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McKellar L, Graham K, Sheehan A, Fleet JA, Sidebotham M, Sweet L. Examining the transformation of midwifery education in Australia to inform future directions: An integrative review. Women Birth 2023; 36:155-166. [PMID: 36473797 DOI: 10.1016/j.wombi.2022.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Integral to quality midwifery practice is the education of midwives. Like other countries, Australia faces ongoing challenges in delivering midwifery education programs. Reasons include escalating program costs, challenges in securing meaningful clinical experiences, subsumption of midwifery with nursing, and associated loss of identity in some institutions. AIM To critically examine the literature exploring the historical and current drivers, supports and impediments for entry-to-practice midwifery programs to identify strategies to strengthen midwifery education in Australia. METHODS A structured integrative literature review using Whittemore and Knafl's five-stage framework was undertaken; 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis, and 5) presentation of results. FINDINGS The literature search identified 50 articles for inclusion. The thematic analysis identified four key themes: i. a commitment to educational reform, ii. building a midwifery workforce, iii. quality maternity care through midwifery education, and iv. progressing excellence in midwifery education. DISCUSSION Extensive literature describes the evolution of midwifery education in Australia over the last 30 years. Through collaboration and amidst opposition, quality midwifery education has been established in Australia. Identification of midwifery as a distinct profession and transformative leadership have been integral to this evolution and must be grown and sustained to prevent a decline in standards or quality. CONCLUSION There is a need to address priorities in midwifery education and for the evaluation of midwifery programs and pedagogy. The provision and maintenance of quality education and practice require shared responsibility between education providers and health care services.
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Affiliation(s)
- Lois McKellar
- School of Health and Social Care, Edinburgh Napier University, UK.
| | - Kristen Graham
- College of Nursing and Health Sciences, Flinders University, Australia
| | - Athena Sheehan
- School of Nursing and Midwifery, Western Sydney University, Australia
| | - Julie-Anne Fleet
- Clinical & Health Sciences, Rosemary Bryant AO Research Centre, University of South Australia, Australia
| | - Mary Sidebotham
- School of Nursing and Midwifery, Griffith University, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Australia
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Tassoni D, Kent F, Simpson J, Farlie MK. Supporting health professional educators in the workplace: A scoping review. MEDICAL TEACHER 2023; 45:49-57. [PMID: 35914529 DOI: 10.1080/0142159x.2022.2102467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Clinical educators frequently request additional support for educating pre-qualification health professions students despite having access to professional development programs to build education knowledge and skills. The breadth of 'additional support' options remains unclear. The aim of this review is to explore what is known about support options for health professional educators in the workplace through the lens of learning organisations. MATERIALS AND METHODS A scoping review was conducted searching Ovid Medline, CINAHL, ProQuest and PsycINFO electronic databases from 1 January 2005 up to 21 October 2020 for studies that identified support strategies for clinical educators of pre-qualification students in the workplace. Relevant data were charted, summarised thematically and synthesised with reference to support type and implementation level. RESULTS Fifty relevant records related to medicine, nursing and allied health clinical education were included. Twelve support themes and five cross-cutting support categories were identified across four implementation levels of healthcare systems. CONCLUSIONS A diversity of support for clinical educators beyond professional development was identified. Future research combined with leadership and commitment from the healthcare and education sectors is needed to better understand the applicability, efficacy and resourcing of any newly integrated support to ensure it is sustainable and improves clinical educator capability.
