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Manninen, Katri
Publications (9 of 9) Show all publications
Manninen, K., Karlstedt, M., Sandelin, A., von Vogelsang, A.-C. & Pettersson, S. (2022). First and second cycle nursing students' perceptions of the clinical learning environment in acute care settings - A comparative crossectional study using the CLES+T scale. Nurse Education Today, 108, Article ID 105211.
Open this publication in new window or tab >>First and second cycle nursing students' perceptions of the clinical learning environment in acute care settings - A comparative crossectional study using the CLES+T scale
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2022 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 108, article id 105211Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Research has shown that the clinical learning environment can both facilitate and hinder students' learning. Students' perceptions need to be evaluated, preferably using nationally and internationally validated instruments. In Sweden, there is a lack of research about students' evaluation in acute care settings and from the perspectives of different levels of students.

OBJECTIVES: The aim was to explore and compare perceptions of the clinical learning environment of first- and second-cycle nursing students in an acute care setting using the Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T).

DESIGN: The design involves cross-sectional data collection with comparisons between groups.

SETTING AND PARTICIPANTS: Data were collected from a convenience sample of first- and second-cycle students at the end of their clinical placements in an acute care setting at a university hospital.

METHODS: A paper version and a web version of the culturally adapted version of CLES+T was filled out by the students. An independent t-test was used to explore the differences between CLES+T scores and distribution methods and educational level. Internal consistency was evaluated using Cronbach's alpha.

RESULTS: Overall, the students (N = 179) were satisfied with the clinical learning environment. There was no significant difference in the total score (m = 4.31, SD = 0.63) between first- and second-cycle students except for the subscale of "Premises of nursing on the ward" and the individual items "The ward's nursing philosophy was clearly defined" and "Patients received individual nursing care", showing that the first-cycle students were more satisfied compared to the second-cycle students. The scale demonstrated high internal consistency (α = 0.97 vs. 0.96) for the paper survey and the web survey, respectively.

CONCLUSIONS: Our findings provide initial support for the CLES+T as a useful instrument to evaluate the clinical learning environment at different levels of education and in different contexts regardless of distribution method.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Clinical learning environment, Evaluation scale, First-cycle nursing student, Second-cycle nursing student, Supervision
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4155 (URN)10.1016/j.nedt.2021.105211 (DOI)000724919500020 ()34784564 (PubMedID)
Available from: 2021-11-25 Created: 2021-11-25 Last updated: 2021-12-16Bibliographically approved
Manninen, K., Björling, G., Kuznecova, J. & Lakanmaa, R.-L. (2020). Ethical Coffee Room: An international collaboration in learning ethics digitally. Nursing Ethics, 27(8), 1655-1668
Open this publication in new window or tab >>Ethical Coffee Room: An international collaboration in learning ethics digitally
2020 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 27, no 8, p. 1655-1668Article in journal (Refereed) Published
Abstract [en]

Background:

Ethics is a fundamental part of health care professionals’ competence and one of the major quality factors in good nursing care. Research shows challenges in learning and applying ethics. Ethical Coffee Room is an electronic platform, where the students, nurses and teachers discuss anonymously ethical issues during students’ clinical practice. ECR offers 1 credit (27 working hours) for the students. This work included reading theoretical material, contributions for discussion of ethical dilemmas and reflection of one’s own learning. Every user – student, nurse supervisor or teacher – could choose her or his own pseudonym.

Aim:

The aim of this study was to describe how nursing students experience learning ethics with digital learning activity during clinical practice, how usable the Ethical Coffee Room platform is and how this learning activity should be developed further.

Research design, participants and context:

The study employed a qualitative descriptive design and was an EU project between Finland, Sweden and Latvia. In total, 34 second-year nursing students participated in the study. The data collection methods were semi-structured interviews and written comments in the discussion forum Ethical Coffee Room. The data were analysed using content analysis.

Ethical considerations:

Ethical approval and research permission were obtained from each partner organization, according to their national standards.

