Introduction: In light of reforms demanding increased transparency of student performance assessments, this study offers an in-depth perspective of how teachers develop their assessment practice. Much is known about factors that influence assessments, and different solutions claim to improve the validity and reliability of assessments of students' clinical competency. However, little is known about how teachers go about improving their assessment practices. This study aims to contribute empirical findings about how teachers' assessment practice may change when shared criteria for assessing students' clinical competency are developed and implemented.

Methods: Using a narrative-in-action research approach grounded in narrative theory about human sense-making, one group including nine health professions teachers was studied over a period of 1 year. Drawing upon data from observations, interviews, formal documents and written reflections from these teachers, we performed a narrative analysis to reveal how these teachers made sense of experiences associated with the development and implementation of joint grading criteria for assessing students' clinical performances.

Results: The findings present a narrative showing how a shared assessment practice took years to develop and was based on the teachers changed approach to scrutiny. The teachers became highly motivated to use grading criteria to ensure fairness in assessments, but more importantly, to fulfil their moral obligation towards patients. The narrative also demonstrates how these teachers reasoned about dilemmas that arose when they applied standardised assessment criteria.

Discussion: The narrative analysis shows clearly how teachers' development and application of assessment standards are embedded in local practices. Our findings highlight the importance of teachers' joint discussions on how to interpret criteria applied in formative and summative assessments of students' performances. In particular, teachers' different approaches to assessing ‘pieces of skills’ versus making holistic judgements on students' performances, regardless of whether the grading criteria are clear and well-articulated on paper, should be acknowledged. Understanding the journey that these teachers made gives new perspectives as to how faculty can be supported when assessments of professionalism and clinical competency are developed.

Large-scale open education initiatives, commonly referred to as MOOCs (Massive Open Online Courses), may be said to offer universities a new form of public outreach, whereby universities can take an active role in educating society and provide affordable pathways to lifelong learning for all. In this chapter, we examine how MOOC initiatives resonate with the notion of the responsible university from the perspective of Swedish higher education. Based on an analysis of notions of intent expressed by three Swedish universities, we reason about the roles that MOOC initiatives may play. Further, we adapt a framework on how public organisations negotiate bounded realities in order to juxtapose discourses that reflect different rationales for the MOOC initiatives at three Swedish universities. As a result, we identify a number of affordances that MOOCs potentially provide, such as access to lifelong learning from higher education institutions to diversified and unprivileged groups, but also how the universities intend to utilise MOOC projects for internal capacity-building related to the digitalisation of education. Currently, potentially conflicting rationalities arise between strong norms of tuition-free, state-funded education and the developing business models of the MOOC platform providers that illustrate a challenge for the Nordic model.

Objective The purpose of this article is to explore learners' perceptions of using virtual patients in a behavioral medicine Massive Open Online Course (MOOCs) and thereby describe innovative ways of disseminating knowledge in health-related areas. Methods A 5-week MOOC on behavioral medicine was hosted on the edX platform. The authors developed two branched virtual patients consisting of video recordings of a live standardized patient, with multiple clinical decision points and narration unfolding depending on learners' choices. Students interacted with the virtual patients to treat stress and sleep problems. Answers to the exit survey and participant comments from the discussion forum were analyzed qualitatively and quantitatively. Results In total, 19,236 participants enrolled in the MOOC, out of which 740 received the final certificate. The virtual patients were completed by 2317 and 1640 participants respectively. Among survey respondents (n = 442), 83.1% agreed that the virtual patient exercise was helpful. The qualitative analysis resulted in themes covering what it was like to work with the virtual patient, with subthemes on learner-centered education, emotions/eustress, game comparisons, what the participants learned, what surprised them, how confident participants felt about applying interventions in practice, suggestions for improvement, and previous experiences of virtual patients. Conclusions Students were enthusiastic about interacting with the virtual patients as a means to apply new knowledge about behavioral medicine interventions. The most common suggestion was to incorporate more interactive cases with various levels of complexity. Further research should include patient outcomes and focus on interprofessional aspects of learning with virtual patients in a MOOC.

