]

Aims

To identify clusters based on graduating nursing students’ self‐reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students’ perceptions of overall quality of the nursing programme and students’ general self‐efficacy.

Design

A cross‐sectional study combining survey data and results from a national examination.

Methods

Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self‐Efficacy scale and results from the National Clinical Final Examination. A Two‐Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.

Results

Three clusters were identified illustrating students’ different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self‐assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.

Conclusion

The study illustrates how nursing students’ self‐assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self‐evaluation is a key learning outcome and is, in the long run, essential to patient safety.

Impact

The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self‐efficacy lower than other students. The findings illuminate the need for student‐centered strategies in nursing education, including elements of self‐assessment in relation to examination to make the students more aware of their clinical competence.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
cluster analysis, nursing education, nursing students, professional competence, questionnaires, self-assessment, survey
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-30691 (URN)10.1111/jan.14222 (DOI)000492752500001 ()31576579 (PubMedID)2-s2.0-85074600928 (Scopus ID)
Projects
NPC gruppen
Note

Funding information: The study was supported by research allocations from the authors’ universities and a scholarship from the The Swedish Society of Nursing named ‘The Alice Lindström Scholarship’.

Available from: 2019-09-25 Created: 2019-09-25 Last updated: 2020-02-17Bibliographically approved
Lindberg, M., Carlsson, M., Engström, M., Kristofferzon, M.-L. & Skytt, B. (2020). Nursing student's expectations for their future profession and motivating factors - a longitudinal descriptive study from Sweden. Nurse Education Today, Article ID 104218.
Open this publication in new window or tab >>Nursing student's expectations for their future profession and motivating factors - a longitudinal descriptive study from Sweden
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2020 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, article id 104218Article in journal (Refereed) Published
Abstract [en]

Background

The shortage of registered nurses is a global concern. Motives to become registered nurses can be to help others, altruism, personal development and career security. Motives in combination with student expectations regarding the role are not explored.

Objective

To describe students' motives to become registered nurses and their expectations regarding their future profession.

Design

A longitudinal descriptive design with a qualitative approach was used to follow nursing students in the beginning, during and at the end of their education.

Participants and setting

A purposive sampling of a group with initially 75 students starting a three-year nursing program at a university in Sweden.

Methods

A study specific questionnaire with open-ended questions was used in the beginning, during and the end of the students' education. At data collection two and three, a copy of the earlier answers was attached. Data were analysed using manifest and latent content analysis.

Results

An important profession with career opportunities, interesting duties and team work were described. Students expected diversified duties, possibilities for development and work satisfaction. Increased concerns regarding their upcoming work life was described at the end of the education.

Conclusion

The students had a positive understanding of the profession and perceived their forthcoming role as interesting. The leading role of coordinating patient care was more comprehensive than expected. Supportive conditions and well planned transition periods could strengthen newly graduated nurses in their professional role and could be an important aspect in the future retention of RNs.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Expectations, Longitudinal qualitative study, Nursing students, Professional role
National Category
Health Sciences Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-30703 (URN)10.1016/j.nedt.2019.104218 (DOI)31698292 (PubMedID)
Available from: 2019-09-27 Created: 2019-09-27 Last updated: 2020-03-05Bibliographically approved
Dahlkvist, E., Engström, M. & Nilsson, A. (2020). Residents’ use and perceptions of residential care facility gardens: a behavior mapping and conversation study. International Journal of Older People Nursing, 15(1), Article ID e12283.
Open this publication in new window or tab >>Residents’ use and perceptions of residential care facility gardens: a behavior mapping and conversation study
2020 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 15, no 1, article id e12283Article in journal (Refereed) Published
Abstract [en]

Aim

To describe the gardens and their use by individuals living at residential care facilities (RCFs) with high ratings on restorative values.

Background

Being outdoors has been described as important to older people's well‐being. Use of outdoor gardens may increase residents’ well‐being through experiences of restorative qualities such as being away and fascination. Thus far, there has been little research on restorative experiences of gardens in the care of older people.

Design

A descriptive design using behaviour mapping observations integrated with qualitative field notes and recorded conversations.

