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  • 1.
    Johannesson, Eva
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Learning manual and procedural clinical skills through simulation in health care education2012Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim of this thesis was to contribute to a deeper understanding of students’ perceptions of learning in simulation skills training in relation to the educational design of the skills training. Two studies were conducted to investigate learning features, what clinical skills nursing students learn through simulation, and how.

    Undergraduate nursing students were chosen in both studies. Study I was conducted in semester three, and study II in semester six, the last semester. Twenty-two students in study I practised intravenous catheterisation in pairs in the regular curriculum with an additional option of using two CathSim® simulators. In study II, ten students practised urethral catheterisation in pairs, using the UrecathVision™ simulator. This session was offered outside the curriculum, one pair at a time.

    In study I, three questionnaires were answered - before the skills training, after the skills training and the third after the skills examination but before the students’ clinical practice. The questions were both closed and open and the answers were analysed with quantitative and qualitative methods. The results showed that the simulator was valuable as a complement to arm models. Some disadvantages were expressed by the students, namely that there was no arm model to hold and into which to insert the needle and that they missed a holistic perspective. The most prominent learning features were motivation, variation, realism, meaningfulness, and feedback. Other important features mentioned were a safe environment, repeated practice, active and independent learning, interactive multimedia and a simulation device that was easy to use.

    In study II the students were video-recorded during the skills training. Afterwards, besides open questions, the video was used for individual interviews as stimulated recall. The interview data were analysed with qualitative content analysis. Three themes were identified: what the students learn, how the students learn, and how the simulator can contribute to the students’ learning. When learning clinical skills through simulation, motivation, meaningfulness and confidence were expressed as important factors to take into account from a student perspective. The students learned manual and procedural skills and also professional behaviour by preparing, watching, practising and reflecting.

    From an educational perspective, variation, realism, feedback and reflection were seen as valuable features to be aware of in organising curricula with simulators. Providing a safe environment, giving repeated practice, ensuring active and independent learning, using interactive multimedia, and providing a simulation tool that is easy to use were factors to take into account. The simulator contributed by providing opportunities to prepare for skills training, to see the anatomy, to feel resistance to catheter insertion, and to become aware of performance ability. Learning features, revealed from the students’ thoughts and experiences in these studies, are probably general to some extent but may be used to understand and design clinical skills training in all health care educations. In transferring these results it is important to take the actual educational context into account.

    List of papers
    1. Learning features in computer simulation skills training
    Open this publication in new window or tab >>Learning features in computer simulation skills training
    2010 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 10, no 5, p. 268-273Article in journal (Refereed) Published
    Abstract [en]

    New simulation tools imply new opportunities to teach skills and train health care professionals. The aim of this study was to investigate the learning gained from computer simulation skills training. The study was designed for optimal educational settings, which benefit student-centred learning. Twenty-four second year undergraduate nursing students practised intravenous catheterization with the computer simulation program CathSim. Questionnaires were answered before and after the skills training, and after the skills examination. When using CathSim, the students appreciated the variation in patient cases, the immediate feedback, and a better understanding of anatomy, but they missed having an arm model to hold. We concluded that CathSim was useful in the students’ learning process and skills training when appropriately integrated into the curriculum. Learning features to be aware of when organizing curricula with simulators are motivation, realism, variation, meaningfulness and feedback.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-67085 (URN)10.1016/j.nepr.2009.11.018 (DOI)
    Available from: 2011-03-29 Created: 2011-03-29 Last updated: 2017-12-11Bibliographically approved
    2. Students’ experiences of learning manual clinical skills through simulation
    Open this publication in new window or tab >>Students’ experiences of learning manual clinical skills through simulation
    2013 (English)In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 18, no 1, p. 99-114Article in journal (Refereed) Published
    Abstract [en]

    Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students’ experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten thirdyear undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision™, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in threethemes: what the students learn, how the students learn, and the simulator’s contribution to the students’ learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.

    Keywords
    Learning theory; professional development; qualitative content analysis; simulation; skills training; undergraduate nursing education
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-75504 (URN)10.1007/s10459-012-9358-z (DOI)000314767300009 ()
    Available from: 2013-04-02 Created: 2012-03-05 Last updated: 2017-12-07Bibliographically approved
  • 2.
    Johannesson, Eva
    et al.
    Linköping University, Department of Medical and Health Sciences, Medical Pedagogics. Linköping University, Faculty of Health Sciences.
    Hult, Håkan
    Linköping University, Department of Medical and Health Sciences, Medical Pedagogics. Linköping University, Faculty of Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Medical and Health Sciences, Medical Pedagogics. Linköping University, Faculty of Health Sciences.
    Simulating the real - manual clinical skills training: Conditions and practices of learning through simulation2013In: Realising exemplary practice-based education / [ed] Joy Higgs, Rotterdam, Nederländerna: Sense Publishers, 2013, p. 187-194Chapter in book (Other academic)
    Abstract [en]