Findings:

The results are presented under three themes: positive learning experiences of Ethical Coffee Room, challenges in learning during Ethical Coffee Room and practical suggestions for future development of Ethical Coffee Room. The results showed that the Ethical Coffee Room was experienced as a novel type of learning activity and an interesting way to learn ethics.

Discussion and conclusion:

Ethical Coffee Room seems to be a promising learning activity enhancing students’ ethical competence in clinical practice. However, active participation of the mentor nurses and teachers is essential. Therefore, mentor nurses and teachers need in-depth knowledge of ethical theories and concepts and how to apply them in clinical context.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Clinical practice, digital learning activity, ethical competence, nursing education, nursing student
National Category
Medical Ethics Nursing
Identifiers
urn:nbn:se:rkh:diva-3440 (URN)10.1177/0969733020934145 (DOI)000548900600001 ()32666868 (PubMedID)2-s2.0-85087993374 (Scopus ID)
Funder
Interreg Central Baltic, CB625
Available from: 2020-07-21 Created: 2020-07-21 Last updated: 2020-12-21Bibliographically approved
Manninen, K. & Björling, G. (2019). Ethical Coffee Room: ett EU-projekt om etiska frågor och diskussioner i verksamhetsförlagd utbildning för sjuksköterskestudenter.
Open this publication in new window or tab >>Ethical Coffee Room: ett EU-projekt om etiska frågor och diskussioner i verksamhetsförlagd utbildning för sjuksköterskestudenter
2019 (Swedish)Other (Other (popular science, discussion, etc.))
Abstract [sv]

Projektet Simulation in Ethics, SimE, syftar till att öka den etiska kompetensen hos sjuksköterskestudenter i Norden och Baltikum. Projektet pågår under åren 2017-2019 i samarbete mellan Röda Korsets Högskola, Turku University of Applied Sciences (Finland) och Riga Medical College of the University of Latvia (Lettland)  och är finansierat av EU och Interregional Central Baltic Programme.

I projektet ingår att planera och genomföra tre kurser: Basic Theories of Ethics (2 ECTS), Ethical Coffee Room (1 ETCS) and Simulation in Ethics (3ECTS) som görs gemensamt av de tre partnerorganisationer. Kurserna finns på en digital plattform med web-seminarier och diskussionsforum som resurs för studenterna. Språket är engelska. I kurs 1 ges grunderna i etik och etiska teorier och begrepp. Kurs 2 handlar om att tillämpa och diskutera teoretiska kunskaper och erfarenheter i etik i en autentisk miljö i den verksamhetsförlagda utbildningen. I kurs 3 genomförs simuleringar där studenterna aktivt medverkar i simuleringsscenarier med efterföljande etisk reflektion. Gemensamma kurser i etik bidrar till en mer harmoniserad utbildning och kompetens inom regionen och främjar mobilitet av arbetskraft och bättre patientvård. Efter avslutat projekt kommer allt kursmaterial inklusive en handbok att finnas fritt tillgängligt och kunna användas av alla utbildningar inom hälso- och sjukvård. Röda Korsets Högskola har huvudansvaret för kurs 2 och vi har under våren genomfört en pilot-testning av den, Ehtical Coffee Room, i termin 3 med gott resultat.

Publisher
p. 3
Keywords
etik, klinisk utbildning
National Category
Medical and Health Sciences Medical Ethics
Identifiers
urn:nbn:se:rkh:diva-2944 (URN)
Projects
SimE Simulation pedagogy in learning ethics in practice in health care
Funder
Interreg Central Baltic
Available from: 2019-06-18 Created: 2019-06-18 Last updated: 2019-08-30Bibliographically approved
Kangas-Niemi, A., Manninen, K. & Mattsson, J. (2018). Facilitating affective elements in learning - In a palliative care context. Nurse Education in Practice, 33, 148-153
Open this publication in new window or tab >>Facilitating affective elements in learning - In a palliative care context
2018 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 33, p. 148-153Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore ways clinical supervisors facilitate the learning of the affective elements of professional competence in a clinical palliative care environment. The secondary aim was to advocate for and raise awareness of the importance of the affective domain in medical education.