Methods

A criterion sampling of two gardens (out of a total of 87) was made based on residents’ ratings of restorative values; the two with the highest values were chosen. Eleven residents at the two RCFs took part. Data were collected through behaviour mapping observations, field notes and conversations on five occasions in the respective facilities during residents’ visits to the garden.

Results

The observations revealed that the main uses of the gardens were to socialise and relax. The conversations also showed that the garden stimulated residents’ senses and evoked memories from the past. These restorative values were interpreted as a sense of being away and fascination. Not having opportunities for outdoor visits was reported to result in disappointment and reduced well‐being.

Conclusions

The findings showed that two basic gardens with different characteristics and views could stimulate residents’ senses and evoke memories from the past; this supports the call for residents to be able to spend time in gardens to promote their well‐being.

Implications for practice

First‐line managers, nurses and healthcare staff in the care of older people should consider that regular opportunities to spend time outdoors may promote older people's well‐being through feelings of being away and fascination.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
behaviour mapping, gardens, health, nurses, older people, residential facilities
National Category
Gerontology, specialising in Medical and Health Sciences Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-30724 (URN)10.1111/opn.12283 (DOI)000513523300001 ()2-s2.0-85074755895 (Scopus ID)
Note

Funding: Faculty of Health and Occupational Studies, University of Gävle

Available from: 2019-10-03 Created: 2019-10-03 Last updated: 2020-03-05Bibliographically approved
Engström, M., Högberg, H., Strömberg, A., Hagerman, H. & Skytt, B. (2020). Staff working life and older persons' satisfaction with care: a multilevel, correlational design. Journal of Nursing Care Quality
Open this publication in new window or tab >>Staff working life and older persons' satisfaction with care: a multilevel, correlational design
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2020 (English)In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care.

PURPOSE: The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care.

METHODS: A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care.

RESULTS: Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment.

CONCLUSIONS: Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.

Keywords
elderly care, empowerment, job satisfaction, nurses, quality of care
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-31975 (URN)10.1097/NCQ.0000000000000463 (DOI)32079960 (PubMedID)
Available from: 2020-03-02 Created: 2020-03-02 Last updated: 2020-03-02Bibliographically approved
Zhu, L., Lian, Z. & Engström, M. (2020). Use of a flipped classroom in ophthalmology courses for nursing, dental and medical students: A quasi-experimental study using a mixed-methods approach.. Nurse Education Today, 85, Article ID 104262.
Open this publication in new window or tab >>Use of a flipped classroom in ophthalmology courses for nursing, dental and medical students: A quasi-experimental study using a mixed-methods approach.
2020 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 85, article id 104262Article in journal (Refereed) Published
Abstract [en]

Background

Traditional teaching is associated with dilemmas, such as low motivation to learn and passive learning. In contrast, use of a flipped classroom with the proper learning design has the potential to promote accelerated learning, bolster transmission of competencies (i.e., critical thinking, communication and problem-solving skills) and improve teamwork capacity, all of which are of great significance in professional healthcare practice, including nursing, dentistry and medicine.

Objective

The aim of the study was to examine the effects of using a flipped classroom in ophthalmology courses for undergraduate nursing students, dental students and higher vocational medical students.

Design

A quasi-experimental design was used with an intervention (n = 100) and a comparison group (n = 100), pre-/post-testing measures and a mixed-methods approach.

Setting

A university in China.

Participants

A total of 200 students were included.

Methods

Students' self-rated learning ability was measured before and after the courses, and skill exams were performed after the courses. In addition, interviews were conducted with the clinical medical students concerning their experiences of the flipped classroom.

Results

Students' self-rated learning ability improved significantly more in the intervention than in the comparison group, for the total scale and the three factors ‘learning goals’, ‘self-efficacy and social learning’ and ‘problem-solving’. Skill exam scores were statistically significantly better in the intervention than in the comparison group. On the whole, the clinical medicine students felt the flipped classroom had a positive impact and improved their learning ability as well as knowledge in ophthalmology.

