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Samuelsson M, Jakobsson J, Bengtsson M, Lydrup ML, Wennick A. Family members' conceptions of their supportive care needs across the colorectal cancer trajectory - A phenomenographic study. J Adv Nurs 2024. [PMID: 38940487 DOI: 10.1111/jan.16308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/12/2023] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
AIM To describe the variations of family members' conceptions of their supportive care needs (SCN) across the colorectal cancer (CRC) trajectory. DESIGN A descriptive qualitative study with a phenomenographic approach. METHOD Individual semi-structured interviews were conducted from May 2022 to October 2022 with 23 family members of persons diagnosed with colorectal cancer. The interviews were analysed using phenomenographic analysis following the Consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS The phenomenographic analysis resulted in five categories. Not of importance describes family members' needs as unimportant due to the good prognosis and the organization of care and in relation to the needs of others. Only satisfiable by professionals describes information possessed by the healthcare professionals as key, as well as the need for professional counselling for the family members to process their emotions. Managed by themselves describes family members preferring to manage their SCN themselves by turning to the appropriate social support and/or by using coping skills. Understood retrospectively describes SCN as only understandable when things have calmed down and as requiring one's own experience to understand. Left unmet describes SCN as unnoticed by the healthcare professionals or not brought to light by the family members, or family members not knowing where to turn for support. CONCLUSION Supportive care should involve individualized information, proactive and repeated assessments of needs across the trajectory, as well as encouragement of family members to reflect on their needs and to accept support when needed. IMPACT There is a gap in the literature regarding family members' SCN across the CRC trajectory which this study addresses. Findings show five categories of family members' conceptions of their SCN. Those findings could serve as a basis for the development of clinical colorectal supportive care across the cancer trajectory. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Findings show that to offer family members of persons diagnosed with colorectal cancer support only at the time of diagnosis is insufficient. Instead, the healthcare team is recommended to proactively and repeatedly try to identify those in need and the characteristics of their needs. In addition, it is important to offer individualized information and strive to encourage family members to reflect on their situation and to not suppress their own needs if emerging. REPORTING METHOD Reporting adheres to the consolidated criteria for reporting qualitative research (COREQ) checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Maria Samuelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Jenny Jakobsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
| | - Mariette Bengtsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Marie-Louise Lydrup
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
| | - Anne Wennick
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Zuckerman AL, Lo SM, Juavinett AL. Mentorship for Transfer Student Success in STEM Research: Mentor Approaches and Reflections. CBE LIFE SCIENCES EDUCATION 2024; 23:ar27. [PMID: 38805587 PMCID: PMC11235116 DOI: 10.1187/cbe.23-08-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Mentorship has been widely recognized as an effective means to promote student learning and engagement in undergraduate research experiences. However, little work exists for understanding different mentors' perceived approaches to mentorship, including mentorship of students from backgrounds and educational trajectories not well represented in science, technology, engineering, and mathematics (STEM). Transfer students, in particular, face unique trajectories in their pursuit of research opportunities, yet few studies investigate how mentors describe their approaches to supporting these students. Using semistructured interviews, this study examines how mentors approach mentoring students from diverse backgrounds as research trainees, with an emphasis on transfer students. First, using phenomenography as an analytical approach, we identified four categories describing variations in how mentors reflected upon or accounted for the transfer student identity in their approaches. We find that research mentors vary in their understanding and exposure to the transfer student identity and may have preconceived notions of the transfer student experience. Second, we present vignettes to illustrate how mentors' approaches to the transfer student identity may relate or diverge from their general approaches to mentoring students from different backgrounds and identities. The emerging findings have implications for developing effective mentorship strategies and training mentors to support transfer students.
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Affiliation(s)
- Austin L Zuckerman
- Joint Doctoral Program in Mathematics and Science Education, San Diego State University, San Diego, CA 92120
- Joint Doctoral Program in Mathematics and Science Education, University of California San Diego, San Diego, CA 92093
| | - Stanley M Lo
- Department of Cell and Developmental Biology, Joint Doctoral Program in Mathematics and Science Education, and Research Ethics Program, University of California San Diego, La Jolla, CA 92093
| | - Ashley L Juavinett
- Department of Neurobiology and Joint Doctoral Program in Mathematics and Science Education, University of California San Diego, San Diego, CA 92093
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Hsu JL, Sung RJ, Swarat SL, Gore AJ, Kim S, Lo SM. Variations in Student Approaches to Problem Solving in Undergraduate Biology Education. CBE LIFE SCIENCES EDUCATION 2024; 23:ar12. [PMID: 38437451 PMCID: PMC11235106 DOI: 10.1187/cbe.23-02-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 01/19/2024] [Accepted: 02/09/2024] [Indexed: 03/06/2024]
Abstract
Existing research has investigated student problem-solving strategies across science, technology, engineering, and mathematics; however, there is limited work in undergraduate biology education on how various aspects that influence learning combine to generate holistic approaches to problem solving. Through the lens of situated cognition, we consider problem solving as a learning phenomenon that involves the interactions between internal cognition of the learner and the external learning environment. Using phenomenography as a methodology, we investigated undergraduate student approaches to problem solving in biology through interviews. We identified five aspects of problem solving (including knowledge, strategy, intention, metacognition, and mindset) that define three qualitatively different approaches to problem solving; each approach is distinguishable by variations across the aspects. Variations in the knowledge and strategy aspects largely aligned with previous work on how the use or avoidance of biological knowledge informed both concept-based and nonconcept-based strategies. Variations in the other aspects revealed intentions spanning complete disengagement to deep interest with the course material, different degrees of metacognitive reflections, and a continuum of fixed to growth mindsets. We discuss implications for how these characterizations can improve instruction and efforts to support development of problem-solving skills.
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Affiliation(s)
- Jeremy L. Hsu
- Schmid College of Science and Technology, Chapman University, Orange, CA 92866
| | - Rou-Jia Sung
- Department of Biology, Carleton College, Northfield, MN 55057
| | - Su L. Swarat
- Office of Institutional Effectiveness and Planning, California State University, Fullerton, CA 92831
| | | | - Stephanie Kim
- Program in Biological Sciences, Northwestern University, Evanston, IL 60201
| | - Stanley M. Lo
- Department of Cell and Developmental Biology
- Joint Doctoral Program in Mathematics and Science Education, and
- Research Ethics Program University of California San Diego, La Jolla, CA 92093
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Balding KJ, Geraghty S, Timler A, Pezaro S, McChlery S. Phenomenography: A useful methodology for midwifery research. J Adv Nurs 2024; 80:2598-2610. [PMID: 37994238 DOI: 10.1111/jan.15978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 11/24/2023]
Abstract
AIMS To outline the theoretical, philosophical, and major assumptions associated with phenomenography and then address the application of a phenomenographical approach within the context of midwifery research. BACKGROUND Phenemonography is a little-known qualitative research approach amongst the main design traditions of phenomenology, grounded theory, case study, and ethnography more typically used within midwifery research. Phenomenography aims to describe the qualitatively different ways that people perceive, conceptualize, or experience a phenomenon. Phenemonography has a distinctly different approach from other qualitative methods as it places emphasis on the 'collective' meaning over individual experience. METHODOLOGY Phenomenography, as an approach, rests within the interpretivist paradigm recognizing that there are multiple interpretations of reality. Phenomenography emphasizes the various ways that people experience the same phenomenon, including both the similarities and differences. The second-order perspective embraced by phenomenography suggests that the researcher directs themselves towards people's understanding of the world; essentially the world is described as it is understood rather than as it is. It is the reporting about how these different realities appear at a collective level that is the output of phenomenographic research. FINDINGS A framework for conducting phenomenographic research is illustrated by outlining the steps within the methodological approach required to undertake a research study using phenemonography. CONCLUSION Phenomenography is a qualitative research approach that can usefully be applied in many midwifery contexts where a collective understanding of a phenomena is required. Using a phenomenographic approach can provide the midwifery profession with knowledge about variations in how women and midwives think, and how aspects of different phenomena are experienced in within a midwifery setting.
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Affiliation(s)
- Kirstie Jayne Balding
- School of Nursing & Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Sadie Geraghty
- School of Nursing & Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Amanda Timler
- The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Sally Pezaro
- The University of Notre Dame Australia, Coventry University, Coventry, UK
| | - Sheena McChlery
- School of Nursing & Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Kangasjarvi E, Forsey J, Simpson JS, Ng SL. "We're back in control of the story and we're not letting anyone take that away from us": patient teacher programs as means for patient emancipation. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:487-505. [PMID: 37455294 DOI: 10.1007/s10459-023-10255-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/04/2023] [Indexed: 07/18/2023]
Abstract
While patient engagement in healthcare professions education (HPE) has significantly increased in the past decades, a theoretical gap remains. What are the varied reasons as to why patients get involved with HPE programs? With a focus on understanding what drives patient involvement with HPE programs, this study examined how a patient as teacher (PAT) program was experienced by medical students, patient teachers, and faculty within a medical school. Through a phenomenographic approach, this study captures and describes the different ways our study participants experienced a PAT program (the 'phenomenon'). 24 semi-structured interviews were conducted in total, comprised of interviews with patient teachers (N = 10), medical students (N = 10) and program facilitators (N = 4) who participated in a PAT program. Our focus was on participants' description of the program and was grounded in their experiences of as well as their beliefs about it. Our findings captured 4 layers representing the qualitatively different (yet interrelated) ways in which participants experienced/perceived and conceptualized the various aspects of their experience with the PAT program: (1) A productive disruption of the learning space (2) A re-humanization within healthcare (3) A means of empowerment and agency (4) A catalyst for change and emancipation. Our outcome space results can be visually illustrated by a nesting "Matryoshka" doll, representing the four layers and depicting the process of uncovering the less conscious layers of sense-making within this phenomenon. HPE programs that are co-produced with patients and actively involve patients as teachers have the potential, but not guarantee, to be emancipatory. To engage in PAT programs that exhibit an emancipatory potential, we need to consider transformative paradigms of education, which are aligned with social change, and disrupt the traditional teacher-learner hierarchy.