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Affiliation(s)
- Daniella Tassoni
- Allied Health Clinical Education, The Royal Children's Hospital, Melbourne, Australia
| | - Fiona Kent
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Jacinta Simpson
- Learning and Teaching Directorate, Eastern Health, Melbourne, Australia
| | - Melanie K Farlie
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Lenson S, Mills J. Undergraduate paramedic student psychomotor skills in an obstetric setting: An evaluation. Nurse Educ Pract 2017; 28:13-19. [PMID: 28926753 DOI: 10.1016/j.nepr.2017.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 04/26/2017] [Accepted: 08/06/2017] [Indexed: 11/28/2022]
Abstract
The clinical education of paramedic students is an international concern. In Australia, student placements are commonly undertaken with local district ambulance services, however these placements are increasingly limited. Clinical placements within inter-professional settings represent an innovative yet underdeveloped area of investigation. This paper addresses that gap by reporting a pilot evaluation of paramedic student clinical placements in a specialised obstetrics setting. Using a case study approach, the evaluation aimed to identify paramedic psychomotor skills that could be practised in this setting, and understand the nature of key learning events. A purposive sample of paramedic students was recruited following completion of the obstetrics placement. A combination of student reflection and assessed psychomotor skills data were collected from clinical placement logs. Content analysis of all data was conducted inductively and deductively, as appropriate. Findings indicated a comprehensive range of psychomotor skills can be practised in this setting, with over thirty psychomotor skills identified directly related to the paramedic curriculum; and seven psychomotor skills indirectly related. The themes finding confidence in maternity care, watching the experts, and putting theory into practice provide narrative insight into the clinical learning experience of paramedic students in this setting. Further research is recommended to build upon this pilot.
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Affiliation(s)
- Shane Lenson
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, PO Box 256 Dickson ACT 2602, Australia.
| | - Jason Mills
- School of Nursing, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove 4059 QLD, Australia.
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O’Keefe M, Wade V, McAllister S, Stupans I, Burgess T. Improving management of student clinical placements: insights from activity theory. BMC MEDICAL EDUCATION 2016; 16:219. [PMID: 27552987 PMCID: PMC4995630 DOI: 10.1186/s12909-016-0747-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 08/18/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND An approach to improve management of student clinical placements, the Building Teams for Quality Learning project, was trialed in three different health services. In a previous paper the authors explored in some detail the factors associated with considerable success of this approach at one of these services. In this paper, the authors extend this work with further analysis to determine if the more limited outcomes observed with participants at the other two services could be explained by application of activity theory and in particular the expansive learning cycle. METHODS Staff at three health services participated in the Building Teams for Quality Learning project: a dental clinic, a community aged care facility and a rural hospital. At each site a team of seven multi-disciplinary staff completed the project over 9 to 12 months (total 21 participants). Evaluation data were collected through interviews, focus groups and direct observation of staff and students. Following initial thematic analysis, further analysis was conducted to compare the processes and outcomes at each participating health service drawing on activity theory and the expansive learning cycle. RESULTS Fifty-one interview transcripts, 33 h of workplace observation and 31 sets of workshop field notes (from 36 h of workshops) were generated. All participants were individually supportive of, and committed to, high quality student learning experiences. As was observed with staff at the dental clinic, a number of potentially effective strategies were discussed at the aged care facility and the rural hospital workshops. However, participants in these two health services could not develop a successful implementation plan. The expansive learning cycle element of modeling and testing new solutions was not achieved and participants were unable, collectively to reassess and reinterpret the object of their activities. CONCLUSION The application of activity theory and the expansive learning cycle assisted a deeper understanding of the differences in outcomes observed across the three groups of participants. This included identifying specific points in the expansive learning cycle at which the three groups diverged. These findings support some practical recommendations for health services that host student clinical placements.
