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Aim: To test a model of clinical learning that focuses on the role of the ward manager. Background: The ward manager's role in supporting clinical learning indirectly focuses on the ward climate connected to students' clinical placements. In this way, the ward manager influences both nursing care and the pedagogical atmosphere in the ward. Design: Cross-sectional, secondary analysis. Methods: The sample included nursing and midwifery students (N = 5,776, n = 1,900) who had completed their clinical placement. Data were collected with the Clinical Learning Environment, Supervision and Nurse Teacher scale. Structural equation modelling was adopted to test the hypotheses. Results: Estimates of the model parameters demonstrated that a ward manager's leadership style influences both the premises of nursing at the ward (0.84, p

Aim The study aimed to describe and explain the self‐assessed gerontological nursing competence levels of Finnish nursing students and factors relating to it. Design A cross‐sectional study design, reported by The Strengthening the Reporting of Observational studies in Epidemiology guidelines. Methods Data were collected with the GeroNursingCom instrument, which features 53 items relating to 11 competence factors. The K‐clustering technique and the Chi‐squared, Kruskal‐Wallis and Mann Whitney tests were used to analyse the data. Results Seven hundred and ninety‐nine nursing students from nine randomly selected higher education institutions were invited to participate in 2019. Three distinct student profiles were identified according to the data (N = 274): Profile A—lower intermediate competence (23.1% of students), Profile B—intermediate competence (45.8%) and Profile C—high competence (31.1%). The strongest competence area for all students was appreciative encounter and interaction, and the weakest was supporting the older person’s sexuality. Nursing students have diverse backgrounds and their overall competence in gerontological nursing is shaped in part by their previous education, motivations and work experience. Relevance to clinical practice Recognizing students’ different gerontological nursing competence profiles enables the implementation of targeted education to improve competence in clinical practice.

Peer mentoring in nursing is imperative to both mentors' and mentees' personal and professional development. Yet, there is a dearth of reviews appraising the relevant qualitative and quantitative studies reported in the literature.To synthesize the best evidence exploring the impacts of peer mentoring programs on nursing students.A mixed-method systematic review.Published and unpublished literature written in English between January 2011 and May 2022 were identified from nine databases, including PubMed, CINAHL, Cochrane Library, Embase, and PsycINFO.A systematic search strategy was applied in June 2021. Two reviewers independently screened and selected the eligible studies focusing on nursing students in higher education institutions who participated in peer mentoring programs. We included studies of quantitative, qualitative, or mixed methods and explored the main outcomes of peer mentoring programs. Eligible studies were appraised independently using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. Two independent reviewers extracted relevant data using a standardized form. A meta-analysis, narrative synthesis, and meta-aggregation were then conducted, followed by a convergent segregated approach to integrate the findings.Thirty-one studies were selected for analysis. We aggregated four sets of synthesized findings from fourteen categories. A meta-analysis of the data showed that the intervention group experienced significant improvement in stress levels. In addition, the integrated results revealed peer mentors, with the support of academia, served as rich resources and support for peer mentees.This review highlights the importance of providing support to peer mentors to help them achieve the desired outcomes of peer mentoring while they cater to the needs of nursing student mentees.

Aims To identify distinct orientation competence profiles amongst nurse preceptors and explain the associated factors. Design A cross-sectional study design. Methods The data were collected during the winter of 2020-2021 from registered nurses (N = 8279, n = 844) at one university hospital in Finland through an online questionnaire that included a self-administered electronic version of the Preceptors' Orientation Competence Instrument. K-means clustering was then used to identify nurse preceptor profiles. Chi-square, Fisher's exact test, Kruskal-Wallis and Mann-Whitney tests were used to analyse factors associated with competence profiles. The results were reported as frequencies, percentages, mean and standard deviation. Results A total of three distinct orientation competence profiles (A, B, C) were identified. Profile A nurses evaluated their orientation competence at the highest level, whereas profile C nurses evaluated their competence at the lowest level. Sufficient clinical and theoretical experience, a motivation to work, willingness to orient new employees and participation in orientation and/or mentoring education were found to be associated with competence profiles. Conclusion The findings expand the current knowledge base of nurse preceptors' orientation competence. Health care organizations should recognize different orientation competence profiles amongst the nursing staff since the selection of a preceptor should always be based on possessing the necessary orientation competence rather than availability. The results indicate that preceptors (who reported taking on various tasks and covering multiple roles) need support from co-workers to sufficiently concentrate on employee orientation tasks. The results also indicate that preceptors need further orientation education, which should-for example-outline the learning goals for new employees and how preceptors can assess employee performance. Impact What problem did the study address? Prior research has not applied a robust theoretical framework covering all aspects relevant to a preceptor's competence. What were the main findings? A nurse's clinical and theoretical experience, motivation to work, willingness to orient new employees, and prior participation in orientation and/or student mentoring education were found to influence their level of orientation competence. Where and on whom will the research have an impact? Healthcare organizations can use the results of this study to make the selection of preceptors competency-based rather than their availability. Nurse leaders can use the results of this study to pinpoint which areas of nurses' orientation competence and associated factors need to be improved. Increased orientation competence will enable clinical nurses to provide high-quality orientation to new employees, which is crucial to the retention of nursing staff and the quality of patient care.

The digital competence of health sciences educators is important for the delivery and development of modern education and lifelong learning. The aim of the study was to assess the appearance of digital competence in the work of Finnish health sciences educators and to determine whether educators' background factors are related to the areas of digital competence appearance. The European Framework for the Digital Competence of Educators was used as a theoretical background. The participants were Finnish health sciences educators (n = 388). Data were collected by quantitative survey and statistically analyzed. Results show that health sciences educators had participated in continuing education to develop their expertise and used a variety of digital methods and materials. Educators need more competence to improve healthcare students' ability to use digital technology. In the area of Teaching and Learning, educators younger than 40 years rated the appearance of digital competence as better than did those between the ages of 40 and 49 years. In the future, health sciences educators' basic and continuing education could take into account the competence requirements for digital competence, and educators' expertise must be increased in areas where digital competence does not appear strong.

Aims: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan. Methods: The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis. Results: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p 3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean

Future social- and health-care educators will be required to have versatile competence in educating professionals that reflects both the constantly changing health-care environment and delivery of high-quality patient care. Continuing professional development can be defined as a process that aims to increase educators' competence and well-being, along with the effectiveness of an organisation. This study aimed to describe educators' continuing professional development and clarify the contribution of continuing education. The research applied a qualitative approach as only limited information about social- and health-care educators' professional development currently exists.' Data were collected by group interviews of 35 experienced social- and health-care educators from six institutions of higher education and two vocational schools across Finland. An inductive content analysis yielded 39 subcategories, 11 categories and three main categories, namely, educators' approaches for developing professional competence, barriers to continuing education, and educators' continuing education needs. The educators reported that they maintain and develop their competence in versatile ways; for example, continuing professional development takes place through both formal continuing education and informal collaboration at daily work. Regarding barriers to continuing education, the educators most often cited the lack of planning and a lack of resources, for example, scheduling and financial factors. The continuing education needs of social- and health-care educators are highly individual and should not only reflect organisational goals. The fact that this study only included experienced educators can be considered a limitation, as a sample that also included novice educators may have yielded different perceptions of continuing education and professional development. The results of the research can be utilised when designing the continuing professional development of educators at the individual, group or organisational level.

Objective The aim of this study was to evaluate dentists', dental hygienists' and dental assistants' competence in mentoring students and to identify distinct mentor profiles. Methods The study employed a cross-sectional design. Data were collected using the Mentors' Competence Instrument (MCI), which includes 45 items structured under seven mentoring competence sub-dimensions. The data were collected during autumn 2017 from dentists, dental hygienists and dental assistants working in the Finnish primary healthcare (n = 1097) using a paper survey, whilst dentists (n = 26) who have completed mentoring education in one university completed an electronic questionnaire. Cases with more than 5% missing data (n = 164) were listwise deleted, whilst the remaining data (n = 933) underwent analysis. K-mean clustering was used to identify significantly different mentor profiles, whilst comparisons of mentoring competence between the identified profiles were performed with Kruskal-Wallis and Mann-Whitney tests. Results Three distinct mentor profiles (A, B and C) that differed in the level of mentoring competence were identified. The participants in profile A encompassed mostly dental assistants, profile B included mostly dental assistants and dentists, and profile C mainly comprised dentists and dental assistants. Profiles A, B and C differed significantly in terms of education, job title, role of mentor and participation in mentoring education. The largest difference in competence was observed between participants of profiles A and C. Each profile differed significantly from the other two across all seven competence areas. Most of the participants had not previously received any mentoring education. Conclusion There is room for improvement in the competence of dentistry student mentors, especially regarding knowledge of effective mentoring practices, goal-oriented mentoring, mentor characteristics and motivation for mentoring. Every mentor that works with oral healthcare students should receive mentoring training.

