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Swain C, Stathakarou N, Alzuguren P, Lemarteleur V, Moffatt R, Karlgren K. Trauma surgical simulation: discussing the replacement of live animals used as human patient simulators. Adv Simul (Lond) 2024; 9:7. [PMID: 38342893 PMCID: PMC10860211 DOI: 10.1186/s41077-024-00279-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/30/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Despite advances in simulator technology, live anaesthetised animals continue to be used as human patient simulators for medical professionals to practice techniques in the management of surgical trauma. This article describes the process of convening a working group of individuals with a professional interest in simulation to discuss the use of live animals and consider if and how they can be replaced in the future. MAIN BODY A working group was formed of voluntary attendees to a workshop held at the SESAM 2023 conference. Iterative discussions reflecting on the topic were used to produce statements summarising the working group's opinions. The working group determined that live animals are used as human patient simulators due to the presence of accurate and responsive physiology in the presence of bleeding, realistic tissue tactility and an emotional response experienced by the learner due to interaction with the animal. They were unable to reach a consensus on replacement, determining that there is currently no single model which is able to provide all the learning aspects which a live animal model can provide. Several suggestions were made regarding development of technologies and pedagogical change. CONCLUSION Replacement of live animals in surgical simulation is not straightforward but should be an aspiration, if possible. For the ongoing development of trauma surgical simulation models, it is important to combine the knowledge, skills and perspectives of medical stakeholders and educators, academic researchers and industry experts in producing alternative options to the use of live animal simulators.
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Affiliation(s)
- Cara Swain
- Department of Learning, Informatics, Management & Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
- Academic Department of Military Surgery & Trauma, Royal Centre for Defence Medicine (RCDM), Birmingham, UK.
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management & Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Pilar Alzuguren
- Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain
| | - Vincent Lemarteleur
- Unité de Recherche en Biomatériaux Innovants Et Interfaces (URB2i), Healthcare Simulation Department, Université Paris Cité, Paris, France
| | - Ryan Moffatt
- Northern Ireland Medical & Dental Training Agency, Belfast, Northern Ireland
| | - Klas Karlgren
- Department of Learning, Informatics, Management & Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- Department of Research, Education, Development & Innovation, Södersjukhuset, Stockholm, Sweden
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Pettersson A, Karlgren K, Hjelmqvist H, Meister B, Silén C. An exploration of students' use of digital resources for self-study in anatomy: a survey study. BMC Med Educ 2024; 24:45. [PMID: 38195470 PMCID: PMC10777562 DOI: 10.1186/s12909-023-04987-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND The development of technology has provided new ways for active engagement and for visualizing structures in anatomy education including digital resources that may be used outside of the classroom. To support students' learning, there is a need to better understand students' experiences of using digital resources. This study aimed to identify which resources students use, their preferences, the purpose of using them, and barriers to adopting tools for self-study of anatomy. METHODS A mixed -methods approach combining qualitative and quantitative data was used to collect and analyse data. Two consecutive cohorts of first-semester medical students (n = 278) were invited to complete an anonymized survey. The survey consisted of itemized questions, free-text space for comments, and one open-ended question. Descriptive statistics were used for demographics and itemized answers. Comments and free-text answers were analysed qualitatively using abductive inference. RESULTS One hundred and twenty-seven students completed the survey (response rate 45%). Most students (46%) reported that they spend more than 30 h/per week on self-study. They used a variety of digital resources for different purposes. Most students used digital resources to prepare for examinations, when they encountered difficulties and after going through a section. Students reported that they would use digital resources to a greater extent if they were offered an introduction, if resources were more accessible, and if they could interact with a tutor. The free-text responses revealed that digital resources helped students understand anatomy, allowed them to make active choices, provided tools for repetition and memorization, accelerated and simplified the learning process, and complemented other learning resources. CONCLUSIONS Digital resources may support the understanding of anatomy by offering alternative modes of learning and providing a valuable complement to other learning resources. Educators should consider how digital resources are introduced and offer support and feedback.
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Affiliation(s)
- Anna Pettersson
- Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Solna, Sweden.
- Department of Learning, Informatics, Management and Ethics, 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
| | - 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
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Wannheden C, Hasson H, Hager A, Karlgren K, Pukk Härenstam K. Now What? Collective Sensemaking and Sensegiving in the Cystic Fibrosis Community in Sweden During the Initial Phase of the COVID-19 Pandemic. Health Commun 2023; 38:3102-3112. [PMID: 36250348 DOI: 10.1080/10410236.2022.2134705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic's effects on people's lives and society induced a need for rapid individual and collective sensemaking, including communication forums enabling stakeholders in the health ecosystem to share information, solve problems, and learn. This study specifically focused on the needs of the patients and family caregivers living with cystic fibrosis (CF) or primary ciliary dyskinesia (PCD), conditions that lead to chronic infections and inflammation in the airways. We explored how CF and PCD patients, family caregivers, and clinicians collectively received, processed, and used information about COVID-19 to facilitate self-care and health care decisions at the beginning of the pandemic. We applied macrocognitive theory to analyze qualitatively the questions and answers exchanged in a series of six webinars facilitated by a CF learning network at the beginning of the pandemic (March - April 2020). We identified three macrocognitive functions: sensemaking, decision-making, and replanning. We further generated nine themes: (a) understanding the nature of COVID-19, (b) exploring self-care needs and possibilities, (c) understanding health care possibilities, (d) making decisions about prevention and testing, (e) managing COVID-19 within families, (f) adjusting planned care, (g) replanning chronic care management, (h) defining COVID-19 health care strategies, and (i) refining health care policies. The exchange of questions and answers played a central role in facilitating important cognitive processes, which enabled a rapid anticipation of needs and adaptation of services to support patients, family caregivers, and clinicians during the COVID-19 pandemic.
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Affiliation(s)
- Carolina Wannheden
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet
| | - Henna Hasson
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm
| | | | - Klas Karlgren
- MINT, Health Informatics Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet
- Education Center, Department of Research, Education, Development and Innovation, Södersjukhuset
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences
| | - Karin Pukk Härenstam
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet
- Pediatric Emergency Department, Astrid Lindgren Children's Hospital, Karolinska University Hospital
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Stathakarou N, Kononowicz AA, Swain C, Karlgren K. Game Elements in the Design of Simulations in Military Trauma Management Training: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e45969. [PMID: 37682596 PMCID: PMC10517381 DOI: 10.2196/45969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/22/2023] [Accepted: 07/28/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Military trauma teams are commonly operating in civilian hospitals during peacetime; in a war situation they must adjust their practices to the austere conditions. Simulations can replicate austere conditions to allow training in a safe environment that tolerates errors. Gamification, understood as the use of game elements to motivate and engage learners in nongame contexts, is gaining interest in medical education and military training. Applying game elements in the design of military trauma management simulations has the potential to provide learners with active learning opportunities and prepare them for providing medical services under austere conditions. Although gamification is known for its engaging and motivational benefits, there are controversies about its pedagogical value. The controversies can be attributed to the fact that various gamification strategies may consist of a different combination of game elements, leading to different outcomes. OBJECTIVE This systematic review aims to understand how game elements are used in the design of simulations in military trauma management training and their reported outcomes. METHODS We have designed a search strategy for the purpose of the review. Two researchers will independently assess the identified studies based on the defined inclusion and exclusion criteria. The selection process will be represented using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. The search will be repeated and updated as necessary prior to publication of the review. Two reviewers will independently extract and manage the data for each of the articles using a structured data extraction form. Any disagreement that arises between reviewers will be resolved through discussion, and a third review author will be consulted when needed. We are going to conduct a thematic synthesis of the extracted game element descriptions. The results are going to be presented in a diagrammatic or tabular form, alongside a narrative summary. The quality of the studies will be assessed. RESULTS We implemented and tested the developed search strategy in May 2023. We retrieved 1168 study abstracts, which were reduced to 630 abstracts after deduplication. We have piloted the screening on 20% (126/630) of the identified abstracts in groups of 2 reviewers. CONCLUSIONS Although gamification has the potential to motivate learners in various ways, there is a lack of understanding about specific game elements and how they can inform instructional design in different contexts. Our findings will increase the understanding of how game elements are used in the design of simulations in military trauma management training and, thus, contribute to more effective development of future simulations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45969.
