Background: Recently, all medical universities in Sweden jointly developed a framework for Entrustable Professional Activities (EPAs) for work-based training and assessment. This framework is now being introduced nationally in thenew 6-year undergraduate medical programme that directly lead to a licence to practise. When EPAs are introduced,it is of central importance to gain clinical supervisors’ acceptance to apply the framework in their supervision ofstudents. The aim of this study was therefore to investigate how clinical supervisors, not familiar with EPAs, experienceclinical supervision using the framework for EPAs.

Methods: We used a purposive sampling to recruit clinical supervisors. They were given written information on EPAswith a selection of suitable EPAs and the Swedish observation rating scale for assessment of autonomy, and theywere offered to attend a 30-minute introductory web course. The participants were informed that EPAs were to betested, and the students were asked to participate. After the study period the clinical supervisors participated in semistructured interviews. Inductive qualitative content analysis was used to analyse the transcribed interviews.

Results: Three general themes emerged in the qualitative analysis: Promoting Feedback, Trusting Assessmentsand Engaging Stakeholders. The participants described benefits from using EPAs, but pointed out a need forpreparation and adaptation to facilitate implementation. The structure was perceived to provide structured supportfor feedback, student involvement, entrustment decisions, enabling supervisors to allow the students to do morethings independently, although some expressed caution to rely on others’ assessments. Another concern waswhether assessments of EPAs would be perceived as a form of examination, steeling focus from formative feedback.To understand the concept of EPA, the short web-based course and written information was regarded as sufficient.However, concern was expressed whether EPA could be applied by all clinical supervisors. Involvement and adaptionof the workplace was pointed out as important since more frequent observation and feedback, with documentationrequirements, increase the time required for supervision. 

Conclusions EPAs were accepted as beneficial, promoting structured feedback and assessments of the students’autonomy. Preparation of supervisors and students as well as involvement and adaptation of the workplace waspointed out as important.

There is increased interest in understanding how sociotechnical systems can be conceptualized beyond corporate-customer service relationships. Digital ecosystems support flexible, fluid interaction, enabling participation and engagement. In the context of societal integration, these systems can create inclusiveness and ultimately contribute to a more sustainable society. To obtain these benefits, we argue that sociotechnical systems must be deliberately and responsibly designed and that such an approach needs to be integrated into the training of future designers. This paper draws on the Nordic sociotechnical approach to design and theories on digital ecosystem. Building on a qualitative case study on integration and language learning, involving students as designers, we discuss three existing principles of sustainable digital ecosystems: part-of-ness; systemic wisdom and; information ecology. The paper contributes an extended understanding of the design of sustainable sociotechnical ecosystems and a discussion of the role of students in the design.

Today’s working life faces a major ongoing transformation characterised by increased complexity and specialisation of work and conditions for lifelong learning. This requires competencies beyond traditional theoretical knowledge, including the ability to prepare for uncertainty and unknown outcomes. Therefore, involving students in work-integrated learning (WIL) and learning how to learn for lifelong learning is essential. At University West in Sweden, educational programs are WIL-based and developed in collaboration with strategic partners to provide a relevant and attractive range of programs and courses. In this study, we argue that it is a shared responsibility for academia and business organisations to collaboratively develop innovative approaches to working and learning to secure a future workforce ready for a complex working life and continuous competence development. The purpose of the study is to identify and provide knowledge underpinning the understanding and application of WIL in higher education and working life. The goal is to develop a framework that supports key stakeholders in understanding, designing and applying WIL. Findings from this study suggest that the collaboration between teachers, partners, and students can be strengthened by a quality framework supporting the planning, implementation, reflection and improvement of WIL-based education and competence initiatives. The main contribution of the paper is a nuanced description of WIL conceptualizations along with a multi-perspective approach, bringing multiple perspectives into the development and application of WIL. It also highlights how a framework based on these foundations can support quality development and enhance the application of WIL in higher education and working life.

Demographic changes with an elderly population and more patients living longer with chronic illnesses will result in an increased need for care (OECD/EuropeanUnion 2022, Maresova et al. 2019). Remote patient monitoring (RPM), which allows patients to monitor their health and medical conditions from locations outside of healthcare, such as at home, is one example of a new digital service intended to simplify for patients, nurses, and other health professionals. RPM can broadly be defined as the use of digital technology (apps, sensors, wearables) that enables people to monitor their health and well-being automatically,systematically, and over time – for example, aspects like diet, exercise, sleep, mood,blood pressure and heart rate (e.g., Feng et al. 2021, Azevedo, Rodrigues & Londral2021).

RPM aims at enhancing patients' quality of life through self-care and active participation while also optimizing healthcare resource utilization by reducing in-person visits and hospital admissions. However, there is a lack of evidence of patient benefit and risks (Vallo Hult et al. 2023), and more research is needed regarding how RPM affects clinical practice and how healthcare professionals perceive its impact on their work (Černá 2019;, Vallo Hult et al. 2019; Islind et al.2022).

