Extensive research shows nurses’ work environment to be particularly stressful. This study develops, explores, and psychometrically tests a new profession-specific questionnaire identifying generalised and specific resistance resources, that make it possible to measure resources to manage work-related stress. An exploratory study design was employed. The questionnaire development was inspired by the MEASURE approach and the salutogenic theory of health. Building on the results from a literature review of nursing research and salutogenesis, supplemented by twelve interviews with hospital nurses, an item pool was generated. The first version was pilot-tested in a group of nurses who were studying to become specialist nurses. The second version of the questionnaire was psychometrically tested on a sample of registered nurses in close patient care (n = 475), analysed using confirmatory factor analysis to test seven predefined domains of the questionnaire. The analysis revealed a first order seven-domain model of 21 items: job satisfaction, professional role, work motivation, commitment, belonging in the workplace, factors and conditions for remaining in the profession, and workload. The structure of the questionnaire indicates its usefulness in clinical practice for measuring resistance resources.

En studie visar att handledarmodellen Patientnära Lärande är ett enkelt pedagogiskt verktyg som fungerar som en form av byggnadsställning som stödjer studentens lärande, underlättar självhjälp och professionsutveckling vid verksamhetsförlagd utbildning för sjuksköterskestudenter.

Verksamhetsförlagd utbildning i sjuksköterskeprogrammet ger studenterna en möjlighet att applicera teoretiska kunskaper i praktiken och kan på så sätt skapa en förståelse över hur de fungerar i verkliga vårdsituationer. Det är inte bara ett tillfälle att lära sig yrkeskunskaper, utan även att uppleva arbetsplatsens kultur, dynamik inom och mellan yrkesgrupper samt de krav som ställs på vårdpersonalen. Det är en tid av utmaningar, upptäckter och ibland även överraskningar, men framför allt en ovärderlig erfarenhet som förbereder studenterna för det kommande yrket. I ett samarbete mellan vårdpersonal, huvudhandledare, kliniska adjunkter samt studenter från sjuksköterskeprogrammet vid Högskolan Väst, utformades en studentcentrerad handledingsmodell baserad på patientnära lärande för att säkra kvalitén under den verksamhetsförlagda utbildningen. Handledningsmodellen har använts under fyra år och har introducerats på flera vårdavdelningar vid Norra Älvsborgs sjukhus och testas nu inom kommun och primärvård.

Handledningsmodellen Patientnära Lärande är baserad på Cajverts beskrivning av interaktivt lärande och fokuserar på hur handledaren kan stödja studenterna att reflektera över sitt lärande. Modellens innehåll baseras på de lärandemål som ingår i kursplanen för den kurs som studenten deltar i. Ett specifikt verktyg som ingår i handledningsmodellen är Gibbs’ reflektionscykel, vilket kan ses som ett ramverk för lärandet. Att jobba utifrån handledningsmodellen innebär att i stället för att endast följa handledarens direkta arbete följer och ansvarar studenten för den valda patienten och dennes vård under den tid patienten finns i verksamheten. Antalet patienter som studenten ansvarar för ökar över tid samt utifrån studentens erfarenhet och lärandeprocess. Då studenten inte är knuten till en specifik handledare utses en sjuksköterska som huvudansvarig handledare. Varje students lärande följs via dokument som förvaras i en personlig pärm (kan också vara elektronisk) tillsammans med kursens lärandemål, läraktiviteter och förväntad kunskapsutveckling. Studentens lärande diskuteras och dokumenteras, tillsammans med en handledare, varje dag. Handledningsmodellen är både uppgift- och processorienterad där det ingår att regelbundet reflektera över sitt lärande. Modellen kan med fördel kombineras med kollaborativ lärande som exempelvis modellen Peer Learning.

Den aktuella studien syftade till att beskriva studenternas erfarenheter av lärande med stöd av modellen under deras VFU. Studien hade en kvalitativ beskrivande design där tolv semistrukturerade intervjuer genomfördes med studenter. Datamaterialet analyserades genom induktiv kvalitativ innehållsanalys med fokus på både det manifesta och latenta innehållet i studenternas utsagor.

Studiens resultat visade att studenternas erfarenheter av att arbeta med handledningsmodellen var generellt positiva. De uppgav att modellen var lätt att förstå, tillgänglig, tydlig och gav en bra struktur att följa. Resultatet visade även att studenterna erfor en personlig-, kunskaps- och professionell utveckling under den praktiska utbildningen. Handledningsmodellen främjade studenternas utveckling mot en professionell identitet och de beskrev att de hade fått insikter om sjuksköterskans arbete, ansvar samt vikten av teamsamverkan. Handledningsmodellens uppgift var att stimulera varje students lärande och förmågan att skapa vårdrelationer, förberedelser inför det kommande yrket. Studenternas lärande utvecklades genom träning som involverade dagligt arbete, ansvar, reflektion, kritiskt tänkande och samarbete med andra yrkesgrupper. Resultatet visade att handledningsmodellen är ett enkelt pedagogiskt verktyg som fungerar som en form av byggnadsställning som stödjer studentens lärande, ett stöd som underlättar självhjälp, och är en viktig del i den professionella utvecklingen.  När studenten har förmåga att agera självständigt i olika vårdsituationer och etablering av en professionell identitet har utvecklats, behövs inte längre byggnadsställningen. Studenternas lärande kunde därmed ses som en process och där byggnadsställningen successivt togs bort i takt med studenternas ökade kunskap och förmåga att agera självständigt och skapa en professionell identitet.

