Sverige har under de senaste decennierna utvecklats till ett mångkulturellt samhälle. Som sjuksköterska möter vi dagligen situationer där människor, på grund av olika kulturer, har olika syn på hälsa, ohälsa, sjukdom och behandling. Syftet är att beskriva sjuksköterskors upplevelser av att möta och vårda patienter med olika kulturella bakgrunder för att belysa vikten av kulturell kompetens. Studien är en litteraturstudie med en kvalitativ ansats. Totalt valdes sju artiklar som kvalitetsgranskades och användes i resultatet. Resultatet presenteras i fem huvudkategorier och nio underkategorier. Ett genomgående tema i resultatet var att identifiera vilka hinder sjuksköterskor upplevde försvårade vårdrelationen med patienterna som i sin tur påverkade kvalitén på den vård som gavs. I mötet med människor från andra kulturella bakgrunder uppmärksammas behovet av kulturell kompetens. Genom att förstå hur andra människor tänker kan sjuksköterskor tillmötesgå patienten och utforma vården utifrån den enskilda patientens önskningar.

The focus of the research programme within this thesis is an investigation of scenario-based simulation training in undergraduate healthcare education. The aim of the main study was to determine the effectiveness of high-fidelity simulation training with adult branch nursing students. Their acquisition of knowledge and skills was tested using a 15-station Objective Structured Clinical Examination (OSCE) pre- and post- the simulation intervention with randomised control and experimental groups of volunteer students. The results show that simulation training is an effective learning method as students from the experimental group, who were given the opportunity to observe and take part in high-fidelity simulation training followed by debriefing, made significantly higher improvements between their two OSCE performances than students from the control group. The second study focused on interprofessional learning with a randomised control group investigation of the students’ knowledge of the roles and skills of other healthcare professions involved in the same simulation session. The results demonstrate that observing and taking part in multidisciplinary scenarios and their debriefings contributed to the students’ acquisition of knowledge about the roles and skills of other health professionals. The study also showed that students’ perception of multidisciplinary team working was significantly influenced by whether or not they had experienced interprofessional high-fidelity scenario-based simulation training. The main original themes emerging from the research work presented in this thesis comprise the implementation of high-fidelity scenario-based simulation training and debriefing with undergraduate students from a range of healthcare disciplines and the objective measure of the effectiveness of such learning opportunities. This work has now started to impact on simulation practice in undergraduate education within the University and beyond

The problem with which this investigation is concerned is the development of a theoretical framework for a program of graduate education for the preparation of teachers and administrators in nursing education. The theoretical framework for the program was developed after extensive research of the literature concerning graduate education generally and nursing specifically. Additional data were obtained from four different questionnaires sent to the presidents, chairmen, and faculty of all Texas colleges with programs for an Associate Degree in Nursing as well as to 100 students and 100 graduates representing all Texas programs for the Associate Degree in Nursing. The purpose of the study was to review the history of nursing, its development as a profession, and its system of education, including past, present, and future trends in each category of education. This survey gave a perspective to the graduate program proposed in this study. hen all fifty-seven accredited graduate nursing programs in the United States were analyzed to determine the current nature of graduate education in nursing and innovations initiated by specific graduate programs, as substantiated by the literature. The data from the questionnaires sent to all the Texas programs for the Associate Degree in Nursing paralleled the developments and facts revealed in the literature. From all of this information, a theoretical framework for a graduate program in nursing was developed. A description of the program follows. A master's degree received from an accredited university is considered the acceptable minimum preparation for positions of faculty and administrators of basic educational programs in nursing. The following graduate curriculum was developed in order to strengthen this preparation. The student in the master's degree curriculum is provided with the opportunity to capitalize on past knowledge, skill, and education acquired in any setting and to build on this foundation. A research, teaching/administration, and advanced clinical nursing interdisciplinary core of nine credits is required in the program. Then, with the help of the faculty in considering the student's learning needs and career goals, a minimum of twenty-seven additional modular units are incorporated into the program. The student is then assisted by the faculty in determining program behavioral objectives and specific modular unit behavioral objectives. Evaluation of the student's work and progress and successful completion of the program will be based on the developed objectives. These are recorded on the student's transcript in lieu of grades. The minimum criterion of acceptable behavior is a satisfactory completion of the broad expected behaviors established for the graduate program. Implementation, accountability, and demonstration of these objectives are determined by each student as guided by the faculty. When the objectives have been met, the student is eligible for a Master of Arts or Master of Science Degree in Nursing Education. It is recommended that an experimental program be established to test the proposed graduate program and the postulates underlying it. In addition, it is recommended that the findings be analyzed in order to determine the adaptability and applicability of this program to other professional graduate educational programs.