In this study, we focus on how nurses' work is changed by RPM. In their professional development, it is mandated that nurses should develop the ability to use digital technology in the care of patients, like remote care (Asthma, Allergy,and COPD Nurses Association, 2015). Previous research has identified and outlined challenges and essential knowledge for the digitalization of healthcare, highlighting the need for more research on learning, collaboration and competence development (Svensson 2019;, Vallo Hult et al. 2020; Svensson & Vallo Hult 2022), especially regarding nurses continuous professional development, and what role collegial and collaborative learning and knowledge sharing have for this learning (Khademi et al. 2021, Mlambo, Silén & McGrath 2021).

The aim of this paper is to investigate barriers and opportunities of RPM in relation to nurses’ working, collaborating and learning. The study is guided by the following research question: What are the implications of RPM on nurses’ work, collaboration and learning?

BACKGROUND: The forced transition to emergency remote teaching (ERT) during the COVID-19 pandemic has significantly impacted health professions education worldwide. In Sweden, the need for alternative solutions for the training of junior doctors became urgent, as many of the mandatory onsite courses required for residents to qualify as specialists were canceled. The purpose of this study was to understand course leaders' perceptions and experiences of using digital technologies, such as video conferencing, to teach medical residents (ST) during the pandemic and beyond.

METHODS: A qualitative study using semi-structured interviews was conducted with seven course leaders responsible for residency courses during the first year of the pandemic to capture their perceptions and experiences. The interviews were transcribed verbatim and analyzed using thematic analysis, drawing on the technology affordances and constraints theory (TACT) as a framework to explore pedagogical strategies and new teaching practices emerging from the forced use of digital technologies for remote teaching.

RESULTS: The data analysis revealed affordances of, as well as constraints to, teaching specialist medical training during the pandemic. The findings show that the use of digital conference technologies for ERT can both enable and inhibit social interactions, the interactive learning environment and the utilization of technological features, depending on the individual course leaders' goals of using the technology and the situated context of the teaching.

CONCLUSIONS: The study reflects the course leaders' pedagogical response to the pandemic, as remote teaching became the only way to provide residency education. Initially, the sudden shift was perceived as constraining, but over time they found new affordances through the enforced use of digital technology that helped them not only to cope with the transition but also to innovate their pedagogical methods. After a rapid, forced shift from on-site to digital courses, it is crucial to utilize experiences to create better preconditions for digital technology to facilitate learning in the future.

Background

In Region Västra Götaland (VGR), the development of remote patient monitoring is given high priority, aiming for improvements for patients and reduction of healthcare costs. In this report we defined remote patient monitoring as continuous follow-up of relevant health-related parameters of patients located outside healthcare facilities (e.g. at home). Measurements taken by analogue or digital devices, objective and/or subjective assessments, are delivered digitally to the patient and to a healthcare professional. The healthcare professional provides the patient with feedback on the reported data (feedback may be automatically generated if data are within a predefined range). The plan in VGR is to introduce remote monitoring in selected diagnosis groups – some of which already started using remote monitoring.

Aim

The aim of this report was to provide an overview of systematic reviews regarding remote monitoring(as add on or replacement of visits in current standard of care) compared to standard of care in 25 selected diagnosis groups.

Method

In order to clarify how remote monitoring is intended to be used in the 25 diagnosis groups, representatives from the respective clinical areas were interviewed. As the scope of this project covered many diagnosis groups, the search was limited to systematic reviews (SRs) of randomised (RCTs) or non-randomised clinical trials. The relevance of each identified SR for our PICO(Population, Intervention, Comparator and Outcomes) was assessed by at least two project members (one clinical representative and one from HTA-centrum). Relevant SRs were assessed by at least two project members using SNABBSTAR, a tool developed by The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) for assessment of risk of bias/systematic errors in SRs. The tool consists of six steps and assessment of an SR is stopped as soon as the criteria for a specific level are not met.

The steps are: 1. Definition of PICO and literature search; 2. Inclusion/exclusion according to PICO, listing of included studies; 3. Risk of bias assessments; 4. Evidence synthesis/meta-analyses; 5. Certainty of evidence consideration; 6. Documentation of excluded studies, conflicts of interest, and an a priori published SR protocol.

SNABBSTAR evaluates how useful an SR is by assessing the methodology used in the SR. In the current project, SRs reaching at least SNABBSTAR level 4 were considered to provide relevant data synthesis. As reaching SNABBSTAR level 5 or 6 is considered necessary for reliable conclusions, we cited key conclusions only from SRs reaching these levels. We did not extract any data from the included SRs.ResultsThe literature search resulted in 3,332 hits. Of these, 279 were read in full text to assess their relevance for the PICO. Seventy-five SRs were considered relevant and were included; these were assessed by SNABBSTAR. 

Through a literature review in combination with qualitative analysis of course evaluations, this study examines aspects that contribute to enhancing elearning for physicians in a residency education program. The literature review and the qualitative analysis outline three main factors (pedagogical, technological, and organizational), highlighting the importance of a holistic approach that includes learning and technology in context when integrating e-learning strategies in adult learning programs. The findings contribute insights and practical guidance for education organizers on how to conduct e-learning during and after the pandemic.