To develop and psychometrically test an instrument - GeroNursingCom - that measures gerontological nursing competence of nursing students.An instrument development guided by COSMIN guidelines.The development and testing of the GeroNursingCom instrument proceeded according to four distinct phases: (a) establishing a theoretical background; (b) testing face and content validity; (c) examining structural validity; and (d) testing internal consistency. The items of instrument were based on a theoretical framework developed from a comprehensive literature review and focus group interviews with experts (N = 27) in spring 2018. Content validity was assessed by nine experts in gerontological nursing, while face validity was tested in a pilot study including 36 nursing students. Structural validity was examined with exploratory factor analysis with 267 nursing students from nine universities of applied sciences. The internal consistency was established with Cronbach's alpha. The data were collected in spring and autumn 2019. The data analysis was conducted with multivariate statistical methods.The GeroNursingCom development and testing process yielded an instrument that includes 53 items across 11 factors: (a) appreciative encounters and interactions with older people; (b) medication for older people; (c) nutrition for older people; (d) safe living environment for older people; (e) supporting the functioning of older people; (f) end-of-life care; (g) developing one's competencies; (h) supporting an older person's mental well-being; (i) supporting an older person's sexuality; (j) guiding self-care among older people; and (k) responding to challenging situations. The instrument was able to explain 66.15% of the total observed variance, while Cronbach's alpha values for individual items varied from 0.75-0.89.TheGeroNursingCom instrument can be used to measure gerontological nursing competence among nursing students to improve gerontological nursing education and/or geriatric care.Graduating nursing students must develop versatile competencies to face the multiple needs of older patients and curriculums need to be further developed to ensure students are prepared for gerontological nursing.目的: 为对工具GeroNursingCom进行开发和心理计量试验--衡量护士生的老年护理能力。 设计: 根据基于共识的健康测量工具选择标准(COSMIN)进行工具开发 方法: GeroNursingCom工具的开发和测试过程将分为以下四个不同的阶段:(a)建立理论背景;(b)测试表面与内容效度;(c)检验结构效度;以及(d)测试内部一致性。工具项目的理论框架源于综合文献综述以及2018年春季专家(27位)进行的焦点小组访谈。内容效度由九位老年护理专家进行评估,同时以36名护士生为研究对象,对表面效度进行初步研究。通过采用探索性因素分析方法,以9所应用科技大学的267名护士生为研究对象,进行结构效度试验。采用克隆巴赫系数测试了内部一致性。数据收集于2019年春季和秋季,并采用多元分析方法进行数据分析。 结果: 在GeroNursingCom的开发和测试过程中,对其包含的11个因素进行了53个项目的测试:(a)与老人见面和互动;(b)老年人用药;(c)老年人所需营养;(d)老年人的安全生活环境;(e)对老年人机能的支持;(f)临终关怀;(g)能力发展;(h)支持老年人的心理健康;(i)支持老年人的性欲;(j)指导老年人自我照顾;以及(k)对具有挑战性的情况做出回应。该工具可说明61.5%的总观测方差,且单个项目的克隆巴赫系数值在0.75至0.89之间。 结论: GeroNursingCom工具可用于衡量护士生的老年护理能力,以改善老年护理教育和/或老年护理。 影响: 护士生在毕业前须多方面地发展自身能力,以面对老年患者的多样需求。应进一步完善课程,以确保学生能够应对老年护理。.

This study aimed to explore nursing and midwifery students' evaluation of the clinical learning environment and mentoring and to identify distinct student profiles relating to their perceptions.This study employed a cross-sectional design.The study population included nursing and midwifery students in a university hospital in Finland.All nursing and midwifery students who completed their clinical placement were invited to take part in the study in the academic year 2017-2018.The data (N = 2,609) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale. The data were analysed using a K-mean cluster algorithm to identify nursing and midwifery students' profiles.The findings from this study indicate four distinct profiles (A, B, C,D) of nursing and midwifery students in relation to the clinical learning environment and mentoring. Profile A (N = 1,352) students evaluated their clinical learning environment and mentoring to the highest level (mean varied from 9.44-8.38); and Profile D (N = 151)- to the lowest (mean varied from 5.93-4.00).The findings highlight that nursing and midwifery students evaluate their clinical learning environment and mentoring more highly when: they have a named mentor, student and mentor discuss learning goals, there is a final assessment in clinical learning, the mentor's guidance skills support student learning, the clinical learning supports the student's professional development and pre-clinical teaching in an educational institution supports learning in the clinical placement.Clinical learning plays an important role in nurse and midwifery education. Mentoring of clinical practice was shown to have a great influence on students' perceptions of their success in clinical learning. We suggest that clinical practice should be strengthened by the building of collaboration between nursing teachers and registered nurses.目的: 该研究旨在探讨护理和助产专业学生对临床学习环境和指导的评价,并确定与他们看法有关的不同学生情况。 设计: 该研究采用横断面设计。 背景: 研究对象包括芬兰一所大学医院的护理和助产专业学生。 参与者: 受邀参与研究的所有完成临床实习的2017-2018级护理和助产专业学生。 方法: 通过使用临床学习环境、监督和护士教师评估表的在线调查收集数据(N = 2,609)。使用K-均值聚类算法对数据进行分析,以确定护理和助产专业学生的情况。 结果: 该研究结果表明,护理和助产专业学生对临床学习环境和指导有四种不同的评价(A、B、C、D)。评价A(N = 1,352)表示学生对其临床学习环境和指导的评价最高(平均值范围:9.44-8.38);评价D(N = 151)表示学生对其临床学习环境和指导的评价最低(平均值范围:5.93-4.00)。 结论: 调查结果强调,护理和助产专业的学生在以下情况下对其临床学习环境和指导的评价较高:学生有指定的导师、学生和导师讨论学习目标、临床学习中有期末评估、导师的辅导技能支持学生的学习、临床学习支持学生的专业发展以及教育机构的临床前教学支持临床实习方面的学习。 影响: 临床学习在护士和助产士教育中发挥着重要作用。研究表明,临床实践的指导对学生临床学习的成就感有很大影响。我们建议,应加强护理教师与注册护士之间的合作建设,进而加强临床实践。.

Aims: To describe the mentoring competence of clinical practice nurse mentors and identify different mentor profiles. Design: Cross-sectional research design, secondary analysis. Methods: An international, cross-sectional study design was performed in five European countries. A total of 1 604 mentors from 33 healthcare organizations participated in the study between 2016–2019. The Mentors' Competence Instrument (MCI), which includes seven sub-dimensions and 44 items, was used to collect data. K-means cluster and binary regression analyses were performed to detect mentor profiles and determine how various factors affect competence, respectively. Results: The K-means cluster analysis identified three distinct profiles: A (n = 926); B (n = 566); and C (n = 85). The profiles showed significantly different values (p < .001) across all seven areas of mentoring competence. In comparison with the other profiles, nurses in profile A were older, had more work experience and were more probably to have completed mentoring-specific training. We would like to acknowledge European Commission, Erasmus+and KA2: Strategic partnership for providing funding for the project Quality mentorship for developing competent nursing students (QualMent).

Aim: To develop and psychometrically test a Preceptors' Orientation Competence Instrument measuring orien-tation competence of nurses working as new employee preceptors.Background: Competence of nurse preceptor is essential for a successful preceptorship and thus nursing staff acute accent s commitment to the organization.Design: Instrument development according to the COSMIN guidelines.Methods and participants: Four phases were implemented: 1) establishment of the theoretical framework, modi-fication of the validated Mentor Competence Instrument and generation of new items; 2) content validity testing; 3) structural validity testing; and 4) internal consistency testing. Content validity was evaluated by 14 experts using content validity index methods. Structural validity was evaluated using exploratory factor analysis with a convenience sample of 844 Finnish nurses. Internal consistency was evaluated by measuring Cronbach's alpha.Results: The content validity index of subdimensions of the instrument ranged from 0.80 to 0.94 for relevance and 0.80-0.94 for clarity. Exploratory factor analysis resulted in a seven-factor model with 53 items (61.62% of total variance): preceptor characteristics, goal-oriented orientation, guidance in reflective discussion, knowledge of work unit orientation practices, creation of a supportive learning atmosphere, preceptor motivation and giving of developmental feedback. Cronbach's alpha values varied from 0.79 to 0.93.Conclusion: Preceptors' Orientation Competence Instrument demonstrated adequate psychometric properties based on content and construct validity as well as internal consistency. Therefore, it is useful for self-evaluation of orientation competence of nurses working as new employee preceptors.

