Symposium 3: Current transformation of the health care sector and related training needs
Discussant: Miriam PETERS
The need for highly and specifically qualified personnel is a key concern in healthcare world-wide. Healthcare professionals are continuously confronted with changing competence re-quirements due to the increasing complexity of the tasks required, as well as the trends linked to organizational transformations and increasing digitalization of the world of work. Vocational and professional education and training (VPET) need to respond to these challenges to meet the demand for qualified staff. This symposium examines potential ways to enrich and adapt VPET in healthcare from various perspectives. The first contribution takes an articulation of an ethnographic work-analytic approach and uses analysis of neonatal nurses’ activity to identify competence requirements in neonatal care in France and derives possible improvements for training from the key concerns that structure the nurses’ activity. The second contribution also adopts an ethnographic approach to explore the impact of digital technology on nursing activities in Swiss hospitals, particularly on the transmission of patient care information; from this research, video-based learning situations will be created to train nursing staff. The third contribution analyzes the requirements for and needs of nurses in long-term care in the Swiss canton of Ticino, with the aim of developing a continuing education program that strengthens the resilience of active nurses and reintegrates nurses who have left the healthcare sector but wish to return under sustainable conditions. The fourth contribution examines the factors that contribute to companies training more tertiary-qualified nurses and supporting graduates of vocational education as healthcare assistants to pursue tertiary-level training in nursing; recommendations for subsequent action are made.
Nursing care for a very premature newborn: an embodied experience
Laboratoire Interdisciplinaire de recherche en didactique education et formation (Lirdef, Montpellier, France); Institut de Formation aux Métiers de la Santé du CHU de Nimes
The aim of our research was to produce knowledge on the real, individual-social activity of neonatal nurses interacting with a very premature newborn and to open up perspectives for improving training. This activity takes place in a context where the increase number of preterm births is a global public health problem (WHO, 2012). The environment and nursing care of these neonates hospitalized in the neonatal intensive care unit are considered as a significant source of stress (Griffiths et al., 2021), and have a critical issue for their neurosensory development (Millette & al., 2019). The individual-social activity of neonatal nurses is studied within the framework of the Course of Action Research Program (PRCA), being part of an epistemology of action and for which human activity is studied in natural practice situations (Theureau, 2006). The methodological device articulates data concerning activity constraints in the bodies, situations and cultures constructed according to the usual methods of ethnography, psycho-phenomenological data constructed during self-confrontation interviews and proxemic data. It has been enriched by arrangements that favour the consideration of the corporeal and spatial dimension of this activity. Three main concerns structure this activity: 1) Maintain a continuity of presence with the newborn by a communication through the body which aims to (re)build a physical proximity with the child and to inscribe him in a continuity of existence within its family. 2) Exercise vigilance associating an activity of prevention, monitoring and investigation. 3) Maintain comfort by supporting the newborn in managing stress. The notion of 'contact' with the neonate is crucial. The neonatal nurse relies on incorporated sensory and sensorimotor dimensions to coordinate herself in action with the newborn. These results lead us to consider ways of enriching training.
Observed situations involving transmission of patient care information: A basis for promoting learning and development among nursing staff
1Swiss Federal University for Vocational Education and Training SFUVET; 2Bern University of Applied Sciences BFH
The timeliness and completeness of patient care information (PCI) are essential to ensuring the continuity and quality of care. The digital transformation is leading to new competence require-ments for nurses and healthcare teams regarding PCI transmission—a key activity of both par-ties—involving digital devices. This project examines how clinical information systems and other digital devices affect PCI transmission. The literature provides comprehensive evidence of the implications of technologies for PCI transmission. However, research is limited on the shared collaborative processes that base educational and technical innovation on the lived experience of qualified workers.
This study employs a course-of-action approach to work analysis, combining empirical re-search and technological research for training purposes. It emphasizes nurses’ experience in real work situations, as well as implicit aspects of their professional activity that are significant to them, and uses the collected evidence to adapt training tools to the real work observed in the field.
