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  • 1. Barman, Linda
    et al.
    Silén, Charlotte
    Bolander Laksov, Klara
    Karolinska Institutet, Sweden.
    Outcome based education enacted: teachers' tensions in balancing between student learning and bureaucracy2014In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 19, no 5, p. 629-643Article in journal (Refereed)
    Abstract [en]

    This paper reports on how teachers within health sciences education translate outcome-based education (OBE) into practice when they design courses. The study is an empirical contribution to the debate about outcome- and competency-based approaches in health sciences education. A qualitative method was used to study how teachers from 14 different study programmes designed courses before and after OBE was implemented. Using an interpretative approach, analysis of documents and interviews was carried out. The findings show that teachers enacted OBE either to design for more competency-oriented teaching-learning, or to further detail knowledge and thus move towards reductionism. Teachers mainly understood the outcome-based framework as useful to support students' learning, although the demand for accountability created tension and became a bureaucratic hindrance to design for development of professional competence. The paper shows variations of how teachers enacted the same outcome-based framework for instructional design. These differences can add a richer understanding of how outcome- or competency-based approaches relate to teaching-learning at a course level.

  • 2.
    Bolander, Klara
    et al.
    Karolinska Institutet.
    Josephson, Anna
    Mann, Sarah
    Lonka, Kirsti
    Teachers promoting expertise in medical education: Understanding the role of the core curriculum2006In: Quality in Higher Education, ISSN 1353-8322, E-ISSN 1470-1081, Vol. 12, no 1, p. 41-55Article in journal (Refereed)
  • 3.
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education.
    Academic feedback practice - a scholarly approach2018Conference paper (Other academic)
    Abstract [en]

    Feedback is at the centre of academic practice and ever present in our daily work as academics. We give feedback on student work at different levels; on PhD students at their defense of their thesis; of colleagues submitting manuscripts to journals or applications for funding; in the process of employing new academics. However, what we do when we engage in feedback, and how we do it is seldom problematized in public. It is expected of us that we as academic professionals know how to do it, how much, how explicit and what to focus on. Sometimes we have clear criteria for what to put our emphasis on, but often this is never made explicit. In the talk I aim to discuss academic feedback and draw on research on feedback in higher education to present a possible way of approaching feedback from a scholarly perspective.

  • 4.
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sverige.
    Att bedöma pedagogisk skicklighet – är det verkligen så svårt? – en studie av skillnader i bedömningar mellan vetenskapligt och pedagogiskt sakkunniga2018In: Högre Utbildning, ISSN 2000-7558, E-ISSN 2000-7558, Vol. 8, no 2, p. 55-68Article in journal (Refereed)
    Abstract [sv]

    Pedagogisk skicklighet ska enligt högskoleförordningen ägnas lika stor omsorg som vetenskaplig skicklighet i anställningsförfaranden vid svenska högskolor och universitet. Vilka förutsättningar som finns att visa omsorg om pedagogisk skicklighet och ägna den uppmärksamhet ter sig dock tämligen olika vid lärosätena. I denna fallstudie undersöks skillnader i de sätt på vilket pedagogisk skicklighet kommer till uttryck i utlåtanden från särskilt tillsatta pedagogiskt sakkunniga och vetenskapligt sakkunniga i anställnings- och befordringsärenden vid en fakultet vid ett svenskt lärosäte. Studien visar på flera skillnaderi utlåtandena där de pedagogiskt sakkunniga gör mer omfattande, mer kvalitativa och mer systematiska utlåtanden än de vetenskapligt sakkunniga redovisar. Dessutom diskuteras några återkommande utmaningar som formuleras i sakkunnigutlåtandena, och hur dessa utmaningar hanteras.

  • 5.
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education.
    Educational ambassadorship: an approach to institutional change2018Conference paper (Refereed)
    Abstract [en]

    After the collapse of the previous academic development unit (ADU) at a large Swedish university, I was asked in 2015 to build up a new ADU. I inherited a generous budget and six academic developers. My goal was threefold: to build capacity to inspire and generate educational development; to establish communities of practice around teaching and learning at the departmental level; and to develop an institutional culture built on sharing and collaboration and in line with the scholarship of teaching and learning. In this presentation, I share what we did and the findings based on interviews with 24 participants.

  • 6.
    Bolander Laksov, Klara
    Karolinska Institutet.
    Learning across paradigms: towards an understanding of the development of medical teaching practice2007Book (Refereed)
  • 7.
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Lessons learned: towards a framework for integration of theory and practice in academic development2018In: International journal for academic development, ISSN 1360-144X, E-ISSN 1470-1324Article in journal (Refereed)
    Abstract [en]

    In this paper, I describe an approach to the integration of theory and practice at the intrapersonal, interpersonal, and organizational levels. The results of the research projects in which I have been involved over the last ten years are used to illustrate how these three levels have facilitated the identification of three tensions. These tensions together create a framework that can help academic developers better understand how to approach the challenges of advocating for the integration of higher education theory with academic practice in their own institutional environments, and how this integration is linked to existing higher education literature.

  • 8.
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education.
    Pedagogiska ambassadörer - förändringsagenter på hemmaplan2018Conference paper (Refereed)
    Abstract [sv]

    Bakgrund: Trots ökade krav på högskolepedagogisk utbildning, höjda röster från studentföreträdare och en kontinuerligt växande skara pedagogiska utvecklare är svårigheterna att etablera pedagogiska samtal på institutionsnivå påtagliga. Förekomsten av kontinuerliga pedagogiska samtal tillsammans med en delande kultur, en praxisgemenskap (Wenger, 1998), där undervisning ses som ett gemensamt ansvar som man delar med sig av – i med- och motgång – har i studier visat sig utgöra en knäckfråga för s k starka microkulturer (Roxå & Mårtensson, 2011).