Aim: To identify current evidence on health care managers’ competence in knowledge management. Background: Although successful knowledge management improves the quality of care and performance of health care organisations, there is limited evidence on health care managers’ competence in knowledge management. Evaluation: A scoping review was conducted by including original published and unpublished studies (qualitative, quantitative, and experimental) and review designs in English, Finnish, or Swedish. The studies were retrieved from six databases (CINAHL, ProQuest, PubMed, Scopus, Mednar, and Finnish database Medic) in November 2020 and then complemented in January 2022. Narrative synthesis was used to synthesize data. Key issues: A total of 21 articles was included in the review. The main themes of managers’ competence in knowledge management presented in these were system management, professional development, and leadership behaviour and attitude. No valid and reliable instruments were described in the included studies. Conclusion: At present, there is a limited understanding of health care managers’ competence in knowledge management. A comprehensive understanding of this topic can provide a direction for future research. Implications for Nursing Management: The results can be utilized in the assessment and development of managers’ competence in knowledge management, as well as the formulation of education and in-service training for health care managers.

Background\ud Those who mentor nursing students from diverse backgrounds should be educationally prepared to provide safe, culturally appropriate mentoring in clinical learning environments.\ud \ud Objective\ud To evaluate the effects of an educational intervention on mentors' competence in mentoring culturally and linguistically diverse nursing students during clinical placement.\ud \ud Design\ud Nonrandomised, quasi-experimental study.\ud \ud Settings.\ud \ud The study was conducted at two hospitals located in Finland.\ud \ud Participants\ud Mentors responsible for mentoring nursing students during clinical placements.\ud \ud Methods\ud The intervention group (n = 49) completed blended learning mentoring education containing a cultural competence component. The control group (n = 62) completed online mentoring education lacking a cultural competence component. Data were collected from both groups at baseline, immediately after education, and at six-months follow-up using the Mentors' Competence Instrument and Mentors' Cultural Competence Instrument. Wilcoxon signed-rank test and Mann-Whitney U test were used to determine differences before and after education. Mixed model for repeated measures was used to compare the differences between the two groups.\ud \ud Results\ud Pretest-posttest results revealed statistically significant improvements in both groups on general mentoring competences. Both groups evaluated their competence in cultural sensitivity and awareness highly throughout the study period. Following education, competence in cultural interaction and safety and cultural skills increased statistically significantly in the intervention group. The intervention group was statistically significantly more satisfied with mentoring education, and reported that it had statistically significantly higher impact on their ability and willingness to mentor students. Comparison between groups revealed statistically nonsignificant differences in mentors' competence in mentoring culturally and linguistically diverse nursing students following education.\ud \ud Conclusions\ud The study provides evidence on the development and evaluation of education designed to improve mentors' competence in mentoring, which may help nursing students from diverse backgrounds overcome challenges faced during clinical placements. Reinforcement strategies following education are needed in order to facilitate the maintenance of competence over time.

Aims and objectives: This study aims to provide insight into healthcare professionals’ lived experiences of digital health competence with the objective of improving the knowledge of how digital health competence is perceived by healthcare professionals. Background: Healthcare professionals need to adjust to the digital era to provide quality and ethical care. Previous research has rarely adopted a healthcare professional’s standpoint to describe their perceptions of digital health competence, even though their perspective in how new care practices are designed and implemented is vital. Design: A qualitative descriptive study. Methods: Healthcare professionals (nurses and allied health professionals) from versatile healthcare settings were recruited for individual semi-structured interviews in Sweden (n = 5) and Finland (n = 15) (spring 2019-summer 2020). Purposive and convenience sampling was used. Participants’ backgrounds were in the public and private sectors. The interviews were transcribed for inductive content analysis. The SRQR guideline guided the study process. Results: Healthcare professionals’ perceptions of digital health competence are connected to competence to provide patient-centric care through digital channels, using technology and digital health systems, interacting with the patient through digital means, evaluating what digital health is and combining digital and traditional methods. Professionals’ perceptions of their own digital health competence were divided, with the participants either reporting sufficient competence or perceiving a lack of skills in some specific areas. Conclusions: Healthcare professionals’ perceptions of digital health competence focus on the ability to provide patient-centric care by evaluating the need and possibilities for using digital health services jointly with more traditional methods. This study provides a sound basis for digital health research, but future studies should focus on elucidating factors which affect digital health competence and competence development. Relevance to clinical practice: The results of this study can guide healthcare practices and digital health implementation, as well as function as a basis for instrument or theory development. Health care and nursing leaders should enable the resources to hybrid practices in patient-centric care provision.

The aim of this umbrella review was to establish recent evidence on integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments.Umbrella review conducted according to Joanna Briggs institute guidelines.Data were collected from CINAHL, PubMed, Medic, ProQuest and Scopus electronic databases in 2021.Two researchers simultaneously screened studies' eligibility by title, abstract and full text. Quality appraisal for the selected studies was assessed according to Joanna Briggs institute critical appraisal. Data were synthesized by conducting content analysis.Twenty-seven reviews were included in the final synthesis. Strategies and models for supporting the transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments were structured as intra-organizational, sociocultural, and professional development. Intra-organizational strategies and models were unique to a particular organization and included policies and support, diversity, collegial and peer support, employee treatment and workplace environment. Sociocultural strategies and models addressed social, cultural and group dynamics using cultural training, learning and support, social support and friendships, language and communication, and personal skills development. Professional development enhanced nursing competence, ability to practice and workplace professional development. This was supported through licensure and orientation to work, career and competence development, and workplace mentorship and preceptorship.There is a need to understand culturally and linguistically diverse nurses' needs and motivation to integrate, which is essential toward developing efficient integrational strategies and models. Strategies and models also need to support cultural and personal competence development of native nurses to aid efficient integration of culturally and linguistically diverse colleagues. Future studies can evaluate nursing workforce shortages and their implications on integration process.

The objective of this work was to develop and test an empirical model of social and healthcare educators' continuing professional development. A cross-sectional survey study design was adopted, and a total of 422 part-time and full-time social and healthcare educators from 28 universities of applied sciences and vocational schools in different regions of Finland participated. Data were collected from October to December in 2018. The participants taught in the fields of healthcare, social services, and rehabilitation. The questionnaire included the EduProDe scale and background questions. Confirmatory factor analysis and structural equation modelling were used to develop the model, and its quality was assessed by computing goodness of fit indexes. The main finding was that when educators understand the benefits of continuing professional development, they will recognise their developmental needs and proactively seek support from their superiors. The results obtained provide insight into the preconditions for professional development and offer guidance for the design of future shared development programmes or activities for social and healthcare educators. publishedVersion

Introduction Nursing roles are changing, as several countries have amended legislation so that nurses can make referrals for medical imaging examination that utilize ionising radiation. Nevertheless, nurses' radiation knowledge remains a poorly studied concept. The aim of the study was to characterize Finnish nurses’ knowledge of radiation use and radiation safety. In this study, nurses were working in operating theaters, first aid clinics and cardiology laboratories. Methods A cross-sectional design was applied in which data were simultaneously collected from nurses working in eight hospitals. All nurses working in operating theaters, first aid clinics and cardiology laboratories (N = 1500) at the hospitals in Finland were invited to participate in the study. The response rate was 17% (n = 252). The employed Healthcare Professional Knowledge of Radiation Protection (HPKRP) scale included three areas of knowledge: radiation physics, biology and principles of radiation use; radiation protection; and guidelines of safe ionizing radiation use. Descriptive statistics and logistic regression analyses were used to identify factors that influence these three areas. Results Nurses reported high knowledge levels in radiation protection but low knowledge levels in radiation physics, biology and principles of radiation use. Moreover, nurses who had not received radiation education reported lower knowledges across all three areas than the nurses who had completed education. Conclusion This study identified one major factor that significantly affects nurses’ radiation knowledge, namely, having completed medical radiation education, as this factor positively influenced all three of the included areas of radiation knowledge factors. Therefore, healthcare organizations should concentrate on providing education to all nurses working with, or exposed to, radiation.