A clinical palliative care learning environment has been reported to be emotionally challenging. The affective and transformative learning processes taking place requires special support. However, little is known about how clinical supervisors facilitate this learning processes. A qualitative, explorative study was designed to capture supervisors' perceptions of their supervision using semi-structured interviews. Six experienced clinical supervisors working within a palliative care context were recruited using convenience sampling. Data were analyzed using inductive content analysis. The affective elements were viewed as essential for learning, clinical supervision, and professional competency. Supervisors use a variety of different ways of facilitation. Four main themes were identified; building a relationship, creating space for learning, creating a pedagogical environment, and Mirroring.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Affective elements, Palliative care, Home care, Nursing students, Competence
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-2698 (URN)10.1016/j.nepr.2018.09.007 (DOI)30296727 (PubMedID)
Available from: 2018-10-03 Created: 2018-10-03 Last updated: 2021-09-09Bibliographically approved
Manninen, K., Welin Henriksson, E., Scheja, M. & Silén, C. (2015). Supervisors’ pedagogical role at a clinical education ward: an ethnographic study. BMC Nursing, 14, Article ID 55.
Open this publication in new window or tab >>Supervisors’ pedagogical role at a clinical education ward: an ethnographic study
2015 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, article id 55Article in journal (Refereed) Published
Place, publisher, year, edition, pages
BioMed Central, 2015
National Category
Nursing Learning
Identifiers
urn:nbn:se:rkh:diva-1578 (URN)10.1186/s12912-015-0106-6 (DOI)26549985 (PubMedID)
Note

As submitted in dissertations

Available from: 2015-03-16 Created: 2015-03-16 Last updated: 2021-09-08Bibliographically approved
Manninen, K. (2014). Experiencing authenticity: the core of student learning in clinical practice. (Doctoral dissertation). Karolinska Institutet
Open this publication in new window or tab >>Experiencing authenticity: the core of student learning in clinical practice
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present thesis explored student learning at a clinical education ward with an explicit pedagogical framework. Although nursing students were the focus of the studies the intention is to gain more generally understanding of student learning in clinical settings. Learning in this thesis is understood as a transformative process that involves knowledge construction and meaning-making processes. Clinical education is carried out in real clinical work-places and consists of encounters with patients, healthcare professionals and peer students. Students train their future professional role in these encounters. Previous research has shown challenges that are tied to both organizational and pedagogical issues indicating that clinical learning environments are not always ideal. One way to meet these challenges is by introducing clinical education wards. These are units run collaboratively by educational institutions and the clinical settings; they train students on different levels and focus on inter-professional training or on one profession.

The overall aim of the present thesis was to contribute to our understanding of students’ learning at a clinical education ward where students are supported in taking care of patients independently. A qualitative approach was used to explore students’ learning from the perspectives of students, patients and supervisors. The theory of transformative learning and the concepts of authenticity and threshold were used in interpreting and understanding of the findings.

The results show that the core of student learning at a clinical education ward is the experience of both external and internal authenticity In Study I, first-year nursing students created mutual relationships with patients and expressed feelings of belongingness, which resulted in experiences of both external and internal authenticity. Experiencing authenticity resulted in learning and understanding of nursing and students’ future professional role.

In Study II, final-year students’ learning turned out to be more complex; they experienced only external authenticity, with feelings of ambivalence and selfcentredness creating uncertainty as a threshold for their learning. Taking care of patients in need of extensive nursing care helped students overcome the threshold and experience internal authenticity as well.

Study III explored student-patient encounters and showed that mutual relationships resulted in learning relationships, where patients were active participants in student learning.

In Study IV, supervisors’ approaches to student learning were explored, and the supervisors’ role was shown to involve balancing patient care and student learning by having a nursing care plan for patients and a learning plan for students. Supervisors allowed students to have independence while giving them adequate support at the same time.