    Denna studie har sin utgångspunkt i initiativet att etablera en modell med pedagogiska ambassadörskap vid Stockholms Universitet. Syftet med pedagogiska ambassadörskap var att skapa ett närmare samarbete mellan den pedagogiska utvecklingsenheten CeUL och institutionerna genom ett tydligt partnerskap (Bolander Laksov et al. 2008). Sedan 2015 har Centrum för universitetslärarutbildning, CeUL, årligen utlyst möjligheten för 8-10 institutioner att under ett år ha en pedagogisk ambassadör. Ambassadören arbetar på uppdrag av och med stöd från CeUL, med ett lokalt pedagogiskt utvecklingsprojekt och ska bidra till att skapa kontinuerliga pedagogiska samtal i den egna institutionsmiljön.

    24 intervjuer har genomförts med de 12 första pedagogiska ambassadörerna och prefekterna vid deras institutioner för att undersöka hur syftet hade uppfyllts. Genom tematiska innehållsanalyser sökte jag efter mönster i intervjumaterialet (Vaismoradi, Turunen & Bondas, 2013).

    De preliminära resultaten visar på flera överlappande teman. Exempel på faktorer som framkom som viktiga för de pedagogiska ambassadörskapen var fokus på pedagogiska frågor, syn på ledarskap och engagemang. Ett viktigt tema under processen var hur de pedagogiska ambassadörerna erhöll legitimitet i sitt pedagogiska ledarskap (Bolander Laksov & Tomson, 2017), där ambassadörer och prefekter tog olika roller. Resultaten av analysen kommer att presenteras vid konferensen.

    Denna studie ger värdefulla insikter i möjligheterna förknippade med pedagogiskt förändringsarbete på organisationsnivå genom pedagogiska ambassadörskap i nära anknytning till den högskolepedagogiska utvecklingsverksamheten.

  • 9.
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sverige.
    Samspelet mellan lärandemiljö och lärande2016In: Framtidens lärandemiljöer: Rapport från SUHF:s arbetsgrupp, Sveriges universitets- och högskoleförbund (SUHF) , 2016, p. 95-114Chapter in book (Other academic)
    Abstract [sv]

    Under det senaste decenniet har intresset för lärandemiljöns roll inom högre utbildning ökat. Värdet av lärandemiljön för kvaliteten på utbildning stöds av forskningsresultaten och det är allmänt erkänt att miljön utgör en viktig faktor för en effektiv utbildning och påverkar studenternas beteende och välbefinnande (Soemantriet al., 2010, Dent and Harden, 2013). Syftet med föreliggande kapitel är att tydliggöra om och på vilket sätt lärandemiljön har betydelse för lärandet, vad det finns för empiriskt underlag i dagsläget och vad detta samband kan tänkas bero på. Kapitlet inleds med ett avsnitt om tillgänglig evidens kring olika aspekter på lärandemiljön, den fysiska, IT-miljöer och lärplattformar, och hur detta länkar till utbildningsklimat eller kultur. Därefter följer ett avsnitt om de underliggande tankesystem som präglar lärandemiljön. Kapitlet avslutas med en diskussion om utmaningar och möjligheter baserat på ovanstående, för både studenter och lärare samt några rekommendationer som resultat av resonemanget.

  • 10.
    Bolander Laksov, Klara
    Karolinska Institutet.
    Strategic educational development2008In: Higher Education Research and Development, ISSN 0729-4360, E-ISSN 1469-8366Article in journal (Other academic)
  • 11.
    Bolander Laksov, Klara
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Education.
    Björck, Erik
    Från engagerad individ till fungerande systemperspektiv på pedagogisk utveckling i klinisk utbildningsmiljö2018Conference paper (Refereed)
    Abstract [sv]

    Detta 10-åriga forskningsprojekt har titeln ’Från engagerad individ till fungerande systemperspektiv’. Projektet, som påbörjades 2010 tar sin utgångspunkt i problemet med att det trots att det återkommande tas goda initiativ till att förändra och utveckla den pedagogiska miljön, i detta fall inom den kliniska utbildningen, tycks vara svårt att etablera pedagogisk utveckling som är hållbar över tid. Syftet med projektet är att undersöka både hur studenter interagerar med utbildningsmiljön för att lära, och vilka förutsättningar som finns för lärares möjligheter att bedriva pedagogisk utveckling i sådan miljö, samt pröva en modell för pedagogisk utveckling och undersöka vad resultatet av detta blev. Vi har i projektet sökt oss till systemteori (Senge, Engeström, Billet) som ett sätt att bättre fö rstå den komplexa miljö som den kliniska utbildningsmiljön ugör. Olika teoretiska perspektiv har guidat olika stadier i projektet. Den övergripande forskningsfrågan bottnar i Peter Senges arbete och idén om den lärande organisationen (2006). Genom att förstå den kliniska utbildningsmiljön som en lärande organisation, som ett intrikat system där olika delar interagerar och skapar förutsättningar för lärande, hoppades vi kunna belysa skillnader mellan olika kliniska utbildningsmiljöer i en jämförande fallstudie. I utforskandet av studenters lärande i den kliniska utbildningsmiljön har Stephen Billets (2001; 2004; 2008) arbete, med lärande som ett resultat av relationen mellan praktikens/ arbetsplatsens erbjudande i fråga om deltagande och individens engagemang, utgjort en viktig utgångspunkt i studierna för att bättre förstå sjuksköterske- och läkarstudenters interaktion och lärande med den kliniska utbildningsmiljön. Vad gäller förutsättningarna för kliniska lärare att arbeta med pedagogiskt förändringsarbete i den kliniska miljön vände vi oss till Yrjö Engeströms arbete (1999; 2010; 2011). Engeströms syn på mänsklig aktivitet som sammanhängande i ett aktivitetssystem som påverkar varandra fungerar som utgångspunkt för en serie studier där vi undersöker lärares drivkrafter till att ägna sig åt pedagogiskt förändringsarbete och förutsättningarna för att bedriva utvecklingsprocesser samt dess resultat. De metodologiska utgångspunkterna för projektet har bottnat i ett sociokonstruktivistiskt perspektiv, och utgår från ett flertal olika sätt att samla data för att fokusera på olika aspekter i den kliniska utbildningsmiljön och de ledare, lärare och studenter som verkar i den. Det är dock huvudsakligen intervjuer, både individuella intervjuer (27) och fokusgruppintervjuer (6), men också ett stort antal observationer (200h), som utgjort underlag för våra studier. Resultaten av projektet som helhet visar på flera centrala aspekter för möjligheterna till lärande i den kliniska utbildningsmiljön. Studiernas visar att engagemanget och utgångspunkterna hos de individer, både studenter, kliniker som lärare, och ledare, som deltar i miljön är mycket centralt (Elmberger et al., inskickad). I våra studier identifierade vi system