Competent educators are needed to ensure that social and healthcare professionals are effective and highly competent. However, there is too little evidence-based knowledge of current and required enhancements of educators' competences in this field. The aim of this study was to describe social and healthcare educators' perceptions of their competence in education. The study had a qualitative design, based on interviews with educators and rooted in critical realism. Forty-eight participants were recruited from seven universities of applied sciences and two vocational colleges in Finland, with the assistance of contact persons nominated by the institutions. The inclusion criterion for participation was employment by an educational institution as a part-time or full-time, social and/or healthcare educator. Data were collected in the period February-April 2018. The participants were interviewed in 16 focus groups with two to five participants per group. The acquired data were subjected to inductive content analysis, which yielded 506 open codes, 48 sub-categories, nine categories and one main category. The educators' competence was defined as a multidimensional construct, including categories of educators' competences in practicing as an educator, subject, ethics, pedagogy, management and organisation, innovation and development, collaboration, handling cultural and linguistic diversity, and continuous professional development. Educators recognised the need for developing competence in innovation to meet rapid changes in a competitive and increasingly global sociopolitical environment. Enhancement of adaptability to rapid changes was recognised as a necessity. The findings have social value in identifying requirements to improve social and healthcare educators' competence by helping educational leadership to improve educational standards, construct a continuous education framework and create national and/or international curricula for teacher education degree programs to enhance the quality of education. We also suggest that educational leadership needs to establish, maintain and strengthen collaborative strategies to provide effective, adaptable support systems, involving educators and students, in their working practices.

Introduction Healthcare professionals must sufficiently understand ionising radiation and the associated protection measures to avoid unnecessarily exposing patients and staff to ionising radiation. Hence, a proper safety culture is important to lowering health risks. The development and establishment of an instrument that can indicate healthcare professionals' understanding/knowledge of radiation protection concepts can greatly contribute to a good safety culture. The purpose of the present study was to develop and psychometrically test the Healthcare Professional Knowledge of Radiation Protection (HPKRP) self-evaluation scale, which was designed to measure the knowledge level of radiation protection by healthcare professionals working with ionising radiation in a clinical environment. Methods The presented research employed a cross-sectional study design. Data were collected from eight Finnish hospitals in 2017. A total of 252 eligible nurses responded to the newly developed HPKRP scale. The face and content validity were tested with the Content Validity Index (CVI). Explorative factor analysis was used to test construct validity, whereas reliability was tested with Cronbach's alpha. Results Overall S-CVI for the HPKRP scale was 0.83. Exploratory factor analysis revealed a three-factor model for the HcPCRP scale containing 33 items. The first factor was defined by Radiation physics and principles of radiation usage, the second factor by Radiation protection, and the third factor by Guidelines of safe ionising radiation usage. These three factors explained 72% of the total variance. Cronbach's alpha coefficient for the scale ranged from 0.93 to 0.96. Conclusion The results provide strong evidence for the validity and reliability of the HPKRP scale. Additionally, educators can use the scale to evaluate healthcare students' understanding in radiation safety before and after education.

Background Social and healthcare operating environments are constantly evolving, so educators have major responsibility for ensuring that Evidence-Based Healthcare is included in the education of future healthcare professionals and applied in their practice. A holistic understanding and implementation of evidence-based healthcare competence is critical to the delivery of appropriate, relevant, and effective healthcare. Aim To identify and describe social and healthcare educators' EBHC competence according to the five main components of the JBI model and associated factors to it. Methods A mixed-methods systematic review was conducted, with inclusion and exclusion criteria identified according to PICo and PEO inclusion criteria for qualitative and quantitative studies, respectively. Five databases—the CINAHL (EBSCO), PubMed, Scopus, Medic and ProQuest databases— were searched in June 2020. In total, 12 original studies (qualitative and quantitative) were included for quality appraisal, data extraction and narrative synthesis. Results Key competence areas addressed in the selected studies were integrated into the four components of the JBI model of EBHC (evidence generation, synthesis, transfer, and implementation, and focus on its ultimate goal: global health). In the majority of chosen studies', it was found that educators had a positive attitude towards EBHC and wanted to stay up-to-date in the areas of global health and collaboration. Educators demonstrated their abilities to locate, appraise, and interpret the best current relevant evidence. They knew how to integrate EBHC into their teaching and had strong communication skills in evidence transfer. Their EBHC competence was strongest in the educational context and educators could transfer evidence when teaching but were not able to translate it into how to implement EBHC in clinical care. In addition to higher academic education and work experience, organizational support and continuous education reportedly play essential roles in development of educators' EBHC competence. Conclusion Measures are needed to maintain and improve social and health educators' EBHC competence and develop robust methods to reliably assess it.

The social and health care educator's role in educating future professionals need to be stronger emphasised and deserves international recognition. The purpose of this study was to develop and test an empirical model of social and health care educators' competence in higher and professional education. The presented research employed a cross-sectional study design. Data were collected using HeSoEduCo-instrument from 28 educational institutions in Finland. The model was empirically tested with confirmatory factor analysis through Structural Equation Modelling that applied the Full Imputation Maximum Likelihood estimator. A total of 422 social and health care educators participated in the study. The empirical model of social and health care educators including eight competence areas: leadership and management, collaboration and societal, evidence-based practice, subject and curriculum, mentoring students in professional competence development, student-centred pedagogy, digital collaborative learning, and cultural and linguistic diversity. All of the connections between concepts of the empirical model were found to be statistically significant. There were strong connections between most of the identified competence concepts; however, two weak connections were found, namely, the link between competence in evidence-based practice and competence in subject and curriculum, along with the link between competence in digital collaborative learning and competence in student-centred pedagogy. The presented empirical model can help stakeholders identify which areas of social and health care educators' curricula should be further developed. The model is also relevant for improving continuous education, allowing educators to assess their competence levels and evaluating educators' performance at the organisational level. publishedVersion

Aim: The purpose of the study was to identify and describe the characteristic profiles of evidence-based practice competence of educators in the social, health and rehabilitation sectors and to establish relevant background factors. Design: This study was carried out as a descriptive cross-sectional study. Methods: Data were collected from social, health and rehabilitation sector educators working in the 21 Finnish universities of applied sciences and seven vocational colleges (n = 422; N = 2,330). A self-assessment instrument measuring evidence-based practice competence was used. Competence profiles were formed using a K-cluster grouping analysis. Results: Three distinct competence profiles were identified and delineated. Most educators feel that they can guide students' critical thinking and are able to seek and produce scientific knowledge. Evidence-based practice competence was explained by background factors such as year of graduation (for higher degree), level of education, job title, current employer and current field of work. publishedVersion

Background The challenges of caring for stroke patients are growing due to population ageing and improved survival rates. Healthcare professionals' competence development in stroke care is a necessity to ensure high-quality patient care. Objectives To identify and describe the competence areas of healthcare professionals working in the stroke patient care pathway and factors influencing these competences. Design A mixed-methods systematic review. Methods The review was conducted according to the JBI guidelines and registered in the PROSPERO database (CRD42020204062). PRISMA checklist guided the review process. Relevant original studies were identified by searching four databases-CINAHL (EBSCO), PubMed, Scopus and Medic. After researcher consensus was reached, 32 studies were selected for inclusion and subjected to content analysis and data tabulation. Results Competence in care processes, clinical competence, competence in using self-management strategies, interaction skills, skills in acknowledging family and competence in integrating the available evidence base into patient care were identified as key competence areas. Organisation of services, specialisation in stroke care, continuous development and education, family and carer and training in oral care and cognitive rehabilitation were identified as factors that influence healthcare professionals' competence. Conclusions Diverse clinical and interaction competencies are needed throughout the stroke care pathway, and various factors affect healthcare professionals' competence. Further research on healthcare professionals' stroke care competence will be needed to respond to changing healthcare demand. Relevance to clinical practice We recommend organisational support and formulation of stroke care patient guidelines in line with healthcare competence requirements. Focus should be added for nursing professions in developing interactive communication competence since nurses spend the majority of the time providing individual patient care. Also, organisations should integrate continuing training in specialised stroke care for healthcare professionals' competence development.

Background and purpose Educators’ ethical competence is of crucial importance for developing students’ ethical thinking. Previous studies describe educators’ ethical codes and principles. This article aims to widen the understanding of health- and social care educators’ ethical competence in relation to core values and ethos. Theoretical background and key concepts The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. Methods Data material was collected from nine educational units for healthcare and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. Ethical considerations The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. Findings The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. Conclusion Educators’ personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators’ training regarding ethical competence.