In this contribution, we present results from the ethnographic part of the study. The objective of this part was to identify and characterize situations involving PCI transmission with digital de-vices that the participants perceived as significant. It included job shadowing and self-confrontation interviews with nurses working in six hospital wards in Switzerland. At the VET Congress, we will present and characterize the observed situations involving PCI transmission with digital devices. We will also discuss the initial results of our semiological analyses intend-ed to identify what participants perceive as significant in the observed activities/episodes re-garding PCI transmission.
The scientific evidence collected through real work analysis will feed into the development of training material for nurses and healthcare teams and enable the linking of digital competences and nursing competence profiles. It will also be used to adapt the design of information and communications technology (ICT)/digital devices to workplace practices and requirements.
Re Care: an action research to promote the resilience and work reintegration of nursing staff in long-term healthcare facilities
1Swiss Federal University for Vocational Education and Training SFUVET, Switzerland; 2Indipendent Researcher; 3Scuola Specializzata Superiore in Cure infermieristiche Ticino
The health sector, particularly nursing, is increasingly affected by problems of staff shortages at the international, national and regional levels. The Re Care project, which is being promoted in Canton Ticino on the basis of Swiss Secretariat for Education, Research and Innovation (SERI) grants, aims at dealing with this phenomenon by activating a multidimensional strategy to cope with organisational criticalities and occupational turnover.
Through measures aimed at identifying and simultaneously promoting good practices in the sector, this project has two main objectives: strengthening the resilience of nursing staff and fostering the reintegration of qualified workers who leave the sector by activating appropriate measures, especially in the long-term care sector. Both strategies are indispensable to preventing early exits.
The actions envisaged are based on two main axes that influence each other: (a) a series of inquiries aimed at obtaining a clear vision of what produces and accelerates turnover in the sector, identifying the best practices to avoid this phenomenon and documenting the development of training courses aimed at active nursing staff, executives in the sector and those who wish to re-enter it; and (b) the proposal of an innovative training pathway (Future Ateliers) based on concepts and methods developed in the field of futures studies to promote proactivity and resilience among the target population.
In this paper, we will present (a) the main results of the surveys carried out, with a focus on a selection of best practices in the field, and (b) the characteristics of the training path followed by 17 nurse facilitators to prepare and animate the Future Ateliers training process. The latter will be activated in the school year 2021–2022 in six long-term care facilities based in Canton Ticino.
The Role of Organizational Training Strategies in Addressing the Shortage of Tertiary Healthcare Workers
Swiss Federal University for Vocational Education and Training, Switzerland
In Switzerland, enrolment in tertiary-level nursing education is too low to satisfy the increasing demand for qualified staff which has resulted from various demographic changes. In particular, graduates of firm-based upper-secondary vocational education and training as Healthcare Assistants (HCAs) who are an important recruitment group for tertiary nursing education, too rarely choose this career trajectory as compared to the increasing demand. At the same time, the healthcare labor market is segmented; tertiary-qualified personnel tend to work in acute care, and this is also reflected in the correspondingly higher transition rate of HCAs who work in these settings into tertiary education. In contrast, changing demographics such as a generally aging society mean that the long-term care sector is experiencing a particularly high demand for staff with advanced nursing qualifications. Increasing the rates of transition to tertiary nursing education and of subsequent staff retention is therefore important, especially in long-term care.
Existing research indicates that institutional training strategies may help to address changes in the supply and demand of qualified staff. Against this background, this paper explores the training strategies that different healthcare organizations use to increase transitions among their HCAs and, ultimately, develop sufficient tertiary personnel. The study uses a mixed-methods approach to analyze records, surveys, and qualitative interviews of and with healthcare organizations in the Swiss canton of Berne.
Preliminary results indicate that the chosen strategy is linked to, among other things, the organizational need for tertiary-trained employees. For example, institutions that are unable to recruit skilled workers externally have to develop their own staff and therefore invest more in training, mentoring, and promoting apprentices for transition into higher education.