    för den kliniska utbildningsmiljön som har sin utgångspunkt i väldigt olika organisationsrationaliteter (Laksov et al, 2015). Dessa olikheter kunde ibland upplevas av studenter som motsägelsefulla (Liljedahl et al, 2015). Den kliniska utbildningsmiljön är komplex, men genom att lärare och pedagogiska ledare tar ett perspektiv på studenter som deltagare snarare än konsumenter, finns möjlighet att underlätta för studenters insocialisering i både sin profession, och i vad det innebär att vara student i den kliniska miljö n (Liljedahl et al 2016; 2017). Som deltagare lär sig studenterna att förhålla sig till de normer, värderingar och praktiker som förekommer i de olika miljöerna. Genom deltagandet i den kliniska miljön får de också möjlighet att lära sig vikten av att balansera mellan att anpassa sig, och att vara flexibel, och därmed utveckla sin professionella identitet (Liljedahl et al 2016; 2017). Förhållanden som framstår som särskilt utmanande i den kliniska utbildningsmiljön är de spä nningar som olika aktivitetssystem skapar i relation till utbildningsverksamheten och man kan ifrågasätta om och på vilket sätt olika aktörer som är involverade i högre utbildning tar ett sådant helhetsperspektiv, och om detta är möjligt? Seminariet läggs upp som en introduktion (15min) följt av en diskussion med utgångspunkt i följande frågor: Vilka styrkor och svagheter finns i ett systemperspektiv på pedagogisk utveckling? Med bas i vår och andras forskning, vad innebär hållbarhet i utvecklingen av pedagogisk verksamhet? Hur ser möjliga modeller ut för att implementera högskolepedagogisk forskning i olika utbildningsmiljöer?  Vilken bäring har våra resultat i andra utbildningsmiljöer?

  • 12.
    Bolander Laksov, Klara
    et al.
    Karolinska Institutet, Sweden.
    Boman, Lena
    Silén, Charlotte
    Implementation of Scholarship of Teaching and Learning through an On-Line Masters Program2013In: Cases on Professional Distance Education Degree Programs and Practices: Successes, Challenges, and Issues / [ed] Kirk P. H. Sullivan, Peter E. Czigler, Jenny M. Sullivan Hellgren, IGI Global, 2013, p. 258-295Chapter in book (Refereed)
    Abstract [en]

    In this case, the introductory course in an international masters program in medical education (MMedEd) called “Scholarship of Medical Education” is described. Some of the background to why the MMedEd was started and the underlying ideas and principles of the program are provided. The individual course, which consists of 10 weeks part time study on-line with an introductory face to face meeting, is described in terms of the intentions and pedagogical principles underlying the design, the teaching and learning activities, and how the students were supported to achieve the intended learning activities, as well as the challenges and concerns that arose throughout and after the course. Finally, some solutions to these problems are discussed.

  • 13.
    Bolander Laksov, Klara
    et al.
    Karolinska Institutet, Sweden.
    Engqvist Boman, Lena
    Liljedahl, Matilda
    Björck, Erik
    Identifying keys to success in clinical learning: a study of two interprofessional learning environments2015In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 29, no 2, p. 156-158Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to study the intrinsic system behind interprofessional clinical learning environments. Two health care units were selected on the basis of having received a reward for best clinical learning organization. Interviews were carried out with health care staff/clinical supervisors from different professions. The interviews were transcribed and analysed according to qualitative content analysis, and categories and themes were identified. Analysis revealed two different systems of clinical learning environments. In one, the interplay between the structural aspects dominated, and in the other, the interplay between the cultural aspects dominated. An important similarity between the environments was that a defined role for students in the organization and interprofessional teamwork around supervision across professional borders was emphasized.

  • 14.
    Bolander Laksov, Klara
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Education.
    Liljedahl, Matilda
    Elmberger, Agnes
    Björck, Erik
    Developing clinical education based on medical education research - findings from a faculty development program2018In: Amee 2018: Educating the Future Healthcare Professional and the Roles of the Teacher: Abstract Book, 2018, p. 52-52Conference paper (Refereed)
    Abstract [en]

    Background

    Students in health and medical education spend a great deal of their education in clinical learning environments. There is today a growing knowledge of how learning in the clinical education environment can be facilitated, as well as about existing barriers to the implementation of these skills. By studying how clinical teachers engaged in educational development work, we wanted to better understand the conditions and systems required for successful implementation. This project aimed at examining the conditions for the successful use of medical-educational research results to stimulate learning in clinical education. 