I resultatet framkom att handledningsmodellen, tillsammans med aktiva handledare, säkerställde att studenterna uppnådde kursens lärandemål samt skapade en pedagogisk lärandemiljö. Studenterna kände sig trygga, trodde mer på sig själva och upplevde att de tog mer ansvar för sitt eget lärande och sina handlingar. Genom att arbeta med instruktionerna som finns i pärmen, var det lättare för studenterna att förstå hur de skulle översätta lärandemålen till praktiskt arbete med patienten. I stället för specifika insatser under arbetsdagen fick studenterna skapa en förståelse för patientens vård utifrån ett holistiskt perspektiv. Att vara delaktig och fokusera på patientens behov, var det mest effektiva sättet för studenterna för att utveckla kompetens i att ha ett etiskt förhållningssätt i mötet med patienten och att utveckla en professionell identitet. Handledningsmodellen var ett stöd för studenterna att medvetandegöra sin lärandeprocess, då lärandet startade från studenten själv. De visste vad som förväntades. Lärandet följdes upp regelbundet och planerades på ett strukturerat sätt med hjälp av studentpärmen där studenterna och handledare gjorde anteckningar och skrev ner reflektioner från dagens vårdaktiviteter. Handledningsmodellen gynnar verksamheterna eftersom ansvaret för studenternas handledning och utveckling fördelas på fler personer. På så sätt minskar sårbarheten om någon handledare inte finns till hands vid till exempel sjukdom.

De utmaningar som studenterna uppgav var kunskapsbristen om handledningsmodellen hos nyanställda sjuksköterskor med handledarfunktion. I dessa fall undervisade studenterna om hur modellen skulle användas för de nyanställda handledarna.

Att bli medveten om sin lärandeprocess kan ses som en framgångsfaktor för studenterna Det blir tydligt att verksamhetsförlagd utbildning inte bara är en del av utbildningen utan även en kunskapstrappa mot det framtida yrket.

Objective

The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.

Design

The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors.

Setting

Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers. Participants Of 2283 students, 851 (37.3%) participated.

Results

The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11.

Conclusions

The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students’ health and well-being in the long run.

Clinical placement constitutes a significant part of developing a professional identity and an essential bridge to future professional work as a registered nurse (Vabo et al., 2021). In traditional supervision in Sweden, the student follows the workplace supervisor, where the focus is on teacher-driven learning (Hellström-Hyson et al., 2012), or student-driven such as peer learning (Jassim et al., 2022). Due to high staff turnover, there is a need to develop pedagogical supervision models that are sustainable over time. Therefore, a student-centered model was developed in collaboration between healthcare staff, hospital educators, university teachers and nursing students, to ensure the quality of clinical placement for students.

The Student-Centered Supervision Model

The supervision model is based on Cajvert’s (2021) description of integrated learning and focuses on how the workplace supervisor can help students reflect on their work. The content of the model is based on the learning objectives specified in the curriculum of the nursing student’s course. Gibbs’ (1988) reflective cycle model is included to stimulate each student’s ability to create care relationships and be prepared for the future profession by training responsibility, reflection, critical thinking, and cooperation. The supervision model implies that instead of merely following the workplace supervisor’s work, students follow the selected patient's care trajectory during their clinical placement. The number of patients for which they are responsible increases over time. While the student is not connected to one workplace supervisor, one nurse is assigned as the main supervisor. Each student's learning is followed via documents stored in a personal folder outlining their expected development. During the week, each student's learning is documented together with a workplace supervisor.

Theoretical Framing

According to the sociocultural perspective (Vygotsky, 1978), the learning process requires communication, interaction, reflection and meaning-making to be successful. The clinical environment connects and encourages learning for a future professional function. According to Zegwaard et al. (2023) work-integrated learning can be defined as an educational approach in which the student, educational institution and an external stakeholder are included and where experiences are developed in the organization as part of the program syllabus. The student's learning takes place through active engagement together with purposeful work tasks. This allows the integration of theory with meaningful practice relevant to the student's professional development.

Aim

This study aimed to describe nursing students’ experiences of learning with the student-centered supervision model based on patient-oriented care during their clinical placement.

