In honours programmes, teachers face the task of designing courses in which students feel challenged and learn from accomplishing demanding assignments. The aim of this study was to investigate students’ and teachers’ perceptions of challenge and learning in an honours programme. From 2016 to 2019, students and teachers rated the learning activities during the programme and explained their ratings. The results showed that in the first two years, teachers estimated challenge and learning significantly higher than the students did. However, both students and teachers viewed the tasks as the factor with the strongest impact on challenge and learning. In the first year, students also identified group dynamics as challenging and a source for learning. Enhancing task complexity and supporting group dynamics are the main factors to adjust the level of challenge in an honours programme. Monitoring students’ and teachers’ perceptions can help to adapt the programme to improve students’ learning.
MULTIFILE
This project studies whether a redesigned baccalaureate nursing curriculum in a University of Applied Sciences in the Netherlands can stimulate positive interest for the field of community care. In many Western countries, healthcare is changing from institutional care delivery to caring for patients in their own homes. Problematic is that most nursing students orientate on a career in the hospital and they do not see community care as an attractive option, due to a limited and often mistaken view of the field. Their career choices lead to increasing shortages in the labour market, which in many Western countries is a societal problem urgently needing attention. Providing students with a curriculum with more elements of community nursing could help them build a more positive perception of the field, leading to more students choosing this area as a career.The curriculum-redesign was based on quantitative and qualitative research about first-year students’ perceptions, placement preferences and underlying assumptions on the field. First, a cross-sectional multicentre survey study (n = 1058) was conducted using the SCOPE (Scale on COmmunity care PErceptions) questionnaire. The findings confirm the hospital’s popularity, with community care being perceived as a ‘low-status-field’ with many elderly patients and few challenges. Students’ perceptions of community care appear to be at odds with things they consider important for their placement (i.e., opportunities for advancement and enjoyable relationships with patients).To better understand the factors underlying the perceptions, a focus group study with first-year students at the start of their programme (n = 16) was performed.This led to formulation of eight redesign themes, namely:(1) variety and diversity,(2) challenges,(3) improving people's health,(4) collaboration,(5) role models,(6) patient- or environment-based perceptions,(7) self-efficacy, and(8) immediate vicinity.First-year students have clear ideas about what they see as important in a placement, but their perceptions do not always appear to be realistic.To remedy these misperceptions, recommendations for curriculum redesign strategies were formulated. Curriculum designers can more prominently highlight the complexity of community nursing in the theory part of the curriculum. As many students strive for challenges, in-depth knowledge about community nursing can be presented about aspects that students lacking experience in the field are not aware of (e.g., working in an interprofessional network). In the courses, patient cases can be presented that do not fit the stereotypical views of community care commonly held. Also, as role models are influential, it is important that students collaborate with mentors in the field with an appropriate level of education, who can act as a source of inspiration, but who also create a structured and supporting learning environment. Finally, it is useful to organise meetings where political developments and labour market issues in healthcare are discussed. This can potentially increase awareness of these topics and contribute to well-informed career decisions. These strategies can potentially foster a more optimistic and realistic career outlook on the community care field.
