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  • 1.
    Abrandt Dahlgren, Madeleine
    et al.
    Department of Medicine, Health and Caring Sciences, Medical Education, Linköping University, Linköping, SE, Sweden.
    Valeskog, Karin
    Department of Medicine, Health and Caring Sciences, Division of Physiotherapy Linköping University, Linköping, SE, Sweden.
    Johansson, Kajsa
    Department of Medicine, Health and Caring Sciences, Division of Physiotherapy Linköping University, Linköping, SE, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Understanding clinical reasoning: A phenomenographic study with entry-level physiotherapy students2022Inngår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 38, nr 13, s. 2817-2826Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Entry-level students' conceptualizations of clinical reasoning can provide a starting point for program planning related to clinical reasoning development with a focus on patient-centered care.

    OBJECTIVE: The aim of the study is to explore how physiotherapy students understand clinical reasoning midway through their education. Nine physiotherapy students were interviewed at the end of their third semester.

    METHODS: Semi-structured individual interviews were conducted, recorded and transcribed verbatim. A phenomenographic approach to qualitative data analysis, seeking to explore variations in students' conceptions was applied.

    RESULTS: The students' ways of understanding clinical reasoning could be described as: 1) the cognitive process of the physiotherapist; and 2) the relational process of the collaborative partnership between the physiotherapist and the patient. A contrastive analysis shows how the cognitive and relational perspectives are developed through the relationships among three dimensions of clinical reasoning: 1) problem-solving; 2) context of working; and 3) own learning.

    CONCLUSION: By identifying the critical variation in students' conceptions of clinical reasoning, focus can be placed on pedagogical arrangements to facilitate students' progression toward a person-centered approach.

  • 2.
    Ahn, Song-ee
    et al.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Designing a virtual patient as an interprofessional enactment: lessons learnt from the process2020Inngår i: International Journal of Learning Technology, ISSN 1477-8386, E-ISSN 1741-8119, Vol. 15, nr 3, s. 204-218Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study is based on observations of the design process of a virtual patient (VP), which aimed to facilitate interprofessional learning. By following the design process of this particular VP, this study aimed to trace how different practices and the knowledge within these practices were enacted as a VP and to understand the design team's difficulties and challenges. Drawing upon actor-network theory (ANT), the study demonstrates how technology and various practices in healthcare and education were enrolled to build the VP and the different translations that took place during the process. We discuss the results by reflecting on the intertwined relationship among the different enactments of a patient in the different professional practices, the enactment of pedagogical intentions and the role of technology in the design process.

  • 3.
    Allvin, Renée
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Clinical Skills Centre, Örebro University Hospital, Örebro, Sweden.
    Berndtzon, Magnus
    Metodikum – Skill Centre of Medical Simulation Region County Jönköping, Jönköping, Sweden.
    Carlzon, Liisa
    Simulation Centre West, Department of Research, Education and Development, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Edelbring, Samuel
    Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Hult, Håkan
    Institute of Medicine and Health, Medical Faculty, Linköping University, Linköping, Sweden.
    Hultin, Magnus
    Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care, Medical Faculty, Umeå University, Umeå, Sweden.
    Karlgren, Klas
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Research, Education and Development and Innovation, Södersjukhuset Hospital, Stockholm, Sweden.
    Masiello, Italo
    Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset Hospital, Stockholm, Sweden.
    Kallestedt, Marie-Louise Södersved
    Clinical Skills Centre, Centre for Clinical Research, Uppsala University, Västerås, Sweden.
    Tamás, Éva
    Department of Cardiovascular Diseases, Institute of Medicine and Health, Medical Faculty, University of Linköping, Linköping, Sweden.
    Confident but not theoretically grounded - experienced simulation educators' perceptions of their own professional development2017Inngår i: Advances in Medical Education and Practice, E-ISSN 1179-7258, Vol. 8, s. 99-108Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature.

    Objectives: To explore changes in experienced simulation educators' perceptions of their own teaching skills, practices, and understanding of teaching over time.

    Methods: A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis.

    Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor's pedagogical development.

    Conclusion: Experienced simulation educators' pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.

  • 4.
    Allvin, Renée
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Center Skills Center, Örebro University Hospital, Örebro, Sweden.
    Thompson, Carl
    School of Health Care, University of Leeds, Leeds, UK.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Assessment of interprofessional competence in undergraduate health professions education: protocol for a systematic review of self-report instruments2020Inngår i: Systematic Reviews, E-ISSN 2046-4053, Vol. 9, nr 1, artikkel-id 142Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Health practitioners from different professions, and with differing competencies, need to collaborate to provide quality care. Competencies in interprofessional working need developing in undergraduate educational preparation. This paper reports the protocol for a systematic review of self-report instruments to assess interprofessional learning in undergraduate health professionals' education.

    METHODS: We will search PubMed, Web of Science, CINAHL and ERIC from January 2010 onwards. A combination of search terms for interprofessional learning, health professions, psychometric properties, assessment of learning and assessment tools will be used. Two reviewers will independently screen all titles, abstracts and full-texts. Potential conflicts will be resolved through discussion. Quantitative and mixed-methods studies evaluating interprofessional learning in undergraduate health professions education (e.g. medicine, nursing, occupational and physical therapy, pharmacy and psychology) will be included. Methodological quality of each reported instrument, underpinning theoretical frameworks, and the effects of reported interventions will be assessed. The overall outcome will be the effectiveness of instruments used to assess interprofessional competence. Primary outcomes will be the psychometric properties (e.g. reliability, discriminant and internal validity) of instruments used. Secondary outcomes will include time from intervention to assessment, how items relate to specific performance/competencies (or general abstract constructs) and how scores are used (e.g. to grade students, to improve courses or research purposes). Quantitative summaries in tabular format and a narrative synthesis will allow recommendations to be made on the use of self-report instruments in practice.

    DISCUSSION: Many studies use self-report questionnaires as tools for developing meaningful interprofessional education activities and assessing students' interprofessional competence. This systematic review will evaluate both the benefits and limitations of reported instruments and help educators and researchers (i) choose the most appropriate existing self-report instruments to assess interprofessional competence and (ii) inform the design and conduct of interprofessional competency assessment using self-report instruments.

    SYSTEMATIC REVIEW REGISTRATION: Open Science Framework [https://osf.io/vrfjn].

  • 5.
    Allvin, Renée
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Clinical Skills Centre.
    Thompson, Carl
    School of Healthcare, University of Leeds, Leeds, UK.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Variations in measurement of interprofessional core competencies: a systematic review of self-report instruments in undergraduate health professions education2024Inngår i: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 38, nr 3, s. 486-498Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Educating health care professionals for working in interprofessional teams is a key preparation for roles in modern healthcare. Interprofessional teams require members who are competent in their roles. Self-assessment instruments measuring interprofessional competence (IPC) are widely used in educational preparation, but their ability to accurately and reliably measure competence is unknown. We conducted a systematic review to identify variations in the characteristics and use of self-report instruments measuring IPC. Following a systematic search of electronic databases and after applying eligibility criteria, 38 articles were included that describe 8 IPC self-report instruments. A large variation was found in the extent of coverage of IPC core competencies as articulated by the Interprofessional Education Collaborative. Each instrument's strength of evidence, psychometric performance and uses varied. Rather than measuring competency as "behaviours", they measured indirect proxies for competence, such as attitudes towards core interprofessional competencies. Educators and researchers should identify the most appropriate and highest-performing IPC instruments according to the context in which they will be used.Systematic review registration: Open Science Framework (https://archive.org/details/osf-registrations-vrfjn-v1).

  • 6.
    Edelbring, Samuel
    Centre for Medical Education, Department LIME, Karolinska Institutet, Stockholm, Sweden.
    Measuring strategies for learning regulation in medical education: Scale reliability and dimensionality in a Swedish sample2012Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 12, artikkel-id 76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    The degree of learners’ self-regulated learning and dependence on external regulation influence learning processes in higher education. These regulation strategies are commonly measured by questionnaires developed in other settings than in which they are being used, thereby requiring renewed validation. The aim of this study was to psychometrically evaluate the learning regulation strategy scales from the Inventory of Learning Styles with Swedish medical students (N = 206).

    Methods

    The regulation scales were evaluated regarding their reliability, scale dimensionality and interrelations. The primary evaluation focused on dimensionality and was performed with Mokken scale analysis. To assist future scale refinement, additional item analysis, such as item-to-scale correlations, was performed.

    Results

    Scale scores in the Swedish sample displayed good reliability in relation to published results: Cronbach’s alpha: 0.82, 0.72, and 0.65 for self-regulation, external regulation and lack of regulation scales respectively. The dimensionalities in scales were adequate for self-regulation and its subscales, whereas external regulation and lack of regulation displayed less unidimensionality. The established theoretical scales were largely replicated in the exploratory analysis. The item analysis identified two items that contributed little to their respective scales.

    Discussion

    The results indicate that these scales have an adequate capacity for detecting the three theoretically proposed learning regulation strategies in the medical education sample. Further construct validity should be sought by interpreting scale scores in relation to specific learning activities. Using established scales for measuring students’ regulation strategies enables a broad empirical base for increasing knowledge on regulation strategies in relation to different disciplinary settings and contributes to theoretical development.

  • 7.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Medicinsk informatik och lärande2020Inngår i: Medicinsk informatik / [ed] Göran Petersson, Martin Rydmark & Anders Thurin, Stockholm: Liber, 2020, 1, s. 192-203Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

    Detta kapitel handlar om informatikens funktioner i lärandeprocesser irela tion till studenter, professionella och patienter. Det introducerarbegrepp, syn på kunskap och några klassiska modeller för lärande för att synliggöra pedagogiska processer som läsaren känner igen i sinvardags- och yrkessituation. Exemplen hämtas från olika lärandesituationer och vårdområden.