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Affiliation(s)
- Natalia Stathakarou
- Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Andrzej A Kononowicz
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland
| | - Cara Swain
- Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, United Kingdom
- Institute of Naval Medicine, Alverstoke, Gosport, United Kingdom
| | - Klas Karlgren
- Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Education and Development and Innovation, Södersjukhuset, Stockholm, Sweden
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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Swain CS, Cohen HML, Helgesson G, Rickard RF, Karlgren K. A Systematic Review of Live Animal Use as a Simulation Modality ("Live Tissue Training") in the Emergency Management of Trauma. J Surg Educ 2023; 80:1320-1339. [PMID: 37516576 DOI: 10.1016/j.jsurg.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/11/2023] [Accepted: 06/17/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION Live anaesthetized animals are used as simulation models to teach techniques in the emergency management of trauma. We aimed to explore how "live tissue training" (LTT) is designed, delivered and evaluated in order to better understand and characterize aspects of educational merit. METHODS A systematic review was performed using PRISMA guidance. A combined approach, involving a 3-stage modified narrative synthesis process and reflexive thematic analysis was used to identify key concepts across the published literature. FINDINGS Qualitative synthesis of 48 selected articles suggests that LTT is mainly used to teach military and civilian physicians and military medical technicians. The procedures trained vary with the learner population, from simple pre-hospital trauma tasks to advanced operative surgical skills. Many courses use a combination of didactic and practical training, with an animal model used to train practical application of knowledge and procedural skills. Descriptions of the learning interventions are limited, and explicit use of educational theory or pedagogic frameworks were absent within the literature. Four themes were identified regarding aspects of LTT that are valued by learners: "recreating the experience," relating to fidelity and realism; "tick tock" "dynamics of hemorrhage", encompassing the impact of bleeding and urgent pressure to act; "emotional impact" of conducting the training, and "self-efficacy: I believe I can do it." CONCLUSION Thematic analysis of published literature suggests that there may be educational benefit in the use of live tissue models due to time criticality and bleeding, which creates a real-life event. LTT also invokes an emotional response, and learners experience an increase in self-efficacy from participation. We consider that these aspects and associated pedagogy should be addressed when researching and developing alternative simulation modalities, in order to intelligently replace, reduce and refine the use of animals in training practitioners in the emergency management of trauma.
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Affiliation(s)
- C S Swain
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden; Academic Department of Military Surgery and Trauma, Royal Centre of Defence Medicine (RCDM) Birmingham, United Kingdom.
| | - H M L Cohen
- HQ Army Medical Services Support Unit, Camberley, United Kingdom
| | - G Helgesson
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - R F Rickard
- Academic Department of Military Surgery and Trauma, Royal Centre of Defence Medicine (RCDM) Birmingham, United Kingdom
| | - K Karlgren
- Department of Learning, Informatics, Management and Ethics (LIME), 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
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Swain CS, Karlgren K. Comment on: "A Role for Live-Animal Models in Undergraduate Surgical Education During the Cadaver Shortage". Ann Surg Open 2023; 4:e305. [PMID: 37746624 PMCID: PMC10513254 DOI: 10.1097/as9.0000000000000305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/20/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- Cara S. Swain
- From the Department of Learning, Informatics, Management & Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Klas Karlgren
- From the Department of Learning, Informatics, Management & Ethics, Karolinska Institutet, Stockholm, 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. Anat Sci Educ 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Wannheden C, Roczniewska M, Hasson H, Karlgren K, von Thiele Schwarz U. Better self-care through co-care? A latent profile analysis of primary care patients' experiences of e-health-supported chronic care management. Front Public Health 2022; 10:960383. [PMID: 36211687 PMCID: PMC9540373 DOI: 10.3389/fpubh.2022.960383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Background Efficient self-care of chronic conditions requires that an individual's resources be optimally combined with healthcare's resources, sometimes supported by e-health services (i.e., co-care). This calls for a system perspective of self-care to determine to what extent it involves demanding or unnecessary tasks and whether role clarity, needs support, and goal orientation are sufficient. This study aims to explore typical configurations of how the co-care system is experienced by individuals with chronic conditions who used an e-health service supporting self-monitoring and digital communication with primary care. Method We performed a latent profile analysis using questionnaire data from two waves (7 months apart) involving 180 of 308 eligible patients who pilot-tested an e-health service for co-care at a Swedish primary care center. The five subscales of the Distribution of Co-Care Activities (DoCCA) scale were used to create profiles at Time 1 (T1) and Time 2 (T2). Profiles were described based on sociodemographic variables (age, gender, education level, and health condition) and compared based on exogenous variables (self-rated health, satisfaction with healthcare, self-efficacy in self-care, and perceptions of the e-health service). Results We identified four typical configurations of co-care experiences at T1: strained, neutral, supportive, and optimal. Patients with optimal and supportive profiles had higher self-rated health, self-efficacy in self-care, and satisfaction with healthcare than patients with strained and neutral profiles. Slightly more than half transitioned to a similar or more positive profile at T2, for which we identified five profiles: unsupportive, strained, neutral, supportive, and optimal. Patients with optimal and supportive profiles at T2 had higher self-efficacy in self-care and satisfaction with healthcare than the other profiles. The optimal profiles also had higher self-rated health than all other profiles. Members of the optimal and supportive profiles perceived the effectiveness of the e-health service as more positive than the unsupportive and strained profile members. Discussion Primary care patients' co-care profiles were primarily distinguished by their experiences of needs support, goal orientation, and role clarity. Patients with more positive co-care experiences also reported higher self-rated health, self-efficacy in self-care, and satisfaction with healthcare, as well as more positive experiences of the e-health service.
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Affiliation(s)
- Carolina Wannheden
- PROCOME, Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden,*Correspondence: Carolina Wannheden
| | - Marta Roczniewska
- PROCOME, Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden,Psychology Department, SWPS University of Social Sciences and Humanities, Sopot, Poland
| | - Henna Hasson
- PROCOME, Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden,Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Klas Karlgren
- MINT, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden,SimArena, Department of Health and Functioning, Faculty of Health and Social Sciences, The Western Norway University of Applied Sciences, Bergen, Norway,Department of Research, Education, Development and Innovation, Education Center, Södersjukhuset, Stockholm, Sweden
| | - Ulrica von Thiele Schwarz
- PROCOME, Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Lim HM, Ng CJ, Wharrad H, Lee YK, Teo CH, Lee PY, Krishnan K, Abu Hassan ZF, Yong PVC, Yap WH, Sellappans R, Ayub E, Hassan N, Shariff Ghazali S, Jahn Kassim PS, Nasharuddin NA, Idris F, Taylor M, Poussa C, Karlgren K, Stathakarou N, Mordt P, Konstantinidis S. Knowledge transfer of eLearning objects: Lessons learned from an intercontinental capacity building project. PLoS One 2022; 17:e0274771. [PMID: 36126036 PMCID: PMC9488788 DOI: 10.1371/journal.pone.0274771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 09/04/2022] [Indexed: 11/28/2022] Open
Abstract
Background Effective knowledge transfer of eLearning objects can hasten the adoption and dissemination of technology in teaching and learning. However, challenges exist which hinder inter-organisational knowledge transfer, particularly across continents. The ACoRD project aimed to transfer knowledge on digital learning development from UK/EU (provider) to Malaysian (receiver) higher education institutions (HEIs). This study explores the challenges encountered during the knowledge transfer process and lessons learned. Methods This is a qualitative study involving both the knowledge providers and receivers in focus group discussions (n = 25). Four focus group discussions were conducted in the early (n = 2) and mid-phase (n = 2) of the project by trained qualitative researchers using a topic guide designed to explore experiences and activities representing knowledge transfer in multi-institutional and multi-cultural settings. The interviews were audio-recorded, transcribed verbatim, and checked. The transcripts were analysed using thematic analysis. Results Five main themes emerged from this qualitative study: mismatched expectations between providers and receivers; acquiring new knowledge beyond the professional "comfort zone"; challenges in cascading newly acquired knowledge to colleagues and management; individual and organisational cultural differences; and disruption of knowledge transfer during the COVID-19 pandemic. Conclusion This study highlights the need to create a conducive platform to facilitate continuous, timely and bi-directional needs assessment and feedback; this should be done in the early phase of the knowledge transfer process. The challenges and strategies identified in this study could guide more effective knowledge transfer between organisations and countries.