DOCUMENT
Perceptions of community care and placement preferences in first-year nursing students: A multicentre, cross-sectional studyMargriet VAN IERSEL MSc1, Corine H.M. LATOUR PhD1, Rien DE VOS PhD2, Paul A. KIRSCHNER PhD3,5, Wilma J.M. SCHOLTE OP REIMER PhD1,4.1 ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, The Netherlands2 Centre of Evidence Based Education, Academic Medical Centre, Amsterdam, The Netherlands3 Open University of the Netherlands, Heerlen, The Netherlands4 Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands 5 University of Oulu, Oulu, FinlandBackground: Despite increasing shortages of well-educated community nurses, far too few nursing students choose community care for their future profession; a strong societal problem that urgently needs resolution. This study provides a solid understanding of causes for the fields’ low popularity by exploring first-year baccalaureate nursing students' perceptions of community care, and their placement preferences along with their underlying assumptions. Insights from this study can be used by educators to positively influence students’ perceptions with targeted curriculum redesign strategies.Summary of work: A cross-sectional multicentre survey study was performed. First-year nursing students from six universities of applied sciences in the Netherlands (n = 1058) participated in the study from September-December 2014. The students completed the ‘Scale on Community Care Perceptions’ (SCOPE), consisting of demographic data, current placement preferences, and three subscales measuring the affective component of community care perception, perceptions of a placement, and a profession in community care. Descriptive statistics were used. Summary of results: For placement, 71.2% of the students prefer the general hospital, 23.4% another area, and only 5.4% choose community care. Students consider opportunities for advancement and enjoyable relationships with patients as most important for their placement. Community care is perceived as a ‘low-status-field’ with many elderly patients, where students expect to find little care variety and few opportunities for advancement. Discussion and conclusions: This study shows why few students show an interest for a career in community care. Students’ perceptions of the field are at odds with aspects they regard as important for their placement. They also underestimate the complexity of community care, where specific traits are required to ensure appropriate nursing care in patients’ homes. Take-home messages: The results of this study allow for three recommendations. First, students and educators should be aware of misconceptions about career opportunities in the field of community care. Second, educators should provide students with experiences that foster an optimistic and realistic career outlook on community care. Third, growing shortages in the community care sector urgently require representatives from the field and educators to collaborate to make community nursing an attractive career alternative.Keywords: Career choice; Students
DOCUMENT
The purpose of this study was to provide insight into the interplay between student perceptions of competence-based assessment and student self-efficacy, and how this influences student learning outcomes. Results reveal that student perceptions of the form authenticity aspect and the quality feedback aspect of assessment do predict student self-efficacy, confirming the role of mastery experiences and social persuasions in enhancing student self-efficacy as stated by social cognitive theory. Findings do not confirm mastery experiences as being a stronger source of self-efficacy information than social persuasions. Study results confirm the predictive role of students’ self-efficacy on their competence outcomes. Mediation analysis results indicate that student’s perceptions of assessment have an indirect effect on student’s competence evaluation outcomes through student’s self-efficacy. Study findings highlight which assessment characteristics, positively influencing students’ learning, contribute to the effectiveness of competence-based education. Limitations of the study and directions for future research are indicated.
DOCUMENT
Background: The shift in healthcare to extramural leads to more patients with complex health problems receiving nursing care at home. However, the interest of baccalaureate nursing students for community nursing is moderate, which contributes to widespread labour-market shortages. This study investigates the effect of a more ‘communitycare-oriented’ curriculum on nursing students’ perceptions of community care. Methods: A quasi-experimental quantitative survey study with a historic control group (n = 477; study cohorts graduating in 2015, 2016, and 2017; response rate 90%) and an intervention group (n = 170; graduating in 2018; response rate 93%) was performed in nursing students of a University of Applied Sciences in a large city in the Netherlands. The intervention group underwent a new curriculum containing extended elements of community care. The primary outcome was assessed with the Scale on Community Care Perceptions (SCOPE). The control and intervention group were compared on demographics, placement preferences and perceptions with a chi-square or T-test. Multiple regression was used to investigate the effect of the curriculum-redesign on nursing students’ perceptions of community care.Results: The comparison between the control and intervention group on students’ perceptions of community care shows no significant differences (mean 6.18 vs 6.21 [range 1–10], respectively), nor does the curriculum-redesign have a positive effect on students’ perceptions F (1,635) = .021, p = .884, R2 = < .001. The comparison on placement preferences also shows no significant differences and confirms the hospital’s popularity (72.7% vs 76.5%, respectively) while community care is less often preferred (9.2% vs 8.2%, respectively). The demographics ‘working in community care’ and ‘belonging to a church/religious group’ appear to be significant predictors of more positive perceptions of community care. Conclusions: Graduating students who experienced a more ‘community-care-oriented’ curriculum did not more often prefer community care placement, nor did their perceptions of community care change. Apparently, four years of education and placement experiences have only little impact and students’ perceptions are relatively static. It would be worth a try to conduct a large-scale approach in combination with a carefully thought out strategy, based on and tying in with the language and culture of younger people. Keywords: Community care, Nurse education, Curriculum design, Perceptions, Career choice