  • 8.
    Edelbring, Samuel
    Karolinska Institutet, Stockholm, Sweden.
    Research into the use of virtual patients is moving forward by zooming out2013Inngår i: Medical Education, ISSN 0308-0110, E-ISSN 1365-2923, Vol. 47, nr 6, s. 544-546Artikkel i tidsskrift (Annet vitenskapelig)
  • 9.
    Edelbring, Samuel
    Dept of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Technology in education, necessary but not sufficient: understanding learning with virtual patients2012Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    With the rapid technological development and the broadening access to computers over recent decades, several technological innovations have emerged in medical education, including virtual patients. Students’ use of virtual patients is proposed to fill gaps in clinical exposure, and train clinical reasoning. However, higher education faculties have been slow to adopt new technology as a regular part of curricula. Virtual patients and similar technologies have either been implemented by enthusiastic teachers or by university policy directives. A possible reason for the low uptake of virtual patients in curricula is a lack of a clear understanding of how their use contributes to student learning.

    The four studies described in this thesis address learning with virtual patients from three perspectives: the student perspective on learning with virtual patients; the course integration perspective; and the individual study strategy perspective. A mixed methods approach was used given the overarching interest to seek understanding and clarification of student learning with virtual patients.

    Data were gathered by research interviews with medical students during clerkship, and by questionnaires in clerkship preparatory courses. Interview data was analysed by a phenomenological approach, and scales were formed from questionnaire responses which were analysed cross-sectionally for the four teaching hospitals affiliated with the medical programme at Karolinska Institutet. Use frequency, students’ perceived benefit of virtual patients, their wish for more guidance on using virtual patients and, wish for more assessment and feedback on virtual patient work were targeted in the questionnaires. Furthermore, the students’ preferences of study strategies were analysed in relation to the virtual patient activity using regulation strategy scales from the Inventory of Learning Styles devised by Jan Vermunt.

    The findings suggested that virtual patient learning activities offer possibilities of applying biomedical knowledge to clinical cases in a way that was engaging and supported decisionmaking. Furthermore, the virtual patient learning activities were perceived as having an intermediate function between textbook learning and learning with actual patients. The consequences of integration strategies in the course context were influential for how students perceived the benefit of learning with virtual patients. Intensity of processing of virtual patient cases, and presenting cases for other students were associated with high perceived benefit of virtual patient learning activities. Students’ self-regulation abilities were also associated with perceived benefit of the virtual patient learning activities, although to a lesser extent than the influence of the course context.

    The technology of virtual patients provides possibilities that enhance student learning, and should thus be a necessary part of education. However, this research show that an educational integration strategy is needed that supports students’ active processing of virtual patient cases.

  • 10.
    Edelbring, Samuel
    Department of Learning Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Validating Knowledge and Fostering Creativity in the University2012Inngår i: Thrita, ISSN 2352-0620, Vol. 1, nr 2, s. 67-68Artikkel i tidsskrift (Fagfellevurdert)
  • 11.
    Edelbring, Samuel
    et al.
    Division of Community Medicine, Linköping University, Linköping, Sweden.
    Abrandt Dahlgren, Madeleine
    Division of Community Medicine, Linköping University, Linköping, Sweden.
    Bodies in Simulation: Exploring Sociomaterial Theory in Collaborative Video-Analysis2016Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    The third presentation builds on practice theory. Practice theory views knowledge as being embodied and relational, intertwined with ethical reasoning and materiality. The findings show that the student teams relate to the manikin as a technical, medical and human body, and that interprofessional knowings and enactments emerge as a fluid movement between bodily positioning in synchrony, and bodily positioning out of synchrony, in relation to the sociomaterial arrangements. The findings are related to contemporary theorisations of practice comprising an integrated view of body and mind, and it is discussed how the findings can be used in simulation exercises to support participants’ learning in new ways.

  • 12.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Abrandt Dahlgren, Madeleine
    Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Wiegleb Edström, Desirée
    Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Stockholm, Sweden; Department of Dermatology, Karolinska University Hospital, Stockholm, Stockholm, Sweden.
    Characteristics of two questionnaires used to assess interprofessional learning: psychometrics and expert panel evaluations2018Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 18, artikkel-id 40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Interprofessional learning activities are included in many curricula but are difficult to assess. For languages that are not widely spoken such as Swedish, few validated questionnaires exist that relate to interprofessional outcomes. Therefore, the aim was to examine two such questionnaires in relation to interprofessional competence domains.

    Methods: Psychometric characteristics, such as homogeneity of items and internal consistency, were assessed for the Swedish versions of the Jefferson Scale of Attitudes Towards Physician-Nurse Collaboration (JSAPNC) and the Readiness for Interprofessional Learning Scale (RIPLS). The questionnaires were distributed directly following IPL activities. Mokken scale analysis based on Loevingers coefficient for homogeneity and Cronbachs alpha were used to evaluate the scales. Two expert panels performed a qualitative analysis of items in relation to four internationally defined interprofessional competences.

    Results: In total, 88 and 84 responded to the JSAPNC and RIPLS questionnaires, respectively. Estimates of homogeneity were low for both the JSAPNC (H = 0.16) and the RIPLS (H = 0.21). Reliabilities were weak (0.62 and 0.66, respectively) for the total scales. The expert panels categorised 68% of items into similar competence domains. However, their discussion revealed ambiguous wordings and imbalances in the two questionnaires in relation to domains.

    Conclusion: Interprofessional competence domains are defined but few validated tools exist to assess them. Examined tools relating to interprofessional learning in Swedish do not qualify for assessing overarching IPL outcomes, and summed scores from these tools should be used with caution.

    Fulltekst (pdf)
    Characteristics of two questionnaires used to assess interprofessional learning: Psychometrics and expert panel evaluations
  • 13.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Alehagen, Siw
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Mörelius, Evalotte
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden; School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
    Johansson, AnnaKarin
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Rytterström, Patrik
    Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden.
    Should the PBL tutor be present?: A cross-sectional study of group effectiveness in synchronous and asynchronous settings2020Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 20, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The tutorial group and its dynamics are a cornerstone of problem-based learning (PBL). The tutor's support varies according to the setting, and it is pertinent to explore group effectiveness in relation to different settings, for example online or campus-based. The PBL groups' effectiveness can partly be assessed in terms of cognitive and motivational aspects, using a self-report tool to measure PBL group effectiveness, the Tutorial Group Effectiveness Instrument (TGEI).This study's aim was to explore tutor participation in variations of online and campus-based tutorial groups in relation to group effectiveness. A secondary aim was to validate a tool for assessing tutorial group effectiveness in a Swedish context.

    Methods: A cross-sectional study was conducted with advanced-level nursing students studying to become specialised nurses or midwives at a Swedish university. The TGEI was used to measure motivational and cognitive aspects in addition to overall group effectiveness. The instrument's items were translated into Swedish and refined with an expert group and students. The responses were calculated descriptively and compared between groups using the Mann-Whitney U and Kruskal-Wallis tests. A psychometric evaluation was performed using the Mokken scale analysis. The subscale scores were compared between three different tutor settings: the tutor present face-to-face in the room, the tutor present online and the consultant tutor not present in the room and giving support asynchronously.

    Results: All the invited students (n=221) participated in the study. There were no differences in motivational or cognitive aspects between students with or without prior PBL experience, nor between men and women. Higher scores were identified on cognitive aspects (22.6, 24.6 and 21.3; p<0.001), motivational aspects (26.3, 27 and 24.5; p=002) and group effectiveness (4.1, 4.3, 3.8, p=0.02) for the two synchronously tutored groups compared to the asynchronously tutored group. The TGEI subscales showed adequate homogeneity.

    Conclusions: The tutor's presence is productive for PBL group effectiveness. However, the tutor need not be in the actual room but can provide support in online settings as long as the tutoring is synchronous.

  • 14.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Linköping University, Linköping, Sweden.
    Allvin, Renée
    Örebro University Hospital, Örebro, Sweden.
    Karlsson, Katarina
    Linköping University, Linköping, Sweden.
    Hjelmqvist, Hans
    Örebro universitet, Institutionen för medicinska vetenskaper. Örebro University Hospital, Örebro, Sweden.
    Hjelm, Carina
    Linköping University, Linköping, Sweden.
    Brandt, Jonathan
    Capio Specialistvård Motala, Motala, Sweden.
    Tamás, Éva
    Linköping University, Linköping, Sweden.
    Interprofessionell simulering är engagerande och relevant: Utbildningsstrategi som tränar samverkan över yrkesgränser, visar enkätstudie [Interprofessional simulation: an engaging and relevant technique for teamwork practice]2019Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, artikkel-id FHWLArtikkel i tidsskrift (Fagfellevurdert)
    Abstract [sv]

    Studenter behöver träna på teamarbete och utveckla interprofessionell kompetens för att rustas för framtidens hälso- och sjukvård.

    Utbildning för interprofessionell samverkan kan ske genom simulering där läkar- och sjuksköterskestudenter möts och agerar tillsammans i patientscenarier. 

    Interprofessionell simulering upplevdes som relevant och engagerande av studenter på två lärosäten. Studenter från den andra professionen bidrog till lärandet. Det finns dock utrymme att ytterligare förbättra det pedagogiska genomförandet, och professionsperspektiven kan balanseras bättre. 

  • 15.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Broberger, Eva
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Sandelius, Susanna
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Norberg, Jessica
    Department of Dermatology, Karolinska University Hospital, Solna, Sweden.
    Wiegleb Edström, Desirée
    Örebro universitet, Institutionen för medicinska vetenskaper. Dermatology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
    Flexible interprofessional student encounters based on virtual patients: a contribution to an interprofessional strategy2022Inngår i: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 36, nr 2, s. 310-317Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    It is challenging to organize interprofessional activities in terms of coordinating students' various schedules. These challenges can be overcome by providing flexible online opportunities based on virtual patients (VPs). This study set out to study feasibility of using a blended approach based on virtual patients and a flexible interprofessional student encounter. The encounter was arranged in pairs or triads between nursing and medical students from two separate courses. Data were gathered through a questionnaire and followed up with group interviews. Reflective texts from the interprofessional encounters were analyzed in relation to descriptions of interprofessional competence. The great majority (86%) chose to meet online due to its flexibility. The participants gained an understanding of the other profession's roles and competences and a holistic patient awareness. Given its flexible and scalable opportunities, the blended online virtual patient approach provides a valuable contribution to an interprofessional programme.