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Affiliation(s)
- E Kangasjarvi
- Li Ka Shing Knowledge Institute, Applied Education Research Operatives (AERO), Faculty of Medicine, University of Toronto at St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
| | - J Forsey
- University of Toronto, Rehabilitation Sciences Institute, Toronto, ON, Canada
| | - J S Simpson
- Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - S L Ng
- University of Toronto, Centre for Interprofessional Education, University Health Network Toronto, Toronto, ON, Canada
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Andersen Ljungdahl K, Nissfolk S, Flodén A. The circulatory death that saves lives-Intensive care nurses' conceptions of participating during 'donation after circulatory death': A phenomenographic study. Nurs Open 2024; 11:e2124. [PMID: 38429987 PMCID: PMC10907890 DOI: 10.1002/nop2.2124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/24/2023] [Accepted: 02/07/2024] [Indexed: 03/03/2024] Open
Abstract
AIM To describe intensive care nurses' conceptions of participating during the donation after circulatory death (DCD) process in intensive care units in Sweden. DESIGN A qualitative design with a phenomenographic approach. METHODS In total, 12 semi-structured interviews were conducted in April 2022 with intensive care nurses from three hospitals. Data were analysed using a phenomenographic approach. RESULTS Conceptions of participating during the DCD process varied. Four main themes emerged: DCD as a system; Intensive care nurses' role in the situation; Life to death to life; The essence of DCD. Variations emerged regarding what the informants talked about and how they talked about the what. Variations were based on informants' perspective of their role in relation to the structure and the team, and their conceptions of care for patients and their relatives. CONCLUSION The findings illustrated success factors and challenges. Knowledge, experience, distinct structure, and relationship with relatives, among other factors, were described as success factors, while a lack of experience, difficulty in prognosing death, and organisational obstacles emerged as challenges. Furthermore, the findings showed that intensive care nurses play an important role in optimising the outcome of the DCD process. Their work related to DCD was conceived as being meaningful to fulfil more peoples' wishes to donate organs. IMPACT People on the waiting list for organ transplantation are dying due to a shortage of organs. The implementation of DCD, as a complement to Donation after Brain Death (DBD), contributed to an increase in the number of organ donors, and intensive care nurses play an important role during the DCD process. Previous research manifests the complexity concerning their role. There is a lack of nursing research regarding intensive care nurses' conceptions of what it means to participate in the DCD process, which emphasises the significance of this study. REPORTING METHOD This study is reported using consolidated criteria for reporting qualitative research (SRQR). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Kristin Andersen Ljungdahl
- Intensive and Critical Care Nurse, Neuro Intensive Care UnitSahlgrenska University HospitalGothenburgSweden
| | - Sara Nissfolk
- Intensive and Critical Care Nurse, General Intensive Care UnitÖstersund HospitalÖstersundSweden
| | - Anne Flodén
- Södra Älvsborg HospitalBoråsSweden
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
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Dutt DDCS, Carr SE, Scott TM, Petsoglou C, Grigg J, Razavi H. Educators' consideration of learner motivation in ophthalmology education in medical school: Influences on teaching practice and course design. MEDICAL TEACHER 2024; 46:387-398. [PMID: 37703439 DOI: 10.1080/0142159x.2023.2256956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND Ophthalmology education in medical school has historically neglected the impact of autonomous motivation on student learning and wellbeing. This study aimed to understand ophthalmology educators' consideration and application of student motivation in ophthalmology medical education. MATERIAL AND METHODS Lead ophthalmology educators from Australian and New Zealand medical schools participated in an online semi-structured in-depth interview. Interview transcripts were analysed using thematic analysis. Codes were generated and aligned into overarching themes. FINDINGS Six educators participated in the study. Five main themes arose from the transcripts: the lack of explicit consideration of student motivation, implicit consideration of motivation in curriculum design and in teaching practices, the impact of innovation on motivation and the relationship between teacher and student motivation. Participants also commented on trends in ophthalmology education including generalists' confidence in managing ophthalmic disease, the role of fundoscopy in medical education and time pressure on ophthalmology in medical schools. CONCLUSION There has only been an implicit instead of explicit consideration of motivation in ophthalmology education in medical school, which leaves an unfulfilled potential for teaching practices to impact the affective along with cognitive and metacognitive aspects of learning. This study highlights the need for motivation to be explicitly incorporated into the development of teaching practices and curriculum reform.
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Affiliation(s)
- Deepaysh D C S Dutt
- Health Professions Education, The University of Western Australia, Perth, Western Australia, Australia
| | - Sandra E Carr
- Health Professions Education, The University of Western Australia, Perth, Western Australia, Australia
| | - Tabitha M Scott
- Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
| | | | - John Grigg
- Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
- The Children's Hospital at Westmead, Eye Genetics Research Group, Children's Medical Research Institute, Sydney, New South Wales, Australia
- Genetic Medicine and Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Hessom Razavi
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
- Department of Ophthalmology, Lions Eye Institute, Perth, Western Australia, Australia
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Bayuo J, Aziato L, Wong KCA, Su J, Abu-Odah H, Wong FKY. Phenomenography: An emerging qualitative research design for nursing. J Adv Nurs 2024; 80:821-834. [PMID: 37743604 DOI: 10.1111/jan.15874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/25/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Phenomenography emerged from pedagogy to examine the qualitatively different ways that individuals experience and perceive the same phenomenon. Despite its uniqueness, the uptake of phenomenography in nursing research is still limited. Potentially, this may be related to confusion regarding what the design is about, its philosophical underpinnings and how distinct it is from other qualitative designs. OBJECTIVES To offer a better understanding of phenomenography by comparing it with other established qualitative research designs, examining its theoretical foundations, highlighting some studies that have employed the approach in nursing and offering methodological guidance to improve its uptake in nursing. DESIGN Discussion paper. FINDINGS Compared to the traditional qualitative designs employed in nursing, phenomenography has been utilized in fewer studies. The ontological, epistemological and methodological basis of phenomenography highlights it as a distinct design. The strength of phenomenography lies in its emphasis on understanding the collective variations between participants and presenting these holistically as an 'outcome space'. DISCUSSION Phenomenography is a distinct qualitative research approach that presents a unique opportunity for nursing to further its use. Issues regarding bracketing, the inclusion of phenomenography studies in qualitative meta-synthesis and employing a hermeneutic approach to phenomenography are avenues for further work in nursing. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Lydia Aziato
- University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Jingjing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Flood M, Strawbridge JD, Barlow JW. The experiences of migrant pharmacists: A phenomenographical study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100367. [PMID: 38045650 PMCID: PMC10692705 DOI: 10.1016/j.rcsop.2023.100367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/16/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
Objectives To understand the experiences of migrant pharmacists in Ireland as they applied for recognition of their qualifications and registration with the national accrediting body. Methods Semi structured interviews were conducted with eight participants recruited using purposive sampling. Interview transcripts were subject to a phenomenographic study using a stepwise, inductive approach. Results Data analysis led to the development of a number of categories or descriptions of understanding that provided insight into the ways that participants experienced and conceptualised the phenomenon under study. Five categories of description were identified. These are (1) the migrator, (2) the navigator, (3) the student again, and (4) the registrant. For some, an additional category, (5) the mentee, was experienced. Within these categories, variation in participants' experiences was explored. Conclusions Participants reported a variety of reasons for migration, and upon embarking on the process, applicants were required to take on a variety of roles, with variation within each role dependent on a number of personal and external factors. Applicants faced personal, administrative, experiential and regulatory hurdles prior to registration, all of which should inform the development of future iterations of this and similar processes.
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Affiliation(s)
- Michelle Flood
- School of Pharmacy and Biomolecular Sciences, 1st Floor, Ardilaun House Block B, 111 St. Stephen's Green, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Judith D. Strawbridge
- School of Pharmacy and Biomolecular Sciences, 1st Floor, Ardilaun House Block B, 111 St. Stephen's Green, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - James W. Barlow
- Department of Chemistry, 123 St. Stephen's Green, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
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Dutt DD, Razavi H, Carr SE. Self-determination theory in ophthalmology education: factors influencing autonomy, competence and relatedness in medical students. MEDICAL EDUCATION ONLINE 2023; 28:2258633. [PMID: 37729582 PMCID: PMC10512850 DOI: 10.1080/10872981.2023.2258633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The affective components of learning, including student motivation, has yet to be thoroughly investigated in undergraduate ophthalmology education. This study aims to use Self-Determination Theory (SDT) as a framework to describe the variations in student perceptions of motivation in studying ophthalmology through their satisfactions of autonomy, competence and relatedness, and to highlight factors that stimulate or hinder this. METHODS Penultimate year medical students from a single tertiary educational institution undertaking a clinical placement in ophthalmology participated in in-depth interviews to explore factors affecting their perceptions of motivation in studying ophthalmology. Interviews were transcribed and analysed according to the principles of interpretive phenomenography through the theoretical framework of SDT. RESULTS Of the 39 students invited, 10 agreed to participate. Variations in perceptions of experiences generated the outcome space. Participants experienced either amotivation, external locus extrinsic motivation, internal locus extrinsic motivation and intrinsic motivation (conceptions of the outcome space). This was described with respect to their satisfaction of autonomy, competence and relatedness (dimensions of the outcome space). Additionally, 21 factors that impacted on motivation were identified, of which five over-arching factors impacted all three basic psychological needs - guidance, growth mindset, assessment, curricular pressure and extracurricular pressure. CONCLUSIONS The findings of this study provide a unique insight into the motivation of medical students studying ophthalmology. This provides an exciting opportunity for medical educators to address the affective aspect of learning.
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Affiliation(s)
- Deepaysh D.C.S. Dutt
- Health Professions Education, The University of Western Australia, Perth, Western Australia, Australia
| | - Hessom Razavi
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
- Lions Eye Institute, Department of Ophthalmology, Perth, Western Australia, Australia
| | - Sandra E. Carr
- Health Professions Education, The University of Western Australia, Perth, Western Australia, Australia
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Lama A. Reflective Teaching Journals as an Effective Embedded Formative Assessment Process of Teaching Skill Development Confidence in a Longitudinal Medical Student-as-Teacher Elective. MEDICAL SCIENCE EDUCATOR 2023; 33:1493-1503. [PMID: 38188416 PMCID: PMC10766913 DOI: 10.1007/s40670-023-01938-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 01/09/2024]
Abstract
Background This study focuses on the use of reflective teaching journals by fourth year US allopathic medical school students (MS4) during a longitudinal medical student-as-teacher (SaT) elective, and how MS4s self-assess their perceptions around teacher skill development and individual transitions into resident educators who teach junior learners. Method Between September 2020 and December 2020, twelve MS4s in a longitudinal SaT elective completed 21 hours in a clinical bedside student teaching placement with embedded structured reflective teaching journals. Sixty-nine individual reflective teaching journal entries were collected in two distinct stages and analyzed using a phenomenographical lens. Conclusion From these data, the author established three thematic categories where reflective teaching journals reveal (a) a framework for pedagogical skill building, (b) provided a sense-making tool to navigate the psychosocial environment, and (c) a framework for educator identity formation. Structured reflective teaching journals with educator feedback support self-reflection and awareness of growth through the SaT elective. Health professions educators can leverage the reflective teaching journal as a formative assessment process to help learners identify transitions and grapple with educator identity confidence and the formation of new teacher skill development to further advance the field of future health professions education.
