Dispositif d'apprentissage du calcul de dose A.L. Poinssot [Abstract] La non-maîtrise du calcul de dose est rédhibitoire pour l’exercice de la profession. Nous observons, au sein de notre institut, que cet apprentissage est anxiogène pour un grand nombre d’étudiants. Ce constat nous a amené à penser un dispositif d’accompagnement des étudiants : progressif, individuel et collectif. Il se décline sur les trois années de formation avec des méthodes pédagogiques diversifiées(inductives, déductives). Lors de la première séquence pédagogique, pour démystifier le calcul de dose, un quizz basé sur les activités de la vie quotidienne est proposé aux étudiants. Il est réalisé en direct sur smartphone, les résultats projetés sur écran, s’ensuit un échange autour des résultats. Chacun peut découvrir que les difficultés sont partagées, ce qui créé les conditions d’entraide entre étudiants. La deuxième séquence consiste en des exercices corrigés entre pairs, puissant levier d’apprentissage. La troisième séquence repose sur des temps de révision accompagnés, pour identifier les méthodes utilisées et envisager une aide individualisée. Dans les situations de blocage, un entretien d’explicitation est proposé à l’étudiant pour accéder aux informations implicites de l’action de réaliser ces calculs, et conscientiser les processus qu’il met en jeu. Les résultats montrent que le quizz modifie les représentations des étudiants. Cette entrée ludique, interactive libère la parole, autorise à partager ses difficultés et lève certaines inquiétudes. 95% des étudiants se disent moins anxieux à l’idée d’aborder cet apprentissage. Les TD durant lesquels les étudiants se sont corrigés entre pairs, leurs ont permis de s’approprier une méthode de réalisation du calcul et de développer leur confiance en soi. L’accompagnement pédagogique situe, clarifie la méthode et l’exposé du raisonnement de l’étudiant. Au terme de l’année, 71 étudiants sur 72 ont réussi le calcul de dose lors de l’évaluation normative. Identifier les besoins et s’appuyer sur les ressources des étudiants est la plus-value de ce dispositif.
	« Une expérience de partenariat à l’IFSI d’Argenteuil : étudiants en soins infirmiers créatifs, formateurs, experts accompagnants et soignants : ensemble… pour une EPP » O. Melihi, N. Costes [Abstract] Dans le cadre du référentiel 2009, l’analyse des pratiques est intégrée au processus d’apprentissage : l’étudiant doit être capable d’analyser la qualité et améliorer sa pratique professionnelle. Depuis 2011, une collaboration avec le Centre Hospitalier de rattachement permet aux étudiants en 3ème année de formation d’expérimenter sur le terrain une évaluation des pratiques professionnelles (EPP). L’équipe pédagogique, en partenariat avec l’équipe opérationnelle d’hygiène et la cellule qualité de l’établissement, a construit un projet qui inscrit les étudiants dans la réalisation d’une EPP en fonction des besoins et priorités identifiés dans le programme qualité. La construction de la séquence pédagogique nécessite en amont une réflexion et une concertation entre les partenaires. Ainsi, les thématiques retenues centrées exclusivement sur les pratiques infirmières sont différentes pour chaque promotion. Les groupes d’étudiants sont accompagnés  pas à pas  pour concrétiser un audit clinique ciblé (ACC) dans le respect de la méthodologie préconisée par la Haute Autorité de Santé (HAS). Les étudiants en situation réelle d’évaluation des pratiques mobilisent autant leurs compétences individuelles que leur capacité à travailler en équipe dans un but commun. L’engagement des apprenants renforcent la cohésion du groupe et leur motivation. Leurs compétences individuelles sont mises au service du groupe : informatique, informationnelle, logistique, rédactionnelle... Cette confrontation à la méthodologie de l’EPP, révèle les capacités à la créativité et à communiquer au sein du groupe. L’enquête de terrain permet la rencontre des professionnels et place les étudiants dans une posture d’observateur et de distanciation en tant qu’apprenti auditeur, reconnus par les équipes soignantes. Cette approche, riche d’enseignements, permettra aux futurs professionnels d’appréhender une méthodologie et de réfléchir à l’importance de la pratique fondée sur des preuves associant ainsi la démarche qualité à l’évaluation de la pratique.
	Un partenariat enseignement et clinique pour co-construire et implémenter un nouveau modèle de soins infirmiers: le Modèle de Partenariat Humaniste en Santé M. Laloux, F. Wantier, D. Lecocq [Abstract] Fédérés autour d’un projet visant l’amélioration de l’accompagnement infirmier proposé au patient, les équipes d’enseignants-chercheurs de la Haute Ecole Libre de Bruxelles Ilya Prigogine (HELBIP), de l’école de santé publique de l’Université libre de Bruxelles et de gestionnaires et de praticiens des Cliniques Universitaires de Bruxelles Hôpital Erasme (CUB Erasme) ont mis en oeuvre un projet de recherche centré sur les interactions infirmières-patients (”degré de caring”). Cette étude a permis de montrer que la dimension relationnelle des soins est celle pour laquelle les patients se déclarent les moins satisfaits et les professionnels infirmiers les moins compétents. Il est dès lors apparu comme prioritaire de travailler cet aspect de l’accompagnement infirmier. Parallèlement, avec l’appui de collègues de l’Université de Montréal, une réflexion à propos du modèle de soins infirmiers enseigné et utilisé dans la pratique a été entreprise. D’autre part, le partenariat patient s’est également développé. Différents projets pilotes font maintenant l’objet d’un accompagnement (formation-coaching). Sur base des résultats de l’enquête degré de caring et en intégrant le développement du partenariat patient, les partenaires ont co-construit avec des patients partenaires un nouveau modèle de soins infirmiers: le Modèle de Partenariat Humaniste en Santé (MPHS). Ce modèle a pour objectif à la fois de rencontrer les considérations humanistes et de susciter l’implication du patient pour qu’il puisse, s’il le souhaite, devenir partenaire de ses soins. Il sert de fondement au nouveau programme d’études de la formation en soins infirmiers de la HELBIP et guide la pratique infirmière des CUB Erasme. Inscrit dans l’évolution de notre société et de la pensée infirmière, [le Modèle de Partenariat Humaniste en Santé] propose une nouvelle déclinaison des concepts centraux de la discipline et invite les professionnels et les patients partenaires à ”aller ensemble vers” un futur co-construit qui s’inscrit dans le projet de vie du patient.
	MUMN a journey through time: the contribution of a union in the education sphere A. Saliba, L. Pullicino [Abstract] Over the past decades, the emphasis on professional improvement and evidence- based practice has grown steadily, driven by a rapidly changing society and vast developments within the healthcare and educational systems. These changes brought about various challenges like underfunding, workloads and the need of multisectoral collaboration. In this regard, the Malta Union of Midwives and Nurses (MUMN) has not only undertaken a dynamic role in shaping policy through its negotiations as a trade union, but has been a pioneer and a leader in continuous professional development (CPD) of nurses and midwives. Primarily, MUMN took over and revamped the preceding NAM -a professional academic body which was losing stream at that time- shaping it into an educational committee that relentlessly strived to enhance competency, knowledge and skills ever since. MUMN has also adopted a proactive approach, carrying out Training Needs Analysis and Peer reviews, so as to identify, evaluate and prioritize educational needs; address gaps; and determine potential effective learning interventions with attainable and measurable outcomes. Moreover, in the various sectoral agreements, MUMN has been the thrust behind the implementation of various initiatives to further enable professional development, including the creation of the CPD Scheme and the Competency Assessment Framework. A recent innovative venture was the transformation of the MUMN educational committee into Learning Institute for Health Care Professionals (IHCP), so as to be at par with contemporary educational models. The purpose of this presentation is to shed light on the MUMN’s essential contribution in CPD, illustrating how it evolved over time to better respond to the ongoing changing needs and priorities of health care and of its members. It will give a reflective account of the best practices which have been implemented in the effort to promote effective learning and enhancement of skills, as well as elucidate the projected way forward.
	Pain Management in Dementia: Nursing Home Nurses' Knowledge, Attitudes and Reported Practice J. Saliba, J. Trapani, D.A. Scerri [Abstract] Background: Older persons with dementia may lack the facility to self-report pain. When self-reporting is not possible, nurses should assume the responsibility of observing, recognising and subsequently managing pain when caring for residents with dementia. To successfully do so, nurses need to have adequate knowledge in pain assessment and management, sympathetic attitudes, adequate educational training and sufficient resources. Aims and objectives: To examine nursing home nurses’ knowledge, attitudes and reported practice in the management of pain in residents with dementia and identify potential barriers to such practices. Design and Methods: A descriptive, cross sectional design with the use of self-administered questionnaire. Participants: Nurses working in a nursing home in Malta. 321 questionnaires were distributed and 206 were completed (response rate: 64.2%). Results: The findings reveal poor knowledge and inappropriate attitudes among nurses regarding pain in residents with dementia. The most common inconsistent responses, were on aspects related to pain management, analgesic administration and misconceptions about opioids. Other barriers identified include inadequate training and education on the subject, inappropriate practice and lack of pain assessment tools. Conclusions: Local nurses are not well trained and equipped to manage the complexity of pain assessment and management in residents with dementia. Educational Implications and Relevance to Clinical Practice: Training and education on the subject should focus on guiding nurses towards the successful introduction of a multifaceted systematic approach to pain assessment. Staff development and educational activities should also focus on the introduction of pain assessment tools in practice and the use of opioid analgesics in persons with dementia. A successful practice change initiative must also encourage peer education with sharing of knowledge, inter-professional support, good communication and effective discussion on the subject among all possible stake holders.

	Retour d'un Projet Européen de Simulation en Santé P. Delrez, Y. Clerbois, P. Jamar [Abstract] Le projet européen simucare pro est un consortium de six partenaires de quatre pays européen, Belgique-Portugal-Roumanie-France, dont les objectifs sont: 1)l’identification d’une problématique de soins par les étudiants et les enseignants en collaboration avec une équipe de soins. 2)La création de scénarios de simulation par les instituts de formation sur base de données probantes (EBN/EBM). La finalité du projet vise à améliorer la qualité des soins en optimalisant les compétences des soignants. Ce projet arrivant dans sa phase finale, nous pouvons mettre en avant les plus-values que celui-ci à apporter à notre institution, ainsi qu’aux formateurs et aux étudiants. Le retour très positif des milieux professionnels, nous encourage et nous motive à poursuivre dans cette dynamique
	De l’alliance thérapeutique à l’alliance pédagogique : le patient « expert » comme partenaire de la formation initiale des étudiants en soins infirmiers en ETP S. Dauphin, S. Perin [Abstract] En 2009, le référentiel de formation en soins infirmiers intègre l’éducation du patient dans deux unités d’enseignement (UE) de deuxième année : UE 4.6 soins éducatifs et préventifs. Depuis la loi HPST de 2009, le patient expert trouve diverses applications dans le paysage de la santé en France : à titre individuel, il est partenaire du projet de soins. A titre collectif, il devient éducateur, partenaire privilégié de l’équipe médicale participant à une refondation de la relation soignant/soigné ; enfin, à titre institutionnel, il devient un collaborateur des pouvoirs publics (élaboration de recommandations de bonnes pratiques). Pourquoi les IFSI resteraient-ils en marge de cette évolution ? Cette communication repose sur une expérience pédagogique initiée à l’IFSI de Beaumont-sur-Oise en 2016-2017 : simulation d’entretiens  bilan éducatif partagé  entre étudiants et patients experts à l’IFSI. Dans une visée socio-constructiviste, l’objectif est de dépasser la relation pédagogique centrée sur  comment éduquer un patient ? , en proposant une alliance pédagogique patient-étudiant-formateur centrée sur la co-construction de l’alliance thérapeutique. En septembre 2016, des formateurs ont filmé des entretiens entre des patients volontaires, issus du  programme autorisé en éducation du patient en diabétologie  attaché à notre établissement de référence et des étudiants de 3ème année volontaires, ayant validé les deux UE  soins éducatifs et préventifs  et l’UE 2.7 S4 (processus dégénératifs). Ces entretiens ont été le support des travaux dirigés auprès de 65 étudiants de 2ème année. Le bilan de cette première expérience révèle une adhésion totale à la méthode et une maturation du processus de compréhension du diagnostic éducatif en co-construction avec le soigné. L’avenir tend à développer le partenariat avec l’association de patients du programme autorisé afin de proposer aux étudiants des mises en situation simulée régulières.
	Module de formation en ligne (blended learning) sur les pousse-seringue électriques, en formation infirmière C. Cornet [Abstract] Dans le cadre du semestre 4 de la formation infirmière nous avons créé un module de formation en ligne regroupant une partie distancielle et une partie présentielle (blended learning). Basé sur le volontariat des étudiants, ce dispositif élaboré à partir d’outils gratuits, a montré la valeur ajoutée d’un tutorat en ligne. L’objectif pédagogique visait l’amélioration de la lecture, de la compréhension et de l’analyse d’un énoncé avec un pousse seringue électrique. Utilisant l’espace collaboratif de travail agora project comme environnement numérique d’apprentissage, le dispositif regroupait des activités individuelles et collaboratives en ligne, par le biais des sites learningapps.org et socrative.com. La séquence d’apprentissage de 14 jours a permis à l’apprenant d’obtenir un feedback (explicite et/ou dichotomique) sur ses activités et ainsi, l’encourager dans sa progression. La plus-value de ce dispositif repose sur le tutorat, réactif et proactif, assuré par le formateur et reposant sur des outils de communication synchrones (tchat) et asynchrones (forum). La partie présentielle a permis un apport cognitif et métacognitif. Un tel dispositif démontre l’intérêt et la nécessité d’un tutorat cognitif, méthodologique et socio affectif au cours de l’apprentissage en ligne. L’ergonomie des outils a permis une supervision des activités tout comme un suivi de la progression et des acquis de l’étudiant. Finalement, 21 % des apprenants du semestre 4 ont suivi intégralement les activités. Parmi les étudiants qui ont participé plus ou moins totalement au dispositif, 95 % sont pleinement satisfaits du dispositif et 85 % estiment qu’ils pourront réinvestir leur acquis. D’un point de vue formateur, des erreurs persistent sur la compréhension des énoncés avec un score de 45 /100 aux exercices concernés. La supervision des activités a permis de suivre 7 étudiants particulièrement en difficultés. L’intérêt des applications utilisées reposent sur leur possible intégration sur une plateforme LMS.