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Affiliation(s)
- Hooi Min Lim
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Research, SingHealth Polyclinics, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Heather Wharrad
- School of Health Sciences, University of Nottingham, Nottingham, England
| | - Yew Kong Lee
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chin Hai Teo
- UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Ping Yein Lee
- UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Kuhan Krishnan
- Dean’s Office, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Phelim Voon Chen Yong
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Wei Hsum Yap
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Renukha Sellappans
- School of Pharmacy, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Enna Ayub
- Taylor’s Digital, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Nurhanim Hassan
- Teaching and Educational Development (TED), Centre of Future Learning, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Puteri Shanaz Jahn Kassim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurul Amelina Nasharuddin
- Department of Multimedia, Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Faridah Idris
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Michael Taylor
- School of Health Sciences, University of Nottingham, Nottingham, England
| | - Cherry Poussa
- School of Health Sciences, University of Nottingham, Nottingham, England
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Petter Mordt
- NettOp, Department of E-Learning Development, University of Stavanger, Stavanger, Norway
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Dalum J, Christidis N, Myrberg IH, Karlgren K, Leanderson C, Englund GS. Are we passing the acceptable? Standard setting of theoretical proficiency tests for foreign-trained dentists. Eur J Dent Educ 2022. [PMID: 36039793 DOI: 10.1111/eje.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/05/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Dentists educated outside the EU, EEA and Switzerland have the option to undergo proficiency testing to practice dentistry in Sweden. A standardised evidence-based procedure for proficiency tests is crucial. This paper explores if the standard setting of the theoretical examination in the Swedish proficiency test for foreign dentists is fit to differentiate candidates who meet the acceptable standard for licensure from those who do not, by analysis of inter-rater reliability and credibility of Angoff panels and the test's ability to differentiate candidates regarding learning outcomes and dental disciplines. MATERIALS AND METHODS In a cohort study design, test results were collected from seven examinations during 2018-2019 (n = 316), combined with Angoff judgements and demographic data from The National Board of Health and Welfare. Intraclass correlation, Pearson correlation and linear regression were calculated. RESULTS All exams demonstrated substantial judge inter-rater reliability using the Angoff procedure (0.65-0.82). Item difficulty predicted by the expert panels showed significant positive correlations with the item difficulty by candidate results (0.69-0.77). Candidates who did not meet the requirements for pass mark in the theoretical test revealed a significantly reduced performance overall in professional qualifications (i.e., learning outcomes) and reduced performance within dental disciplines. CONCLUSIONS The results indicate that a modified Angoff method is a feasible, simple, and defensible method for setting the pass mark for the theoretical examinations. The standard setting appears to differentiate candidates who do not meet the requirements of the professional qualifications of the dental degree. Adjustments could be undertaken to further discriminate for competence within single dental disciplines.
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Affiliation(s)
- Jesper Dalum
- Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
| | - Nikolaos Christidis
- Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
| | - Ida Hed Myrberg
- Institute of Environmental Medicine, Division of Biostatistics, Karolinska Institutet, Huddinge, Sweden
| | - Klas Karlgren
- Department Learning, Informatics, Management and Ethics, Karolinska Institutet, Huddinge, Sweden
- Department of Research, Education, Development and Innovation, Education Center, Södersjukhuset, Stockholm, Sweden
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Charlotte Leanderson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Gunilla Sandborgh Englund
- Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
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Silén C, Karlgren K, Hjelmqvist H, Meister B, Zeberg H, Pettersson A. Three-dimensional visualisation of authentic cases in anatomy learning - An educational design study. BMC Med Educ 2022; 22:477. [PMID: 35725408 PMCID: PMC9210673 DOI: 10.1186/s12909-022-03539-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Many studies have investigated the value of three-dimensional (3D) images in learning anatomy. However, there is a lack of knowledge about students learning processes using technology and 3D images. To understand how to facilitate and support the learning of anatomy, there is a need to know more about the student perspectives on how they can use and benefit from 3D images. METHODS This study used designed educational sessions informed by Educational Design Research to investigate the role of technology-enhanced 3D images in students' anatomy learning. Twenty-four students representing different health professions and multiple study levels, and one tutor, participated in the study. A visualisation table was used to display the images of real patient cases related to disorders associated with the abdomen and the brain. Students were asked to explore the images on their own and audio/video capture was used to record their words and actions. Directly following the session, students were interviewed about their perceptions and different ways of learning and studying anatomy. The tutor was interviewed about his reflections on the session and his role as a facilitator on two occasions. Content analysis was used in its manifest and latent form in the data analysis. RESULT Two main categories describing the students' and tutor's accounts of learning using the visualisation table were identified: 1. Interpreting 3D images and 2. Educational sessions using visualisation tables. Each category had signifying themes representing interpretations of the latent meaning of the students' and tutor's accounts. These were: Realism and complexity; Processes of discernment; References to previous knowledge; Exploring on one's own is valuable; Context enhances learning experiences; Combinations of learning resources are needed and Working together affects the dynamics. CONCLUSIONS This study identifies several important factors to be considered when designing effective and rewarding educational sessions using a visualization table and 3D images in anatomy education. Visualisation of authentic images has the potential to create interest and meaningfulness in studying anatomy. Students need time to actively explore images but also get tutor guidance to understand. Also, a combination of different resources comprises a more helpful whole than a single learning resource.
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Affiliation(s)
- Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, 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
| | - 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
- Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Anna Pettersson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Solna, Sweden
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Stathakarou N, Sonesson L, Lundberg L, Boffard KD, Kononowicz AA, Karlgren K. Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them? Health Informatics J 2021; 27:14604582211052253. [PMID: 34821149 DOI: 10.1177/14604582211052253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Surgical training in civilian hospitals may not be sufficient for managing complex trauma in a setting where such care is not commonly practiced. Understanding the challenges that civilian teams face when moving to austere environments can inform the competencies that need to be trained. The aim of this study was to explore the competencies required in austere environments for teams managing complex trauma, and how they can be trained with simulation technologies. Ethnographic field observations were conducted, and field notes were synthesized. The field notes were structured with the elements of Activity Theory to generate the teams' competencies that need to be trained. A literature review was conducted to verify the results and identify examples of relevant simulation modalities. The analysis resulted in a structured list of competencies for civilian teams to manage complex trauma in an austere environment and recommendations which simulation technologies could be used in training of those competencies based on published studies. Our study contributes to understanding the challenges that civilian teams face when operating in an austere environment. A systematized list of competencies with suggested simulation technologies directs future research to improve quality of complex trauma training in civilian and military collaboration.
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Affiliation(s)
- Natalia Stathakarou
- Department of Learning, Infortmatics, Management and Ethics (LIME), 27106Karolinska Institutet, Stockholm, Sweden
| | - Linda Sonesson
- Collaborative Partnerships Office, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Lars Lundberg
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kenneth D Boffard
- Department of Surgery, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Andrzej A Kononowicz
- Department of Bioinformatics and Telemedicine, 49573Jagiellonian University Medical College, Kraków, Poland
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,Department of Research, Education and Development and Innovation, Södersjukhuset, Sweden.,Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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Karlgren K, Dahlström A, Birkestam A, Drevstam Norling A, Forss G, Andersson Franko M, Cooper S, Leijon T, Paulsson C. The TEAM instrument for measuring emergency team performance: validation of the Swedish version at two emergency departments. Scand J Trauma Resusc Emerg Med 2021; 29:139. [PMID: 34544459 PMCID: PMC8454124 DOI: 10.1186/s13049-021-00952-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/08/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The Team Emergency Assessment Measure (TEAM) questionnaire is designed for rating the non-technical performance of emergency medical teams during emergencies, e.g., resuscitation or trauma management. Originally developed in Australia it has today been translated and validated into eleven languages, but a Swedish version is lacking. The aim was therefore to cross-culturally translate and evaluate the reliability and validity of the TEAM questionnaire in a Swedish health care setting. METHODS The instrument was forward and backward translated and adapted into a Swedish context according to established guidelines for cross-cultural adaptation of survey-based measures. The translated version was tested through 78 pairwise assessments of 39 high-priority codes at the emergency departments of two major hospitals. The raters observed the teams at work in real time and filled in the questionnaires immediately afterwards independently of each other. Psychometric properties of the instrument were evaluated. RESULTS The original instrument was translated by pairs of translators independently of each other and reviewed by an expert committee of researchers, nurses and physicians from different specialties, a linguist and one of the original developers of the tool. A few adaptations were needed for the Swedish context. A principal component factor analysis confirmed a single 'teamwork' construct in line with the original instrument. The Swedish version showed excellent reliability with a Cronbach's alpha of 0.955 and a mean inter-item correlation of 0.691. The mean item-scale correlation of 0.82 indicated high internal consistency reliability. Inter-rater reliability was measured by intraclass correlation and was 0.74 for the global score indicating good reliability. Individual items ranged between 0.52 and 0.88. No floor effects but ceiling effects were noted. Finally, teams displaying clear closed-loop communication had higher TEAM scores than teams with less clear communication. CONCLUSIONS Real time observations of authentic, high priority cases at two emergency departments show that the Swedish version of the TEAM instrument has good psychometric properties for evaluating team performance. The TEAM instrument is thus a welcome tool for assessing non-technical skills of emergency medical teams.