  • 16.
    Edelbring, Samuel
    et al.
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden.
    Broström, Olle
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden.
    Henriksson, Peter
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Sweden.
    Vassiliou, Daphne
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden.
    Spaak, Jonas
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Sweden.
    Dahlgren, Lars Owe
    Department of Behavioural Sciences and Learning, Faculty of Educational Sciences, Linköping University, Linköping, Sweden.
    Fors, Uno
    Department of Computer and Systems Sciences, Faculty of Social Sciences, Stockholm University, Sweden.
    Zary, Nabil
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden.
    Integrating virtual patients into courses: follow-up seminars and perceived benefit2012Inngår i: Medical Education, ISSN 0308-0110, E-ISSN 1365-2923, Vol. 46, nr 4, s. 417-425Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Context: The use of virtual patients (VPs) suggests promising effects on student learning. However, currently empirical data on how best to use VPs in practice are scarce. More knowledge is needed regarding aspects of integrating VPs into a course, of which student acceptance is one key issue. Several authors call for looking beyond technology to see VPs in relation to the course context. The follow-up seminar is proposed as an important aspect of integration that warrants investigation.

    Methods: A cross-sectional explanatory study was performed in a clinical clerkship introduction course at four teaching hospitals affiliated to the same medical faculty. The VP-related activities were planned collaboratively by teachers from all four settings. However, each setting employed a different strategy to follow up the activity in the course. Sixteen questionnaire items were grouped into three scales pertaining to: perceived benefit of VPs; wish for more guidance on using VPs, and wish for assessment and feedback on VPs. Scale scores were compared across the four settings, which were ranked according to the level of intensity of students processing of cases during VP follow- up activities.

    Results: The perceived benefit of VPs and their usage were higher in the two intense-use settings compared with the moderate-and lowintensity settings. The wish for more guidance was high in the low-and one of the highintensity settings. Students in all settings displayed little interest in more assessment and feedback regarding VPs.

    Conclusions: High case processing intensity was related to positive perceptions of the benefit of VPs. However, the low interest in more assessment and feedback on the use of VPs indicates the need to clearly communicate the added value of the follow-up seminar. The findings suggest that a more intense follow-up pays off in terms of the benefit perceived by students. This study illustrates the need to consider VPs from the perspective of a holistic course design and not as isolated add‐ons.

  • 17.
    Edelbring, Samuel
    et al.
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Dahlgren, Lars Owe
    Avdelningen för studier av vuxenutbildning, folkbildning och högre utbildning (VUFo), Department of Behavioural Science and Learning, Linköping University, Linköping Sweden.
    Phenomenology as research approach in medical education: Characteristics and empirical examples2010Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: In contemporary educational research learning is not necessarily determined by outcomes measured by scales or prefabricated instruments. Student learning is rather looked upon as a process where individuals learn in relation to what is meaningful to him or her (Marton & Booth). This implies that the students’ perception of their learning environment is of importance for the researcher. Phenomenology is a research approach focusing on how individuals experience their environment and thus, suitable for such investigations.

    Summary of work: The empirical phenomenological approach has been investigated regarding its aim and procedures. Elements of this approach will be presented illustrated by a recent study.

    Summary of results: Phenomenology has characteristic core elements that the researcher must acknowledge.

    Conclusions: Husserl’s phenomenological philosophy constitutes an excellent base for a research approach that aims at taking a subjects standpoint as a foundation for the research. A medical education researcher can be overwhelmed by philosophical literature, but contemporary psychologists have worked out empirical methods making the philosophy feasible to carry out in practice.

    Take-home messages: Empirical phenomenology is a research methodology highlighting individuals’ experiences, adapted from Husserl’s philosophical method. There are guidelines that break down the approach into practical procedures that make the approach possible to carry through in a medical education context.

  • 18.
    Edelbring, Samuel
    et al.
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Dastmalchi, Maryam
    Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
    Hult, Håkan
    Department of Behavioural Science and Learning, Linköping University, Linköping, Sweden.
    Lundberg, Ingrid E.
    Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
    Dahlgren, Lars-Ove
    Department of Behavioural Science and Learning, Linköping University, Linköping, Sweden.
    Experiencing virtual patients in clinical learning: a phenomenological study2011Inngår i: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 16, nr 3, s. 331-345Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Computerised virtual patients (VPs) are increasingly being used in medical education. With more use of this technology, there is a need to increase the knowledge of students experiences with VPs. The aim of the study was to elicit the nature of virtual patients in a clinical setting, taking the students experience as a point of departure. Thirty-one students used VPs as a mandatory part of an early clinical rotation in rheumatology. Using the qualitative approach of phenomenology, we interviewed these students and then analysed data regarding their experiences of VPs as a learning activity. The result shows that students perceived VP activities in relation to actual patients, the clinical context and other learning activities. The VPs represented typical clinical cases which encouraged clinical reasoning and allowed for decision making. The students experienced the activities as integrating biomedical knowledge and clinical experience, providing structure that prepared for the unstructured clinical environment and patient encounters under unstressful conditions. However, the VPs were experienced as lacking the emotional interactivity and complexity of actual patients. Theoretical frameworks of clinical reasoning and experiential learning are suggested as foundations for further educational integration of VPs in the clinical environment. VP activities during clinical rotations provide experiences of clinical reality and allow students to solve problems actively. These features are dependent on VP technology but are also contingent on the surrounding environment.

  • 19.
    Edelbring, Samuel
    et al.
    LIME, Karolinska Institutet, Stockholm, Sweden.
    Dastmalchi, Maryam
    LIME, Karolinska Institutet, Stockholm, Sweden.
    Lundberg, Ingrid E.
    LIME, Karolinska Institutet, Stockholm, Sweden.
    Hult, Håkan
    Pedagogik och vuxnas lärande, Linköpings University, Linköping, Sweden.
    Dahlgren, Lars Owe
    Avdelningen för studier av vuxenutbildning, folkbildning och högre utbildning (VUFo), Linköping University, Linköping, Sweden.
    Virtual Patients in clinical education from a phenomenological perspective2009Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Although Virtual Patients (VPs) are more commonly used today there is no clear-cut picture of the nature of VPs as a learning tool. This means that educators hesitate in further curricular integration of VPs. Students and educators need examples of how this innovation can support student learning in practice.

    Summary of work: We have analysed the use of VPs in a clinical rotation of medical students of rheumatology lasting 2-4 weeks. The phenomenological approach was used in order to maximise the student perspective. Focus lied with the character of VP learning and the immediate framework supporting meaningful learning with VPs at the clinic. We interviewed31 students followed by a phenomenological analysis of the transcriptions. This resulted inincreased knowledge of the value of VPs in this setting.

    Summary of results: VPs as a learning tool play a role of enhancing the value of other learning activities at the clinic. The immediate framework affects the way that students approach VPs. When students work in pairs, reflection and argumentation strengthen the learning experience.

    Conclusions: The study approach provided a way to characterise learning with VPs as enhancing the value of clinical education.

    Take-home messages: Phenomenological research interviews provide a way of discovering the value of innovations in medical education.

  • 20.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Elvén, Maria
    Mälardalen University, Västerås, Sweden.
    Holmström, Inger K.
    Mälardalen University, Västerås, Sweden.
    Prenkert, Malin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Person-Centeredness in Clinical Reasoning of Interprofessional Stroke Teams2023Inngår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 109, nr Suppl., s. 70-70, artikkel-id O.16.5Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Background: Although person-centered care is prioritized in healthcare, challenges remain before such care is integrated in everyday communication and practice. One way to strengthen person-centered care is that health professionals’ clinical reasoning (i.e., assessment and management) is pervaded by patient participation and individualized to patient needs. Interprofessional team meetings, focusing on goals and management planning, is an opportunityt o improve person-centeredness. However, there is a lack of understanding of how person-centeredness is created in the clinical reasoning of teams. This study aims to explore how clinical reasoning is performed from a person-centered perspective in team meetings with patients with stroke and next of kin.

    Methods: Explorative qualitative design employing a thematic analysis of audio recorded communication at three team meetings. In total, three patients, two next of kin, and 15 professionals representing eight health professions, participated in the meetings.

    Findings: Four themes and eight subthemes were established: a) Emphasizing the patient’s resources; b) Struggling to find a common understanding, including subthemes: Unite the person’s narrative, the relative’s view, and the expertise of the interprofessional team, missed opportunities to clarify patient needs and wishes, and active listening and receptiveness; c) Balancing the patient’s goals and professionals’ goals, including subthemes: Shared goals, the professionals’ view of appropriate goals, and the professionals’ assessment governs achievement of goals; d) Ambiguity in decisions about the management plan, including subthemes: Initiating shared decision making and lack of clarity and consensus.

    Discussion: This study reveals how the patient, next of kin and team contribute to shared understanding of the patient’s problem. Goals were guided by the patient’s and professionals’ expertise. To improve person-centeredness in clinical reasoning, the team need to further put the patient’s personal goals and perception of goal-achievement in the forefront as well as improve communication skills to catch patient needs and facilitate shared decisions.

  • 21.
    Edelbring, Samuel
    et al.
    Department of Learning Informatics, Management and Ethics Karolinska Institutet, Stockholm, Sweden.
    Fors, Uno
    Department of Learning Informatics, Management and Ethics Karolinska Institutet, Stockholm, Sweden.
    Saether, Björn
    Statoil ASA, Stavanger, Norway.
    SvalSim: field work simulation system for problem-oriented learning in petroleum geology2004Inngår i: International Journal of Innovation in Science and Mathematics Education, ISSN 2200-4270, Vol. 12, nr 1, s. 9-11Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    The Educational Technology Unit at Karolinska Institutet (KI) in Sweden has developed an on-screen simulation software, SvalSim, that simulates field work for problem-oriented learning in petroleum geology. The system is using numerous authentic geological data, takes the time aspect into account and lets users control almost all events resulting in a very realistic simulation. The educational setting for use of the simulation software is general training in geosciences and field courses in Norway e.g., at Svalbard. This article describes the system and the pedagogical objectives.