    Summary of work

    Based on knowledge generated from educational research, a faculty development program was designed to enable five teams of clinical teachers from three university hospitals to participate in a faculty development program aiming to develop, implement and evaluate an educational 'tool' together. The five teams that participated in the program were interviewed in focus groups at the start and end of the program. Observational and document data were collected throughout the process.

    Summary of results

    All teams managed to develop a tool aimed at students or clinical teachers, implement and evaluate it. The faculty development program and its structure as a year-long scaffolding of driving and legitimising change processes in the clinical environment was acknowledged as facilitating the implementation of the educational tools. One year after the end of the program, four of the five teams had presented their work at medical education conferences, three teams are currently working to publish their work.

    Discussion & Conclusion

    The design of the program around building capacity for change together with workshops focusing different aspects of Mayer and Stensaker's Change process prescriptors was identified as a successful framework for successful implementation and use of medical education research in the clinical education environment.

    Take-home message

    The invitation of teams to faculty development program, together with a design building on scaffolding educational change and leadership enabled participants to translate medical education research into their clinical teaching practice.

  • 15.
    Bolander Laksov, Klara
    et al.
    Karolinska Institutet.
    Lonka, Kirsti
    Karolinska Institutet.
    Josephson, Anna
    Karolinska Institutet.
    How do medical teachers address the problem of transfer?2008In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 13, no 3, p. 345-60Article in journal (Refereed)
    Abstract [en]

    Clinical teachers often complain that medical students have forgotten or somehow "lost" knowledge that has been taught at pre-clinical levels at the time of entering the clinical part of education. The purpose of this qualitative study was to explore, whether transfer of knowledge was identified as a problem by the teaching staff of anatomy and surgery, and if so, what strategies they used to overcome it. Semi-structured interviews were conducted with ten medical teachers in anatomy and surgery. Most teachers recognised that there was a problem of transfer and some individuals had adopted strategies to address this. However, there was no formal educational strategy suggested to overcome the problem of transfer. The conclusion is that transfer needs to be addressed both by basic science teachers and clinical teachers. There is a need for a mutual educational discourse of the contexts students will face.

  • 16.
    Bolander Laksov, Klara
    et al.
    Karolinska Institutet.
    Mann, Sarah
    Dahlgren, Lars Owe
    Developing a community of practice around teaching: a case study2008In: Higher Education Research and Development, ISSN 0729-4360, E-ISSN 1469-8366, Vol. 27, no 2, p. 121-132Article in journal (Refereed)
  • 17.
    Bolander Laksov, Klara
    et al.
    Karolinska Institutet, Sweden; Centre for Medical Education, Sweden.
    McGrath, Cormac
    Karolinska Institutet, Sweden.
    Josephson, Anna
    Karolinska Institutet, Sweden.
    Let’s talk about integration: a study of students’ understandings of integration2014In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 19, no 5, p. 1709-1720Article in journal (Refereed)
    Abstract [en]

    Today, the knowledge concerning clinical reasoning is advanced enough to translate into curriculum interventions such as an integrated curriculum, in which science theory and clinical practice can be interwoven effectively. However, the interpretations of what integration means differ and the purpose of this study was to elicit how students understand integration. This study was carried out using an interpretative perspective. Medical students, in their 2nd year of study, were asked to apply basic science knowledge from all previous courses to clinical cases in an examination. Subsequent to the examination, focus group interviews were conducted. The interviews were audio recorded, transcribed and analysed by the use of qualitative content analysis. The analysis revealed how students comprehended integration: as the creation of wholeness, as relating new knowledge to core concepts, as reasoning, as application and as collaboration between teachers. The five categories were linked to three dimensions: intra-personal, inter-personal and organizational, each of which resonates with different theories of how expertise is developed. The outcome of this study adds to our understanding of how students conceptualize integration. The categories of 'integration' drawn out by the study are helpful in promoting further discussion of how eliciting students' own reports of cognition and may help the ongoing design of curricula by putting students at the center of the curriculum design process.

  • 18.
    Bolander Laksov, Klara
    et al.
    Karolinska Institutet, Sweden.
    Tomson, Tanja
    Karolinska Institutet, Sweden.
    Becoming an educational leader – exploring leadership in medical education2017In: International Journal of Leadership in Education, ISSN 1360-3124, E-ISSN 1464-5092, Vol. 20, no 4, p. 506-516Article in journal (Refereed)
    Abstract [en]

    Research on educational leadership emphasizes the importance of having institutional leaders heavily involved with advanced instructional programming. Best practices for developing educational leadership in higher education health care and medical faculties have to be better understood. Within the framework of a seminar series, researchers and practitioners were involved in a dialogical process of inquiry, coupled with an explicit activity-oriented approach emphasizing empowerment among educational leaders. In a reflective paper, 10 participants of the seminar series elaborated on what it meant to develop and to ‘take’ leadership in your professional role and which factors that were identified as adding value to the development of professional leadership expertise. Qualitative content analysis was conducted resulting in thirteen categories reported in relation to Wenger’s theory of communities of practice. The findings show that educational leadership involves processes on the levels of students, teachers as community and at the organizational level. The individuals created a place for backstage conversations at which they got opportunity to develop their thinking and inspiration to break new ideas into their own educational communities. In addition, a systemic approach is essential for the effective implementation of educational leadership to reach all levels via interaction and communication across an organization.