Conclusions

Use of a flipped classroom for nursing, dental and clinical medical students in ophthalmology courses shows promising results in the form of students' skill exam scores and self-rated learning ability.

Keywords
Dental students, Flipped classroom, Medical students, Nursing students, Ophthalmology
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-31142 (URN)10.1016/j.nedt.2019.104262 (DOI)000513989200012 ()31759243 (PubMedID)2-s2.0-85075214841 (Scopus ID)
Available from: 2019-11-28 Created: 2019-11-28 Last updated: 2020-03-05Bibliographically approved
Pålsson, Y., Mårtensson, G., Engström, M., Hellström-Hyson, E. & Leo Swenne, C. (2019). An intervention study on peer learning. In: : . Paper presented at 2019 NET Conference, 3-5 September, Keele University, UK.
Open this publication in new window or tab >>An intervention study on peer learning
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2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-30688 (URN)
Conference
2019 NET Conference, 3-5 September, Keele University, UK
Available from: 2019-09-24 Created: 2019-09-24 Last updated: 2020-03-02Bibliographically approved
Jarnulf, T., Skytt, B., Mårtensson, G. & Engström, M. (2019). District nurses experiences of precepting district nurse students at the postgraduate level. Nurse Education in Practice, 37, 75-80
Open this publication in new window or tab >>District nurses experiences of precepting district nurse students at the postgraduate level
2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 37, p. 75-80Article in journal (Refereed) Published
Abstract [en]

District nurses are preceptors of district nurse students at the postgraduate level. These district nurse students are already registered nurses who have graduated and are now studying to become district nurses; this training is at the postgraduate level. As preceptors at the postgraduate level, district nurses play an important role in helping these students to achieve the learning outcomes of the clinical practice part of their education. However, there is a lack of studies on precepting at this level. Thus, the aim was to describe district nurses' experiences of precepting district nurse students at the postgraduate level. The study was descriptive in design and used a qualitative approach. Purposive sampling was used and nine district nurses from seven primary health care units in Sweden were interviewed. Data were analysed using qualitative content analysis. An overall theme ”Fluctuating between transferring knowledge and striving for reflective learning” and two subthemes emerged. The preceptors’ views on precepting and performance varied depending on the situation. The conclusions is that given the current learning outcomes for clinical practice education at the postgraduate level, district nurses need to bemore influenced by preception focused on reflective learning.

Keywords
Clinical practice education, District nurses, Postgraduate level, Preceptor
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-29626 (URN)10.1016/j.nepr.2019.05.004 (DOI)000473840000011 ()31128519 (PubMedID)2-s2.0-85066121129 (Scopus ID)
Note

Funding: 

- University of Gävle

Available from: 2019-06-01 Created: 2019-06-01 Last updated: 2020-02-10Bibliographically approved
Strömberg, A., Engström, M., Hagerman, H. & Skytt, B. (2019). First-line managers dealing with different management approaches. Leadership in Health Services, 32(4), 543-557
Open this publication in new window or tab >>First-line managers dealing with different management approaches
2019 (English)In: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 32, no 4, p. 543-557Article in journal (Refereed) Published
Abstract [en]

Purpose – The purpose of this paper is to contribute new knowledge about how first line managers (FLMs) in elderly care perceive their situation, with a focus on differences in management approaches at the intersection of the central and local parts of the organization.

Design/methodology/approach – The present study has a qualitative approach and is part of a larger project on FLMs in elderly care. The results presented here are based on a secondary analysis of 15 of the totalof 28 interviews carried out in the project.

Findings – Themain results are twofold: the majority of FLMs perceived differences in management approaches between local and central management; the differences caused some struggle because FLMs perceived that the management system did not support the differences. The two main aspects that caused the FLMs to struggle were differences in the foci of the management levels and difficulties in influencing the conditions ofmanagement.