	Innovation et créativité au service de l'interculturalité : une expérience à l'Institut de Formation en Soins Infirmiers de Gonesse M.-C. Armato, S. Tessier [Abstract] Introduction La diversité culturelle croissante de la population française, requiert des compétences spécifiques de la part du personnel soignant. Les étudiants reflètent cette diversité. Afin de préparer l’entrée dans le monde professionnel, l’IFSI a construit depuis 2015 dans le cadre de l’unité d’enseignement optionnelle un programme de convergence entre les étudiants de 3ème et 1ère années autour de l’interculturalité en partenariat avec l’association REGARDS. Matériel et méthodes Une journée de réflexion collective sur le thème de l’interculturalité insistant sur l’évolutivité des cultures, sur la laïcité est animée par un expert. Elle invite les étudiants de 3ème année mais aussi les formateurs qui sont partie prenante dans l’animation des séances de formation, à travailler sur leurs représentations. Les étudiants écrivent un projet sur  la laïcité à l’hôpital . Les formateurs initient ces rencontres en laissant libre cours à l’innovation, l’invention, la créativité des étudiants. Le tout est ensuite restitué dans un séminaire conjoint des deux groupes, incitant les 3ème année à mettre en place des outils pédagogiques pour se faire comprendre par leurs cadets. Résultats Parmi toutes les réflexions émises par les étudiants, deux semblent plus éclairantes :  Mieux comprendre les patients, les familles  et  Mettre des mots sur des choses effectuées de manière inconsciente . Discussion L’accueil de la part des étudiants était conforme aux attentes, avec quelques réticences, mais surtout la satisfaction de pouvoir échanger sereinement sur ces sujets tabous. Certaines attentes de recettes n’ont pas pu être satisfaites, mais elles furent relativement limitées. Conclusion Un tel module est une entreprise à risque, tant le sujet est sensible et les étudiants fragiles. Pour autant, ne pas l’aborder en formation initiale expose ces futurs soignants à de nombreuses déconvenues préjudiciables aux soins et à leur propre bien-être professionnel.
	Intervention infirmière familiale auprès d’un diabétique ampute du membre inférieur selon l’approche systémique de Calgary S. Ben Abdeljelil [Abstract] L’amputation du membre inferieur est un événement bouleversant la vie quotidienne du patient et de sa famille. A travers la littérature, de multiples auteurs réclament la valeur de l’approche systémique familiale. Effectivement, la famille peut être une source de stress ou de soutien pour le diabétique amputé. Cette étude descriptive, ancrée dans le paradigme constructiviste est mixte (quantitative et qualitative). Le processus de recrutement des participants a impliqué 60 infirmiers (ères) afin d’explorer leurs connaissances sur l’application du modèle, et 5 familles, comportant un diabétique amputé du membre inférieur. L’utilisation de l’approche systémique pour la collecte des données qui a été réalisée à l’aide d’un questionnaire auto-administré et un guide d’entretien semi-structuré incluant l’échelle de Likert. Cette investigation a pris en considération l’anonymat, la confidentialité et le consentement des participants à l’étude. L’analyse des données a été effectué selon la démarche de Huberman et Miles (1991, 1994) pour l’approche qualitative, et par le logiciel SPSS version 19 pour les données descriptives. Le questionnaire nous révèle une ambigüité entre les modèles conceptuels connus par nos infirmiers : 35 % des infirmiers interrogés déclarent qu’il s’agit du modèle de Virginia Henderson. 70% croient que le rôle de la famille se limite surtout au soutien du diabétique. Pour l’approche qualitative, le principal besoin ressorti d’être soutenu par leur famille après la perte du membre. En plus le besoin de comprendre la contribution de l’infirmier et de la famille pour promouvoir le niveau de leur bien-être. L’infirmier peut travailler selon les plus belles perspectives familiales, mais sans une famille impliquée cela portera peu fruit. Ainsi, de son côté, la famille a avantage à s’engager. En somme, l’intervention infirmière congruente en termes de perspective familiale et l’engagement de l’entourage des diabétiques amputés mènent à un travail de collaboration tout à fait profitable.
	La pratique avancée du contexte international à l'experience d'un modèle français J. Biglietto, A. Torne -Celler, M. Ostermeyer, S. Gakou, J.-L. Danan [Abstract] Les premières infirmières de pratique avancée ont été formées à l’Université du Colorado en 1965 suivant un programme de niveau Master. En leur donnant la capacité de répondre à des prérogatives plus large que leur formation initiale elles sont devenues des actrices incontournables en matière de santé primaire dans des zones de déserts médicaux. Au niveau international la pratique avancée à su s’intégrer au sein de nombreux systèmes de santé, toutefois en France sa reconnaissance n’est que récente avec la promulgation de la loi du 26 janvier 2016. De plus ses contours restent à définir face à des décrets qui se font attendre. Or, le contexte sanitaire met en exergue les nécessités de transformation des pratiques et des organisations soignantes pour répondre aux enjeux contemporains de la santé publique. Avec d’une part un vieillissement global de la population associé à une augmentation des pathologies chroniques non infectieuses . Et d’autre part une hyper spécialisation des disciplines médicales qui complexifie les parcours de soins . Conscient de ces besoins émergents en santé, l’hôpital Maison-Blanche (membre du GHT Paris-Psychiatrie et Neurosciences) assurant la prise en charge en santé mentale de la population du nord et de l’est parisien a été le pionnier dès 2012 dans l’implémentation de la pratique avancée avec l’entrée en Master d’une infirmière diplômée d’État. Dans cette même démarche l’établissement s’est associé en 2014 à l’expérimentation  Préfics : préfiguration d’infirmiers cliniciens spécialisés  de l’Agence Régionale de Santé Île-de-France afin de structurer l’intégration de la pratique avancée dans les milieux soignants. Aujourd’hui l’EPS Maison-Blanche dispose de cinq programmes spécifiques permettant un accompagnement idoine des patients suivis en santé mentale. Ces programmes sont mis en application par une équipe de cinq IPA constitué au sein d’une unité fonctionnelle indépendante dont l’organisation est visible et lisible au sein de l’hôpital.
	Universitarisation des formations paramédicales A. Dubray, M. Sommelette [Abstract] Depuis 2009, la France est entrée dans une démarche d’universitarisation de la formation infirmière avec une inscription dans le dispositif de Bologne et une reconnaissance niveau Licence. Chaque IFSI est ainsi membre d’un GCS permettant le passage de convention avec l’université. Ce partenariat n’est pas uniformément développé sur le territoire Français. Toutefois, les pouvoirs politiques ont engagé une   grande conférence de santé  en 2016 conclue par une feuille de route du gouvernement de l’époque, confirmant le passage à l’université de la formations infirmière. Une mission a été confiée à l’IGAS et l’IGAENR conclue par un rapport nommé :   pour une meilleure intégration des formations paramédicales à l’université... ,(juin 2017). Mme Buzyn, Ministre de la santé et Mme Vidal, Ministre de l’enseignement supérieur et de la recherche, ont ensuite confié à Mr Le Bouler la mise en œuvre concrète de cette universitarisation. Le CEFIEC a proposé en mars 2017, 11 propositions concernant l’intégration à l’université de la formation infirmière. Le CEFIEC représente 100% des structures de formation en France. L’association s’engage ainsi dans une réflexion pour l’accompagnement des formateurs et des directeurs actuels pour que chacun trouve sa place dans le dispositif à venir. Deux groupes de travail ont été initiés. Le premier a pour objectif de montrer la plus-value du formateur dans l’accompagnement à la professionnalisation et réfléchir au corps des enseignants chercheurs de demain pour le développement de la recherche en sciences infirmières. Le second est chargé de réfléchir au positionnement des Directeurs dans la gouvernance du futur dispositif de formation dans les dimensions stratégiques, politiques, managériales, financières et pédagogiques. Nous proposons un état des lieux de l’universitarisation de la formation infirmière en France et une présentation de l’ensemble des prospectives proposé par notre gouvernement mais aussi pas les acteurs eux même, formateurs et directeurs.
	La formation en compétences émotionnelles, la clé de soins infirmiers authentiques S.R. Guadalupe [Abstract] Introduction: De Gardner (1983) à l’explosion médiatique qui a conduit à la publication de l’œuvre de Goleman (1995), l’intérêt académique et populaire pour les émotions a progressivement augmenté. En soins infirmiers, cet intérêt n’est pas nouveau. La recherche infirmière sur les émotions, bien que naissante, augmente progressivement. Objectif: Présenter une proposition formative d’étudiants en sciences infirmières basée sur les résultats obtenus de la recherche menée sur la perception des usagers et des infirmières du rôle des émotions dans les soins infirmiers. Champ d’étude: Centres hospitaliers et de soins primaires du Consortium Sanitaire de Terrassa (Barcelone, Espagne). Méthodologie: Une étude exploratoire-descriptive avec une approche méthodologique mixte et une comparaison par groupe a été réalisée. L’échantillon comprenait 40 participants (usagers et infirmières). Les instruments utilisés étaient des entretiens semi-structurés et des questionnaires. Résultats : Les usagers disent qu’ils se sentent émotionnellement quand les infirmières les traitent avec gentillesse et écoutent attentivement. Ce type de soins leur procure un sentiment de bien-être. Les usagers et les infirmières apprécient le fait que les infirmières doivent posséder des aptitudes émotionnelles, particulièrement l’écoute active, l’empathie et la gestion émotionnelle. La plupart des participants comprennent que les soins émotionnels sont nécessaires, mais ils perçoivent que leur réalisation peut nuire à l’efficacité et à l’équilibre émotionnel des infirmières. Conclusions: L’empathie, l’écoute active et la capacité de gestion émotionnelle sont des compétences émotionnelles de base et des constituants de la compétence infirmière émotionnelle. Le manque de compétences émotionnelles est indiqué comme une cause possible du faible développement de l’attention et du soin des émotions. Il est nécessaire de repenser la formation infirmière dans ces compétences. Une proposition formative est présentée visant à améliorer la compétence émotionnelle au cours de la formation universitaire des infirmières.
	Motiver et recruter les jeunes pour les études en Sciences infirmières Défi pour la Faculté de Santé Publique à l’Université Libanaise (UL) N. Zeidan, M.T. Sabbagh [Abstract] Le Liban souffre d’une pénurie d’infirmières vu les besoins accrus en santé, l’immigration des infirmières, l’image de la profession. La densité d’infirmières au Liban est de 2,19 pour 1000 contre une moyenne mondiale de 4,06 pour 1000 (OMS 2006) , d’où l’impact négatif sur les soins de santé et l’image des infirmières. L’UL tenue de répondre aux besoins nationaux de santé, a développé une stratégie à travers 5 axes : Une politique assurant l’accessibilité de la formation à tous (géographiquement, économiquement et langue d’enseignement) et une orientation intensive dans les écoles. La réhabilitation des infirmières en exercice, conjointement avec le ministère de la Santé publique, développant ainsi l’image de l’infirmière et sa position dans les institutions. La mobilisation de la communauté par des accords avec un grand nombre d’établissements de santé sur tout le territoire, l’interaction des cadres hospitaliers et enseignants en milieu clinique et académique. La réorientation du curriculum et des méthodes d’enseignement (adoption du LMD); développant la créativité, la pensée critique, le Caring et les compétences techniques nouvelles, en privilégiant la recherche professionnelle. Favoriser la rétention des infirmières, en encourageant les professionnels et les étudiants à avoir un rôle actif à l’Ordre, facteur clé dans l’autonomisation des infirmières, et le maintien de leur choix professionnel. Malgré les défis à surmonter, l’effectif des inscrits après concours en formation de base est passé de 251 en 2012-2013 à 410 en 2016-2017. Le total des diplômés depuis 1982 est de 4566 infirmiers et infirmières.
	La littératie en santé un concept fondamental dans la dispensation d’une éducation thérapeutique du patient adaptée J. Biglietto, M. Ostermeyer, A. Torne -Celler, J.-L. Danan, S. Gakou [Abstract] Notre système de santé évolue actuellement à la conjecture, entre autre, de trois contextes : une hyperspécialisation des disciplines médicales complexifiant les parcours de soins. Un accès facilité à l’information en santé chez les usagers utilisateurs des nouvelles technologies. Enfin, un désir des politiques de santé apparue au début des années 1990 d’encourager le  disease management  auprès de la population atteinte de pathologies chroniques en promulguant l’autogestion des soins. D’ailleurs, aujourd’hui ce propos est illustré par la présence de plus de 3700 programmes d’Education Thérapeutique du Patient (ETP) autorisés sur le territoire par les Agences Régionales de Santé. A travers ces évolutions, la Littératie en Santé (LS) s’inscrit comme la capacité des individus à mobiliser les compétences et les ressources nécessaires dans la compréhension des données relatives au maintien de leur santé. Depuis l’apparition du concept en 1974 dans un texte de Simonds, de nombreuses études ont mis en évidence la corrélation entre le niveau de LS et la santé des personnes. Cependant on a constaté seulement en 2013 qu’un faible niveau de LS peut s’avérer être un obstacle dans l’accès à l’ETP (enquête menée sur le territoire parisien) La LS et l’ETP partage effectivement les mêmes bases conceptuelles, issues des champs de la systémique et du socioconstructivisme. Ces deux modèles ont pour but de renforcer les savoirs en santé du patient et développer chez lui ses capacités d’Empowerment. Ainsi, l’adaptation des méthodes et des outils de mesure de la LS dans le cadre des programmes d’éducation thérapeutique permettra au soignant de mieux s’adapter aux filtres cognitifs, émotionnelles et expérientiels du bénéficiaire. Cette compréhension améliorée amènera progressivement l’usager dans une meilleure maîtrise de ses auto-soins et plus globalement dans une stratégie de résilience.
	La simulation, un laboratoire pour développer des compétences relationnelles en soins infirmiers ? C. Vander Meulen [Abstract] L’exposé propose une réflexion pédagogique sur un dispositif de simulation pleine échelle pour accompagner le développement des compétences relationnelles des apprenants en soins infirmiers. Durant des séances de simulation, des apprenants et des patients simulés se rencontrent pour mettre en scène, ensuite analyser des enjeux de la relation soignant-soigné. Le rôle du patient simulé est joué par des partenaires professionnels de la santé ou bénéficiaires de soin. Un regard réflexif est posé sur les séances de simulation. Le questionnement pédagogique porte sur la phase de débriefing, plus précisément sur la dynamique interactive qui s’y déploie entre les apprenants, les partenaires et les formateurs. Les données sont recueillies à la Haute École de Namur-Liège-Luxembourg (Belgique) dans le cadre des séances de simulation avec des apprenants bacheliers en soins infirmiers en troisième année de formation, soit 160 apprenants. Une analyse thématique qualitative des interactions, lors des débriefings, entre les différents participants impliqués dans le dispositif est effectuée. L’analyse explore l’apport d’un partenariat avec des professionnels de la santé et des bénéficiaires de soin, comme ressource pour développer des compétences relationnelles. Des résultats de l’analyse seront présentés et discutés lors de la conférence internationale FINE.