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Affiliation(s)
- Maree O’Keefe
- Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| | - Victoria Wade
- Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| | - Sue McAllister
- Faculty of Health Sciences, Flinders University, Adelaide, Australia
| | - Ieva Stupans
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Teresa Burgess
- Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
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Axelsson C, Herrera MJ, Bång A. How the context of ambulance care influences learning to become a specialist ambulance nurse a Swedish perspective. NURSE EDUCATION TODAY 2016; 37:8-14. [PMID: 26596850 DOI: 10.1016/j.nedt.2015.10.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 10/22/2015] [Accepted: 10/30/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Ambulance emergency care is multifaceted with extraordinary challenges to implement accurate assessment and care. A clinical learning environment providing opportunities for mastering these essential skills is a key component in ensuring that prehospital emergency nurse (PEN) students acquire the necessary clinical competence. AIM The aim is to understand how PEN students experience their clinically based training, focusing on their learning process. METHOD We applied content analysis with its qualitative method to our material that consisted of three reflections each by 28 PEN students over their learning process during their 8 weeks of clinical ambulance practice. The research was carried out at the Center for Prehospital Care, University of Borås, Sweden. RESULTS The broad spectrum of ambulance assignments seems to awaken great uncertainty and excessive respect in the students. Student vulnerability appears to decrease when the clinical supervisor behaves calmly, knowledgeably, confidently and reflectively. Early traumatic incidents on the other hand may increase the students' anxiety. Each student is offered a unique opportunity to learn how to approach patients and relatives in their own environments, and likewise an opportunity to gather information for assessment. Infrequency of missions seems to make PEN students less active in their student role, thereby preventing them from availing themselves of potential learning situations. Fatigue and hunger due to lack of breaks or long periods of transportation also inhibit learning mode. CONCLUSION Our findings suggest the need for appraisal of the significance of the clinical supervisor, the ambulance environment, and student vulnerability. The broad spectrum of conditions in combination with infrequent assignments make simulation necessary. However, the unique possibilities provided for meeting patients and relatives in their own environments offer the PEN student excellent opportunities for learning how to make assessments.
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Affiliation(s)
- Christer Axelsson
- Faculty of Caring Science, Working Life and Social Welfare, University of Borås, SE-501 90 Borås, Sweden.
| | - Maria Jimenez Herrera
- Nursing Department, Universitat Rovira I Virgili, Campus Catalunya despatx 0.22, Av. Catalunya, 35, 43002 Tarragona, Spain.
| | - Angela Bång
- Faculty of Caring Science, Working Life and Social Welfare, University of Borås, SE-501 90 Borås, Sweden.
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Devenish AS, Clark MJ, Flemming ML. Experiences in Becoming a Paramedic: The Professional Socialization of University Qualified Paramedics. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ce.2016.76081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hickson H, Williams B, O'Meara P. Paramedicine students' perception of preparedness for clinical placement in Australia and New Zealand. BMC MEDICAL EDUCATION 2015; 15:168. [PMID: 26438130 PMCID: PMC4593214 DOI: 10.1186/s12909-015-0446-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 09/21/2015] [Indexed: 05/30/2023]
Abstract
BACKGROUND Clinical placement is an essential element of paramedicine education and training as the profession completes the transition from vocational training to a pre-employment, university based model. The objective of this study was to survey pre-employment paramedicine students at Universities in Victoria, Australia and Auckland, New Zealand to measure their self-assessed preparedness for clinical placement. METHODS This was a cross-sectional study involving paper-based questionnaires employing a convenience sample of 682 undergraduate paramedicine students (years 1-4) who had completed at least one clinical placement. Student perceptions of preparedness for clinical placement were measured using an adaptation of the 'Preparedness for Hospital Practice' questionnaire. RESULTS There are significant differences in students' perception of preparedness for clinical placement, which reflects the differences between universities in relation to structure of their paramedicine programs, the timing of clinical education and the number of hours of clinical placement. DISCUSSION There needs to be clinical placement agreements between the ambulance services and universities that clearly describe the standards and expected elements of a quality clinical placement. CONCLUSIONS In order to improve the preparedness for placement for paramedicine students, a united approach is required by all stakeholders, including ambulance services, students and universities.
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Affiliation(s)
- Helen Hickson
- La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, VIC, 3552, Australia.
| | - Brett Williams
- Department of Community Emergency Health & Paramedic Practice, Monash University, Frankston, Australia.
| | - Peter O'Meara
- La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, VIC, 3552, Australia.