Aims and objectives\ud To develop and test an empirical model of clinical learning environment and mentoring of culturally and linguistically diverse nursing students.\ud \ud Background\ud Clinical learning is an essential part of nursing education; nursing students are required to master clinical competences and build a professional identity during their education. The global mobility of nurses requires high proficiency in cultural adaptability as well as the successful integration of cultural diversity into the healthcare system on a national level.\ud \ud Design\ud The research design was a quantitative cross-sectional study. STROBE statement was used to enhance the quality and transparency of research.\ud \ud Methods\ud Data were collected from eight universities during the 2015–2016. The analysis included data from 187 participants, collected using the CLES+T scale and CALDs. Instrument validity was tested with confirmatory factor analysis, while the hypotheses were tested with a structural equation model.\ud \ud Results\ud Pedagogical atmosphere was shown to be positively related to cultural diversity (0.66), orientation into the clinical placement (0.54) and the role of the student (0.25), and all of these relationships were statistically significant. These dimensions—with the exception of the role of the student—also showed a significantly positive influence on the mentoring relationship (respectively, 0.32, 0.71, 0.18). Fit indexes demonstrate an adequate model's fit.\ud \ud Conclusions\ud The model needs to be further piloted and tested in organisational structures of clinical practice of culturally and linguistically diverse nursing students. The dimensions that explain mentoring in clinical learning needed to be further addressed in a theoretically consistent and empirically driven approach, according to these findings.\ud \ud Relevance to clinical practice\ud In our study, we found that environmental and relational aspects are the most important for building an effective clinical learning environment. Universities and healthcare organisations can jointly leverage the model to foster clinical learning environments in clinical practice.

Background: Health and social care education is highly important for preparing future professionals for their future roles in sustainable health and social care. However, previous studies have emphasized that health and social care educators’ competence is complex and poorly defined. Thus, there is a clear need for a psychometrically validated instrument to enable clarification and assessment of the required skills. Objective: To develop and psychometrically validate an instrument (the HeSoEduCo) for assessing health and social care educators’ competence in higher and professional education. Design: Cross-sectional study. Methods: A HeSoEduCo instrument, with items inviting 1–4 Likert scale responses, was developed, based on one systematic review and one qualitative study, then validated in terms of face, content and construct validity and internal consistency (Cronbach′s alpha values). All health and social care educators based in all 21 universities of applied sciences in Finland and seven vocational colleges were subsequently invited to participate in a large-scale application of the instrument in fall 2018. In total, responses of 390 of these educators are analyzed here. Results: The face and content validity of 71 newly developed items were assessed by experts in two evaluation rounds. The final content validity showed high scores for the instrument’s relevance and clarity. Confirmatory factor analysis (to test construct validity) yielded eight factors (43-items remaining), defining the following competence areas of educators: evidence-based practice, digital collaborative learning, student-centered pedagogy, collaboration & societal, leadership & management, cultural & linguistic diversity, mentoring student into professional competence development and subject & curriculum. Cronbach’s alpha values for the factors ranged from 0.70 to 0.89. Conclusion: The instrument can be used to obtain self-evaluations of educators’ competence when assessing their general competence levels and help human resources departments and managers to identify suitable continuous education programs for their staff.

Background: Mentoring in clinical settings is an important factor in the development of nursing students' professional knowledge and competences, but more knowledge of mentors' current and required competences is needed to improve nursing students' clinical learning. Objectives: This study aimed to develop and test an evidence-based model of mentoring nursing students in clinical practice. Design: An international cross-sectional survey coordinated in five European countries: Finland, Italy, Lithuania, Slovenia and Spain. Methods: Mentors, 4980 registered nurses working in both primary and specialist healthcare organizations, were invited to participate in the study during 2016–2019. The final sample consisted of 1360 mentors (mean age 41.9 ± 11). Data were collected with background questions and the Mentor Competence Instrument. The instrument was psychometrically validated then the data were used to construct a Structural Equation Model (SEM) with Full Imputation Maximum Likelihood (FIML) estimation. Results: All of six hypotheses were verified. In summary: mentors' characteristics related to their motivation and reflection are positively related to mentoring practices in the workplace, which (together with constructive feedback) are positively related to and foster goal-orientation in students' clinical learning and student-centered evaluation. All parameters in the SEM model were significant and the model's fit indexes were verified (RMSEA = 0.055; SRMR = 0.083; CFI = 0.914, TLI = 0.909). Conclusion: Our evidence-based modeling confirms the research hypotheses about mentorship, and identifies focal competences for designing mentors' education to improve students' clinical learning and establish a common European mentoring model. Mentorship is important for both healthcare organizations and educational systems to enhance students' clinical competences, professional growth and commitment to the nursing profession and organizational environments. We would like to acknowledge European Commission, Erasmus+, KA2: Strategic partnership for providing funding for the project Quality mentorship for developing competent nursing students (QualMent).

Background The purpose of clinical placements and supervision is to promote the development of healthcare students´ professional skills. High-quality clinical learning environments and supervision were shown to have significant influence on healthcare students´ professional development. Objectives This study aimed to describe healthcare students` evaluation of the clinical learning environment and supervision, and to identify the factors that affect these. Design The study was performed as a cross-sectional study. Methods The data (n = 1973) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale during the academic year 2015–2016 from all healthcare students (N = 2500) who completed their clinical placement at a certain university hospital in Finland. The data were analysed using descriptive statistics and binary logistic regression analysis. Results More than half of the healthcare students had a named supervisor and supervision was completed as planned. The students evaluated the clinical learning environment and supervision as ‘good’. The students´ readiness to recommend the unit to other students and the frequency of separate private unscheduled sessions with the supervisor were the main factors that affect healthcare students` evaluation of the clinical learning environment and supervision. Individualized and goal-oriented supervision in which the student had a named supervisor and where supervision was completed as planned in a positive environment that supported learning had a significant impact on student's learning. Conclusions The clinical learning environment and supervision support the development of future healthcare professionals' clinical competence. The supervisory relationship was shown to have a significant effect on the outcomes of students' experiences. We recommend the planning of educational programmes for supervisors of healthcare students for the enhancement of supervisors' pedagogical competencies in supervising students in the clinical practice.

Aim The purpose of this study was to develop and test the psychometric properties of the new Cultural and Linguistic Diversity scale, which is designed to be used with the newly validated Clinical Learning Environment, Supervision and Nurse Teacher scale for assessing international nursing students’ clinical learning environments. Background In various developed countries, clinical placements are known to present challenges in the professional development of international nursing students. Design A cross-sectional survey. Methods Data were collected from eight Finnish universities of applied sciences offering nursing degree courses taught in English during 2015–2016. All the relevant students (N = 664) were invited and 50% chose to participate. Of the total data submitted by the participants, 28% were used for scale validation. The construct validity of the two scales was tested by exploratory factor analysis, while their validity with respect to convergence and discriminability was assessed using Spearman's correlation. Results Construct validation of the Clinical Learning Environment, Supervision and Nurse Teacher scale yielded an eight-factor model with 34 items, while validation of the Cultural and Linguistic Diversity scale yielded a five-factor model with 21 items. Conclusion A new scale was developed to improve evidence-based mentorship of international nursing students in clinical learning environments. The instrument will be useful to educators seeking to identify factors that affect the learning of international students.