	Flipping the class without flopping: The journey from face to face to online learning K. Connaire [Abstract] The aim of this presentation is to provide an overview and critical discussion of the structure, process and outcomes of converting 3 modules of the MSc Palliative Care course from face to face mode of delivery to on-line delivery. Advances in learning technology continues to progress. Traditional approaches to teaching and learning in third level education where students are expected and required to attend college for lecture are now being superseded by using a blended approach to teaching and learning. Evidence suggests that students engaged in third level education find it more difficult to attend college as they may not be released by their employer to attend class. Additionally, while employers wish to support their employees to develop their professional and craft knowledge, they are challenged to maintain staffing levels in order to provide a comprehensive clinical service. In order to address this challenge, I embarked on converting 3 x 30 hour modules from face to face delivery to online mode of delivery. For 2 modules, I provided 7 hours of face to face delivery, while the remainder of the content was delivered on-line. The third module was delivered completely on line. The aim of this presentation is to provide an overview of the structure, process and outcomes of ”flipping” the classroom from face to face to online. The presentation will present exemplars of best practice of how this was achieved, together with a critical reflection of the overall process. Stakeholders evaluation will also be included.
	Emotional Labour in Paediatric Nursing: a propose Model for practice guidance P. Diogo [Abstract] The health-disease processes experienced by children and youth, and their families, are often associated with intense emotionality and, simultaneously, entails a great emotional challenge for nurses in their care, requiring emotional labour of triple centrality: in the client, in the nurse and in the nurse-client relationship (Diogo, 2015). Nurses perform this emotional labour according to their personal resources and learning from the day-to-day experience of care (Smith, 2012). Moreover, this emotional dimension of nursing care continues to be undervalued by health institutions, and by nurses themselves, so that emotional labour is not always the object of reflection and/or support in scientific evidence (Diogo, 2006; Diogo, 2017). For this reason, conceptual models are needed to guide and strengthen nurses in their practice, especially when the context is peculiar as in paediatric care. Diogo (2012, 2015), in her PhD thesis presents an explanatory hypothesis of the process of therapeutic use of emotions in paediatric nursing, arguing that Emotional Labour in Paediatric Nursing translates into actions of positive transformation of emotional experience in interactions care with paediatric client, through five categories of intervention: 1) Promoting a safe and affectionate environment; 2) Nurturing care with affection; 3) Facilitate client emotions management; 4) Build stability in relationship; 5) Regulate their own emotional disposition to care. This Emotional Labour Model in Pediatric Nursing was developed based on the nursing paradigm of transformation (Kérouac et al., 1996) whose central concept is Caring, supported in Watson’s Human Care theory (2002, 2008), and theorized about the ”personal knowing” (Carper, 1985; Fawcett et al., 2001). This Model also integrates the principles of family-centered care and non-traumatic care in Paediatric Nursing, such as the holistic and humanized perspective on health. At the heart of the proposed Model are the Emotional Labour of Nursing conception (Smith, 2012).
	Defining phenomena using a sequential qualitative mixed- methods design: The case of the Maltese prehospital emergency nurse T. Abela-Fiorentino, R. Kneafsey, G. Furze [Abstract] The notion of mixed - methods research is commonly attributed to the combination of methods from each of the quantitative and qualitative paradigms within a single study. This approach has been widely debated and increasingly adopted, and is now an established research design. On the other hand the possibility of combining methods from the same paradigm has been limitedly explored, and as such this approach is still relatively underutilised. This paper uses examples from a study on pre-hospital emergency nursing to describe how two qualitative methods, namely individual and group interviews, were combined in a qualitative mixed-methods study. Throughout this paper, the techniques used to enhance the exploratory, confirmatory and explanatory powers of this approach are also highlighted. While the exploratory nature of both methods used is acknowledged, the combination of two qualitative methods allowed for a deeper and more comprehensive examination of this relatively unexplored area of emergency nursing practice. The sequential exploratory - confirmatory approach adopted also enabled the validation of an initial theoretical framework which was developed from the individual interviews through a process of thematic analysis and abduction. This theoretical framework defines the role and functions of pre-hospital nurses, and the competencies required to fulfil this role. To uncover the underlying structures leading to these findings a process of retroduction was also employed, which also enhanced the explanatory power of this approach.
	Wellbeing in Nurse Education: its Place in Public Health and Health Promotion A. Knight, V. La Placa [Abstract] Aim: To present the concept of wellbeing and wellbeing policy approaches in order to address the importance of educating nursing students, and registered nurses, to develop their understanding of wellbeing and how it informs their role in health promotion. There is increasing awareness, particularly in the United Kingdom (UK) that nurses should promote health and wellbeing and it is an integral part of nurse education (UK) (La Placa and Knight, 2013; 2014). However, the concept of wellbeing is contested as is its application to care and measurement of outcomes. This presentation seeks to apply a conceptual and policy approach to address the importance of educating both nursing students, and registered nurses, to develop their understanding of wellbeing and to inform their role in health promotion. Firstly, it will explore the context of wellbeing, for example, its origins and contemporary definitional frameworks which proceed beyond the bio- medical model (Knight and McNaught 2011). Secondly, it will explore how nurses can develop and use concepts of wellbeing through training and education, making them an integral part of nursing and health promotion, and engaging individuals and communities with it. It will also focus upon how wellbeing can be integrated into education, practice and care and the effects of this. The presentation will focus on some current initiatives but also suggest how these can be developed in contemporary nursing education and practice. Knight, A. and La Placa, V. (2011). Understanding Wellbeing An Introduction for Students and Practitioners of Health and Social Care. Banbury: Lantern Publishing. La Placa, V. and Knight, A. (2013). Wellbeing: Its Influence and Local Impact on Public Health, Public Health, 128 (1): 38-42. La Placa, V. and Knight, A. (2014). Wellbeing: A New Policy Phenomenon. In A. Knight, V. La Placa and A. McNaught (eds.), Wellbeing: Policy and Practice.
	Paediatric Developmental Screening Services within Child Care Centres in Malta C. Sciberras, M. Galea, C. Sciberras, J. Mamo [Abstract] Children attending Childcare Centres undergo a Developmental Screening test. When a problem is detected, the child is referred for a full Developmental Assessment process within the Child Development Unit, where the Community Paediatric Team discusses with the parents/guardians plans for an interventional programme. Early intervention will assist the children with specific needs. This will enhance their development and help them achieve their full potential. This study presents a two year observation of development of children attending Child Care Centre in Malta. Children between three months to three years attending each of the 13 Child Care Centres in Malta were included in this study. With the help of the parents , through a multidisciplinary team assessment, the primary problem and concerns are discussed and a management plan outlined in the best interests of the child.
	Like Dorothy I realise I am stronger than I thought I was”: Facilitation of Global Health Competence- utilising the metaphor of the Wizard of Oz J. Benbow, D. James [Abstract] Metaphors can enable creative ways of examining everyday life differently and engender new insights. An academic strategy to help understand abstract theory, e.g. in nursing students, the Wizard of Oz (Le Roy and Thorpe 1938) the abstract concepts of good character and their journey of self-discovery (Baldwin, et al 2014). To help establish personal values to underpin professional identity and nursing practice. At the end of the programme, students reflect on year two global learning experiences. The Wizard of Oz metaphor is used to enable students to explore their experiences. The students’ learning can be categorised into four key themes: - first the importance of compassion, (the heart) to create a healing environment regardless of language or culture. Second, the courage to question practice. The courage to go abroad, often alone, had increased their courage in nursing. Third, the increase in their knowledge and skills; from greater understanding of other healthcare environments. Lastly, their increased self-awareness; one student summed it up: ”By moving out of my comfort zone, like Dorothy I realise I’m stronger than I thought I Was”. The students demonstrated learning in different environments can offer significant learning. The metaphor helped describe their personal values, skills as well as global learning competence which can be difficult to articulate. Suggesting that they are looking at their familiar concrete worlds in a different abstract way and exploring new meaning. References:- Baldwin, A., Bentley, K., Langtree, T. and Mills, J., 2014. Achieving graduate outcomes in undergraduate nursing education: following the Yellow Brick Road. Nurse Education in Practice, 14(1), 9-11. Koshinen, L. and Tossavainen, K. 2004. Study Abroad as a process of learning intercultural competence in nursing. International Journal of Nursing Practice 10, 111-120. Le Roy, M. and Thorpe, R. 1938 The Wizard of Oz motion picture United States Metro Goldwyn Mayer.
	Nursing School and Municipality: an alliance next of the youth health I. Fernandes, L. Andrade, M. Martins, K. Rolim [Abstract] Introduction: The project of the nursing school and the municipality joined by the research have a strong potentiality in the improvement of the quality of life of the young residents in there. Purpose: To describe the results of an alliance among nursing school and a municipal government. Methods: Included three phases: planning, implementation, dissemination. In planning established the conditions and role of partnership and definition and analysis of the study. In implementation developed a quantitative and descriptive study to describe the health and social behaviours of Youngers in municipality at North of Portugal. Results: After signed an interinstitutional agreement between ESEP and Vila Nova de Famalicão Municipality, designed a research and have been assured the ethical procedures applied between 2013-2015 a survey composed by sociodemographic and social behaviour characterization, Family APGAR scale and Youth Risk Behavior Survey Portuguese adaptation. The data collection took place in high school and university institutions. The sample was 1614 Youngers. The data analyse allowed for example to majority the family was nuclear and considered their family highly functional; perceived adequate weight, good self-perception and health level; higher level consumption of alcoholic beverages, that happen, in some cases, before the last sexual intercourse, almost a quarter of this population felt depressed; the adoption of protection measures in bicycle driving and sun exposure were the least adopted, a few participants systematically performed recycling materials. For the dissemination developed a brochure addressed to Youngers, summarizing the main results. Conclusion: The Youngers had a positive profile, existing a possibility to enhance them lifestyles. Considering that the majority areas analysed be goals of the Portuguese system of health, through specific health programs for Youngers, must be increased the alliance around the political, education and health institutions. This be a way, to increase/improve gains on Youngers health and consequently economical gains.
	The Provision of Specialist Community Paediatric and Nursing Services for Children with Disability in Malta C. Sciberras, C. Sciberras, M. Galea, J. Mamo [Abstract] The newly set up outsourced speciality of the Community Paediatric and Nursing Services is to reach out for the Disabled Children within their particular environment and to decentralise the speciality from the acute hospital care onto a specialised and personalised form of Community Care directed specifically to the disbled child and to the parents or carers involved in the child’s care. These services are organised within the Resource Centres, Child Care Centres, CDAU, the newly set up Home Care team service and within the peripheral community clinics all over Malta. The aim of these services are to assist childen with individual needs in achieving their full potential.
	An Outline of the Developmental Screening and Assessment Support Services for Autistic Children in Malta C. Sciberras, C. Sciberras, M. Galea, J. Mamo [Abstract] The ability to identify developmental problems from early on is crucial in order to ensure the best prognosis for these children, and thus, more appropriate support services can be provided to ensure a child’s optimal development. In Malta, a number of screening services are available including: - Child Care Centres (for children between 3 months and 3 years of age), - Well Baby Clinics (for infants between 6 weeks and 18 months), - M-CHAT Screening within the newly set up programme ”Lenti ghall-izvilupp ta’ wliedek” within the local Health Centres, - Peripheral Paediatric Community Services such as speech therapy, occupational therapy and early intervention teacher services and - Developmental Assessment Services within the Child Development Unit
	The Phenomenon of Savant Syndrome in Autistic Children C. Sciberras, C. Sciberras, J. Mamo, M. Galea [Abstract] Savant syndrome (also known as autistic savant) is a condition in which a person with a developmental disability demonstrates prodigious capacities or abilities far in excess of what would be considered normal. It is estimated that 10% of those with autism have some form of savant abilities. Generally, the ”savant skills” most commonly seen, are from 5 general categories of music, art, calender calculating, mathematics and mechanical/spatial skills. Further research investigating links between individuals with Autism Spectrum Disorders (ASD) and those with Savant syndrome could help in our understanding on the Autism Spectrum Disorder and in providing new insights on how to improve the prognosis of people with this disorder.
	Encouraging the learning from mistakes in nurse education S. Stephen Ebejer [Abstract] Human error is inevitably an element present in all of human activity, therefore it is also an active component in nurses’ professional lives. This paper draws upon the contention that errors may however be reduced, restrained, or even used to prevent similar episodes of errors from reoccurring in the future. This calls for a concrete and deliberate effort to learn from experienced errors. In fact, learning from mistakes is a widely acknowledged favourable reality in the academic and clinical contexts. However, mistakes are nonetheless associated with emotional reactions, triggers to the blame-finding game, and are known to impede positive working relationships. This discussion paper evaluates theoretical perspectives around positioning the role of mistakes as potential learning opportunities. It argues that, if tapped constructively into, errors make translate into enhanced patient care delivery, improved patient safety, and increased productivity. In a constant changing word, it is imperative to set a continuous learning mind-set, which entails a deliberate effort to learn from mistakes. Nursing students may be helped to synthesise learning following self-made mistakes as well as by reflecting on those of others, particularly which occur in real life clinical environments during the practical placements. The paper proposes a research agenda for the forthcoming years in relation to: the importance of learning from mistakes in student clinical placements and how this learning could be extracted; how a continuous learning mind-set can be fostered through class instruction; and through the use of lab simulation scenarios to create a safe environment in which they are allowed to make mistakes without fear of retribution or catastrophic ending.
	Nurses’ preparedness to deliver care to children with complex care needs: An integrative review E. Montanana, A. Clancy, P. Larkin, M. Brenner [Abstract] Aim To explore theoretical and empirical literature to achieve a better understanding of nurses’ preparedness for the care of children with complex care needs and their families. Background Advances in the field of medicine have increased the number of children living longer with complex conditions, and with that the need for an optimal environment with high quality health care. The move towards primary care attempts to facilitate the psychosocial needs of children with complex care needs and their families. Care settings now extend from hospitals to the community, including children’s own homes. Nurses play a key role in the care of children in these settings. The knowledge and training acquired by the nurses working with children and families has to be targeted in order to deliver optimal and high level care. This study is part of the EU funded project: Models of Child Health Appraised (MOCHA). Methods A systematic approach was used to search literature in different electronic databases (CINAHL, PubMed, InterNurse journals, EMBASE, PsychInfo and Cochrane Library). Theoretical and empirical papers in the English language published within the last 10 years and from European countries were included for review. Results Findings suggest that further training and educational programmes are required for nurses in order to meet the needs of these children. Implications The integrative review give valuable information on how to enhance the nursing care of children and their families by giving insight into areas where nursing knowledge and training need to be improved. The methodology and findings can be transferable to other areas of nursing practice, such as the care of older persons.
	Parcours de découverte de l’interprofessionnalité P. Cani, E. Pinilla-Jacques, P. Kessedjian [Abstract] Un parcours de formation au sein du Pôle Biologie, Imagerie, Activités médicales transversales et Santé publique (Pôle BIAS), à destination des étudiants en soins infirmiers, a été mis en place afin d’optimiser la coordination des activités de soins des futurs infirmiers avec les services prestataires (laboratoires, radiologie, équipe opérationnelle d’hygiène, pharmacie, stérilisation, chambre mortuaire, médecine nucléaire) et renforcer le travail en équipe pluri professionnelle. Ce parcours permet d’identifier les partenaires professionnels et connaître les contraintes organisationnelles quotidiennes des secteurs d’activité. Il contribue également à l’acquisition par l’étudiant d’une posture qui lui permettra de construire des échanges interprofessionnels de qualité. Cette journée de découverte est proposée aux étudiants en soins infirmiers à partir du semestre 3 en stage au Centre hospitalier René-Dubos de Pontoise. Ces visites sont considérées comme une journée de formation et sont inscrites dans les objectifs de stage institutionnels. Chaque groupe est accueilli sur une journée et pris en charge par les cadres de santé pour une visite d’une heure par secteur d’activité. Les étudiants disposent d’un outil de suivi et de traçabilité intitulé Passeport de découverte du Pôle BIAS qui formalise les engagements du Pôle BIAS, de l’institut et des étudiants. Cette journée rencontre un véritable succès auprès des étudiants. Les enquêtes de satisfaction montrent sur deux ans une augmentation du taux de satisfaction et un excellent score de recommandation. Les étudiants apprécient la richesse des échanges, la découverte des missions et des organisations des services prestataires. Ils disent être sensibilisés à l’importance de la communication et des liens entre ces services et les unités de soins pour une meilleure collaboration et coopération. Ils soulignent que la journée est très instructive pour leur future activité professionnelle et leur permet de faire des liens, de donner du sens aux actions et aux soins réalisés dans les unités.
	How will nurse lecturers determine how the new nursing standards will be integrated into the curriculum? S. Green [Abstract] For the purpose of this study, a theory is sought from the data in how curriculum content and delivery is determined by the nurse lecturer. With the new nursing standards from April 2018, how will this be integrated into a new nursing curriculum, and will self funding affect how this is approached? Because grounded theory is about the development of theories this is the ideal methodology to use for this study. It is also appropriate for a study where there is little knowledge known (Rintala et al 2014), or where a new perspective is needed about that phenomenon (Strauss & Corbin 1998, Corbin & Strauss 2008) as is the case here. This proposed study is anticipating theory to be developed from the collected data, rather than just developing hypotheses from this, as Glaser & Strauss discovered over half a century ago (Charmaz, 2014). Their breakthrough in qualitative research and its methodologies was at a time when quantitative theory was thought to be superior in every way, and there was a type of "hegemony" to do with quantitative research that their discovery challenged (Charmaz, 2014 p.7). Their response was that qualitative analysis had its own place in research, which could generate worthwhile theory, and their aim was to build an "abstract theoretical explanation of a social process" (ibid). GT contains a system whereby data analysis runs alongside data collection, so that theory can be derived from the data as Glaser and Strauss did, rather than just developing hypotheses from it (Charmaz, 2014). As there is an absence of a theory about how curriculum writing and delivery is determined, the researcher hopes that this study will highlight this situation locally, and a larger study at a later date could be carried out to ascertain if this is a more widely used theory.
	Comparative study on Cost Analyzing of Interventional Cardio Thoracic services in Sri Lanka- 2016 S.P. Konara Mudiyanselage, K. Edirisinghe, I. Silva [Abstract] Introduction: Sri Lanka provides free universal healthcare. The ageing population and rise in non communicable diseases (NCDs) will increase the burden on the healthcare system. Around 219,000 heart patients are admitted to hospitals yearly. The government spends Rs 3,500 million per year to treat heart patients. The government hospitals had a heart surgery waiting list of over 5,000 patients Objectives; To study the Cost of Interventional Cardio Thoracic Services in Sri Lanka, 2016: Unit cost of coronary artery bypass & graft (CABG) and stent and balloon therapy after comparison of government, private and international Methods: Descriptive, Cross sectional study with an analytical component. It was a Comparative study on Cost Analysis of Interventional Cardio Thoracic Services in Sri Lanka. Cost contributors: Human Resource, Equipment, Space, and Supplies .Unit cost of CABG and stinting and balloon therapy was calculated Results: Total number of surgeries (CABG) per year was 336 and stent and balloon procedures were 898 in 2015. Units cost for CABG was Rs: 948019.14 and catheterization lab cost per procedure was Rs: 655509.43. Considering Operation theatre cost, Building cost was 6.7% (21,600,000.00). 2.7% of amount was Equipment cost. Cost of Human Resource was 21,060,000.00(6.6%). Supplies cost was 83.8 %( 267,150,000.00). Catheterization lab cost contributors: Building cost was 3.7%. Cost equipments were 6.4% (37,601,643.00). It also found Human resource cost which was 2,095,333.00(0.4%) and supplies cost per year was 89.6%. The highest cost contributor was supplies. The cost of government sector was fairly higher than private sector however the comparison of world, it also cheaper. Conclusion & Recommendation; Supply cost extremely high than expected. Routine cost analysis to be performed in other related cost centers such as ICU HDU and surgical words. Cost benefit analysis and Outcome analysis have to be performed for future benefits.
	MITRAL VALVE PROLAPSE AND CEREBRAL ISCHEMIA: Nurse Specialist V. Perovic [Abstract] Background : Mitral valve prolapse (MVP), with 2% general population prevalence (more frequent in younger women) is bening condition. Althought rare, this patients can experience seriosus complications, such as sudden cardiac death (0,5 - 2%) and stroke (0,6%). Aim: The aim of this stydi was to identify the prognostic value of a group of risk factors that werw obtained by combining non-invasive methods (echocardiography and holter-ECG) in assesment of risk for stroke (embolic/ischemic) in subjects with non complicated MVR. Methods: There were 158 subjects examined in the period 2012. in ultrasound lab. They were divided into two groups. In the first group there were 40 subjects aged 20-45 (36% male, 64% female) with clearly identified MVP without complications. In the second group there were 87 subjects aged 37-50 (22% male, 78% female) with clearly identified MVP without complications who suffered stroke in observed period. The following statistical tests were used: t-test, variance analysis, chi equare test, binary logistic regression and descriptive statistics. In all the tests applied the level of significance was set at 5%. Results: We determined by using statistical methods that a group of risk factors: anterior mitral leaflet thickness-AMLt (7,15±1,2 mm; p<0,05; HR 5,7), interatrial septel aneurysm (p<0,05; HP 9,6), paroxysmal atrial fibrillation (p<0,05; HR 8,7), left atrium systolic volume-LAVs (42,6±10,7,p<0,05; HR 3,8) and asystolic pause (3,5±1s; p<0,05, HR 5,2) defined by a combination of non-invasive methods can predict stroke onset with a 87% sensitivity, in patients with MNP. Conclusion: This study confirmed that by combining non-invasive methods we can create a group of risk factors with a 87% prognostic sensitivity for onset of stroke, extremly rare (1/6000 patients per year) complication.
	DM 2, HGA1 or homa index – whether they are a better predictors of coronary artery disease and its extensiveness compared to standard risk factors S. Vucinic [Abstract] Aims Evaluation of patients with diabetes mellitus type 2 (DM2), HgA1c, HOMA-IR and standard risk factors for CAD (smoking, heredity, hyperlipoproteinemia, arterial hypertension ( HTA )), who were sent to a tertiary center for invasive cardiology diagnostics, in assessing the existence of coronary artery disease (CAD ) and its extensiveness. Method Patients at high suspicion of CAD were evaluated on the basis of laboratory and clinical parameters. After invasive cardiology, diagnostics are divided into a group that do not have/ have CAD and is graded in relation to the number of diseased vessels, the one-, two-, three-, four-and-more-vessel disease. Results The study included 837 patients (60±8year), 76.9% were male. Evaluation of the individual risk factors have shown that HOMA-IR (p=0.761; p=0.415), HgA1c (p=0.208; p= 0.345), hereditary (p=0.171 vs. p=0.346), hyperlipidemia (p=0.140; p=0.346), hypertension (p= 0.422; p=0.101) had no significant correlation, while DM2 (p=0.0001; p=0.0001), smoking (p= 0.002; p=0.0001) had a significant positive correlation with the existence of CAD and its extensiveness. Multivariate analysis of individual risk factors, including clinical and laboratory parameters, showed that only DM2 and smoking are significantly important in predicting CAD. Conclusion In our study, after appropriate therapeutic approach, which significantly reduced the number of risk factors, DM2 and smoking were point out, as the only important parameters in assessing the CAD and its extensiveness.
	Teaching US students Community Health in Malta S. Martinelli, J. Robinson, K. Jagiello [Abstract] Community health is a historic cornerstone in nursing and remains an important curricular for nursing programs. The phenomenon of globalization, or the shrinking of borders, was the impetus to pilot an international study abroad course as a site for community clinical. Using a community assessment wheel as a guide, a novel concept in the country of Malta, students conducted assessments, participated in a practicum, and experienced the Maltese culture through immersion. Students summarized the experience by creating a digital story using moving and still images attained during active surveillance to tell the story of the community, identifying strengths and areas for growth.
	Nurses' experience of body nursing care: a qualitative study A. Marchetti, M. Piredda, M. Matarese, G. Facchinetti, M. Virgolesi, L. Garrino, V. Dimonte, M.G. De Marinis [Abstract] Background. As a practice, nursing centres on patients’ bodies and how they live the experience of illness and disability through their bodies (embodiment). International nursing studies conducted on the topic of body care primarily include theoretical studies, whereas empirical studies remain sparse. Aim. To describe nurses’ perceptions of the role of their bodies, and the bodies of patients during body care. Method. This study used a descriptive phenomenological study based on Husserl’s philosophical perspective. A purposive sample of 11 Italian registered nurses representing the highest level of nursing education, different clinical experience levels and different clinical specialties were interviewed. Data were collected between July 2015 and September 2015. Open-ended interviews were analysed using Giorgi’s descriptive phenomenological method. Lincoln and Guba’s strategies were used to ensure the trustworthiness of the data. Results. In addition to the overarching theme, ëBody care is the heart of nursing’, four major themes with thirteen subthemes emerged from the data. The four major themes were (1) ëBody care seizes the essence of person’, (2) ëBody care touches the heart of person’, (3) ëThe body generates opposite strategies of care’, and (4) ëIn time, the body ”nourishes” the helping relationship’. Conclusions. Nurses considered body and embodiment concepts central to nursing. Body care is treated as an experience with extraordinary emotional contents, allowing nurses to discover the essentials of human nature.
	The Perceived Needs of Nursing Students Regarding Transcultural Education: A Pilot Study M. Prosen, S. Licen, U. Bogataj, D. Rebec, I. Karnjuš [Abstract] Background: Due to current migration trends are now, more than ever before, nurses faced with practicing in highly diverse cultural settings. Since nursing is based on holistic approach, cultural competences are essential in providing high quality care and fighting health disparities. Nurse educators should address these issues and develop strategies within the nursing programs to influence the process of developing cultural competences. Aim: The aim of a pilot study was to explore nursing students’ needs towards transcultural education on baccalaureate nursing program. Methods: A qualitative research paradigm was utilized. The purposive sample included 15 part-time nursing students: 5 (33.3%) male and 10 (66.7%) female third year students, with a mean age of 28.3 (SD=10.03) years and 9.8 (SD=7.96) years of work experience in clinical setting. The majority of them (n=10) works in primary healthcare. The data were gathered via open-ended questionnaire, composed of 7 questions in December 2017. The data obtained were analysed (content analysis) by using qualitative data analysis software NVivo ver. 10.0. Results: The majority of students learned about key concepts of transcultural nursing during the study at the faculty. All students expressed the need for learning and training to increase their cultural competences, some by integrating the cultural content in the existing nursing courses and a few as an individual course. The analysis identified two main themes: (1) recognized importance of transcultural education in delivering culturally congruent nursing care, (2) developing cultural competences in advanced nursing curriculum. Conclusions: Developing cultural competences is a long-term commitment of both students and faculty. Students demonstrated increased cultural awareness which should be recognized in designing nursing curricula and implementing transcultural education. Future educational strategies should also entail transcultural education for nursing students after graduation as a lifelong learning process.
	Assessing Cultural Competence in Nursing Education: An Integrative Review S. Licen, I. Karnjuš, U. Bogataj, D. Rebec, M. Prosen [Abstract] Background.The number of migrants continues to increase and therefore the transcultural nursing has become an international concern. At this point, the globalization requires that nursing education focuses on culturally competent care. Design. Limited literature exists in identifying and describing the instruments that assess cultural competence in nursing students. Method. The integrative review was undertaken to identify the instruments that were validated, identify the conceptual frameworks within the instruments, and their assessment methods. Results. There were six instruments identified that assess cultural competence in nursing students. Conclusions. The literature identifies that the instruments to assess cultural competence in nursing students are based mostly on individuals’ perceptions as self-assessment tools. Moreover, the comparison of instruments suggests that multiple factors should be considered when deciding which instrument to use when assessing the cultural competence among nursing students.
	Nursing Leadership Educational Program for Doctoral and Postdoctoral Nurses – possibilities to academic career L. Salminen, R. Suhonen, T. Hafsteinsdóttir [Abstract] It has been recognized the global shortage of highly qualified nurses as a limiting factor to rapid scale-up of global nursing capacity and also the lack of highly qualified postdoctoral nurse educators and academic career opportunities for postdoctoral nurses, which is necessary to enhance patient care through the creation of evidence base to inform practice in which nurse educators play a pivotal role. The aim of this presentation is to describe the content, protocol and expected outcomes of the Erasmus+ -program funded EU-project (2017-1-IS01-KA203-02659), Leadership Educational Program for Doctoral and Postdoctoral Nurses (Nurse-Lead). The objective of the project is to direct doctoral students and postdoctoral nurses into an academic career in nursing by providing them with opportunities to expand their educational, research and leadership competencies. The objectives aimed at both doctoral students and postdoctoral nurses are to improve their leadership competencies focusing on research and make the group more relevant as scientific educators and attune it to emerging labor market’s needs. This three year project conducted in six European countries consists of a 1 1/2 year preparation and development of the Nurse-Lead program and the implementation and execution of the 1 1/2 year Nurse-Lead program where postdoctoral nurses and doctoral students enhance their competencies in leadership, research, education, professional development and establish new transnational networks. The expected outcomes of the project will be among other things: a) Internet based learning modules for postdoctoral nurses and doctoral students co-produced by the partners; b) online community and website; c) competence profile for assessing the competence of postdoctoral nurses and doctoral students’ leadership in research, d) studies to measure the impact and experiences of the program; and f) a symposium reporting the outcomes of the program.
	The nursing licensure exam: a cross-sectional study A. Marchetti, D. D'Angelo, M. Virgolesi, A. Stievano, I. Notarnicola, F. Giorgi, M.D. Zecca, A. Petrizzo, M. Piredda, M.A. Pulimeno, M.G. De Marinis [Abstract] Background. National and international debate about nursing licensure exam regards the competences that this exam must certify and the types of the qualifying tests used. Italian nursing lecturers identified the ëcore competences’ for Bachelor’s Degree; however, from nursing literature emerges a high discrepancy in the competences and in the types of the qualifying tests used to evaluate cognitive, psychomotor and relational competences.. Aim: To verify if the ëcore competencies’ are evaluated during nursing licensure exam and the types of the qualifying tests used in the four Medical Schools of the Lazio Region. Methods: The data were collected and interpreted through a lecture-grid. Descriptive analysis was conducted through SPSS statistical software.. Results: Ninety-five exams from the academic years 2013-2014 and 2014-2015 were analysed. The ability to manage medications and other therapies was the competence most evaluated. Discussion of a clinical case was the most used test (43%), while on the bed test was the less used (2%). Conclusions: The study showed that most ëcore competences’ were evaluated during the nursing licensure exam. Moreover, it confirmed the high discrepancy in the types of tests used and the scarce assessment of psychomotor and relational skills.
	Development of student guidance skills as a part of nurse’ professional growth E. Jouppila-Kupiainen, R. Riikonen [Abstract] Elina Jouppila-Kupiainen, MNSc, MA; RN, Senior lecturer of Nursing, South-Eastern Finland University of Applied Sciences Riitta Riikonen, MNSc, RN, Senior lecturer of Nursing, South-Eastern Finland University of Applied Sciences Development of student guidance skills as a part of nurse’ professional growth Student guidance through evidence based approach is being developed in nursing education in Finland. The topic is researched and studied extensively. The purpose of this poster is to depict post-graduation education how the nurses can broaden and deepen their professional growth and pedagogical knowledge. Minimum know-how criteria for nursing education created in Finland 2014 are the basis of nurse education in Finland (Eriksson et al. 2014). During education nurses develop their skills in student guidance. The criteria defines the basis of nurse’ capabilities for patient guidance and the purpose of the criteria is to unify the instructive and practicum procedures during nurse education. (Potilasturvallisuusstrategia, 2017). In the nurse education the main emphasis for the student is in individual support of the learning of nursing, guidance process, setting the learning goals, finding learning opportunities, assessment and in giving and receiving feedback. In student guidance, the relationship between the personal mentor nurse and the student nurse is highly important. It is important that the mentor nurse think themselvs the goals for the student guidance. Determining the quality of nursing education in Finland, the validated CLES (The Clinical Learning Environment) scale is being used. This scale produces knowledge on a yearly basis of guidance capabilities of hospitals and practicum locations in a unit scale. The results through out years show that guidance education has an effect on the CLES results and that the nurses have the possibility to learn the latest in knowledge of guidence. References Eriksson, E., Korhonen, T., Merasto, M. ja Moisio, E-L.2014. Sairaanhoitajan ammatillinen osaaminen - Sairaanhoitajakoulutuksen tulevaisuus -hanke. Valtioneuvoston periaatepäätös. Potilas- ja asiakasturvallisuusstrategia 2017-2021. stm. julkaisuja 2017:9. Saarikoski, M., 2008. The Clinical Learning Environment CLES. https://www.utu.fi/en/units/med/units/hoitotiede/research/projects/pedagogic-health-care/cles/Pages/home.aspx. Read 9.11.2017.
	Developing cultural competence in nursing education through simulations I. Karnjuš, M. Prosen, U. Bogataj, D. Rebec, S. Licen [Abstract] Background. Due to increasing globalization, cultural competence has become essential for the provision of quality nursing care. Using simulations as a learning strategy in nursing education are one of the many initiatives worldwide to create and enhance cultural competence and prepare the nurses to work in multicultural environment. Design. Limited literature exists regarding the effectiveness of simulations for cultural competence training in nursing. Method. The integrative review was undertaken to identify what are the best simulation strategies and the effectiveness of their use to enhance cultural competence in nursing. Results. Strategies that have been established include standardized patient, computer-based programs, and human patient simulators. The use of simulations can support cultural competence nursing care by ensuring safe and controlled environment to provide a cultural assessment, increase student awareness toward ethnically diverse patients, and improve critical thinking, communication, and nursing skills. Conclusions. The use of simulations enhances effective transcultural nursing care. However, due to the scarcity of simulation studies further research is still needed to support its effectiveness in developing cultural competence among nursing students.
	Student’s Perception and Attitude Toward Migration and Transculturalism: Opportunity and Necessity for Change U. Bogataj, I. Karnjuš, M. Prosen, S. Licen, D. Rebec [Abstract] Introduction: Migration continues to be one of the most prominent issues in Europe. Most imigrants to Slovenia are form republics of former Yugoslavia and they still represent majority of foregin-born population. But over the past few years, the trend of migration through the territory of Slovenia has increased considerably according to the ”Balkan path”. Therefore, the health care system actually found itself in sudden changes, unknown problems and limitations. In Slovenian area, it is undoubtedly important that the process of educating health professionals should include that important content in the curriculum, as well. The purpose of this research was to identify perceptions and attitudes towards transculturality and migration in the Slovenian territory through the eyes of future health care professionals. Method: The research was conducted with short questionnaire, sent to Slovenian nursing and midwifery students via online media. The questionnaire was formed, sent and data were analysed using open source web survey application. Results: Main results showed that in a clinical environment, students mostly do not have much contact with migrants, except in specific areas eg. primary health care, gynaecological and maternity care, mental health care etc. For health care professionals - mentors is working with migrants also challenging. We also cannot ignore the fact that, that these issues are not enough integrated into the study programs. Conclusions: Due to the fact that those situations are something new in our socio-cultural environment it is necessary to think about the direction of further research on multiple area.
	Geriatric Early Warning Instrument for the Detection of Acute Fysical Deterioration of Elderly Living in Nursing Homes Y. Bonnez, B. Maertens, S. Dehaes, E. Van der Linden, A. Wildiers, B. Van Rompaey [Abstract] Background Almost 10% of elderly living in nursing homes are hospitalized annually. This has an impact on the nursing home residents, their familiy, and on the society. Futhermore, these hospitalizations are often unnecessary or could be prevented. Today, there are no instruments to detect acute fysical deterioration of elderly living in nursing homes. The purpose of this study is to develop a Geriatric Early Warning Instrument (GEWI). Method A pilotstudy, with a controlled trial without randomisation. In the intervention group (n=119), parameters were taken weekly during two months. In case of deviating parameters, a little survey was conducted. Residents below the age of 65 or with DNR 3 code, were excluded from the study. The control group included 150 residents. Results The number of hospitalizations and deaths were equal. There was a relation between systolic blood pressure and hospitalization (p<0,001), as well as between pain and decease (p=0,008). Most parameters were between limits. Eight residents had a negative outcome during the study (hospitalization or deceased). Of those eight residents, caregivers worried about only one resident. Discussion The current study has some limitations. First of all the outcomes, deceased and hospitalization, did not occur often. Secondly, only two different nursing homes were included. The results of this pilot study showed that recurrently taking parameters had no predictive value towards decease and hospitalization. A concerning result was that caregivers were worried about only one resident with a negative outcome. This could mean that the clinical observations from caregivers are possibly not adequate. Advanced research will be conducted after optimalisation of the screening instrument to obtain a larger and more adequate database. As result of a larger database, the negative outcomes decease and hospitalization will occur more often.
	A Quality Grading Matrix for Care Homes for Older Persons P. Vella, A. Vella, M. Sciberras, M. Mangion, I. Avallone, S. Martinelli, M.G. Cassar, M.A. Fenech [Abstract] Background This inter professional project originated by the Quality and Compliance team together with the management of the Active Ageing and Community Care Department (AACCD) to monitor the standards of care/services for older persons in care homes. Aims and objectives 1) To assess if care homes meet the older persons’ needs. 2) To profile standards of care and ensure good quality of service. 4) To enhance cooperation between AACCD and care homes. 5) To support and inform policy developments. 6) To provide data for research purposes. Audit tool The local, National Minimal Standards for Care Homes for Older People, (2015) provided a framework for developing the tool. The tool was also guided through quality rating in the hotel industry and the Donabedian model as follows, 1) Structure or the service providers’/facility’s capacity towards high quality care. 2) Process or the service provided/administered. 3) Outcome or the changes in health status and conditions. Criteria weighting and scoring 1) Critical - indispensable have to be achieved 2) Major - important expected to be achieved 3) Minor - less important 4) Additional - not expected but enhance quality rating. The scoring system was based on a 3 point Likert scale to score if each criterion is met in full, in part or not met. Home Star Grading following implementation process, 1) The best 20% receive a five-star rating. 2) The middle 60% percent receive a rating of 2/3/4 stars. 3) The worst 20% receive a 1star rating. Initiatives Initiatives to improve the standards for the care homes eg quality awards, seminars, workshops will be considered to improve the facility and service delivery. Conclusion The tool effectively strengthens AACCD’s agenda, that of putting the older person in the midst of care and service provision.