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Affiliation(s)
- Klas Karlgren
- Department of Research, Education, Development and Innovation, Södersjukhuset, 118 83 Stockholm, Sweden
- MINT, Department Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | - Anders Dahlström
- Department of Research, Education, Development and Innovation, Södersjukhuset, 118 83 Stockholm, Sweden
- Department of Neonatology, Sachs’ Children and Youth Hospital, Stockholm, Sweden
| | - Anderz Birkestam
- Department of Emergency, 118 83 Södersjukhuset, Stockholm, Sweden
| | | | - Gustav Forss
- Department of Emergency, 118 83 Södersjukhuset, Stockholm, Sweden
| | - Mikael Andersson Franko
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Södersjukhuset, 118 83 Stockholm, Sweden
| | - Simon Cooper
- Health Innovation and Transformation Centre (HITC), School of Health, Federation University Australia, Room 113, Building 1, Berwick Campus, Clyde Road, Berwick, VIC 3922 Australia
| | - Thomas Leijon
- Department of Emergency Medicine,
Capio S:t Göran’s Hospital
, 112 81 Stockholm, Sweden
| | - Charlotta Paulsson
- Department of Emergency Medicine,
Capio S:t Göran’s Hospital
, 112 81 Stockholm, Sweden
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Lim HM, Ng CJ, Teo CH, Lee PY, Kassim PSJ, Nasharuddin NA, Yong PVC, Sellappans R, Yap WH, Lee YK, Abu Hassan ZF, Krishnan K, Ghazali SS, Idris F, Hassan N, Ayub E, Konstantinidis S, Taylor M, Poussa C, Karlgren K, Stathakarou N, Mordt P, Nilsen AT, Wharrad H. Prioritising topics for developing e-learning resources in healthcare curricula: A comparison between students and educators using a modified Delphi survey. PLoS One 2021; 16:e0253471. [PMID: 34166432 PMCID: PMC8224897 DOI: 10.1371/journal.pone.0253471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 06/06/2021] [Indexed: 12/03/2022] Open
Abstract
Background Engaging students in the e-learning development process enhances the effective implementation of e-learning, however, students’ priority on the topics for e-learning may differ from that of the educators. This study aims to compare the differences between the students and their educators in prioritising the topics in three healthcare curricula for reusable e-learning object (RLO) development. Method A modified Delphi study was conducted among students and educators from University Malaya (UM), Universiti Putra Malaysia (UPM) and Taylor’s University (TU) on three undergraduate programmes. In Round 1, participants were asked to select the topics from the respective syllabi to be developed into RLOs. Priority ranking was determined by using frequencies and proportions. The first quartile of the prioritised topics was included in Round 2 survey, which the participants were asked to rate the level of priority of each topic using a 5-point Likert scale. The mean score of the topics was compared between students and educators. Result A total of 43 educators and 377 students participated in this study. For UM and TU Pharmacy, there was a mismatch in the prioritised topics between the students and educators. For UPM, both the educators and students have prioritised the same topics in both rounds. To harmonise the prioritisation of topics between students and educators for UM and TU Pharmacy, the topics with a higher mean score by both the students and educators were prioritised. Conclusion The mismatch in prioritised topics between students and educators uncovered factors that might influence the prioritisation process. This study highlighted the importance of conducting needs assessment at the beginning of eLearning resources development.
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Affiliation(s)
- Hooi Min Lim
- Faculty of Medicine, Department of Primary Care Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Faculty of Medicine, Department of Primary Care Medicine, University Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Chin Hai Teo
- Faculty of Medicine, Department of Primary Care Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Ping Yein Lee
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Puteri Shanaz Jahn Kassim
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurul Amelina Nasharuddin
- Faculty of Computer Science and Information Technology, Department of Multimedia, Universiti Putra Malaysia, Serdang, Malaysia
| | - Phelim Voon Chen Yong
- Faculty of Health & Medical Sciences, School of Biosciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Renukha Sellappans
- Faculty of Health & Medical Sciences, School of Pharmacy, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Wei Hsum Yap
- Faculty of Health & Medical Sciences, School of Biosciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Yew Kong Lee
- Faculty of Medicine, Department of Primary Care Medicine, University Malaya, Kuala Lumpur, Malaysia
| | | | - Kuhan Krishnan
- Faculty of Medicine, Medical Research and Development Unit, University Malaya, Kuala Lumpur, Malaysia
| | - Sazlina Shariff Ghazali
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Faridah Idris
- Faculty of Medicine and Health Sciences, Department of Pathology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurhanim Hassan
- E-Learning Academy, INTELLECT, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Enna Ayub
- E-Learning Academy, INTELLECT, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | | | - Michael Taylor
- School of Health Sciences, University of Nottingham, Nottingham, England
| | - Cherry Poussa
- School of Health Sciences, University of Nottingham, Nottingham, England
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Sweden
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Sweden
| | - Petter Mordt
- NettOp, Department of E-Learning Development, University of Stavanger, Stavanger, Norway
| | - Arne Thomas Nilsen
- NettOp, Department of E-Learning Development, University of Stavanger, Stavanger, Norway
| | - Heather Wharrad
- School of Health Sciences, University of Nottingham, Nottingham, England
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von Thiele Schwarz U, Roczniewska M, Pukk Härenstam K, Karlgren K, Hasson H, Menczel S, Wannheden C. The work of having a chronic condition: development and psychometric evaluation of the distribution of co-care activities (DoCCA) scale. BMC Health Serv Res 2021; 21:480. [PMID: 34016102 PMCID: PMC8138998 DOI: 10.1186/s12913-021-06455-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic care involves multiple activities that can be performed by individuals and healthcare staff as well as by other actors and artifacts, such as eHealth services. Thus, chronic care management can be viewed as a system where the individual interacts with people and eHealth services performing activities to maintain or improve health and functioning, called co-care. Yet, the system perspective is not reflected in concepts such as person-centered care and shared decision making. This limits the understanding of individuals' global experience of chronic care management and subsequently the ability to optimize chronic care. The aim of this study was threefold: (1) to propose a theory-based operationalization of co-care for chronic care management, (2) to develop a scale to measure co-care as a distributed system of activities, and (3) to evaluate the scale's psychometric properties. With the theory of distributed cognition as a theoretical underpinning, co-care was operationalized along three dimensions: experience of activities, needs support, and goal orientation. METHODS Informed by the literature on patient experiences and work psychology, a scale denoted Distribution of Co-Care Activities (DoCCA) was developed with the three conceptualized dimensions, the activities dimension consisting of three sub-factors: demands, unnecessary tasks, and role clarity. It was tested with 113 primary care patients with chronic conditions in Sweden at two time points. RESULTS A confirmatory factor analysis showed support for a second-order model with the three conceptualized dimensions, with activities further divided into the three sub-factors. Cronbach's alpha values indicated a good to excellent reliability of the subscales, and correlations across time points with panel data indicated satisfactory test-retest reliability. Convergent, concurrent and predictive validity of the scale were, overall, satisfactory. CONCLUSIONS The psychometric evaluation supports a model consisting of activities (demands, unnecessary tasks, and role clarity), needs support and goal orientation that can be reliably measured with the DoCCA scale. The scale provides a way to assess chronic care management as a system, considering the perspective of the individuals with the chronic condition and how they perceive the work that must be done, across situations, either by themselves or through healthcare, eHealth, or other means.
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Affiliation(s)
- Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, 721 23, Västerås, Sweden.
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Marta Roczniewska
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
- Psychology Department, SWPS University of Social Sciences and Humanities, 81-745, Sopot, Poland
| | - Karin Pukk Härenstam
- Clinical Management, Medical Management Centre, LIME, Karolinska Institutet, 171 77, Stockholm, Sweden
- Paediatric Emergency Department, Astrid Lindgren's Children's Hospital, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Klas Karlgren
- MINT, LIME, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of health and functioning, Faculty of Health and Social Sciences, The Western Norway University of Applied Sciences, 5063, Bergen, Norway
- Department of Research, Education, Development and Innovation, Södersjukhuset, 118 83, Stockholm, Sweden
| | - Henna Hasson
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Stockholm Region, 171 29, Stockholm, Sweden
| | - Sivan Menczel
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Carolina Wannheden
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
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Jafari J, Karlgren K, Moonaghi HK, Layegh P, Bonacina S, Masiello I. Designing internet-enabled patient education for self-management of T2D diabetes-The case of the Razavi-Khorasan province in Iran. PLoS One 2021; 16:e0250781. [PMID: 33905458 PMCID: PMC8078778 DOI: 10.1371/journal.pone.0250781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The number of people with diabetes is estimated to increase to 642 million by 2040, with most having type 2 diabetes. Patients with diabetes require continuous monitoring and possible treatment changes. Patient education is the process of enabling individuals to make informed decisions about their personal health-related behaviours and internet-enabled interventions have the potential to provide support and information to patients with diabetes. OBJECTIVE The aim of the study was to design a portal prototype based onto two models of care and a contextualised education programme to support the self-management of diabetes patients by involving stakeholders in the Iranian province of Razavi-Khorasan. METHODS A Design-Based Research framework was adopted. A qualitative research method was used to analyse interviews with patients and care givers. Mock-ups were developed first and designed with features of user-driven and self-care models of care. The mock-ups also had adaptation features, such as for control of the disease, ability to cure self, and family support. The portal prototype was developed iteratively by building on the mock-ups and evaluated through interviews. The features and elements of the mock-ups and the portal prototype were evaluated in an outpatient diabetes clinic in Mashhad. RESULTS Thirty-three participants were involved in the study. The evaluation of the mock-ups resulted in two themes and seven categories: 1) self-care improvement, including self-care requirements and self-management, and 2) educational usefulness, including medical information, information mode, mobility, interaction, and efficiency. The mock-up evaluation was used as a basis for designing a portal prototype. Next, the portal prototype was evaluated, and three categories emerged from the interview data: 1) user experience, 2) functionality, and 3) interactivity. Participants were not able to prioritise between the two care models. Some functionalities of the portal could benefit from the development within a cultural context to determine differences to the best way to present material. CONCLUSIONS A portal prototype has been designed to include two care models to support self-management and functionalities that support aspects of culture-specific diabetes self-care. This study provides guidance on developing an internet-enabled educational portal, aimed at providing support for patients in their social context.