  • 19. Elmberger, Agnes
    et al.
    Björck, Erik
    Liljedahl, Matilda
    Nieminen, Juha
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Contradictions in clinical teachers' engagement in educational development: an activity theory analysis2019In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 24, no 1, p. 125-140Article in journal (Refereed)
    Abstract [en]

    Many medical universities offer educational development activities to support clinical teachers in their teaching role. Research has focused on the scope and effectiveness of such activities and on why individual teachers attend. However, systemic perspectives that go beyond a focus on individual participants are scarce in the existing literature. Employing activity theory, we explored how clinical teachers' engagement in educational development was affected by the systems they act within. Three focus groups were held with clinical teachers from different professions. A thematic analysis was used to map the contradictions between the systems that the participants were part of and the manifestations of these contradictions in the system of education. In our model, clinical teachers were part of three activity systems directed by the objects of patient care, research and education respectively. Contradictions arose between these systems as their objects were not aligned. This manifested through the enacted values of the academic hospital, difficulties establishing educational discussions in the clinical workplace, the transient nature of educational employments, and impediments to developing a teacher identity. These findings offer insights into the complexities of engaging in educational development as clinical teachers' priorities interact with the practices and values of the academic hospital, suggesting that attention needs to shift from individual teachers to developing the systems in which they work.

  • 20. Elmberger, Agnes
    et al.
    Björck, Erik
    Liljedahl, Matilda
    Nieminen, Juha
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education.
    From faculty development program to educational change in the clinical workplace: exploring the transfer of educational innovations through activity theory2018In: Amee 2018: Educating the Future Healthcare Professional and the Roles of the Teacher: Abstract Book, 2018, p. 51-51Conference paper (Refereed)
    Abstract [en]

    Background

    Faculty development programs (FD) are aiming to advance the teaching practice in health professions education (HPE) by equipping teachers with knowledge and skills as professional educators. Research on faculty development has focused on scope and effectiveness of FD, however, little is regarding how knowledge learned in FD is transformed into the workplace and how change may happen as a result of FD. Drawing on activity theory and its notion of individual action as closely connected to context, we sought to explore the transfer of educational innovations into the clinical workplace . 

    Summary of work

    Five interprofessional teams of clinical teachers attended a one-year FDP where they created and transferred educational innovations to their workplaces. The participants were interviewed in 3 focus groups at the end of the program, and analyzed thematically. The findings were discussed in relation to activity theory.

    Summary of results

    Transfer of the educational innovation was characterized by three interacting and iterative processes: the educational innovation itself 1) the innovation process, including time and support during development as well as the development of the aim of the innovation; 2) the clinical workplace process, including interactions with the workplace, acquiring mandate to change, communication and negotiation; 3) team process, including team development, collective action and adopting new roles.

    Discussion and Conclusions

    Understanding change and pedagogical knowledge transfer is central in developing and sustaining educational scholarship and high quality teaching in HPE. This study suggest that transfer of educational innovations created in a FDP comprise multiple interacting processes taking place in two activity systems, the workplace and the team. Contradictions arise between these systems as they have partly differing objects.

    Take-home Messages

    As transfer between faculty development and teaching practices seem to be a case of interlinked processes in multiple social systems, faculty development should support participants in navigating this transfer and consider the workplace as an active part in the process.

  • 21. Johannsen, A.
    et al.
    Bolander Laksov, Klara
    Karolinska Institutet, Sweden.
    Bjurshammar, N.
    Nordgren, B.
    Fridén, C.
    Hagströmer, M.
    Enhancing meaningful learning and self-efficacy through collaboration between dental hygienist and physiotherapist students - a scholarship project2012In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 10, no 4, p. 270-276Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Within the field of Dental Hygiene (DH) and Physiotherapy (PT), students are taught to use an evidence-based approach. Educators need to consider the nature of evidence-based practice from the perspective of content knowledge and learning strategies. Such effort to seek best available evidence and to apply a systematic and scholarly approach to teaching and learning is called scholarship of teaching and learning.

    OBJECTIVES: To evaluate the application of the scholarship model including an evidence-based approach to enhance meaningful learning and self-efficacy among DH and PT students.

    METHODS: Based on the research on student learning, three central theories were identified (constructivism, meaningful learning and self-efficacy). These were applied in our context to support learner engagement and the application of prior knowledge in a new situation. The DH students performed an oral health examination on the PT students, and the PT students performed an individual health test on the DH students; both groups used motivational interviewing. Documentation of student's learning experience was carried out through seminars and questionnaires.

    RESULTS: The students were overall satisfied with the learning experience. Most appreciated are that it reflected a 'real' professional situation and that it also reinforced important learning from their seminars.

    CONCLUSION: The scholarship model made the teachers aware of the importance of evidence-based teaching. Furthermore, the indicators for meaningful learning and increased self-efficacy were high, and the students became more engaged by practising in a real situation, more aware of other health professions and reflected about tacit knowledge.

  • 22.
    Laksov, Klara Bolander
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Dornan, Tim
    Teunissen, Pim W.
    Making theory explicit - An analysis of how medical education research(ers) describe how they connect to theory2017In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, article id 18Article in journal (Refereed)
    Abstract [en]

    Background: As medical education develops into a varied and well-developed field of research, the issue of quality research anchored in or generating theory has gained increasing importance. Medical education researchers have been criticized of not connecting their work to relevant theory. This paper set out to analyse how researchers can connect to theory in medical education. The goal of this paper is to provide an accessible framework for those entering medical education research, regarding how theory may become an integral part of one's work. Methods: Fifteen purposefully selected researchers in medical education were asked to nominate papers they considered influential in medical education. Through this process 41 papers were identified and included in the study. Results: The papers were analysed with thematic content analysis, which resulted in three approaches to the use of theory: as close-up exploration; as a specific perspective; and as an overview. The approaches are exemplified by quotes from the papers included in our dataset and further illuminated by a metaphoric story. Conclusions: We conclude by pointing at the importance of making explicit how theory is used in medical education as a way to collaboratively take responsibility for the quality of medical education research.