Background: Over one half of all pregnancies in the United States are unintended. Nurses are on the frontlines of the health care work force and often encounter women with unintended pregnancies in the clinical setting. They may find themselves responsible for options counseling and helping these women to explore their options of pregnancy, adoption and abortion. Discussing these three options in a non-judgmental, well-informed manner allows the woman to consider all possibilities. Leading this type of conversation requires specific skills and knowledge as well as the ability to deliver this information in a therapeutic, nonbiased manner. Purpose: The intent of this study was to analyze data regarding the inclusion of options counseling and abortion education in undergraduate nursing programs in New England. Identification of gaps can provide opportunities for curriculum reform. Due to the enormous impact that nurses have with patients, institutions have a responsibility to provide their students with accurate, honest, factual, current knowledge about options counseling including abortion. Doing so is a public health issue with the incentive of not only providing women with optimal health care and better maternal-fetal outcomes, but also to reduce spending nationwide. This study can support efforts to accomplish these goals. Methods: A cross-sectional survey was sent out via email to the faculty members of accredited undergraduate nursing programs throughout New England. It was active for approximately three months between June 2015 and September 2015 with intermittent reminders sent during that time frame. The survey inquired about personal attitudes, inclusion/exclusion of options counseling and abortion education as well as methods used to include this material in the curricula. Results: All states in New England were included in this study. Fifty percent of responding institutions reported that they include options counseling and abortion education in the curricula, while the remaining 50% reportedly do not. When asked to identify reasons that this content is not included in the current curricula, 80% of respondents indicated that it is not a curriculum priority due to time constraints. The main identified methods that support inclusion of options counseling and abortion in the curricula include classroom sessions focused on technical/evidence-based instruction, classroom sessions focused on ethical issues and assigned readings. Conclusions: Options counseling and abortion education is not adequately covered in undergraduate nursing curricula across New England. This data set is remarkably similar to a study done in 1997, showing that in the course of nearly 20 years, there has been little advance in the inclusion of options counseling and abortion education. In many instances, this material is given equal or more attention in ethical discussions rather than focusing on technical evidence-based instruction. Personal attitudes about abortion have been correlated with the inclusions of options counseling and abortion education and likely affect the content that is incorporated in the curricula.

This study described the mentoring relationship between doctoral nursing students and their committee chairs. Twenty-two public university doctoral programs responded to a request for names and addresses of their doctoral candidates. The Major Professor Mentoring Scale was used to measure the mentoring relationship. The survey also included demographic and open-ended questions regarding the student-committee chair relationship. Surveys were mailed to 269 doctoral students with an 86% return rate. A principal components analysis was performed to identify the structure underpinning the relationship. The typical doctoral student in this sample was found to be a 44 year old Caucasian female, married with children, working full or part time while pursuing a PhD degree. Students traveled an average of 85 miles each way to campus and nearly half had selected their program based on its location. The typical committee chair was a Caucasian, tenured, associate or full professor between 46 and 69 years of age. The majority of chairs were married and had funded research projects. The students in the study reported knowing their chairs for an average of five years. The study revealed that mentoring is occurring in the majority of relationships between doctoral nursing students and their committee chairs. Students identified many strengths and weaknesses in their relationships with their chairs although the relationship appears to be largely positive. The mentoring relationship is composed of four principal components, the largest of which is psychosocial support. Dissertation support, role modeling and scholarly collaboration comprise the other three components. The factor receiving the most positive rating was role modeling, suggesting that students see their chairs as intelligent and hard-working. Students also report positive feelings about both the psychosocial and dissertation support they have received from their chairs. Students reported more neutral feelings about scholarly collaboration suggesting that this is not a frequent occurrence in the relationship. Demographic variables including age, sex, race, geographic distance and family status were not predictors for mentoring scores.