	Curriculum Development Collaboration Between Finland and Kazakhstan H. Tiittanen, J. Heikkilä [Abstract] In Kazakhstan the nursing education is principally carried out in Medical colleges as vocational education, mainly taught by the physicians. The education is discipline based, having a medical approach. Currently a reform is going on in nursing education, the aim is to upgrade the the nursing education to the higher education level, which would be comparable to the European nursing education standards. With the World Bank funding, JAMK and Lahti Universities of Applied Sciences (Finland) have supported this reform in years 2014-2015. With the cooperation of the faculty of six pilot Medical colleges, the competences for nurses have been defined, and the competence based educational standard have been developed corresponding to the European directives. The implementation of the new curriculum has been supported, and the first students from the pilot colleges are graduating in spring 2018. The development process has been both challenging and rewarding, where the cultural issues have also paid their role. Now the reforming work is continuing by developing the fast track programmes, and making the real career development possible for nurses in Kazakhstan. The aim of the presentation is to describe the competence based curriculum development process in the cooperation between the two universities of applied sciences in Finland, and six pilot medical colleges in Kazakhstan.
	Transcultural nursing a European project: Developing multimedia learning for transcultural collaboration and competence in Nursing M. Brown, C. Hall, I. Bergmann-Tyacke, M. Dhaeze, E. McSharry, M. Santos [Abstract] Promoting internationalisation, recognition and mobility, supporting changes in line with Bologna principles TransCoCon focuses upon enhancing cultural awareness and promotion of transcultural competence in the professional context of nursing and healthcare. This is achieved through the development and dissemination of stand alone, self contained Open Educational Resources (OER’s) which address practical cultural concerns and highlight best professional practice. Each resource represents about 15 minutes of learning and focuses upon addressing a single learning goal, which may be used many times and in different settings. The participatory design and development, testing, implementation and dissemination of 7 interactive multimedia Reusable Learning Objects (RLOs) provide an innovative method of teaching for lifelong learning, which can be used for initial nurse education and continuing professional development, as well as providing significant learning opportunities for those in other healthcare professions to explore their roles within multi-disciplinary teams. The implementation of the RLOs will strengthen the quality in our cooperation as a whole as well as partners’ educational programmes, as it will be a tool for better preparation of mobilities for student nurses and nursing lecturers. In continuous vocational education, qualified nurses will benefit from the RLO’s, as they can use them at their own convenience to improve their work within an inter-cultural team in their own country or to prepare for a mobility in order to promote their own expertise. For those with less opportunities for mobility or inter-cultural exchange, the RLO’s can give a first insight into nursing in other countries and offer a base for reflection of the respective own cultural and professional understanding.
	Etugen University: Onward to a quality improvement journey O. Batsukh, S. Gankhuyag, I. Nyamzagd, M.T.'. Panizales [Abstract] Etugen University (EU) located in Ulanbaatar, Mongolia started its nursing school in 2004 offering a baccalaureate nursing degree program. The school of nursing started with 36 students and has achieved a total of 740 graduates in 2017. Verbal narratives have noted that Etugen nursing graduates are preferred nurses in the various local hospitals. University and nursing school leaders have a vision of improving nursing school curriculum so it will meet international accreditation standards. A team was created to formalize and align the vision, and develop plans of action with nursing faculty ownership and EU management support. A US-Asian trained nurse leader was engaged to work with the EU team. A translator/project manager was provided throughout the engagement. Series of meetings, classroom and clinical area visits, and planned lectures ensued to help gain insight on current academic curriculum and build relationships. Meetings were either formal or informal. A two-day lecture was developed to engage the nursing faulty in building leadership and management skills focusing on gap analysis. As an outcome, the faculty redesigned their curriculum, and nursing faculty leaders developed a plan of action. The plan of action targets the improvement that the faculty would like to address. The faculty and translator/project manager facilitated the ongoing discussion via email. Mongolia nursing accreditation standards and the ANCC international accreditation standards were parsed to identify current compliance status and where ongoing improvement needs to be worked on. EU benchmarked their curriculum on a SouthEast Asian country nursing standards. Simulation laboratory was a major target in 2017 improvement.
	Emergency care students practice in multiple simulation learning environments J. Hämäläinen [Abstract] Simulated practice learning is a key method in the Degree Program in Emergency Care at The South-Eastern Finland of University of Applied Sciences (XAMK). It is a realistic and highly motivational way to learn emergency care skills. Patient safety and practicing non-technical skills are main principles during simulated exercises. XAMK campus at the City of Kotka has multiple different simulation learning environments, such as ambulance simulator, ”mini-hospital” and a building with many apartments. Our students also practice their skills in more public environments, in- and outside of the school. Collaboration with working life during simulation exercises is important, as it brings the exercises more real and larger scale. XAMK collaborates for example with local Emergency Care Service, Kymenlaakso Fire department, Gulf of Finland Coast Guard, South-Eastern Finland Police department and volunteer organizations. The collaboration benefits all, as working life partners offer human resources and equipment, and XAMK offers them high-quality training, and students get to practice with real-life paramedics and field directors. At the conference, two simulation exercises with working life collaborators will be presented. In first exercise, the patient is unconscious. In the second exercise, the patient has had a falling accident on an island, thus the exercise includes boats and even a helicopter.
	Educational Implications of dual agency in critical care nursing J. Trapani [Abstract] Research indicates that that of seeking help from doctors, other nurses or other health professionals is one of the most frequent nursing decisions; yet, there is very limited research around the factors related to, and the actual process of, such referring. This study sought to address this research gap by exploring the factors associated with critical care nurses’ decisions to seek help from doctors, and to explain the process of referral in the critical care setting through a substantive theory derived from the data. The study took place in a general intensive care unit in a local state hospital. Data collection involved twenty hours of preliminary non-participant observation; fifty hours of participant observation and informal interviewing; fifteen hours of formal semi-structured interviewing with ten nurses selected by means of purposive and theoretical sampling; and two 2-hour focus group sessions. Concurrent data collection and analysis was guided by the dimensional analysis approach to grounded theory involving a series of inductive-deductive cycles with increasing levels of abstracton. The findings suggest that nurses’ decisions to seek help from doctors involve nurses weighing up several occasionally conflicting motivators. A central consideration is that of balancing their moral obligation to safeguard critically ill patients’ interests with their duty to respect medical practitioners’ authority. Subsequently, nurses find themselves in a position of dual agency as they concurrently act as agents to two different principals - the medical practitioner and the patient -which is potentially morally distressing. The substantive theory underscores nurses’ role in acting on behalf of patients in a scenario of significant patient vulnerability and the factors that enhance, mediate and potentially suppress this advocacy role. It provides insight into educational requirements for enhancing nurses’ courage to place patients’ interest at the forefront of their actions and interactions, without eroding existing collaborative aspects within multidisciplinary teams.
	Interdisciplinary and International Teaching Unit A.-M. Sonon [Abstract] The interdisciplinary and international teaching allows 8 categories of health practitioners to work together in English: Nurses, Midwifes, Dieticians, Speech Therapists, Physiotherapists, Psychometricians, Medical Imaging technicians and Medical Laboratory technicians. Erasmus IN students are included as well. The project aims to develop new skills and abilities which will lead to: Collect and select discipline-specific information in the clinical cases presented; Identify health problems and problems to be addressed collaboratively; Set objectives of interdisciplinary care; Establish a list of multidisciplinary care interventions; Mobilise English langage ressources; Expand the interdisciplinary knowledges through the approach of the profiles and the interventions of the different health practitioners; Enable internationalization at home, namely the meeting of foreign students without going abroad, by working together with students ERASMUS IN; By interdisciplinarity, students will acquire a range of knowledges, skills, intellectual abilities, behaviors and values that make them more adaptable and prepared for a better professional future. Interdisciplinarity can evolve over time. What is today an interdisciplinary work can lead to full integration and create a new discipline. This new discipline can be a new field of scientific study, with its own concepts and methods and its own experts. Interdisciplinarity has two advantages: complementarity and creativity: the contribution of several disciplines provides better lighting; interactions between disciplines are questioning the views of the members of a team and puts them in the obligation to produce more original explanations and methodological innovations. Problem Based Learning (PBL) turned out to be the methodology needed. Indeed, PBL encourages reflexive thought, group communication, learning throughout life, problem-solving, self-regulation and collaboration, a key factor in motivation among students. The knowledge gained through this method allows students to apply problem-solving skills to other situations. In addition, PBL would be more effective than traditional methods to prepare students in the field of their profession.
	Intention to change practice following continuing education: evaluation innovation M.A. Gendek, C.A. Wellings, S.E. Gallagher [Abstract] Background: Continuing education and translation of new knowledge to practice is increasingly important to improve patient care in today’s health environment. However, evaluating the effectiveness of the education is often focused on learner satisfaction with the event and whether learning took place. It does not always address behavioural change and its impact on patient outcomes. Therefore, using the concept of intention as a precursor of behaviour (Ajzen, 2007), a provider of continuing nurse education revised its evaluation tool to capture more meaningful data. Methods: The evaluation revision included open-ended questions that were predictive and designed to capture learners’ intention to change practice as well as perceived benefits of learning to patient care. A qualitative analysis was undertaken of the responses from 1003 evaluations returned from a random convenience sample of 61 seminars. Results: The return and completion rate of evaluations demonstrated a willingness to respond to open-ended questions. As well as providing feedback about the educational experience, the nurses reflected on their learning and its transfer to practice; and, wrote their intentions regarding changing their future practice behaviours. However, results also revealed multiple challenges related to translation of new learning into practice. Conclusion: Ascertaining translation of new knowledge to practice may not always be easily assessed, especially when education is provided independently to the workplace. The use of open-ended questions placed more emphasis on reflection and learner intention to positively change practice; and, assisted in improving the level of evaluation. While nurses may express an intention to implement new leaning, there still continues to be barriers that many face. Nurse educators are in a position to enable change and must consider the synergies that exist in the practice arena that will facilitate the implementation of new learning. References: Ajzen, I. (2007). Attitudes, Personality and Behavior. 2nd ed. Berkshire: McGraw-Hill Education.
	Nursing Education in the Community Practice M. Cassar, A. Zammit [Abstract] Community health nursing as defined by the American Nurses Association (ANA, 2013) is the amalgamation of nursing and public health practice applied to protect and promote the health of the population. The World Health Organisation (2010) highlights the importance of community health nursing and its inclusion as part of the nursing students’ curriculum. Teaching nursing students how to properly identify, assess, plan, implement, and evaluate the population at risk is believed to improve the health of the community and thus improving the health of individuals and families. Community health nursing also enhances the capacity of families, individuals, and communities to cope with their health needs outside of the hospital, keeping hospital admissions down and freeing up beds for critical cases and preventing long admission times. Nurses working in the community therefore hold a huge responsibility towards enabling students to experience and learn the essential skills and knowledge that a qualified nurse in such context needs to be equipped with in order to function effectively and efficiently This implies that they must be adequately competent to do so with allocated student nurses allocated to this sector. Unfortunately in the Maltese community clinical area, there is a limited number mentors/supervisors/clinical educators who may guide and encourage students’ learning. This reality echoes that which is found in various other countries across. This is ironic against the backdrop of increased worldwide awareness regarding the need to establish and promote enhanced quality of community care. This paper seeks to present the salient elements of the ongoing discussion in the world of nurse education and modern health systems regarding the approach and requirement for optimal teaching for students in the community setting, and optimal instruction and development by the nurses who practice in the area and nurse educators.

