The aim of the research reported in this thesis was to gain knowledge about the implementation of evidence‐based practice (EBP) in nursing to find a way to integrate shared decision making (SDM) with EBP in a chronic care environment in nursing, and to develop a strategy for an integrated approach of EBP and SDM in daily nursing practice in the individual aftercare for cancer survivors.
Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action research. Method: The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. Results: A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of EBP were that nurses had little knowledge of EBP and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of EBP was adapted. Nurses worked according to the EBP discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Conclusions: Action research provides an opportunity to empower nurses and to tailor EBP to the practice context. Applying and implementing EBP is difficult for front-line nurses with limited EBP competencies. Relevance to clinical practice: Adaptation of the academic model of EBP to a more pragmatic approach seems necessary to introduce EBP into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice, it seems relevant to integrate scientific evidence with clinical expertise and patient values in nurses’ clinical decision making at the individual patient level.
The advantages and drawbacks of components of flexible assessment have been studied mostly from the standpoint of students and, to a lesser extent, teachers. A gap persists in understanding the collective perspectives of teachers and students concerning flexible assessment. This study aimed to explore experiences and perspectives of students and teachers regarding flexible assessment within the specific context of nursing education. Seven focus groups comprised four sessions with teachers and three with students, each involving 5-8 participants. Results showed that students and teachers have a predominantly positive perspective towards flexible assessment. They acknowledge the opportunities that flexible assessment provides for diverse forms to present evidence. However, concerns were raised regarding the design of flexible assessments, issues of fairness in rating evidence, and the understanding among teachers and students regarding the assessment processes. Additionally, discussions focused on the perceived benefit of flexible assessments, particularly concerning the time investment required for their implementation and evaluation. In conclusion, the success of flexible assessments is contingent on the careful consideration of its design, ensuring equitable evaluation of evidence, and fostering comprehensive understanding among both teachers and students. Recognizing potential disparities in views of students and teachers offers valuable insights into the effectiveness of flexible assessment. Achieving a balance between the flexibility of assessment formats, aligned forms of evidence, and an appropriate rating methodology is crucial for effective implementation.
Vind jij het ook een uitdaging om onderwijsinnovaties om te zetten tot veranderingen in de onderwijspraktijk? Wil je niet alleen beter begrijpen wat onderwijsinnovatie zo moeilijk maakt, maar ook samen op zoek gaan naar oplossingen? Kom dan naar de innovatiewerkplaats, een project van lectoraat Organiseren van Verandering in Onderwijs en het Teaching and Learning Network. Open voor alle onderwijsprofessionals (binnen en buiten de HU).
Het kennisnetwerk “Leren en Ontwikkelen voor Toekomstgericht Onderwijs” richt zich op onderwijsvernieuwingsvraagstukken. Scholen staan voor complexe uitdagingen waaronder een toename in diversiteit aan leerlingen die maatwerk vragen, de hardnekkige kansenongelijkheidsproblematiek, de noodzaak nieuwe technologieën adequaat in te zetten, en de opdracht leerlingen nieuwe leerinhouden maar vooral nieuwe leervaardigheden aan te leren. Voor scholen leidt dit tot aanpassingen zoals afstappen van klassikaal werken, focussen op leerprocessen in plaats van leerproducten en inzetten op autonomievergroting bij leerlingen. Onafhankelijk van de sector kampen scholen met vergelijkbare (ontwikkel)vraagstukken zoals nieuwe (meer ontwerpende en coachende) rollen van leraren, het anders beoordelen en monitoren van leerlingen en nieuwe samenwerkingsvormen binnen teams. Ons kennisnetwerk omvat bestaande samenwerkingsverbanden van lerarenopleidingen en scholenclusters die ervaring hebben met gezamenlijk onderzoek doen, opleiden en professionaliseren. De lectoren kennen elkaar van gemeenschappelijke (praktijkgerichte) onderzoeksprojecten, professionaliseringsactiviteiten en onderwijsontwikkeling. In het kennisnetwerk brengen we de verschillende samenwerkingsverbanden fysiek samen doordat onderzoekers, (toekomstige) leraren en lerarenopleiders in kennislabs op een onderzoeksmatige manier werken aan praktische oplossingen voor eerdergenoemde vraagstukken. Daarbij wordt gebruik gemaakt van een methodiek voor hybride kennislabs, ontwikkeld door een van de lectoraten, samen met de OU. Binnen het netwerk is een kernteam verantwoordelijk voor enerzijds destillatie van prangende onderzoeksvragen en het doen van onderzoeksaanvragen en anderzijds de monitoring van zowel de leeropbrengsten als praktische opbrengsten (werkzame principes) van de kennislabs en de verfijning van de werkwijze binnen de kennislabs. Het uiteindelijke doel zijn kennislabs die zodanig regionaal verankerd zijn wat betreft de professionalisering van betrokkenen, kennisdeling, inspiratie en ondersteuning bij het ontwikkelen van toekomstgericht onderwijs en het aanvragen en uitvoeren van praktijkgericht onderzoek dat deze na vier jaar zonder subsidie kunnen worden voortgezet. Daarnaast vormen ze een onmisbaar onderdeel van een landelijke kennisinfrastructuur. We beogen een open netwerkorganisatie waarbij lerarenopleidingen, scholen en kennisinstellingen zich op basis van hun expertise kunnen aansluiten
How can European migration, between countries and within countries between regions, contribute to the development of vulnerable regions in Europe? This is the central question of project Premium_EU (Policy REcommendations to Maximise the beneficial Impact of Unexplored Mobilities in and beyond the European Union), which is financed by Horizon Europe.The key goal of Premium_EU is the development of a Regional Policy Dashboard for national and regional policy makers to help them in the formulation of new policies aimed at the potential of migration to enhance the development of vulnerable regions. The Dashboard combines all available knowledge of three domains in three modules: the Mobility Module, the Regional Development Effects Module, and the Policy Module.The Mobility Module includes both past trends and projections and scenarios, in addition to new mobility estimates based on data from social media usage, such as LinkedIn and Facebook. The module also includes qualitative information from case studies on specific types of mobility groups, such as Polish seasonal workers, or Turkish migrants to EU countries. These trends, projections and case studies will be summarized in a regional typology on the basis of the mobility profile of the region.In the Regional Development Effects Module all available data on regional development is summarized in a regional development typology, where regional development is interpreted much broader than economic development. Using causal models the role of regional mobility in regional development will be established.In the Policy Module all possible forms of regional policies will be collected and linked to the mobility- and regional development characteristics of the region.The Dashboard integrates these modules so that a policy maker, on the basis of the unique mobility and regional development profile of his or her region is able to make an evidence based choice out of a relevant set of policy options. Users of the Dashboard will also be able to add their experiences to the Dashboard, so that other users can benefit from their knowledge.