Ethics is a prominent topic in learning analytics that has been commented on from conceptual viewpoints. For a broad range of emerging technologies, systematic literature reviews have proven fruitful by pinpointing research directions, knowledge gaps, and future research work guidance. With these outcomes in mind, we conducted a systematic literature review of the research on ethical issues that have been empirically approached in the learning analytics literature. In our final analysis, 21 articles published in the period 2014–2019 met our inclusion criteria. By analyzing this data, we seek to contribute to the field of learning analytics by 1) characterizing the type of empirical research that has been conducted on ethics in learning analytics in the context of higher education, 2) identifying the main ethical areas addressed in the selected literature, and 3) pinpointing knowledge gaps.

Ethical considerations and the values embedded in the design, development, deployment, and use of Learning Analytics (LA) systems have received considerable attention in recent years. Ethical frameworks, design guidelines, principles, checklists, and a code of practice have contributed a conceptual basis for focused discussions on ethics in LA. However, relatively little is known about how these different conceptual understandings of ethics work in practice and what specific tensions practitioners (e.g., administrators, developers, researchers, teachers, learners) experience when designing, deploying, or using LA with care.This half-day interactive workshop aims to provide participants with a space for information, dialogue, and collaboration around Responsible LA. The workshop will begin with a brief overview of Responsible LA. After that, the participants will present their cases drawing attention to the ethical considerations covered and not covered in LA practices. Following this, participants in groups will discuss the cases illustrating ethical tensions and create semantic categories to document such edge cases. The collected edge cases will be shared in a wiki or database. The workshop outcomes will help inform LA practitioners on ethical tensions thatneed to be discussed with care while highlighting places where more research work is required. 

The purpose of this chapter is to introduce learning analytics LA), exemplify how LA has currently been implemented in higher education, and discuss critically the ethical issues and concerns that arise when LA is introduced into HE.

The focus of ethics in learning analytics (LA) frameworks and guidelines is predominantly on procedural elements of data management and accountability. Another, less represented focus is on the duty to act and LA as a moral practice. Data feminism as a critical theoretical approach to data science practices may offer LA research and practitioners a valuable lens through which to consider LA as a moral practice. This paper examines what data feminism can offer the LA community. It identifies critical questions for further developing and enabling a responsible stance in LA research and practice taking one particular case — algorithmic decision-making — as a point of departure.

AI chatbots have recently fuelled debate regarding education practices in higher education institutions worldwide. Focusing on Generative AI and ChatGPT in particular, our study examines how AI chatbots impact university teachers' assessment practices, exploring teachers' perceptions about how ChatGPT performs in response to home examination prompts in undergraduate contexts. University teachers (n = 24) from four different departments in humanities and social sciences participated in Turing Test-inspired experiments, where they blindly assessed student and ChatGPT-written responses to home examination questions. Additionally, we conducted semi-structured interviews in focus groups with the same teachers examining their reflections about the quality of the texts they assessed. Regarding chatbot-generated texts, we found a passing rate range across the cohort (37.5 - 85.7%) and a chatbot-written suspicion range (14-23%). Regarding the student-written texts, we identified patterns of downgrading, suggesting that teachers were more critical when grading student-written texts. Drawing on post-phenomenology and mediation theory, we discuss AI chatbots as a potentially disruptive technology in higher education practices.

For some, entrepreneurs are inventors or champions of technology, whose new ideas transform the world in radical ways, and entrepreneurship education (EE) is a way of promoting and stimulating the qualities those individuals have. This view of entrepreneurship is one we have encountered many times in our teaching practice, where entrepreneurship is often synonymous with starting a business. For others, EE falls under a broader definition of entrepreneurship and does not necessarily focus on starting a new business but is an activity focused on creativity and the development of one’s own practice. This view resonates more with our own view of entrepreneurship and is in focus in this chapter, where we share how we endeavour to integrate a broad view of entrepreneurship and healthcare entrepreneuring in a course on service innovation within healthcare.