DOCUMENT
Background: Extramuralisation in healthcare has influenced medical and nursing curricula internationally with the incorporation of themes related to primary/ community care. Despite this, students do not easily change their career preferences. The hospital is still favourite, leading to labour market shortages in extramural care. This study investigates how baccalaureate nursing students' perceptions of community care and placement preferences develop over time in a more 'community-care-oriented' curriculum, to gain insights on which curriculum elements potentially influence career choices.Methods: A nursing student cohort of a University of Applied Sciences in the Netherlands (n = 273) underwent a new four-year curriculum containing extended elements of community care. The primary outcome was assessed with the Scale on Community Care Perceptions (SCOPE). Data were collected each year of study. Descriptive statistics were used to investigate students' placement preferences and perceptions, and linear mixed model techniques (LMMs) for measuring how students' perceptions develop over time. Patterns of placement preferences at individual level were visualised.Results: Students' perceptions of community care, as measured with SCOPE, show a slight decrease between year 1 and 4, while items mutually differ substantially. In contrast, the preference of community care for a placement increases from 2.6% in year 1 tot 8.2% in year 4. The hospital is favourite in year 1 (79.8%), and remains most popular. At individual level, students often change placement preferences, although a preference for the hospital is more consistent. The LMMs indicates that, at the four time-points, the estimated marginal means of students' perceptions fluctuate between 6 and 7 (range 1-10). A placement in community care did not positively influence students' perceptions, and an intensive 1 week theoretical programme was only temporarily influential.Conclusions: Although interest for placement in community care increased substantially, it was not clear which curriculum elements stimulated this, nor did the curriculum positively influence students' perceptions. As most students do not look forward to the high responsibility of the field, other curricula with educational tracks for more mature students/ nurses with a vocational training may be an alternative contribution to solving the labour market problems in community care.
DOCUMENT
Despite increased healthcare extramuralisation, related to increased elderly patients living at home, most nursing students still see the hospital as career favourite. This is problematic, because of the widespread labour-market shortages in community care in many Western countries. At the Amsterdam University of Applied Sciences, the bachelor nursing programme was redesigned to stimulate students’ interest in community-care. The effect of this ‘community-oriented’ curriculum on students’ perceptions and placement preferences was then investigated. To measure both, the Scale on Community Care Perceptions (SCOPE) was used. The intervention group (170 students graduating in 2018), followed the new curriculum and was compared to a historic control group (477 students) that followed the older, more ‘hospital-oriented’ curriculum (three cohorts graduating 2015-2017). Both groups were compared on placement preferences, and multiple regression was used to investigate the effect of the curriculum-redesign on their perceptions of community care.The redesign consisted of an integrative approach based on the influence of lecturers, placement experiences, and the introduction of new educational elements in the curriculum. Goal was to broaden students’ views, showing that nursing is more than hospital care. While the curriculum was scrutinised on how patient cases were presented, more than 60 of the 110 cases were located in the hospital, compared to four in community care. Thus, this aspect of the ‘hidden curriculum’ was adjusted. Five new themes related to community nursing were integrated in the ‘generalist’ programme in years 1 and 2, namely: (1) fostering patient self-management, (2) shared decision-making, (3) collaboration with the patients’ social system, (4) healthcare technology, and (5) care allocation. A community care week was organised in year 2, in which all students visited a community nursing team. In the last two years of study, a ‘paved way’ to community care was created in the form of an interesting minor programme ‘Complex Community care’ in year 3, a well-organised 30-week placement in year 4, and a concluding case study from their own practice [Figure 1].[Figure 1]Figure 1. Curriculum-redesign to stimulate interest in community care.A comparison between the historic control and intervention group on perceptions of communitycare and placement preferences, measured with SCOPE, showed no significant positive results in both outcomes. The model in the regression analysis, predicting students' perceptions from the type of curriculum (historic/intervention), showed no statistically significant result, F(1,635) = .021, p = .884, and a low explained variance R2 = .001. A preference for a placement in community care decreased from 9.2% in the historic control group to 8.2% in the intervention group. However, the regression analysis revealed that two variables, in contrast with the curriculum, had a significant influence, to wit ‘belonging to a church/religious group’ and ‘working/has been working in community care’.Though described in the literature as the only effective way, this study showed that curriculum-redesign was not effective, despite its holistic approach. A combination of factors might explain this result. Other pathways in the curriculum may have strongly competed. Disappointing experiences during placements, leading to ‘bad-mouthing between peers, may also be a reason. Finally, highly publicised workforce problems leading to shortages of higher-educated role models may have played a role.As in this study, the effect of the curriculum as a whole is measured, more research is needed on the effect of separate more powerful curriculum interventions, for example the theme-week in year 2. A well thought-out large-scale strategy that mostly appeals to young people aiming to promote positive perceptions of community care could be a valuable supplement.
