Self-rated professional competence and well-being at work after obtaining a Swedish nursing license: A longitudinal mixed-methods study of internationally and domestically educated nurses.

BACKGROUND: An inclusive workplace is where everyone is supported to thrive and succeed regardless of their background. Supportive working conditions and general self-efficacy have been found to be important for nurses' perceived competence and well-being at work, however, in the context of being a nurse in a new country, research is limited. Moreover, knowledge is lacking about whether different paths to a nursing license are related to nurses' perceived competence and well-being when working. OBJECTIVE: To examine determinants and experiences of nursing competence and well-being at work (thriving and stress) among internationally and domestically educated nurses. DESIGN: A longitudinal descriptive and correlational design with a mixed-methods convergent approach was used. METHODS: A longitudinal study was conducted between January 2019 and June 2022 with two groups of internationally educated nurses who had completed a bridging program or validation to obtain a Swedish nursing license and one group of domestically newly educated nurses. Data were collected on three occasions: Time1 at the end of the nursing licensure process (n = 402), Time2 after three months (n = 188), and Time3 after 12 months (n = 195). At Time3, 14 internationally educated nurses were also interviewed. Data were analyzed separately and then interpreted together. RESULTS: Multiple regression models showed that greater access to structural empowerment (B = 0.70, 95 % CI [0.31; 1.08]), better cooperation (B = 3.76, 95 % CI [1.44; 6.08]), and less criticism (B = 3.63, 95 % CI [1.29; 5.96]) were associated with higher self-rated competence at Time3, whereas the variable path to a nursing license was non-significant (R2 = 49.2 %). For well-being, greater access to structural empowerment (B = 0.07, 95 % CI [0.02; 0.12]), better cooperation (B = 0.36, 95 % CI [0.07; 0.66]) and being domestically educated (B = 0.53, 95 % CI [0.14; 0.92]) were associated with higher thriving at work (R2 = 25.8 %). For stress, greater access to structural empowerment (B = -0.06, 95 % CI [-0.09; -0.02]), better cooperation (B = -0.30, 95 % CI [-0.51; -0.10]), and less criticism (B = -0.28, 95 % CI [-0.46; -0.05]) were associated with having symptoms less frequently while being domestically educated was associated with having stress symptoms more often (B = 0.44, 95 % CI [0.07; 0.81]) (R2 = 43.3 %). Higher general self-efficacy at Time1 was associated with higher self-rated competence at Time2 (B = 4.76, 95 % CI [1.94; 7.59]). Quantitative findings concurred with findings from interviews with internationally educated nurses. However, qualitative findings also highlighted the importance of previous education, working experience, the new context, and communication abilities. CONCLUSIONS: Both quantitative and qualitative data showed that working conditions were important for nurses' self-rated competence and well-being at work. Although communication difficulties, previous education, and working experience were not statistically significant in the multiple regression models, in the interviews these factors emerged as important for internationally educated nurses' competence and well-being.

Multidimensional factors determine skill acquisition development in Guided Self-Determination: A qualitative study.

AIM: The aim of the study was to investigate nurses' skill acquisition in Guided Self-Determination according to the Dreyfus model of skill acquisition and Patricia Benner's studies based on the same model. BACKGROUND: Globally, person-centred care is acknowledged as an essential aspect of quality in health care. To succeed with person-centred care methods and skills are necessary. Guided Self-Determination is a person-centred method developed in the field of nursing. The method represents a new way of skill acquisition requiring knowledge of how skills are acquired, unfolded and best supported in Guided Self-Determination. DESIGN: Qualitative interview study. METHOD: From January 2019 to August 2019, 16 nurses were interviewed about their experiences of learning and using Guided Self-Determination in three different gynaecological settings: cancer, endometriosis and sexual abuse. The study was registered with the Danish Data Protection Agency (file no.: VD-2018-445, I-Suite no.: 6700). RESULTS: The spectrum in Guided Self-Determination acquisition skills ranged from following schematical procedures in a rigorous way to an extended understanding of exploring and supporting the person-centred concept. Two main themes were identified: Elements in the transition of knowledge from theory to practice and Aspects associated with Guided Self-Determination skill acquisition. CONCLUSIONS: Nurses practised Guided Self-Determination at different levels. Quantity of practising Guided Self-Determination was not the only aspect determining rapid progression. The Dreyfus model lacked several explanatory components of skill acquisition, such as personal dispositions, preferences, motivation, personal values and context.

Three paths to a Swedish nursing license: Two for internationally educated nurses and one for regular nursing students - A cross-sectional study of self-rated professional competence, self-efficacy, and thriving.