To conclude, authenticity makes learning meaningful, and students need to experience both external and internal authenticity in their learning process. Patients’ active participation and supervisors giving both challenges and support are essential to students’ learning. An explicit pedagogical framework based on patient-centredness, peer-learning and supervisors working as a team creates prerequisites for experiences of external and internal authenticity. The present thesis points out that creating possibilities for experiencing authenticity should be the basis for designing clinical learning environments.

Place, publisher, year, edition, pages
Karolinska Institutet, 2014. p. 79
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-1579 (URN)978-91-7549-532-3 (ISBN)
Public defence
2014-05-23, Vesalius Salen, Berzelius väg 3, Solna, 09:00 (English)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Submitted. Paper 4: Submitted.

III. Manninen, K., Welin Henriksson, E., Scheja, M., Silén C. Patient-student encounters and students’ learning at a clinical education ward – an ethnographic study. [Submitted]

IV. Manninen K., Welin Henriksson, E., Scheja, M., Silén, C. Supervisors’ pedagogical role at a clinical education ward – an ethnographic study. [Submitted]

Available from: 2015-03-17 Created: 2015-03-16 Last updated: 2017-05-16Bibliographically approved
Manninen, K., Welin Henriksson, E., Scheja, M. & Silén, C. (2014). Patients' approaches to students' learning at a clinical education ward: an ethnographic study. BMC Medical Education, 14, Article ID 131.
Open this publication in new window or tab >>Patients' approaches to students' learning at a clinical education ward: an ethnographic study
2014 (English)In: BMC Medical Education, E-ISSN 1472-6920, Vol. 14, article id 131Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: It is well known that patients' involvement in health care students' learning is essential and gives students opportunities to experience clinical reasoning and practice clinical skills when interacting with patients. Students encounter patients in different contexts throughout their education. However, looking across the research providing evidence about learning related to patient-student encounters reveals a lack of knowledge about the actual learning process that occurs in encounters between patients and students. The aim of this study was to explore patient-student encounters in relation to students' learning in a patient-centered health-care setting.

METHODS: An ethnographic approach was used to study the encounters between patients and students. The setting was a clinical education ward for nursing students at a university hospital with eight beds. The study included 10 observations with 11 students and 10 patients. The observer followed one or two students taking care of one patient. During the fieldwork observational and reflective notes were taken. After each observation follow-up interviews were conducted with each patient and student separately. Data were analyzed using an ethnographic approach.

RESULTS: The most striking results showed that patients took different approaches in the encounters with students. When the students managed to create a good atmosphere and a mutual relationship, the patients were active participants in the students' learning. If the students did not manage to create a good atmosphere, the relationship became one-way and the patients were passive participants, letting the students practice on their bodies but without engaging in a dialogue with the students.

CONCLUSIONS: Patient-student encounters, at a clinical education ward with a patient-centred pedagogical framework, can develop into either a learning relationship or an attending relationship. A learning relationship is based on a mutual relationship between patients and students resulting in patients actively participating in students' learning and they both experience it as a joint action. An attending relationship is based on a one-way relationship between patients and students resulting in patients passively participating by letting students to practice on their bodies but without engaging in a learning dialogue with the students.

Keywords
Patient-student encounters, Clinical education ward, Patient-centeredness, Learning relationship, Attending relationship
National Category
Nursing Learning
Identifiers
urn:nbn:se:rkh:diva-1577 (URN)10.1186/1472-6920-14-131 (DOI)24989155 (PubMedID)
Available from: 2015-03-16 Created: 2015-03-16 Last updated: 2022-02-10Bibliographically approved
Manninen, K., Welin Henriksson, E., Scheja, M. & Silén, C. (2013). Authenticity in learning: nursing students’ experiences at a clinical education ward. Health Education, 113(2), 132-143
Open this publication in new window or tab >>Authenticity in learning: nursing students’ experiences at a clinical education ward
2013 (English)In: Health Education, ISSN 0965-4283, E-ISSN 1758-714X, Vol. 113, no 2, p. 132-143Article in journal (Refereed) Published
Abstract [en]

Purpose– This study aims to explore and understand first year nursing students’ experiences of learning at a clinical education ward.

