Author: Imane Elonen

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Nurse Educator Education Project experiences

Student online mentoring

Authors: Professor Leena Salminen, Project researcher Imane Elonen

Empowering the Nurse Educators in the Changing World –study programme was developed, as a first step towards joint nurse educator education in Europe. During our educator education programme a great variety of distance teaching and learning methods were used to give participants equal opportunities to participate and enable self-directiveness at the same time. This called a great amount of support and mentoring for the students during the studies. In our project we think mentoring as partnership which contains authentic communication, enriching support, sharing knowledge (Busby et al., 2023) and supervising the studies.

Definition, content and forms of mentoring

Mentoring has been found to be an important thing to adapt new faculty to teaching and socialize them to the academic community (Webber et al., 2020). Mentoring contributes to career development through a continuous learning process and support for role development (Costa & Smith, 2023). Mentoring is often defined as a relationship between a more experienced mentor and a less experienced mentee for the purpose of supporting the mentee’s competence and career (Busby et al, 2022), but it is also considered as a support and guidance during the studies and career development (van Dongen et al., 2023.).

Mentoring can have different forms, e.g. formal mentoring, where mentors are assigned to mentees; informal mentoring, based on social attraction between the mentee and mentor; peer mentoring and group mentoring, where multiple mentors support the mentee (Busby et al., 2022). For novice nurse educator entering in nursing education without guidance and support, the transition can be frustrating and lead to career dissatisfaction. Mentoring can be one of the most important things for the successful learning process and also transition to academia, inspiring confidence in new nurse educators. Therefore, we aimed to mentor our student during the nurse educator education program.

Student online mentoring was activity conducted during the whole study programme “Empowering the nurse educators in the changing world”. Mentoring included guiding and instructing the students in the use of the learning environment, helping the students to access the study materials and tasks and supporting to use and utilize the technical solutions and applications used. Also, the educator professional development and career was discussed. The more experienced participants mentored and guided the less experienced participants. The participants wrote the learning diary to reflect their experiences and what they have learnt.

Elements of mentoring

Mentoring in the study programme consisted of three main elements. Techinical support and practical information, online mentoring with the study programme content and learning process, and on-site mentoring during the Empowering Learning Environments in Nursing Education (ELENE) intensive week and teacher training week during Evidence-Based Teaching (EBT) study unit. Technical support and practical information, and online mentoring with the study programme content and learning process was ongoing throughout the whole study programme. On-site mentoring occurred during the two week long on-site studying and training.

Technical support

Technical support and practical information started already before the study programme started, with preparation of material for students, who come from different backgrounds and countries. Written instructions with informative images were prepared, to ease the enrollment process and access of the digital environment and resources. Furthermore, after the enrollment, students received also one on one guidance via phone, e-mail and video conferencing tools, in case they had trouble accessing the learning platform or finding necessary materials or resources there. In addition, students could approach one of the instructors throughout the study programme. There were various instructors conducting mentoring during the study programme, but there was one instructor from University of Turku, assigned to keep in touch with the students throughout the whole 10-month programme. Students could self-determine the means they contacted the instructors, phone, e-mail or video conferencing. The learning platform news was utilized often, and instructors forwarded information and reminders about the learning tasks and deadlines and practical arrangements of the studies and travels.

Online mentoring

Similarly, as technical and practical support, online mentoring with the study programme content and learning process started already before the study programme started. Students who pondered participation and their own abilities to complete the study programme or some of the units, were guided and informed about the requirements and content of the study programme. The mentoring of the studies, started already on the second week of the programme, during ELENE online teaching. All students were invited to a video conferencing, should they need guidance in their group work. This was repeated also on the third week after a request from the students. Furthermore, guided group work was utilized in almost all of the study units.

In ELENE and Global Health Issues, there were two sessions of guided group work, and in Issues in Future Nurse Education (IFNE) and Ethics and Nurse Educators’ Work (ENEW) there were weekly online guided group work sessions. In addition, two study units, EBT and ENEW had a question hour. In EBT the question hour was about the practical and theoretical content and requirements of the teacher training, in ENEW the students had an opportunity to ask questions about the content of the study unit from an ethics expert.

Online mentoring was utilized also for preparation of the on-site elements of the programme. Before ELENE, students received information and instructions about practical arrangements. Communication was frequent, as the ongoing Covid-19 pandemic and constantly changing restrictions and travel requirements caused plenty of uncertainty. Students received information and guidance about anything and everything related to traveling to Turku in the after waves of the global pandemic. Before EBT teacher training, the students had several online meetings with the receiving universities. They were guided in their preparations for the teacher training and presentations and teaching sessions that were expected from them during the training week, as well as practical issues about travel and accommodation, including frequent weather broadcasts and assurance the people coming from warmer climate would cope in the winter of the colder climate countries.

On-site mentoring

On-site mentoring, lasted for the two weeks students were visiting the organizing universities. On-site mentoring during ELENE was guided group works and helping students to find places where they needed to be. During EBT teacher training, on-site mentoring varied from place to place, as each and every receiving university had created individual programmes, based on the training opportunities and schedules and local expertice. Study visits were arranged in all of the universities to different collaboration partners and some extra curricular activities were also arranged to make the students feel welcome and give them opportunity to get familiar with the culture they were visiting. Students were also offered guidance during their learning tasks and the instructors in the universities shared their own experiences and expertise with the students.

Summary

Mentoring, during the Empowering the Nurse Educators in the Changing World study programme was successful, as majority of the students completed the study units they started, which is positive considering that online education has usually high dropout rates (Wang et al., 2019). During the study programme, the mentoring was seen as an ongoing process rather than a designed task. The mentors were available and listened to the students, and the structure of the guidance was altered based on feedback from the students. The regular availability of the mentors and guidance for social interaction, may have improved the completion rate. (Wang et al., 2019.) Furthermore, mentoring was not limited to instructors mentoring the students, but the students stated learning from each other’s experiences and expertice as well.