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Affiliation(s)
- Anna Lama
- Department of Medical Education, West Virginia University School of Medicine, Box 9111, Morgantown, WV 26505 USA
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12
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Carlsson Y, Bergman S, Nilsdotter A, Liljedahl M. The medical internship as a meaningful transition: A phenomenographic study. MEDICAL EDUCATION 2023; 57:1230-1238. [PMID: 37283081 DOI: 10.1111/medu.15146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND The transition from student to doctor is often depicted as a struggle in the literature, and previous research has focused on interventions to minimise difficulties in transitioning from undergraduate to postgraduate training. In considering this transition as a potential transformative experience, we intend to produce new insights into how junior doctors experience the transition to clinical work. The aim of this study was to explore medical interns' conceptualisations of the transition from student to doctor through studying the Swedish medical internship, which serves as a bridge between undergraduate and postgraduate studies. The research question was formulated as follows: How do medical interns perceive the meaning of the medical internship? METHODS The data were collected through in-depth interviews with 12 senior medical interns in western Sweden. The transcribed interviews were analysed using a phenomenographic approach, which resulted in four qualitatively varying ways of perceiving the meaning of the internship, organised hierarchically in a phenomenographic outcome space. RESULTS The interns perceived the meaning of the internship as an opportunity to work and learn in an authentic setting (internship as in-service training) and in a protected environment (internship as a space). The internship guaranteed a minimum level of competence (internship as a quality marker) and allowed the interns to gain new insights into themselves and their world (internship as an eye-opener). DISCUSSION Being allowed to be learners in a protected space seemed pivotal for the interns to develop into competent, confident and independent practitioners. The medical internship studied here could be viewed as a meaningful transition into new ways of experiencing, allowing for an increased understanding of oneself and the world. This study adds to the scientific literature on what constitutes a transformative transition.
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Affiliation(s)
- Yvonne Carlsson
- General Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Bergman
- General Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Nilsdotter
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Matilda Liljedahl
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Sims DA, Cilliers FJ. Clinician educators' conceptions of assessment in medical education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1053-1077. [PMID: 36662334 PMCID: PMC10624725 DOI: 10.1007/s10459-022-10197-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
In pursuing assessment excellence, clinician-educators who design and implement assessment are pivotal. The influence of their assessment practice in university-run licensure exams on student learning has direct implications for future patient care. While teaching practice has been shown to parallel conceptions of teaching, we know too little about conceptions of assessment in medical education to know if this is the case for assessment practice and conceptions of assessment. To explore clinician-educators' conceptions of assessment, a phenomenographic study was undertaken. Phenomenography explores conceptions, the qualitatively different ways of understanding a phenomenon. Data analysis identifies a range of hierarchically inclusive categories of understanding, from simple to more complex, and the dimensions that distinguish each category or conception. Thirty-one clerkship convenors in three diverse Southern settings were interviewed in three cycles of iterative data collection and analysis. Four conceptions of assessment were identified: passive operator, awakening enquirer, active owner and scholarly assessor. Six dimensions were elucidated to describe and distinguish each conception: purpose of assessment; temporal perspective; role and responsibility; accountability; reflexivity and emotional valence. Additionally, three characteristics that appeared to track the progressive nature of the conceptions were identified: professional identity, assessment literacy and self-efficacy. These conceptions encompass and extend previously described conceptions across different educational levels, disciplines and contexts, suggesting applicability to other settings. There is some evidence of a relationship between conceptions and practice, suggesting, together with the hierarchical nature of these conceptions, that targeting conceptions during faculty development may be an effective approach to enhance assessment practice.
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Affiliation(s)
- D A Sims
- University of the Western Cape, 14 Blanckenberg Street, Bellville, South Africa.
| | - F J Cilliers
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Chin H, Ingerman Å, Hergès HO. Anesthesiologists' conceptions of learning anesthesia in the context of their specialty training program: a phenomenographic study. BMC MEDICAL EDUCATION 2023; 23:594. [PMID: 37605231 PMCID: PMC10464223 DOI: 10.1186/s12909-023-04573-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Training anesthesiologists poses challenges and complexities, particularly in defining and teaching excellence in anesthesia. Existing anesthesia curricula primarily emphasize the acquisition of knowledge, practical skills, and professional competencies, often neglecting the development of intangible skills like tacit knowledge. Despite efforts to establish learning goals through carefully describing competencies, there is a risk of oversimplifying the intricate aspects of professional anesthesia practice. Therefore, the objective of this study is to gain a deeper understanding of the genuine curriculum of a specialty training program in anesthesia. This will be achieved by exploring the perceptions of learners with different levels of experience within the program. METHODS This study employs a phenomenographic research approach to explore the conceptions of anesthesiology trainees and specialists, specifically from a student's perspective, regarding what constitutes an excellent anesthesiologist i.e., what to learn, and the learning process associated with it. RESULTS This study identified three different conceptions of learning anesthesia within the context of a specialty training program: "Learning Competencies of Anesthesia," "Learning Work as an Anesthesiologist" and "Learning Being an Anesthesiology Professional." These conceptions ranged from a relatively instrumental view of education and self-responsibility for learning to a perspective of continuous personal reflection and development integrated with professional interaction. The three conceptions can be described in six dimensions describing the variation in approach to learning and the conceptualization of an anesthesiologist. Relationships between the conceptions and the dimensions were represented in a descriptive framework, showing the hierarchy of increasing understanding. CONCLUSION This study has uncovered diverse learner perspectives among anesthesiologists at various experience levels concerning their understanding of the role of an anesthesiologist and the associated learning process. These distinct understandings can be categorized into different groups and presented in a descriptive framework that encapsulates the fundamental elements and important educational aspects of an anesthesiologist's progression through a specialty training program in anesthesia. By recognizing and integrating these diverse perspectives, anesthesia education can be enhanced, ultimately resulting in improved preparation of future anesthesia curriculum, teaching and assessments.
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Affiliation(s)
- Hanna Chin
- Department of Anaesthesia and Intensive Care, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Åke Ingerman
- Department of Pedagogical, Curricular and Professional Studies, University of Gothenburg, Gothenburg, Sweden
| | - Helena Odenstedt Hergès
- Department of Anaesthesia and Intensive Care, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Pettersson AF, Karlgren K, Al-Saadi J, Hjelmqvist H, Meister B, Zeberg H, Silén C. How students discern anatomical structures using digital three-dimensional visualizations in anatomy education. ANATOMICAL SCIENCES EDUCATION 2023; 16:452-464. [PMID: 36636907 DOI: 10.1002/ase.2255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/29/2022] [Accepted: 01/07/2023] [Indexed: 05/11/2023]
Abstract
Learning anatomy holds specific challenges, like the appreciation of three-dimensional relationships between anatomical structures. So far, there is limited knowledge about how students construct their understanding of topographic anatomy. By understanding the processes by which students learn anatomical structures in 3D, educators will be better equipped to offer support and create successful learning situations. Using video analysis, this study investigates how students discern anatomical structures. Sixteen students at different levels of education and from different study programs were recorded audiovisually while exploring 3D digital images using a computerized visualization table. Eleven hours of recorded material were analyzed using interaction analysis and phenomenography. Seven categories were identified during data analysis, describing the qualitatively different patterns of actions that students use to make sense of anatomy: decoding the image; positioning the body in space; purposeful seeking, using knowledge and experience; making use of and creating variation; aimless exploration, and arriving at moments of understanding. The results suggest that anatomy instruction should be organized to let the students decide how and at what pace they examine visualized images. Particularly, the discovery process of decoding and positioning the body in space supports a deep learning approach for learning anatomy using visualizations. The students' activities should be facilitated and not directed.
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Affiliation(s)
- Anna F Pettersson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Education, Development, and Innovation, Södersjukhuset, Stockholm, Sweden
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jonathan Al-Saadi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hans Hjelmqvist
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Björn Meister
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hugo Zeberg
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Salifu I. Leading, but are there followers? Exploring the influence of heads of departments on staff and students in Ghanaian higher education institutions. EDUCATIONAL RESEARCH FOR POLICY AND PRACTICE 2023; 22:349-366. [PMID: 38625173 PMCID: PMC10123476 DOI: 10.1007/s10671-023-09345-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 03/30/2023] [Indexed: 04/17/2024]
Abstract
This research investigated followers' expectations of their heads of departments (HoDs) and how they felt about the fulfilment of the expectations within the context of Ghanaian higher education. It further explored the nature of the challenges the HoDs faced as they tried to meet followers' expectations. The research used a phenomenological design and engaged 36 participants selected from three large Ghanaian universities to participate in individual interviews. Data were analysed using the interpretative phenomenological analytical technique. The research revealed that while the subordinate staff expected a more supportive work environment, the students wanted a more conducive learning environment. The HoDs were, however, constrained to do much because of the ethos of the Ghanaian HE sector. The study concluded with recommendations informing policy and practice, both locally and internationally.
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Affiliation(s)
- Inusah Salifu
- Department of Adult Education and Human Resource Studies, School of Continuing and Distance Education, College of Education, University of Ghana, Accra, Ghana
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17
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Brauer S, Kettunen J, Levy A, Merenmies J, Kulmala P. The educational paradigm shift-a phenomenographic study of medical teachers' experiences of practices. BMC MEDICAL EDUCATION 2023; 23:29. [PMID: 36641444 PMCID: PMC9840161 DOI: 10.1186/s12909-023-04013-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND This paper proposes a novel approach to the development of competence-oriented higher education, a national transformation aimed at harmonising and digitising undergraduate medical and dental education in Finland. METHODS We apply phenomenography as a viable qualitative method for medical education research. To better understand medical teachers' expectations towards the change in the educational paradigm, we need to study teachers' experiences of the current practices in undergraduate medical and dental education. The phenomenographic approach facilitates solid links between research, educational development, and change. RESULTS The phenomenographic study maps the qualitatively different ways in which medical teachers experience undergraduate medical and dental education practices. The answers reflect the changing educational paradigm in medical schools, suggesting practical implications for further development of medical and dental education and training. Core content analysis is preferred instructional scaffold for both teachers and students to prioritise the extensive medical education objectives. The change towards competence-based orientation is in progress and national co-operation accelerates its impact. CONCLUSION There is an obvious need to enrich the content of the current curriculum with national guidelines that aim for congruence in assessment and objectives. Our results suggest an assessment application for the theoretical concepts presented and promote the competence orientation of education throughout the curricula of medical and dental undergraduate education. Moreover, our results contribute to current European discourses on competence-based approaches in higher education. Up-to-date pedagogical faculty development programmes are a key prerequisite for teacher empowerment and future orientation in teaching and learning for healthcare professions.