  • 23. Liljedahl, Matilda
    et al.
    Bjorck, Erik
    Ponzer, Sari
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Navigating without a map: how medical students interact with clinical learning environments2019In: Studies in Higher Education, ISSN 0307-5079, E-ISSN 1470-174X, Vol. 44, no 2, p. 275-286Article in journal (Refereed)
    Abstract [en]

    Through an exploration of the interdependence between workplace affordances and individual engagement, this study addressed how medical students interact with clinical learning environments (CLEs). Building on the workplace participatory practices approach outlined by Billett, CLEs can be viewed as constructed through a negotiation of meaning between the workplace and the student. Inspired by ethnography, an observational study using field observations and follow-up interviews was performed. Workplace affordances included being given a marginal status in the healthcare team which students adapted to through striving to fit into the workplace. Further, there were many potential activities available to students; however, students seemed selective in terms of what activities they elected to engage in. As such, interacting with CLEs entailed students navigating complexity without the immediate access to any explicit 'map' of workplace learning. This study indicates that workplaces increasingly need to invite and include students in the practice of workplaces.

  • 24. Liljedahl, Matilda
    et al.
    Björck, Erik
    Kalén, Susanne
    Ponzer, Sari
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    To belong or not to belong: nursing students' interactions with clinical learning environments - an observational study2016In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, article id 197Article in journal (Refereed)
    Abstract [en]

    Background: Belongingness has been argued to be a prerequisite for students' learning in the clinical setting but making students feel like they belong to the workplace is a challenge. From a sociocultural perspective, workplace participatory practices is a framework that views clinical learning environments to be created in interaction between students and the workplace and hence, are dependent on them both. The aim of this study was to explore the interdependence between affordances and engagement in clinical learning environments. The research question was: How are nursing students influenced in their interactions with clinical learning environments? Methods: An observational study with field observations and follow-up interviews was performed. The study setting comprised three academic teaching hospitals. Field observations included shadowing undergraduate nursing students during entire shifts. Fifty-five hours of field observations and ten follow-up interviews with students, supervisors and clinical managers formed the study data. A thematic approach to the analysis was taken and performed iteratively with the data collection. Results: The results revealed that students strived to fill out the role they were offered in an aspirational way but that they became overwhelmed when given the responsibility of care. When students' basic values did not align with those enacted by the workplace, they were not willing to compromise their own values. Workplaces succeeded in inviting students into the community of nurses and the practice of care. Students demonstrated hesitance regarding their desire to belong to the workplace community. Conclusion: The results imply that the challenge for clinical education is not to increase the experience of belongingness but to maintain students' critical and reflective approach to health care practice. Additionally, results suggest students to be included as an important stakeholder in creating clinical learning environments rather than being viewed as consumer of clinical education.

  • 25. Liljedahl, Matilda
    et al.
    Engqvist Boman, Lena
    Porthén Fält, Charlotte
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    What students really learn: contrasting medical and nursing students' experiences of the clinical learning environment2015In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 20, no 3, p. 765-779Article in journal (Refereed)
    Abstract [en]

    This paper explores and contrasts undergraduate medical and nursing students' experiences of the clinical learning environment. Using a sociocultural perspective of learning and an interpretative approach, 15 in-depth interviews with medical and nursing students were analysed with content analysis. Students' experiences are described using a framework of 'before', 'during' and 'after' clinical placements. Three major themes emerged from the analysis, contrasting the medical and nursing students' experiences of the clinical learning environment: (1) expectations of the placement; (2) relationship with the supervisor; and (3) focus of learning. The findings offer an increased understanding of how medical and nursing students learn in the clinical setting; they also show that the clinical learning environment contributes to the socialisation process of students not only into their future profession, but also into their role as learners. Differences between the two professions should be taken into consideration when designing interprofessional learning activities. Also, the findings can be used as a tool for clinical supervisors in the reflection on how student learning in the clinical learning environment can be improved.

  • 26. Mattsson, Jane
    et al.
    Forsner, Maria
    Bolander Laksov, Klara
    Karolinska Institutet, Sweden.
    Facilitation of learning in specialist nursing training in the PICU: The supervisors’ concerns in the learning situation2014In: Journal of Nursing Education and Practice, ISSN 1925-4040, Vol. 4, no 12Article in journal (Refereed)
    Abstract [en]

    With the aim to unfold nurses’ concerns of the supervision of the student in the clinical caring situation of the vulnerable child, clinical nurses situated supervision of postgraduate nursing students in the Pediatric Intensive Care Unit (PICU) are explored. A qualitative approach, interpretive phenomenology, with participant observations and narrative interviews, was used. Two qualitative variations of patterns of meaning for the nurses’ clinical facilitation were disclosed in this study. Learning by doing theme supports the students learning by doing through performing skills and embracing routines. The reflecting theme supports thinking and awareness of the situation. As the supervisor often serves as a role model for the student this might have an immediate impact on how the student applies nursing care in the beginning of his or her career. If the clinical supervisor narrows the perspective and hinders room for learning the student will bring less knowledge from the clinical education than expected, which might result in reduced nursing quality.