References

Busby, K.R., Draucker, C.B., Reising, D.L., 2022. Exploring mentoring and nurse faculty: an integrative review. J. Prof. Nurs. 38, 26–39. https://doi.org/10.1016/j. profnurs.2021.11.006

Busby, K.R., Draucjer, C.B., & Reising D.L. 2023. Mentoring-as-Partnership: The Meaning of Mentoring Among Novice Nurse Faculty. Journal of Nursing Education 62 (2), 83-88. DOI: 10.3928/01484834-20221213-03

Costa CB., & Smith JE. 2023. Career Satisfaction and Advancement Related to Mentorship Experiences of Underrepresented Nursing Faculty.Nurse Education Perspective 44(5), 291-294 doi: 10.1097/01.NEP.0000000000001173

van Dongen, L.J.C., Leino-Kilpi H., Jónsdóttir, H.J., Meyer, G., Henriques, M.A., Schoonhoven, L., Suhonen, R., & Hafsteinsdóttir, T.B. 2023. The experiences of doctorally prepared nurses and doctoral nursing students with being mentored in the Nurse-Lead programme: A focus group study. Nurse Education in Practice, epub. https://doi.org/10.1016/j.nepr.2023.103744

Wang, W., Guo, L., He, L., & Wu, Y. J. (2019). Effects of social-interactive engagement on the dropout ratio in online learning: insights from MOOC. Behaviour & Information Technology, 38(6), 621-636.

Webber, E., Vaughn-Deneen, T., & Anthony, M. 2020. Three-Generation Academic Mentoring Teams – A New Approach to Faculty Mentoring in Nursing. Nurse Educator 45(4), 210-213. DOI: 10.1097/NNE.000000000000077

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Importance of Close Proximity International Collaboration and Conferences

We were all students once and we know what we liked about education, various methods, and teachers’ approaches and attitudes. As teachers, we use this experience and knowledge whether we realise it or not. In addition to the formal and widely used teaching strategies, we often act intuitively using our own ideas, techniques, and strategies When we share this information and when we say things aloud, we realise that other teachers use similar ideas, techniques, and strategies and adapt them to new situations. Together we can develop them, give them names, and thus make them part of formal education. One sentence activates another, which makes us see things in new perspectives. New ideas occur, and changes are made because everything is constantly in motion. Despite or thanks to the spatial distance and cultural differences, we produce better ways and solutions in our mission to improve nurse educator education, and thus care for patients.

This suggests the importance of collaboration between teachers, nurses, and scientists locally, nationally, and internationally. International collaboration in this project includes participation in classes, group meeting, workshops, seminars, and conferences. Both face-to-face and online meetings allow sharing the ideas, motivations, experiences, rationale, study results, strengths and limitations, and challenges and suggestions for the future. Various backgrounds of the participants are a great asset and enrichment for the development of ideas and achieving common goals.

Furthermore, international collaboration is important because health-related beliefs and needs may vary in patients who come from different backgrounds, cultures, or countries. The project activities, such as designing teaching plans, problem solving, writing papers, and exploring other issues draw attention also to those particularities.

Proximity means nearness or closeness in distance or time. We have become close not only in time and (online) space but also in our eagerness to learn new things, broaden our horizons and improve nurse educator education through open cross-border interaction.

The authors of the blog are (from left to right):

Tomas Sollar, Andrea Solgajová, Ľuboslavá Pavelova and Dana Zrubcova from Constantine the Philosopher University in Nitra, Slovakia.

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Mapping and Modeling for Themes or How to Make Sense of your Data

“To make the invisible more visible to others, is after all, a major goal of the interpreter”

(Denzin 2010: 32).

A blog post from Susanne Kean. The University of Edinburgh.

Mapping or modelling is one way of making the invisible more visible to the researcher and, eventually, to the reader of research.  Mapping or modelling are data analysis techniques that come into play after the first round of analysis. These techniques can be used independent of methodology.  To explain this technique, I will draw on Thematic Analysis (TA) and coding.

Coding, of course, is only one way of analysing data and not THE way.  Coding originates in Grounded Theory but is today used well beyond this methodology. TA is an example where coding is used as an analytical device.  A code, Saldaña (2021) proposes, “is most often a word or short phrase that symbolically assigns a summative, saline, essence-capturing, and/or evocative attribute for a portion of language-based or visual data” (p5). In other words, it is shorthand for data content, and this could be a word or a line or a paragraph.

Now, coding is only the beginning of data analysis, and yes, coding is analysis.  In conversations with others (and specifically research students), I often get the impression that coding is thought of as a mechanistic devise to somehow sort data.  However, how we sort data demands thinking and analysis. Coffey and Atkinson capture this beautifully when they remind us that: 

“First, coding links different segments or instances in the data. We bring those fragments of data together to create categories of data that we define as having some common property or element. The coding thus links all those data fragments to a particular idea or concept.

The important analytic work lies in establishing and thinking about such linkages, not in the mundane process of coding.

We use the data to think with, in order to generate ideas that are thoroughly and precisely related to our data. Coding can be thought about as a way of relating our data to our ideas about those data.

In practice, coding can be thought of as a range of approaches that aid organization, retrieval, and interpretation of data” (Coffey & Atkinson 1996:27).

Coding, and thus analysis of data, is an iterative process.  I am a Grounded Theorist by training and background and so am very familiar with the cycles of coding from open coding to focused coding to developing categories and eventually one or two core categories. A core category is nothing more, or less, than the main story in a data set. Whether we call this a core category, or a theme is neither here nor there but simply a differed terminology depending on the approach one takes. In TA, this would be called a theme. My point here is that coding, and thus analysis, evolves from a descriptive level to an abstract level of analysis. I agree with Thorne (2020) when she highlights that “finding themes” is too often declared as the end product of analysis when in reality, this is reflects nothing more than “surface-level considerations” of any given data set.  I am wary when I review articles where authors claim they found seven themes and 15 sub-themes.  This more often than not indicates nothing more than a data analysis that stopped at this surface-level describing data but not analysing them.