Threshold concepts (TCs) are increasingly used in health professions education (HPE) research. TCs are claimed to be conceptual gateways which are often traversed with substantial difficulty. In this paper, we report on a scoping review investigating the following research question: What is the scope and nature of the currently available research on threshold concepts in health professions education literature? We employed Arksey and O’Malley’s model for scoping reviews. A search for literature on TCs in HPE research between 2003 and 2020 yielded 999 records of which 59 were included in the review. The data set was subject to quantitative descriptive analysis of article characteristics as well as qualitative thematic analysis of the scope of research on TCs. Among the 59 articles selected for review, there were 30 empirical, 26 conceptual and three reviews. A majority were published in 2015 or later. Almost half of the included articles attempted to identify possible TCs within HPE. Others investigated how TCs can be traversed or suggested how TCs could influence curriculum design. Some critically appraised the framework of TC. Although TCs are increasingly utilised in HPE, the present review identified how researchers came across methodological challenges related to identifying possible TCs and definitional challenges around identifying the essential characteristics of TCs. Before embracing TCs as the next go-to theory for learning in HPE, we acknowledge the need for methodological stringeny and rigour as well as more data to support TCs. Until then, any implementation of TCs in HPE curricula should be done cautiously.

In recent decades, corporate social responsibility (CSR) as part of socially sustainable business organizations operations has become a common practice across developed and developing countries. The objective of this mini review is to reflect on the potential role that CSR might have on the health of stakeholders (employees and society in general). We suggest that there is an opportunity for business to become agents of change and contribute to improved population health. Therefore, public health researchers need to explore how business organizations can, through CSR impact population health currently and in years to come. This would occur through helping to address global challenges in the workplace and immediate local communities, but above all through identifying the role businesses play in contributing to sustainable development and sustainable population health/health promotion across entire societies regardless of their stage of economic development.

In recent years, there has been a revival of the term “structural violence (SV)” which was coined by Johan Galtung in the 1960s in the context of Peace Studies. “Structural violence” refers to social structures—economic, legal, political, religious, and cultural—that prevent individuals, groups and societies from reaching their full potential. In the European context, very few studies have investigated health and well-being using an SV perspective. Therefore, this paper sought to systematically and descriptively review studies that used an SV framework to examine health-related outcomes across European countries. The review included two studies each from Spain and France, one each from the UK, Ukraine and Russia, and another study including the three countries Sweden, Portugal and Germany. With the exception of one mixed-method study, the studies used a qualitative design. Furthermore, the eight studies in the review used different conceptualizations of SV, which indicates the complexity of using SV as a concept in public health in the European context. Future research that attempts to identify and standardize measures of SV is needed; the knowledge gained is hoped to inform appropriate interventions aiming to reduce the effects of SV on population health.

Corporate social responsibility (CSR) can contribute to the triple bottom line of economic, social and environmental performance in organizations. However, the relationship between CSR, employee health and well-being has not been frequently assessed despite an increased awareness that this relationship can contribute to sustainable workplaces. To identify studies addressing the relationship between CSR and employee health and well-being within the EuClropean context, we conducted a systematic literature search using Web of Science and Medline. Of the 60 articles screened for inclusion, 16 were retained. The results suggest that the majority (n = 14) of the identified studies aimed to understand the impact of CSR strategies on employees' job satisfaction. None of the studies investigated the relationship between internal CSR and physical health. There was no clarity in the measurement of either internal CSR or the extent to which it affected employee outcomes. There is a need for consensus on measurement of internal CSR and of the health and well-being-related outcomes. Public health and occupational health researchers should be part of the discussion on the potential role of CSR in physical and psychological health outcomes beyond job satisfaction.