  • 22.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Karlberg-Traav, Malin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Hultgren, Anna
    Örebro universitet. Högskolepedagogiskt centrum.
    Alverland, Vicky
    Student Sjuksköterskeprogrammet.
    Edgren, Gudrun
    Lunds universitet, Lund.
    Förslag till pedagogisk strategi och åtgärder för att stärka genomströmningen i medicinsk vetenskap inom sjuksköterske-programmet2020Rapport (Annet (populærvitenskap, debatt, mm))
    Fulltekst (pdf)
    Förslag till pedagogisk strategi och åtgärder för att stärka genomströmningen i medicinsk vetenskap inom sjuksköterskeprogrammet
  • 23.
    Edelbring, Samuel
    et al.
    Avdelningen för samhällsmedicin, Linköpings universitet, Linköping.
    Karlsson, Katarina
    Avdelningen för omvårdnad, Linköpings universitet, Linköping,.
    Meyer, Frida
    Institutionen för medicin och hälsa, Linköpings universitet, Linköping.
    Tamás, Éva
    Avdelningen för kardiovaskulär medicin, Linköpings universitet, Linköping.
    Utvärdering av IPL-simulering på Clinicum: Simuleringsdag ”Akuta situationer” för sistaårsstudenter från sjuksköterske- och läkarprogrammen HT 20162017Rapport (Annet vitenskapelig)
    Abstract [sv]

    En gemensam simuleringsdag för sjuksköterske- och läkarstudenter har utvärderats och diskuteras här i relation till interprofessionellt lärande och simuleringsbaserat lärande.

    IPL-simuleringen kännetecknas av ett starkt studentengagemang och upplevs som mycket relevant och kliniskt autentisk. Den simuleringsbaserade satsningen är alltså fortsatt aktuell och har utvecklats till en hög nivå med relevans för lärande och klinisk förberedelse. Innehållet rör såväl kliniska som team­relaterade kunskaper och kompetenser. Simulering som undervisningsform uppskattas högt och simulerings­instruktörens bidrag till lärandet lyfts fram. Ambitionsnivån kan ytterligare höjas på några punkter. Kurskamraternas bidrag i lärandet kan ytterligare stärkas, likaså omvårdnads­innehållet i scenarierna.

    IPL-mål adresseras i aktiviteten, i synnerhet ökar teamsamverkan progressivt under dagen. Det inter­professionella lärandet kan stärkas ännu mer  genom att linjera tydligare med övriga IPL-moment samt knyta an till de uttalade IPL-curriculum-målen.

    Fulltekst (pdf)
    Utvärdering av IPL-simulering på Clinicum: Simuleringsdag ”Akuta situationer” för sistaårsstudenter från sjuksköterske- och läkarprogrammen HT 2016
  • 24.
    Edelbring, Samuel
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Lammgård, Tomas
    Örebro universitet, Institutionen för hälsovetenskaper.
    Pettersson, Susanne
    Örebro universitet, Institutionen för hälsovetenskaper.
    Ringnander, Mats
    Örebro universitet, Institutionen för hälsovetenskaper.
    Diskussion om styrkor och utvecklingsbehov av färdighetsträning på KTC. Enkät till lärare, extern feedback och workshop.2020Rapport (Annet (populærvitenskap, debatt, mm))
    Fulltekst (pdf)
    Diskussion om styrkor och utvecklingsbehov av färdighetsträning på KTC. Enkät till lärare, extern feedback och workshop.
  • 25.
    Edelbring, Samuel
    et al.
    LIME, Karolinska Institutet, Stockholm, Sweden.
    Lundberg, Ingrid E.
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Zary, Nabil
    LIME, Karolinska Institutet, Stockholm, Sweden.
    Expectations and experiences of the collaborative aspect of virtual patient work2013Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: The small group setting has proved beneficial for learning (Lou et al., 2001). Furthermore, the reasoning process is a goal in itself within an interpersonal view of learning (Crook, 2010). In medical education the use of virtual patients (VPs) has emerged as a method to train clinical reasoning which implies an increased interest for peer collaboration. The VPs are however often used individually in a self-study manner. One study reports 94% individual use (Fall et al., 2005).The aim of this study is to gain knowledge about how students perceive collaboration using VPs and the reasons for individual or collaborative VP work.

    Summary of work: Students worked with four VPs during clinical clerkship in Rheumatology. All students during one semester (n=30) were asked to fill in a questionnaire concerning collaborative VP work. Questionnaire responses were analysed thematically (Braun and Clarke, 2006).

    Summary of results: Twenty-nine students (97%) answered the questionnaire. 62% of the students worked individually with the virtual patients, 24% both individually and collaboratively, and 14% only in the collaborative setting. All of those working in the collaboratively stated learning reasons for doing so. Almost all (94%) of the reasons for working individually were of practical character. Those working in both settings stated both practical and learning reasons for doing so.

    Conclusions: Students clearly see educational benefits of working collaboratively with VPs. However, for practical reasons collaborative case work seems often to give way to the individual self-study approach.

    Take-home messages: Practical opportunities should be arranged for in order to benefit from collaborative learning when using VPs.

  • 26.
    Edelbring, Samuel
    et al.
    Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Parodis, Ioannis
    Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Lundberg, Ingrid E.
    Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Increasing Reasoning Awareness: Video Analysis of Students' Two-Party Virtual Patient Interactions.2018Inngår i: JMIR Medical Education, E-ISSN 2369-3762, Vol. 4, nr 1, artikkel-id e4Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Collaborative reasoning occurs in clinical practice but is rarely developed during education. The computerized virtual patient (VP) cases allow for a stepwise exploration of cases and thus stimulate active learning. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature.

    OBJECTIVE: The objective of this study was to thoroughly investigate interactions during medical students' clinical reasoning in two-party VP settings.

    METHODS: An in-depth exploration of students' interactions in dyad settings of VP sessions was performed. For this purpose, two prerecorded VP sessions lasting 1 hour each were observed, transcribed in full, and analyzed. The transcriptions were analyzed using thematic analysis, and short clips from the videos were selected for subsequent analysis in relation to clinical reasoning and clinical aspects.

    RESULTS: Four categories of interactions were identified: (1) task-related dialogue, in which students negotiated a shared understanding of the task and strategies for information gathering; (2) case-related insights and perspectives were gained, and the students consolidated and applied preexisting biomedical knowledge into a clinical setting; (3) clinical reasoning interactions were made explicit. In these, hypotheses were followed up and clinical examples were used. The researchers observed interactions not only between students and the VP but also (4) interactions with other resources, such as textbooks. The interactions are discussed in relation to theories of clinical reasoning and peer learning.

    CONCLUSIONS: The dyad VP setting is conducive to activities that promote analytic clinical reasoning. In this setting, components such as peer interaction, access to different resources, and reduced time constraints provided a productive situation in which the students pursued different lines of reasoning.

  • 27.
    Edelbring, Samuel
    et al.
    Department of Medical and Health Sciences, Division of Community Medicine, unit of Medical Education, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Wahlström, Rolf
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Dynamics of study strategies and teacher regulation in virtual patient learning activities: a cross sectional survey2016Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 16, nr 1, artikkel-id 122Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Students’ self-regulated learning becomes essential with increased use of exploratory web-based activities such as virtual patients (VPs). The purpose was to investigate the interplay between students’ self-regulated learning strategies and perceived benefit in VP learning activities.

    Method: A cross-sectional study (n = 150) comparing students’ study strategies and perceived benefit of a virtual patient learning activity in a clinical clerkship preparatory course. Teacher regulation varied among three settings and was classified from shared to strong. These settings were compared regarding their respective relations between regulation strategies and perceived benefit of the virtual patient activity.

    Results: Self-regulation learning strategy was generally associated with perceived benefit of the VP activities (rho 0.27, p < 0.001), but was not true in all settings. The association was higher in the two strongly regulated settings. The external regulation strategy did generally associate weakly with perceived benefit (rho 0.17, p < 0.05) with large variations between settings.

    Conclusions:  The flexible student-autonomous appeal of virtual patients should not lead to the dismissal of guidance and related course activities. External teacher and peer regulation seem to be productive for increasing learners’ perceived benefit. Awareness of the interplay among teacher regulation (external) and various study strategies can increase the value of flexible web-based learning resources to students.

    Fulltekst (pdf)
    Dynamics of study strategies and teacher regulation in virtual patient learning activities: a cross sectional survey
  • 28.
    Eikeland Husebø, Sissel
    et al.
    University of Stavanger, Stavanger, Norway.
    Abrandt Dahlgren, Madeleine
    Linköping University, Linköping, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Nordenström, Elin
    University of Gothenburg, Gothenburg, Sweden.
    Nordahl Amorøe, Torben
    University of Gothenburg, Gothenburg, Sweden.
    Rystedt, Hans
    University of Gothenburg, Gothenburg, Sweden.
    Dieckmann, Peter
    Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources, Capital Region of Denmark, Copenhagen, Denmark; Department for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department for Quality and Health Technology, University of Stavanger, Stavanger, Norway.
    Reflecting on Interprofessional Simulation2019Inngår i: Interprofessional Simulation in Health Care: Materiality, Embodiment, Interaction / [ed] Madeleine Abrandt Dahlgren, Hans Rystedt, Li Felländer-Tsai and Sofia Nyström, Cham: Springer Publishing Company , 2019, s. 139-171Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    This chapter explores and discusses how models of debriefing can support interprofessional learning in simulation-based education activities. The role of video as a tool for feedback and reflection is described and the ways video can be integrated in the learning environment to optimize opportunities for learning.