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Kennedy S, Kenny A, O'Meara P. Student paramedic experience of transition into the workforce: A scoping review. NURSE EDUCATION TODAY 2015; 35:1037-1043. [PMID: 26025582 DOI: 10.1016/j.nedt.2015.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 03/29/2015] [Accepted: 04/21/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES In this article we present the findings from a scoping review that sought to identify what is known about the experiences of paramedic students transitioning into the workforce. BACKGROUND Within the emergency healthcare sector, paramedics are primarily tasked with the assessment, treatment and safe transport of patients to hospital. New paramedics entering the workforce are exposed to the full extent of human emotion, injury and suffering as part of their everyday work. There is evidence from other healthcare disciplines that the transition to practice period can be difficult for new graduates. METHODS We utilised Arksey and O'Malley's five-stage scoping review framework to identify what is known about the transition of paramedicine graduates to the workplace. The framework involves identifying relevant studies; study selection; charting the data; and collating, summarizing and reporting results. RESULTS We identified eleven articles that explored transition of newly qualified paramedics. Thematic content was identified and discussed into four separate categories. Each theme revealing the emotional, physical and social impacts new paramedics face as they strive to find acceptance in a new workplace and culture. CONCLUSION Given the significant role that paramedics have in modern healthcare, the transition from student to practitioner is a period of significant stress to the new paramedic. Limited research in this field though inhibits a thorough understanding of these issues.
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Affiliation(s)
- Sean Kennedy
- PO Box 813, Strathfieldsaye, Victoria, Australia.
| | - Amanda Kenny
- La Trobe Rural Health School, La Trobe University, Victoria, Australia.
| | - Peter O'Meara
- La Trobe Rural Health School, La Trobe University, Victoria, Australia.
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Fernandez N. Evidence-based arguments in support of medical education reform. MEDICAL EDUCATION 2014; 48:347-8. [PMID: 24606617 DOI: 10.1111/medu.12419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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O'Keefe M, Burgess T, McAllister S, Stupans I. Twelve tips for supporting student learning in multidisciplinary clinical placements. MEDICAL TEACHER 2012; 34:883-887. [PMID: 22817382 DOI: 10.3109/0142159x.2012.700431] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Healthcare profession students participate in a range of clinical placements within multidisciplinary health care settings. Often these placements offer students opportunities to participate in activities with staff and/or students from other healthcare disciplines. Although health service staff generally recognise the importance of clinical placements for student learning, they sometimes feel overwhelmed by workload and resource constraints. As a consequence, the potential of the clinical team to contribute to student learning may not be fully realised. A key element of successful clinical placement programs across all healthcare disciplines is a coordinated approach to the development and management of complex university/health service partnerships. Explicit mechanisms to support clinical team members in their teaching roles can also contribute to develop and sustain staff capacity for student supervision, as appropriate recognition of clinical staff contributes to student learning. Twelve tips are offered for consideration by universities, health services and clinical staff when planning and implementing student clinical placements in multidisciplinary healthcare settings.
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Affiliation(s)
- Maree O'Keefe
- Faculty of Health Sciences, University of Adelaide, Adelaide, SA 5005, Australia.