To identify current best evidence on the types of interventions that have been developed to improve job satisfaction among nurses and on the effectiveness of these interventions.The systematic review is a quantitative systematic review and meta-analysis following a profile-likelihood random-effects model.CINAHL, Medic, and Pubmed (Medline).PICOS eligibility criteria were used to select original studies published between 2003-2019. The articles were screened by title (N = 489), abstract (N = 61), and full-text (N = 47). A total of 20 articles remained after the full-text screening process and further assess on risk of bias. The screening process was conducted by two authors independently and finally agreed together. A meta-analysis was performed to determine how the identified interventions influence nurses' job satisfaction.The interventions were primarily educational and consisted of workshops, educational sessions, lessons, and training sessions. The postintervention differences between intervention and control groups in meta-analysis revealed that two interventions significantly improved nurses' job satisfaction. Notably, the spiritual intelligence training protocol and Professional Identity Development Program were found to be effective in improving job satisfaction.Healthcare organizations and managers should consider implementing effective interventions to improve nurses' job satisfaction and reduce turnover. The results reported in this study highlight that nurse managers should focus on organizational strategies that will foster the intrinsic motivation of employees.The current nursing shortage and increased turnover intentions are proving to be a global problem. For this reason, it is imperative that nurse managers plan strategies to improve nurses´ job satisfaction. The effective interventions detected in this study are a first step for developing human resource strategies for healthcare organizations. These findings propose that extrinsic factors (e.g., salary and rewards) will never be as effective in maintaining job satisfaction as intrinsic factors (e.g., spiritual intelligence, professional identity, and awareness).目的: 识别提高护士工作满意度的介入治疗类型及其有效性的现有最佳证据。 设计: 系统综述指的是遵循子集似然随机效应模型的定量系统综述与荟萃分析。 数据来源: CINAHL护理学数据库、Medic国际医疗器械展览会和Pubmed文献服务检索系统(Medline联机医学文献分析和检索系统)。 审查方法: 采用PICOS合格标准用于甄选2003年至2019年期间发表的原创研究。按照标题(N=489)、摘要(N=61)和全文(N=47)对文章进行筛选。在完成全文筛选后,留下20篇文章,进一步评估偏倚风险。由两位作者独立进行筛选过程,并最终达成一致。并且还要进行荟萃分析,以探讨所确定的介入治疗对护士工作满意度的影响。 结果: 介入治疗以教育为主,包括讲习班、教育班、上课和培训班。通过荟萃分析,从干预后介入治疗组与对照组的差异可以看出,两种介入治疗显著提高了护士的工作满意度。值得注意的是,灵性智力训练方案和职业认同发展计划能够行之有效地提高工作满意度。 结论: 医疗机构和管理者应考虑实施有效的介入治疗,以提高护士的工作满意度,减少离职率。本研究报告的结果强调,护士部门的管理人员应当侧重能够培养护士内在动机的组织策略。 影响: 当下医护人员的短缺和离职意愿的攀升被证明是一个全球普遍化的问题。为此,护士部门的管理人员制定提高护士工作满意度的策略势在必行。本研究中发现的有效介入治疗是制定医疗机构人力资源战略的第一步。这些发现表明,在维持护士的工作满意度方面,外在因素(如工资和报酬)永远不及内在因素(如灵性智力、职业认同和认识)来得有效。.

Aim To identify and synthesize the best available evidence on nurse mentors' experiences of their competence in mentoring nursing students during clinical practice. Design The research employed a systematic literature review that followed the guidelines of the Joanna Briggs Institute (JBI). Data sources The databases CINAHL, Medline Ovid, Scopus, Eric, Web of Science, Medic, and OATD were systemically searched from 2000 to 2017. Review methods The identified studies were screened by title, abstract (n = 3080) and full-text (n = 91) using the following inclusion criteria: registered nurses, nurses' experiences of competence in mentoring nursing students, acute and primary care organizations providing clinical practice for nursing students, qualitative study. Quality appraisal was performed, data extracted and findings from the included studies (n = 21) were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI). Results A total of 92 extracted findings were aggregated into 21 categories and then further grouped into five synthesized findings: 1) creating an interactive relationship with the student; 2) developing mentor's characteristics and cooperation with stakeholders; 3) providing goal-oriented mentoring; 4) supporting students' development to nurse profession; 5) supporting the student's learning process. Conclusions This review demonstrated that multifaceted mentoring competence is essential to supporting students' learning processes and helping them become confident professionals. For this reason, the findings suggest that healthcare organizations which provide clinical practice for students should emphasize developing the mentoring competence of nurses by offering nurse mentors adequate education, ensuring that the organizational structure affords them sufficient support, and creating a receptive learning atmosphere.

Background Health science teacher competence is multifaceted and continuously changing according to national and international healthcare standards. Organizational restructuring and emphasis on cost effectiveness is changing the scope of health science teachers' practical work and their role in healthcare (worldwide). Aim This study aimed to describe student teachers' perceptions of the competencies needed to work as an educator in the healthcare field. Objective of study was to gain new knowledge which can be used in the development of teacher education programs in nursing science and to define a broader definition of the health science educators. Methods A qualitative study was conducted. Data were collected from 23 Finnish students completing a master's degree in teaching in the healthcare context using focus group interviews. The data were analyzed by inductive content analysis. Results The student teachers identified eight main categories of teacher competence: leadership and management competence; evidence-based practice competence; subject competence; ethical competence; pedagogical competence; collaboration competence; internationalization competence; and continuous professional development competence. Conclusion This study identified essential teacher competencies that can be evaluated among students to develop health science teacher curricula. The findings can be used in follow-up studies or comparative research to investigate competence differences between novice and experienced teachers.

Objectives The aim of this systematic review was to evaluate the effectiveness of educational interventions in digital collaborative learning implemented in nursing education. Design A systematic literature review of randomised controlled trials (RCTs) was carried out in accordance with Joanna Briggs Institute (JBI) and Centre for Reviews and Dissemination guidelines and the PRISMA statement. Data sources CINAHL (EBSCO), ERIC, MEDLINE (Ovid) and Scopus databases were used to identify original peer-reviewed RCT studies published between 2003 and 2018. Review method The 'hits' were systematically screened by title, abstract and full text by two authors acting independently. The quality of the selected original studies was evaluated using the quality assessment criteria of the JBI and Cochrane collaboration's tool for assessing risk of bias in randomised trials. The studies were analysed by narrative synthesis. Results Five peer-reviewed RCT studies were included in the review. All participants in these studies (647 in total) were nursing students exposed to educational interventions in various nursing programme courses. The reviewed studies indicated that digital collaborative learning increased students' knowledge and nursing skills. The results show that collaborative learning in digital learning environments enhanced nursing students' interaction and collaborative skills, problem-solving skills, satisfaction and motivation for learning. Conclusion Collaborative learning in digital learning environments has encouraging effects in enhancing nursing students' knowledge, competence, satisfaction and problem-solving skills. Moreover, evidence-based digital collaborative learning is becoming increasingly effective in nursing education, as available tools and teachers' abilities to use them are improving and providing new learning activities to boost students' learning outcomes in higher education. Thus, its systematic use in digital collaborative learning environments in various nursing courses is recommended.

Background Mentors need diverse competencies, sources of motivation and characteristics to successfully mentor nursing students and support students' learning processes. Effective mentoring education can benefit future nursing professionals, students' satisfaction and learning, as well as the general perception of the nursing profession. Objective The purpose of this study was to evaluate how an educational intervention affects nurse mentors' competence in mentoring nursing students during clinical practice. Design A quasi-experimental study design with pre- and post-tests was used. Settings Educational interventions were conducted in one university hospital and two central hospitals in Finland between 2013 and 2017. The intervention was conducted twice per year with a duration of 3 months for each group. The inclusion criteria for the participants were as follows: volunteer participation to mentor education employment at the university hospital or central hospitals in Northern Finland. Methods The intervention aimed to increase Registered Nurses' competence in mentoring nursing students. The education lasted 3 months and included online learning as well as three face-to-face teaching sessions. A total of 120 nurse mentors completed the Mentor Competence Instrument (MCI), which includes 10 subscales that describe various competence areas, before and after the education. Results Nurse mentors' mentoring competence increased across all mentoring competence areas after the educational intervention. More specifically, the participating nurses showed a statistically significant increase in their competence regarding knowledge of mentoring practices in the workplace, student-centred evaluation, identifying student needs, mentoring practices between mentor and student, supporting students' learning processes, goal orientation in mentoring and constructive feedback. Conclusions On an international level, nurse mentors are not typically required to have completed mentoring education prior to the mentoring of nurse students. Since mentoring education increased nurses' competence at mentoring nursing students, we recommend that all nurse degree programs include mentoring education to prepare future nurses for the important future role in mentoring.

Background Social and health care educators are crucial to educating competent professionals that are prepared to work in a rapidly changing society. Previous studies have primarily assessed educators' continuing professional development from a single perspective. It would be important to gauge educators' perceptions about their professional development from multiple dimensions to identify the strengths and weaknesses of the current learning process. Aim To develop and validate a new educators' professional development scale that is relevant to social and health care education institutions. Method The development and validation of the scale comprised four phases: defining continuing professional development; creating an item pool; an expert review of the item pool; and psychometric testing of the scale. Face and content validity were evaluated by two expert panels. The initial item pool included 104 items, with 41 remaining after the expert review. A total of 2330 social and health care educators from 29 organizations were invited to respond to the developed self-assessment survey. The response rate was 18% (n = 422). Results Explorative factor analysis identified six factors, including a total of 22 items, that accounted for 68.37% of the total variance. The factors defined different elements of continuing professional development for educators, namely, “need for pedagogical development” (7 items), “need to manage challenging situations in teaching” (3 items), “leadership of competence development” (3 items), “self-directed learning” (3 items), “need to develop clinical competence” (3 items) and “benefits of professional development” (3 items). Internal consistency for the six subscales, measured through Cronbach's alpha coefficient, ranged from 0.70 to 0.89. Conclusion The EduProDe scale is a relevant and reliable tool for the planning and evaluation of continuing professional development processes or programs designed for educators of social and health care students.