  • 29.
    Elvén, Maria
    et al.
    School of Health, Care, and Social Welfare, Mälardalen University, Västerås, Sweden; School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Holmström, Inger K
    School of Health, Care, and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlestav, Malin
    Department of Neurology and Rehabilitation Medicine, Örebro University Hospital, Örebro, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    A tension between surrendering and being involved: An interview study on person-centeredness in clinical reasoning in the acute stroke setting2023Inngår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 112, artikkel-id 107718Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To explore how stroke survivors experience and prefer to participate in clinical reasoning processes in the acute phase of stroke care.

    METHODS: An explorative qualitative design was used. Individual interviews were conducted with 11 stroke survivors in the acute phase of care and analyzed using reflexive thematic analysis.

    RESULTS: The analysis identified five themes: What's going on with me?; Being a recipient of care and treatment; The need to be supported to participate; To be seen and strengthened; and Collaboration and joint understanding.

    CONCLUSION: Stroke survivors experience many attributes of person-centeredness in the acute phase of care but, according to their stories, their participation in clinical reasoning can be further supported. The tension between surrendering and the desire to be more actively involved in the care needs to be considered to facilitate participation in clinical reasoning.

    PRACTICE IMPLICATIONS: Stroke survivors' participation in clinical reasoning in the acute phase can be facilitated by health professionals noticing signs prompting a shift towards increased willingness to participate. Furthermore, health professionals need to take an active role, sharing their expertise and inviting the stroke survivors to share their perspective. The findings can contribute to further develop person-centered care in acute settings.

  • 30.
    Elvén, Maria
    et al.
    School of Health, Care, and Social Welfare, Mälardalen University, Västerås, Sweden; School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Prenkert, Malin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Holmström, Inger K.
    School of Health, Care, and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Reasoning about reasoning: using recall to unveil clinical reasoning in stroke rehabilitation teams2024Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The study objective was to investigate how health care providers in stroke teams reason about their clinical reasoning process in collaboration with the patient and next of kin.

    Materials and methods: An explorative qualitative design using stimulated recall was employed. Audio-recordings from three rehabilitation dialogs were used as prompts in interviews with the involved staff about their clinical reasoning. A thematic analysis approach was employed.

    Results: A main finding was the apparent friction between profession-centered and person-centered clinical reasoning, which was salient in the data. Five themes were identified: the importance of different perspectives for a rich picture and well-informed decisions; shared understanding in analysis and decision-making - good intentions but difficult to achieve; the health care providers' expertise directs the dialog; the context's impact on the rehabilitation dialog; and insights about missed opportunities to grasp the patient perspective and arrive at decisions.

    Conclusions: Interprofessional stroke teams consider clinical reasoning as a process valuing patient and next of kin perspectives; however, their professional expertise risks preventing individual needs from surfacing. There is a discrepancy between professionals' intentions for person-centeredness and how clinical reasoning plays out. Stimulated recall can unveil person-centered practice and enhance professionals' awareness of their clinical reasoning.

  • 31.
    Elvén, Maria
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Welin, Elisabet
    Örebro universitet, Institutionen för hälsovetenskaper.
    Wiegleb Edström, Desirée
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Petreski, Tadej
    Institute for Biomedical Sciences, Faculty of Medicine, University of Maribor, Maribor, Slovenia; Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia.
    Szopa, Magdalena
    Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland.
    Durning, Steven J.
    Department of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Clinical Reasoning Curricula in Health Professions Education: A Scoping Review2023Inngår i: Journal of medical education and curricular development, E-ISSN 2382-1205, Vol. 10, artikkel-id 23821205231209093Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: This scoping review aimed to explore and synthesize current literature to advance the understanding of how to design clinical reasoning (CR) curricula for students in health professions education.

    METHODS: Arksey and O'Malley's 6-stage framework was applied. Peer-reviewed articles were searched in PubMed, Web of Science, CINAHL, and manual searches, resulting in the identification of 2932 studies.

    RESULTS: Twenty-six articles were included on CR in medical, nursing, physical therapy, occupational therapy, midwifery, dentistry, and speech language therapy education. The results describe: features of CR curriculum design; CR theories, models, and frameworks that inform curricula; and teaching content, methods, and assessments that inform CR curricula.

    CONCLUSIONS: Several CR theories, teaching, and assessment methods are integrated into CR curricula, reflecting the multidimensionality of CR among professions. Specific CR elements are addressed in several curricula; however, no all-encompassing CR curriculum design has been identified. These findings offer useful insights for educators into how CR can be taught and assessed, but they also suggest the need for further guidance on educational strategies and assessments while learners progress through an educational program.

  • 32.
    Escher, Cecilia
    et al.
    CLINTEC-Department of Clinical Science Interventions and Technology, Karolinska Institutet, Stockholm, Sweden; CAMST-Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden.
    Rystedt, Hans
    Department of Education, Communication and Learning, University of Gothenburg, Gothenburg, Sweden.
    Creutzfeldt, Johan
    CLINTEC-Department of Clinical Science Interventions and Technology, Karolinska Institutet, Stockholm, Sweden; CAMST-Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden.
    Meurling, Lisbet
    CLINTEC-Department of Clinical Science Interventions and Technology, Karolinska Institutet, Stockholm, Sweden; CAMST-Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden.
    Nyström, Sofia
    Department of Behavior Sciences and Learning, Linköping University, Linköping, Sweden.
    Dahlberg, Johanna
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Edelbring, Samuel
    6Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Nordahl Amorøe, Torben
    Simulator Centre West, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Hult, Håkan
    CLINTEC-Department of Clinical Science Interventions and Technology, Karolinska Institutet, Stockholm, Sweden.
    Felländer-Tsai, Li
    CLINTEC-Department of Clinical Science Interventions and Technology, Karolinska Institutet, Stockholm, Sweden; CAMST-Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden.
    Abrandt Dahlgren, Madeleine
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Method matters: impact of in-scenario instruction on simulation-based teamwork training2017Inngår i: Advances in Science and Technology Research Journal, ISSN 2364-3277, E-ISSN 2059-0628, Vol. 2, artikkel-id 25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The rationale for introducing full-scale patient simulators in training to improve patient safety is to recreate clinical situations in a realistic setting. Although high-fidelity simulators mimic a wide range of human features, simulators differ from the body of a sick patient. The gap between the simulator and the human body implies a need for facilitators to provide information to help participants understand scenarios. The authors aimed at describing different methods that facilitators in our dataset used to provide such extra scenario information and how the different methods to convey information affected how scenarios played out.

    Methods:  A descriptive qualitative study was conducted to examine the variation of methods to deliver extra scenario information to participants. A multistage approach was employed. The authors selected film clips from a shared database of 31 scenarios from three participating simulation centers. A multidisciplinary research team performed a collaborative analysis of representative film clips focusing on the interplay between participants, facilitators, and the physical environment. After that, the entire material was revisited to further examine and elaborate the initial findings.

    Results: The material displayed four distinct methods for facilitators to convey information to participants in simulation-based teamwork training. The choice of method had impact on the participating teams regarding flow of work, pace, and team communication. Facilitators’ close access to the teams’ activities when present in the simulation suite, either embodied or disembodied in the simulation, facilitated the timing for providing information, which was critical for maintaining the flow of activities in the scenario. The mediation of information by a loudspeaker or an earpiece from the adjacent operator room could be disturbing for team communication.

    Conclusions:  In-scenario instruction is an essential component of simulation-based teamwork training that has been largely overlooked in previous research. The ways in which facilitators convey information about the simulated patient have the potential to shape the simulation activities and thereby serve different learning goals. Although immediate timing to maintain an adequate pace is necessary for professionals to engage in training of medical emergencies, novices may gain from a slower tempo to train complex clinical team tasks systematically.

    Fulltekst (pdf)
    Method matters: impact of in-scenario instruction on simulation-based teamwork training
  • 33.
    Friman, Anne
    et al.
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Wiegleb Edström, Desirée
    Örebro universitet, Institutionen för medicinska vetenskaper. Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Sweden.
    Ebbeskog, Britt
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    General practitioners' knowledge of leg ulcer treatment in primary healthcare: an interview study2020Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 21, artikkel-id e34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To describe general practitioners' (GPs') knowledge and the development of their knowledge regarding leg ulcer treatment when treating patients with leg ulceration at primary healthcare centers.

    BACKGROUND: Earlier research regarding GPs' knowledge of leg ulcer treatment in a primary healthcare context has focused primarily on the assessment of wounds and knowledge of wound care products. Less is known about GPs' understandings of their own knowledge and knowledge development regarding leg ulceration in the everyday clinical context. This study, therefore, sets out to highlight these aspects from the GPs' perspective.

    METHODS: Semi-structured interviews were conducted with 16 individual GPs working at both private and county council run healthcare centers. The data were analyzed inductively using a thematic analysis.

    RESULTS: Four themes were identified. 'Education and training' describe the GPs' views regarding their knowledge and knowledge development in relation to leg ulcer treatment. 'Experience' refers to GPs' thoughts about the importance of clinical experience when treating leg ulcers. 'Prioritization' describes the issues GPs raised around managing the different knowledge areas in their clinical work. 'Time constraints' explore the relationship between GPs' sense of time pressure and their opportunities to participate in professional development courses.

    CONCLUSIONS: The study shows that the GPs working in primary healthcare are aware of the need for ongoing competence development concerning leg ulceration. They describe their current knowledge of leg ulcer treatment as insufficient and point to the lack of relevant courses that are adapted for their level of knowledge and the limited opportunities for clinical training.

  • 34.
    Friman, Anne
    et al.
    LIME, Karolinska Institutet, Stockholm, Sweden.
    Wiegleb Edström, Desirée
    Dermatology, Karolinska Institutet, Stockholm, Sweden.
    Edelbring, Samuel
    LIME, Karolinska Institutet, Stockholm, Sweden.
    A mixed methods approach to nursing and medicine students’ attitudes towards collaboration2014Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Lack of physician-nurse collaboration in wound management may result in prolonged healing process for the patients (Apelqvist, 2012). In order to facilitate future professional collaboration interprofessional undergraduate learning activities has been proposed (Barr et al., 2005). The aim of this study is to investigate changes and characteristics of nursing and medical students’ attitudes towards each other’s future professions in relation to a joint learning activity.