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Affiliation(s)
- Javad Jafari
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - 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
| | - Hossein Karimi Moonaghi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Layegh
- Endocrine Research Center, Imam Reza Hospital, School of Medicine Mashhad University of Medical Sciences, Mashhad, Iran
| | - Stefano Bonacina
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Italo Masiello
- Faculty of Technology, Department of Computer Science and Media Technology, Linnaeus University, Växjö, Sweden
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Tamás É, Södersved Källestedt ML, Hult H, Carlzon L, Karlgren K, Berndtzon M, Hultin M, Masiello I, Allvin R. Simulation educators in clinical work: the manager's perspective. J Health Organ Manag 2021; ahead-of-print:0. [PMID: 32073806 PMCID: PMC7410304 DOI: 10.1108/jhom-04-2018-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Information is scarce on healthcare managers' understanding of simulation educators' impact on clinical work. Therefore, the aim of this study was to explore healthcare managers' perceptions of the significance of clinically active simulation educators for the organisation. DESIGN/METHODOLOGY/APPROACH Healthcare managers were invited to be interviewed in a semi-structured manner. Inductive thematic analysis was used to identify and analyse patterns of notions describing the managers' perceptions of simulation educators' impact as co-workers on their healthcare organisations. FINDINGS The identified relevant themes for the healthcare unit were: (1) value for the manager, (2) value for the community and (3) boundaries. Simulation educators were perceived to be valuable gatekeepers of evidence-based knowledge and partners in leadership for educational issues. Their most prominent value for the community was establishing a reflective climate, facilitating open communication and thereby improving the efficacy of teamwork. Local tradition, economy, logistics and staffing of the unit during simulation training were suggested to have possible negative impacts on simulation educators' work. PRACTICAL IMPLICATIONS The findings might have implications for the implementation and support of simulation training programs. SOCIAL IMPLICATIONS Healthcare managers appreciated both the personal value of simulation educators and the effect of their work for their own unit. Local values were prioritised versus global. Simulation training was valued as an educational tool for continual professional development, although during the interviews, the managers did not indicate the importance of employment of pedagogically competent and experienced staff. ORIGINALITY/VALUE The study provided new insights about how simulation educators as team members affect clinical practice.
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Affiliation(s)
- Éva Tamás
- Institution for Medicine and Health, Linkopings Universitet, Linkoping, Sweden
| | | | - Håkan Hult
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liisa Carlzon
- Simulation Centre West, Department of Research, Education and Development, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Klas Karlgren
- The Södersjukhuset Hospital and Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Berndtzon
- Metodikum - Skill Centre of Medical Simulation, Region County Jönköping, Jönköping, Sweden
| | - Magnus Hultin
- Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care (Sunderbyn), Umeå University, Umeå, Sweden
| | - Italo Masiello
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Renée Allvin
- Clinical Skills Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Sormunen T, Westerbotn M, Aanesen A, Fossum B, Karlgren K. Social media in the infertile community-using a text analysis tool to identify the topics of discussion on the multitude of infertility blogs. Womens Health (Lond) 2021; 17:17455065211063280. [PMID: 34856827 PMCID: PMC8646758 DOI: 10.1177/17455065211063280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/14/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Infertility affects one in six couples. New digital resources exist which enable the study of lived experience of persons with infertility. Blogging represents a forum for sharing narratives and experiences. To provide high quality care for persons with a history of infertility, it is crucial to ascertain what they value as significant in their situation. Blogs with a focus on infertility may provide this information. OBJECTIVES The aim of this study was to gain insight into which infertility-related issues are discussed on Swedish infertility blogs. METHODS In total, 70 infertility blogs were identified on the Internet and 25 met the inclusion criteria. A quantitative-qualitative content analysis was performed with the support of the Gavagai Explorer text analysis software. RESULTS A total of 4508 postings were retrieved from the blogs, all of which were written by women. The outcome of the analysis resulted into the following topics: Emotions (16.8%), Relations (12.5%), Time and waiting (7.1%), Body (6.6%), Care and treatment (4.2%), Food and diet (1.4%) and Exercise (0.5%). For most topics, there was a balance between positive and negative statements, but the body topic stood out by having more negative than positive sentiment. CONCLUSION By considering the topics expressed in blogs, health care personnel are provided with an opportunity to better understand the situation of individuals affected by infertility.
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Affiliation(s)
- Taina Sormunen
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - Margareta Westerbotn
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Arthur Aanesen
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
- Sophiahemmet Hospital, Stockholm, Sweden
| | - Bjöörn Fossum
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Department of Nursing Science, Sophiahemmet University, 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
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Abstract
BACKGROUND Today, there are fewer opportunities for health care students and staff for skills training through direct patient contact. The World Health Organization therefore recommends learning about patient safety through hands-on experience and simulation. Simulation has the potential to improve skills through training in a controlled environment, and simulation has a positive effect on knowledge and skills, and even patient-related outcomes. Reviews addressing the use of simulation across the different radiography specialties are lacking. Further knowledge on simulation in radiography education is needed to inform curriculum design and future research. The purpose of this scoping review is to explore, map, and summarize the extent, range, and nature of published research on simulation in radiography education. METHODS We will follow the methodological framework for scoping reviews originally described by Arksey and O'Malley. We will search the MEDLINE, Embase, Epistemonikos, The Cochrane Library, ERIC, Scopus, and sources of grey literature. A comprehensive search strategy for Ovid MEDLINE was developed in collaboration with a research librarian. An example of a full electronic search from the Ovid MEDLINE (1641 articles records, January 9, 2020) is provided and will be used to adapt the search strategy to each database. Two independent review authors will screen all abstracts and titles, and full-text publications during a second stage. Next, they will extract data from each included study using a data extraction form informed by the aim of the study. A narrative account of all studies included will be presented. We will present a simple numerical analysis related to the extent, nature, and distribution of studies, and we will use content analysis to map the different simulation interventions and learning design elements reported. Any type of simulation intervention within all types of radiography specializations will be included. Our search strategy is not limited by language or date of publication. DISCUSSION An overview of publications on simulation in radiography education across all radiography specialties will help to inform future research and will be useful for stakeholders within radiography education using simulation, both in the academic and clinical settings. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (OSF). Submitted on October 18, 2020.
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Affiliation(s)
- Mona Vestbøstad
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | - Klas Karlgren
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, 5063 Bergen, Norway
- The Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
- The Department of Research, Education, Development and Innovation, Södersjukhuset, 118 83 Stockholm, Sweden
| | - Nina Rydland Olsen
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway University of Applied Sciences, 5063 Bergen, Norway
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Karlgren K, Larsson F, Dahlström A. Eye-opening facilitator behaviours: an Interaction Analysis of facilitator behaviours that advance debriefings. BMJ Simul Technol Enhanc Learn 2020; 6:220-228. [PMID: 32832101 PMCID: PMC7410112 DOI: 10.1136/bmjstel-2018-000374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/02/2019] [Indexed: 11/04/2022]
Abstract
Introduction Analyses of simulation performance taking place during postsimulation debriefings have been described as iterating through phases of unawareness of problems, identifying problems, explaining the problems and suggesting alternative strategies or solutions to manage the problems. However, little is known about the mechanisms that contribute to shifting from one such phase to the subsequent one. The aim was to study which kinds of facilitator interactions contribute to advancing the participants' analyses during video-assisted postsimulation debriefing. Methods Successful facilitator behaviours were analysed by performing an Interaction-Analytic case study, a method for video analysis with roots in ethnography. Video data were collected from simulation courses involving medical and midwifery students facilitated by highly experienced facilitators (6-18 years, two paediatricians and one midwife) and analysed using the Transana software. A total of 110 successful facilitator interventions were observed in four video-assisted debriefings and 94 of these were included in the analysis. As a starting point, the participants' discussions were first analysed using the phases of a previously described framework, uPEA (unawareness (u), problem identification (P), explanation (E) and alternative strategies/solutions (A)). Facilitator interventions immediately preceding each shift from one phase to the next were thereafter scrutinised in detail. Results Fifteen recurring facilitator behaviours preceding successful shifts to higher uPEA levels were identified. While there was some overlap, most of the identified facilitator interventions were observed during specific phases of the debriefings. The most salient facilitator interventions preceding shifts to subsequent uPEA levels were respectively: use of video recordings to draw attention to problems (P), questions about opinions and rationales to encourage explanations (E) and dramatising hypothetical scenarios to encourage alternative strategies (A). Conclusions This study contributes to the understanding of how certain facilitator behaviours can contribute to the participants' analyses of simulation performance during specific phases of video-assisted debriefing.