This thesis is a story of how I came to construct and illuminate a reflexive narrative as a journey of self-inquiry and transformation towards personal realisation. It shares a view of reflection as lived in being and becoming a reflective nurse educator in higher education. My narrative draws upon, autoethnography, critical social theory and hermeneutic perspectives. Johns (2010) six dialogical movements have been used to give structure to my narrative. Nineteen reflections generate the reflexive narrative in a hermeneutic spiral, as each text informs the other along the journey. Insights become clearer through guidance, dialogue, and engagement with the literature. Early reflections show anxiety, emotional distress and entanglement as I tried to solve student problems. Maternalism influenced my approach to being with distressed and struggling students. Gradually these feelings give way to being available, becoming student kind as an enabling relationship with students. Becoming student kind is framed through my adaptation of the Being Available Template (Johns 2013). It is realised through; listening, presence, caring, empathy, compassion and emotional intelligence. Poise, a self-management practice ensures that personal concerns and tensions do not hinder my relationships with students. Mindfulness expressed as spirituality sustains this process. This path to becoming student kind creates a learning space for student growth and development. In so doing, students are enabled to enter into a nurse patient relationship through being available. I express my empowerment through a dialogical voice, transforming my practice with individual students, in the classroom and beyond. Understanding the tensions within the complexity of university culture influencing nurse education, informs collaboration with colleagues towards a shared vision of nurse education. I turn to reflect on a journey of constructing a reflexive narrative. Five stepping stones for dialogue in advancing guided reflection as a foundation for nurse education are offered. My inquiry weaves a story of reflection as testimony to a fusion of practice and theory. I reveal practice wisdom, informing my day to day work in being available becoming student kind in relationships with students. I explore the contribution to knowledge, my practice and future research, considering the strengths and challenges therein.

Nowadays, there has been an increasing interest in using 360degrees video in medical education. Recent efforts are starting to explore how nurse students experience and interact with 360degrees videos. However, once these interactions have been registered in a database, there is a lack of ways to analyze these data, which generates a necessity of creating a reliable method that can manage all this collected data, and visualize the valuable insights of the data. Hence, the main goal of this thesis is to address this challenge by designing an approach to analyze and visualize this kind of data. This will allow teachers in health care education, and medical specialists to understand the collected data in a meaningful way. To get the most suitable solution, several meetings with nursing teachers took place to draw the first draft structure of an application which acts as the needed approach. Then, the application was used to analyze collected data in a study made in December. Finally, the application was evaluated through a questionnaire that involved a group of medical specialists related to education. The initial outcome from those testing and evaluations indicate that the application successfully achieves the main goals of the project, and it has allowed discussing some ideas that will help in the future to improve the 360degrees video experience and evaluation in the nursing education field providing an additional tool to analyze, compare and assess students.

