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Aim(s): To describe nurse leaders' perceptions of culturally and linguistically diverse (CALD) nurses' competence-based management., Design: A descriptive qualitative study of the competence-based management of CALD nurses, from the perspectives of nurse leaders in three primary and specialised medical care organisations. This study followed the COREQ guidelines., Methods: Qualitative semi-structured individual interviews were conducted with 13 nurse leaders. Eligible interviewees were required to have management experience, and experience of working with or recruiting CALD nurses. Data were collected during November 2021-March 2022. The data were analysed using inductive content analysis., Results: Competence-based management was explored in terms of competence identification and assessment of CALD nurses, aspects which constrain and enable competence sharing with them, and aspects which support their continuous competence development. Competencies are identified during the recruitment process, and assessment is based primarily on feedback. Organisations' openness to external collaboration and work rotation supports competence sharing, as does mentoring. Nurse leaders have a key role in continuous competence development as they organise tailored induction and training, and can indirectly reinforce nurses' work commitment and wellbeing., Conclusion(s): Strategic competence-based management would enable all organisational competencies potential to be utilised more productively. Competence sharing is a key process for the successful integration of CALD nurses., Relevance to Clinical Practice: The results of this study can be utilised to develop and standardise competence-based management in healthcare organisations. For nursing management, it is important to recognise and value nurses' competence., Impact: The role of CALD nurses in the healthcare workforce is growing, and there is little research into the competence-based management of such nurses., Patient or Public Contribution: No patient or public contribution., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aims: This study aimed to identify mentors' cultural competence profiles at mentoring culturally and linguistically diverse nursing students in clinical practice and explore associating factors., Background: Globalization has had a significant impact on healthcare, increasing the diversity of healthcare workforces and the number of culturally and linguistically diverse nursing students in clinical practice. The cultural competence of mentors is important to secure students' safe and successful learning. The mentor role in clinical practice contributes toward enabling and ensuring students' high-quality and goal-oriented development of competence., Design: This study implemented a cross-sectional design with a final sample of 270 clinical practice mentors from Finland, Lithuania, Spain and Slovenia., Methods: The data were collected using an online survey including the Mentors' Cultural Competence Instrument, Mentors' Competence Instrument and background questions during 2020-2021. The data were analyzed using a K-mean cluster algorithm to identify mentors' competency profiles., Results: Three significantly differing mentor competency profiles (Profile A 42%, Profile B 41%, Profile C 17%) were identified in this study. The cultural competence of the mentors in clinical practice varied between intermediate and high levels. Mentors rated their cultural competence as best in the area of cultural sensitivity and awareness, whereas the lowest scored area was cultural interaction and safety., Conclusions: This study showed that the cultural competence of mentors in clinical practice varied and was influenced by mentors' work experience, age, job title and frequency of mentoring. This study provides new knowledge that could help to develop cultural competence operating models and education to enhance the cultural competence of healthcare professionals., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The nursing shortage is a global and ongoing phenomenon that is expected to worsen. In many countries, imbalances in the nursing workforce will require international recruitment and plans to increase domestic and international nursing graduates. Nurses from culturally and linguistically diverse backgrounds have been reported to experience challenges while integrating into the workforce., Aim: To describe culturally and linguistically diverse registered nurses' experiences of their integration into the Finnish nursing workforce., Methods: The study adopted a qualitative descriptive design. Data were collected during the spring of 2021 from 24 culturally and linguistically diverse registered nurses working in various healthcare settings in Finland. Data were analyzed using content analysis, which resulted in 596 open codes, 21 sub-categories, and 8 categories., Results: According to the performed analysis, culturally and linguistically diverse nurses in Finland face cultural, ethnic and linguistic challenges. Organizational acceptance and acknowledgement of culturally and linguistically diverse nurses' competence can help decrease the practice of deskilling and the perception that foreign nurses have purely opportunistic goals. Cultural and language learning support, tailored orientation programs, and mentorship are the most common organizational strategies for supporting integration and competence development. The role of the nurse manager and organizational strategies were also identified as essential components of smooth integration, work wellbeing and retention., Conclusions: Finnish