    Summary of Work: Medical (n=38) and nursing (n=30) students were jointly trained in compression therapy, Doppler assessment and wound case studies. Students were measured by the Jefferson scale on attitudes toward Physician-Nurse Collaboration (Hojat, et al., 1999) and compared to previously gathered baseline scores. Focus group interviews were held to deepen the knowledge about characteristics of attitudes towards both the others’ profession and towards collaboration.

    Summary of Results: Attitudes towards the other profession increased after interprofessional learning activity. This kind of learning activities may increase future professional collaboration and thus improve wound management.

    Discussion and Conclusions: Attitudes towards the other profession increased after interprofessional learning activity. This kind of learning activities may increase future professional collaboration and thus improve wound management.

    Take-home messages: Efforts should be made to find strategies for structures facilitating collaboration in clinical practice. Joint learning activities are appreciated by the students. These may result in better collaboration in students future professionals and may ultimately benefit patient care with better wound healing.

  • 35.
    Friman, Anne
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Wiegleb Edström, Desirée
    Karolinska University Hospital, Stockholm, Sweden.
    Edelbring, Samuel
    LIME, Karolinska Institutet, Stockholm, Sweden.
    An effort to winding future nurses and physicians together: Students’ joint learning about wound management2014Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Lack of physician-nurse collaboration in wound management may result in prolonged healing process for the patients (Apelqvist, 2012). In order to facilitate future professional collaboration interprofessional undergraduate learning activities has been proposed (Barr et al., 2005).

    Objectives: The aim of this study is to investigate changes and characteristics of nursing and medical students’ attitudes towards each other’s future professions in relation to a joint learning activity in wound management. Methods Medical (n=40) and nursing (n=50) students were jointly trained in compression therapy, Doppler assessment and wound case studies. Students were measured by the Jefferson scale on attitudes toward Physician-Nurse Collaboration (Hojat, et al., 1999) and compared to previously gathered baseline scores. Focus group interviews were held to deepen the knowledge about characteristics of attitudes towards both the others’ profession and towards collaboration.

    Results: Students scored high on the Jefferson scale in conjunction to the IPE activity. However, since also the baseline group scored high, no differences were detected after joint training. Preliminary analysis of qualitative data shows that medical students’ consider the nursing role as practically oriented with focus on the patients’ different needs of care, while nursing students sees the role of physicians as generation bound pointing to elderly physicians’ dominance and younger physicians’ flexibility but also to variations between organizational levels of care. Students experienced a lack of structural support for collaboration in their clinical practice. Interprofessional training was considered as important to gain insight into each other’s complementing knowledge area. Furthermore joint training was considered providing wider perspectives of patient care.

    Implications: The joint learning activity provided new insight into the other profession’s competence, and was appreciated by the students. This kind of learning activity may increase future professional collaboration and thus improve wound management. Efforts should be made to find strategies for structures facilitating collaboration in clinical practice.

  • 36.
    Friman, Anne
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Wiegleb Edström, Desirée
    Örebro universitet, Institutionen för medicinska vetenskaper. Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden.
    Edelbring, Samuel
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Attitudes and perceptions from nursing and medical students towards the other profession in relation to wound care2017Inngår i: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 31, nr 5, s. 620-627Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Lack of nurse‒physician collaboration in wound care may result in prolonged healing times for patients. In order to facilitate future professional collaboration, undergraduate learning activities in interprofessional education (IPE) have been proposed. The aim of this study was to investigate nursing and medical students’ attitudes and perceptions towards each other’s future professions and interprofessional collaboration in wound care. Nursing and medical students took part in an interprofessional learning activity about wound care. Data were collected using the Jefferson Scale of Attitudes towards Physician‒Nurse Collaboration questionnaire to student groups before and after an IPE activity (pooled n = 221). Focus groups were conducted to deepen the knowledge about students’ attitudes and perceptions. The results showed high scores on the attitude scale (mean 53.2, possible maximum = 60) both before and after IPE, indicating positive attitudes towards nurse‒physician collaboration. Nursing students scored higher than medical students both pre-IPE (p < 0.001) and post-IPE (p = 0.006). However, no difference on scale scores could be identified between pre- and post-IPE. The following themes emerged in the analysis of focus group discussions: “Approaching patient care from different perspectives,” “Need for collaboration and clear professional roles in practice,” “Structures hindering future collaboration,” and “IPE as a tool for professional practice and roles.” The shared learning activity provided insights into the other profession’s competence. This kind of learning activity may increase future interprofessional collaboration, and thus, improve wound care.

  • 37.
    Friman, Anne
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Huddinge, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Wiegleb Edström, Desirée
    Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Huddinge, Sweden; Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden.
    Edelbring, Samuel
    Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Huddinge, Sweden.
    General practitioners’ perceptions of their role and their collaboration with district nurses in wound care2019Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 20, artikkel-id UNSP e39Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To explore the perceptions of general practitioners (GPs) regarding their role and their collaboration with district nurses (DNs) in the management of leg ulcers in primary healthcare.

    Background: Earlier research regarding the treatment of leg ulcers in a primary care context has focussed primarily on wound healing. Less is known about GPs’ understandings of their role and their collaboration with DNs in the management of leg ulcers. Since the structured care of patients with leg ulcers involving both GP and DN is currently rather uncommon in Swedish primary care, this study sets out to highlight these aspects from the GP’s perspective.

    Methods: Semi-structured individual interviews with 16 GPs including both private and county council run healthcare centres. Thematic analysis was used to analyse the data.

    Results: Four themes were identified. The first theme: ‘role as consultant and coordinator’ shows how the GPs perceived their role in wound care. In the second theme: ‘responsibility for diagnosis’ the GPs’ views on responsibility for wound diagnosis is presented. The third theme: ‘desire for continuity’ is based on the GPs’ desire for continuity concerning various aspects. In the fourth theme: ‘collaboration within the organisation’ the importance of the organisation for collaboration between GPs and DNs is presented.

    Conclusions: The GP’s often work on a consultation-like basis and feel that they become involved late in the patients’ wound treatment. This can have negative consequences for the medical diagnosis and, thereby, lead to a prolonged healing time for the patient. Shortcomings regarding collaboration are mainly attributed to organisational factors.

  • 38.
    Hege, Inga
    et al.
    Medical Education Sciences, University of Augsburg, Augsburg, Germany.
    Adler, Martin
    Instruct gGmbH, Munich, Germany.
    Donath, Daniel
    Faculty of Medicine and Health, EDU Higher Education Institute, Kalkara, Malta.
    Durning, Steven J.
    Uniformed Services University of the Health Sciences, Bethesda, USA.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Elvén, Maria
    School of Health Sciences, Örebro University, Örebro, Sweden; School of Health, Care and Social Welfare, Mälardalen University, Örebro, Sweden.
    Bogusz, Ada
    Jagiellonian University Medical College, Kraków, Poland.
    Georg, Carina
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Huwendiek, Sören
    Department for Assessment and Evaluation, Institute for Medical Education, Bern, Switzerland.
    Körner, Melina
    Medical Education Sciences, University of Augsburg, Augsburg, Germany.
    Kononowicz, Andrzej A.
    Jagiellonian University Medical College, Kraków, Poland.
    Parodis, Ioannis
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Södergren, Ulrika
    Sophiahemmet University, Stockholm, Sweden.
    Wagner, Felicitas L.
    Department for Assessment and Evaluation, Institute for Medical Education, Bern, Switzerland.
    Wiegleb Edström, Desirée
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Developing a European longitudinal and interprofessional curriculum for clinical reasoning2023Inngår i: Diagnosis (Berlin, Germany), ISSN 2194-8011, Vol. 10, nr 3, s. 218-224Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Clinical reasoning is a complex and crucial ability health professions students need to acquire during their education. Despite its importance, explicit clinical reasoning teaching is not yet implemented in most health professions educational programs. Therefore, we carried out an international and interprofessional project to plan and develop a clinical reasoning curriculum with a train-the-trainer course to support educators in teaching this curriculum to students. We developed a framework and curricular blueprint. Then we created 25 student and 7 train-the-trainer learning units and we piloted 11 of these learning units at our institutions. Learners and faculty reported high satisfaction and they also provided helpful suggestions for improvements. One of the main challenges we faced was the heterogeneous understanding of clinical reasoning within and across professions. However, we learned from each other while discussing these different views and perspectives on clinical reasoning and were able to come to a shared understanding as the basis for developing the curriculum. Our curriculum fills an important gap in the availability of explicit clinical reasoning educational materials both for students and faculty and is unique with having specialists from different countries, schools, and professions. Faculty time and time for teaching clinical reasoning in existing curricula remain important barriers for implementation of clinical reasoning teaching.

  • 39.
    Hege, Inga
    et al.
    Institute for Medical Education, Ludwig-Maximilians-Universität München, München, Germany; Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
    Kononowicz, Andrzej A.
    Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University, Krakow, Poland; Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Tolks, Daniel
    Institute for Medical Education, Ludwig-Maximilians-Universität München, München, Germany.
    Edelbring, Samuel
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Kuehlmeyer, Katja
    Institute for Ethics, History and Theory of Medicine, Ludwig-Maximilians-Universität München, München, Germany.
    A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review2016Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 16, artikkel-id 146Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Virtual Patients (VPs) have been in the focus of research in healthcare education for many years. The aim of our study was to analyze how virtual patients are described in the healthcare education literature, and how the identified concepts relate to each other.

    Methods: We performed a literature review and extracted 185 descriptions of virtual patients from the articles. In a qualitative content analysis approach we inductively-deductively developed categories and deducted subcategories. We constructed a concept map to illustrate these concepts and their interrelations.

    Results: We developed the following five main categories: Patient, Teacher, Virtual Patient, Curriculum, and Learner. The concept map includes these categories and highlights aspects such as the under-valued role of patients in shaping their virtual representation and opposing concepts, such as standardization of learner activity versus learner-centeredness.