BACKGROUND: Bridging programs are offered to support migrated nurses, but in some countries, nurses can also choose to validate their nursing competence. Thus far, little is known about how migrated nurses estimate their competence when they are about to enter working life in a new country and how this differs from regular nursing students. OBJECTIVE: To compare two groups of internationally educated nurses' - those from bridging programs and those who chose validation - and one group of regular nursing students' self-rated professional competence when they are about to start working as registered nurses. The hypotheses were: 1) internationally educated nurses rate their competence higher than regular nursing students and 2) those from bridging programs rate their competence higher than those who chose validation. In addition, the aim was to compare the groups' self-efficacy and thriving. DESIGN: A cross-sectional, comparative design. SETTINGS: Five universities in Sweden. PARTICIPANTS: Nurses educated in non-European countries from a bridging program (n = 128, response rate 79.0 %) or validation process (n = 61, response rate 59.2 %) and students graduating from the regular nursing program (n = 213, response rate 68.3 %). METHODS: Data were collected with coded questionnaires (paper or online) between 2019 and 2021 and analyzed using non-parametric tests, e.g., Kruskal-Wallis. RESULTS: Both groups of internationally educated nurses had higher median scores on total nursing competence (both groups p < 0.001), general self-efficacy (bridging programs p < 0.001, validation p = 0.020), and total thriving (bridging programs p < 0.001, validation p = 0.012) than regular nursing students did. However, comparing the groups of internationally educated nurses showed no significant differences. CONCLUSION: Internationally educated nurses rated their competence high but with differences within the groups for different competence areas. More research is needed to investigate whether the different paths are important for nurses' competence later in working life, and some of the competence areas might need extra attention when nurses start working.

Implementation of an Objective structured clinical examination (OSCE) as a tool to evaluate the development of clinical reasoning in physical therapy students / Implementación de un Examen clínico objetivo estructurado (ECOE) como herramienta para evaluar el desarrollo del razonamiento clínico en estudiantes de fisioterapia

Abstract Introduction: Clinical reasoning involves critical thinking and decision-making in clinical situations. It can be evaluated using Objective structured clinical examination (OSCE), which measures clinical skills associated with the development of clinical reasoning. Objective: To describe the implementation of an OSCE to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and to determine their level of satisfaction with this methodology. Materials and methods: Cross-sectional descriptive study conducted in 159 physical therapy students from Universidad Andres Bello, Chile, enrolled in the Reasoning in Physical therapy course (second semester of 2018). The OSCE had 11 stations and a student satisfaction survey was administered. Data normality was determined using the Shapiro-Wilk test. Descriptive statistics (percentages, medians, and interquartile ranges (IQR)) were used for data analysis. Results: The median global score was 142 points (IQR: 132-150) and 61.1% of the students obtained a passing score (> 134 points). Stations in which most students had a passing score were S3, S5 and S7 (standardized patient stations): 78.62%, 96.85% and 85.53%, respectively. Regarding the satisfaction survey, 36.48% and 59.12% of the students agreed and strongly agreed with using tools that assess their clinical skills. Conclusions: The OSCE was successfully designed and implemented to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and most of them reported a high level of satisfaction with its use; this confirms OSCE is an excellent methodology to train and evaluate these students.

Resumen Introducción. El razonamiento clínico implica el pensamiento crítico y la toma de decisiones en situaciones clínicas. Esto puede evaluarse mediante el Examen clínico objetivo estructurado (ECOE), que mide las habilidades clínicas asociadas con el desarrollo del razonamiento clínico. Objetivo. Describir la implementación de un ECOE para evaluar las habilidades clínicas asociadas con el desarrollo de razonamiento clínico en estudiantes de fisioterapia, así como su nivel de satisfacción con esta metodología. Materiales y métodos. Estudio transversal descriptivo realizado en 159 estudiantes de fisioterapia de la Universidad Andres Bello, Chile, inscritos en el curso Razonamiento en Fisioterapia (segundo semestre de 2018). El ECOE contó con 11 estaciones y se aplicó una encuesta de satisfacción estudiantil. La normalidad de los datos se determinó mediante la prueba de Shapiro-Wilk y el análisis de los datos se realizó mediante estadística descriptiva (porcentajes, medianas y rangos intercuartílicos (RIC)). Resultados. La mediana del puntaje global fue de 142 puntos (RIC: 132-150) y el 61.1% de los estudiantes obtuvo una puntuación aprobatoria (> 134 puntos). Las estaciones con mayor número de estudiantes con un puntaje aprobatorio fueron E3, E5 y E7 (estaciones con paciente estandarizado): 78.62%, 96.85% y 85.53%, respectivamente. Respecto a la encuesta de satisfacción, 36.48% y 59.12% de los estudiantes estuvieron de acuerdo y muy de acuerdo con el uso de herramientas que evalúen sus habilidades clínicas. Conclusiones. El ECOE fue diseñado e implementado exitosamente para evaluar las habilidades clínicas asociadas con el desarrollo del razonamiento clínico en estudiantes de fisioterapia; además, la mayoría de ellos reportó altos niveles de satisfacción con su uso, lo que confirma que es una excelente metodología para capacitar y evaluar estos estudiantes.

