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MILO - A Conceptual Learning Model Grounded in a Hermeneutical and a Caritative Caring Perspective: Development and Evaluation
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Sustainable development
SDG 3: Ensure healthy lives and promote well-being for all at all ages
Alternative title
MILO - en konceptuell lärandemodell grundad i ett hermeneutiskt och ett karitativt vårdande perspektiv : Utveckling och Utvärdering (Swedish)
Abstract [en]

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.

Place, publisher, year, edition, pages
Linnaeus University Press, 2024. , p. 110
Series
Linnaeus University Dissertations ; 518
Keywords [en]
conceptual model, learning, undergraduate nursing students, hermeneutics, caring, caritas, competence, understanding, natural caring, professional caring
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-128335DOI: 10.15626/LUD.518.2024ISBN: 9789180821339 (print)ISBN: 9789180821346 (electronic)OAI: oai:DiVA.org:lnu-128335DiVA, id: diva2:1845504
Public defence
2024-04-12, Linnésalen, Hus H, Växjö, 11:00 (Swedish)
Opponent
Supervisors
Available from: 2024-03-21 Created: 2024-03-19 Last updated: 2024-03-26Bibliographically approved
List of papers
1. Model for Improvements in Learning Outcomes (MILO): Development of a conceptual model grounded in caritative caring aimed to facilitate undergraduate nursing students’ learning during clinical practice (Part 1)
Open this publication in new window or tab >>Model for Improvements in Learning Outcomes (MILO): Development of a conceptual model grounded in caritative caring aimed to facilitate undergraduate nursing students’ learning during clinical practice (Part 1)
2021 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 55, no August, article id 103144Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Clinical practice, Learning, Caring, Educational models, Nursing
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-106226 (URN)10.1016/j.nepr.2021.103144 (DOI)000701903200013 ()34298404 (PubMedID)2-s2.0-85110598459 (Scopus ID)2021 (Local ID)2021 (Archive number)2021 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2021-08-23 Created: 2021-08-23 Last updated: 2024-03-19Bibliographically approved
2. Supervisors’ experiences of undergraduate nursing students’ learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2)
Open this publication in new window or tab >>Supervisors’ experiences of undergraduate nursing students’ learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2)
2021 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 52, no March, article id 103004Article in journal (Refereed) Published
Abstract [en]

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. 

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Clinical practice, Learning, Caring, Models educational
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-101756 (URN)10.1016/j.nepr.2021.103004 (DOI)000651644500017 ()33684871 (PubMedID)2-s2.0-85101980826 (Scopus ID)2021 (Local ID)2021 (Archive number)2021 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2021-03-26 Created: 2021-03-26 Last updated: 2024-03-19Bibliographically approved
3. Undergraduate nursing student's attitudes to learning during clinical practice in different semesters when using a conceptual learning model grounded in a caritative caring perspective – A cross-sectional study
Open this publication in new window or tab >>Undergraduate nursing student's attitudes to learning during clinical practice in different semesters when using a conceptual learning model grounded in a caritative caring perspective – A cross-sectional study
Show others...
2023 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
attitudes, caring culture, caritas, clinical practice, concepts, implementation, learning, learning models, questionnaire
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-125873 (URN)10.1111/scs.13229 (DOI)001111904700001 ()2-s2.0-85178389357 (Scopus ID)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2023-12-04 Created: 2023-12-04 Last updated: 2024-03-19

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Koldestam, Maria

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