	Health@world: towards a culture sensitive nurse identity W. Decock [Abstract] Within the international project health@world, first year nursing students of Howest (University of Applied Sciences) learn about the importance of social and cultural influences on nursing, health and health care and open their minds to the diversity of our globalizing society. The health@world project is organized as an international week which takes place in April each academic year. The Nursing Department of Howest invites international nursing students and lecturers to participate. With an evidence- and experience-based approach, participants learn with and from each other about cultural sensitive care and health promotion worldwide. For a future nurse it’s important to reflect on his/her own position within a more global and evolving context both national and international. Through this international week, students learn to know the importance of social and cultural influences on health and health care and open their minds to the diversity of our society. During this international week students learn about the differences in healthcare in the world and the influence of Europe and the world on healthcare in their home country, mainly in the area of cultural sensitive care. Students will also learn to be sensitive for other cultures they meet in health care settings and learn how it influences the daily practice as a nurse. Mixed teams are assembled, coached by international lecturers and experts, in order to work on intercultural cases in different domains: child/mother health, mental health, elderly care,... Through this project, an extensive set of intercultural competences are embedded in the new Nursing curriculum. Students will finally learn how to reflect on their own intercultural competences and to set new goals for their future development.
	“Just go for it”:-Student and Staff Evaluative Reflections of an innovative global learning opportunity-POLO J. Benbow, B. Johnson [Abstract] The value from volunteering studying/working abroad are widely agreed upon for both UK and overseas health care delivery development and the growth of individual students and qualified staff (All Party Parliamentary Group on Global Health, 2013). For students to achieve such benefits the multi-dimensional challenges need to be overcome by both the students going abroad as well as the staff facilitating the experiences (Mendes and Ventura 2016). In this paper the evaluations of over 120 students, over a 4 year period, will be presented to include the significant professional and personal rewards students gained, alongside the challenges and how the students managed those challenges. Examples of such rewards include enhanced confidence, communication and cultural competence (Campinha-Bacote, 2002). Challenges encountered by students include, for example, overcoming professional differences and practical challenges. Finally the collaborative learning gained and outcomes will be offered, to enable development of future students’ global health competencies. References:- All Party Parliamentary Group on Global Health, 2013. Improving Health at Home and Abroad: How overseas volunteering from the NHS benefits the UK and the world Campinha- Bacote, J. (2002). The Process of Cultural competence in the delivery of healthcare Services: a model of care. Journal of Transcultural Nursing 13, 181-84 Mendes, I. A.C. and Ventura, C.A.A., 2016. Editorial: Leading and advocating for global health competencies: a nursing challenge. Journal of Nursing Management 24, 843-844.
	Intended and Actual Outcomes of Study Abroad opportunities: An Exploration of Maltese Nursing Students' Experiences J. Trapani, M. Cassar [Abstract] Student mobility programmes are believed to benefit students and educational institutions. Several Maltese nursing students participate in an exchange through the Erasmus+ programme every year; yet, no published studies have formally explored their mobility experiences. In view of the increasing emphasis of evaluating the quality of higher education internationalisation, this study sought to explore the motivations for and outcomes of Maltese nursing students’ Erasmus exchanges and compare them to the intended outcomes of the Erasmus+ programmes. Data collection started with an online survey to which all 145 current and former Maltese nursing students who had participated in an Erasmus exchange were invited to participate. Sixty-five persons (response rate = 44.8%) completed the survey, of whom 16 respondents took part in a two 2-hour focus groups held at a later stage. The survey revealed that participants were overwhelmingly in agreement that the intended outcomes of the Erasmus+ programme were achieved through their exchange. Thematic analysis of the focus group data confirmed that the experiences were generally positive and supplemented the questionnaire data with concrete examples. The following six themes were elicited: jobs and employability; exposure beyond the Maltese shores; personal growth; relationships; context-sensitivity of nursing care delivery; language and citizenship. The positive experiences reported in this study confirm that nurse educators should continue investing time and energy in encouraging and facilitating study-abroad experiences for nursing students, and that such opportunities should be provided to even more students. More research is, however, required to explore any negative outcomes of Erasmus exchanges. Longitudinal studies would be helpful in investigating whether perceptions about such exchanges change along time.
	HEALINT: Developing a Pan-European Tool to Assess Placement Quality, Enhance the Learning Experience and Promote Student Nurses’ Mobility C. Higgins, C. Hall, S. Cunningham [Abstract] Background: In a fast-paced modern world, cultural exchange programmes like ERASMUS+ have allowed innovation and education to blossom across borders. However, within nursing this has been difficult to enact due to cross-cultural differences in nursing standards when auditing the quality of practice placements as places for student learning. Resulting in an expensive, inefficient and under-used resource. Aim: This project aims to evaluate current audit approaches for placement learning and develop universal standards with an accompanying audit tool and benchmark system. We will pilot the audit tool in practice, peer review and release the benchmark system for use across the European Union. Participants: 7 partners across 5 European countries representing a range of nursing and healthcare education, and clinical nursing practice. Methods: Over the next 3 years the project will produce 5 clear outputs. Output 1; a briefing paper around nursing standards for practice placements as places of learning followed by the development of an audit tool designed to objectively and reliably evaluate placement areas. Output 2; piloting the audit tool and monitoring its effectiveness. Output 3; developing teaching for auditors and exploring their validation process. Output 4; a retrospective evaluation of the pilot process to measure the tools validity and reliability. Output 5; running concurrently throughout the project will focus on dissemination of the project and audit tool. Expected Outcomes & Innovations: Promotion of international, transcultural nursing education with an aim to promote mobility and innovation. Internationally recognised audit protocol, mainly focused on European nursing practice. Application to Future Practice: Potential to further develop audit tool to be applicable to multiple healthcare professions, with worldwide recognition. Development of International placement database.

	Lonely experts? Expert nurses working within the municipal health servises for Asylum Seekers in Norway I.M. Bregaard [Abstract] Background Asylum seekers are entitled equitable health services in Norway, in all parts of the health sector. Most municipalities have designates asylum and refugee health centers, where nurses are the first point of contact. Methodology In-depth interviews with seven expert nurses were conducted. Their view of relevant competencies in working with asylum seekers and how their own competencies and experiences were perceived by their collaborators were investigated. An inductive approach was used to analyse the data. Results The participants had on average 15 years (7-40 years) working experience within the municipal asylum and refugee health servises. They represented all four health regions in Norway, including rural and urban municipalities. The participants had extensive experiences in working with asylum seekers, and emphasized empathy, openness and creativity as a crucial part of their daily work in meeting vulnerable patients. Knowledge related to epidemiology and specific health needs of asylum seekers were also relevant, as well as knowledge related to the system including rights to health services for asylum seekers. Knowledge about how the patients experience their life while in the hands of the system waiting for answers to their asylum application, settlement or forced return was also considered of great importance. The participants experienced lack of professional support from other parts of the health services and the immigration authorities, and they felt that their experiences and competencies were perceived as irrelevant or wrong. This lead to a lack of legitimacy in preforming their profession. Conclusion Nurses play an important role in providing health care to asylum seekers. Experience and competencies related to the complex health and life situation of asylum seekers was perceived important by the participants. Lack of legitimacy and professional support was considered a challenge in providing equitable health services for asylum seekers.
	Equity in Health Care during Nursing Studies How can equity in health care related to immigrant patients be implemented during clinical practice in nursing studies? I.M. Bregaard [Abstract] Background Oslo and Akershus University College (HiOA) has the largest nursing education in the Nordic countries. The focus on migration, health and equity in health care is scarce, with no particular focus during the 1,5 years of clinical studies. Oslo University Hospital (OUS) is the main provider of clinical internships for the nursing students at HiOA, and has a designated section for Equity in health care and patient safety. Methodology Literature review related to equity in health care during clinical studies. Development of a methodology for implementing equity in health care within the current structures of the clinical studies in medical and surgical hospital wards in OUS. Results This resulted in the project Equity in health care for immigrant patients in clinical nursing studies, where 60 students have participated. The project was conducted in close collaboration with the section for Equity in health care and patient safety. The students had 8-10 weeks of clinical studies during the project period, during which they had a four hours workshops every two weeks with experts in the field of migration and equity in health care. The student presented cases from their internships, and the cases were discussed in relation to good practice with a focus on how to provide equitable services in general and related to the specific cases. The students found the project beneficial, especially the integration of theory, clinical studies and the possibility to discuss cases with experts and learn from them. Conclusions Equitable health services are imperative, but has little focus during nursing studies. This project found a beneficial way to integrate theory and practice within the current structures of the education thus having no need for additional funding and resources. The students felt more competent and prepared to provide equitable health services to immigrant patients after the project.
	How do you develop interprofessional leadership in clinical practice? E. Maxwell, C. Nadaf [Abstract] This presentation will discuss the realist evaluation of an educational Fellowship scheme designed to develop clinical leadership. The Darzi Fellowship is a bespoke leadership programme within the English NHS to address a perceived lack of clinical leadership in practice. The eighth cohort completed their Fellowship in summer 2017 and was notable for the balance of professions, including medical and nursing staff, therapists and psychologists and pharmacists The findings of a longitudinal, theory driven evaluation will be presented. This will include the development of the program theory identifying the mechanisms that the Faculty anticipated would be triggered and the subsequent findings about what worked for whom and in what circumstances. Results indicate that the fellows’ experience on their own learning journey was heavily influenced by two mechanisms: 1. Collaborative inter-professional learning - Fellows placed high value on the learning that they had achieved through relationships with their peers where they could share their ësense making’ of the teaching and its application in practice. Peer learning had helped fellows to deal with the initial ’culture shock’ on entering the world of experiential learning and later helped them to start to think about different sorts of relationships in workplace and the way that they viewed other healthcare professional groups. 2. The provision of real-life work-based improvement projects became the vehicle for the practising unrehearsed skills, developing confidence and new ways of thinking. This was closely linked to the perceived success of the year however was dependent on the organisational sponsor support. Projects enabled fellows to see things through a different lens, some of whom questioning if they were the project themselves. The findings have a number of recommendations and implications for the development of future leadership programmes for clinicians working towards continuous improvement.
	Rethinking Health Professional Education in a World of Motion: Mission impossible? M. Bonello [Abstract] It is argued that health professional education has not kept pace with contemporary challenges in health care and health care systems mostly because of fragmented, outdated and static curricula that produce ill-equipped graduates (Frenk et al., 2010). One of the ways in which some governments have attempted to respond to these challenges is through interprofessional education (IPE) which is acknowledged as being one of the strategies to improve collaborative practices. IPE, defined as ”occasions when two or more professions learn with, from and about each other to improve quality of care” (CAIPE, 2002), has been gaining ground in many countries, however, in Malta there are no initiatives in undergraduate curricula. This presentation, based on a doctoral study, explored the concept of undergraduate IPE as a possible model of practice at the Faculty of Health Sciences, University of Malta. The methodology employed was an instrumental qualitative case study with data collected from eleven focus groups, five one-to-one interviews and documentary searches. Participants across these methods included academics from nursing, midwifery and allied health professions, newly qualified health professionals and key stakeholders from the education and health sectors. Findings yielded rich insights into participants’ perceptions of IPE; while they lauded the notion in principle, they identified a multiplicity of factors which would pose barriers to its enactment in practice. Some barriers might be described as symbolic while others were rooted in the practical domain of operational systems. This presentation examines those determinants that would affect the development of IPE focusing on symbolic macrostructural barriers which were perceived to conflict with the enactment of IPE; in particular, the impact of macrocultural factors on a potential IPE initiative. Although the conclusions are contextual, the implications could highlight new insights for European mini-states and other nations that share similar features.

	Psychological Impact of Employment Conditions among Health Service Providers Employed in Australian Regional Offshore Processing Centres T. Holmes, S. Rees, T. Ziaian, A. Tay [Abstract] Aim and significance: Australia’s offshore refugee processing facilities for refugees have been under intense scrutiny following reports of unacceptable living conditions, poor physical health and a deterioration of the mental health of refugees. There is, however, no empirical evidence of the psychological impact on health service providers in those settings. The aim of this research was to examine the psychological impact of employment conditions on health service providers in the Regional Offshore Processing Centre at Manus Island. Methods: A thematic analysis was undertaken on data from a senate inquiry into an incident at the Manus Island Regional Offshore Processing Centre as a mechanism to gather evidence from employees regarding their workplace experiences. We examined public submissions and hearing transcripts from a senate inquiry held primarily to investigate an incident that took place at the Manus Island detention centre in 2014. The data available to that inquest was reanalysed to examine day-to-day experiences of the off-shore detention environment beyond that single event. We focused on reflections provided relating to the general experience of employment and the mental health impacts for health service providers. Results: Psychological stressors associated with employment included witnessing violence and traumatic events; sexual harassment and sexual assault from co-workers; a restricted capacity to speak about traumatic experiences; working in conditions of remoteness and isolation; fearful anticipation of violence and feelings of intimidation; and a workplace characterized by a prevailing tension and apprehension. Conclusion: Our research examines an area never-before studied and it concerns a politically silenced area of inquiry- the mental health wellbeing of health service providers employed in offshore detention centres. This is a politically fraught area, that can be debated variously as vitally important, as well as ethically challenging.
	Exploring resilience of contemporary nursing roles in Wales: a mixed methods study J. Benbow [Abstract] Background:- Stress and burnout of nurses are known consequences of healthcare workplace adversity which can negatively affect care. Resilience is known to buffer the negative effects of stress through behaviours that facilitate adaptation in the context of adversity, resulting in the ability to function above the norm in spite of significant stress (Masten 2001). Resilience may positively influence the well-being of nurses (e.g. Mealer et al, 2014). However, limited research exists examining nurses’ understanding of resilience and its relevance to workplace environments. This paper partially addresses this gap by answering the research question: - What is the relevance of resilience to nurses? Methods:- Mixed methods two phased design consisting of a questionnaire and analysis of free text responses exploring perceptions of resilience and work environments. Participants included Registered Nurses (n=1459) from all fields, pay bands and job roles/settings. Survey responses including 8, 000 free-text comments totalling 89,000 words, were descriptively analysed. Findings:- Nurses’ provided clear insights of resilience and hundreds of examples of resilience and lowered resilience in practice. Frequently nurses recognised challenges of not merely keeping calm but keeping calm, compassionate and professional. Emergent novel linkages between emotional and professional efficacy, which can promote resilience, within regulatory frameworks, and nurse educator implications will be discussed. Conclusion:- These unique insights open the door for resilience to be redefined within a professional/employment frame focusing upon realities of practising nurses. Potentially leading to enhanced educational preparation and workplace support for nurses’ striving to deliver excellent patient care. References:- Masten, A. 2001. Ordinary Magic, resilience processes in development American Psychologist 56 (3), pp. 227-238. Mealer, M., Conrad, D., Evans, J., Jooste, K., Solyntjes, J., Rothbaum, B. and Moss, M. 2014 Feasibility and Acceptability Of Resilience Training Program For Intensive Care Unit Nurses. American Journal of Critical Care 23 (6), pp. 97-105.
	Interculturality, Training and Care M.-C. Durier [Abstract] Interculturality concerns the meeting between 2 people, 2 cultures, 2 ways of thinking and 2 concepts of the world. The encounter implies not only that those persons are available to meet, but also that communication between them should be adapted in relation to each other. In the current context, where, with the development of the RRAAC (rapid rehabilitation improved after surgery), outpatient surgery is increasingly present and requires optimal knowledge of the person within a limited timeframe and where home care intensifies and the number of people cared for due to immigration increases, the question is: How is this meeting between care-giver and patient possible? How should not only nursing students be educated within the context of their training, but also care-givers, whether they practise within or outside a hospital be taught to be sufficiently receptive to the culture of another person and to develop this sensitivity to interculturality and take it into account in their professional practice? I shall present and illustrate how we, at the Vinatier Nursing Institute approach cultural competence, using the PTT IENE model, with the aim of developing this cultural competence, which is essential within care, in our students. PTT IENE model : Papadopoulos, Tilki and Taylor model for Developping Cultural Competence. Intercultural education for Nurses in Europe