As lacunas existentes na gestão de recursos humanos por competências são uma realidade em diferentes instituições de saúde. Ao considerar que a gestão de recursos humanos faz o diferencial das empresas, inclusive porque o percentual de colaboradores de enfermagem pode representar até 60% do quadro de pessoal, o investimento realizado nesta área poderá refletir significativamente nos resultados da Instituição. Ainda, cabe ressaltar que o contexto produtivo se altera rapidamente, a velocidade das mudanças tecnológicas gera desequilíbrios constantes entre qualificação e competência das pessoas. Diante de tais considerandos e por acreditar que para a organização acompanhar as mudanças do mundo do trabalho, os profissionais devem ser cada vez mais qualificados, atualizados, portanto, faz-se necessário investimentos em recursos humanos que possam mantê-los competentes, contribuindo para a saúde e competitividade da organização. Assim, a pesquisa objetivou construir e implantar um programa de desenvolvimento de competências profissionais dos enfermeiros em serviço e identificar as entregas realizadas pelos grupos de enfermeiros. Para tanto, o estudo foi realizado no referencial da pesquisa-ação, numa Instituição hospitalar pública de ensino e pesquisa, de grande porte e de referência na área Cardiovascular. A partir da fase de diagnóstico situacional da organização, campo de estudo, foram constituídos cinco grupos : Sistematização da Assistência de Enfermagem, Auditoria de Enfermagem, Indicadores de Enfermagem, Avaliação e Terapêutica de Feridas e Educação em Enfermagem. A coleta de dados foi realizada com base nos relatórios gerados pelos grupos de estudo, e os resultados foram apontados fundamentando-se na síntese de relatórios, relacionados à proposta de trabalho, descrição de atividades e percepção do pesquisador. Os resultados obtidos foram o desenvolvimento das competências dos diferentes saberes com suas respectivas entregas: saber agir, mobilizar recursos caracterizados pelo trabalho coletivo realizado; comunicar-se percebido no acesso a informática, na elaboração de padrões normativos e operacionais; o saber aprender, evidenciado perante as dificuldades para a construção do projeto, a busca de aprendizado e do autodesenvolvimento pelo grupo; comprometer-se, assumir responsabilidades percebidas pela adesão ao programa de desenvolvimento de competências; e ter visão estratégica, constatada na elaboração dos diagnósticos situacionais, nas entregas realizadas, e intervenção e modificações necessárias para a melhoria contínua. As entregas relacionaram-se ao desenvolvimento de competências, agregação de valores sociais e econômicos à empresa, impactos de cunho de ensino e pesquisa e de alcance de objetivos pré-determinados nos grupos. Mediante este estudo, pode-se concluir que é possível realizar a construção e desenvolvimento de competências profissionais em serviço, se houver uma competência organizacional diretiva, subsidiando as ações, possibilitando intervenções com autonomia para tomada de decisões e transformações na natureza do trabalho / There are gaps in competence-based human resource management at several health institutions. Considering that human resource management makes a difference in a company and that nursing associates can represent up to 60% of the headcount, investment on this area can significantly and positively affect the results of institutions. It is also worth mentioning that production is undergoing changes very quickly and the velocity of technological changes produce constant unbalances between the qualifications and competences of individuals. Because of these facts and because organizations must follow the changes in the working environment, professionals should be increasingly skilled and aware of the newest knowledge. It is important to invest on human resources for maintaining professionals competent, contributing for the health and competitiveness of the organization. Therefore, the goal of this study was to design a program for developing competences to working nurses via education at the workplace, which allowed for training and ongoing education regarding the competences required for their performance and to identify what was delivered by the nursing teams. This was a research and action-based study at a large, cardiovascular public hospital for teaching and research. Based on the diagnostics of the organization and area of study, five groups were established - Systematization of Nursing Care, Nursing Auditing, Nursing Indicators, Evaluation and Treatment of Wounds and Nursing Education. Data was collected on reports produced by the study groups, related to the goal of the group, activity description and researcher perception. The results obtained led to the development of competences of different types of knowledge and their respective deliveries: know how to act, use resources marked by the collective work performed; perceived communication in IT access, development of normative and operational standards; know how to learn, based on the difficulties for developing the project, the group decided to pursuit their own learning, self-development; commit themselves, take responsibilities - perceived by adhering to the competence development program; and to have strategic view, confirmed when developing the diagnosis of the situation, what was delivered, and the required intervention and changes for continuous improvement. The deliveries were related to the development of competences, adding socioeconomic values to the company, impact on teaching and development and achievement of goals predetermined by the groups. Based on the study, it is possible to build and develop professional competences at the workplace, if there is an organizational competence guideline to support the actions and to allow for interventions marked by empowerment for making work-related decisions and changes

