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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
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: 2019-11-20Bibliographically 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
Identifiers
urn:nbn:se:hig:diva-31142 (URN)10.1016/j.nedt.2019.104262 (DOI)31759243 (PubMedID)2-s2.0-85075214841 (Scopus ID)
Available from: 2019-11-28 Created: 2019-11-28 Last updated: 2019-12-03Bibliographically 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
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: 2019-09-26Bibliographically approved
Forsman, H., Inger, J., Leksell, J., Lepp, M., Sundin Andersson, C., Engström, M. & Nilsson, J. (2019). Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students. Journal of Advanced Nursing
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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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed) Epub ahead of print
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, 2019
Keywords
cluster analysis, nursing education, nursing students, professional competence, questionnaires, self-assessment, survey
National Category
Nursing
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: 2019-11-22Bibliographically 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
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: 2019-10-11Bibliographically 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: 2019-11-25Bibliographically 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
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: 2019-11-29Bibliographically 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: 2019-10-07Bibliographically approved
Löfmark, A., Mårtensson, G., Ugland Vae, K. J. & Engström, M. (2019). Lecturers' reflection on the three-part assessment discussions with students and preceptors during clinical practice education: A repeated group discussion study. Nurse Education in Practice, 36, 1-6
Open this publication in new window or tab >>Lecturers' reflection on the three-part assessment discussions with students and preceptors during clinical practice education: A repeated group discussion study
2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 36, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Assessment of students' learning and achievement requires active involvement of participating students, preceptors and lecturers. The lecturers have overall responsibility for both the content of the assessment and students' learning. The aim of the present study was to investigate lecturers' reflections on the mid-course discussion and final assessment that are part of nursing students' clinical practice education. The design was descriptive and had a qualitative approach. Repeated group discussions were undertaken with 14 lecturers at two university campuses in Norway. Five categories were identified: preparing for the three-part discussion, creating a collaborative atmosphere, facilitating student learning, verifying student learning, using the assessment tool to create the assessment discussion; one theme emerged: ‘being able to see and justify students’ learning processes'. Lecturers' reflections on both assessment discussions and students' learning proceeded from a clear pedagogical viewpoint.

Keywords
Assessment, Clinical practice education, Nursing student, Preceptor, University lecturer
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-29404 (URN)10.1016/j.nepr.2019.02.010 (DOI)000470041900001 ()30826626 (PubMedID)2-s2.0-85062689814 (Scopus ID)
Projects
AssCEVFU
Note

Funding:

- University of Gavle, Sweden- Western Norway University of Applied Sciences, Norway

Available from: 2019-03-27 Created: 2019-03-27 Last updated: 2019-08-12Bibliographically approved
Lian, Z., Skytt, B., Li, C. & Engström, M. (2019). Nursing students’ reflections on caring for end-of-life patients in a youth volunteer association. Nurse Education in Practice, 34, 204-209
Open this publication in new window or tab >>Nursing students’ reflections on caring for end-of-life patients in a youth volunteer association
2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 34, p. 204-209Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to describe nursing students' reflections on caring for end-of-life patients in a youth volunteer service. A purposive sample of 11 nursing students in one province in China were interviewed and diaries were collected. The data were analysed using qualitative content analysis. The students described the service as “an empowering care that makes a difference – but not without challenges on different levels”. The service was said to provide devoted caring adjusted to the person's need, condition and wishes. According to the students, the service had an impact on them; the internal and/or external support was stimulating and rewarding, whereas deficient support was frustrating and made them feel helpless. They emphasized the need for improvements at different levels. In conclusions, the youth volunteer service empowers both patients and students and can be seen as person-centred care. The students' professional knowledge, skills and ability improved, while these aspects were still perceived as deficient. Appropriate curriculum and training for nursing students are necessary and should be tailored to improving students' caring ability and confidence. Expanding the service was emphasized and suggestions for improvements were identified.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
End-of-life care, Nursing students, Nursing education, Reflections, Volunteers
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-29036 (URN)10.1016/j.nepr.2018.12.006 (DOI)000459841600031 ()30605789 (PubMedID)2-s2.0-85059225110 (Scopus ID)
Note

Funding:

- Lishui University- University of Gävle 

Available from: 2019-01-03 Created: 2019-01-03 Last updated: 2019-10-11Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9912-5350

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