healthcare organizations need to implement strategies that support culturally and linguistically diverse nurses' integration into the workforce. Nurse managers are important leaders that can foster culturally and linguistically diverse nurses' competence development, ensure the efficient use of their specialized skills, promote work wellbeing, and improve nurse retention., Competing Interests: Declaration of competing interest Given their role as Editor on this journal, Professor Kristina Mikkonen had no involvement in the peer-review of this article and has no access to information regarding its peer-review. Full responsibility for the editorial process for this article was delegated to an independent Editor. The authors have no conflict of interests to declare., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Different types of educational approaches are needed to build a mentor's competence in guiding students during clinical practice; this education should be provided in an interprofessional setting., Objectives: The objective of this review was to evaluate how effective mentoring education interventions are at improving mentoring competence among health care professionals., Design: A systematic review., Data Sources: A systematic search was conducted across five electronic databases: CINAHL, PubMed, ProQuest, Scopus, and Medic. The search did not have any time limitations and included original studies published in English, Finnish or Swedish., Review Methods: JBI critical appraisal tools for quasi-experimental studies and randomized controlled trials were used to assess the quality of the selected studies. The eligibility of potentially relevant studies was assessed by two independent researchers based on title, abstract, and full text, along with overall methodological quality. The study findings were synthesized using data tabulation and narrative analysis., Results: A total of two randomized controlled trials and six quasi-experimental studies were included in the review. The described mentoring education interventions were carried out in university hospitals, central hospitals, tertiary care centers, and other health service settings. All of the described educational interventions involved the pedagogical method of blended learning, while three studies also involved web-based learning. The presented educational interventions included versatile pedagogical frameworks, e.g., interactive practical training sessions, teaching workshops, and technology-mediated interactions. One study contained a control group., Conclusion: This systematic review can provide insight and evidence-based that can be used to design effective mentoring education. Further research is needed and would ideally include randomized controlled trials and quasi-experimental studies with reference groups; this type of research could further elucidate which aspects of mentoring education are most important for improving the guidance skills of health care professionals., Competing Interests: Declaration of competing interest Given their role as Editor on this journal, Professor Kristina Mikkonen had no involvement in the peer-review of this article and has no access to information regarding its peer-review. Full responsibility for the editorial process for this article was delegated to an independent Editor., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Health care experts need high levels of competence, yet there is little evidence on the influence of digital learning on health science students' competence development., Objectives: This study aims to describe health sciences students' experiences of the development of their competence and the influences of digital learning upon their competence., Design: A qualitative descriptive research., Participants: A total of 15 health sciences students were interviewed., Methods: The data was collected by using individual semi-structured interviews during the spring of 2021. The data was analyzed using content analysis., Results: The health sciences students felt that their expertise encompasses motivation for future career development, understanding the social and professional influences on their career development, versatile expertise in various aspects of health sciences, and developing competence in different learning environments. The students recognized that digital learning requires the active participation, digitalization is a part of a successful learning environment, and digital learning challenges social interactions. The students' digital learning facilitated competence development, which broadened their understanding of skills relevant to health sciences; however, these benefits could only be obtained when including adequate support., Conclusions: The results hold social value for the development of health sciences education as policy-makers can use the presented information to develop high-quality, digital learning procedures., Competing Interests: Declaration of competing interest Given her role as Editor of the target journal, Professor Kristina Mikkonen had no involvement in the peer-review of this article and has no access to information regarding its peer-review. An independent editor was given full responsibility for the editorial process of this article., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Competing Interests: Declaration of competing interest Given their role as Editor on this journal, Professors Kristina Mikkonen and Marco Tomietto had no involvement in the peer-review of this article and has no access to information regarding its peer-review. Full responsibility for the editorial process for this article was delegated to an independent.