Primary care needs to find strategies to deal with today’s societal challenges and continue to deliver efficient and high-quality care. Employee-driven innovation is increasingly gaining ground as an accessible pathway to developing successful and sustainable organisations. This type of innovation is characterised by employees being engaged in the innovation process, based on a bottom-up approach. This qualitative study explores employees’ experiences of employee-driven innovation at a primary care centre in Sweden. Data are collected by focus group interviews and analysed by inductive qualitative content analysis. The result is presented with the overarching theme “Standing together at the helm” followed by three categories: “Motivating factors for practising employee-driven innovation”, “Challenges in practising employee-driven innovation” and “Benefits of employee-driven innovation”, including nine subcategories. The study found that employee-driven innovation fosters organisational innovation, empowers employees, and enhances adaptability at personal and organisational levels. This enables individual and collective learning, and facilitates the shaping, development, and adaptation of working methods to meet internal and external requirements. However, new employees encountered difficulty grasping the concept of employee-driven innovation and recognising its long-term advantages. Additionally, the demanding and task-focused environment within primary care posed challenges in sustaining efforts in innovation work. The employees also experienced a lack of external support to drive and implement some innovative ideas.

AIM: This study aimed to explore nursing personnel's health while working in end-of-life care.

INTRODUCTION: End-of-life care is challenging both for nursing personnel and for the healthcare organisation, as retaining nursing staff is difficult. Although end-of-life care involves the risk of burnout, it also encompasses protective factors that can lead to personal and professional development and satisfaction, and that can enable personnel to encounter their own inner selves. In order to focus on the health of nursing personnel we chose the theory of caritative caring as our theoretical perspective.

METHOD: A qualitative inductive research design with a hermeneutical approach was chosen to explore nursing personnel's health while working in end-of-life care. Two assistant nurses and six registered nurses with experience in end-of-life care at a palliative care unit participated. The study was approved by a Regional Ethical Review Board.

RESULTS: The results are presented on three levels: rational, structural and existential. In the rational level, fellowship and togetherness with colleagues, as well as being able to distinguish between private life and work were important for nursing personnel's strategies for maintaining their health. At the structural level, social togetherness, sharing emotions and being involved in each other's emotions were important for nursing personnel's health. The existential level showed that the nursing personnel's own existential situation was affected when their inner self was emotionally affected by the patients' suffering. The awareness of suffering, life and death made the nursing personnel feel inner security, both as nursing professionals and as human beings.

CONCLUSION: A common perspective based on a theory of caritative care may be helpful for retaining nursing personnel. While the study highlights nursing personnel's health while working in an end-of-life care context, the results may also be applicable to nursing professionals' health in other contexts.

Purpose

To meet future healthcare needs, primary care is undergoing a transformation in which innovations and new ways of working play an important role. However, successful innovations depend on joint learning and rewarding collaborations between healthcare and other stakeholders. This study aims to explore how learning develops when entrepreneurs, healthcare professionals and older people collaborate in a primary care living lab.

Design/methodology/approach

The study had an action research design and was conducted at a clinically embedded living lab at a primary care centre on the west coast of Sweden. Data consisted of e-mail conversations, recordings from design meetings and three group interviews with each party (entrepreneurs, healthcare professionals and older people). Data were analysed with inductive qualitative content analysis.

Findings

An overarching theme, “To share each other’s worlds in an arranged space for learning”, was found, followed by three categories, “Prerequisites for learning”, “Strategies to achieve learning” and “To learn from and with each other”. These three categories comprise eight subcategories.

Originality/value

This research contributes to knowledge regarding the need for arranged spaces for learning and innovation in primary care and how collaborative learning can contribute to the development of practice.

The nursing profession is close to clinical practice and vital to the student’s professional development. Innovative learning activities and models are sought to improve clinical placements. A student-centered supervision model based on patient-oriented care was introduced in a medical ward. The aim of this study was to describe nursing students’ experiences of learning with a student-centered supervision model based on patient-oriented care during their clinical placement. A qualitative descriptive study involving interviews with 12 nursing students analyzed through inductive qualitative content analysis was conducted in accordance with COREQ. The findings revealed that the nursing students viewed learning as personal, knowledge, and professional development. Their learning experiences can be seen as a process in which the scaffolding is gradually reduced in line with each student’s ability to act independently and establish a professional identity. The model can enhance structure and support in the practice setting to maximize learning.

Nursing education and the nursing profession have an artisanal character, which has dominated the profession for a long time. Work-integrated learning in nursing education means that theoretical studies are integrated with a clinical placement. The aim of the study was to describe how nursing students experience work-integrated learning in nursing education. The study has a qualitative descriptive design. Qualitaitive content analysis was used and the analysis focused on both the manifest and latent content of the material. The analysis resulted in the theme Sustainable learning during education and for the future profession as a nurse, revealing students' experiences of work-integrated learning during their education. The categories Different methods, Collaboration and Bringing the parts together as a whole constitute the integrated learning process during the education and depend on each other for increased understanding. When the students practice their theoretical knowledge in the clinical placement, work-integrated learning can facilitate them to bring the parts together as a whole, thus giving them an opportunity to enhance their learning process and develop professional skills.