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Affiliation(s)
- Sanna Brauer
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jaana Kettunen
- Finnish Institute for Educational Research, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Levy
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jussi Merenmies
- University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Petri Kulmala
- Faculty of Medicine, University of Oulu, Oulu, Finland
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Whitfield MM, Mimirinis M, Macdonald D, Klein T, Wilson R. Phenomenographic Approaches in Research About Nursing. Glob Qual Nurs Res 2023; 10:23333936231212281. [PMID: 38028736 PMCID: PMC10676629 DOI: 10.1177/23333936231212281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
We propose that phenomenography is well-suited to research about nursing, given its focus on identifying variation in individuals' experiences, and inclusion of diverse voices and perspectives. Phenomenography explores qualitatively different ways in which a group of people experience a phenomenon, often using semi-structured interviews. The use of phenomenography is especially relevant in research about nursing which provides accounts of the experiences of nurses and patients within complex practice settings. We consider the tenets of phenomenography and examine phenomenography's relationship to and differences from phenomenology. We review literature published about phenomenographic research in nursing and reflect on the potential benefits of phenomenographic research about nursing. This paper adds to knowledge about use of phenomenography in research about nursing.
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Affiliation(s)
- Martha M. Whitfield
- Queen’s University, Kingston, ON, Canada
- University of Vermont, Burlington, VT, USA
| | - Mike Mimirinis
- University of Liverpool, Liverpool, United Kingdom
- University of West London, London, Middlesex, United Kingdom
| | | | - Tracy Klein
- Washington State University Vancouver, Vancouver, WA, USA
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Zuckerman AL, Lo SM. Examining the Variations in Undergraduate Students' Conceptions of Successful Researchers: A Phenomenographic Study. CBE LIFE SCIENCES EDUCATION 2022; 21:ar55. [PMID: 35925918 PMCID: PMC9582811 DOI: 10.1187/cbe.21-10-0295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 06/15/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Undergraduate education represents an important transitional stage in which students make career decisions, and undergraduate research experiences (UREs) play a critical role in training the next generation of science, technology, engineering, and mathematics researchers. Extensive studies have identified the different ways in which researchers and graduate students understand their profession, but little work has focused on undergraduate students. To contribute to this gap in literature, this study examines how undergraduate students conceptualize successful researchers. Data were collected using semistructured interviews with transfer students at a research-intensive university, in which participants articulated how they perceive a successful researcher and how their conception had changed based on their undergraduate experiences. Using phenomenography as the research approach, three conceptions of successful researchers were identified based on variations within the following aspects: process of research, interactions with other researchers, and scope of contribution. Retrospective conceptions were more simplistic, with little appreciation for the complex methodological processes and collaborations needed to meaningfully contribute to the research community. After UREs, participants reported conceptions with more nuanced understanding that successful researchers demonstrate proactive engagement, collaboration, and contribution. These findings can be applied to facilitate meaningful research experiences and target undergraduates' professional development as they are enculturated into the research community.
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Affiliation(s)
- Austin L. Zuckerman
- Department of Cell and Developmental Biology, School of Biological Sciences, and Program in Mathematics and Science Education, University of California San Diego, La Jolla, CA 92093
- Program in Mathematics and Science Education, San Diego State University, San Diego, CA 92120
| | - Stanley M. Lo
- Department of Cell and Developmental Biology, School of Biological Sciences, and Program in Mathematics and Science Education, University of California San Diego, La Jolla, CA 92093
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Ljungvall H, Öster C, Katila L, Åsenlöf P. "Opioids are opioids" - A phenomenographic analyses of physicians' understanding of what makes the initial prescription of opioids become long-term opioid therapy. Scand J Pain 2022; 22:494-505. [PMID: 35172418 DOI: 10.1515/sjpain-2021-0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/25/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To explore prescribers' understanding of what makes initial prescription of opioids become long-term opioid therapy (opioids >90 days). METHODS A qualitative research design, phenomenography, was used for this study. Fifteen attending physicians working within primary, secondary and tertiary care in Sweden in the fields of general practice, rehab medicine, orthopedic surgery, neurosurgery, or obstetrics and gynecology were purposively recruited consecutively until categorical saturation was reached. Semi-structured interviews were used for data collection. The transcripts were analyzed and categorized by two researchers. A third researcher checked for consistency between the data and the categories. An outcome space was constructed representing the logical relationship between the categories. RESULTS The analysis identified six categories: The addictive opioid, The deserving patient, The ignorant prescriber, The lost patient, The compassionate prescriber, and The exposed prescriber. The differences in conceptions among the categories were clarified through three main contributors related to opioid therapy: prescriber's characteristics, patient's characteristics, and the healthcare organization. CONCLUSIONS Opioids were understood as being addictive with long-term use promoting a downward spiral of tolerance and withdrawal driving the pain, leading to continued prescription. Long-term opioid therapy could be justified for patients who improved in function, and who were perceived as trustworthy. Inadequate follow-up of patients, poor training in pain management and addiction medicine, personal attitudes and beliefs about opioids, a perceived professional obligation to treat patients with pain, and lack of collegial support, were factors understood to promote clinically unindicated long-term opioid therapy.
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Affiliation(s)
- Hanna Ljungvall
- Department of Women's and Children's Health, Uppsala University, Sweden
- Department of Sociology, Centre for Social Work (CESAR), Uppsala University, Sweden
| | - Caisa Öster
- Department of Medical Sciences, Uppsala University, Sweden
| | - Lenka Katila
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Pernilla Åsenlöf
- Department of Women's and Children's Health, Uppsala University, Sweden
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Hovlin L, Hallgren J, Dahl Aslan AK, Gillsjö C. The role of the home health care physician in mobile integrated care: a qualitative phenomenograpic study. BMC Geriatr 2022; 22:554. [PMID: 35787260 PMCID: PMC9252081 DOI: 10.1186/s12877-022-03211-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background An increasing older population, along with the organizational principle of remaining at home, has moved health care from institutions into the older person’s home, where several health care providers facilitate care. The Mobile Integrated Care Model strives to provide cost-efficient, coherent, person-centered health care in the home. In the integrated care team, where the home health care physician is the medical authority, several health care professions work across organizational borders. Therefore, the aim of this study was to describe Home Health Care Physicians perceptions of working and providing health care in the Mobile Integrated Care Model, as well as perceptions of participating in and forming health care. Methods A phenomenographic qualitative study design, with semi-structured interviews using an interview guide. Results Working within Mobile Integrated Care Model was a different way of working as a physician. The physicians’ role was to support the patient by making safe medical decisions. Physicians described themselves as a piece in the team puzzle, where the professional knowledge of others was crucial to give quality health care. Being in the patients’ homes was expressed as adding a unique dimension in the provision of health care, and the physicians learned more about the patients by meeting them in their homes than at an institution. This aided the physicians in respecting patient autonomy in medical decision making, even though the physicians sometimes disregarded patient autonomy in favor of their own medical experience. There was a divided view on next of kin participation among the home health care physicians, ranging from always including to total absence of involving next of kin in decision making. Conclusions The home health care physicians described the Mobile Integrated Care Model as the best way to work, but there was still a need for additional resources and structure when working in different organizations. The need for full-time employment, additional time or hours, more equipment, access to each other’s medical records, and additional collaboration with other health care providers were expressed, which could contribute to increased work satisfaction and facilitate further development of person-centered care in the Mobile Integrated Care Model. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03211-3.
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Affiliation(s)
- Lina Hovlin
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28, Skövde, Sweden. .,School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Jenny Hallgren
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28, Skövde, Sweden
| | - Anna K Dahl Aslan
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28, Skövde, Sweden.,School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Gillsjö
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28, Skövde, Sweden.,College of Nursing, University of Rhode Island, Kingston, RI, USA
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Munangatire T, McInerney P. A phenomenographic study exploring the conceptions of stakeholders on their teaching and learning roles in nursing education. BMC MEDICAL EDUCATION 2022; 22:404. [PMID: 35619092 PMCID: PMC9134698 DOI: 10.1186/s12909-022-03392-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Nursing education involves a number of stakeholders in the teaching and learning process, and these are student nurses, lecturers, clinical instructors and nurses. The role that each of these parties play in the teaching and learning process is dependent on each other and is key to the development of competence among student nurses. However, there is scanty literature on the discourse of how these stakeholders conceptualise their roles to maximise student learning. The objective of this study was to explore the conceptions of stakeholders on their teaching and learning roles in nursing education. METHODS Thirty-eight semi-structured interviews and three focus group discussions were conducted with nursing students, lecturers, clinical educators at a Namibian nursing college and nurses at teaching hospitals. Phenomenographic data analysis approach was applied. RESULTS Four conceptions were constructed that described the level of involvement of the different parties in teaching and learning. These were initiating, supporting, becoming part of and owning the teaching and learning role. Three dimensions of variation marked the differences among the conceptions: responsibility and accountability, priorities and level of collaboration. CONCLUSIONS The parties involved in the teaching and learning in nursing education have qualitatively different understating of their roles and those of others. There is a pattern transcending from being at the periphery of teaching and learning to taking ownership of teaching and learning. And a movement from limited responsibility and collaboration to that of being responsible, accountable and high level of collaboration in the teaching and learning of nursing students. The conceptions in this study add more ways of enhancing collaboration between theoretical and clinical sites in nursing education, by ensuring that those involved are aware of their role and that of others and work collaboratively at the micro-level.
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Affiliation(s)
| | - Patricia McInerney
- Faculty of Health Sciences, Centre for Health Sciences Education, University of Witwatersrand, Johannesburg, South Africa
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‘Should I Turn on My Video Camera?’ The Students’ Perceptions of the use of Video Cameras in Synchronous Distant Learning. ELECTRONICS 2022. [DOI: 10.3390/electronics11050813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
One of the challenges teachers and students face in online synchronous learning is not turning on their video cameras. The reasons are multitasking, being concerned about the background, psychological barriers, and poor internet connection. In this study, social presence theory (SPT) was employed as the theoretical lens to understand the possible impacts of video cameras in synchronous online learning. Social presence allows individuals to make personal characteristics visible to the community. Students experience greater levels of trust and rapport because of verbal and nonverbal cues that occur when video cameras are turned on in video conferencing. The use of video cameras in synchronous distant learning creates intimacy and immediacy, leading to teacher–learner social presence, which leads to dialog. The phenomenographic study was carried out to analyze the students’ perceptions of the phenomena. The eighty-two first-year undergraduate and doctoral students took part in the study. It showed that students perceive a video camera as a tool for cooperation, as well as for self-discipline and self-control. The students relate the use of video cameras with quality studies, the ability to interact, and to be a part of the process. They feel less inclined to participate when their cameras are off. That leads to the weaker student–teacher relationship, which is achieved with a higher social presence. It is essential to see one other to strengthen students’ motivation, sense of belonging, and community in the courses for first-year students who are still developing learning habits and social networks.