Evaluación docente como factor de desarrollo profesional desde una pedagogía reflexiva / Teacher evaluation as a factor for professional development from the perspective of reflexive pedagogy

Resumen Introducción. Esta investigación cualitativa y hermenéutica-interpretativa explora el proceso de evaluación docente de la Facultad de Medicina de la Universidad Nacional de Colombia con profesores de modalidad cátedra en la cohorte de ingreso 2007-2011. Objetivo. Analizar el proceso de evaluación docente y su relación con el desarrollo profesional de los profesores. Materiales y métodos. Estudio descriptivo transversal llevado a cabo en fases metodológicas: 1) fase documental, profundización temática en evaluación educativa, tendencias de evaluación docente, políticas educativas en evaluación y marco legal en evaluación docente de la Universidad Nacional de Colombia; 2) trabajo de campo, entrevista personal con apoyo de encuesta semiestructurada, y 3) proceso analítico de datos cualitativos hecho a partir de la codificación axial y por medio del programa Atlas ti. Resultados. Se construyeron categorías deductivas descriptivas: percepciones, modalidades, aspectos, ventajas y desventajas de la evaluación docente y categorías inductivas interpretativas: pedagogías reflexivas, evaluación por competencias profesionales y profesionalización de la docencia. Conclusión. Se generan consideraciones pedagógicas que promueven la comprensión de la evaluación docente como un proceso reflexivo, formativo e integral que favorece el desarrollo profesional de los profesores, los procesos educativos y las prácticas académicas de investigación-acción.

Abstract Introduction: This qualitative and hermeneutic-interpretative research explores the evaluation process applied to the teaching staff of the Faculty of Medicine at the Universidad Nacional de Colombia that were hired as lecturers during the period 2007-2011. Objective: To analyze the teacher evaluation process and its correlation with the professional development of professors. Materials and methods: Descriptive cross-sectional study carried out in methodological phases: 1) documentary phase, with emphasis on educational evaluation, teacher evaluation trends, educational evaluation policies and the legal framework for teacher evaluation at the Universidad Nacional de Colombia; 2) field work, personal interviews through semi-structured surveys, and 3) analysis of qualitative data based on axial coding and using the Atlas Ti program. Results: The following descriptive deductive categories were established: perceptions, methods, aspects, advantages and disadvantages of teacher evaluation. Interpretive inductive categories were also established: reflexive pedagogy, evaluation based on professional competencies, and professionalization of teaching. Conclusion: Pedagogical considerations are proposed to promote the understanding of teacher evaluation as a reflexive, formative and comprehensive process that favors professional development of teachers, educational processes and academic practices related to action research.

Propuesta de competencias profesionales para docentes de programas de salud en educación superior / Professional skills training proposal for professors of health programs

Resumen Introducción. Los profesores son reconocidos como parte fundamental de la ejecución del currículo y, por ende, como protagonistas de la calidad educativa. Objetivos. Construir un modelo de competencias profesionales para los docentes de programas de salud en educación superior que permita identificar las necesidades de formación de los profesores y, de esta manera, optimizar el proceso educativo de los estudiantes. Materiales y métodos. Se realizó una investigación cualitativa en la que se hizo una revisión de la bibliografía y se aplicaron unas entrevistas a profesionales médicos que se desempeñaban como docentes de un programa de posgrado en salud; se tuvo como criterio único de inclusión la aceptación del consentimiento informado. Se realizó triangulación de fuentes para garantizar la validez y confiabilidad. Resultados. A partir de la revisión de la bibliografía, se construyeron cuatro ejes de análisis para las entrevistas, se caracterizó al grupo de docentes del programa académico y se estudiaron las respuestas obtenidas. Luego, se construyó un modelo de competencias para profesores que se puede extrapolar a cualquier programa de formación en salud en educación superior con características similares a la del programa investigado. Conclusiones. Este estudio pone de manifiesto la necesidad urgente de generar espacios de formación docente en pedagogía, didáctica y evaluación, por lo que propone un modelo que contempla competencias cognitivas, metodológicas, sociales y personales.

Abstract Introduction: Professors are recognized as a fundamental part for the execution of the curriculum and, therefore, as protagonists of educational quality. Objectives: To propose a professional skills model for professors of health programs to identify their training needs and optimize the educational process of students. Materials and methods: Qualitative research in which a review of the literature was made and interviews were applied to medical professionals who worked as professors of a graduate health program. Signing an informed consent was the only inclusion criterion. Triangulation of sources was used to guarantee validity and reliability. Results: Based on the literature review, four axes of analysis were established for the interviews. The group of professors was characterized and all the responses were studied. Then, a skills model was created, which can be extrapolated to any health education program in higher education with similar characteristics to the investigated program. Conclusions: This study shows the urgent need for creating training spaces in pedagogy, didactics and evaluation. In consequence, a model that includes cognitive, methodological, social and personal skills is proposed.