    For educators, scholars, practitioners and researchers this book offers an opportunity to explore and engage with practice-based education theories and concepts in real life teaching spaces. It is a place to see theory embodied and situated within PBE practices. It is also an opportunity to see how educators and scholars from other disciplines are applying theory to understand teaching and learning in their particular area. This volume provides an opportunity for readers to deepen their understanding of practice-based education and broaden and critically appraise their strategies for engaging

  • 3.
    Johannesson, Eva
    et al.
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Olsson, Mats
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Petersson, Göran
    Högskolan i Kalmar.
    Silèn, Charlotte
    Centre for Medical Education, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm.
    Learning features in computer simulation skills training2010In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 10, no 5, p. 268-273Article in journal (Refereed)
    Abstract [en]

    New simulation tools imply new opportunities to teach skills and train health care professionals. The aim of this study was to investigate the learning gained from computer simulation skills training. The study was designed for optimal educational settings, which benefit student-centred learning. Twenty-four second year undergraduate nursing students practised intravenous catheterization with the computer simulation program CathSim. Questionnaires were answered before and after the skills training, and after the skills examination. When using CathSim, the students appreciated the variation in patient cases, the immediate feedback, and a better understanding of anatomy, but they missed having an arm model to hold. We concluded that CathSim was useful in the students’ learning process and skills training when appropriately integrated into the curriculum. Learning features to be aware of when organizing curricula with simulators are motivation, realism, variation, meaningfulness and feedback.

  • 4.
    Johannesson, Eva
    et al.
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Silén, Charlotte
    Centre for Medical Education, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Hult, Håkan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Students’ experiences of learning manual clinical skills through simulation2013In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 18, no 1, p. 99-114Article in journal (Refereed)
    Abstract [en]

    Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students’ experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten thirdyear undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision™, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in threethemes: what the students learn, how the students learn, and the simulator’s contribution to the students’ learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.

  • 5.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Aanstoot, Janna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Lundeborg Hammarström, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Samuelsson, Christina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Johannesson, Eva
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Sandström, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Berglind, Ulrika
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Learning in the tutorial group: A balance between individual freedom and institutional control2014In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 28, no 1-2, p. 47-59Article in journal (Refereed)
    Abstract [en]

    The study investigates factors in problem-based learning tutorial groups which promote or inhibit learning. The informants were tutors and students from speech-language pathology and physiotherapy programmes. Semi-structured focus-group interviews and individual interviews were used. Results revealed three themes: Responsibility, Time and Support. Under responsibility, the delicate balance between individual and institutional responsibility and control was shown. Time included short and long-term perspectives on learning. Under support, supporting documents, activities and personnel resources were mentioned. In summary, an increased control by the program and tutors decreases students motivation to assume responsibility for learning. Support in tutorial groups needs to adapt to student progression and to be well aligned to tutorial work to have the intended effect. A lifelong learning perspective may help students develop a meta-awareness regarding learning that could make tutorial work more meaningful.

  • 6.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Ferreira, Janna
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    LundeborgHammarström, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Samuelsson, Christina
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Johannesson, Eva
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Sandström, Karin
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Rehabilitation Medicine.
    Berglind, Ulrika
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Learning in the tutorial group – a challenge between freedom and control2011In: The Third International Conference on Problem Based Learning in Speech Language Pathology and Audiology / [ed] Tara Whitehill & Susan Bridges, Hong Kong: University of Hong Kong , 2011Conference paper (Refereed)
    Abstract [en]

    Introduction: In order to improve and clarify the demands within tutorial groups in the speech and language pathology (SLP) and physiotherapy (PT) programs a joint study was conducted exploring problem areas in the tutorial groups.

    The aim was to investigate and further develop the requirements for a passing grade in the tutorial group. A long term goal was that the results could form a base for future changes regarding instructions and requirements in tutorial groups.

    Methodology:  Focus-group interviews were used to collect data. Three different groups were interviewed, two consisting of tutors from the SLP and PT programs and one consisting of last year student tutors from the SLP-program.  This data was also augmented by individual interviews of four SLP-students and five PT-students on different levels in the education.  A semi structured interview guide was used.  The interviews were analyzed using content analyses.

    Results: The analyses revealed three important themes for work in tutorial groups: Responsibility, Time and Support. Within these themes, several categories were also identified. Responsibility: Within this theme the main category was the importance of balance between individual and institutional responsibility. The students, the tutorial group, the tutor and the program all need to assume their part of the responsibility in order to clarify requirements. Time: Here different aspects of time management and work in the tutorial group were identified. These categories also related to aspects of support and continuous or lifelong learning. Support: Within this theme different support functions were identified such as documents, activities and personnel resources in the tutorial groups.  No suggestions were made in the interviews regarding the requirements for a passing grade in the tutorial groups. 

    Discussion/Conclusion: The main finding was the delicate balance between institutional control and the students own responsibility for the work within the tutorial groups.  An increased control decreases the students’ motivation to assume responsibility for their own learning. Also, study programs should adapt requirements in tutorial groups depending on years in the education.  Different support functions need to be closely coupled to tutorial work in order to have the intended effect.   

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