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学生与护理专业人员在学习与创新网络中所经历的紧张关系:一项运用叙事法的回应性评估

Tensions experienced by student and care professionals in a learning and innovation network: a responsive evaluation using storytelling.

作者信息

Albers M Marjolein, Gobbens R J J Robbert, Reitsma M Margreet, Nies H L G R Henk, Timmermans O A A M J Olaf

机构信息

Faculty of Health, Sports and Social Work, Inholland University of Apllied Sciences, De Boelelaan 1109 1081, HV, Amsterdam, the Netherlands.

Department of Organization Sciences, Faculty Social Sciences, Vrije Universiteit, De Boelelaan 1105 1081, HV, Amsterdam, the Netherlands.

出版信息

Int J Nurs Stud Adv. 2025 May 29;9:100360. doi: 10.1016/j.ijnsa.2025.100360. eCollection 2025 Dec.

Abstract

BACKGROUND

Learning and innovation networks are collaborative initiatives between educational and healthcare institutions aimed at integrating the learning of students and care professionals and improving the quality of care through shared practices.

AIM

This study aims to explore how care professionals and students experience learning and working within a learning and innovation network.

METHODS

Using a responsive evaluation, we collected data in four iterative phases: (1) interviews with four students and two care professionals to identify themes; (2) development of four fictional stories illustrating tensions based on interview data and practical experience; (3) focus groups with students and care professionals to validate and refine the stories; and (4) a mixed stakeholder group discussion to reflect and start to formulate improvement actions. Thematic analysis was used across all phases.

RESULTS

Participants experienced various tensions, and one of the primary challenges for both students and care professionals was to balance the time allocated between learning activities, care provision and innovation projects. Students faced role ambiguity when performing unsupervised care tasks, feeling part of the team but also vulnerable in their learner status. Care professionals struggled with time constraints and competing demands between patient care and student supervision, which sometimes led to them withdrawing from guiding students. Another tension emerged around engaging in quality improvement. While participants recognized the importance of improving care, engaging in this progress was hindered by a lack of shared understanding of optimal rehabilitation practices and unclear responsibilities regarding implementing innovation. The student-dense environment, though rich in learning potential, heightened these tensions due to differing expectations and unclear roles.

CONCLUSION

Although learning and innovation networks offer valuable opportunities for mutual learning and improving care, they also introduce tensions that need to be acknowledged and addressed. Managing these tensions, especially around time division, role clarity and a shared vision for improving care, is essential for creating sustainable learning and innovation climates in practice.

摘要

背景

学习与创新网络是教育机构和医疗机构之间的合作项目,旨在整合学生和护理专业人员的学习,并通过共享实践提高护理质量。

目的

本研究旨在探讨护理专业人员和学生在学习与创新网络中的学习和工作体验。

方法

我们采用响应式评估,分四个迭代阶段收集数据:(1)对四名学生和两名护理专业人员进行访谈以确定主题;(2)根据访谈数据和实践经验编写四个说明紧张关系的虚构故事;(3)与学生和护理专业人员进行焦点小组讨论以验证和完善这些故事;(4)进行一次混合利益相关者小组讨论以反思并开始制定改进措施。所有阶段均采用主题分析法。

结果

参与者经历了各种紧张关系,学生和护理专业人员面临的主要挑战之一是平衡学习活动、护理提供和创新项目之间的时间分配。学生在执行无人监督的护理任务时面临角色模糊的问题,感觉自己是团队的一员,但作为学习者又很脆弱。护理专业人员在时间限制以及患者护理和学生监督之间的相互竞争需求方面苦苦挣扎,这有时导致他们不再指导学生。在参与质量改进方面出现了另一种紧张关系。虽然参与者认识到改善护理的重要性,但由于对最佳康复实践缺乏共同理解以及在实施创新方面责任不明确,参与这一过程受到了阻碍。学生密集的环境虽然具有丰富的学习潜力,但由于期望不同和角色不明确,加剧了这些紧张关系。

结论

尽管学习与创新网络为相互学习和改善护理提供了宝贵机会,但它们也带来了需要认识和解决的紧张关系。管理这些紧张关系,尤其是在时间分配、角色明确和改善护理的共同愿景方面,对于在实践中营造可持续的学习和创新氛围至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c7/12173126/fb86330c5949/gr1.jpg

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