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Akademisering av specialistsjuksköterskans utbildning i Sverige: Spänningsförhållanden med anledning av utbildningsreform i sådana med Bologna
Avdelningen för omvårdnad, Karlstads universitet, Karlstad, Sverige.
2012 (Swedish)Licentiate thesis, comprehensive summary (Other academic)Alternative title
The academisation of specialist nursing education in Sweden – tensions arising from the Bologna process (English)
Abstract [sv]

Licentiatavhandlingens övergripande syfte var att studera konsekvenser av ökad akademisering och akademiskt lärande inom Svensk specialist-sjuksköterskeutbildning efter genomförande av ny utbildningsreform enligt Bologna.

Bakgrund: Specialistsjuksköterskor förväntas i dagens hälso– och sjukvård att kunna bedriva en patientsäker och evidensbaserad vård, vilket kräver akademisk kompetens. Utbildningen till specialistsjuksköterska fördes i och med Bolognaprocessens införande i Sverige 2007 till avancerad utbildningsnivå. Både yrkesexamen och akademisk examen (magisterexamen) skulle inkluderas och integreras i samma utbildning. Detta medförde en förändring från en ämnesinriktad (samlingskodsinriktad) läroplan till en läroplan som syftar till att integrera ämnen (integrationskodsinriktad). Förutom ämnesintegrering skulle yrkesspecifika mål integreras med akademiska mål.

Metod: Artikel I genomfördes i form av ett didaktiskt aktionsforskningsprojekt som pågick under 2½ år. En projektledningsgrupp (n=15-18) från fem lärosäten bildades. Denna grupp har aktivt deltagit i hela aktionsforskningsprocessen och vid projektmöten. Vid varje lärosäte utsågs en projektansvarig som ansvarade för den lokala aktionsforskningsprocessen. Dessa personer samlande in data i form av kursplaner, utbildningsplaner, studiehandledningar, minnesanteckningar från lärarmöten och möten med vårdverksamheter samt minnesanteckningar från forskargruppensmöten. Analys har gjorts med hjälp av konstant komparativ analysmetod. I artikel II användes konstruktivistisk Grounded Theory för att samla in och analysera data. Datainsamlingen påbörjades utifrån specialistsjuksköterskestudenters svar på en enkäts öppna fråga (n=120) i samband med utbildningens avslutning 2009 och 2010. Enkätsvaren reste frågor om specialistsjuksköterskans akademiska lärande. För att inhämta en djupare förståelse genomfördes intervjuer med specialistsjuksköterskor (n=12) som yrkesarbetat mellan 5 och 12 månader efter sin examen. Intervjuerna genomfördes från juni till oktober 2011. Avslutningsvis jämfördes svaren på den öppna enkätfrågan med analysen av intervjuerna.

Resultat: Vid utbildningsreformens införande fanns pedagogiska motsättningar och didaktiska svårigheter som gav upphov till spänningsförhållanden mellan vårdutveckling, forskning, yrkesspecifika mål och akademiska mål. Spänningsförhållanden framkom också när specialistsjuksköterskorna inte erfor att deras akademiska kompetens tillvaratogs och värderades i vårdverksamheten. När stöd inte fanns för akademiskt lärande uppkom villrådighet och specialistsjuksköterskorna blev ambivalenta över om akademiskt lärande var meningsfullt. För att främja meningsfullt akademiskt lärande framhåller deltagarna betydelsen av samverkan och gemensamma arenor mellan lärosäten och vårdverksamhet där nyttoaspekten med akademiskt lärande tydliggörs. De spänningsförhållanden som framkommer var av både positiv och negativ karaktär.

Abstract [en]

The overarching aim of this Licentiate thesis was to study the consequences of academisation and academic learning in the context of Swedish specialist nursing education after the Bologna educational reform had been introduced.

Background: Modern healthcare services expect specialist nurses to be able to execute safe and evidence-based care, which requires academic competence. With the introduction of the Bologna process in Sweden in 2007, specialist nursing programmes were elevated to an advanced level of education. Both a professional qualification and an academic one (Master one year) would be included and integrated into the same programme, leading to a change from a subject-oriented curriculum to one which aims to integrate subjects. As well as subject integration, occupationally-specific objectives would be integrated with academic objectives.

Method: Article I was prepared on the basis of a didactic action-research project which lasted 2½ years. A project leadership team composed of 15-18 members from five universities was created, and this group actively participated in the entire action research process and at project meetings. At each university, one member was appointed project leader for the local action research process and the collation of data from course plans, study plans, study supervision notes and memos from teachers’ meetings and meetings with healthcare providers, as well as the research groups’ own memos. The analysis has been done with the help of the constant comparative analysis method. For article II, constructivist Grounded Theory was used to collect and analyse data. Data collection began with specialist nursing students’ responses (n=120) to the open-ended question of a questionnaire conducted at the end of their programme in 2009 and 2010. The responses to the questionnaire raised questions about the specialist nurses’ academic learning, which was deepened by conducting interviews with specialist nurses (n=12) who had been working for between 5 to 12 months after qualifying. The interviews were conducted in the period JuneOctober 2011. Finally, the answers to the open-ended question were compared with the analysis of the interviews.