DOCUMENT
Community care is becoming increasingly important. In the Netherlands, the percentage of people over the age of 65 is expected to increase to 22% by 2025, leading to more elderly patients, often with long-term and complex health problems (multimorbidity). Because many of these patients continue to live at home until a very old age, nurses are increasingly working outside of institutions. The 17 Dutch Bachelor nursing programmes responded to this development with a new national education profile 'Bachelor Nursing 2020 (BN2020)’ with more elements of community care. However, despite the increase in extramural care, the Dutch labour market has a shortage of community nurses with higher professional education qualifications, partly because most nursing students focus on the general hospital setting as the environment for their future career. Whether this is based on a perception of community care that deters making this choice has never been systematically investigated. It is also unclear whether a more community-oriented curriculum will better equip students for working in community care. In response to these issues, the nursing programme at the Amsterdam University of Applied Sciences (AUAS) redesigned its curriculum to include more elements of community care. Three perspectives were chosen for the redesign: (1) the influence of lecturers as role models, (2) positive placement experiences, and (3) five new ‘community-based’ themes in education. These new themes are as follows: patient self-management, shared decision-making, collaboration with the patients’ social system, healthcare technology, and allocation of care. The redesign also includes a ‘paved way’ into community care in the form of a coherent and attractive programme for interested students.This thesis describes whether and how the curriculum-redesign within higher professional education in nursing can be effective in terms of (1) stimulating a positive perception of community care and (2) realising a form of community care in line with the new themes in BN2020. In other words, that students will base choices in their actions/nursing interventions on these new themes in the education profile.
DOCUMENT
ABSTRACT This study investigates how perceptions of radicalisation and co-occurring mental health issues differ between mental health care and the security domain, and how these perceptions affect intersectoral collaboration. It is generally thought that intersectoral collaboration is a useful strategy for preventing radicalisation and terrorism, especially when it concerns radicalised persons with mental health issues. It is not clear, however, what perceptions professionals have of radicalisation and collaboration with other disciplines. Data was obtained from focus groups and individual interviews with practitioners and trainers from mental health care and the security domain in the Netherlands. The results show a lack of knowledge about radicalisation in mental health care, whereas in the security domain, there is little understanding of mental health issues. This leads to a mad-bad dichotomy which has a negative effect on collaboration and risk management. Improvement of the intersectoral collaboration by cross-domain familiarization, and strengthening of trust and mutual understanding, should begin with the basic training of professionals in both domains. The Care and Safety Houses in the Netherlands offer a sound base for intersectoral collaboration. Future professionals from different domains ought to be familiarized with each other’s possibilities, limitations, tasks, and roles.
DOCUMENT
To understand under what conditions intercultural group work (IGW) leads to more intercultural interactions, a survey was conducted among local students (n = 80) and international students (n = 153) in Dutch universities. In this study, students were more inclined to engage in intercultural interactions when they perceived that working with culturally diverse others prepared them to work and live in a diverse setting. The positive association was strengthened when students perceived that diversity, in terms of nationality within their work group, was also beneficial for accomplishing their group task. The findings demonstrate the significance of students’ perceptions of IGW, including the perceived general value for personal development and intellectual benefits related to specific tasks. This implies that institutions and teachers could be made responsible for engaging with innovative educational methods to address and incorporate student diversity into curriculum.
MULTIFILE