Analysis, as Flick points out “can be oriented to various aims. The first such aim may be to describe a phenomenon. Or the analysis could focus on comparing several cases (individual or groups) and on what they have in common, or on the differences between them.  The second aim may be to identify conditions on which such differences are based – which means looking for explanations for such differences.  The third aim may be to develop a theory of the phenomenon under study from that analysis of empirical material” (Flick 2023:385, Italics in original).

There is, of course, nothing wrong with description and descriptive studies have their place.  However, description remains on an inductive level of analysis, and this does not get us to themes.  To truly develop themes, we need abduction as analytical process.  It is this process that allows us to go beyond description to explanation and explore not only why somethings happens but also what is going on (Blaikie and Priest (2017).  

One way of developing an analysis beyond descriptions is mapping for themes.  This technique comes into paly after focused codes have been developed. So, not right at the beginning but at a stage where the analysist is thinking about the linkages between different codes and categories to develop themes.  Saldaña (2021) describes different ways one can develop themes through mapping. He distinguished between (1) theming data categorically and (2) theming data phenomenologically. I usually have the first approach of developing themes in mind when using modelling or mapping as a technique. This approach to data analysis allows the analyst to go beyond the descriptive coding schemes and include theoretical ideas/ concepts as they apply to the data.

Here is an example where we used modelling in a systemtic review exploring intensive care survivorship experiences.  

Kean S., Donaghy E., Bancroft A., Clegg G. & Rodgers S. (2021). Theorising survivorship after intensive care: A systematic review of patient and family experiences. Journal of Clinical Nursing, Open access.

At this stage of the analysis, we were thinking about the linkages and hierarchies of theoretical concepts in our data set.  Software packages, like NVivo, allow models to be “active” models, meaning one can play around with hierarchies and think through linkages with every change. Mapping alongside the developing analysis also functions as an audit trail of the data analysis and provides a structure for writing up at a later stage.

Analysis always requires the interaction with data, and this process of modeling allows the researcher to think theoretically about the data as well as deriving any ideas from the data because, as Atkinson (2015) argues “the end-point of analysis is not a knitting -together of coded themes” (p 62). It is this process that allows us to go beyond description to explanation and the process that too often is missing in much of qualitative work in nursing (Thorne 2020, Atkinson 2015).

In summary, mapping and modeling are data analysis techniques that are useful in developing analysis beyond description.  These techniques help analysts to think through linkages of codes and hence the interpretation of data.

References:

Atkinson P (2015) For Ethnography, SAGE, London

Blaikie, N & Priest, J (2017) Social research – paradigms in action, polity

Coffey A & Atkinson P (1996) Making sense of qualitative data, SAGE, Thousand Oaks

Denzin N (2010) The qualitative manifesto. Left Coast Press, Walnut Creek

Flick U (2023) An Introduction to Qualitative Research, 7th edition, SAGE, Los Angeles

Saldaña J (2021) The coding manual for qualitative researchers, 4th edition, SAGE, Los Angeles Thorne S (2020) Beyond theming: making qualitative studies count (editorial), Nursing Inquiry, 27: e12343, doi.org/10.1111/nin.12343

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Occupational wellbeing

Maintaining occupational well-being during a hectic project work

As the holiday is approaching its good to discuss a little bit about occupational well-being. Occupational well-being in education (we are in this project as nurse educators) can be considered to consist of working conditions, work community, worker’s recourses and work, and professional competence. Working conditions includes physical, biological and chemical factors ja occupational safety. Work community refers to management, the working atmosphere, collegiality, and appreciation. Worker’s resources and work means the health, physical and mental fitness, the workload and occupational health care services. Professional competence refers to education, continues professional development and different areas of competence. (Saaranen et al. 2020.)

And how these aspects are visible in educators work and in this case project workers? For example, ergonomic furniture and equipment have a great impact on our health and well-being during and after a working day. Biological factors, such as social isolation during COVID-19 pandemic have had its own influence on our well-being in many ways. Because of COVID-19, we were unable to organize the first Kick-of meeting, and the first face-to-face meeting moved on for a year. Nevertheless, our project started well, and the meeting was replaced by virtual meetings.

An appreciative and supportive atmosphere and collaborative management improves employee satisfaction in their work (Arian et al., 2018). Based on research we can say that educators in health care are feeling that they are respected, and they get help and support from their colleagues (Saaranen et al., 2021). One of the best contributions of this project has been an inclusive and conversational atmosphere. In addition to the numerous virtual meetings, we have been able to meet face to face and openly discuss matters that are important to us. The feeling of cohesion has been tangible and confirmed we want to continue work together after this project. The power of co-operation brings a great sense of well-being. In addition, the project includes employees from many different career stages, and this can be seen as a great richness. We have all heard that competence brings confidence, but the competence of a more experienced colleague also gives confidence to the less experienced.

Picture from NETNEP 2022 conference in Sitges, Spain. (From left: Professor Terhi Saaranen, University teacher Juha Pajari, Project researcher Anneli Vauhkonen)

On the other hand, the work of educator is very independent (Arian et al., 2018) and that is partially why we like this work. Working hours are flexible and we can influence our working schedule. However, this involves the reverse side of the coin. When we are experiencing the great engagement to work, we may forget to take breaks in our work. The educator’s work is often more mentally than physically demanding (Saaranen et al., 2020), and often the amount of work is felt too heavy (Rinne et al., 2022). The peaceful Christmas holiday in approaching, but often the time before the holidays can feel nerve-wracking. As we know the work of educator is pretty hectic before holidays (Saaranen et al., 2020) and this is true also in the project work. The deadlines are coming closer, and we have hurrying to do all the work we have promised to do. We almost wish that there should be more hours in one day or an extra day in a week. However, we should not belittle our need to recover from the strain of work. Recovery from work means the process when we reduce or eliminate the psychical or mental strain caused by work (Sonnentag, 2015). There must be sufficient recovery between working days; although one of them likes more regular working hours every day and the other one likes a more intensive work week with a longer return. The main thing is that there is enough recovery from the work. We know that exercise, a meaningful hobby, good nutrition, and adequate sleep promotes our recovery from work and thus our well-being.

