Aim: To describe the variations in undergraduate nursing students' perceptions of learning during clinical practice when using the conceptual learning model, Model for Improvements in Learning Outcomes (MILO), grounded in a caritative caring perspective.

Background: A conceptual learning model grounded in hermeneutics and a caritative caring perspective addressing ethical values of caring and learning, intertwining didactics, nursing, pathophysiology and medicine to facilitate nursing students' learning during clinical practice and ease challenges in relation to healthcare and supervision was implemented.

Methods: A qualitative descriptive design with a phenomenographic approach was used. Twenty strategically sought undergraduatenursing students in semester six from one university participated (19 women and 1 man aged between 23 and 40 years). Data were collected through semi-structured individual interviews after the model had been applied in a 7-week clinical practice course in different departments (surgical, medical and psychiatric/medical rehabilitation care) at 3 hospitals and in 13 municipalities (home care in southern Sweden) and then analysed to identify variations (similarities and differences) in ways of understanding the phenomenon of students' learning using MILO.

Results: Five mutually exclusive descriptive categories of what MILO's concepts and applications had meant for the students' learning emerged; the outcome space was illustrated by the following metaphors: a way to bridge the learning threshold; a way to learn to incorporate the spirit of meaning in caring; a way to learn to put one's soul into something; a way to notice the atmosphere's impact on learning; and a twosome's contradiction in the learning.

Conclusions: Achieving a synthesis of ethical, aesthetical, theoretical and practical knowledge in becoming professional caring nurses was found to be facilitated using MILO. However, the use of peer learning was perceived as contradictory.

Background

The Model for Improvements in learning Outcomes (MILO), theoretically based on ethical values was applied. The aim was to describe undergraduate nursing students’ attitudes to learning during clinical practice in three different semesters when using MILO.

Methods

A descriptive comparative study design with cross-sectional data collected via a questionnaire. SPSS for Windows was used; demographic data were analysed, using the chi-squared test, variables measuring the students’ attitudes were computed, and using the Kruskall-Wallis test, the total scores and the scores for separate areas in the questionnaire were compared between the groups. For reliability, Cronbach’s alpha was calculated.

Results

In comparison, intrapersonal concepts were in all semesters rated to be of greater value for learning than contextual concepts. Understanding the needs of others were rated to be of major importance. Peer learning and MILO’s applications were valued the highest in the earlier semesters. In all semesters, support from co-clinical teachers scored very low. Some of the concepts and their applications were to great extent not applied in agreement with the fundamental idea of MILO.       

Conclusions

Fundamentals in caritative caring and the student’s own characteristics and abilities were valued higher than organizational concepts. A bearing of a caritative caring culture and a shared understanding between all involved in student learning is needed.  

Ethical issues and approvals

The study was conducted in accordance with the Declaration of Helsinki, reviewed by the Boards of Ethics committee, Linköping, Sweden, approved by the Dean at the university, health care directors, and head of social services.

Aim: The overall aim was to develop and evaluate a conceptual learning model grounded in a caritative caring perspective aimed to facilitate undergraduate nursing students’ learning during clinical practice.

Methods: This thesis comprises four studies with a descriptive explorative design overall. In the inductively applied research, different designs using both qualitative and quantitative methods, were used. Studies I–III used qualitative methods; data for study I were collected using the Delphi method and analysed using qualitative data analysis. In study II, data were collected using focus group interviews and analysed using latent content analysis. In study III, data were collected using individual interviews and analysed using a phenomenographic approach. Study IV used quantitative methods and data were collected using a questionnaire and analysed using statistical methods.

Results: Study I resulted in a conceptual learning model grounded in hermeneutics and a caritative caring perspective. The Model for Improvement in Learning Outcomes (MILO) encompasses eight concepts: four intrapersonal, i.e. the students’ own characteristics, reflecting understanding, and four contextual concepts, i.e. environmental concepts, reflecting structure. Study II showed that students’ learning is facilitated as a result of natural actions and elements that occur in daily life, integrating natural caring with professional caring. Studies III and IV showed that students’ learning was a gain in knowledge and understanding of supportive elements for learning and the perspective of the patients, and a gain in engagement and dedication. Study IV also showed that the intrapersonal concepts were valued more than the contextual concepts in the three different semesters studied. The use of the applications was valued more at the start of the students’ education. Some of the concepts and their applications had not been used in accordance with MILO’s implementation in the region involved.

Conclusions: The fundamentals needed to become a professional caring nurse include having compassion and competence. Undergraduate nursing students’ learning during clinical practice needs to be facilitated by a theoretical foundation establishing an ethical bearing, by knowledge and understanding of one self and of the patient as a whole, and by challenged learning using a diversity of tools to achieve the intended outcome of better health and well-being for the patient.

Aim:To describe undergraduate nursing students' attitudes to learning during clinical practice in different semesters when using the conceptual learning model, Model for Improvements in Learning Outcomes (MILO) grounded in a caritative caring perspective.

Background: With the intention to support interlinking between theory and praxis and offer understanding and structure to facilitate learning, MILO, theoretically grounded in hermeneutics and a caritative caring perspective based on ethical values, was implemented. MILO consists of four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision) and four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety).

Methods: A descriptive comparative quantitative study design was applied at a Swedish university, 3 hospitals and 13 municipalities in one county. Cross-sectional data collected via a questionnaire developed to assess attitudes to learning related to MILO's contextual and intrapersonal concepts and their applications were used.