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Dadkhah M, Mehraeen M, Rahimnia F, Kimiafar K. Exploring the experts’ perceptions of barriers to using internet of things for chronic disease management in Iran. JOURNAL OF SCIENCE AND TECHNOLOGY POLICY MANAGEMENT 2022. [DOI: 10.1108/jstpm-07-2021-0104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Internet of things (IoT) promises advantages in different sectors, especially the health-care sector. Due to its capabilities for chronic disease management, IoT has attracted the attention of researchers. Nowadays, there is research that focuses on the use of IoT for chronic disease management. However, the use of IoT in various contexts faces different barriers. This paper aims to explore Iranian experts’ conceptions of the barriers to using IoT in Iran regarding its application for chronic disease management.
Design/methodology/approach
This study follows a phenomenographic method to investigate Iranian experts’ conceptions of the barriers to using IoT in Iran regarding its application for chronic disease management.
Findings
The results show that there are four categories of description (governance, technical, economic and social barriers) that vary among experts’ conceptions.
Originality/value
The findings of the present work could provide valuable insights for managers and policymakers who want to address IoT barriers.
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Perceptions of Experiences of Recovery After Pancreaticoduodenectomy—A Phenomenographic Interview Study. Cancer Nurs 2022; 45:172-180. [DOI: 10.1097/ncc.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mattsson K, Rosendahl S. Teaching Gerontology in Transcultural Academics: A Phenomenographic Study of Thai and Swedish Nurse Educators' Conceptions of Gerontological Nursing. J Transcult Nurs 2022; 33:446-455. [PMID: 35000509 PMCID: PMC9082963 DOI: 10.1177/10436596211068432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION There is an urgent need for registered nurses with gerontological competence within long-term care (LTC) of older adults. Despite increases of life expectancy, LTC for older adults is not emphasized in nursing curricula in neither Sweden nor Thailand. Thus, the aim was to explore conceptions on gerontological nursing (GN) among Swedish and Thai nurse educators. METHOD A qualitative phenomenographic method, based on open-ended interviews with five Thai and nine Swedish nurse educators was conducted. RESULTS The results indicate a paradox between the educators' knowledge about the implications of global aging, their hope of own aging, and LTC. The ethical responsibility of being credible and a source of inspiration in teaching about aging are focused, while GN seem to be less important. DISCUSSION To increase students' interest in GN, measures need to be taken within the educational arenas, where the educators' own conceptions toward GN, cultural aspects of aging, and LTC are discussed.
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Teachers’ Abstracted Conceptualizations of Their Way in Experiencing the Leadership in the Classroom: Transferring Knowledge, Expanding Learning Capacity, and Creating Knowledge. EDUCATION SCIENCES 2021. [DOI: 10.3390/educsci11120782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite the abundance of decades of research into teacher leadership, uncertainty remains due to confusion around the notions of teacher leadership and the unity or at least the authenticity of definitions, and there is a need for a deeper understanding of this leadership process as the teacher works with students in the classroom. The existing definitions and descriptions of teacher leadership do not determine the connection between teacher leadership and student learning, and the subject remains empirically unsubstantiated. The aim of this study was to develop a set of categories of description derived from the teachers’ conceptions of their leadership in the classroom through learning interactions with students. The study was based on the phenomenographic research methodology. Data were collected by conducting semistructured interviews with 37 teachers. A phenomenographic analysis sought a description, analysis, and understanding of experiences with the focus on variation in the conceptions of the phenomenon, as experienced by teachers. Findings revealed that teachers discern their leadership through working with students at school in three stages represented by three categories of description—transferring knowledge, expanding learning capacity, and creating knowledge. All these stages are linked by teacher-student interaction which facilitates successful and meaningful learning for students within the classroom. The connections between the three stages demonstrate the need for teacher–student collaboration, teaching personalization, the professional expertise of the teacher, and learning cocreation. The findings of this study contribute to the expansion of the concept of teacher leadership not only as expert influence through the application of specific teaching methods, but as a coherent process from knowledge transfer to its creation through reciprocal teacher–student learning in the classroom.
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Leese J, MacDonald G, Backman CL, Townsend A, Nimmon L, Li LC. Experiences of Wearable Technology by Persons with Knee Osteoarthritis Participating in a Physical Activity Counseling Intervention: Qualitative Study Using a Relational Ethics Lens. JMIR Mhealth Uhealth 2021; 9:e30332. [PMID: 34766912 PMCID: PMC8663466 DOI: 10.2196/30332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/27/2021] [Accepted: 09/19/2021] [Indexed: 12/27/2022] Open
Abstract
Background Current evidence indicates physical activity wearables could support persons with knee osteoarthritis (OA) to be more physically active. However, recent evidence also identifies some persons with arthritis experience guilt or worry while using a wearable if they are not as active as they feel they should be. Questions remain around how persons with knee OA experience benefits or downsides using a wearable in their everyday lives. Better understanding is needed if wearables are to be incorporated in arthritis self-management in ethically aware ways. Objective Using an ethics lens, we aimed to describe a range of experiences from persons with knee OA who used a wearable during a physical activity counseling intervention study. Methods This is a secondary analysis of qualitative interviews nested within a randomized controlled trial. Guided by phenomenography, we explored the experiences of persons with knee OA following participation in a physical activity counseling intervention that involved using a Fitbit Flex and biweekly phone calls with a study physiotherapist (PT) in an 8-week period. Benefits or downsides experienced in participants’ relationships with themselves or the study PT when using the wearable were identified using a relational ethics lens. Results Interviews with 21 participants (12 females and 9 males) aged 40 to 82 years were analyzed. Education levels ranged from high school graduates (4/21, 19%) to bachelor’s degrees or above (11/21, 52%). We identified 3 categories of description: (1) participants experienced their wearable as a motivating or nagging influence to be more active, depending on how freely they were able to make autonomous choices about physical activity in their everyday lives; (2) some participants felt a sense of accomplishment from seeing progress in their wearable data, which fueled their motivation; (3) for some participants, sharing wearable data helped to build mutual trust in their relationship with the study PT. However, they also expressed there was potential for sharing wearable data to undermine this trust, particularly if this data was inaccurate. Conclusions Findings provide an early glimpse into positive and negative emotional impacts of using a wearable that can be experienced by participants with knee OA when participating in a randomized controlled trial to support physical activity. To our knowledge, this is the first qualitative study that uses a relational ethics lens to explore how persons with arthritis experienced changes in their relationship with a health professional when using a wearable during research participation.
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Affiliation(s)
- Jenny Leese
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Vancouver, BC, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Graham MacDonald
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Catherine L Backman
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Vancouver, BC, Canada
| | - Anne Townsend
- Arthritis Research Canada, Vancouver, BC, Canada.,Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Laura Nimmon
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Vancouver, BC, Canada
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Gillsjö C, Nyström M, Palmér L, Carlsson G, Dalheim-Englund AC, Eriksson I. Balance in life as a prerequisite for community-dwelling older adults' sense of health and well-being after retirement: an interview-based study. Int J Qual Stud Health Well-being 2021; 16:1984376. [PMID: 34633914 PMCID: PMC8725713 DOI: 10.1080/17482631.2021.1984376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose This study aimed to describe community-dwelling older adults’ perceptions of health and well-being in life after retirement. Methods This study is part of a larger project using a mixed-methods design to address lifestyles’ influence on community-dwelling older adults’ health. Individual semi-structured interviews were conducted with 18 older adults in age 70 to 95 years. Data were analysed according to a phenomenographic approach. Results The results encompass four categories describing variations in community-dwelling older adults’ perceptions of health and well-being after retirement: feeling well despite illness and disease, interacting with and being useful for oneself and others, independently embracing opportunities and engaging in life, and maintaining a healthy lifestyle. Conclusions The absence of illness and disease is not a clear prerequisite for a sense of health and well-being. To promote and preserve health and well-being after retirement, older adults strived for—and coached themselves to uphold—a balance in life, focusing on not burdening others. This life orientation after retirement must be acknowledged by society at large, especially from an ageist perspective, and in health and social care to preserve and promote health and well-being.
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Affiliation(s)
- Catharina Gillsjö
- School of Health Sciences, University of Skövde, Skövde, Sweden.,College of Nursing, University of Rhode Island, USA
| | - Maria Nyström
- Faculty of Caring Science, Work Life and Social Welfare, Department of Caring Science, University of Borås, Sweden
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, Department of Caring Science, University of Borås, Sweden
| | - Gunilla Carlsson
- Faculty of Caring Science, Work Life and Social Welfare, Department of Caring Science, University of Borås, Sweden
| | | | - Irene Eriksson
- School of Health Sciences, University of Skövde, Skövde, Sweden
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Stoffels M, van der Burgt SME, Stenfors T, Daelmans HEM, Peerdeman SM, Kusurkar RA. Conceptions of clinical learning among stakeholders involved in undergraduate nursing education: a phenomenographic study. BMC MEDICAL EDUCATION 2021; 21:520. [PMID: 34607586 PMCID: PMC8491399 DOI: 10.1186/s12909-021-02939-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND To prepare nursing students to become critical, autonomous members of the workforce, an agreement among stakeholders on how this can be achieved in the clinical setting is needed. However, a critical discussion of the clinical learning process in relation to actual and desirable outcomes is lacking in the nursing education literature. This study aimed to map conceptions of the desired process and outcomes of clinical learning among stakeholders involved in undergraduate clinical nursing education. METHODS Twenty-five semi-structured interviews about their understanding of clinical learning were conducted with nursing students, supervisors, clinical educators and higher education institute professionals involved in clinical nursing education in a Dutch academic medical center. Data were analyzed using a phenomenographic approach. RESULTS Four conceptions were identified: clinical learning as a process to 1) meet curricular demands, 2) learn to deliberately deliver patient care, 3) learn to deliver patient care within the larger (healthcare) context, and 4) become a continuously developing professional. Conceptions 3 and 4 represented a broader, more inclusive perspective on clinical learning than conception 1 and 2. Conceptions were distinguished by five dimensions: role of guidelines from the school; learning opportunities, focus of supervisor; focus of reflection; desirable outcomes of clinical learning. CONCLUSIONS Those directly involved in clinical learning in nursing may have qualitatively different understandings of its desired nature and outcomes. Two patterns across conceptions could be discerned: a) a shift in focus from learning as following standards, to following an individualized learning trajectory and b) a shift in focus from increasing patient load, to understanding oneself and the patient within the healthcare context. To prepare nursing students for the future workforce, a flexible, social form of self-regulated learning is warranted, as well as an understanding of one's own role within the healthcare system and a critical attitude towards healthcare. Schools and hospitals should collaborate to integrate these values in the curriculum. The current study adds different ways of applying self-regulated learning as a relevant dimension in understanding clinical learning to the literature. Through the phenomenographic approach we identified conceptions that can be a basis for training and policy development.