Picture from Syöte 2022.

During busy days, it is good to consciously stop and think about the recovery from work during the working day. Recovery from work should start already during the working day and breaks are one of the most important ways to promote the recovery during the working day. By detaching ourselves from our work during the break and feeling that the break is meaningful is important for recovery and well-being (Virtanen et al., 2021). This can be for example something that we like to do, short walk outside, breathing or relaxing exercise (Rinne et al., 2020), or discussion (something else than work-related) with your colleague during your lunch break.

So we send a message to ourselves and to others: Take some time for yourself today, tomorrow and the coming weeks and do something relaxing in the middle of the day and between working days. By doing so, we can start our Christmas holiday with a better well-being and more relaxed. What could be your promise to yourself for the following year related to your well-being?

Anneli, Juha and Terhi

University of Eastern Finland, Department of Nursing Science

References:

Arian, M., Soleimani, M., & Oghazian, M. (2018). Job satisfaction and the factors affecting satisfaction in nurse educators: A systematic review. Journal of Professional Nursing, 34(5), 389–399. https://doi.org/10.1016/j.profnurs.2018.07.004

Rinne, J., Koskinen, S., Leino-Kilpi, H., Saaranen, T., & Salminen, L. (2021). Self-conductive interventions by educators aiming to promote individual occupational well-being—A systematic review. International Journal of Educational Research, 107, 101755–. https://doi.org/10.1016/j.ijer.2021.101755

Saaranen, T., Kankkunen, P., & Juntunen, A. (2020). Terveysalan opettajien työhyvinvointi ja sen edistäminen – työntekijän ja hänen työnsä näkökulma. (The status and promotion of the occupational well-being of health care teachers – the perspective of workers and their work.) Journal of Nursing Science, 32(3), 154–165. (Abstract in English)

Saaranen, T., Kankkunen, P., & Mönkkönen, A. (2021). Occupational wellbeing through community factors – questionnaire survey to health educators. (Työyhteisötekijöillä työhyvinvointia – kyselytutkimus terveysalan opettajille.) Tutkiva Hoitotyö, 19(3), 32–39. (Abstract in English)

Sonnentag, S., & Fritz, C. (2015). Recovery from job stress: the stressor‐detachment model as an integrative framework. Journal of Organizational Behavior, 36(1), 72–103. https://doi.org/10.1002/job.1924

Virtanen, A., Van Laethem, M., de Bloom, J., & Kinnunen, U. (2021). Drammatic breaks: Break recovery experiences as mediators between job demands and affect in the afternoon and evening. Stress and health : journal of the International Society for the Investigation of Stress, 37(4), 801–818. https://doi.org/10.1002/smi.3041

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Sharing knowledge among professionals

Nowadays knowledge and experience are considered to be significant assets for sustainable success of projects. Sharing them properly through appropriate examples, cases, and justification of successes or failures offers better estimation of the project efforts among the stakeholders.

The Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, Slovakia, organised a two-day International Symposium “Nursing of the 21st Century in the Process of Changes 2022” on 8 and 9 September 2022. The meeting of experts from the universities in the Czech Republic, Hungary, Poland and Slovakia brought many interesting and stimulating speeches focused on research findings and linking theory with practice.

On behalf of all the participants of the New Agenda for Nurse Educator Education in Europe Project, Andrea Solgajová, Dana Zrubcová and Ľuboslava Pavelová informed the professionals on the nature, structure and implementation of the project intentions. We clarified the Project evidence-based recommendations for health policy makers of all the European countries and the EHEA countries. We discussed on nurse educator education and possibilities of enhancing educators’ knowledge, skills and professionalism.

There was the fruitful discussion about education for nursing students and their equal possibilities for high-quality education in Europe. The attention was also drawn to the content and course of education in the five Project modules.

Sharing the Project experience and achieved knowledge gives a possibility for new collaborations and to become more efficient in the development of the field of nursing internationally. Therefore, it is important to share experiences, best practice, opinions and ideas with project managers.

All the discussion participants recognised the importance of developing pedagogical competence and enhancement of collaboration in educator education and training in the EU. They recognised the Project as an effective education programme for nurse educators reflecting on current changes in health care.

Authors: Ľuboslava Pavelová, Andrea Solgajová, Dana Zrubcová and Tomas Sollar from Constantine the Philosopher University in Nitra.

Categories
Nurse Educator Education

USING FILMS FOR TEACHING ETHICAL DILEMMAS IN NURSING EDUCATION

Authors of the blog:

Dr. Pilar Fuster-Linares

Dr. Leandra Martin Delgado

Dr. Laia Wennberg Capellades

From Universitat Internacional de Catalunya, Barcelona, Spain

The concept of ethical dilemmas has been broadly explored in nursing because of the prevalence of this dilemmas in daily practice (1,2). As nurses we understand the need and importance of having ethical standards in our profession. In 2021, the ICN reviewed and updated the Code of Ethics for Nurses, a statement of the ethical values, responsibilities and professional accountabilities of nurses that defines and guides ethical nursing practice. This document includes the changes that appear in the working environments and the new challenges and dilemmas that have appeared due to the COVID-19 pandemic (3).

Faced with these new elements and in order to show the essence of the ethics of care in the different professional roles, nursing educators must also be updated, not only in the content of the Code of Ethics, but also in the ways in which it is incorporated into nursing curricula.