This paper presents the findings of a four-year research project studying change practice and agency in higher education. The main findings of five empirical studies are presented. These findings lay bare how academic staff perceive opportunities to change their practice, identify leaders’ strategies when trying to bring about change, illustrate the different and at times incompatible ways of understanding change initiatives, acknowledge the importance of moral dimensions in change, and demonstrate how leaders mobilise theory when engaging in change practice. The article synthesizes the results of the project and draws conclusions with a view to how academic developers may best engage with critical stakeholders in higher education institutions. The paper concludes by presenting some thoughts on how a new model for academic development may take form. The paper aims to provide insights, inspiration, and critical dialogue to researchers in academic development.

This reflective article sets out to illustrate some of the difficulties involved in developing capacity in Nordic collaboration. The project involves the development of digital open educational resources (OER) focused on bioethics in the Nordic region through a close collaboration between five universities. The article presents a case study and details the rationale for the development of the digital OER, describing how they were developed, tested and implemented. The article uses a framework of change management to identify current shortcomings, challenges and critical areas for further development.

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.

Concerns have been raised about how well legal education prepares law students for the reality of their future work life. Some research suggests that law students find it difficult to transfer and apply theoretical knowledge to decision-making in real-life contexts. This article presents a novel way, virtual law cases (VLCs), to teach and learn legal knowledge, analytical reasoning and decision-making skills in a safe environment without real-life repercussions. The paper sets out a number of steps when developing a virtual law case and illustrates the different elements that are included. The article also reports the results of the pilot testing with other colleagues, legal experts, as well as with law students in a Swedish legal education context. Early evidence suggests that colleagues and legal experts are confident that using VLCs is a valuable way to teach legal reasoning and decision-making, and that VLCs offer students a tool that allows them to see how legal fields are interconnected.

Objectives: As educational theories are increasingly used in medical education research there are concerns over how these theories are used, how well they are presented and what the authors intend. Communities of practice (CoP) is one example of an often-used theory and conceptual framework. This paper presents a critical analysis of how CoP theory is used in medical education research.

Methods: A critical literature analysis was undertaken of articles published between 1998 and 2018 in eight internationally recognised medical education journals. From a total of 541 articles, 80 articles met the inclusion criteria and were analysed and mapped according to various patterns of use.

Results: We discerned five categories of use, two misleading and cosmetic, off target and cosmeticising, and three functional, framing, lensing and transferring. A considerable number of articles either misrepresented the point of communities of practice or used it in a cosmetic fashion. The remainder used the theory to frame an ongoing study in relation to other work, as a lens through which to design the study and collect or analyse data, or as a way of discussing or demonstrating the transferability of the findings.

Conclusions: We conclude that almost half of the reviewed articles did not offer a functional and rigorous definition of what is meant by CoP; instead, they used it in a potentially misleading or cosmetic manner. This study therefore calls on editors, reviewers and authors alike to increase clarity and quality in the application of CoP theory in medical education.

Data sharing is increasingly practiced by researchers and mandated by research funders as well as scientific journals. However, data sharing within qualitative research paradigms is less common, and sharing interview data has particular challenges. Earlier debate has pointed to the value of data sharing for discouraging research fraud and permitting critical scrutiny. We elaborate on this discussion by highlighting the value of data sharing for cumulative science, for re-use, and to maximise the value of the participants’ contribution. We review methods and possibilities for sharing interview data, and give concrete recommendations for mitigating risks to the participants. In conclusion, we find that sharing of interview data is possible, valuable, and ethical, and serves a purpose for both journals and researchers.

The authors reflect on how students’ perception of belongingness is central to their learning and how a Sense of Community needs to be encouraged, shaped and continuously sustained. 

The qualitative research interview is an important data collection tool for a variety of methods used within the broad spectrum of medical education research. However, many medical teachers and life science researchers undergo a steep learning curve when they first encounter qualitative interviews, both in terms of new theory but also regarding new methods of inquiry and data collection. This article introduces the concept of qualitative research interviews for novice researchers within medical education, providing 12 tips for conducting qualitative research interviews.