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Affiliation(s)
- Malou Stoffels
- Faculty of Medicine, Research in Education, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Amsterdam UMC, Amstel Academy, Institute for Education and Training, Amsterdam, The Netherlands.
- LEARN! research institute for learning and education. Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands.
| | | | - Terese Stenfors
- Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Amsterdam, The Netherlands
| | - Hester E M Daelmans
- Faculty of Medicine, Research in Education, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Faculty of Medicine, Department of skills training, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Saskia M Peerdeman
- Faculty of Medicine, Research in Education, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- AmsterdamUMC, Location AMC, Institute for education and training, Amsterdam, The Netherlands
- Department of Neurosurgery, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rashmi A Kusurkar
- Faculty of Medicine, Research in Education, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- LEARN! research institute for learning and education. Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
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MacKinnon RJ, Slater D, Pukk-Härenstam K, von Thiele Schwarz U, Stenfors T. Adaptations to practice and resilience in a paediatric major trauma centre during a mass casualty incident. Br J Anaesth 2021; 128:e120-e126. [PMID: 34563337 DOI: 10.1016/j.bja.2021.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Innovation and human adaptation in the face of unfolding catastrophe is the cornerstone of an effective systemwide response. Capturing, analysing, and disseminating this is fundamental in developing resilience for future events. The aim of this study was to understand the characteristics of adaptations to practice early in a paediatric major trauma centre during a mass casualty incident. METHODS A qualitative interview study of 40 healthcare staff at a paediatric major trauma centre in the immediate aftermath of a terrorist bombing was conducted. An inductive thematic analysis approach was used, followed by a deductive analysis of the identified adaptations informed by constructs of resilience engineering. RESULTS Five themes of adaptations to practice that enhanced the resilient performance of the hospital were identified: teamworking; psychologically supporting patients, families, and staff; reconfiguring infrastructure; working around the hospital electronic systems; and maintaining hospital safety. Examples of resilience potential in terms of respond, monitor, anticipate, and learn are presented. CONCLUSIONS Our study shows how adaptations to practice sustained the resilient performance of a paediatric major trauma centre during a mass casualty incident. Rapid, early capture of these data during a mass casualty incident provides key insights into enhancing future emergency preparedness, response, and resilience planning.
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Affiliation(s)
- Ralph J MacKinnon
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Manchester, UK.
| | - David Slater
- School of Engineering, Cardiff University, Cardiff, UK
| | - Karin Pukk-Härenstam
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Paediatric Emergency Department, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrica von Thiele Schwarz
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Abrandt Dahlgren M, Valeskog K, Johansson K, Edelbring S. Understanding clinical reasoning: A phenomenographic study with entry-level physiotherapy students. Physiother Theory Pract 2021; 38:2817-2826. [PMID: 34544323 DOI: 10.1080/09593985.2021.1976332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Madeleine Abrandt Dahlgren
- Department of Medicine, Health and Caring Sciences, Medical Education, Linköping University, Linköping, SE, Sweden
| | - Karin Valeskog
- Department of Medicine, Health and Caring Sciences, Division of Physiotherapy Linköping University, Linköping, SE, Sweden
| | - Kajsa Johansson
- Department of Medicine, Health and Caring Sciences, Division of Physiotherapy Linköping University, Linköping, SE, Sweden
| | - Samuel Edelbring
- School of Health Sciences, Örebro University, Örebro, SE, Sweden
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Björk J, Stenfors T, Juth N, Gunnarsson AB. Personal responsibility for health? A phenomenographic analysis of general practitioners' conceptions. Scand J Prim Health Care 2021; 39:322-331. [PMID: 34128751 PMCID: PMC8475098 DOI: 10.1080/02813432.2021.1935048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To analyse and describe general practitioners' perceptions of the notion of a 'personal responsibility for health'. DESIGN Interview study, phenomenographic analysis. SETTING Swedish primary health care. SUBJECTS General Practitioners (GPs). MAIN OUTCOME MEASURES Using the phenomenographic method, the different views of the phenomenon (here: personal responsibility for health) were presented in an outcome space to illustrate the range of perceptions. RESULTS The participants found the notion of personal responsibility for health relevant to their practice. There was a wide range of perceptions regarding the origins of this responsibility, which was seen as coming from within yourself; from your relationships to specific others; and/or from your relationship with the generalized other. Furthermore, the expressions of this responsibility were perceived as including owning your health problem; not offloading all responsibility onto the GP; taking active measures to keep and improve health; and/or accepting help in health. The GP was described as playing a key role in shaping and defining the patient's responsibility for his/her health. Some aspects of personal responsibility for health roused strong emotions in the participants, especially situations where the patient was seen as offloading all responsibility onto the GP. CONCLUSION The notion of personal responsibility for health is relevant to GPs. However, it is open to a broad range of interpretations and modulated by the patient-physician interaction. This may make it unsuitable for usage in health care priority settings. More research is mandated to further investigate how physicians work with patient responsibility, and how this affects the patient-physician relationship and the physician's own well-being.Key PointsThe notion of personal responsibility for health has relevance for discussions about priority setting and person-centred care.This study, using a phenomenographic approach, investigated the views of Swedish GPs about the notion of personal responsibility for health.The participants found the notion relevant to their practice. They expressed a broad range of views of what a personal responsibility for health entails and how it arises. The GP was described as playing a key role in shaping and defining the patient's responsibilities for his/her health.The notion was emotionally charged to the participants, and when patients were seen as offloading all responsibility onto the GP this gave rise to frustration.
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Affiliation(s)
- Joar Björk
- Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Stockholm, Sweden
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
- CONTACT Joar Björk Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Tomtebodavägen 18 A, Stockholm, 171 77, Sweden
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Niklas Juth
- Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Stockholm, Sweden
| | - A. Birgitta Gunnarsson
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
- Institute of Neuroscience and Physiology, Section for Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Nxumalo CT, Mchunu GG. Healthcare providers' perceptions and understanding of voluntary medical male circumcision in KwaZulu-Natal, South Africa: A qualitative study. S Afr Fam Pract (2004) 2021; 63:e1-e6. [PMID: 34476965 PMCID: PMC8424757 DOI: 10.4102/safp.v63i1.5318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/13/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background There is compelling evidence that voluntary medical male circumcision (VMMC) reduces the chances of heterosexual transmission of HIV infection. Healthcare workers are among the key influencers in terms of the scale-up of VMMC as they are often involved in mobilisation for uptake. There is a paucity of qualitative research on healthcare workers’ experiences, understanding and perceptions of VMMC; particularly in the South African rural primary healthcare context. This study was conducted to examine healthcare workers perceptions and understanding of VMMC in KwaZulu-Natal, South Africa. Methods The study employed a qualitative approach using a phenomenographic design. A purposive sample of 15 doctors, nurses and clinical associates working in 6 different rural clinics in KwaZulu-Natal, South Africa, were interviewed in English in-depth using a semi-structured interview schedule. The interviews were audio-recorded, and transcribed. The results were analysed thematically using phenomenographic data analysis procedures. Results Categories of description in participants’ perceptions and understanding of VMMC emerged. The findings of this study revealed that healthcare workers perceptions and understanding of VMMC were predominantly influenced by the hegemonic religious and cultural norms associated with male circumcision in KwaZulu-Natal, South Africa. Conclusion The findings of this study suggest that tailored training to address healthcare workers misperceptions and poor understanding of VMMC is necessary to ensure that they become effective custodians for VMMC implementation.
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Affiliation(s)
- Celenkosini T Nxumalo
- KwaZulu-Natal Department of Health, Ndwedwe Community Health Centre, Verulam, South Africa; and, School of Nursing and Public Health, Faculty of Health Sciences, University of KwaZulu-Natal, Durban.
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Munangatire T, McInerney P. Nursing students' conceptions of competence and the learning processes that support the development of competence: a phenomenographic study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1113-1132. [PMID: 33730296 DOI: 10.1007/s10459-021-10041-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
The development of competence among student nurses is important to nurse educators, nursing regulatory bodies, employers and patients. Several teaching and learning strategies support the development of competence among student nurses, but the level of competence at the point of graduation remains below expected standards. Therefore, more research is needed to find strategies that can enhance the development of competence among students. The study explored students' conceptions of competence and the learning processes that support the development of competence in nursing practice. Gaining an understanding of learning and competence from the student's perspective can improve our current understanding of the development of competence. Utilising a phenomenographic approach, in-depth interviews and focus group discussions were conducted among purposively sampled groups of nursing students. The analysis of data was managed through ATLAS. ti 8.1 and followed the process of familiarisation, condensation, comparison, grouping, articulating labelling and contrasting of excerpts to generate the students' conceptions of learning. Five categories of description emerged and showed that the development of competence involves students increasing their understanding of what competence is, hence changing their learning strategies to meet the level of competence, as they understood it. In order of hierarchy from the lowest, the categories of description were: competence is understood as task completion; competence is understood as passing assessments /satisfying facilitators; competence is understood as applying theory to practice; competence is understood as performance of nursing according to clinical standards/guidelines; and competence is understood as performance that yields positive health outcomes.
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Affiliation(s)
- Takaedza Munangatire
- Faculty of Health Sciences, Department of Nursing, University of Namibia, Rundu, Namibia.
| | - Patricia McInerney
- Faculty of Health Sciences, Centre for Health Sciences Education, University of Witwatersrand, Johannesburg, South Africa
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Dyar A, Stenfors T, Lachmann H, Kiessling A. What about the supervisor? Clinical supervisors' role in student nurses' peer learning: A phenomenographic study. MEDICAL EDUCATION 2021; 55:713-723. [PMID: 33325543 PMCID: PMC8246972 DOI: 10.1111/medu.14436] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Peer learning is increasingly used for healthcare students in the clinical setting. However, as peer learning between students involves students taking a teaching role, it is unclear what the supervisor's role then becomes. It is vital to determine the role of the supervisor in student peer learning to ensure high quality learning and patient safety. METHODS Semi-structured interviews were performed with 15 student nurse supervisors (nurses and assistant nurses) from two hospital wards that practice peer learning to investigate the different ways clinical supervisors view their role in students' peer learning. Transcribed data were coded and analysed using a phenomenographic approach. RESULTS Four hierarchical levels of the supervisor's understanding of their role in students' peer learning were identified: the teacher; the facilitator; the stimulator; and the team player. These categories represent an increasingly inclusive view of which people present on the ward play a role in enabling effective peer learning. CONCLUSIONS The various understandings of supervisor roles have implications for how supervision of peer learning could be implemented in the future.