Although ethical dilemmas are frequent in day-to-day life of the nursing professional, it is difficult for nursing students to identify situations potentially susceptible to be recognized as ethical dilemmas, due to their lack of knowledge of the professional role, their lack of clinical practice or even their lack of autonomy to make decisions in the clinical environment among others (4). For this reason, it is important to work on ethical dilemmas through methodologies that facilitate and stimulate reflection, but that in turn propose situations that students can understand and analyse even if they have not lived them.

Several studies have shown that education through films helps to improve teaching skills and stimulates learner reflection (5,6). Films could be considered as “the audio-visual version of storytelling (….) The cinema experiences act like emotional memories for developing attitudes and keeping them as reflective reference in the daily activities and events” (Blasco, P. et al Journal for Learning through the Arts, v22, n1,2015).

Image courtecy of Freepik Imagen de pch.vector

In our case, we incorporate the methodology of reflection through the cinema precisely to offer nurse educators the possibility of experiencing the possibilities of this methodology. We used the film Wit (2001), in which the leading actress Vivian (Emma Thopmson) shares her experience of illness with the viewer, and makes him a participant in her decisions, her experiences and her thoughts. Through the magic of the cinema, Vivian forces us to feel and be moved by her experience, and leads us to reflect on aspects of the nursing profession in a complex situation that is not always evident to us. But above all it allows us to do it from the perspective of the patient and through our own emotion, adding the value of the “experience” to something that priori, could be totally external to us.

This methodology allows us to empathize with the other from the safety of our home, it also allows us to live and relive those moments that cause us more doubt, more surprise or more indignation. We can analyse, dissect and reflect on what we see, but also on what makes us feel what we see, and that part of emotion, adds value to the learning experience, helping to develop concepts and to strongly record elements, in this case of professional ethics.

REFERENCES

1- Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461.

2- Koskimies, E., Koskinen, S., Leino‐Kilpi, H., & Suhonen, R. (2020). The informational privacy of patients in prehospital emergency care—Integrative literature review. Journal of Clinical Nursing, 29(23-24), 4440-4453.

3- Sperling, D. (2021). Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic. Nursing Ethics, 28(1), 9-22.

4- Albert, J. S., Younas, A., & Sana, S. (2020). Nursing students’ ethical dilemmas regarding patient care: An integrative review. Nurse Education Today, 88, 104389.

5- Blasco, P. G., Moreto, G., Blasco, M. G., Levites, M. R., & Janaudis, M. A. (2015). Education through Movies: Improving teaching skills and fostering reflection among students and teachers. Journal for Learning through the Arts, 11(1), n1.

6- Jerrentrup, A., Mueller, T., Glowalla, U., Herder, M., Henrichs, N., Neubauer, A., & Schaefer, J. R. (2018). Teaching medicine with the help of “Dr. House”. PLoS One, 13(3), e0193972

Categories
Nurse Educator Education Project experiences

Ethics and Nurse Educators’ Work – Utilising Case-studies in Ethics Education

Authors: Ľuboslava Pavelová, Constantine the Philosopher University in Nitra & Imane Elonen, University of Turku

“My first “gentle” touch with the subject of ethics was at the beginning of my Nursing studies in 1988 (I have a nostalgic smile on my face right now). Initially it was an uninteresting subject for me, based on theory and philosophy only and I couldn’t really understand.”

Ethics education, as all education, has traditionally been lecture based in all health sciences and in nursing. Furthermore, it was more focused on theoretical knowledge on philosophical base of ethics and learning the codes, rather than engaging in ethical problem solving or providing tools to do that. (Woods, 2005.)

“ Subsequently, as a nurse in clinical practice, I knew about the code of ethics, I respected the four main principles in the provision of nursing care and somehow intuitively solved ethical issues, dilemmas.”

Education in health sciences and ethics, has come a long way since and there is great amount of information on evidence based teaching in ethics. Problem based learning (PBL), Case based learning (CBL), simulations, games and others (Opsahl et al., 2020; Herron et al., 2019; Namadi et al., 2019; Srinivasan et al., 2007).

The study unit Ethics and Nurse Educators’ Work, which was the final of the five study units forming the Empowering Nurse Educators in the Changing World (ENEC) study programme organized by the Erasmus+ funded project “New Nurse Educator”, utilised case-studies as the method of teaching. Knowing the effectiveness of CBL (Herron et al., 2019; Namadi et al., 2019), the organizers wanted to ensure the participants don’t only learn ethics of nurse educators but may also rediscover the effectiveness and acceptability of CBL in ethics education.

CBL has its benefits in teaching ethics, especially in time constricted, fairly intensive study units, as the study units within the ENEC study programme (Herron et al., 2019; Namadi et al., 2019 Srinivasan et al., 2007). Compared to similarly effective method, PBL, CBL provides clearer structure and more streamlined approach, enabling students to reach conclusion with less time and effort, yet demanding them to develop their problem solving skills and engage in collaborative inquiry to reach their goal (Srinivasan et al., 2007). CBL has been proven an effective and preferable method in ethics education, and it equips the students with necessary problem solving skills (Namadi et al., 2019).

“Later, as a teacher, I introduced the students – future nurses to the moral, ethical requirements, rules, principles to be followed in the performance of daily nursing activities. Being “here” today in 2022 (I have a satisfactory smile on my face) I am at the end of graduating from the educational module “ethics and nurse educators work” within the Empowering the nurse educators in the changing world (ENEC) – study program. My role as a teacher enriched by the fact that the current, dynamically evolving time demands in the educational process to not only use the classical teaching methods, but also less traditional ones. Those that can inspire and make students to work independently, in finding appropriate solutions to ethical issues and dilemmas in diligence. “

In addition to traditional word based case scenarios, there are promising results, in utilising case videos, they may further enhance both learning and acceptability in students (Herron et al, 2019). The study unit “Ethics and Nurse Educators’ Work” was completed by majority of the registered students. The case studies were engaging and students represented their cases during the final webinar of the whole one-year ENEC programme, prompting fascinating and inspiring international discussions, which hopefully will inspire the educators and educator candidates further in their educator careers.