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.

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.

This study explores teacher candidates' experiences of grading in higher education. A phenomenographic approach was adopted and four qualitatively different categories were identified. Grading was experienced as: self-identification, motivation, personal interpretation and academic enculturation. The results indicate that teacher candidates accept existing grading systems but have difficulty interpreting and explaining them, illustrating areas of importance in teacher education and argues that if teacher candidates do not perceive genuine differences in the performance of assessing by grade descriptors, there is a risk that they may develop an insufficient understanding of grading practices.

From the run-of-the-mill use of calculators and tablets to the utilization of artificial intelligence to test students’ ability to read, educational technology (EdTech) plays a ubiquitous and important role in preschools and compulsory and secondary schools, as well as in higher education in the Swedish context today. Sweden is among the European countries with the best access to bandwidth and connectivity and has a high student-to-computer ratio, making the Nordic countries well placed to avail themselves of new and emerging educational technologies. EdTech is an emerging concern in the broader European context, too, demonstrated not least by the establishment of the European Institute of Innovation & Technology (EIT) in 2008. In this chapter, we consider to what extent educational technology has a disruptive or transformative influence on the educational environment today. For the purpose of this chapter, EdTech is used as an umbrella concept to define and identify a wide range of technologies that have been designed and developed with a stated purpose to be used for teaching and learning.

BACKGROUND: Continuing professional development (CPD) is central to nurses' lifelong learning and constitutes a vital aspect for keeping nurses' knowledge and skills up-to-date. While we know about the need for nurses' continuing professional development, less is known about how nurses experience and perceive continuing professional development. A metasynthesis of how nurses experience and view continuing professional development may provide a basis for planning future continuing professional development interventions more effectively and take advantage of examples from different contexts. The aim of this paper is to conduct such a metasynthesis, investigating the qualitative research on nurses' experiences of continuing professional development.

METHODS: A metasynthesis of the qualitative literature was conducted. A total of 25 articles fulfilled the inclusion criteria and were reviewed.

RESULTS: We determined five overarching themes, Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse's professional values, Nurses' perceptions of barriers and Perceived impact on practice as a core value. This metasynthesis highlights that nurses value continuing professional development and believe that it is fundamental to professionalism and lifelong learning. Moreover CPD is identified as important in improving patient care standards.

CONCLUSIONS: Based on the metasynthesis, we argue that access to continuing professional development could be made more attainable, realistic and relevant. Expediently, organizations should adequately fund and make continuing professional development accessible. In turn, nurses should continue to actively engage in continuing professional development to maintain high standards of nursing care through competent practice. This paper highlights the perceived benefits and challenges of continuing professional development that nurses face and offers advice and understanding in relation to continuing professional development. We believe that this metasynthesis contributes with insights and suggestions that would be valuable for nurses and policy makers and others who are involved in nurse education and continuing professional development.

Introduction: Massive Open Online Courses (MOOCs) are an increasingly popular form of education in health professional education. VPs have been introduced in MOOCs to increase interactivity. There is a lack of research in understanding the reasons behind high dropout rates in MOOCs. We explored how learners interact with VPs and compared the significance of different VP designs on dropout rates. Methods: RCT of 378 participants split into two groups to interact with two VPs using different design: branching and linear. Data on node progression and VP attempts was analysed using descriptive and quantitative analysis. Results: Eight groups of learner interaction patterns were identified. The majority of learners completed the VP in a linear path in one attempt. A significant number either completed the case in a loop path in one attempt, completed in a linear path in multiple attempts or dropped out without attempting the case. VP design has a significant effect on dropout rates of learners. There is a higher dropout rate from a branched VP compared to linear VP. Discussion: Prior research showed that branched VPs are more engaging and promote greater learning compared to linear VPs. However, our results indicate that branched VPs had greater dropout compared to VPs that require less time to be solved. Conclusions: We conclude that branching had a negative effect on completion of the VP activity in the MOOC. Moreover, we believe that more complex VPs require more effort on task and this might not be a design that facilitates the interaction in a MOOC audience, where the participants might wish to acquire the basic medical knowledge offered by the course.