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Affiliation(s)
- Anna Dyar
- Department of Clinical Sciences Danderyd HospitalKarolinska InstitutetStockholmSweden
| | - Terese Stenfors
- Department of Learning, Informatics and EthicsKarolinska InstitutetStockholmSweden
| | - Hanna Lachmann
- Department of Learning, Informatics and EthicsKarolinska InstitutetStockholmSweden
- The Swedish Red Cross University CollegeStockholmSweden
| | - Anna Kiessling
- Department of Clinical Sciences Danderyd HospitalKarolinska InstitutetStockholmSweden
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Communion, Care, and Leadership in Computer-Mediated Learning during the Early Stage of COVID-19. SUSTAINABILITY 2021. [DOI: 10.3390/su13084234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This qualitative inquiry explores how, during the early stage of the COVID-19 pandemic in Lithuania (European Union), the stakeholders in the education system—university teachers, general education teachers, students, and children’s parents—coped with the encountered challenge and what was important to them under the changed conditions. This paper uses a communication management objective to describe how participants in the education system responded to the emerging distance learning situation and its challenges. The phenomenographic research approach was chosen to carry out the qualitative study. The 37 interviews from higher education teachers, university students, school teachers, and parents of minor school-aged children were conducted during the early stage of COVID-19 quarantine. The research allows for concluding that, after a successful transition to distance learning, the dimensions of communion and supportive collaboration acquired importance among stakeholders in education. Starting new activities, a need for communion and mobilization for joint activities under the crisis emerged. The research showed that the adaptation period was necessary at the beginning of these new activities. Competent leadership was expected from the teacher. Additionally, the preparation of all the actors in the education process was needed. The data offer a window into the dynamics of online teaching in crisis and experiences with a new activity that are key to success. Although research on technology-mediated learning has increased in recent years, it still lags behind developments in practice.
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Balakumaran J, Forestell B, Dowhos K, Nagji A. Experiences of Participants During In Situ Simulation With a Learner Present. AEM EDUCATION AND TRAINING 2021; 5:e10510. [PMID: 33898913 PMCID: PMC8053001 DOI: 10.1002/aet2.10510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND While in situ simulation (ISS) provides robust value for health care teams, it is less clear how medical learners affect the experiences of other participants. METHODS This was a single-center qualitative analysis of a community hospital's emergency department ISS program that included medical learners (medical students, family and emergency medicine residents). Focus groups were conducted before and after with nurses, staff physicians, and resident physicians. Phenomenologic analysis using a constructivist framework was used to examine themes. RESULTS Fifty-two ISSs were held from February 2019 to March 2020. Of those simulations, 36 had learners present. Positive effects included creating an open learning environment and offering staff physicians a safe teaching space. Negative effects arose when objectives of ISS were highly team based or latent safety threat (LST) focused. All groups thought learners added value to ISS. CONCLUSION Thought should be given to ISS objectives when considering how learners affect other participants. When including learners, review objectives, clarify expectations in prebriefing, and ensure that debriefing begins with LSTs and process objectives before diving into medical objectives. This study provides insight into the effect of medical learners on ISS.
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Affiliation(s)
- Janatani Balakumaran
- Department of MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Benjamin Forestell
- Department of MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Krista Dowhos
- Department of Family MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Alim Nagji
- Department of Family MedicineDivision of Emergency MedicineMcMaster UniversityHamiltonOntarioCanada
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Ljunggren C, Carlson E, Isma GE. Drama with a focus on professional communication - A phenomenographic study. Nurse Educ Pract 2021; 52:103022. [PMID: 33721577 DOI: 10.1016/j.nepr.2021.103022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/12/2021] [Accepted: 03/02/2021] [Indexed: 10/22/2022]
Abstract
The nursing program is intended to prepare students for future occupational life. One role for nurses in the nursing occupation includes being prepared to communicate well in various patient situations. The aim of this study was to describe variations in nursing students' conceptions of a drama workshop to practically illustrate communication in nurses' work. This qualitative study was conducted at a university in southern Sweden. Interviews with 15 nursing students were conducted and the data were analyzed using a phenomenographic approach. Four descriptive categories were identified through the analysis: 'Conceptions in relation to the development of empathy', 'Conceptions in relation to "my" learning', 'Conceptions in relation to personal development of professional identity' and 'Conceptions in relation to the understanding of applying pedagogy through drama as a method'. This study illustrates that the use of drama in nursing education can increase nursing students' understanding of professional communication relating to the care of patients. To use drama as an educational method provides opportunities to develop nurses' professional identity and professional role. Moreover, drama can act as a teaching strategy that increases the understanding of theory through practical exercises.
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Affiliation(s)
- Cecilia Ljunggren
- Faculty of Health and Society, Department of Care Science, Malmo University, Sweden.
| | - Elisabeth Carlson
- Faculty of Health and Society, Department of Care Science, Malmo University, Sweden
| | - Gabriella E Isma
- Faculty of Health and Society, Department of Care Science, Malmo University, Sweden
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Ahola S, Skjaerven LH, Piirainen A. Physiotherapists' conceptions of movement awareness- A phenomenographic study. Physiother Theory Pract 2021; 38:1438-1452. [PMID: 33393413 DOI: 10.1080/09593985.2020.1868028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The phenomenon of movement awareness requires more attention to make it explicit in physiotherapy. The aim of this study was to explore the variation in physiotherapists' conceptions of movement quality, focusing on movement awareness. The informants were 15 physiotherapists from a variety of physiotherapy fields. We collected data through two group interviews and used the phenomenographic method to analyze them. Four themes emerged from the data: 1) Being in contact with one's own moving body; 2) Increased awareness of movement experiences; 3) Interrelationship between physiotherapist and patient; and 4) Better understanding of movement awareness. These themes varied by four descriptive categories of the movement awareness phenomenon: (I) Hesitation regarding own movement experiences; (II) Momentary contact with own movement experiences; (III) Presence in movement awareness and (IV) Better understanding of others' movement awareness. The physiotherapists' understanding of the movement awareness phenomenon widened through three critical aspects in the descriptive categories: Recognizing one's own movement awareness, Distinguishing one's own and others' movement awareness and New insights into implementing actions related to movement awareness in physiotherapy. These results can expand the understanding of the phenomenon of movement awareness among physiotherapists, although further research is needed.
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Affiliation(s)
- Sirpa Ahola
- Department of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Liv Helvik Skjaerven
- Department of Function and Health, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Arja Piirainen
- Department of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Abstract
AbstractObjectivePhenomenography is a qualitative research method used to explore the different ways individuals experience phenomena. Over the last few decades, use of the research method grew in various higher education disciplines; however, use of the method for nursing education research was limited until early in the 21st century.Therefore, the purpose of this article is to describe the main ideas of phenomenography methodology and provide a simplified integrative review of the contributions to nursing education research.MethodsWhittemore and Knafl (2005) five-step integrative review process was used to guide the literature search and evaluate findings of published works between 2009 and 2019.ResultsThirteen articles, including one comprehensive literature review, were identified in the literature search.ConclusionFindings illustrated phenomenography methodology was used to evaluate and improve teaching and learning principles, complex faculty and student issues, curriculum and professional development, and educational practices within nursing education. Phenomenography research can be instrumental in providing a more realistic worldview of individual differing experiences of nursing education phenomena.
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Affiliation(s)
- Tammy Lynn McClenny
- School of Nursing, University of West Georgia, 1601 Maple Street, 30118-0001, Carrollton, Georgia, USA
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Ramalho AR, Vieira-Marques PM, Magalhães-Alves C, Severo M, Ferreira MA, Falcão-Pires I. Electives in the medical curriculum - an opportunity to achieve students' satisfaction? BMC MEDICAL EDUCATION 2020; 20:449. [PMID: 33225951 PMCID: PMC7681969 DOI: 10.1186/s12909-020-02269-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 09/28/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Electives are perceived by medical students as a valuable, highly regarded experience, allowing them to customize learning experiences and enabling them to early differentiate during medical training. The present work aims to uncover students' major determinants of satisfaction and how they interfere with their future elective choices in order to identify the best approach to implement electives in medical curricula. METHODS A cross-sectional study was conducted through a written evaluation survey concerning the electives available in the academic year 2015-2016. Our institution provides 106 electives to students from the 2nd to the 5th year. Students' satisfaction was assessed through a validated questionnaire with eight sentences expressing opinions related to electives global satisfaction. Data from 538 inquiries from 229 students were analyzed quantitatively using regression and correlation models, and qualitatively through phenomenography. RESULTS Quantitative analysis of the questionnaires allowed to establish both: 1) The determinants of students' satisfaction with electives, which were Agreement with teaching and learning methodologies, followed by Agreement with assessment methodologies employed, Perception of the workload demanded and Requirement for continuous work and 2) The predictors of students preferences in the following years, namely, Agreement with assessment methodologies employed, Classes attendance and Ranking of the allocated elective established in the previous year. Qualitative analysis of questionnaires revealed that students consider electives as being innovative and interesting, claiming that some, for their relevant content, could be integrated into the medical core curriculum. CONCLUSIONS Our work raises awareness on the best practices when it comes to electives' organization to meet students' satisfaction. We can conclude that medical schools should measure students satisfaction as a tool to organize and predict future needs of electives and placements when designing and implementing this alternative student-centred curriculum or even to improve the existing practices regarding electives in medical courses.
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Affiliation(s)
- Ana Rita Ramalho
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine of University of Porto, Porto, Portugal
| | - P. M. Vieira-Marques
- CINTESIS - Center for Research in Health Technologies and Information Systems. Faculty of Medicine, University of Porto, Porto, Portugal
| | - C. Magalhães-Alves
- Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - M. Severo
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine of University of Porto, Porto, Portugal
| | - M. A. Ferreira
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine of University of Porto, Porto, Portugal
- Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - I. Falcão-Pires
- Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
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Bullock JL, Lockspeiser T, Del Pino-Jones A, Richards R, Teherani A, Hauer KE. They Don't See a Lot of People My Color: A Mixed Methods Study of Racial/Ethnic Stereotype Threat Among Medical Students on Core Clerkships. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:S58-S66. [PMID: 32769459 DOI: 10.1097/acm.0000000000003628] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Stereotype threat is an important psychological phenomenon in which fear of fulfilling negative stereotypes about one's group impairs performance. The effects of stereotype threat in medical education are poorly characterized. This study examined the prevalence of racial/ethnic stereotype threat amongst fourth-year medical students and explored its impact on students' clinical experience. METHOD This was an explanatory sequential mixed methods study at 2 institutions in 2019. First, the authors administered the quantitative Stereotype Vulnerability Scale (SVS) to fourth-year medical students. The authors then conducted semistructured interviews among a purposive sample of students with high SVS scores, using a qualitative phenomenographic approach to analyze experiences of stereotype threat. The research team considered reflexivity through group discussion and journaling. RESULTS Overall, 52% (184/353) of students responded to the survey. Collectively, 28% of students had high vulnerability to stereotype threat: 82% of Black, 45% of Asian, 43% of Latinx, and 4% of White students. Eighteen students participated in interviews. Stereotype threat was a dynamic, 3-stage process triggered when students experienced the workplace through the colored lens of race/ethnicity by standing out, reliving past experiences, and witnessing microaggressions. Next, students engaged in internal dialogue to navigate racially charged events and workplace power dynamics. These efforts depleted cognitive resources and interfered with learning. Finally, students responded and coped to withstand threats. Immediate and deferred interventions from allies reduced stereotype threat. CONCLUSIONS Stereotype threat is common, particularly among non-White students, and interferes with learning. Increased minority representation and developing evidence-based strategies for allyship around microaggressions could mitigate effects of stereotype threat.