Design/methodology/approach– The setting is a clinical education ward for nursing students at a department of infectious diseases. A qualitative study was carried out exploring students’ encounters with patients, supervisors, students and other health care professionals. A total of 19 students were interviewed. Data were analyzed using qualitative content analysis investigating both the manifest and the latent content.

Findings– The most important components in students’ learning are mutual relationships and a sense of belongingness. A mutual relationship between the students and the patients is created and becomes the basis of students’ learning. Belongingness means the students’ experience of being for real a part of the team taking care of the patients.

Research limitations/implications– The study, while linked to a particular teaching hospital, offers insights of more general nature by linking the findings to a theory of transformative learning.

Originality/value– This study adds a deeper understanding of students’ perspectives of significant characteristics to take into account when organizing clinical practice in health care education. Being entrusted and supported by a team of supervisors to take care of patients at a clinical education ward early in the education program provides an experience of internal and external authenticity. The students learn from, with and through the patients, which contributes to meaningful learning, understanding nursing, and professional development.

Keywords
Medical education, Authenticity, Belongingness, Clinical education ward, Meaningful learning, Nursing students, Relationships, Education, Students, Nursing
National Category
Nursing Learning
Identifiers
urn:nbn:se:rkh:diva-1560 (URN)10.1108/09654281311298812 (DOI)
Available from: 2015-03-12 Created: 2015-03-12 Last updated: 2017-05-16Bibliographically approved
Manninen, K., Scheja, M., Welin Henriksson, E. & Silén, C. (2013). Self-centeredness or patient-centeredness–final year nursing students’ experiences of learning at a clinical education ward. Journal of Nursing Education and Practice, 3(12), 187-198
Open this publication in new window or tab >>Self-centeredness or patient-centeredness–final year nursing students’ experiences of learning at a clinical education ward
2013 (English)In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 3, no 12, p. 187-198Article in journal (Refereed) Published
Abstract [en]

Background: Different types of clinical education wards with the aim of facilitating transition from student to professional have been established giving students more autonomy and responsibility. Studies report positive effects but deeper understanding concerning how clinical education wards can contribute to learning for students nearing graduation is needed.

Aim: To explore final year nursing students’ experiences of learning when they are supported to take care of patients independently.

Methods: The context for this study was a clinical education ward for nursing students at a university hospital in Sweden. Individual and group interviews with 18 students of 29 eligible students were conducted after their clinical practice. The data was analyzed using qualitative content analysis with a focus on students’ experiences of their encounters with patients, supervisors, students and other professionals.

Results: The two main themes appeared as important aspects influencing final year students’ learning, uncertainty as a threshold and experiencing engagement. Sub-themes characterizing uncertainty as a threshold were self-centeredness and ambivalence describing the patient from the perspective of performing nursing tasks. Sub-themes characterizing experiencing engagement were creating mutual relationship and professional development. Caring for patients with extensive need for nursing care helped the students to become patient-centered and overcome the threshold, experience engagement and authenticity in learning the profession.

Conclusions: A clinical education ward may enhance the students’ experience of both external and internal authenticity enabling meaningful learning and professional development. It is important to acknowledge final year nursing students’ need for both challenges and support in the stressful transition from student to professional. Therefore, an explicit pedagogical framework based on patient-centered care and encouraging students to take responsibility should be used to help the students to overcome self-centeredness and to focus on the patients’ needs and nursing care.

Keywords
Clinical education ward, Self-centeredness, Patient-centeredness, Nursing students, Authenticity, Threshold, Engagement
National Category
Nursing Learning
Identifiers
urn:nbn:se:rkh:diva-1575 (URN)10.5430/jnep.v3n12p187 (DOI)
Available from: 2015-03-16 Created: 2015-03-13 Last updated: 2017-05-16Bibliographically approved
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