Results: In summary, the results revealed that implementation of the Bologna process resulted in pedagogic obstacles and didactic difficulties that gave rise to tensions between specific professional objectives, academic objectives research and clinical development. Tensions also arose when the specialist nurses did not feel their academic competence was being utilized and valued in the healthcare context. When no support for academic learning was given, specialist nurses became hesitant and ambivalent as to the meaningfulness of academic learning. In order to promote meaningful academic learning, the participants highlighted the importance of collaboration and common arenas of activity for universities and healthcare providers in which the benefits of academic learning are made clear. The tensions that arose were of both positive and negative character. 

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2012. , p. 54
Series
Karlstad University studies, E-ISSN 1403-8099 ; 2012:56
Keywords [en]
Action Research, Clinical Nurse Specialist, Curriculum, Education Nursing Masters, Grounded Theory, Higher Education, The Bologna Process, Postgraduate Degree Projects.
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:hh:diva-41043Libris ID: 13753539ISBN: 978-91-7063-468-0 (electronic)OAI: oai:DiVA.org:hh-41043DiVA, id: diva2:1373534
Presentation
2013-01-22, 9C203, Universitetsgatan 2, Karlstad, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2020-02-19 Created: 2019-11-27 Last updated: 2020-02-19Bibliographically approved
List of papers
1. Tensions related to implementation of postgraduate degree projects in specialist nursing education
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2011 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 31, no 3, p. 283-288Article in journal (Refereed) Published
Abstract [en]

In conjunction with the introduction of the Bologna process in Sweden, specialist nursing education programmes were moved up to the second cycle of higher education with the opportunity to take a one-year master's degree, which also meant that students would undertake a degree project carrying 15 ECTS. The purpose of this study was to examine the introduction of postgraduate degree projects on the second-cycle level into Swedish specialist nursing programmes in accordance with the Bologna process. Five universities were involved and the study design took the form of action research. Problem formulation, planning, evaluation and follow-up with reflection led to new actions over a period of 2 1/2 years. Through a review of local curriculum documents, the implementation of a postgraduate degree project was monitored and these reviews, together with field notes, were analysed by means of constant comparative analysis. The results revealed a variety of tensions that arose when postgraduate degree projects were introduced, taking the form of differing views on the relationship between research, clinical development, specific professional objectives and academic objectives. These tensions were reflected in six areas of change. In summary, it can be noted that implementation of the postgraduate degree projects highlighted tensions related to basic views of learning. © 2010 Elsevier Ltd.

Place, publisher, year, edition, pages
Oxford: Elsevier, 2011
Keywords
Action research, The Bologna process, Education Nursing Masters, Postgraduate degree projects, Subject Didactics
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:hh:diva-41045 (URN)10.1016/j.nedt.2010.11.012 (DOI)000289323200013 ()21112676 (PubMedID)2-s2.0-79952483945 (Scopus ID)
Note

Del av licentiatavhandlingen "Akademisering av specialistsjuksköterskans utbildning i Sverige", KUS 2012:56. Funding: The Swedish Agency for Networks and Cooperation in Higher Education, the Swedish Society of Nursing, Luleå University of Technology, Umeå University, Karlstad University, University of Borås and Sahlgrenska Academy at the University of Gothenburg.

Available from: 2019-11-27 Created: 2019-11-27 Last updated: 2020-02-25Bibliographically approved
2. Academic learning for specialist nurses: A grounded theory study
Open this publication in new window or tab >>Academic learning for specialist nurses: A grounded theory study
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2014 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 6, p. 714-721Article in journal (Other academic) Published
Abstract [en]

The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful. © 2014 Elsevier Ltd.

Place, publisher, year, edition, pages
Oxford: Elsevier, 2014
Keywords
Clinical Nurse Specialist, Grounded Theory, Higher Education, The Bologna Process, Nursing Masters, Postgraduate Degree Projects
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:hh:diva-41044 (URN)10.1016/j.nepr.2014.08.008 (DOI)000349568300022 ()25240945 (PubMedID)2-s2.0-84918584836 (Scopus ID)
Note

Del av licentiatavhandlingen "Akademisering av specialistsjuksköterskans utbildning i Sverige", KUS 2012:56

Available from: 2019-11-27 Created: 2019-11-27 Last updated: 2020-02-25Bibliographically approved

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