    Conclusions: The presented concept map synthesizes VP descriptions and serves as a basis for both, VP use and discussions of research topics related to virtual patients.

    Fulltekst (pdf)
    A qualitative analysis of virtual patient descriptions in healthcare education based on a systematic literature review
  • 40.
    Hodza-Beganovic, Ruhija
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. International Medical Program-IMP, Centre for Teaching and Research inDisaster Medicine, Region Östergötland, Linköping, Sweden.
    Berggren, P.
    International Medical Program-IMP, Centre for Teaching and Research inDisaster Medicine, Region Östergötland, Linköping, Sweden; Linköping University, Linköping University, Linköping, Sweden.
    Hugelius, Karin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Survey-based experiential learning - means of raising professional awareness in developing countries2019Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, nr Suppl. 4, s. 586-586, artikkel-id ckz186.547Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Healthcare in post-war Balkans is still under development. Healthcare changes towards more complex clinical scenarios that need different competencies around patients. This study reports on survey based learning to increasing professional awareness for developing sustainable healthcare settings using an experiential learning approach.

    Methods: In this study, researchers and educators identified non-technical skills concepts on individual, team, and organizational levels. These concepts were contextualized into the local setting through interactive workshops. Two pediatric surgery clinics in Kosovo and Bosnia and Herzegovina participated who were part of an international clinical skills training project. The tools and surveys were: Johari window, Kolb’s learning style questionnaire, team members exchange quality scale, the IPEC framework for interprofessional competence, Team STEPPS observation tool and organizational models.

    Results: A model is developed for contextualizing core concepts on professional awareness into a local developing healthcare setting. It entails three steps conducted in consecutive workshops: Identifying research-based concepts on professional compe-tence on individual, team and organizational levels. Facilitating local contextualization of these concepts by using surveys in interactive workshops. Agreeing on indicators to maintain high professional awareness.

    Conclusions: Capacity-building in public health can be conducted through increasing professional awareness. Professional awareness can be approached in individual, team and organizational dimensions. Established core concepts of non-technical skills can be contextualized in other cultures through a survey-based experiential learning approach.

    Key messages:

    • Professional individual, team and organizational awareness is a vital part of conducting efficient healthcare.
    • The professional awareness can be enhanced through processing core concepts in a local context through facilitated workshops.
  • 41.
    Hodza-Beganovic, Ruhija
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. International Medical Program, Region Östergötland, Center for Disaster Medicine and Traumatology, Linköping University Hospital, Linköping, Sweden.
    Berggren, Peter
    Örebro universitet, Institutionen för hälsovetenskaper. International Medical Program, Region Östergötland, Center for Disaster Medicine and Traumatology, Linköping University Hospital, Linköping, Sweden; Department of Computer and Information Science, Linköping University, Linköping, Sweden.
    Hugelius, Karin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Survey-based experiential learning as a new approach to strengthening non-technical skills in LMIC health care settings2021Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 21, nr 1, artikkel-id 240Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: This study outlines key aspects of professional development among health professionals in low- and middle-income countries (LMIC). LMICs need support in developing their continuing medical education, and non-technical skills (NTS) that have been neglected in this respect. Given the nature of NTS, educational methods should be used experientially. This study aims to explore an interactive educational approach to increase NTS among health care professionals in an LMIC setting.

    METHODS: A design-based research approach was applied to develop an educational method. Key NTS concepts were identified, which directed the selection of research-based surveys. A series of workshops was designed in which a survey-based experiential approach was developed. The educational process followed a pattern of individual reflection, small group discussion and relating the concepts to the local practice in a wider group.

    RESULTS: An approach to increase NTS in LMIC settings emerged in iterative development through conducting workshops with health care teams in the Balkans. The topics could be grouped into individual, team, and organisational dimensions. The approach can be described as survey-based experiential learning involving steps in recurring interaction with participants. The steps include identifying concepts in individual, team and organization dimensions and contextualising them using experiential learning on the individual and group levels.

    CONCLUSION: An overarching approach has been developed that addresses NTS in an LMIC setting. The survey-based experiential learning approach can be beneficial for raising professional awareness and the development of sustainable healthcare settings in LMICs.

  • 42.
    Hugelius, Karin
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Prehospital major incident management: how do training and real-life situations relate? A qualitative study2021Inngår i: BMJ Open, E-ISSN 2044-6055, Vol. 11, nr 9, artikkel-id e048792Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore the relationship between preparations and real-life experiences among prehospital major incident commanders.

    Design: An explorative, qualitative design was used.

    Setting: Prehospital major incidents in Sweden. Data were collected between December 2019 and August 2020.

    Participants: Prehospital major incident commanders (n=15) with real-life experiences from major events, such as fires, bus accidents, a bridge collapse and terrorist attacks, were included. All but one had participated in 2-day training focusing on the prehospital management of major incidents. In addition, about half of the participants had participated in simulation exercises, academic courses and other training in the management of major incidents.

    Methods: Data from two-session individual interviews were analysed using inductive thematic analysis.

    Results: The conformity between real-life major incidents and preparations was good regarding prehospital major incident commanders' knowledge of the operational procedures applied in major incidents. However, the preparations did not allow for the complexities and endurance strategies required in real-life incidents. Personal preparations, such as mental preparedness or stress management, were not sufficiently covered in the preparations. To some extent, professional experience (such as training) could compensate for the lack of formal preparations.

    Conclusions: This study identified perceived gaps between preparations and real-life experiences of being a prehospital major incident commander. To minimise the gaps between demands and expectations on perceived control and to better prepare individuals for being prehospital major incident commanders, the training and other preparations should reflect complexities of real-life incidents. Preparations should develop both technical skills required, such as principles and methodology used, and personal preparedness. Personal preparations should include improving one's mental preparedness, self-knowledge and professional self-confidence required to successfully act as a prehospital incident commander. Since little is known about what pedagogical methods that should be used to enhance this, further research is needed.

  • 43.
    Kononowicz, Andrzej A.
    et al.
    Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland.
    Hege, Inga
    Medical Education Sciences, Medical School, University of Augsburg, Augsburg, Germany.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Sobocan, Monika
    Faculty of Medicine, Centre for Medical Education, University of Maribor, Maribor, Slovenia.
    Huwendiek, Sören
    Institute for Medical Education, University of Bern, Bern, Switzerland.
    Durning, Steven J.
    Division of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
    The need for longitudinal clinical reasoning teaching and assessment: Results of an international survey2020Inngår i: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 42, nr 4, s. 457-462Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Clinical reasoning is a key ability essential for practising health professionals. However, little is known about the current global adoption of clinical reasoning teaching and assessment.

    Purpose: We aimed to provide insights into how clinical reasoning is deliberately taught and assessed in curricula worldwide and to identify needs and perceived barriers for teaching clinical reasoning to students and educators.

    Methods: A questionnaire was devised by an international expert group and distributed in a large international medical education community. Data were collected in 2018 and analysed using descriptive statistics. We identified themes in free-text responses using content analysis.

    Results: Three hundred and thirteen responses from 76 countries were collected. Most respondents were from Europe (34%). While the presence of a longitudinal clinical reasoning curriculum was only reported by 28%, 85% stated that such a curriculum was needed. The lack of awareness of the need to explicitly teach clinical reasoning was the most commonly identified barrier. For assessment, the greatest need identified was for more workplace-based assessment.

    Conclusions: Global respondents indicate the need to implement explicit longitudinal clinical reasoning curricula. Our findings suggest that efforts should be put into improving faculty development, including evidence-based materials on how to teach and assess clinical reasoning.

  • 44.
    Kononowicz, Andrzej A.
    et al.
    Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland.
    Woodham, Luke A.
    Institute of Medical and Biomedical Education, St George’s, University of London, London, United Kingdom; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Learning and Professional Development Group, School of Health Sciences, Örebro University, Örebro, Sweden.
    Stathakarou, Natalia
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Davies, David
    Warwick Medical School, University of Warwick, Coventry, United Kingdom.
    Saxena, Nakul
    Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore.
    Car, Lorainne Tudor
    Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
    Carlstedt-Duke, Jan
    President’s Office, Nan yang Technological University, Singapore, Singapore.
    Car, Josip
    Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nan yang Technological University, Singapore, Singapore; Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
    Zary, Nabil
    Games for Health Innovations Centre, Lee Kong Chian School of Medicine, Nan yang Technological University, Singapore, Singapore; Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
    Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration2019Inngår i: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 21, nr 7, artikkel-id e14676Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education.

    Objective: The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction.

    Methods: We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models.

    Results: A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI -0.17 to 0.39, I-2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I-2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence.

    Conclusions: Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low-and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.

  • 45.
    Kononowicz, Andrzej A.
    et al.
    Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Stockholm, Sweden; Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland.
    Woodham, Luke
    Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Stockholm, Sweden; Institute of Medical and Biomedical Education, St George’s, University of London, London, UK.
    Georg, Carina
    Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Stockholm, Sweden.
    Edelbring, Samuel
    Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Stockholm, Sweden; Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Stathakarou, Natalia
    Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Stockholm, Sweden.
    Davies, David
    Warwick Medical School, University of Warwick, Warwick, UK.
    Masiello, Italo
    Department of Clinical Science and Education, Karolinska Institutet, Solna, Stockholm, Sweden.
    Saxena, Nakul
    Health Services and Outcomes Research (HSOR), National Healthcare Group, Singapore, Singapore.
    Tudor Car, Lorainne
    Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
    Car, Josip
    Health Services and Outcomes Research Programme, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK; Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
    Zary, Nabil
    Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Stockholm, Sweden; Mohammed VI University of Health Sciences, Casablanca, Morocco; Medical Education Research and Scholarship Unit, Lee Kong Chian Sch ool of Medicine, Nanyang Technological University, Singapore, Singapore.
    Virtual patient simulations for health professional education2016Inngår i: Cochrane Database of Systematic Reviews, E-ISSN 1469-493X, nr 5, artikkel-id CD012194Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review is to evaluate the effectiveness of virtual patient simulation as an educational intervention versus traditional learning, other types of e-Learning interventions and other forms of virtual patient simulation interventions for delivering pre-registration and post-registration healthcare professional education. We will primarily assess the impact of these interventions on learners knowledge, skills and attitudes. Our secondary objective is to assess the cost-effectiveness of these interventions.