Background Globalisation has brought new possibilities for international growth in education and professional mobility among healthcare professionals. There has been a noticeable increase of international degree programmes in non-English speaking countries in Europe, creating clinical learning challenges for healthcare students. Objective The aim of this systematic review was to describe mentors' experiences of international healthcare students' learning in a clinical environment. The objective of the review was to identify what influences the success or failure of mentoring international healthcare students when learning in the clinical environment, with the ultimate aim being to promote optimal mentoring practice. Design A systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination. Data sources Seven electronic databases were used to search for the published results of previous research: CINAHL, Medline Ovid, Scopus, the Web of Science, Academic Search Premiere, Eric, and the Cochrane Library. Review Methods Search inclusion criteria were planned in the PICOS review format by including peer-reviewed articles published in any language between 2000 and 2014. Five peer-reviewed articles remained after the screening process. The results of the original studies were analysed using a thematic synthesis. Results The results indicate that a positive intercultural mentor enhanced reciprocal learning by improving the experience of international healthcare students and reducing stress in the clinical environment. Integrating international healthcare students into work with domestic students was seen to be important for reciprocal learning and the avoidance of discrimination. Conclusion Many healthcare students were found to share similar experiences of mentoring and learning irrespective of their cultural background. However, the role of a positive intercultural mentor was found to make a significant difference for international students: such mentors advocated and mediated cultural differences and created a welcoming environment for international students by helping to minimise feelings of social isolation.

Background Digitalisation has made digital competence a necessity for those working in social and healthcare. A high degree of competence in digital pedagogy is required of educators to meet the challenge of educating future professionals who are themselves highly digitally competent. Objectives The aim of this study was to describe the perceptions of competence in digital pedagogy that educators in social and healthcare have. Design A qualitative descriptive study. Participants The participants were Finnish-speaking social and healthcare educators (n = 37) working at six Finnish universities of applied sciences (UAS). Methods Group interviews (n = 12) were conducted during spring 2018. Each group consisted of 2–5 educators, with a total of 37 educators. The data was analysed using an inductive content analysis. Results According to the interviewed educators, competence in digital pedagogy involved pedagogical, digital, and ethical skills and awareness. The educators were aware of the possibilities afforded by digital technology and had a positive view on how the technology could be utilised in education. However, the educators were concerned that technology might solely be utilised for the sake of digitalisation instead of being pedagogically preferable. Conclusions In the future, the results of this study can be utilised while developing an instrument to evaluate the level of competence in digital pedagogy. Examining the perceptions of the educators will allows us to better understand the phenomena from the educators' point of view.

Background Intercultural communication has become increasingly important in nursing due to the cross-border mobility of patients, health professionals and students. Development of cultural competence continues to be a challenge, particularly among professionals such as educators or healthcare providers who work in professions requiring communication across cultural boundaries. Despite challenges in nursing education related to cultural diversity, competence in intercultural communication has been proven to empower students and to help them grow professionally. Objectives The aim of this study was to describe clinical mentors' experiences of their intercultural communication competence in mentoring culturally and linguistically diverse nursing students during completion of their clinical practice. Design Qualitative study design. Participants The participants were 12 nurses who had previously mentored at least two culturally and linguistically diverse nursing students. Methods Data were collected during spring 2016 using semi-structured interviews of 12 mentors working in specialized nursing care at one hospital located in central Finland. Data were analyzed using deductive-inductive content analysis. The main concepts of the Integrated Model of Intercultural Communication Competence were used during the semi-structured theme interviews and during analysis. These concepts include empathy, motivation, global attitude, intercultural experience and interaction involvement. Results Mentors stated that empathy motivates them in the development of intercultural communication. Mentors experienced a lack of resources and support from their superiors, which caused psychological and ethical strain and reduced mentors' motivation. Mentors openly admitted that they had experienced fear towards unknown cultures, but that this fear was reduced through positive mentoring experiences and cultural encounters. Conclusions Continuous education on intercultural communication competence could succeed to further develop clinical mentors' mentoring expertise, which could have the potential to greatly benefit students, patients and staff. Such education could be designed, implemented and measured for its effect in collaboration between health care organizations and higher educational institutions.

Background Due to a steady rise in cultural and linguistic diversity in healthcare settings and evident challenges associated with this diversity, there is an urgent need to address cultural competency of nurses. Ongoing, continuing professional development is needed to ensure nurses can provide culturally congruent nursing care. Objectives The aim of this systematic review was to identify current best evidence on the types of educational interventions that have been developed to improve nurses’ self-assessed cultural competence and on the effectiveness of these interventions. Design A systematic literature review. Data sources Four electronic databases (PubMed, CINAHL, Medic, Eric) were searched for studies using a quasi-experimental design or randomised controlled trial published between January 2000 and June 2018. Review methods Guidelines from the Centre for Review and Dissemination and the Joanna Briggs Institute guided the review. Two researchers independently assessed the eligibility of the studies by title, abstract and full-text and the methodological quality of the studies. Data tabulation and narrative analysis of study findings was performed. Results Six studies met criteria for inclusion in the review. Studies used a quasi-experimental study design (n = 5) and a randomised controlled trial (n = 1). The participants (n = 334) were mainly nurses and interventions were conducted in various healthcare settings. Cultural competence education was offered through traditional contact teaching (n = 5) or web-based modules (n = 1) and ranged from one to 17 hours in length. Learning was enhanced through lectures, group discussions, case studies, reflective exercises and simulations. In two studies, following cultural competence interventions, participants in the intervention group had statistically significantly increased levels of competence in culture-related outcomes when compared to the control group. The four remaining studies did not include control group comparisons. Effect sizes (Cohen’s d) of the studies varied from small (d = 0.22) to very large (d = 1.47). Conclusions There continues to be a need for high quality studies investigating educational interventions to develop nurses’ cultural competence. Further research should focus on reporting specific components of interventions that result in an increase in cultural competence.

Due to educational reforms in Finland, the nurse teacher's role is being reduced in mentoring of nursing students in the clinical practice. Students reported experiencing a lack of instruction and feeling abandoned in the clinical practice. The aim of this study was to describe nursing student experiences of mentoring by nurse teachers in clinical practice, as well as the benefits of digital technology in this context. Qualitative study design was used with semi-structured focus group interviews. Nursing students (n = 15) who had completed at least one clinical placement during their nursing education. Data were collected in autumn 2017 from two universities of applied sciences in northern Finland. The data were analyzed using inductive content analysis. Mentoring by nurse teacher was perceived as a key part of learning evaluation, integrating theoretical and practical knowledge, understanding the student's role and emotional support. The results also revealed that mentoring can be improved by using digital technology. However, technology cannot completely replace face-to-face mentoring. The mentoring provided by nurse teachers plays an important role in the success of a nursing student's clinical practice. Digital technology can be leveraged to enhance the learning experience when easy-to-use and ubiquitous applications are integrated into the clinical learning setting.

Aims and objectives To identify key areas of competence for digitalisation in healthcare settings, describe healthcare professionals' competencies in these areas and identify factors related to their competence. Background Digitalisation requires changes in healthcare practices, policies and actions to revise job expectations and workflows. The aspects of patient safety and integration of digitalisation into the professional context necessitate an assessment of healthcare professionals' competencies in digitalisation. Design Systematic review. Methods A systematic review was conducted following Center of Reviews and Dissemination guidelines, including application of a PRISMA statement. Four databases-CINAHL (EBSCO), MEDLINE (Ovid), Web of Science and Academic Search Premiere (EBSCO)-were searched for relevant original peer-reviewed studies published between 2012-2017. Twelve were chosen for final analysis: five quantitative studies and seven qualitative studies, which were, respectively, subjected to narrative and thematic synthesis. Results Key competence areas regarding digitalisation from a healthcare perspective identified encompass knowledge of digital technology and the digital skills required to provide good patient care, including associated social and communication skills, and ethical considerations of digitalisation in patient care. Healthcare professionals need the motivation and willingness to acquire experience of digitalisation in their professional context. Collegial and organisational support appear to be essential factors for building positive experiences of digitalisation for healthcare professionals. Conclusion Healthcare organisations should both pay attention to the social environment of a workplace and create a positive atmosphere if they want to improve the response to digitalisation. The successful implementation of new technology requires organisational and collegial support. Relevance to clinical practice Recommendations for clinical practice include the following: development of competence in digitalisation by healthcare professionals when using technological equipment to minimise errors; provision of sufficient resources, equipment and room for technology usage; and provision of regular education that considers the participants' competencies.