  • 27.
    McGrath, Cormac
    et al.
    Karolinska Institutet, Sweden.
    Barman, Linda
    Stenfors-Hayes, Terese
    Roxå, Torgny
    Silén, Charlotte
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    The Ebb and Flow of Educational Change: Change Agents as Negotiators of Change2016In: Teaching and Learning Inquiry, ISSN 2167-4779, E-ISSN 2167-4787, Vol. 4, no 2Article in journal (Refereed)
    Abstract [en]

    In this paper, we are concerned with how change agents go about and experience change implementation in higher education. We identified change agents and interviewed them about how they implement change. Empirical data was analysed using a theoretical framework of change. The findings suggest that change in the university is enacted through a process of negotiation. The findings of this study may offer academic developers, pedagogical leaders, and change agents insight into the complex nature of the change process and inform change agents as to the complex nature and importance of their role.

  • 28.
    McGrath, Cormac
    et al.
    Karolinska Institutet, Sweden.
    Bolander Laksov, Klara
    Karolinska Institutet, Sweden.
    Laying bare educational crosstalk: a study of discursive repertoires in the wake of educational reform2014In: International journal for academic development, ISSN 1360-144X, E-ISSN 1470-1324, Vol. 19, no 2, p. 139-149Article in journal (Refereed)
    Abstract [en]

    In the wake of the Bologna process, many European universities are undergoing comprehensive educational reform. Our attention in this paper is focused on how a medical university came to terms with the challenges presented therein. We wished to explore how educators identify, understand and deal with opportunities for change at a medical university. To accomplish this, we devised meetings between the respondents and colleagues at the university and examined the reported results of these meetings. Our results suggest that there may be substantial educational crosstalk taking place, whereby people are experiencing a communicative mismatch in terms of negotiating the meaning of change initiatives. This can act as a hindrance for implementation of educational reforms. We acknowledge that educational developers and people in leadership need to consider different ways of creating opportunities for peer review and dialogue around educational issues in order to fully embrace opportunities for change.

  • 29.
    McGrath, Cormac
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Roxå, Torgny
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Change in a culture of collegiality and consensus-seeking: a double-edged sword2019In: Article in journal (Refereed)
    Abstract [en]

    The study aims to move beyond idealised and predominantly trait-based typologies of leadership and leadership roles and addresses collegial leaders' practice of change in higher education. Collegial leaders at two research-intensive higher education institutions, who had received educational leadership training, were studied. In the study, we explored ordinary actions and change practices as a way of understanding emerging practices among collegial leaders. Five categories were identified that show how collegial leaders experience change, process change and organise the practice of change. The article also contributes a critical discussion on the notions of collegiality in a consensus-seeking context, which may be relevant for academic developers, policy makers, and researchers alike.

  • 30.
    McGrath, Cormac
    et al.
    Karolinska Institutet, Sweden.
    Stenfors-Hayes, Terese
    Roxå, Torgny
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Exploring dimensions of change: the case of MOOC conceptions2017In: International journal for academic development, ISSN 1360-144X, E-ISSN 1470-1324, Vol. 22, no 3, p. 257-269Article in journal (Refereed)
    Abstract [en]

    This paper addresses a relatively new phenomenon in higher education, Massive Open Online Courses (MOOCs), and explores conceptions around this new and emerging development from the perspective of a number of stakeholders in the university. A phenomenographic approach is adopted. The study explores how different stakeholders at a university perceive the MOOC phenomenon, and reflects on how the many conceptions stakeholders adhere to are made meaningful for academic developers in their role as 'partners in arms'. The conceptions run across a continuum from the local and narrow to the global and broad. The study identifies challenges to change agency in a higher education institution.

  • 31. Palmgren, Per J.
    et al.
    Laksov, Klara Bolander
    Stockholm University, Faculty of Social Sciences, Department of Education.
    Exploring chiropractic students' experiences of the educational environment in healthcare professional training: a qualitative study2015In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, article id 128Article in journal (Refereed)
    Abstract [en]

    Background: The educational environment has a significant impact on students' behavior, sense of well-being, and academic advancement. While various research methodologies have been used to explore the educational environment, there is a paucity of studies employing qualitative research methods. This study engages in an in-depth exploration of chiropractic students' experiences of the meaning of the educational environment. Methods: A qualitative approach was employed by interviewing 26 students in four focus group interviews at two different points in time. A conventional manifest and latent content analysis was chosen to investigate and interpret the experiences of the educational environment in an undergraduate chiropractic training institution in Sweden. Results: The analysis resulted in five overarching themes: Personal growth; Being part of a community; A place of meaningfulness; Trust in a regulated system; and Scaffolding relationships. Early in the training, the meaning of the educational environment was experienced as part of a vocational community and the scaffolding of intra-institutional relationships. In later stages, the environment was experienced in terms of personal growth - balancing academic pressures and progress within the professional community - thus laying the foundations for autonomy and motivation. During the clinical training, the environment was experienced as where learning happens, thus creating a place of meaningfulness. Throughout the training, the formal and clinical environments were experienced as isolating, with little bridging between the two. A regulated system - conveying an operative organization with clear communication regarding what to expect - was experienced as important for an apt educational environment. Conclusions: We found that experiences of an educational environment are dynamic and change over time. When restructuring or evaluating curriculums, educational managers can consider the emerged themes as constituting facets relating to the educational environment, and thus possible learning conditions. Likewise, researchers can consider these aspects of the educational environment when: interpreting results from quantitative and qualitative inquiries, constructing and refining instruments, or conceptualizing and framing the educational environment phenomenon.