Originality/value – The results contribute to the debate on what aspects are important to sustainable management of elderly care. It is common knowledge that FLMs have a complex position, intermediate to the central, upper level management and their subordinates at the local level – levels with different foci and interests. The study contributes new knowledge about what these differences consist of and the dilemmas they cause and offers suggestions as to what can be done to reduce both energy waste and the risk of low job satisfaction.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2019
Keywords
Leadership, Elderly care, Management, Value-orientation, First-line manager, Production-orientation
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-25926 (URN)10.1108/LHS-09-2018-0046 (DOI)000491144600004 ()31612787 (PubMedID)2-s2.0-85070257920 (Scopus ID)
Projects
B-LONG
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2020-01-29Bibliographically approved
Hagerman, H., Engström, M., Wadensten, B. & Skytt, B. (2019). How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective?: An interview study. Journal of Nursing Management, 27(6), 1208-1215
Open this publication in new window or tab >>How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective?: An interview study
2019 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1208-1215Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The work situation for first-line managers in elderly care is complex and challenging. Little is known about these managers' work situation from a structural and psychological empowerment perspective.

AIM:

To describe first-line managers' experiences of their work situation in elderly care from a structural and psychological empowerment perspective.

METHOD:

Interviews from 14 female first-line managers were analysed using qualitative content analysis.

RESULTS:

The theme described the managers' work situation as "It's not easy, but it's worth it." In the four subthemes, the managers described their work in terms of "Enjoying a meaningful job," "A complex and demanding responsibility that allows great authority within set boundaries," "Supported by other persons, organisational preconditions and confidence in their own abilities" and "Lacking organisational preconditions, but developing strategies for dealing with the situations."

CONCLUSION:

The managers described having various amounts of access to structural empowerment and experienced a feeling of meaning, competence, self-determination and impact, that is, psychological empowerment in their work.

IMPLICATIONS FOR NURSING MANAGEMENT:

It is vital that first-line managers have access to organisational support. Therefore, upper management and first-line managers need to engage in continuous dialogue to customize the support given to each first-line manager.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
elderly care; empowerment; first-line manager; structures of proportions; work situation
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-29363 (URN)10.1111/jonm.12793 (DOI)000486018500019 ()31102540 (PubMedID)2-s2.0-85072508669 (Scopus ID)
Funder
AFA Insurance
Available from: 2019-03-08 Created: 2019-03-08 Last updated: 2020-02-17Bibliographically approved
Kaltenbrunner, M., Mathiassen, S. E., Bengtsson, L. & Engström, M. (2019). Lean maturity and quality in primary care. Journal of Health Organisation & Management, 32(2), 141-154
Open this publication in new window or tab >>Lean maturity and quality in primary care
2019 (English)In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 32, no 2, p. 141-154Article in journal (Refereed) Published
Abstract [en]

Purpose - The purpose of this paper is to 1) describe Lean maturity in primary care using a questionnaire based on Liker’s description of Lean, complemented with observations, and 2) determine the extent to which Lean maturity is associated with quality of care measured as staff-rated satisfaction with care and adherence to national guidelines. High Lean maturity indicates adoption of all Lean principles throughout the organization and by all staff.

Design/methodology/approach - Data were collected using a survey based on Liker’s four principles, divided into 16 items (n = 298 staff in 45 units). Complementary observations (n = 28 staff) were carried out at four units.

Findings - Lean maturity varied both between and within units. The highest Lean maturity was found for ‘adhering to routines’ and the lowest for ‘having a change agent at the unit’. Lean maturity was positively associated with satisfaction with care and with adherence to national guidelines to improve healthcare quality. 

Practical implications - Quality of primary care may benefit from increasing Lean maturity. When implementing Lean, managers could benefit from measuring and adopting Lean maturity repeatedly, addressing all Liker’s principles and using the results as guidance for further development.

Originality/value - This is one of the first studies to evaluate Lean maturity in primary care, addressing all Liker’s principles from the perspective of quality of care. The results suggest that repeated actions based on evaluations of Lean maturity may help to improve quality of care.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2019
Keywords
healthcare, Lean principles, Liker, observations, qualitative
National Category
Other Health Sciences
Identifiers
urn:nbn:se:hig:diva-26374 (URN)10.1108/JHOM-04-2018-0118 (DOI)000463633800002 ()30950305 (PubMedID)2-s2.0-85060950444 (Scopus ID)
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2020-01-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9912-5350

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