	the nurse as a hope fomenter M.Z. Sorares, S. Schoeller, M. Martins, I. Fernandes, D. Lima [Abstract] Aim: Research about hope for people with spinal cord injury. Its premise is the competence of the nurse who promotes the hope of those who care. The philosophical foundation is the Erns Bloch’s hope dialectic. For him, hope presents itself in a constant process of updating and works as a communicator of promises for the construction of a reality future, making possible the construction of something imaginary. To hope for a process is part of the care and it is up to the nurse. Method: dialectical study, with in-depth interviews with 22 people with spinal cord injury. The study followed the ethical criteria of Brazil. Results: hope is dissatisfaction with the present, and, it depends on the life history and the conditions necessary for achieving goals. It starts with the reach of small things, and it gradually widens. Accessibility is a factor of hopelessness. Discussion: It is the nurse’s responsibility to build the hope process, which is one of the pillars for good living. Conclusion: It is up to the undergraduate courses to insert the content with compatible dynamics, so that the nurse reaches the competence to foster hope.
	Profile of the Procedures related to Physical Restraining within Maltese Care Homes for Older Persons M.A. Fenech [Abstract] Background: A physical device, material or equipment is construed as a physical restraint when (a) the device is attached and/or adjacent to the person’s body, and (b) the person cannot easily remove the device and (c) limits the person’s freedom of movement. Aims: (1) To identify the types of physical restraint devices used within care homes. (2) To obtain a profile of the procedures (recommending, explaining, monitoring/removing, documenting restraint use). Methodology: A questionnaire, comprising quantitative and qualitative components, was developed to investigate the use of physical restraining in care homes. It was self-administered by professionals and support staff in 13 care homes in Malta, and returned anonymously to the researcher. Quantitative data was statistically analysed using SPSS. Results: (1) 449 questionnaires were distributed, with a response rate of 38% (15.5% males, 84.5% females). (2) Commonly used restraints were, full bed rails (83.8%), belt harness (54.9%), H/T-harnesses (both 49.7%); least common restraint used was bed harness (4.0%). (3) (a) Nursing and allied health staff ranked high for all the procedures related to the use of restraining. (b) Management mainly decided towards removing the restraints. (c) Family members ranked third as the persons recommending initiation of restraint use. (d) 14.8% of respondents across the homes reported a lack of restraint documentation in the older persons’ medical files. Conclusions: (1) Findings portrayed the various types of physical restraints in use. Full bed rails, the commonest form of restraint used, have been reported in the literature to be the main cause of restraint-associated deaths. (2) The study adds to the body of knowledge around processes underlying restraint use namely the person (a) recommending, (b) explaining, and (c) monitoring/removing restraint use. Published literature was devoid of investigations into these modalities and their associations to physical restraint use.
	Nursing services in the remote areas M.-L. Kauronen [Abstract] The amount of the population in the countryside have strongly decreased during the years 2000-2014 in Finland and the population is aged there. The health care services have centralized in the centers during the recent years that cause problems for the inhabitants in the preventive care and the control visits of the chronic diseases. Research methods: The quantitative data from the sparsely populated municipalities were collected. A qualitative research focused on the evaluation of the implementation of health care services. The supervisors of the primary and secondary care had interviewed. Results: The population groups who need health services in the countryside consist especially of the old or vulnerable groups and suffer from chronic diseases, loneliness, mental health, drinking problems and social exclusion. The municipalities appreciate the equity of health. However, the preventive health services have mostly moved to the population centers, for instance weight manage groups and influenza vaccination, and to attain these services require input from the families. Movable nurse consulting service is establishing that offers primary and secondary preventive services in the countryside. Mostly the clients have chronic diseases and the nurse can follow the lab tests, medication, symptoms and the balance of the care. General influenza vaccination days have offered. An electric patient register, a remote access and picture transmission for the doctor are available that is precondition for the service. In the future, technic and methods for the new nursing services and peer support with supervising will be needed to develop.
	Using Video Interaction Analysis to Explore the Impact of a Psychosocial Intervention I. Kollak, C. Luderer, A. Herzog, M. Woepking [Abstract] Video interaction analysis was successfully used in the qualitative Tales+Dementia+Study that accompanied the project ”Once upon a time... FAIRY TALES AND DEMENTIA”. The project was initiated and conducted by the German Centre for Fairy Tale Culture, project and study were financed by the German Federal Ministry of Family Affaires. The regularly offered events of fairy tale narrations twice a week in five nursing homes located across Germany were recorded with two cameras: one focusing the audience, the other focusing the narrator. 62 nursing home residents with dementia took part in the project. The collected material encompassed - inter alia - 20 hrs. of video film, which was cut and edited. The video interaction analysis took place in group sessions that always followed a strict procedure. The leading questions were: Do fairy tale narrations as psychosocial intervention improve the participants’ well-being and how can we characterize the participants’ well-being? The videos interaction analysis proved, that during the story telling participants’ activity and social interaction were encouraged by fairy tale narrations and competences were (re)activated. Challenging behaviour, especially agitation, fear and apathy, were significantly reduced. A well-being became apparent. The video interaction analysis is an appropriate method to gain scientific evidence for the impact of a psychosocial intervention. It is vital to follow a structured procedure to obtain reliable results.
	Developing Nurses’ Understanding of the Use of Theoretical Frameworks in Doctoral Research W. Walker [Abstract] Building nursing research capacity is a strategic goal in Europe; the essence of which is the preparation of scholarly leaders who can inform, enrich, and deliver the evidence-base of nursing policy and practice (World Health Organization 2015). The nurse educator plays a pivotal role in providing quality supervision to the student researcher, and a dynamic, trusting relationship is a prerequisite for excellence (Severinsson 2015). Constructive dialogue and debate is a healthy feature of the research supervision process (Murphy and Wibberley 2017), fostering critical thinking, informed understanding, and critique. It is not unusual to deliberate the use of a theoretical framework as this can provide guidance for the researcher, and structure to the area of research interest. However, a lack of understanding may be encountered due to a paucity of subject-related literature (Green 2014). This presentation illustrates the use of theoretical frameworks in qualitative research by drawing on two studies, respectively carried out as a doctoral and postdoctoral scholar. The studies are distinct, thus providing contrasting examples of: identifying and applying an existing theoretical framework (study one) and the development and use of a unique theoretical framework (study two). Developing nurses’ understanding of theoretical frameworks in research should form part of the doctoral education and training programme, for the purposes of planning a research study, and producing trustworthy discipline-specific knowledge. References Green H. (2014) Use of theoretical and conceptual frameworks in qualitative research. Nurse Researcher 21, 34-38. Murphy NA. Wibberley C. (2017) Development of an academic identity through PhD supervision - an issue for debate. Nurse Education in Practice 22, 63-65. Severinsson E. (2015) Rights and responsibilities in research supervision. Nursing and Health Sciences 17, 195-200. World Health Organization (2015) European strategic directions for strengthening nursing and midwifery towards Health 2020 goals. The WHO Regional Office for Europe: Copenhagen.

	The emerging use of Social Media: an innovative tool in today's education E. Tartari, T.-H. Borzykowski, D. Pires, D. Pittet [Abstract] Introduction: Social media has emerged as a valuable educational tool, engaging health workers worldwide in the World Health Organization (WHO) SAVE LIVES: Clean Your Hands global annual campaign. Methods: Each year the WHO SAVE LIVES: Clean Your Hands campaign launches a call for action with a theme in response to the global burden of health care associated infections and antibiotic resistance. A campaign toolkit is made available on the WHO IPC webpages with resources to be used from health care facilities worldwide. Hashtags such as #safesurgicalhands, #safeHANDS are made available for use in social media. Symplur.com was used to generate data from the Twitter platform and a marketing company provided a landing page to collect photos shared. Results: The safe hands campaign in 2015, using the hashtag #safeHANDS reported a global reach of 55 million. The volume of conversations on the social networks (especially Twitter) started growing from April 20 with a peak of 12’000 messages using the hashtag #safeHANDS on the 5th of May. More than 6,200 photos have been published on the photo wall and shared through Twitter and Instagram with the hashtag #safeHANDS. The impact of the campaign has further increased, with an estimated reach of 98 million worldwide in 2016, from use of the #safesurgicalhands hashtag. Most of the users communicated in English (63%), while Spanish was the 2nd most common language (18%). 15,000 photos have been shared. The campaign had a global impact with participants from all around the world. 19,217 health care facilities from 177 countries have already registered to support the 5th of May global campaign. Conclusions: The use of social media holds promise to raise awareness and maintain a global momentum. This proved to be a unique platform allowing HCWs to connect and engage in real time on a global scale.
	A randomised control trial to explore whether gamification increases student nurse engagement in an e portfolio of professional practice’ P. Morgan, G. Wills, M. Gobbi [Abstract] Introduction. Gamification has been cited as a potential way of increasing student engagement and learning within education. However, the research within this area remains sparse and tends to reflect experiences of computer science and engineering students. Research aims. The overall aim of this study was to explore whether the introduction of a scoring system into an E-portfolio interface changed student nurses’ behaviour in relation to their engagement with formative activities or an increase in learning as depicted by grades. Methods. In 2015 n = 210 undergraduate Bachelor of Nursing degree students were recruited and were randomly allocated to a control or an experimental group. The experimental group was exposed to a scoring system contained within the portfolio. Those in the control group completed their portfolio in the normal way. The e-portfolio database captured the activity of the participants. Follow up focus groups were used to explore potential motivations behind engagement. Results. Statistical analysis using t-tests, proportional comparisons of means and standard regression demonstrated that gamification did show a statistically significant increase in student engagement. However, this effect appeared to diminish over a period time. Correlation between gamification and age, branch of nursing and gender demonstrated no significant findings. There were no significant findings in relation to an increase in learning The focus group activity upheld the findings of the statistical analysis regarding engagement . Conclusion. This study has demonstrated that gamification is an effective way to increase student engagement. However, it does not indicate that the effect on engagement is sustained over a prolonged period. There is a need for more health professions related research to be carried out to add to the body of evidence concerning gamification to support or refute its use to increase student engagement and learning.
	Nurses: At the forefront of Progett Metamorfosi W.P. Aber, V. Muscat, B. Piscopo, A. Xerri, M. Singh, M.T.'. Panizales [Abstract] Information and communication technology continue to advance, making its way to the end users of the hospital - our nurses. ICT revolutionized how health care is delivered, creating opportunities to improve health outcomes. Vitals Global Healthcare Management, Ltd. invested in the development of the first comprehensive electronic health record (EHR) system in both Gozo General Hospital and Karin Grech Hospital. Work has been in progress for the past months with end user engagement and serving as Champions of the named, ”Progett Metamorfosi”. Champions had the opportunity to work beside developers in India for two weeks and continue their engagement remotely. This opportunity contributed to building an effective and efficient e-health system. Education is a major component in the development and launching of the system. The Nursing Informatics team has engaged nursing end users through a unit based demonstration and conference calls with developers during the initial development phase. As the system reached a stage of completion, Operational Assessment and Validation (OAV) was another educational modality that the hospital staff has experienced. OAV allowed users to test the system and identify gaps in the EHR work stream cycle. At this phase, soft launch was planned to involve select units. As part of the training plan and soft launch, computer skills assessment was conducted to determine the needs of the end users. A computer focus skills training was scheduled and was attended by more than the expected number. The highlight of the training is the EHR system. Series of training schedules were offered. To augment learning, the staff were given access to the system wherever and whenever they can practice. Computer terminals were made available at staff’s respective unit. Leadership and staff support, and education program tailored to meet the end users were key to the success of ”Progett Metamorfosi”.
	Augmented Reality in Nurse Education: A SWOT Analysis S. Pace [Abstract] The concept of augmented reality (AR) is increasing within healthcare and nursing education. The evidence presents promising outcomes regarding the use of AR in education; virtual reality teaching may bridge the gap between practice and theory in that such three-dimensional representations enable auditory and tactile learning, and help address challenges associated with lack of equipment, training space and educators (Foronda et al., 2017). Also, the use of AR through gamification is associated with a heightened student engagement. An education system’s ability to adopt AR is measured across a number of facets. The introduction of AR in education curricula would require duly qualified instructors as well as alterations in curricular structure, including approaches to assessment. The incorporation of AR within healthcare curricula is therefore believed to pose challenges to students and instructors. Specifically trained and qualified educators would need to adapt to a system of education that uses superimpositions of real-life objects to convey knowledge and skills to students. On the other, students would need to take up a receptive approach to the scenarios being presented to them through AR resources. In turn, such a change from the traditional, theoretical education method is to be accompanied by an altered system of assessment criteria which is consistent with the referred teaching and learning approach. This paper seeks to present a critical discussion of the perceived strengths, weaknesses, opportunities and threats of including AR in nurse education across different contexts. References: Foronda, C. L., Alfes, C. M., Dev, P., Kleinheksel, A. J., Nelson Jr, D. A., O’donnell, J. M., & Samosky, J. T. (2017). Virtually Nursing: Emerging Technologies in Nursing Education. Nurse educator, 42(1), 14-17. doi: 10.1097/NNE.0000000000000295
	ISPAD project: an Evaluation of a Simulation Champions Training Programme M. Cassar, J. Trapani, J.L. Mifsud, R. Sammut, E. Kivinen [Abstract] The ISPAD project is an Erasmus+ funded project running between 2016-2019. It is led by the Department of Nursing, University of Malta, and embraces the participation of nine European nurse education entities as project partners from six countries. One scope of the project is to develop simulation champions in each participating entity, in view of developing leaders in the use of simulation in nurse education. The other aim is to create a set of simulation resources which may be used by students at different stages of nurse education programmes. This paper focuseson the scope of developing simulation champions in the ten nurse education entities. It presents (i) an overview of the development of a training programme (5 ECTS) at EQF Level 6 by the University of Malta and Lahti University of Applied Sciences in Finland; and (ii) an account of the findings arising from an evaluation exercise carried out amongst participants and educators involved in this training programme. Focus groups were carried out amongst a group of conveners of the programme (n=4) and a group of trainees on the programme (n=5). Audiotaped Data were transcribed and analysed using thematic analysis. The results portray a number of challenges and outcomes experienced by the educators and the participants in the course of the programme development and delivery. These include; (i) the varying levels of exposure and experience of participants from different countries to simulation teaching and (ii), the varying meaning of debriefing in simulation teaching. Against a backdrop of increasing awareness and investment towards the adoption of simulation teaching and learning strategies across the globe, the sharing of this international initiative and its evaluation is believed to be very contemporary and relevant to other nurse educators education entities.

	An Alternative Approach to Developing Leadership in Nursing: Rolling out Distributed Leadership E. Curtis, S. Corrigan [Abstract] Aim: To focus on the critical role of distributed leadership for the nursing profession, highlighting the activities of our leadership network in addressing leadership challenges and our future plans for nursing education. Background: A key objective of nursing educators is to educate nurses to be caring, knowledgeable, and accountable individuals who are able to contribute to improving patient care outcomes. Leadership is considered fundamental to this process. This determination to improve and develop nursing leadership is driven not only by academics but, also by nurse clinicians and others including patients. For the past three years we have led a Leadership in Nursing Network, as well as hosting an annual leadership seminar for nurses and health professionals for eight years. The common theme emerging from these seminars is the need for a more participative approach to leadership within the profession. Current literature is inundated with articles supporting the need for leadership to be a participatory process and as a consequence, approaches such as distributed leadership have achieved prominence. One of the key outputs of the network is the development of a module on distributed leadership for nurse clinicians. Approach/Method: This presentation will chronicle the development of the proposed module. Specific requirements and learning outcomes will be gathered through two quasi focus group discussions with nurses in clinical practice. This bottom up approach is necessary so that the module content and its delivery methods are tailored to the needs of nurses. Conclusion: The initiative is critical in order to ensure that the nursing profession has the necessary skill base to improve leadership in clinical practice. The module is at an early stage of development, but the positive response received so far from nurse clinicians has assured us that this is exactly what the profession requires
	Preparing the ED nurse for pre-hospital emergency care T. Abela-Fiorentino, R. Kneafsey, G. Furze [Abstract] The nurse’s role in pre-hospital emergency care has received increasing attention over the past few years. Literature suggests that nurses can function effectively in pre-hospital care, however literature looking at how emergency department (ED) nurses can be effectively prepared as front-line pre-hospital emergency responders is limited. The aims of this study are to develop a framework of pre-hospital competencies specific for ED nurses, and to develop a strategy for preparing ED nurses for the pre-hospital role. In this sequential qualitative mixed-methods study, exploratory individual interviews were conducted with a normative panel of thirteen informants. These were followed by three confirmatory group interviews with a total of eighteen ED nurses. All informants were recruited from the Maltese emergency service, in which ED nurses are front-line providers of pre-hospital care. Through Burnard’s method of thematic analysis, five themes were identified. Namely, ëThe nurse in pre-hospital care’, ëThe pre-hospital setting’, ëCompetencies for pre-hospital care’, ëAttributes of the pre-hospital nurse’, and ëDeveloping the pre-hospital nurse’. Findings show that a number of competencies were common for nursing practice within the pre-hospital setting and the ED. However, in view of the higher level of independent practice, the limited human resources and decreased skill-mix within the pre-hospital setting, a deeper knowledge-base and a wider skill-base were desired. A number of pre-hospital specific competencies were also identified, which were mainly related to the physical environment within which pre-hospital care occurs. Training in pre-hospital nursing should thus build on the knowledge, skills and experience already acquired by ED nurses, while adopting appropriate strategies to expand and apply this experience and meet the demands of the pre-hospital setting. Data obtained from this study can be used in conducting training needs analyses, and in the development of pre-hospital nursing programmes sensitive to the needs of ED nurses.
	The Toolbox Project: Teaching Qualified Nurses in the Practice Setting D. Buttigieg [Abstract] Nurses have a responsibility to develop their skills and knowledge. Continuing Professional Development (CPD) secures knowledgeable caregivers, who are the key to good-quality care. Moreover, CPD allows for further business development and is associated with increased job satisfaction, motivation and increased initiative to self-improve. In other sectors, namely construction and other manual roles, Toolbox talks refer to short educational sessions amongst staff members on a specific topic or theme in view of promoting safe and effective practice. This paper describes a project whereby the referred Toolbox approach is being adopted to the teaching of qualified nurses in clinical settings. This project started from organising Toolbox talks amongst the housekeeping staff of a private general hospital in Malta, in an effort to address infection control principles. The successful outcomes of such talks led to extending the teaching initiative to the nursing and the nurse-supporting staff. The TOOLBOX Project is guided by the Model for Improvement, essentially comprising of the Plan Do Study Act (PDSA) cycle. A SWOT analysis was done in the planning phase and used as a guide throughout the rest of cycle. In this presentation, a detailed account of the PDSA stages (for the first cycle) is presented. This is a very young project and is just at the end of the first PDSA cycle. However, it has already yielded significantly favourable outcomes, including the development of a learning environment which accommodates the continual development of the clinical team. The fact that this project has brought the hospital a step closer towards the ultimate goal of having managers, nurses and students sharing reviewed information, knowledge and practice distinguishes Toolbox Talks as an apt approach to teaching qualified nurses in the clinical area. This fact is critically discussed and its relevance to other contexts is explored.
	Bringing active online teaching strategies to graduate level Biostatistics J. Agazio [Abstract] In 2013 our School of Nursing made the decision to also offer our Masters (MSN), Doctor of Nursing Practice (DNP) and Doctor of Philosophy (PhD) degrees in an online format. Courses would run for 8 weeks and faculty committed to providing comparable content and rigor in both campus and online courses. Biostatistics offered challenges in first, offering content in understandable chunks for what is often a difficult conceptual course for students; and second, covering required content within the 8-week framework. Using an innovative framework of short lecturette videos; software demonstrations; and integration of discussion prompts, the course has proved engaging to students and as preparation for the advanced statistical courses that follow. This presentation will demonstrate how adult learning and online teaching principles have been applied in developing and administering the Biostatistics coursework and how this is then reinforced and extended in follow-on advanced statistics or epidemiology courses. In the first three weeks of the course, students are exposed to theoretical content and statistical principles followed by an open book midterm exam for validation. Weeks 4-7 each focus upon separate statistical tests moving from tests of difference (t tests, ANOVA, Chi Square) to those of relationship (correlation, regression). In the final week, students complete an online comprehensive objective examination along with a separate project using datasets to construct research questions with application of appropriate testing and interpretation. Learning is actively reinforced through online discussions and video demonstrations of statistical tests. Integration of web resources further enhances and extends learning for students needing more content. Strategically placed synchronous web-based sessions not only build online community, but provide a forum for demonstration and clarification of elusive content. This presentation will demonstrate the teaching methodology and highlight innovative strategies used in this dynamic course.
	Community nursing: the implications of its importance on nurse education S. Martinelli [Abstract] Confronted with changing health-care systems and needs, nursing educators should visualize nursing and nursing education from a different perspective. Students must be prepared to meet the needs of populations rather than institutions, of families rather than solely individual persons, of communities rather than simply individual citizens. Community nursing programmes of education may offer an apt vehicle in this regard. Challenges in community nursing programs are diverse across different contexts but one strand of challenges echo, consistently, across the entire globe mainly: (i)To make the community nurses’ contribution more visible, (ii)The recognition of the expansive role of the community nurse, (iii) Bridging gaps between primary, secondary and tertiary care, (iv) To create varied opportunities for training in community settings and (v) Policy makers to validate the importance of community nursing. This paper seeks to present how nurse education in Malta has sought to modify the design of community nursing education, and to innovate and develop community nurse education, in the context of the unfolding reality noted above, and in the light of the development and experiences registered in other countries. A reflection upon where we started, spanning to where are we going with community nurse education is critically discussed including conclusions pertaining to actions indicated for the future. These include; 1) To make the course more attractive and feasible to pursue by adopting a blended learning approach, and 2) To focus teaching on diverse individual, family and population needs, promoting health and wellness, specific illnesses, clinical and management skills. This discussion is relevant to nurse educators in other countries who are seeking to innovate and develop nurse Education in their own country or context , and for countries who are seeking to evaluate initiatives taken in their regard.
	Blended learning: Wider door of opportunity for Masters student exchange opportunities M. Gatt, M. Cassar, L. Salminen [Abstract] The Empowering Learning in Nursing Education Intensive Programme (EleneIP) is a 10 ECTS masters study unit offered by the University of Turku, offering a blended learning approach in view of attracting international masters students. The aim of the course was to bring together university students in different countries to ensure high quality nurse educator education related to evidence-based teaching and outcomes concerning social media as a learning environment in nursing education in multicultural European context. The aim of this presentation is to describe experiences of international student about the intensive week of EleneIP course. The intensive training week in Turku, Finland involved a series of workshops. There were altogether 28 students participating in this course from six countries. All lectures and workshops were interesting; focused on different teaching methods of course delivery, which involve technology including 3D learning, and gaming. The online component was consistently engaging, despite challenges with using technology across different continents worldwide, including periodic poor internet connection and incongruent time-zones. The leadership of the academic and technical staff at the host university and the support from the staff at the sending educational entities/ countries is an indispensable element to the successful outcome. As a masters student from Malta, my experience on this programme was excellent. With the University being family-friendly, I was able to travel with my family. The blended approach of the course twinned with this added benefit clearly holds immense potential for offering opportunities to mothers who are students to engage in exchange opportunities. This paper is being presented in view of showcasing the opportunity associated with the use of blended learning with regards to enhancing masters students exchange opportunities, in an effort to promote its adoption by other educational entities seeking to maximise the learning experiences of masters nursing students.
	Innovative methods in nursing education S. Luukkainen, S. Erämaa [Abstract] The ageing and increasingly complex patient population signifies more complicated and demanding problems for health professionals to solve. Globalization means multicultural population,patients and professionals.The qualities and skills needed by practitioners to work effectively in multidisciplinary and multicultural practice is evident. A critical need for new models of shared learning has been identified. In 5 years multicultural project we developed and implemented a recognized and accredited undergraduate transatlantic double degree in Nursing between EU (Finland, Northern Ireland, Hungary) and USA. 26 students has completed the double degree in nursing and enhanced their possibility on the global, multicultural labor market. Due to the lack for clinical practice places and growing demand of effective health care with demanding patients, we have just started a pilot project, where the clinical practice is running in multiprofessional modules. There are nursing, physiotherapy, podiatry, nursing and assistance nurse students doing their clinical practice at same time in same module. Flipped Classroom is a learner-empowering learning culture that emphasizes the student’s own activity in learning, interaction between students, and the use of technology and internet resources in teaching. Simulation is a useful tool for creating realism and practicing knowledge and skills in nursing care both before and after clinical practice. Simulation provide a safe environment for practicing theoretical knowledge, skills and demanding patient situations both in multiprofessional and multicultural teams. E-learning, virtual reality (VR) and augmented reality (AR) offers a wide range of opportunities for multicultural and multiprofessional education in nursing - All for the future.