  • 32. Palmgren, Per J.
    et al.
    Sundberg, Tobias
    Bolander Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Reassessing the educational environment among undergraduate students in a chiropractic training institution: A study over time2015In: Journal of Chiropractic Education, ISSN 1042-5055, Vol. 29, no 2, p. 110-126Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was twofold: (1) to compare the perceived educational environment at 2 points in time and (2) to longitudinally examine potential changes in perceptions of the educational environment over time. Methods: The validated Dundee Ready Educational Environment Measure (DREEM), a 50-item, self-administered Likert-type inventory, was used in this prospective study. Employing convenience sampling, undergraduate chiropractic students were investigated at 2 points in time: 2009 (n = 124) and 2012 (n = 127). An analysis of 2 matching samples was performed on 27% (n = 34) of the respondents in 2009. Results: A total of 251 students (79%) completed the inventory, 83% (n = 124) in 2009 and 75% (n = 127) in 2012. The overall DREEM scores in both years were excellent: 156 (78%) and 153 (77%), respectively. The students' perceptions of teachers differed significantly between the 2 cohort years, decreasing from 77% to 73%. Three items received deprived scores: limited support for stressed students, authoritarian teachers, and an overemphasis on factual learning; the latter significantly decreased in 2012. In the longitudinal sample these items also displayed scores below the expected mean. Conclusion: Students viewed the educational environment as excellent both in 2009 and 2012. The perceptions of teachers declined with time; however, this could be attributed to teachers' new roles. Certain aspects of the educational environment factored prominently during the comparative points in time, as well as longitudinally, and these ought to be further investigated and addressed to provide an enhanced educational environment.

  • 33. Pettersson, Anna
    et al.
    Bolander Laksov, Klara
    Karolinska Institutet, Sweden.
    Fjellström, Mona
    Portfolio: Ett verktyg för lärande och synliggörande av kompetens2013In: Fysioterapi, ISSN 1653-5804, no 2, p. 32-37Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Begreppet portfolio kan ha olika innebörder och användas för olika syften. I vissa sammanhang innebär det en systematisk beskrivning av en persons samlade professionella kompetens. I andra sammanhang innebär det ett verktyg för lärande och utveckling. En sådan portfolio kan benämnas lärande portfolio eller pedagogisk portfolio. I den här kunskapsöversikten förklaras och diskuteras portfolio som verktyg för att främja lärande och synliggöra kompetens i en hälso- och sjukvårdskontext. En portfolio som används för lärande i en professionell kontext bygger på erfarenhetsbaserat lärande samt på principer om hur vuxna lär. Stor vikt läggs på reflektion kopplat till gjorda erfarenheter. Studier och utvärderingar har visat att portfolioanvändning främjar kopplingen mellan teori och praktik och att det också bidragit till ökad självkännedom och bättre självförtroende samt utvecklat användarens kapacitet att lära. Användarens tillgång till vägledning och stöd har stor betydelse för att portfolion ska kännas meningsfull och användbar.

  • 34. Silén, Charlotte
    et al.
    Bolander Laksov, KlaraKarolinska Institutet, Sweden.
    Att skapa pedagogiska möten i medicin och vård2013Collection (editor) (Other academic)
  • 35. Söderhjelm, Teresa
    et al.
    Björklund, Christina
    Sandahl, Christer
    Bolander-Laksov, Klara
    Stockholm University, Faculty of Social Sciences, Department of Education. Karolinska Institutet, Sweden.
    Academic leadership: management of groups or leadership of teams? A multiple-case study on designing and implementing a team-based development programme for academic leadership2018In: Studies in Higher Education, ISSN 0307-5079, E-ISSN 1470-174X, Vol. 43, no 2, p. 201-216Article in journal (Refereed)
    Abstract [en]

    Demands on academic leadership are increasing, which raises the need for leadership training. This article describes development and implementation of a group training intervention in academic leadership at a departmental level. Little systematic research has addressed the question of what forms of leadership training are associated with effectiveness of academic leadership teams. This study examined a comprehensive methodological approach including three different data collection methods. The content analysis of the intervention resulted in identification of vital components that are associated with team effectiveness. Here, the findings are considered in relation to the notion of functional role-taking, and their general implications are explored in relation to the possibility of systematically developing academic leadership.

  • 36. Wilhelmsson, Niklas
    et al.
    Bolander Laksov, Klara
    Karolinska Institutet, Sweden.
    Dahlgren, Lars O.
    Hult, Håkan
    Nilsson, Gunnar
    Ponzer, Sari
    Smedman, Lars
    Josephson, Anna
    Long-term understanding of basic science knowledge in senior medical students2013In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 4, p. 193-197Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this study is to explore the relation between basic science knowledge and the ability to understand and make use of basic science in explaining a clinical scenario in the final year of medical school.

    Methods: A sample of senior medical students was re-assessed using the same test they had taken 3 years earlier. This was followed by an in-depth interview on one of the topics taken from the test. Their respective level of knowledge was compared with their performance in the interview. The test was analysed according to the revised Bloom's Taxonomy, and the interviews carried out according to the phenomenographic approach.

    Results: Performance was around 60% (n=19) of the original performance, with no significant correlation between original test and re-test (r = 0.258, p = 0.29) and large interpersonal variation. A high performance in the original test did not predict a good performance; rather, the reverse seemed probable. None of the students who achieved high grades in the original test displayed a stable long term understanding that was measured in the interview. The test comprised questions of a generally low taxonomical level, but could not explain the mismatch between test-result and level of understanding.

    Conclusions: Findings suggest substantial loss of basic science knowledge during medical training. Attention should be directed to designing examinations that are purposeful, when it comes to what kind of knowledge is desirable in medical graduates as well as how that knowledge should be acquired. Further larger-scale research is needed to corroborate these findings.

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