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Affiliation(s)
- Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Department of Research, Education, Development, and Innovation, The Södersjukhuset Hospital, Stockholm, Sweden
| | - Fredrik Larsson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Department of Neonatology, Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Anders Dahlström
- Department of Research, Education, Development, and Innovation, The Södersjukhuset Hospital, Stockholm, Sweden.,Department of Neonatology, Sachs' Children and Youth Hospital, Stockholm, Sweden
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21
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Stathakarou N, Nifakos S, Karlgren K, Konstantinidis ST, Bamidis PD, Pattichis CS, Davoody N. Students' Perceptions on Chatbots' Potential and Design Characteristics in Healthcare Education. Stud Health Technol Inform 2020; 272:209-212. [PMID: 32604638 DOI: 10.3233/shti200531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chatbots may have the potential to support healthcare education by enabling personalized learning. Trust is a pre-requisite for the users to accept the chatbots. In this study we analyzed students' assignments of the MSc course "User Needs, Requirements Engineering and Evaluation" at Karolinska Institutet, aiming to explore the chatbots' potential in healthcare education and the design characteristics of chatbots that may enhance the trust. The students identified two courses: pharmacology and medical law, that have the potential to leverage chatbots' characteristics. Our analyses on the design characteristics they suggested resulted in: recognition; visibility of system status; anthropomorphism in communication; knowledge expertise, linguistic consistency; realistic interaction. Our results are in line with previous research. Future studies could investigate the educational impact on the learning outcomes and students' satisfaction when interacting with chatbots.
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Affiliation(s)
| | - Sokratis Nifakos
- Karolinska Institutet, Dept. of Learning, Management and Ethics, Sweden
| | - Klas Karlgren
- Karolinska Institutet, Dept. of Learning, Management and Ethics, Sweden
| | | | | | | | - Nadia Davoody
- Karolinska Institutet, Dept. of Learning, Management and Ethics, Sweden
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Sormunen T, Karlgren K, Aanesen A, Fossum B, Westerbotn M. The role of social media for persons affected by infertility. BMC Womens Health 2020; 20:112. [PMID: 32448311 PMCID: PMC7245829 DOI: 10.1186/s12905-020-00964-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/28/2020] [Indexed: 11/23/2022]
Abstract
Background Infertility remains a common universal disorder and a whole range of assisted reproductive technologies has been established. Society may fail to recognize the grief caused by infertility, which may lead to those struggling with it hiding their feelings. Previous research points out that infertile persons experience shortcomings in fertility care regarding continuity of care and social support. Social media may provide social and psychological support for infertile persons. Finding others who are going through similar experiences can help in the realization that the person is not alone and that her/his feelings are reasonable. The aim was to explore the roles of social media for persons affected by infertility. Methods A cross-sectional, computer-assisted, self-administered online questionnaire, containing both open and closed questions, was used to collect data. The questionnaire was linked to the bulletin board of six closed infertility social forums. Both quantitative and qualitative analysis methods were used. A total of 132 participants completed the questionnaire containing questions about their use of social media dealing with infertility. Results Most of the questionnaires were answered by females (97.7%) through Facebook (87%). Over 60% of the respondents had taken part in discussions about infertility in social media, between one and three years and 39% participated more than once a day. Half of the participants devoted one to three hours weekly to the forums and wrote 1–5 postings per week. The forums offered participants information, solidarity, and the opportunity to receive and give support. However, an adverse aspect that was described concerned advice that were not evidence-based. Infertility was experienced as being alienated from social life and being fragmented as a person. Conclusion Participating in infertility forums offers persons information about fertility treatments and social support in the process of coping with infertility.
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Affiliation(s)
- Taina Sormunen
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. .,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
| | - Klas Karlgren
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Department of health and functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Arthur Aanesen
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.,Sophiahemmet Hospital, Stockholm, Sweden
| | - Bjöörn Fossum
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Margareta Westerbotn
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
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23
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Woodham LA, Round J, Stenfors T, Bujacz A, Karlgren K, Jivram T, Riklefs V, Poulton E, Poulton T. Virtual patients designed for training against medical error: Exploring the impact of decision-making on learner motivation. PLoS One 2019; 14:e0215597. [PMID: 31013295 PMCID: PMC6478293 DOI: 10.1371/journal.pone.0215597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/04/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives Medical error is a significant cause of patient harms in clinical practice, but education and training are recognised as having a key role in minimising their incidence. The use of virtual patient (VP) activities targeting training in medical error allows learners to practice patient management in a safe environment. The inclusion of branched decision-making elements in the activities has the potential to drive additional generative cognitive processing and improved learning outcomes, but the increased cognitive load on learning risks negatively affecting learner motivation. The aim of this study is to better understand the impact that the inclusion of decision-making and inducing errors within the VP activities has on learner motivation. Methods Using a repeated study design, over a period of six weeks we provided undergraduate medical students at six institutions in three countries with a series of six VPs written around errors in paediatric practice. Participants were divided into two groups and received either linearly structured VPs or ones that incorporated branched decision-making elements. Having completed all the VPs, each participant was asked to complete a survey designed to assess their motivation and learning strategies. Results Our analysis showed that in general, there was no significant difference in learner motivation between those receiving the linear VPs and those who received branched decision-making VPs. The same results were generally reflected across all six institutions. Conclusions The findings demonstrated that the inclusion of decision-making elements did not make a significant difference to undergraduate medical students’ motivation, perceived self-efficacy or adopted learning strategies. The length of the intervention was sufficient for learners to overcome any increased cognitive load associated with branched decision-making elements being included in VPs. Further work is required to establish any immediate impact within periods shorter than the length of our study or upon achieved learning outcomes.
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Affiliation(s)
- Luke A. Woodham
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Institute of Medical and Biomedical Education, St George’s, University of London, London, United Kingdom
- * E-mail:
| | - Jonathan Round
- Institute of Medical and Biomedical Education, St George’s, University of London, London, United Kingdom
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Aleksandra Bujacz
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Trupti Jivram
- Institute of Medical and Biomedical Education, St George’s, University of London, London, United Kingdom
| | | | - Ella Poulton
- Institute of Medical and Biomedical Education, St George’s, University of London, London, United Kingdom
- Karaganda Medical University, Karaganda, Kazakhstan
| | - Terry Poulton
- Institute of Medical and Biomedical Education, St George’s, University of London, London, United Kingdom
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Lyngå P, Masiello I, Karlgren K, Joelsson-Alm E. Experiences of using an OSCE protocol in clinical examinations of nursing students - A comparison of student and faculty assessments. Nurse Educ Pract 2019; 35:130-134. [PMID: 30802783 DOI: 10.1016/j.nepr.2019.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 10/26/2018] [Accepted: 02/12/2019] [Indexed: 11/18/2022]
Abstract
Peer-assessment in nursing education using an OSCE protocol is an increasing educational activity that complements that of teachers. However, little is known about how students' and teachers' assessments correspond. The study aimed to compare OSCE assessments made by student examiners and faculty examiners during examinations of clinical skills in undergraduate nursing education. Four cohorts of third-year nursing students participated between 2014 and 2016. The students underwent a clinical examination of the management of central venous catheters and totally implantable venous access devices. Students who performed the examinations were observed both by a faculty examiner and student examiner. Both observers used the same OSCE protocol for the assessment but independently. The OSCE protocols from both faculty and student examiners were reviewed and compared. Total agreement between the student and faculty examiner was reached in 127 of 135 (94%) paired protocols. The level of agreement was substantial with a kappa value of 0.79 (95% CI 0.65-0.93). The conclusion was that the level of agreement between student and faculty examiners was high when using an OSCE protocol in clinical examinations of two different clinical skill tasks. The structured checklist (OSCE protocol) was easy to use for the student examiners despite the lack of experience or training in advance.