	Managing Risk & System Change for Nursing & Healthcare Delivery S. Corrigan [Abstract] Managing Risk & System Change for Nursing & Healthcare Delivery Aim: To highlight a ground-breaking and innovative online Masters programme aimed at providing nurses with the capability of leading and sustaining change in order to realise their potential as internal change agents in proactively dealing with future challenges. Background: Nursing is a fundamental element of healthcare delivery. Nurses are at the sharp end witnessing how constant change is impacting health care delivery and patient care. We know that some things are improving in terms of patient care but much is not. Nurses need to see themselves as change agents as they can have a significant impact on needed change. But the question remains: Are nurses ready for this challenge? Evidence-based practices, new emerging models of care and the move towards more accountable care organisations present highly experienced nurses with additional challenges. Nurses are reporting that they don’t have the necessary competence to deal with the sheer pace of constant change and the demands that involves in everyday operations. Therefore bridging this competence gap is crucial. Approach/Method: This online Masters programme provides a rigorous but practical focus on managing risk and change. It provides a core and robust curriculum that has been developed and tested in safety critical collaborative research and practice. An innovative, practice-based and interactive online learning environment ensures a flexible delivery structure deploying cutting edge knowledge to foster advanced standards of professional practice. Conclusion: This online course brings the next generation of safety, risk and change management directly to the nurses, in their work, embedded in their everyday practice with a systemic, proactive and performance focus.
	Enhancing gerontological nursing in Malta – the development of the new Degree in Nursing (elderly care) program D.A. Scerri, R. Sammut, M. Cassar [Abstract] Addressing care needs of older persons in the Maltese Islands has traditionally been considered as a role of the respective family members. Over the last few decades changes in the epidemiological, sociological and demographic facets such as increased longevity, multiple chronicity, smaller family units, and increased female employment, resulted in increased provision of formal care to older persons across the country (Formosa, 2005). Moreover, in the last couple of decades, the importance of health care professionals including nurses working with older persons irrespective of the setting, have become recognized in order to contribute in maintaining their health and improving the quality of life (WHO, 2012; Rowe, Fulmer & Fried, 2016). However, as with other countries, nursing care of older persons has persistently failed to attract an adequate quantity and quality of nursing staff. In addition, the retention of staff who work in settings that provide care services for older persons is also a persistent endeavor (Castle & Engberg, 2005). Against this backdrop, this paper reports the development of a Bachelor’s programme in Nursing (elderly care) by the Department of Nursing at the University of Malta. The aim of the programme is to enhance the preparation of nurses in the specific care of older adults and to augment the recognition and acknowledgement of nurses working with older persons working in any health and social care system. A description of the programme is presented together with a critical analysis of both the experienced and the predicted challenges, outcomes, risks and benefits of developing this programme. The ensuing discussion about capacity building in gerontological nursing through the development of similar programs, is of significant relevance both locally and across other European counties.
	Addressing The Educational Needs Of Nurses Involved In The Care Of Children And Young People With Rheumatic Disease? C. English, B. Davies, R. Wyllie, N. Smith, T. Rapley, H. Foster [Abstract] Background and Purpose: Recent advances in the management of paediatric and adolescent rheumatology conditions has required highly specialised nursing input within multidisciplinary teams. There is an important role for education and support, not only for nurse specialists but also nursing colleagues sharing that caring. This study aimed to establish essential ”core” learning needs of nurses, working in a variety of health care settings, who deliver care to children and young people and their families. Methods; Multi method research was conducted using online survey, focus groups and interviews with key nursing stakeholder groups including clinical nurse specialists (CNS), nursing students, and nurses from general paediatrics, community, research and adult rheumatology. The aim was to improve outcomes and experiences for this patient group through education and support for nurses. Findings; Four themes were identified: (1) Need for Increased Awareness about inflammatory conditions (2) Impact of Personal Experience and Nursing Role, (3) Need for Increased Knowledge about Rheumatic Disease and Management (4) Design Components for a Impactful Learning and Information Resource. The findings demonstrated that the level of need ranged from novice to expert and the next step was production of an educational tool to match these diverse needs. The research guided the construction of an evidence based, educational, web-site for nurses. This website is a free, accessible,educational E-resource for nurses and students (www.pmmonline.org/nurse) which includes top tips for nurses; case studies; care plans; videos and photographs. Conclusions and Implications: Clinical nurses and nursing academics have worked collaboratively with medical professionals, social scientists, psychologists and digital media experts to produce a unique and impactful resource. The nursing website launched in September 2017 complements the existing medical website paediatric musculo-skeletal matters (www.pmmonline.org) with the potential to support and educate nurses globally.
	Delaying Admission to Residential Care Through Appropriate Nursing Support: Implications for Nurse Education C. Attard [Abstract] The demographics of many countries across the globe are witnessing the rapid growth of the respective elderly population. Coupled with this, is a widening recognition of the importance of active ageing and keeping individuals living, as long as possible, in one’s own home whilst aging in place, as opposed to admission in residential care. Assisted living through sheltered accommodation offers, potentially one favourable avenue towards achieving this. The concept of assisted living amongst the elderly was introduced in Malta in 2015, through the creation of Hilltop Gardens Retirement Village built by a private entrepreneur whose main area of expertise is the hospitality industry. This paper seeks to present and reflect on managements’ experience with regards to: (i) Securing optimal quality of care delivery to service users/ clients, (ii) Maximum support to the formal care provider, e.g. the nurses and carers, and (iii) Adequate assistance to informal carers around the service user/ client. (iv) Providing the right educational support in such environments. The challenges and opportunities arising from such experience are discussed in view of contributing to the development of future initiatives of this kind, locally, and also in the international context. For example, the difference in the work practices and mindset required, which characterise care in assisted living environments in comparison with other care contexts are highlighted and discussed. The implications for nurse education arising from this phenomenon are presented together with a number of recommendations towards the better preparation of nursing students and carers in view of this reality and paradigm shift.

	Le blended-Learning : une méthode pédagogique d’avenir pour les Instituts de Formation en Soins Infirmiers (IFSI) ? A. De Brito, C. Frerot [Abstract] Le développement des outils multimédias avec les Technologies de l’Information et de la Communication (TIC) devient incontournable dans les milieux universitaires et au niveau européen (Commission européenne, 2010). Cette communication repose sur une expérience pédagogique initiée à l’IFSI Théodore Simon en 2009 : le e-learning avec  l’utilisation des nouvelles technologies multimédias et de l’Internet, pour améliorer la qualité de l’apprentissage en facilitant l’accès à des ressources et des services, ainsi que des échanges et la collaboration à distance  (HAS, 2015). Dans ce contexte, avec une méthode pédagogique s’inscrivant dans un courant socioconstructiviste, le formateur en IFSI a pour mission de garantir une qualité d’enseignement permettant à l’étudiant infirmier d’acquérir le niveau de connaissances nécessaire à l’exercice de la profession. Après une évaluation positive de la satisfaction des étudiants, le blended Learning est retenu à l’IFSI. Cet apprentissage  mixte  propose une formation à distance à partir de cours sonorisés et de tests d’auto-évaluation, suivie de périodes de regroupement des étudiants en présentiel qui favorisent l’interactivité avec le formateur. Au regard de cette expérience, de nombreux questionnements ont émergé sur trois axes : Quelles compétences le formateur en IFSI doit-il développer pour la conception des contenus de formation en ligne et pour l’animation du présentiel ? Quels types de ressources sont à mettre en œuvre ? Quels sont les impacts de cet apprentissage à distance sur l’acquisition des connaissances, le taux de réussite aux examens et la satisfaction des étudiants ? Pour répondre à ces questions, l’analyse d’une enquête quantitative auprès d’étudiants en soins infirmiers de première année (questionnaire, suivi de l’activité en ligne, analyse des résultats aux évaluations) a permis de montrer l’efficacité et d’identifier les axes d’amélioration de ce dispositif de formation en IFSI.
	The European Junior Leadership Academy for Student Nurses and Midwives S. Johnson, C. Hall [Abstract] Abstract Introduction: This paper presents the methods and rationale for the European Junior Leadership Academy project. The three-year project aims to develop, implement and evaluate a European Junior Leadership Academy (EJLA) for Student Nurses. The project is funded by the European Commission under the Erasmus Plus, Key Action Area 2, Strategic Partnerships. Through this project we seek a better understanding of how to develop leadership identity in student nurses and midwives. Methods: The EJLA programme has identified 40 high performing nursing students from four European Higher Education Institutions who demonstrate leadership aptitude and leadership potential. The programme aims to develop their leadership identity, knowledge, attitudes and skills by creating opportunities to observe leaders in action and leaders’ impact on the individuals and organisations they lead. Through leadership retreats, internships, mentoring and peer network projects, the EJLA will support participants to develop their leadership signature early in their career journey. The project will evaluate students’ and educators’ experiences of the Academy through both qualitative and quantitative methods. Results: This paper focuses on presenting insights emerging from the first Junior leadership retreat held in Nottingham in which student identified the distinctive features of student leadership and reflected upon their own leadership skills and capabilities. They worked together as an international team in preparation for their internships and future retreats Discussion and conclusion: Nurses across Europe face common challenges in delivering more nursing care with less resource. Rising demand for healthcare has been fuelled by an ageing European population, a global epidemic of non-communicable illnesses and the information revolution which has resulted in highly informed patients. At the same time, health systems are under increasing pressure to contain costs. Delivering high quality care requires innovative, collaborative nursing practice and a cadre of leaders able to operate in different professional situations and cultures. The EJLA seeks to contribute to pervasive leadership development aimed at student nurses. It is thought that this approach can ensure that the nursing profession can meet these challenges.
	Raising awareness into complementary therapies among student nurses in Malta T. Bugeja [Abstract] At its inception, nurse education in Malta was very pinned to the bio- medical model. Later it became largely influenced by the catholic religion. A wider holistic approach to nurse education curricula has evolved over the last few decades which gave rise to a more comprehensive pre-registration curriculum spanning various aspects of human life, and embracing different cultures and contexts accordingly. This paper presents a critical discussion around the introduction of an ”innovative” elective credit into the traditional nursing curriculum in Malta. The credit aims: 1. To develop an awareness of complementary modalities and their usefulness in promoting health 2. To provide students with the opportunity to learn about the healing potential of complementary therapies This credit draws upon the contention that although complementary therapies are not essential to care delivery, ensuring that nurses are aware of different complementary therapies available is favourable. In the least, nurses would likewise be able to understand the patient who expresses interest or requests complementary therapy as an adjunct or alternative to conventional care. At the point of service-provision and delivery, the health care system in Malta is still mainly based on the bio-medical model and aspects of health such as mind-body interactions and spiritual aspects, are to-date, still receiving, minimal attention. On the other hand, the enthusiasm of the public for these therapies is on the increase. As a nurse educator, I have been motivated to introduce this credit in response to backdrop. The credit includes didactic and experiential learning about the concepts, philosophies, evidence, and practice of various CT modalities, including mind-body interventions, and energy therapies. Additionally, whole medical systems are experienced when the opportunities arise for students to do so. The paper is believed to be of interest and relevance to educators embarking on similar ”innovative” initiatives in curriculum development.
	Transnational Cooperation to Innovate in Simulation Education S. Ward, C. Hawker, J. Benbow [Abstract] Aim: To share our experiences of multicentre collaboration to develop simulation resources Simulation plays an important part in the education of nursing students. It provides a safe environment for the practice of clinical and interpersonal skills. Enhancing the range of simulation scenarios to capture the realities and diversities of practice can be challenging. To help address this, funding from The Erasmus Strategic Partnerships for Higher Education programme has allowed ten European Universities to work together to design simulation resources for adult nursing students and also provide training for simulation champions. With Malta University as the lead partner and coordinator, we are tasked with developing a simulation education resource for student nurses at novice level year 1, intermediate level year 2/3 and competent level year 3/4. We pooled intelligence gathered and set our focus on community based simulation resources. Developing the scenario for novice student nurses are Cardiff University (CU) Wales, University of Molise Campobasso (UDM), Italy and Turku University of Applied Sciences (TUAS), Finland. Although work is well underway on our community care scenario, we would like to share our experience of transnational working. Using a SWOT analysis framework (strengths, weaknesses, opportunities and threats) we will present how we have developed into an effective working team. The project involves transnational meetings in Malta, Finland, Norway and Italy and what we have come to appreciate is the enthusiasm for simulation education. We are really enjoying our cooperation with fellow nurse academics, one year in and two more to go.
	Learning and teaching to care for people with disability S. Schoeller, L. Brehmer, I. Fernandes, M. Martins, K. Hammerscmitdt [Abstract] Introduction: A report on the experience about a class with the aim to teating nursing care for people with disabilities. This dynamics has been carried out in the last 8 semesters. Part of the student’s need to experience situations of people with disabilities and, from there, to think collectively about how nursing care should be. Method: The class starts 15 minutes before the coffe break. A visual impairment, spinal cord injury, deafness, amputation of legs or arms are simulated in each student. For this there is a material prepared previously (wheelchairs, bands, glasses, ear plugs). Students are divided in doubles (so that one helps the other) and is given a simple task (make a snack, buy a water, go to the stationery) with the time of 40 minutes to comply. When students return, there is a collective refletion about how they experienced the temporary limitation, what feelings are involved, and how they would like to be cared for if they were in this situation. Resolutions and Discussion: The dynamics allows the student to place himself in the place of the disabled person and to perceive the difficulties and prejudices directed at this population. From this results the construction of a care more focused on the integrality of the other, respecting the differences and peculiarities. Conclusion: The experience of limitation enables the empathy and humanization of the care, besides the technique, of people with disabilities.
	Ambulance simulator H. Sumanen [Abstract] Ambulance simulator is a highly modern simulation learning environment placed in Kotka at the South-Eastern Finland of University of Applied Sciences (XAMK). The simulator was completed in the spring 2017. The simulator is almost like a real ambulance with full communication systems and patient treatment space that is well-equipped. Curved-screen video wall in front of the ambulance and advanced motion technologies make driving in the virtual case scenarios very realistic. Control room, auditorium with comprehensive video and sound connections, and debriefing room are placed next to the simulator room completing the modern learning environment. Overall, the simulator and our highly skilled simulation teachers provide realistic and safe learning opportunities for emergency care students and for those already working as paramedics. In emergency care nursing studies, the simulator is used for example to practice vehicle handling characteristics and patient safety during ambulance transfer. Also currently, it is being used in a research and development project focusing on improving patient, work and traffic safety during alarm driving. 360 ∘ presentation of the ambulance can be found at: https://www.xamk.fi/koulutus/ambulanssisimulaattori/ (currently only in finnish)
	How will nurse lecturers determine how the new nursing standards will be integrated into a curriculum S. Green [Abstract] For the purpose of this study, a theory is sought from the data in how curriculum content and delivery is determined by the nurse lecturer. With the new nursing standards from April 2018, how will these be integrated into a new nursing curriculum, and will self funding affect how this is approached? Because grounded theory is about the development of theories this is the ideal methodology to use for this study. It is also appropriate for a study where there is little knowledge known (Rintala et al 2014), or where a new perspective is needed about that phenomenon (Strauss & Corbin 1998, Corbin & Strauss 2008) as is the case here. This proposed study is anticipating theory to be developed from the collected data, rather than just developing hypotheses from this, as Glaser & Strauss discovered over half a century ago (Charmaz, 2014). Their breakthrough in qualitative research and its methodologies was at a time when quantitative theory was thought to be superior in every way, and there was a type of ”hegemony” to do with quantitative research that their discovery challenged (Charmaz, 2014 p.7). Their response was that qualitative analysis had its own place in research, which could generate worthwhile theory, and their aim was to build an ”abstract theoretical explanation of a social process” (ibid). As there is an absence of a theory about how curriculum writing and delivery is determined, the researcher hopes that this study will highlight this situation locally, and a larger study at a later date could be carried out to ascertain if this is a more widely used theory. GT contains a system whereby data analysis runs alongside data collection, so that theory can be derived from the data as Glaser and Strauss did, rather than just developing hypotheses from it (Charmaz, 2014).
	A comparison of values based recruitment and traditional interview methods in recruiting students with high levels of emotional intelligence and the impact on retention, and academic and clinical attainment N. Dunne [Abstract] The recruitment, selection and retention of potential students onto a BSc programme is of paramount importance and therefore recruiting the right candidates that can cope with the demands of a professional course is vital. There is concern about the admission criteria and whether this has an impact on the successful progression of students (Shulruf et al 2011). This raises important questions regarding how to assess people who are not only capable of completing an academic programme, but also people that possess the qualities required for clinical work and therefore have a degree of emotional intelligence during the interview process. There have been a few studies exploring emotional intelligence (Cadman and Brewer 2001, Rankin 2013, Por et al 2001). However these studies cannot be compared as they used different tools to measure emotional intelligence. However, none of these studies assessed whether it was possible to test emotional intelligence during the interview process and whether values based recruitment could be a method in order to assist with this or whether traditional interview methods would be more suitable. The research project presented in this session is a cohort study using both retrospective data collection and cross sectional data collection. Data on retention and academic and clinical attainment will be retrospective. Data on emotional intelligence will be via a questionnaire. It is expected that the results of the study will provide information on the right interview method to adopt in order to recruit more clinically and academically able students. The results of this study could help other institutions delivering professional health related courses decide on the best recruitment method.