Results: 209 students in semester 3, 4 and 6 participated in 6 different clinical practice courses. In comparison, intrapersonal concepts, that is, the student's own characteristics and abilities were viewed to be of greater value for learning than contextual, that is, organisational-related concepts in all semesters. Understanding the needs of others and reflective learning were rated to be of major importance. Students in semester 3 valued the use of the applications the highest. To be supervised in pairs was rated the lowest in semester 6. Some of the concepts and their applications were to great extent not applied.

Conclusions: In all semesters, fundamentals in caritative caring and characteristics and abilities related to the individual student were rated to be of greater importance for learning than environmental support. Providing students opportunities to develop independency seems essential. Use of a learning model such as MILO is dependent on a bearing of a caritative caring culture and a shared understanding between all involved in student learning during clinical practice.

Background: Undergraduate nursing students’ learning during clinical practice is surrounded with complexity, taking its point of departure in demands and challenges connected to supervision and health care. Worldwide, reports show that lack of knowledge, skills and caring behaviour causes patients’ suffering. The Model for Improvements in Learning Outcomes (MILO) is theoretically grounded in hermeneutics along with Eriksson’s theory of caritative caring, designed to intertwine didactics, pathophysiology and medicine with specific concepts important for learning. Caring and learning are understood as parallel phenomena. MILO was implemented in an undergraduate nursing education in southern Sweden with the intention to facilitate learning during clinical practice and contribute to development of a caring approach in the students.

Aim: To describe supervisors’ experiences of undergraduate nursing student’s learning during clinical practice when using a caritative caring conceptual learning model.

Method: A qualitative and explorative design containing four focus groups interviews. Open unstructured questions were used. Seventeen supervisors, purposefully sampled, from different departments at three hospitals participated. Data were analysed using inductive content analysis. 

Results: Learning was found to be enhanced as a result of a facilitated intertwining between theory and practice and the natural and the professional care. Being twosomes, use of specific documents enhanced learning as well as the use of openness, compliance and reflections based on the students’ pre-understanding. Students’ encounters with the patients developed an understanding and sensitivity of the patients’ needs, a natural holistic view was developed, emphasizing the patient’s perspective. 

Conclusion: An awareness of the natural elements that occur in daily life and how these can contribute to intertwine theory and practice is important for learning during clinical practice. 

Implication for caring in a changing world: The achieved knowledge can contribute to how clinical competence can be gained and how a caritative caring approach in the students can be developed.

Aim: The aim was to describe the development of a caritative caring conceptual model aimed to facilitate undergraduate nursing students’ learning during clinical practice.

Design: An explorative design was used.

Methods: The Delphi method with a panel of 12 experts together with a literature search with a systematic approach were used and data were analysed according to content analysis.

Results: The Model for Improvements in Learning Outcomes (MILO) consists of eight core concepts divided into four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety) and four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision, a good learning environment). MILO is grounded in the theory of caritative caring with a hermeneutic approach and the understanding of caring and learning as parallel processes. Tools such as reflection, structure and guiding pm are used to intertwine caring, nursing, pathophysiology and medicine.

Conclusions: MILO intertwines didactics with concepts important for nursing students’ learning with a foundation in caritative caring and may facilitate undergraduate nursing students’ learning in clinical practice.

The Model for Improvements in Learning Outcomes (MILO) is theoretically grounded and designed to intertwine didactics, pathophysiology and medicine with specific concepts important for learning. The aim was to describe supervisors’ experiences of undergraduate nursing students’ learning during clinical practice when using MILO. A qualitative and explorative design was used. Seventeen supervisors, thirteen women and four men from different departments at three hospitals in southern Sweden participated. After using the model, data were collected through four focus group interviews with open unstructured interview questions and analysed using inductive latent content analysis. Twelve subcategories, four generic subcategories and one main category emerged. The students developed a questioning approach and were more reflective, open and compliant. Twosomes enhanced learning. Specific documents generated structure and feelings of participation. The supervisors felt that taking the students’ pre-understanding into account and a caring approach in the learning environment were valuable for enhanced learning. The students established a caring relationship with the patients and the patients’ perspective became emphasized. Using MILO, intertwining between the natural and the professional became possible; enhanced learning in nursing skills together with a more caritative caring approach towards the patient was revealed. The need of compassion is discussed. 

Background:

Undergraduate nursing programs primary aim is to prepare students for their coming professional role by providing a broad education where theoretical and practical skills are included and intertwined.However, demands in clinical practice have increased which negatively affect nurses' possibilities to supervise students during clinical practice. In order to support students learning and nurses' supervision, i.e. the learning process, different models and didactical approaches have been tried out.There is a need of a learning model where core nursing concepts based on theoretical assumptions are included and where didactics are intertwined with concepts of importance for learning.

Aim:

To develop a conceptual model to facilitate undergraduate nursing students' learning process during clinical practice.

Method:

Design:

A Delphi method together with a literature search.

Sample

A panel of 12 informed individuals, i.e. experts; clinical teachers/head supervisors from University Faculties/Health Care Faculties, Sweden.

Data collection and data analysis

A first design meeting (Round 1), a two day education (Round 2), a literature search where 15 articles were chosen. (Databases: Cinahl/PubMed, keywords: pedagogy/pedagogics, supervision, nursing, caring). Literature analysis according to a content analysis revealed in aspects provided to the panel for suggestions to changes (Round 3). A draft of a model where sent back and forth by E-mail to the panelist (Round 4). After clarifications, agreement upon the issue and with each other where reached.

Results:

Eight core concepts; four factors essential for the students' learning based on students´ own characteristics and four environmental factors.

Conclusion:

A learning model designed to facilitate the learning process during clinical practice.

Implications:

The use of the model could facilitate students' learning process in clinical practice. This could, in the long run lead to that patients will be cared for in a more quality and safety way with increased health and well-being in the patient.