Background: 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., Objectives: To synthesize the best evidence exploring the impacts of peer mentoring programs on nursing students., Design: A mixed-method systematic review., Data Sources: 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., Review Methods: 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., Results: 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., Conclusion: 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., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors. All the authors have approved the final version of the article and are entitled to authorship are listed as authors. The content of the manuscript has not been published, or submitted for publication elsewhere., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Aim: To develop and psychometrically test a Preceptors' Orientation Competence Instrument measuring orientation competence of nurses working as new employee preceptors., Background: Competence of nurse preceptor is essential for a successful preceptorship and thus nursing staff´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, modification 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., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Those who mentor nursing students from diverse backgrounds should be educationally prepared to provide safe, culturally appropriate mentoring in clinical learning environments., Objective: To evaluate the effects of an educational intervention on mentors' competence in mentoring culturally and linguistically diverse nursing students during clinical placement., Design: Nonrandomised, quasi-experimental study., Settings: The study was conducted at two hospitals located in Finland., Participants: Mentors responsible for mentoring nursing students during clinical placements., Methods: 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., Results: 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., Conclusions: 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., Clinicaltrials: gov (ID:NCT04280172)., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

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., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

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., (Copyright © 2021. Published by Elsevier Ltd.)

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., (© 2020 Nordic College of Caring Science.)

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., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This scoping review was undertaken to synthesize and describe research related to digital learning interventions in higher education, focusing on technological outcomes. Five electronic databases were searched, and 86 articles were included in the review. The data related to positive and negative technological outcomes and authors' suggestions were analyzed using inductive content analysis. The articles represented six disciplines across six continents and included quantitative (n = 65), qualitative (n = 3), and mixed-methods (n = 18) intervention studies. For positive technological outcomes, digital formats of learning were considered effective and participatory forms of learning in a majority of the articles. The students appreciated individualized and self-paced learning, and the digital form increased their motivation to learn. Automatized technical solutions that enabled learning and teaching had several advantages, and digital learning was believed to save the resources of students, teachers, and organizations. For negative technological outcomes, the technical difficulties in using the digital devices or platforms were described the most, and a need for resources was identified. Feedback from teachers was considered important from positive and negative viewpoints. Authors' suggestions for future digital teaching and learning as well as related interventions consisted of various activities, resources, environments, and methods.

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., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

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., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Clinical placements are an important part of nursing education to developing nursing students' competencies. In enhancing clinical learning, to focus on mentors' competences is pivotal as they are the main role models and experts in guiding. This study is validated the Italian version of the Mentors' Competence Instrument. A sampling frame of 648 mentors was involved. The final sample included 291 mentors (response rate 45%). Confirmatory Factor Analysis was performed. Fit indices were also calculated to evaluate validity. The scale demonstrated optimal fit indexes and its validity was confirmed by psychometrical testing. In detail, Root Mean Square Error of Approximation is 0.058, Standardized Root Mean Residual is 0.046, Comparative Fit Index is 0.893 and Tucker-Lewis Index 0.886. Cronbach's alpha ranges from 0.77 to 0.95 among factors. This is the first validation of the scale performed in a different country from the original study. The performed psychometric testing showed that the scale is valid and reliable, as well as consistent with the theoretical structure reported for a different national context. This scale can be beneficial for comparing mentors' competencies across different clinical learning environments and could be used to build a broader model of mentors' competencies., Competing Interests: Declaration of competing interest The authors have no conflict of interests to declare., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

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., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Context: Learning in the clinical environment of healthcare students plays a significant part in higher education. The greatest challenges for culturally and linguistically diverse healthcare students were found in clinical placements, where differences in language and culture have been shown to cause learning obstacles for students. There has been no systematic review conducted to examine culturally and linguistically diverse healthcare students' experiences of their learning in the clinical environment., Objective: This systematic review aims to identify culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment., Methods: The search strategy followed the guidelines of the Centre of Reviews and Dissemination. The original studies were identified from seven databases (CINAHL, Medline Ovid, Scopus, Web of Science, Academic Search Premiere, Eric and Cochrane Library) for the period 2000-2014. Two researchers selected studies based on titles, abstracts and full texts using inclusion criteria and assessed the quality of studies independently. Twelve original studies were chosen for the review., Results: The culturally and linguistically diverse healthcare students' learning experiences were divided into three influential aspects of learning in a clinical environment: experiences with implementation processes and provision; experiences with peers and mentors; and experiences with university support and instructions. The main findings indicate that culturally and linguistically diverse healthcare students embarking on clinical placements initially find integration stressful. Implementing the process of learning in a clinical environment requires additional time, well prepared pedagogical orientation, prior cultural and language education, and support for students and clinical staff. Barriers to learning by culturally and linguistically diverse healthcare students were not being recognized and individuals were not considered motivated; learners experienced the strain of being different, and faced language difficulties. Clinical staff attitudes influenced students' clinical learning experiences and outcomes., Conclusion: Additional education in culture and language for students and clinical staff is considered essential to improve the clinical learning experiences of culturally and linguistically diverse healthcare students. Further studies of culturally and linguistically diverse healthcare students' learning experiences in the clinical environment need to be conducted in order to examine influential aspects on the clinical learning found in the review., (Copyright © 2015 Elsevier Ltd. All rights reserved.)