“I want to set my work to a new direction. I am empowered to promote a culture of ethical behaviour for students – future nurses. I am ready to talk to students about ethics and adherence to ethical principles, to encourage them to discuss their concerns about their ethical dilemmas without fear of retaliation. I support open and continuous communication between us and I want to act as a positive role model for them. Thank you for this opportunity!”

Srinivasan, M., Wilkes, M., Stevenson, F., Nguyen, T., & Slavin, S. (2007). Comparing problem-based learning with case-based learning: effects of a major curricular shift at two institutions. Academic Medicine, 82(1), 74-82.

Namadi F, Hemmati-Maslakpak M, Moradi Y, Ghasemzadeh N. The effects of nursing ethics education through case-based learning on moral reasoning among nursing students. Nurs Midwifery Stud 2019;8:85-90

Opsahl, A., Nelson, T., Madeira, J., & Wonder, A. H. (2020). Evidence‐Based, Ethical Decision‐Making: Using Simulation to Teach the Application of Evidence and Ethics in Practice. Worldviews on Evidence‐Based Nursing, 17(6), 412-417.

Herron, E. K., Powers, K., Mullen, L., & Burkhart, B. (2019). Effect of case study versus video simulation on nursing students’ satisfaction, self-confidence, and knowledge: A quasi-experimental study. Nurse education today, 79, 129-134.

Woods, M. (2005). Nursing ethics education: are we really delivering the good (s)?. Nursing ethics, 12(1), 5-18.

Categories
Nurse Educator Education

Crucial future issues in nursing curriculum and their implementation in Slovakia

The authors are: Dana Zrubcová, Andrea Solgajová, Ľuboslava Pavelová

Constantine the Philosopher University in Nitra, Slovakia

Contemporary society places high demands on abilities of individuals to work effectively with new information and information resources. Development of science and technology, fast pace in development of new technologies penetrates all areas and is becoming a part of our everyday life. Based on these dynamic changes in society, the necessity of fundamental change in the education system is crucial. Innovative education of nurses is the fundamental source of development in the field, quality of provided care and the patient’s satisfaction with the care provided. Mutual international cooperation and mobility of not only nurses but also the educators point out to the need of significant change in the education of nurses in Slovakia. Changing the traditional way of education as well as implementing the new and modern concept of teaching, plays the key role in the education of nurses in Slovakia.

One of the innovative methods is mobile learning, which is making learning outside of geographical barriers and time constrains possible. It ensures that students have access to various educational materials, with various context with different cultural and environmental cues that are necessary to understand the content. It also facilitates social interaction between students and teachers through mobile applications such as text messaging or tools for student reactions, assessment, and feedback from students. The necessity of implementing mobile education was also indicated by the pandemic situation, because of which it was necessary to move part of the teaching to the online space.

The advances of information technologies, such as mobile apps, offer attractive possibilities for designing more effective learning materials in multimedia environments that may encourage individualized learning and enable efficiency gains for learning achievement (Strandell-Laine et al., 2018).

The mobile apps provide an interactive and individualized opportunity to practice instructional procedures. The virtual reality, designed as structured learning experiences, can replicate high-risk clinical experiences for nursing students to practice skills repeatedly without putting patients at risk (Nielsen et al., 2020).

We see the implementation of simulation methods in the teaching process as an important teaching strategy for improving the quality of education of nurses. The use of simulation methods in teaching is attractive for students. It creates a space to apply theoretical knowledge and practical skills, develops students’ critical thinking and at the same time gives space for immediate feedback and teacher’s response. The simulation of real clinical cases improves mutual communication and enables practicing cooperation in a multidisciplinary team. Repeated opportunities to practice solving a clinical situation in a safe environment, creates space for learning and increases student confidence.

Another area in nurse education that requires change is the implementation of evidence-based teaching strategies. Most important is to apply this concept to the nurse education properly. To educate nurses, it is crucial to respect the four essential elements using evidence-based nursing: evidence, professional judgment, client values, and resource issues. In the current concept of nursers’ education, the prior focus is on promoting critical thinking and evidence-based teaching.

The main aim is to incorporate critical thinking and the concept of evidence-based teaching into teaching of future nurses how to make clinical decisions based on best and reliable evidence. When starting a work practice it is expected in nurses to provide nursing care as well as to be able to justify the reason for their choices and decisions. When making decisions in real life, nurses need critical thinking skills to generate alternatives and use evidence to select the best alternative to achieve specific client outcomes (Ferguson & Day, 2005).

Teaching research and conducting discussions about the credibility of evidence supported by research, is essential to gain the ability to implement evidence-based nursing in practice. Working with scientific databases represents yet another challenge for students of nursing. The support of the educators is particularly crucial at this point. The educator should play the role of a leader, give support, and encourage students to search evidence and find the best possible procedures in care. Part of the evidence-based nursing and nurse education is the acceptance of clients’ values, i.e., holistic care.

Finally, it is also the role of the nurse educator to guide students to be able to make clinical decisions based on resource allocation. After the introduction of the concept of evidence-based nursing and the need to teach future nurses to provide evidence-based nursing care, the question of the provided conditions and facilities for evidence-based nursing care education was raised. What is the acquired knowledge of the educators regarding the concept of evidence-based practice in education? Are these principles applied when curricula and strategies are created for the education of nurses based on the best possible evidence? Do educators use clinical judgment in adopting or adapting recommended practices according to specific situations, curricula, or students? Are students’ values taken into consideration when developing and implementing curriculum and strategies? Are educators considering the implications of applied evidence in education?