    Fulltekst (pdf)
    Virtual patient simulations for health professional education
  • 46.
    Kononowicz, Andrzej
    et al.
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland.
    Zary, Nabil
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Edelbring, Samuel
    Department of Learning, Informatics Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Corral, Janet
    School of Medicine at the University of Colorado Denver, Denver, Colorado, USA.
    Hege, Inga
    Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, München, Germany.
    Virtual patients - what are we talking about?: A framework to classify the meanings of the term in healthcare education2015Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 15, artikkel-id 11Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background

    The term "virtual patients" (VPs) has been used for many years in academic publications, but its meaning varies, leading to confusion. Our aim was to investigate and categorize the use of the term "virtual patient" and then classify its use in healthcare education.

    Methods

    A literature review was conducted to determine all articles using the term "virtual patient" in the title or abstract. These articles were categorized into: Education, Clinical Procedures, Clinical Research and E-Health. All educational articles were further classified based on a framework published by Talbot et al. which was further developed using a deductive content analysis approach.

    Results

    536 articles published between 1991 and December 2013 were included in the study. From these, 330 were categorized as educational. Classifying these showed that 37% articles used VPs in the form of Interactive Patient Scenarios. VPs in form of High Fidelity Software Simulations (19%) and Virtual Standardized Patients (16%) were also frequent. Less frequent were other forms, such as VP Games.

    Analyzing the literature across time shows an overall trend towards the use of Interactive Patient Scenarios as the predominant form of VPs in healthcare education.

    Conclusions

    The main form of educational VPs in the literature are Interactive Patient Scenarios despite rapid technical advances that would support more complex applications. The adapted classification provides a valuable model for VP developers and researchers in healthcare education to more clearly communicate the type of VP they are addressing avoiding misunderstandings.

  • 47.
    Möller, Hans
    et al.
    Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden; Center for Spine Surgery in Stockholm, Stockholm, Sweden.
    Creutzfeldt, Johan
    Department of Clinical Science, Intervention and Technology, Division of Anesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden; Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
    Valeskog, Karin
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Rystedt, Hans
    Department of Education, Communication and Learning, University of Gothenburg, Gothenburg, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Fahlstedt, Madelen
    Division of Neuronic Engineering, Royal Institute of Technology (KTH), Stockholm, Sweden.
    Felländer-Tsai, Li
    Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden; Reconstructive Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
    Abrandt Dahlgren, Madeleine
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Technology-Enhanced Learning of Human Trauma Biomechanics in an Interprofessional Student Context2022Inngår i: Teaching and learning in medicine, ISSN 1040-1334, E-ISSN 1532-8015, Vol. 34, nr 2, s. 135-144Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Phenomenon: This study aimed to investigate how students can develop their understanding of trauma biomechanics by means of technology-enhanced learning—an interactive visualization tool developed to enhance understanding of the biomechanics underlying an injury via dynamic imaging sequences.

    Approach: Students were invited to explore the content as a learning resource during an interprofessional clinical placement on an orthopedic ward. Thirty volunteer medical, nursing, and physiotherapy/occupational therapy students participated in 10 interprofessional groups of three participants. They were video recorded while interacting with learning software that was divided into five sections: Work Up, General Information, Biomechanical Case Study, Biomechanical Risk Assessment, and Treatment. Investigators probed students’ learning experiences via four focus group discussions. A sociomaterial perspective was adopted, directing the analytical focus to how students’ made use of talk, gestures, bodies, and material objects to understand the visualized phenomena.

    Findings: When connecting the visualization to a patient case, certain features of the technology stood out as important for promoting engagement and understanding trauma mechanisms. Decreased tempo, showing the directions and dynamics of trauma biomechanics in slow-motion, and color coding of the strain on the affected structures were especially important for evoking the emotional responses. The visualization tool also supported students’ explorations of causal relationships between external forces and their biomedical effects. These features emphasize the sociomaterial relation between the design of the technology and the student activities.

    Insights: Dynamic visualization of biomechanical events has the potential to improve the understanding of injury mechanisms and specifically to identify anatomical structures at high risk of injury. Dynamic visualizations for educational purposes seem to promote possibilities for learners to contextualize visual representations relative to one’s own body. Educational methods and practice need explicit attention and development in order to use the full potential of the visualization technology for learning for the health care professions.

  • 48.
    Nesterowicz, Krzysztof
    et al.
    Department of Radioligands, Medical College, Faculty of Pharmacy, Jagiellonian University, Poland.
    Librowski, Tadeusz
    Department of Radioligands, Medical College, Faculty of Pharmacy, Jagiellonian University, Poland.
    Edelbring, Samuel
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Validating e-learning in continuing pharmacy education: user acceptance and knowledge change2014Inngår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 14, nr 33, artikkel-id 33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Continuing pharmacy education is becoming mandatory in most countries in order to keep the professional license valid. Increasing number of pharmacists are now using e-learning as part of their continuing education. Consequently, the increasing popularity of this method of education calls for standardization and validation practices. The conducted research explored validation aspects of e-learning in terms of knowledge increase and user acceptance.

    Methods

    Two e-courses were conducted as e-based continuing pharmacy education for graduated pharmacists. Knowledge increase and user acceptance were the two outcome measured. The change of knowledge in the first e-course was measured by a pre- and post-test and results analysed by the Wilcoxon signed–rank test. The acceptance of e-learning in the second e-course was investigated by a questionnaire and the results analysed using descriptive statistics.

    Results

    Results showed that knowledge increased significantly (p < 0.001) by 16 pp after participation in the first e-course. Among the participants who responded to the survey in the second course, 92% stated that e-courses were effective and 91% stated that they enjoyed the course.

    Conclusions

    The study shows that e-learning is a viable medium of conducting continuing pharmacy education; e-learning is effective in increasing knowledge and highly accepted by pharmacists from various working environments such as community and hospital pharmacies, faculties of pharmacy or wholesales.

  • 49.
    Nilsson, Mikael
    et al.
    Section of Internal Medicine and Functional Area Emergency Medicine, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.
    Fors, Uno
    Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden.
    Östergren, Jan
    Section of Internal Medicine and Functional Area Emergency Medicine, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.
    Bolinder, Gunilla
    Clinical Skills and Simulation Center, Karolinska University Hospital, Stockholm, Sweden.
    Edelbring, Samuel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Why Medical Students Choose to Use or Not to Use a Web-Based Electrocardiogram Learning Resource: Mixed Methods Study2019Inngår i: JMIR Medical Education, E-ISSN 2369-3762, Vol. 5, nr 2, artikkel-id e12791Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Electrocardiogram (ECG) interpretation is a core competence and can make a significant difference to patient outcomes. However, ECG interpretation is a complex skill to learn, and research has showed that students often lack enough competence. Web-based learning has been shown to be effective. However, little is known regarding why and how students use Web-based learning when offered in a blended learning situation.

    OBJECTIVE: The aim of this paper was to study students' use of Web-based ECG learning resources which has not previously been studied in relation to study strategies.

    METHODS: A qualitative explanatory design using mixed methods was adopted to explore how medical students reason around their choice to use or not to use a Web-based ECG learning resource. Overall, 15 of 33 undergraduate medical students attending a course in clinical medicine were interviewed. Data on usage of the resource were obtained via the learning management system for all students. At the final examination, all the students answered a questionnaire on study strategies and questions about internet access and estimated their own skills in ECG interpretation. Furthermore, study strategies and use patterns were correlated with results from an ECG Objective Structured Clinical Examination (OSCE) and a written course examination.

    RESULTS: In total, 2 themes were central in the students' reasoning about usage of Web-based ECG: assessment of learning needs and planning according to learning goals. Reasons for using the Web resource were to train in skills, regarding it as a valuable complement to books and lectures. The main reasons for not using the resource were believing they already had good enough skills and a lack of awareness of its availability. Usage data showed that 21 students (63%) used the Web resource. Of these, 11 were minimal users and 10 were major users based on usage activity. Large variations were found in the time spent in different functional parts of the resource. No differences were found between users and nonusers regarding the OSCE score, final examination score, self-estimate of knowledge, or favoring self-regulated learning.

    CONCLUSIONS: To use or not to use a Web-based ECG learning resource is largely based on self-regulated learning aspects. Decisions to use such a resource are based on multifactorial aspects such as experiences during clinical rotations, former study experiences, and perceived learning needs. The students' own judgment of whether there was a need for a Web-based resource to achieve the learning goals and to pass the examination was crucial for their decisions to use it or not. An increased understanding of students' regulation of learning and awareness of variations in their ECG learning needs can contribute to the improvement of course design for blended learning of ECG contexts for medical students.

  • 50.
    Nyström, Sofia
    et al.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Dahlberg, Johanna
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Edelbring, Samuel
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Hult, Håkan
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Abrandt Dahlgren, Madeleine
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Continuing professional development: pedagogical practices of interprofessional simulation in health care2017Inngår i: Studies in Continuing Education, ISSN 0158-037X, E-ISSN 1470-126X, Vol. 39, nr 3, s. 303-319Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for the CPD of health care professionals. Specifically, the study focuses on how a professional development activity, the simulation, is enacted to support interprofessional collaboration and learning. A practice theory perspective is used as the theoretical framework. In this, the professional practice is conceptualised as being embodied, relational and situated in sociomaterial arrangements. Ten introduction and reflection sessions following interprofessional full-scale manikin-based simulations with professionals were video-recorded. The recordings were analysed following a stepwise qualitative collaborative approach developed for the purpose. The key findings suggest that the professional competence activity is enacted and interconnected with and governed by historical traditions of institutional teaching practices as well as simulation practices. Despite the intentions of team and interprofessional training, the institutional teaching and simulation practices constrain and hinder the intended outcomes of professional development in interprofessional collaboration.

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