Despite the emergence of massive open online courses (MOOCs) and the field of MOOC research, we have a limited understanding of the specific needs of different learner groups and how MOOCs can successfully address those needs. Video lectures and demonstrations are a central learning component of MOOCs. This paper contributes to the research community by examining the use of MOOC videos for two groups of learners. In particular, we explore whether there is an observable difference between specialists' and non-specialists' video-watching activity. We analyse data collected from three MOOCs on the edX platform. Our findings indicate that while age and educational background impacts the level of video activity, there is no significant difference between specialists and non-specialists. We conclude that the MOOC format may be suited to non-specialist groups, allowing them to self-direct their learning and utilise videos as educational resources.

There is a lack of consolidated knowledge that identifies best practices when using digital learning tools, technologies and interventions in legal education. This paper seeks to illustrate the scope and nature of the current evidence that supports digital learning in legal education. The paper provides a scoping review of 10 years of empirical research in digital learning in legal education. Moreover, the paper discusses different forms of evidence in an effort to understand the kind of evidence legal scholars invoke when presenting what works in digital learning in legal education and why. In the paper, we present a picture of the empirical field of digital learning in legal education, including where these studies are being done, and the types of studies conducted. Moreover, we thematise the main findings across the studies: improved student learning, student satisfaction with digital tools, and drivers of engagement. We conclude by identifying some potential knowledge gaps. 

Medical specialists’ lifelong learning is essential for improving patients’ health. This study identifies affordances for learning general practitioners (GPs) engage in, and explores what influences engagement in those affordances. Eleven GPs were interviewed and the interview transcripts were analysed thematically. Stephen Billett’s theoretical framework of workplace participatory practices was used as an analytical lens to explore the topic. Challenging patient cases were identified as the main trigger for engagement in learning. Local, national and international colleagues from the same and other specialties, were found to be an important affordance for learning, as was written material such as websites, journals and recommendations. Other inputs for learning were conferences and courses. Workplace aspects that were essential for GPs to engage in learning related to: place and time to talk, relevance to work, opportunity for different roles, organisation of work and workload, and working climate. Importantly, the study identifies a need for a holistic approach to lifelong learning, including spontaneous and structured opportunities for interaction over time with colleagues, establishment of incentives and arenas for exchange linked to peer learning, and acknowledgement of the workplace as an important place for learning and sufficient time with patients. This study contributes with a deepened understanding of how GPs navigate existing affordances for learning both within and outside their workplaces. 

An overview of the research literature about physicians' continuing development was conducted and shows that formal learning activities often target individuals and their development, and focus on increasing knowledge and influencing attitudes. Research studies showing changes in practice are less common. Regulated continuous medical education may lead to instrumental approaches to learning. Informal learning occurs continuously during work, is often spontaneous and focussed on problem solving. Patients and colleagues as well as the physical and social environment provide opportunities for learning. Organizations can offer time and space to facilitate physicians' continuing development, enabling possibilities for formal and informal sharing of knowledge to take place, for example, by enabling collegial discussions.

Today many university teachers attend competency development courses as individuals. In this paper we consider collegial and collective competency development. We examine what role collegial peer review could play in developing the Scholarship of Teaching and Learning for university teachers. The paper is based on a case study that explores how a group of university teachers experienced collegial development and peer review. Based on the teachers’ account, we identify how the activity helped them break the isolation they experienced at their department, enabled them to navigate the landscape of different courses and strengthened their roles as teacher, e.g., through collaboration with colleagues. We also present some frictions and tensions that were reported. Based on the case study, we propose that professional development in academia could benefit from acknowledging collegial peer review as an output in its own right.