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Affiliation(s)
- Patrik Lyngå
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
| | - Italo Masiello
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Research, Education, Development and Innovation, Södersjukhuset, Sweden
| | - Klas Karlgren
- Department of Research, Education, Development and Innovation, Södersjukhuset, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Eva Joelsson-Alm
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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Tamás É, Södersved Källestedt ML, Hult H, Karlgren K, Allvin R. Closing the Gap: Experienced Simulation Educators' Role and Impact on Everyday Health care. J Contin Educ Health Prof 2019; 39:36-41. [PMID: 30768445 PMCID: PMC6400642 DOI: 10.1097/ceh.0000000000000240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Trained simulation educators (SEs) usually work both at simulation centers and in everyday health care, and thus, they possess dual expertise. Experienced SEs are known to grow confident with their expanding experience, but evidence is scarce about how this affects their development as clinical professionals. The aim of this study was to explore how experienced SEs describe their role within the context of everyday health care. METHODS An explorative descriptive study including 14 semistructured interviews and 27 questionnaires was conducted with 41 experienced SEs. An inductive thematic analysis was used to identify and analyze patterns describing SEs' perceptions of the influence of their educational work on everyday health care. RESULTS The SEs' descriptions of their encounters during everyday clinical work, which were affected by the fact that they had experience of facilitating simulation training, were gathered into three main themes with three of their own subthemes: education (educational needs, routines/guidelines, and being a resource), nontechnical skills (communication, feedback, and leadership/coworkership), and clinical proficiency (situational insight, role model, and confidence in clinical practice). The insights gained and actions taken as clinical professionals are all intended to be implemented with the ultimate aim of safe patient care. DISCUSSION All the aspects of the SEs' work are perceived to be successfully translated into clinical practice and can be summarized by the main themes of education, nontechnical skills, and clinical proficiency as delineated by this study. These themes are demonstrated at the individual, team, and organizational levels through increased competence and confidence.
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Affiliation(s)
- Éva Tamás
- Dr. Tamás: Department of Cardiovascular Diseases, Institute of Medicine and Health, Medical Faculty, University of Linköping, Linköping, Sweden. Dr. Södersved Källestedt: Clinical Skills Center, Center for Clinical Research, Uppsala University, Västerås, Sweden. Dr. Hult: Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. Dr. Karlgren: Department of Learning, Informatics, Management, and Ethics and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. Dr. Allvin: Clinical Skills Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Lööf G, Andersson-Papadogiannakis N, Karlgren K, Silén C. Web-Based Learning for Children in Pediatric Care: Qualitative Study Assessing Educational Challenges. JMIR Perioper Med 2018; 1:e10203. [PMID: 33401366 PMCID: PMC7709848 DOI: 10.2196/10203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/02/2018] [Accepted: 07/19/2018] [Indexed: 11/22/2022] Open
Abstract
Background Hospitalization is a significant and stressful experience for children, which may have both short-term and long-term negative consequences. Anaesthesia-Web is a Web-based preparation program that has been well received and is being used worldwide to reduce stressful experiences, increase understanding, and exchange information in pediatric care. A deeper theoretical and educational understanding encompassing children’s learning processes on Anaesthesia-Web may optimize and support the development and design of similar websites for children in pediatric care. Objective The objective of this study was to elucidate key educational principles in the development and design of websites for children in pediatric care. Methods A directed qualitative content analysis was applied to analyze the content and design of Anaesthesia-Web from a theoretical and educational perspective. preunderstanding, motivation, learning processes, and learning outcome were used to analyze the learning possibilities of Anaesthesia-Web for children prior to contact with pediatric care. Results We found 4 themes characterizing children’s learning opportunities on Anaesthesia-Web in the analysis: “In charge of my learning”; “Discover and play”; “Recognize and identify“; and “Getting feedback”. The analysis showed that Anaesthesia-Web offers children control and enables the use of the website based on interest and ability. This is important in terms of motivation and each child’s individual preunderstanding. Through discovery and play, children can receive, process, and apply the information on Anaesthesia-Web cognitively, emotionally, and by active participation. Play stimulates motivation and is very important in a child’s learning process. When facing pediatric care, children need to develop trust and feel safe so that they can focus on learning. On Anaesthesia-Web, children can recognize situations and feelings and can find someone with whom to identify. Several features on the website promote feedback, which is necessary to judge learning achievements, confirm understanding, and embody the need for repetition. Conclusions Web-based preparation programs are important learning resources in pediatric care. Content and design needs to change from simply providing information to embracing the importance of a child’s need to process information to learn and fully understand. By developing Web-based preparation programs that include educational principles, Web-based technology can be used to its fullest advantage as a learning resource for children. The 4 educational themes described in this study should help future similar website developments within pediatric care.
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Affiliation(s)
- Gunilla Lööf
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Department of Paediatric Anaesthesia and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | | | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Georg C, Karlgren K, Ulfvarson J, Jirwe M, Welin E. A Rubric to Assess Students' Clinical Reasoning When Encountering Virtual Patients. J Nurs Educ 2018; 57:408-415. [DOI: 10.3928/01484834-20180618-05] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 03/06/2018] [Indexed: 11/20/2022]
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28
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Sormunen T, Aanesen A, Fossum B, Karlgren K, Westerbotn M. Infertility-related communication and coping strategies among women affected by primary or secondary infertility. J Clin Nurs 2017; 27:e335-e344. [PMID: 28677273 DOI: 10.1111/jocn.13953] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2017] [Indexed: 12/21/2022]
Abstract
AIM AND OBJECTIVES To explore infertility-related communication and coping strategies among women affected by primary or secondary fertility problems. BACKGROUND Infertility is a worldwide problem and is experienced as psychologically stressful. Communication about infertility varies depending on clinical aspects, personal relationships and culture. METHODS A quantitative cross-sectional study design was used. One hundred and ninety-nine women affected by primary and secondary infertility were recruited from one fertility clinic in Stockholm. A structured self-administered questionnaire was used to collect data. The answers were compared across the two groups using the chi-squared test for independence. RESULTS The majority of the women discussed infertility-related subjects with intimate friends and/or relatives and did not discuss the results of examinations and tests with people outside of the family. There were significant differences between the two groups. Twice as many women with secondary infertility acknowledged that they never talk about the causes or results of the tests and examinations with other people, compared with women with primary infertility. Approximately 25% of the women with primary infertility used distraction techniques, such as turning to work, as a coping strategy compared to women with secondary infertility (10%). Some women did not discuss the inability to conceive and reasons why they were childless with their spouses. Twelve percentage of the women reported that they left the room when the subjects of children were being discussed. Approximately 30% of the participants did not ask friends or relatives for advice and a few were not able to discuss how tests and treatments affected them emotionally. CONCLUSION This study indicates that a majority of infertile women discuss about infertility-related subjects with their spouses. However, they are less likely to discuss the reason for infertility and results of tests and examinations with people outside the family. RELEVANCE TO THE CLINICAL PRACTICE The result of the current study can be useful regarding interventions for women affected by primary or by secondary infertility. The healthcare staff must be alert and attentive to pay attention to these possible challenges. Identification of women at risk of developing emotional problems due to communication difficulties regarding infertility-related issues merits close attention.
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Affiliation(s)
- Taina Sormunen
- Sophiahemmet University, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | | | - Bjöörn Fossum
- Sophiahemmet University, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, 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
| | - Margareta Westerbotn
- Sophiahemmet University, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
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Kristiansen AM, Svanholm JR, Schjødt I, Mølgaard Jensen K, Silén C, Karlgren K. Patients with heart failure as co-designers of an educational website: implications for medical education. Int J Med Educ 2017; 8:47-58. [PMID: 28237976 PMCID: PMC5346182 DOI: 10.5116/ijme.5898.309e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 02/06/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To identify the learning needs of patients with heart failure between outpatients follow-up visits from their perspective and to ascertain what they emphasize as being important in the design of an educational website for them. METHODS We conducted a two-step qualitative study at Aarhus University Hospital, Denmark. Twenty patients with heart failure participated either in focus group interviews, diary writing, or video-recorded design sessions. Data on learning needs were collected in step 1 and analyses, therefore, helped develop the preliminary prototypes of a website. In step 2, patients worked on the prototypes in video-recorded design sessions, employing a think-aloud method. The interviews were transcribed and a content analysis was performed on the text and video data. RESULTS Patients' learning needs were multifaceted, driven by anxiety, arising from, and often influenced by, such daily situations and contexts as the medical condition, medication, challenges in daily life, and where to get support and how to manage their self-care. They emphasized different ways of adapting the design to the patient group to enable interaction with peers and professionals and specific interface issues. CONCLUSIONS This study provided insights into the different learning needs of patients with heart failure, how managing daily situations is the starting point for these needs and how emotions play a part in patients' learning. Moreover, it showed how patient co-designers proved to be useful for understanding how to design a website that supports patients' learning: insights, which may become important in designing online learning tools for patients.