Nurse educators need to be trained to understand the benefits of the strategy and their potential impact on knowledge acquisition, such as critical thinking, decision making, and competencies that are essential for today’s nursing students (Breytenbach, ten Ham-Baloyi & Jordan, 2017). Terms and conditions in Slovakia suggest that it is necessary to retrain our educators in the concept of evidence-based education through workshops and/or compulsory training modules. Currently, there is a tendency to use the traditional way of education.

However, the new generation of students needs an innovative, trendy approach. Among other things, the overall population of students of nursing is becoming more and more diverse regarding cultural, social or value differences. It is also necessary to consider the generation gap between students and educators as a factor influencing the educational process. Promoting interaction between educators and students is essential and makes the process more effective and better. Nurse educators need to be urged to pay more attention to the process of assessment and the results in their education.

At the same time, the world is rapidly changing, including advances in science and technology, which points out to increasing demand in the education of future nurses regarding digital skills and competencies. Nursing students’ development is not only the basis for an effective digital transformation in education, but also boosts the graduates’ profile, and the graduate will be able to get involved in society successfully. It is important to incorporate digital learning technologies into education; social media into healthcare as well as simulation and mobile technology; and creation and evaluation of educational material. As an example, interesting models in education of nurses are social media such as blogs, Twitter, Instagram, Facebook, YouTube, Redit, Khan Academy, Pantoon, Canva, Mentimeter, Quizzis, Speaker, Flipgrit or games where they need to provide healthcare and improve their critical reflection, decision making skills, dialogue, and self-efficacy. International collaboration is essential for the digital transformation of nursing education.

At present, Slovakia and other European countries are struggling due to significant lack of nurses. The current situation creates constant pressure to increase the number of nurse graduates therefor the change in the education of nurses is a must. Let’s all support evidence-based nurse education together, so that the myth of ‘evidence-based practice’ becomes a reality under our own terms and conditions.

References

Breytenbach, C., ten Ham-Baloyi, W., & Jordan, P. J. (2017). An Integrative Literature Review of Evidence-Based Teaching Strategies for Nurse Educators. Nursing Education Perspectives, 38(4), 193-197. doi: 10.1097/01.NEP.0000000000000181

Draft Digital Transformation of Education Program in Slovakia and Action Plan for the period 2021-2024 Output from the national project “IT Academy – Education for the 21st Century”, Program_DT_vzdelavania_navrh_20201016-1.pdf

Ferguson, L., & Day, R. A. (2005). Evidence-based nursing education: Myth or reality? Journal of Nursing Education, 44(3), 107-115. doi:https://doi.org/10.3928/01484834-20050301-03

Nielsen, C. A. B., Lönn, L., Konge, L., & Taudorf, M. (2020). Simulation-based virtual-reality patient-specific rehearsal prior to endovascular procedures: A systematic review. Diagnostics, 10(7), 500.

Strandell‐Laine, C., Saarikoski, M., Löyttyniemi, E., Meretoja, R., Salminen, L., & Leino‐Kilpi, H. (2018). Effectiveness of mobile cooperation intervention on students’ clinical learning outcomes: A randomized controlled trial. Journal of advanced nursing, 74(6), 1319-1331.

Categories
Uncategorized

Building Bridges

Blog by Ľuboslava Pavelová, Andrea Solgajová, Dana Zrubcová

There are seven continents, almost two hundred countries, more than seven thousand languages, and almost eight billion people on our planet. There are so many differences in this world – abilities, past, nationalities, love, climate, music, beliefs, political situation, accents, moods, religions, technology, customs, foods, clothes, health, nature, experiences, infrastructure, feelings, values, traditions, colours, temptations, education, personalities, symbols, hopes, characteristics, art, social situation, lifestyles, health care, social classes, ambitions, services, professions, currencies, problems, architecture, families, transport, illnesses, behaviours, dreams, coping mechanisms, sports, attitudes, security, natural resources, day-to-day life, and many more.

Image: Joshua Woroniecki, Pixabay

Differences do not have to mean barriers. We do not need to change other people. Finding ways to each other is what matters. It does not take a lot – we just need to be open-minded, respect each other, and build more bridges and tear down walls.

Diversity makes the world and each of us unique. Diversity and uniqueness are enriching as they make our lives more interesting and colourful, and they enhance tolerance towards other people and their beliefs. We can learn from each other and make our lives more meaningful.

Health care, more than other areas of life, keeps showing us that we are all human beings, we are all the same in our essence. Taking care of and communicating with people from various backgrounds may be challenging – the differences in languages and health-related customs, beliefs and attitudes may cause many problems and treatment may become more time consuming. However, as nurses, we always try to find out what we have in common with other people, and how to help people who are ill, weak, helpless, different in their suffering or life stories but also the same in their needs.

Education is one of the best ways to communicate and understand other people.

Nurse education prepares nurses for their duties as nursing care professionals.

Nurse educator education is a bridge between two major professions – nursing and teaching. It includes even more bridges to other professions whose common goal is to help those in need.

Each and every day, the situation in the world reminds us that education is extremely important and, as a living organism, develops and depends on each of its smallest parts – each of us.

The world is great in its diversity. So, let’s build more bridges to make it a better and happier place. We are all in it together.

Image: Tim Hill, Pixabay
Categories
Uncategorized

Evidence-based teaching – To infinity and beyond!

“Our dreams of being better teachers are coming true and we thank you for your support and this opportunity.”

One can hardly wish for a higher reward than this kind of feedback from a student.

Evidence-based practice is already a familiar concept in nursing, and in education it is clear, that the content that is being taught, ought to be evidence-based. But evidence-based teaching is more, than content. Nurse educators need evidence-based knowledge in designing curriculum and selecting appropriate teaching and learning methods (Kalb et al., 2015). Evidence-based teaching can be seen as a decision-making process including the best available evidence about teaching and learning, and also expertise and judgment of the educator and the preferences and goals of the learners (Oermann, 2021). Furthermore, nurse educators need to be able to facilitate the future nurses in their profession, so that they are familiar with processes and implementation of evidence-based practice (Kajander-Unkuri et al., 2020).

