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  • 1.
    Kangas-Niemi, Annina
    et al.
    Karolinska Institutet.
    Manninen, Katri
    Karolinska Institutet.
    Mattsson, Janet
    The Swedish Red Cross University College, Department of Health Sciences.
    Facilitating affective elements in learning - In a palliative care context2018In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 33, p. 148-153Article in journal (Refereed)
    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.

  • 2.
    Manninen, Katri
    Karolinska Institutet, Inst för lärande, informatik, management och etik .
    Experiencing authenticity: the core of student learning in clinical practice2014Doctoral 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.

  • 3.
    Manninen, Katri
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet; Karolinska Universitetssjukhuset.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Ethical Coffee Room: ett EU-projekt om etiska frågor och diskussioner i verksamhetsförlagd utbildning för sjuksköterskestudenter2019Other (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.

  • 4.
    Manninen, Katri
    et al.
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet.
    Scheja, Max
    Department of Education, Faculty of Social Science, Stockholm University.
    Welin Henriksson, Elisabet
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Silén, Charlotte
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet.
    Self-centeredness or patient-centeredness–final year nursing students’ experiences of learning at a clinical education ward2013In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 3, no 12, p. 187-198Article in journal (Refereed)
    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.

  • 5.
    Manninen, Katri
    et al.
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet.
    Welin Henriksson, Elisabet
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Scheja, Max
    Faculty of Social Science, Department of Education, Stockholm University.
    Silén, Charlotte
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet.
    Authenticity in learning: nursing students’ experiences at a clinical education ward2013In: Health Education, ISSN 0965-4283, E-ISSN 1758-714X, Vol. 113, no 2, p. 132-143Article in journal (Refereed)
    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.

  • 6.
    Manninen, Katri
    et al.
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics.
    Welin Henriksson, Elisabet
    Department of Neurobiology, Karolinska Institutet; Care Sciences and Society.
    Scheja, Max
    Department of Education, Stockholm University.
    Silén, Charlotte
    Department of Learning, Karolinska Institutet, Informatics, Management and Ethics.
    Patients' approaches to students' learning at a clinical education ward: an ethnographic study2014In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, article id 131Article in journal (Refereed)
    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.

  • 7.
    Manninen, Katri
    et al.
    Karolinska University Hospital.
    Welin Henriksson, Elisabet
    Karolinska Institutet.
    Scheja, Max
    Stockholm University.
    Silén, Charlotte
    Karolinska Institutet.
    Supervisors’ pedagogical role at a clinical education ward: an ethnographic study2015In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, article id 55Article in journal (Refereed)
1 - 7 of 7
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  • nn-NO
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