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Affiliation(s)
- Justin L Bullock
- J.L. Bullock is a first-year resident in internal medicine, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Tai Lockspeiser
- T. Lockspeiser is assistant dean of medical education-assessment, evaluation, and outcomes, and associate professor, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Amira Del Pino-Jones
- A. del Pino-Jones is associate professor, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Regina Richards
- R. Richards is director, Office of Diversity and Inclusion, and assistant professor, Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Arianne Teherani
- A. Teherani is director of program evaluation and professor, Department of Medicine and Center for Faculty Educators, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Karen E Hauer
- K.E. Hauer is associate dean for competency assessment and professional standards and professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California
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Joseph-Richard P, Edwards G, Hazlett SA. Leadership development outcomes research and the need for a time-sensitive approach. HUMAN RESOURCE DEVELOPMENT INTERNATIONAL 2020. [DOI: 10.1080/13678868.2020.1815155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Paul Joseph-Richard
- Ulster University Business School, Ulster University, Jordanstown, Northern Ireland
| | - Gareth Edwards
- Leadership and Community Studies, Bristol Business School, Faculty of Business and Law, University of the West of England, Bristol, UK
| | - Shirley-Ann Hazlett
- Queens’ University Management School, Queens’ University Belfast, Belfast, Northern Ireland
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Sjöberg V, Forsner M. Shifting roles: physiotherapists' perception of person-centered care during a pre-implementation phase in the acute hospital setting - A phenomenographic study. Physiother Theory Pract 2020; 38:879-889. [PMID: 32812456 DOI: 10.1080/09593985.2020.1809042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Person-centered care (PCC) is an acknowledged health care practice involving increased patient influence regarding decisions and deliberation. Research indicates that physiotherapists (PTs) embrace patient participation, but that PCC is difficult to grasp and fully implement. OBJECTIVE To contribute to knowledge about how PCC influences physiotherapy by eliciting PTs' experiences from the acute care setting, this study aims to describe and illuminate variations in perceptions of PCC during a pre-implementation phase, among PTs in acute hospital care. METHODS Phenomenological approach: individual interviews with PTs in acute care (n = 7) combined with focus group interviews (n = 3). FINDINGS The analysis yielded two main categories: 1) Physiotherapists perceived a transformed patient role involved in the transition from patient to person; and 2) Physiotherapists perceived a challenged professional role when departing from the expert role, and entailed restrictions to prescribing the best treatment and, instead, meant aiming for a collaborative and equal relationship with the patient. CONCLUSION Although the interviewed PTs embraced PCC in principle, PCC does seem to challenge the professional roles of patient and PT. The findings indicate that theories of power relations need to be considered, and further reflection may facilitate implementation. More research is needed to deepen the knowledge of how PTs perceive PCC during all implementation phases.
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Affiliation(s)
- Veronica Sjöberg
- Department of Care Sciences, School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden
| | - Maria Forsner
- Department of Nursing, Faculty of Medicine, Umeå University, Umeå, Sweden
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46
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London MD, Mackenzie L, Lovarini M, Dickson C, Alvarez-Campos A. Animal Assisted Therapy for Children and Adolescents with Autism Spectrum Disorder: Parent perspectives. J Autism Dev Disord 2020; 50:4492-4503. [PMID: 32333302 DOI: 10.1007/s10803-020-04512-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Animal-Assisted Therapy (AAT) is an intervention for children with Autism Spectrum Disorder (ASD). This study explores parent perspectives of the impact of five AAT sessions involving trained dogs with their children with ASD. A phenomenological qualitative approach was used to explore first-hand perspectives of parents. In-depth, semi-structured interviews were conducted. Data were analyzed using thematic analysis. Seventeen parents reported that the presence of the dogs facilitated their children's engagement, enjoyment, and motivation. Parents also reported that this contributed to gains in the child's communication with others and the dog (n = 11, 64.7%), behavioral regulation (n = 12, 70.6%), and community participation (n = 14, 82.3%). These findings indicate that parents supported the use of AAT and that dogs facilitated therapeutic gains.
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Affiliation(s)
- Maeve Doyle London
- Discipline of Occupational Therapy, The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - Meryl Lovarini
- Discipline of Occupational Therapy, The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia
| | - Claire Dickson
- Occupational Therapist, Assistance Dogs Australia, Engadine, Sydney, Australia
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Using Mobile Health and the Impact on Health-Related Quality of Life: Perceptions of Older Adults with Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082650. [PMID: 32294911 PMCID: PMC7215529 DOI: 10.3390/ijerph17082650] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/30/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022]
Abstract
Digital health technologies such as mobile health (mHealth) are considered to have the potential to support the needs of older adults with cognitive impairment. However, the evidence for improving health with the use of mHealth applications is of limited quality. Few studies have reported on the consequences of technology use concerning the older adults’ quality of life. The purpose of this study was to describe perceptions of mHealth and its impact on health-related quality of life (HRQoL) among older adults with cognitive impairment. The study was conducted using a qualitative design with a phenomenographic approach. A total of 18 older participants with cognitive impairment were interviewed. The interviews were analyzed in order to apply phenomenography in a home-care context. The results showed variations in the older adults’ perceptions that were comprised within three categories of description; Require technology literacy, Maintain social interaction, and Facilitate independent living. In conclusion, the development and design of mHealth technologies need to be tailored based on older adults´ needs in order to be understood and perceived as useful in a home-care context. For mHealth to support HRQoL, healthcare should be provided in a way that encourages various forms of communication and interaction.
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Nxumalo CT, Mchunu GG. Zulu Men's Conceptions, Understanding, and Experiences of Voluntary Medical Male Circumcision in KwaZulu-Natal, South Africa. Am J Mens Health 2020; 14:1557988319892437. [PMID: 32131678 PMCID: PMC7059234 DOI: 10.1177/1557988319892437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Voluntary Medical Male Circumcision (VMMC) is proven to reduce transmission of
HIV/AIDS. Despite concerted efforts to scale up VMMC in men aged 18–49, the
number of medically circumcised men in this age group remains suboptimal.
Research has shown that several individual factors hinder and promote uptake of
VMMC. The nature of these factors is not clearly understood within the
dimensions of religion, culture and tradition, particularly in a low-income
rural setting. This study aimed to analyze Zulu men’s conceptions, understanding
and experiences regarding VMMC in KwaZulu-Natal (KZN), South Africa. A
qualitative phenomenographic study approach was used to collect data from 20
uncircumcised males at six different clinics that provide VMMC services. Ethical
approval to collect data was obtained from the Biomedical Research Ethics
Committee of the University of KZN (BREC – BE627/18). Individual in-depth face
to face interviews were conducted using a semistructured interview guide.
Audiotapes were used to record interviews which were transcribed verbatim and
then analyzed manually. The conceptions regarding medical circumcision appeared
to be related to religious and cultural beliefs surrounding circumcision and the
historical traditional practice thereof. The understanding of males regarding
VMMC was mainly attributed to HIV prevention; however, knowledge on the degree
of partial protection appeared to be limited. An array of negative accounted in
the form of complications such as poor wound healing and postoperative pain
undergone by peers and other close influencers’ accounted for participants’
experiences of VMMC. Poor knowledge and negative experiences relating to VMMC
could account for reasons why men choose not to undergo VMMC.
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Affiliation(s)
- Celenkosini Thembelenkosini Nxumalo
- KZN Department of Health, Ndwedwe Community Health Centre, Verulam, KwaZulu-Natal, South Africa.,Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Gugu Gladness Mchunu
- Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
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Arveklev SH, Wigert H, Berg L, Lepp M. Specialist nursing students' experiences of learning through drama in paediatric care. Nurse Educ Pract 2020; 43:102737. [PMID: 32062529 DOI: 10.1016/j.nepr.2020.102737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/21/2019] [Accepted: 01/31/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Susanna H Arveklev
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; University West, Trollhättan, Sweden.
| | - Helena Wigert
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linda Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margret Lepp
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Østfold University College, Halden, Norway; School of Nursing and Midwifery, Griffith University, Australia
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50
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Cleeve H, Borell L, Rosenberg L. (In)visible materialities in the context of dementia care. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:126-142. [PMID: 31562648 PMCID: PMC7004116 DOI: 10.1111/1467-9566.12988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Seemingly mundane materialities are intertwined with important, but often neglected, care interactions. It has been argued that if healthcare professionals paid more attention to the roles materialities can have, everyday routines could become important occasions for care. In response to such proposals, we argue that it is relevant to examine how materialities are currently understood. In this article, we explore materialities as part of work in a dementia unit. Using abstracted illustrations of everyday materialities to elicit reflections, we conducted 11 individual interviews with certified nursing assistants. Through phenomenographic analysis we explain our findings as three different categories conceptualising understandings of materialities as: 'tools for care', 'a set of principles for care' and 'caring relationships'. Our analysis indicates that understanding materialities as instruments was reinforced and made visible through the healthcare organisation while understanding materialities as part of specific relationships with residents appeared informal and less visible. How materialities were understood seemed to have several implications for residents. While care practices could benefit from nursing assistants' abilities to alternate between ways of understanding materialitites, such competence seemed dependent on how professional care was organised, structured and materialised.
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Affiliation(s)
- Helena Cleeve
- Department of Neurobiology, Care Sciences and SocietyDivision of Occupational TherapyKarolinska InstitutetHuddingeSweden
| | - Lena Borell
- Department of Neurobiology, Care Sciences and SocietyDivision of Occupational TherapyKarolinska InstitutetHuddingeSweden
| | - Lena Rosenberg
- Department of Neurobiology, Care Sciences and SocietyDivision of Occupational TherapyKarolinska InstitutetHuddingeSweden
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