Evidence-based Teaching study unit is the fourth study unit of Empowering the nurse educators’ in the changing world (ENEC) study programme. The study programme is aimed for nurse educator candidates and educators in Europe. The study programme can be utilised as Continuous professional development (CPD) activity or as a part of degree education in nursing and health sciences educator education. University of Eastern Finland has been the coordinator and main organiser of this study unit.

Participants of EBT completing their teacher training in the partner and collaborator organisations.

Evidence-based teaching study unit was organized as hybrid implementation. Majority of the activities were conducted online, but the students of the study unit performed a teacher training in one of the partner universities in international groups. Due to pandemic situation and the war in Ukraine, that has especially affected the neighbouring countries, the students were allowed to participate the teacher training also online. In addition to teacher evaluations, the study programme utilised both self- and peer evaluation as one of the learning methods, as they both can be even more beneficial than educator evaluation, even though the self- and peer evaluation don’t always concur (Iglesias Pérez et al., 2022). The students also received feedback from the students who they were teaching during their teacher training sessions.

Distance participation was possible in both sending and receiving universities. Images from Constantine the Philosopher University in Nitra.

As in the beginning of this blog, students experienced the teacher training beneficial to them. Furthermore, the partners hosting the teacher trainees, also had a good experience with the international students:

“The students managed to engage colleagues in a stimulating discussion about differences and similarities between the countries and I believe that everyone learned a lot. I was very impressed about their well-planned and structured lesson.”

Students and faculty at the University of Eastern Finland.

The impact of visiting students went beyond the teacher training they had during the training week. They met with the faculty and students at the universities, universities of applied sciences, colleges, Hospital districts, vocational institutes and many other collaborators and have made great impression on the hosts of the training.

Students and faculty at the Charité.

 “Just as feedback, your Erasmus students are wonderful. They’ve been well prepared and have spent lots of time considering how to approach the teaching sessions. They deliver well and have helped each other.”  

 “I loved their use of a hospital soundtrack – beeping, phones ringing – to help explain how stressful the backdrop is in a hospital. That worked really well. They used clever QR code links to mentimeter and tried to engage a slightly stubborn year 1-2 audience. I have to learn how to do that!”

EBT students had plenty of different visits during their week at University of Turku.

The evidence based teaching study unit was a very intensive yet beneficial study unit. Both teachers and students had immense opportunities to share experiences and learn from each other, beyond the content of the study unit. All of the hosts arranged some extra curricular activities and possibilities to learn about the culture and quisine of the hosting country.

On behalf of teams UTU and UEF and the whole New Nurse Educator -project, we thank all our collaborators, faculty and students for a great study unit.

Faculty and students of the Nursing Department and Physiotherapy Department in the Universitat Internacional de Catalunya

Nursing, physiotherapist and medical staff from the Hospital Universitari General de Catalunya-Grupo Quironsalud, in special Sara Cano and Montserrat Granados.

Staff of the Faculty Hospital in Nitra

Staff and students from Constantine the Philosopher University in Nitra

Ms. Lorraine Close, Ms. Ally Lai and Dr. Sarah Rhynas from The University of Edinburgh.

Students and staff of The University of Edinburgh

Ms Carmen D’Amato, Director of Nursing, Ms. Bernice Zarb and Mr. Mathew Abela, Mater Dei Hospital, Malta.

Students and staff of University of Malta

Staff and students of the Institute of Health and Nursing Science at Charité Universitätsmedizin Berlin

Students and staff from Savonia University of Applied Sciences

Clinical nurse educators and staff from Kuopio University Hospital

Mika Alhonkoski and the students in practical nursing, Turku Vocational Institute

Öhberg Isa and the student nurses, Turku University of Applied Sciences

Merja Nummelin, the coordinator of clinical nurse educators and the clinical nurse educators from Turku University Hospital

Karolina Olin and Karoliina Marjaniemi, County Patient Safety Control Center at Turku University Hospital

Camilla Strandell-Laine, Novia University of Applied Sciences

Professor Helena Leino-Kilpi, Assistant Professor Anna Axelin and the students of Future health and Technology from University of Turku

And on behalf of all the staff and students of the New Nurse Educator -project, we want to thank Anneli Vauhkonen, Terhi Saaranen and Juha Pajari from University of Eastern Finland for organizing the study unit Evidence Based Teaching.

Authors are:

Imane Elonen, MNSc, Doctoral researcher, University of Turku

Anneli Vauhkonen, MNSc, Doctoral researcher, University of Eastern Finland

References

Iglesias Pérez, M. C., Vidal-Puga, J., & Pino Juste, M. R. (2022). The role of self and peer assessment in Higher Education. Studies in Higher Education, 47(3), 683-692.

Kajander-Unkuri S., Melender H-L., Kanerva A-M., Korhonen T., Suikkanen A. & Silén-Lipponen M. (2020) Sairaanhoitajan osaamisvaatimukset – suomalainen koulutus 2020-luvulle. Teoksessa: Silén-Lipponen M. & Korhonen T. (toim.). Osaamisen ja arvioinnin yhtenäistäminen sairaanhoitajakoulutuksessa – YleSHarviointi-hanke. Kuopio: Savonia-ammattikorkeakoulun julkaisusarja 5/2020, 22-30. https://www.theseus.fi/handle/10024/347289 

Kalb K.A., O’Conner-Von S., Brockway C., Rierson C.L. & Sendelbach S. (2015) Evidence-based teaching practice in nursing education: faculty perspectives and practices. Nursing Education Perspectives 36(4), 212-219. 

Oermann, M. (2021). Evidence-Based Teaching in Nursing. In Oermann, M., De Gagne, J., & Phillips, B (Eds.), Teaching in nursing and role of the educator: the complete guide to best practice in teaching, evaluation, and curriculum (3rd ed., pp. 377–394). Springer.