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Affiliation(s)
| | | | - Inge Schjødt
- Department of Cardiology, Aarhus University Hospital, Denmark
| | | | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
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Allvin R, Berndtzon M, Carlzon L, Edelbring S, Hult H, Hultin M, Karlgren K, Masiello I, Södersved Källestedt ML, Tamás É. Confident but not theoretically grounded - experienced simulation educators' perceptions of their own professional development. Adv Med Educ Pract 2017; 8:99-108. [PMID: 28176931 PMCID: PMC5268374 DOI: 10.2147/amep.s123517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature. OBJECTIVES To explore changes in experienced simulation educators' perceptions of their own teaching skills, practices, and understanding of teaching over time. METHODS A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis. RESULTS Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor's pedagogical development. CONCLUSION Experienced simulation educators' pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.
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Affiliation(s)
- Renée Allvin
- Clinical Skills Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro
| | - Magnus Berndtzon
- Metodikum – Skill Centre of Medical Simulation Region County Jönköping, Jönköping
| | - Liisa Carlzon
- Simulation Centre West, Department of Research, Education and Development, Sahlgrenska University Hospital, Gothenburg
| | - Samuel Edelbring
- Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm
| | - Håkan Hult
- Institute of Medicine and Health, Medical Faculty, Linköping University, Linköping
| | - Magnus Hultin
- Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care, Medical Faculty, Umeå University, Umeå
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm
- Department of Research, Education and Development and Innovation, Södersjukhuset Hospital, Stockholm
| | - Italo Masiello
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset Hospital, Stockholm
| | | | - Éva Tamás
- Department of Cardiovascular Diseases, Institute of Medicine and Health, Medical Faculty, University of Linköping, Linköping, Sweden
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Siouta E, Hellström Muhli U, Fossum B, Karlgren K. Cardiologists' experiences and perceptions of patient involvement and communication related to shared decision-making regarding atrial fibrillation treatment. Commun Med 2017; 14:39-50. [PMID: 29957900 DOI: 10.1558/cam.30587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To feel involved in decisions about atrial fibrillation (AF) treatment, patients need supportive communication from cardiologists. Shedding light on cardiologists' perceptions of patient involvement in AF care settings is thus of importance. We examine (1) how cardiologists describe patient involvement and communication related to shared decisionmaking regarding AF treatment, and (2) their perceptions of efforts to involve patients in the treatment decisions. METHODS Ten cardiologists were interviewed in four Swedish hospitals. A qualitative content analysis was performed on the interview data. RESULTS Cardiologists' perceptions of patient involvement in treatment decisions are framed in terms of (1) ideology, (2) experience, and (3) responsibility. CONCLUSION By taking into account patients' feelings in the consultations, and by actively encouraging patients to be involved, the cardiologists contributed to patient involvement. PRACTICE IMPLICATIONS One key to improving compliance with legislation aimed at increasing patient involvement in treatment decisions could lie in paying attention to physician-patient communication and the conditions for patient involvement in decision-making about treatment.
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Abstract
In 2011 an interprofessional educational programme called "Pediatric systematic assessment and communication for preventing emergencies" designed to increase clinical staff's competence in treating sick children was introduced in one paediatrics department in Norway. To elicit an in-depth understanding of the perceptions of clinical staff about the programme and enact adjustments according to identified enabling and hindering factors for learning, nurses and paediatricians were invited to participate in focus group interviews. The interviews were analysed by content analysis. Enabling factors for learning included improved interprofessional collaboration and positive feedback on performance. Hindering factors included perceptions that the programme was redundant and the fact that collaborating departments, such as the surgical departments, were not familiar with the programme. Peer learning, more interprofessional learning activities, and the fostering of a learning organization were suggestions for sustained learning. Based on the results of the study we have now included collaborating departments in the programme.
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Affiliation(s)
- Anne Lee Solevåg
- a The Department of Pediatric and Adolescent Medicine , Akershus University Hospital , Lørenskog , Norway
| | - Klas Karlgren
- b Department of Learning, Informatics , Management and Ethics (LIME), Karolinska Institutet , Stockholm , Sweden
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Siouta E, Hellström Muhli U, Hedberg B, Broström A, Fossum B, Karlgren K. Patients' experiences of communication and involvement in decision-making about atrial fibrillation treatment in consultations with nurses and physicians. Scand J Caring Sci 2015; 30:535-46. [DOI: 10.1111/scs.12276] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/03/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Eleni Siouta
- Department of Learning, Informatics, Management and Ethics (LIME); Karolinska Institutet; Stockholm Sweden
- Sophiahemmet University; Stockholm Sweden
| | | | - Berith Hedberg
- Jönköping Academy for Quality Improvement and Leadership in Health and Welfare; School of Health Sciences; Jönköping Sweden
- Ryhov County Hospital; The Region of Jönköping County; Jönköping Sweden
| | - Anders Broström
- Department of Nursing Science; School of Health Sciences; Jönköping University; Jönköping Sweden
- Department of Clinical Neurophysiology; Linköping University Hospital; Linköping Sweden
- Institute of Nursing, Faculty of Health and Social Science; Bergen University College; Bergen Norway
| | - Bjöörn Fossum
- Sophiahemmet University; Stockholm Sweden
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics (LIME); Karolinska Institutet; Stockholm Sweden
- Department of Research, Education and Development; Education Center; Södersjukhuset; Stockholm Sweden
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Lachmann H, Fossum B, Johansson UB, Karlgren K, Ponzer S. Promoting reflection by using contextual activity sampling: a study on students’ interprofessional learning. J Interprof Care 2014; 28:400-6. [DOI: 10.3109/13561820.2014.907777] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kristiansen AM, Svanholm JR, Karlgren K. Debriefing after in-hospital cardiopulmonary resuscitation—Does it work? A literature review. Resuscitation 2013. [DOI: 10.1016/j.resuscitation.2013.08.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lachmann H, Ponzer S, Johansson UB, Benson L, Karlgren K. Capturing students' learning experiences and academic emotions at an interprofessional training ward. J Interprof Care 2012; 27:137-45. [DOI: 10.3109/13561820.2012.724124] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lachmann H, Ponzer S, Johansson UB, Karlgren K. Introducing and adapting a novel method for investigating learning experiences in clinical learning environments. Inform Health Soc Care 2012; 37:125-40. [DOI: 10.3109/17538157.2012.678449] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wijk L, Edelbring S, Svensson AK, Karlgren K, Kristiansson M, Fors U. A pilot for a computer-based simulation system for risk estimation and treatment of mentally disordered offenders. Inform Health Soc Care 2009; 34:106-15. [PMID: 19462270 DOI: 10.1080/17538150903014395] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Risk/need analysis and treatment of mentally disordered offenders (MDOs) take place in constrained clinical settings, but violence has to be considered in a context where both social and cultural factors are of significance. One way to improve treatment and risk/need analysis of MDOs could be to develop simulation systems where users interact with video-based scenarios. The objective of this study was to develop and pilot test a simulation system to be used as a tool to study MDOs and possibly also to play a part in their rehabilitation. Collaboration between simulation and forensic psychiatry experts and a professional film team was set up. A simulation system called 'Reactions on Display' (RoD) was developed and a pilot study with eight patients and 13 staff members was carried out. Results from the study showed that RoD's interface and design were well received by patients and staff. Participants indicated that they found the video sequences realistic and the system enjoyable to use. The pilot study of RoD was positive, but further research should study possible clinical outcomes of the system. However, we believe that RoD could provide an advance in treatment and risk/need analysis of MDOs.
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Affiliation(s)
- Linda Wijk
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
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Lonka K, Sharafi P, Karlgren K, Masiello I, Nieminen J, Birgegård G, Josephson A. MED NORD--A tool for measuring medical students' well-being and study orientations. Med Teach 2008; 30:72-9. [PMID: 18278655 DOI: 10.1080/01421590701769555] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND The relationship between medical students' well-being, motivation, and their conceptions of learning and knowledge has not been previously explored. AIMS This study aimed to validate a research instrument intending to measure medical students' (n = 280) (1) experiences of stress, anxiety and disinterest, (2) motivational (thinking) strategies, (3) conceptions of learning and knowledge (epistemologies), and (4) approaches to learning. METHODS We developed an instrument, MED NORD, which is a composition of scales measuring different theoretical constructs that previously have shown good predictive value, validity and reliability. A principal component analysis with Varimax-rotation was performed in order to see how the scales related to each other. RESULTS The internal consistency reliability was found to be satisfactory or good for each scale. The results showed five factors: Dysfunctional Orientation, Collaborative Knowledge Building Orientation, Cookbook Orientation, Social Orientation, and Individual Abilities Orientation. These study orientations were related to how medical students perceived their learning environment. CONCLUSIONS The new tool showed consistency and validity and was judged appropriate for future use in measuring medical students' well-being and study orientations.
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