Background In the face of rapid digitalisation and ever-higher educational requirements for healthcare professionals, it is important that health science teachers possess the relevant core competences. The education of health science teachers varies internationally and there is no consensus about the minimum qualifications and experience they require. Objective The aim of this systematic review was to describe the health science teachers' competences and the factors related to it. Design Systematic review of original quantitative studies. Data sources Four databases were selected from which to retrieve original studies: Cinahl (Ebsco), PubMed, Medic, Eri (ProQuest). Review Methods The systematic review used PICOS inclusion criteria. Original peer-reviewed quantitative studies published between 1/2007 and 1/2018 were identified. Screening was conducted by two researchers separately reading the 1885 titles, 600 abstracts, and 63 full-texts that were identified, and then agreed between them. Critical appraisal was performed using the JBI MAStARI evaluation tool. The data was extracted and then analysed narratively. Results The core competences of health science teachers include areas of knowledge, skills and attitudes. Health science teachers evaluate their own competence as high. Only in relation to entrepreneurship and leadership knowledge was evaluated to be average. The most common factors influencing competence were teachers' title/position, healthcare experience, research activities, age, academic degree and for which type of organisation they work. Conclusion It is important to identify the core competencies required by health science teachers in order to train highly competent healthcare professionals. Based on the findings of this systematic review we suggest that teachers should be encouraged to gain university education and actively participate in research, and that younger teachers should have opportunities to practice the relevant teaching skills to build competence.

Background Nurses play an important role in developing the competence of nursing students and acting as role models for students during clinical practice placements. Nurses need diverse competence to successfully mentor nursing student. Objectives This study aimed to describe and explain nurse mentor competence in mentoring nursing students in clinical practice settings based on self-evaluation, as well as identify different mentor profiles. Design This study employed a cross-sectional, descriptive design involving a self-administered electronic version of the Mentor Competence Instrument. Settings The study population included nurse mentors from all five university hospitals in Finland. Participants Through random sampling, 3355 nurse mentors were invited to take part in the study in 2016. Methods Data was collected using Mentors Competence Instrument, which consists of 63 items structured in 10 mentoring competence categories. Results Mentors (n = 576) evaluated their level of competence in various categories as middle- to high-level. They evaluated reflection during mentoring and identifying a student's need for mentoring the highest, whereas student-centered evaluation and supporting a student's learning process were rated lowest. Three distinct profiles of mentor competence were identified. These profiles differed in evaluation of mentoring competence level, previous participation in mentoring education, and time spent on reflective discussions with students. Conclusions According to their profiles, mentors have diverse needs for support in building their mentoring competence. We suggest that healthcare organizations should provide nursing mentors with education that is based on their individual levels of mentoring competence. Nurses should also be encouraged to use time for reflective discussion with students during clinical practice.

Background Mentors require competence at a diverse array of skills to mentor students during clinical practice. According to the latest evidence, competence at mentoring includes: knowledge, skills and attributes of individual students' learning objectives, core elements of nursing, learning processes, a reciprocal and trustful relationship, feedback, evaluation, cooperation with stakeholders, and the mentor's personal qualities. Objective The purpose of the study was to test psychometric properties of a mentor's competence instrument developed to self-evaluate mentors' competence at mentoring nursing students in clinical practice. Design A cross-sectional, descriptive, explorative study design was used. Settings Data were collected from mentors at five university hospitals in Finland in 2016. Participants A total of 576 mentors participated in this study. Methods The instrument was developed through systematic review, experts' evaluations, and pilot versions of the instrument tested in previous studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis (EFA) with promax rotation and Cronbach's alpha. Results A 10-factor model showed that the instrument has acceptable construct validity. Cronbach's alpha values for the subscales observed ranged from 0.76 to 0.90. Conclusions The instrument exhibited acceptable psychometric properties, thereby proving itself a valuable tool for evaluating mentors' competence at mentoring students. Further assessments of its reliability, validity and generality for measuring mentor's competence for mentoring students in different contexts and cultures are recommended.

Background: The assessment of nursing students’ nursing competence is a matter of concern worldwide and the complexity of assessing students’ clinical competence has challenged educators for decades. It has been recognized that there is inconsistency among assessment methods and tools between countries and institutions. Objective: To identify the current best evidence on the assessment of nursing students’ competence in clinical practice. Design: Systematic review of reviews. Data sources: The electronic databases CINAHL, PubMed, Eric, Medic and the JBI Database of Systematic Reviews and Implementation Reports were searched in autumn 2018. Review methods: Two researchers independently assessed the eligibility of the studies by title, abstract and full-text, and then assessed the methodological quality of the included studies. Analysis of study findings was conducted using the thematic synthesis approach. Results: Six reviews were included following critical appraisal. Assessment tools used to assess students’ nursing competence commonly focus on the domains of professional attributes, ethical practices, communication and interpersonal relationships, nursing processes, critical thinking and reason. Clinical learning environments and mentoring provide important support structures and guide the learning of students. The availability of assessment tools and criteria along with providing individualized feedback and time for reflection strengthen the objectivity and reliability of assessment. Conclusions: There continues to be a need to develop consistent and systematic approaches in assessment, and to use reliable and valid instruments in assessment. Mentors find assessment of students’ competence to be particularly challenging and emphasize the importance of clear assessment criteria, support from nurse educators and further education on assessment. Further development in feedback practices and providing students with opportunities for reflection are important in supporting the continuous learning process of students. We would like to acknowledge European Commission, Erasmus +, KA2: Strategic partnership for providing funding for the project Quality mentorship for developing competent nursing students (QualMent).

Development of educators' and students' global competence in higher education is increasingly important due to internationalization. Internationalization significantly influences healthcare education through an increase in the mobility of students. When conducting clinical practice in healthcare education, culturally and linguistically diverse healthcare students face the challenges of having limited learning opportunities and social isolation. Further investigation is required of students' experiences in this area while asking them to share their experiences. This study aimed to describe students' experiences of clinical learning environment and mentoring. A qualitative research design was used during 2013-2016. Data were collected from 133 culturally and linguistically diverse healthcare students, including exchange students and students studying in English language-taught degree programmes at eight Universities of Applied Sciences in Finland. Data were analysed using inductive content analysis. Students' experiences were related to their mentors' competence in mentoring, culturally diverse pedagogical atmosphere, and aspects of diversity that influence clinical learning. Students reported that they had experienced social isolation, discrimination, bullying, sexual harassment and prejudice during their clinical placements. These issues related to mistreatment of students need to be addressed. Also, structured clinical environments should be developed in which competent mentors assist students in reaching their clinical placement goals.

Background Previously, it has been shown that the clinical learning environment causes challenges for international nursing students, but there is a lack of empirical evidence relating to the background factors explaining and influencing the outcomes. Objective To describe international and national students' perceptions of their clinical learning environment and supervision, and explain the related background factors. Design An explorative cross-sectional design was used in a study conducted in eight universities of applied sciences in Finland during September 2015–May 2016. Methods All nursing students studying English language degree programs were invited to answer a self-administered questionnaire based on both the clinical learning environment, supervision and nurse teacher scale and Cultural and Linguistic Diversity scale with additional background questions. Participants ( n =329) included international ( n =231) and Finnish ( n =98) nursing students. Binary logistic regression was used to identify background factors relating to the clinical learning environment and supervision. Results International students at a beginner level in Finnish perceived the pedagogical atmosphere as worse than native speakers. In comparison to native speakers, these international students generally needed greater support from the nurse teacher at their university. Students at an intermediate level in Finnish reported two times fewer negative encounters in cultural diversity at their clinical placement than the beginners. Conclusion To facilitate a successful learning experience, international nursing students require a sufficient level of competence in the native language when conducting clinical placements. Educational interventions in language education are required to test causal effects on students' success in the clinical learning environment.