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Brown T, Williams B, McKenna L, Palermo C, McCall L, Roller L, Hewitt L, Molloy L, Baird M, Aldabah L. Practice education learning environments: the mismatch between perceived and preferred expectations of undergraduate health science students. NURSE EDUCATION TODAY 2011; 31:e22-8. [PMID: 21131106 DOI: 10.1016/j.nedt.2010.11.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 10/15/2010] [Accepted: 11/04/2010] [Indexed: 05/16/2023]
Abstract
BACKGROUND Practical hands-on learning opportunities are viewed as a vital component of the education of health science students, but there is a critical shortage of fieldwork placement experiences. It is therefore important that these clinical learning environments are well suited to students' perceptions and expectations. PURPOSE To investigate how undergraduate students enrolled in health-related education programs view their clinical learning environments and specifically to compare students' perception of their 'actual' clinical learning environment to that of their 'preferred/ideal' clinical learning environment. METHOD The Clinical Learning Environment Inventory (CLEI) was used to collect data from 548 undergraduate students (55% response rate) enrolled in all year levels of paramedics, midwifery, radiography and medical imaging, occupational therapy, pharmacy, nutrition and dietetics, physiotherapy and social work at Monash University via convenience sampling. Students were asked to rate their perception of the clinical learning environment at the completion of their placements using the CLEI. RESULTS Satisfaction of the students enrolled in the health-related disciplines was closely linked with the five constructs measured by the CLEI: Personalization, Student Involvement, Task Orientation, Innovation, and Individualization. Significant differences were found between the student's perception of their 'actual' clinical learning environment and their 'ideal' clinical learning environment. CONCLUSION The study highlights the importance of a supportive clinical learning environment that places emphasis on effective two-way communication. A thorough understanding of students' perceptions of their clinical learning environments is essential.
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Affiliation(s)
- Ted Brown
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, Frankston, Victoria, Australia.
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Health-Service Organisation, Clinical Team Composition and Student Learning. PROFESSIONAL AND PRACTICE-BASED LEARNING 2011. [DOI: 10.1007/978-90-481-3937-8_11] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Mortensen L, Malling B, Ringsted C, Rubak S. What is the impact of a national postgraduate medical specialist education reform on the daily clinical training 3.5 years after implementation? A questionnaire survey. BMC MEDICAL EDUCATION 2010; 10:46. [PMID: 20565832 PMCID: PMC2902490 DOI: 10.1186/1472-6920-10-46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Accepted: 06/18/2010] [Indexed: 05/15/2023]
Abstract
BACKGROUND Many countries have recently reformed their postgraduate medical education (PGME). New pedagogic initiatives and blueprints have been introduced to improve quality and effectiveness of the education. Yet it is unknown whether these changes improved the daily clinical training. The purpose was to examine the impact of a national PGME reform on the daily clinical training practice. METHODS The Danish reform included change of content and format of specialist education in line with outcome-based education using the CanMEDS framework. We performed a questionnaire survey among all hospital doctors in the North Denmark Region. The questionnaire included items on educational appraisal meetings, individual learning plans, incorporating training issues into work routines, supervision and feedback, and interpersonal acquaintance. Data were collected before start and 31/2 years later. Mean score values were compared, and response variables were analysed by multiple regression to explore the relation between the ratings and seniority, type of hospital, type of specialty, and effect of attendance to courses in learning and teaching among respondents. RESULTS Response rates were 2105/2817 (75%) and 1888/3284 (58%), respectively. We found limited impact on clinical training practice and learning environment. Variances in ratings were hardly affected by type of hospital, whereas belonging to the laboratory specialities compared to other specialties was related to higher ratings concerning all aspects. CONCLUSIONS The impact on daily clinical training practice of a national PGME reform was limited after 31/2 years. Future initiatives must focus on changing the pedagogical competences of the doctors participating in daily clinical training and on implementation strategies for changing educational culture.
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Affiliation(s)
- Lene Mortensen
- Regional Hospital Viborg, Heiberg Alle 4, DK-8800 Viborg, Denmark
| | - Bente Malling
- Aarhus University Hospital Skejby, Department of Human Resources, Brendstrupgaardsvej, DK-8200 Aarhus N, Denmark
| | - Charlotte Ringsted
- University of Copenhagen and Capital Region, Centre of Clinical Education, Rigshospitalet afsnit 5404, Teilumbygningen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Sune Rubak
- Aarhus University Hospital Skejby, Department of. Paediatrics, Brendstrupgaardsvej, DK-8200 Aarhus N, Denmark
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