O desenvolvimento desta pesquisa focaliza as questões relacionadas à formação de competências nos alunos de um Curso de Graduação em Enfermagem de uma instituição privada situada na cidade de São Paulo, quando desenvolvem atividades em uma Clínica de Ensino Simulado. O estudo tem como objetivos: Resgatar segundo a percepção dos docentes, quais as competências que entendem como importantes na formação do estudante de enfermagem quando desenvolvem ensino simulado na clínica; Identificar as estratégias ou mecanismos que adotam para ajudá-los a desenvolvê-las; Intervir, com base nos resultados obtidos, para a transformação desse processo de ensino reconhecendo a relação entre um Projeto Político-Pedagógico (PPP) e o perfil do egresso proposto nas Diretrizes Curriculares Nacionais.Trata-se de uma pesquisa de abordagem qualitativa do tipo estudo de caso, composta metodologicamente em duas etapas: análise das entrevistas segundo o referencial de Minayo realizadas com oito docentes, e grupo focal interpretado com recursos da hermenêutica-dialética. A análise e a interpretação dos dados foram subsidiadas por duas grandes vertentes. A primeira vertente abarca a categoria analítica: “Processo de formação profissional do enfermeiro". A segunda vertente de análise é composta pelas seguintes categorias empíricas, advindas dos discursos dos sujeitos entrevistados: A análise interpretativa norteou-se pelos eixos dos determinantes estruturais: o Projeto Político Pedagógico e as Diretrizes Curriculares Nacionais; como Determinante Particular foi considerada a Unidade de Ensino Simulado (Clínica de Enfermagem); e como Determinantes Singulares as Estratégias de ensino (Instrumentos de Trabalho) e Competências (Produto de trabalho), advindas da interpretação do Grupo Focal produzido aos olhos do sujeito coletivo, ou seja, dos colaboradores, após a reflexão em grupo. Os resultados permitiram identificar as competências que os docentes consideram importantes na formação do enfermeiro, (competências: técnico - científica, ética, política, gerencial, relacional / afetiva, desenvolvimento do pensamento critico), permitiu, também, apreender que a competência técnica está bem sedimentada e que todos os colaboradores sabem quais estratégias devem ser utilizadas para desenvolvê-las. Entretanto, as demais competências elencadas são idealizadas estão no devir. Consideram ainda que quanto ao desenvolvimento de competências, os docentes, têm que estar se capacitando para atender às exigências das Diretrizes Curriculares Nacionais e do Projeto Político Pedagógico da Instituição. Consideram também que essa capacitação passa pela ousadia para que possam avançar primeiro na construção de suas competências docentes, para depois terem condições de propiciar aos alunos desenvolvê-las / The development of this research focus on issues related to building competencies in Students attending Nursing School in a private institution located in São Paulo, where they develop activities in a Clinic of Simulated Teaching. The study aims at addressing, according to the faculty view, the competencies they consider important in a nursing student formation when developing simulated teaching in the clinic; at identifying the strategies or mechanisms adopted to help students to develop these competencies and finally at interfering, based on results, with the transformation of this teaching process taking into consideration the relationship between a Political-Pedagogic Project (PPP) and the student`s profile proposed by the Brazilian Syllabus Guidelines. This research applies the case-study qualitative approach, methodologically composed of two phases: analysis of interviews carried out with eight faculty members, according to Minayo referential, and interpretation of answers given by the focal group with hermeneutics dialect resources. Data analysis and interpretation were supported by two great sources. The first encompasses the analytical category: \"The nurse professional formation process\". The second is composed of the following empirical categories based on the speech of the interviewed subjects: interpretative analysis was oriented by the axis of the structural determinants, namely the Political-Pedagogic Project and the Brazilian Syllabus Guidelines; the Simulated Teaching Unit (Nursing Clinic) was considered as the Particular Determinant and the teaching Strategies (Work Tool) and Competencies (Work Product) - resulting from the interpretations of the Focal Group, produced according to the collective subject, that is, the collaborators after a group reflexion - as the Unique Determinants. The results made possible to identify the competencies faculty members considers important for the nurse formation, (competency: technical-scientific, ethical, political, managerial, relational/emotional, development of critical thinking) and also showed that the technical competency is very well acquired and that all subjects know what strategy to us to develop them. However, the other listed competencies are idealized and constantly changing. Regarding the development of competencies, faculty members should continually develop their own competencies to meet the requirements of the Brazilian Syllabus Guidelines and the Institution`s Political-Pedagogic Project and also, these competencies must be acquired first by faculty members so that they can help students to develop them

O presente estudo intitulado \"A formação do enfermeiro licenciado: foco no Sistema Único de Saúde?\" parte do entendimento que é necessário investir na formação dos futuros profissionais e futuros formadores de profissionais de saúde visando o fortalecimento do SUS. O objetivo deste estudo é analisar o processo de formação dos alunos do curso de Bacharelado e Licenciatura da EERP/USP em relação ao SUS, considerando conteúdos abordados, formas de organização de conteúdos e práticas, a partir da proposta curricular e da perspectiva dos discentes em relação a sua formação. Trata-se de um estudo exploratório descritivo de natureza qualitativa. Para alcançar tais objetivos foram utilizadas as seguintes técnicas: dois grupos focais com nove alunos em cada, do último ano do curso de Bacharelado e Licenciatura em Enfermagem do ano de 2013 e análise documental do Projeto Político Pedagógico (PPP) do curso de Bacharelado e Licenciatura da EERP/USP. Os dados de grupo focal foram analisados por meio de \"análise temática\" (MINAYO, 2008). A análise documental do PPP envolveu sínteses e discussões acerca de suas aproximações e afastamentos das diretrizes político-legais da formação do enfermeiro licenciado no que se refere à aprendizagem relativa ao SUS. A partir da análise documental foi observado que o PPP está em consonância com as Diretrizes Curriculares Nacionais (DCNs) do curso de enfermagem e da formação de professores, porém há contradições entre o que é proposto e o currículo efetivamente realizado, tendo em vista a complexidade inerente à implementação de mudanças no processo formativo. Da análise dos grupos focais foram delineadas sete temáticas: o SUS na estrutura curricular: que se subdivide em organização curricular disciplinar versus integrada; cenários de aprendizagem e métodos de ensino problematizador versus tradicional; reconhecimento da aprendizagem processual; afinal o que aprendem sobre o SUS?; aprender e ensinar SUS na educação profissional em enfermagem; formação docente e suas relações com a aprendizagem relacionada ao SUS; relações de poder e sugestões: possibilidades para transformar. Neste sentido consideramos, dentre outros, que o grande desafio reside em considerar o SUS como eixo do processo formativo. Tal desafio envolve enfrentamentos e negociações que se relacionam a diferentes projetos políticos sociais que se fazem presentes no contexto da formação na universidade, nos serviços de saúde e educação. / The present study entitled \"The formation of the licensed nurse: Focus on Public Health System? (SUS in portuguese)\" emerges from the understanding that it is necessary to invest in the formation of future professionals and future mentors of future health professionals aiming to strengthen the SUS. The objective of this study is to analyze the undergraduation process of the students of a course of Bachelor`s Degree with a teaching diploma in Nursing, EERP/USP in relation to SUS, considering covered contents, forms of content and practices organization, from the curriculum proposal and the perspective of students in relation to their formation. This is a descriptive exploratory qualitative study. To achieve these objectives, we used the following techniques: two focus groups with nine students of the last year of the course of Bachelor`s Degree whit a teaching diploma in Nursing in 2013 and documentary analysis of Pedagogical Political Project (PPP). The focus group data were analyzed using \"thematic analysis\" (MINAYO, 2008). The documentary analysis of PPP has involved summaries and discussions about their approaches and departures from political-legal guidelines in the formation of nurses with a teaching diploma in relation to the relative learning on SUS. From the documentary analysis it was observed that the PPP is in line with National Curriculum guidelines of the nursing course and the training of teachers, but there are contradictions between what is proposed and the curriculum effectively done, due to the complexity inherent in the implementation of changes in the formative process. From the analysis of focus groups were outlined seven themes: SUS in curriculum design, which is divided into disciplinary curricular organization versus integrated; learning environments and methods of problem-solving learning versus traditional teaching; recognition of procedural learning; after all what they learn about SUS?; learning and teaching SUS in professional nursing education; teacher education and its relationship with learning related to SUS; power relations and suggestions: possibilities to transform. In this sense we consider, among others, that the great challenge is to consider the SUS as the axis of the educational process. This challenge involves confrontations and negotiations that are relate to different social political projects that are present in the context of the formation at the university, in health services and education.