	Examining Final Year Undergraduate Student Nurses’ Management and Decision-making Using a Structured Simulated clinical Assessment S. Ward [Abstract] The development of simulation as a pedagogy in nurse education provides possibilities not only for student learning but opportunities to explore simulation as a summative assessment method. In 2012 the new undergraduate nursing curriculum at Cardiff University included an examination in a simulated setting, structured simulated clinical assessment (SSCA). Students were assessed during an unfolding medium fidelity simulation situation where co-players interacted within a given script. This SSCA was situated in a year three leadership and management module, designed to test decision making, communication, team-working and problem-solving skills. Designing a marking tool that would be fit for purpose was a challenge. Following a series of working groups involving clinicians, students and academic staff an innovative tool was designed. The first cohort undertook the examination in April 2015. There were challenges to using a video-recorded SSCA cross all fields of nursing, particularly the resource intensive nature of simulation. However, the enthusiasm to effectively use hardware and software technologies to support and even enhance the academic vision of the concept drove the team forward and approximately 500 students have now undergone this examination. Following the first cohort, student has subsequently given permission for their footage to be used as examples. This now forms the basis for the mock examination where students can use the marking tool to assess the recorded performance of previous students. This has proven valuable for both the module team to ensure parity in marking and for the students to gain an insight into how the examination is conducted and their expected performance. We have evaluated feedback from a number of sources and concluded that it is possible to conduct authentic simulation assessment and provide a mark for student performance of these important leadership and management skills.
	Living with diabetes at the workplace: implications for nurse education C. Farrugia Imbroll, M. Cassar [Abstract] In view of increased focus on the health needs of the person at the workplace, the role of the nurse in the workplace is receiving more and more attention. This has implications on nurse training and education. This paper presents the findings of a research study which sought to explore the support and challenges experienced by adults with diabetes in fulfilling their respective employment commitment at a specific private entity in Malta. Diabetes is one of the most common non-communicable diseases prevalent in the population. The effective management of diabetes implies knowledge, action, and support. Individuals spend long hours at their place of employment and so those having diabetes must have the adequate support needed to manage their condition properly at work. Semi-structured individual face-to-face interviews were conducted with a purposive sample of 11 adults; 6 employees having either Type 1 or Type 2 diabetes, 2 managers, and 3 key informants. Verbatim transcripts were later analysed through a Thematic Analysis of the data revealed four main themes: (i) Awareness of Complications & Risks; (ii) Working with diabetes; (iii) Employing individuals with diabetes; (iv) New Services & Developments/Initiatives. The conclusions drawn from the analysis suggest that both employees and managers were not adequately aware of the possible complications which might develop with the mismanagement of the disease at the place of work. Minor adjustments at the place of employment can enable employees having diabetes lead a normal life at their workplace. More research in this area is indicated particularly in view of the role of the nurse in the workplace and the skills which nurse education need to secure amongst nurses in this regard.
	An exploration of Specialist Nurses in Malta - a qualitative case study C. Ward [Abstract] The aim of this study was to explore the perceptions of the roles, development and preparation of specialist nurses in Malta, an island with its own historical, political and social context. Using a qualitative case study design, a deep understanding of the complex issues surrounding specialist nurses was gained from multiple data sets using purposive sampling techniques. Data included a survey of the total specialist nurse population (N=27), in-depth interviews with a group of specialist nurses (N=9) and four focus groups with key professionals and policy stakeholders (total N=28). Data was collected between 2013 and 2015 and analysed using thematic analysis. The main themes that emerged from the findings including concepts of advanced nursing practice, role boundaries, preparation, regulation and autonomy to practice. In spite of the very positive views on the roles and practice of these specialist nurses, a number of barriers to their future development were exposed. Barriers comprised the lack of understanding and support for their role and the paucity of evaluation research on their role. Additional areas affecting their advancement included the organisational and political systems that were seen to affect leadership, and power in nursing to achieve the ultimate aim of consistent provision of good quality nursing care. The study provides the first research-based insights into the role and development of specialist nurses in Malta, and concludes by highlighting the need for a legally accepted set of definitions, preparation and evaluation of the specialist nurse role from a national policy perspective.
	Nurses prepardness to deliver care to children with complex heath care needs A. Clancy, E. Montanana, P. Larkin, M. Brenner [Abstract] To analyse nurses’ preparedness for the care of children with complex care needs (CCN) and their families in 30 European countries. Background Advances in the field of medicine have increased the number of children living with complex conditions, and with that the need for high quality health care. Nurses play a key role in the care of children. The knowledge and training acquired by the nurses working with children and families has to be targeted in order to deliver highlevel care. This study is part of the EU funded project: Models of Child Health Appraised (MOCHA). Methods A questionnaire, for distribution by country agents in 30 European countries, was developed in order to explore the qualifications required for nursing children with CCN in the community. The questionnaire also included a request for nursing curriculum documents. Results No specialised training is required to deliver community nursing care to children with CCN in 73.9% (n = 17) of the countries. For these countries, a general nursing qualification was the only requirement. Almost three-quarters of the general nursing curricula analysed (70.6%, n = 12) offered one or more compulsory core modules on the care of the child. Most countries had child care mentioned within the context of other compulsory modules. The inductive content analysis conducted in the curricula, detected three main categories focused on the child: Nursing Care of Children, Paediatrics and Psychosocial Aspects. The category that focused on the Psychosocial Aspects had the least number of keywords. Conclusions Results showed the need to promote specialist children’s nurse education in order to enhance the skills and competence of nurses who deliver care to children living with CCN. Creating a European competency framework for regulating the nursing care of children within general nursing programmes can be an important step in reaching this goal.

	Behold, the birth of something new! I. Balzan [Abstract] Amidst the pangs of birth, there is a new birth. The birth of something crying to be given life. South Sudan was born on 9th July 2011, a new nation has come to life. South Sudan is still going through the pangs of childbirth characterised by the on-going conflict and the crisis in the country but also something new is happening as the ”cords” of violence and hatred are being cut. Solidarity with South Sudan (SSS), a group of professionally health trained religious, has ”midwifed” a number of nursing and midwifery students. Since its inception in 2011, the Catholic Health Training Institute in Wau has witnessed the graduation of 140 nursing and midwifery students. This institute is providing the salient cornerstones and growing supplies of building stones which are in turn laying the foundations of a health care system that is insipidly being built and constructed. Nurse education at this training institute in South Sudan is serving a very wide educational role, which extends far beyond the parameters of the standard and regular scope of nurse education programmes, entities, frameworks and systems. The Medical Missionaries of Mary (MMM), a group of religious health professionals have also put their hand to the plough in the tireless efforts to reduce maternal and infant mortality in South Sudan which carries the highest global burden of maternal and infant mortality. Through a community-based health care programme, mothers and children are reached in very remote areas. The programme is holistic in nature, the components of which include: an Expanded Programme of Immunisation, Water, Sanitation and Hygiene activities (WASH), health education and the construction of a Healing Centre. This paper presents and discusses the challenges and triumphs of this nurse education initiative in South Sudan in tandem with the operations of the MMMs in the country.
	Medical Pedagogy by simulation at Hassan 1st University in Morocco: from the integration in the training of midwives and nurses to the study of the impact on the acquisition of skills I. Youlyouz-Marfak, A. Gantare, S. Cherguaoui, A. Marfak, O. Changuiti, N. Moustaghfir, K. Jounaidi, A. Hilali [Abstract] The simulation asserts itself more than ever as a major educational method for all the healthcare professionals in initial and continuous training. The implementation of a center of simulation to Settat is a logical result in the creation of the Higher institute of Health sciences (ISSS), first university institute to have established the LMD (LICENCE-MASTER- DOCTORAT) system in the paramedical formations. The integration of the simulation in the training of the nursing students and the midwives of the ISSS began in 2013 and it follows upon an important reflection on the necessity of this type of training as well as the expected impact. Indeed, the simulation is an integral part modules of teachingaccording to an educational established well program specifying the chosen techniques of simulation, the educational objectives as well as the studied technical and not technical skills. In order to study and evaluate the impact of the simulation on the acquisition of technical and non-technical skills of students in initial training at ISSS, a study was conducted on a sample of students distributed in a different way. randomized into two groups, a control group and a group benefiting from the simulation. The results clearly show that simulation improves the acquisition of knowledge, technical and non-technical skills. A positive effect is also observed on the practices after the repetition of the sessions which is in favor of the experiential contribution of the simulation. The impact of this new pedagogical concept in the training curriculum for midwives and nurses seems to be promising.The impact of this new educational concept in the program of training of the midwives and the nurses seems, already, promising.
	Autonomous Learning and Self-Learning Competence: The case of ESEL’s Bachelor Nursing Programme C.S. Oliveira, J.C. Santos, M.A. Grou Moita, M.I.C. Silva, M.T. Leal [Abstract] According to the Bologna process, to promote student-centered learning (SCL) is one goal of higher education. Among other requirements, SCL must be guided namely by high-level learning outcomes and student support, counseling and tutoring and by tools, as course credits reflecting the workload required to achieve them, considering all teaching-learning strategies including time for projects and individual study. To evaluate the accuracy of credits of a Bachelor Nursing Program (BNP) courses and their operationalization towards the learning outcomes, we are researching the use of autonomous learning time (ALT) as an essential element to develop the capacity of understanding how to learn. We want to know students’ consumption of ALT in each course, as well as its relationship with other variables, namely self-learning competence, higher education entrance grades and academic results. Quantitative and descriptive research approach. Data collection was done online, anonymously, to a sample of 150 (12%) BNP students, after research approval by an ethics committee. Preliminary data point out that ALT is mostly as expected, and varies in accordance to the load of ECTS for most students and in almost all courses. In clinical courses, the results seem to be similar, although with a high dispersion in the ALT. The Self-learning Competence Scale has proved to be internally consistent (Cronbach’s alpha= .991 and correlations-item-total for the 3 subscales variation between .868 and .945). Self-learning skills were perceived as high. In those courses where the final results eventually deviate from the expected ALT and/or reveal discrepancies between the studied variables, there will be done an in depth analysis, to understand which curricular areas may need to be reformulated (learning outcomes, teaching and learning methods, faculty development, or student support services), in order to consolidate student-centered learning all over the curriculum.

	Cross – Border Education for Paediatric Oncology Nurses E. Formosa [Abstract] Rapid innovations in treatment and management of paediatric oncology sector across the globe, run parallel to widespread advances in the diagnosis of cancer amongst child populations. In turn, small nurse communities, as are Maltese paediatric oncology nurses in Malta struggle to remain abreast such innovations and advances in the sector. This is unfavourable upon both nursing staff and patients. This paper focuses on the perceived potential of offering cross-border educational opportunities for paediatric oncology nurses in Malta. A SWOT analysis of such proposed educational opportunities is presented, whereby the Strengths, Weaknesses, Opportunities and Threats of such educational opportunities are described and critically discussed in view of generating awareness and discussion about the importance of accessing educational opportunities which transcend the limitations of the small island of Malta and the health care and education system of the country. This discussion paper is believed to provide an interesting analysis of the challenges incurred in addressing the need for appropriately and adequately trained nursing staff in small speciality areas of practice, such as paediatric oncology. Hence it holds an interesting discussion that interests of both the recipient country and the donor country associated with the phenomenon of nursing staff mobility. In proposing and appraising the introduction of post-border training, sends hope regarding the development of nurse education opportunities of this kind.
	A theatrical path for Teaching of Communication in the Nurses Training F. Bonora [Abstract] Twenty-five years ago, I began to project and test in the Professional Schools, and later in the Degree University Courses for Nurses, formative paths about Help Relationship and Communication nurse/patient and nurse/nurse. The starting point has been my work as actor and theatre director, thanks which I learned to read the non- verbal languages and to analyze (from the only pragmatic point of view) the dramatic situations as conflict situations, during which it’s easily visible the coherence (or incoherence) between say and do, between emotion truth and stereotyped imitation. This work drove me to conceive the idea of Personal Character, of a Job and Help Relationship dramaturgy. The aim of this educational work is to make the nurse able to keep a right balance between Distance and Empathy, for avoid to burn itself emotionally, keeping in the while its support to the patient during the Therapeutic Path. It doesn’t mean to recite a part, but to draw its own personal resources during the execution of a defined role, that only for structural analogy with the theatrical practice I called Professional Character. On the other hand, Erwin Goffman’s question ”What minimal model of the actor is needed if we are to wind him up, stick him in amongst his fellows, and have an orderly traffic in behavior emerge?” , thus presuming a psychology ”but one stripped and cramped to suit the sociological study of conversation, track meets, jury trials, and street loitering” it seems alluding to the need of structuring ourselves even as roles to perform, without put on first line a Person, who as such it’s very much more vulnerable, so more susceptible to lose self-control in conflictual or stress situations
	The collaboration between a nursing school and a psychiatric health unit in the design of a community recovery program E. Macedo, F. Gomes, A. Candeias, C. Azevedo, S. Peixoto, C. Iglésias, A. Garcia, I. Silva [Abstract] In Portugal there have been great efforts to implement policies to progressively replace the caregiving in psychiatric hospitals by more extensive and integrated care into the health system, having implied a philosophy of community accompaniment inherent to the continuity of caregiving. Therefore, to achieve the goals associated to the implicit values and principles in the portuguese National Mental Health Plan (NMHP), in particular the recovery, is necessary a cooperation between the health and educational institutions, in order to fulfill the deinstitutionalization of the patients. It is widely accepted today that the current mental health policies advocate the implementation of continued and integrated care in mental health, where the home care support teams take part. The Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus - Casa de Saúde do Bom Jesus (psychiatric health unit) has been in cooperation and collaboration with the Universidade do Minho - Escola Superior de Enfermagem (nursing school), in the educational projects that it intends to undertake each academic year. The synergies between the two institutions, with action in the north of Portugal, are promoters of a research philosophy which it is presented as an asset to the development of this project in a relevant area such as mental health. This project has as a study object the recovery of individuals with mental illness and presents as general aim the development of an intervention program in the range of recovery. Having as a reference the tacit values in NMHP and the importance of continued and integrated care in mental health, the presented project intends to respond to the aim through an action research, implemented by a team of expert researchers in the mental health area, supported by effective collaboration in scientific research and technological development between the beneficiaries of the project, for the development of knowledge in the mental health range.
	Implementing a Nurse-led Pain/Sedation Management Guideline in the Maltese Adult General ITU: pre and post implementation audits F. Farrugia [Abstract] Introduction: Analgesia and sedation are routinely used in the management of mechanically ventilated patients. Over or under sedation are associated with a length of ICU/hospital stay, aMV days, amortality and PTSD. This projectfs objectives were to look at pain/sedation management practices in our 20-bed general, adult ITU. We aimed to gain knowledge on current assessments practices, assessments frequency and assessments/ medication documentation. Study design and Methodology: An audit (September 2015) was conducted to review current pain/sedation assessments practices. No pain/sedation guideline was in place and assessments were subjectively conducted. A total of 231 MV patient episodes were audited. Data was collected from patientsf flow charts, medical notes and nursing reports. Several concerns were identified in our practices. It was decided that a nurse-led pain/sedation management guideline will be formulated and implemented. Group teaching sessions on this guideline were conducted. The guideline was then introduced (February 2016). A follow-up audit was conducted 3 months later (May 2016). Summary of Results: From the 231 patient episodes followed, 103 patients were verbally assessed for pain, 69 were assessed non-verbally (facial grimaces, non compliance with MV & hemodynamic changes) whilst 59 were not assessed at all. No documentation of pain scoring or frequency of assessments was documented. Regular analgesics were prescribed and administered. Sedation verbal assessment was done in 123 episodes; non-verbal assessments performed in 93 whilst sedation break was done in 80 episodes. No documentation of sedation assessments or assessmentsf frequency was documented. Regular sedation was prescribed and administered. The follow-up audit (198 patient episodes) revealed standardisation and structure in pain and sedation assessments. An increase in assessments and documentation frequency (0% to 63%) was noted post guideline implementation. Conclusions: The introduction of this guideline structured our pain /sedation assessments methods, enhanced their frequency and documentation. Furthermore, it guided nurses and doctors to properly administer analgesia and sedation.
	Caring for a Child with a Progressive Non-Malignant Life-Limiting Condition within the Continuum of the Health Care System: Parents’ Journey through Time M. Cilia [Abstract] Parenting a child with progressive, non-malignant life-limiting condition is a complex, unpredictable and profound experience filled with intense and paradoxical emotions. This qualitative study explored these parents’ experiences of their journey through the continuum of the health care system in the local setting. The intent was to identify was perceived as positive and meaningful, as well as obstacle/s or barrier/s to care. A constructivist perspective was adopted and Bronfenbrenner’s theory was used as a theoretical framework. Narrative methodology was applied to generate deep holistic meanings of parents’ experiences, using a purposeful sample of three different families who were interviewed twice. Narratives gathered were analysed using Polkinghorne’s process of narrative analysis. Further interpretation and presentation of the findings was guided by Arthur Frank’s three narrative typologies: restitution, chaos and quest narratives. Ultimately, the findings were presented in one whole narrative, and discussed in relation to previous literature. Parental stories stretched back to the time before the child was born and thereafter, describing the initial realisations of their child’s condition. Moving along the illness trajectory into the present, parents spoke of different life challenges faced from the point of diagnosis on. However, as a family, they struggled to maintain normalisation, regain stability and build new support structures. Ultimately, following re-adjustments, this journey was deemed as transformational, bringing about a radical change in the parents’ outlook towards the basic philosophy of life. From this study, a number of recommendations for education, practice and further research were made. The findings suggested that good disclosure practices at diagnosis; continuous, timely and comprehensible information-giving; and community support from diagnosis onwards extended to the home of these families, are vital elements which may ease the parents’ burdens throughout their journey as well as promote family resilience.
	Leadership, followership and interprofessional learning: reflections on research, theory and practice A. Machin, S. Crozier, J. Derbyshire [Abstract] Clear leadership and followership for delivering safe and effective collaborative nursing care is essential. However, the importance of leadership and followership for facilitating classroom based, interprofessional education (IPE) to enable students to learn to collaborate is less well understood. This paper presents a 2 phase research study that aimed to understand IPE facilitators’ perceptions of the skills needed for their role (phase 1) and the influence of leadership and followership in an IPE setting (phase 2). Within an interpretive paradigm, using qualitative, grounded theory methodology, phase 1 explored IPE facilitators’ perceptions of IPE facilitation skills. Following ethical approval, using theoretical sampling, nine participants from various health professional backgrounds, were individually interviewed. Constant comparative analysis of transcripts yielded 4 data categories: creating and sustaining an IPL group culture (core category); role modelling an interprofessional approach; readiness for IPL facilitation; and drawing on past interprofessional learning and working experiences. In phase 2, the same research design was used to observe facilitator and student behaviour during 6 classroom based, clinically focused interprofessional education sessions. The emergent propositional grounded theory from phase 1 suggested study participants perceived facilitating successful classroom based IPE required skills for ëtransformational interprofessional learning leadership’. In keeping with other IPL research, establishing a learning context where others’ values were acknowledged and respected was a key to facilitation as was role modelling an ethical approach. Both of these are attributes and actions required of leaders of transformational change. Emerging findings from phase 2 reflect the influence on learning outcomes of facilitators’ leadership skills and followership behaviour from students The case is made for individualised leadership development methods such as coaching to be used for IPL facilitator development and for the importance of suitably preparing students for followership in an interprofessional education setting.
	Teaching infection prevention and control to undergraduate students by infection prevention nurses C. Farrugia [Abstract] Infection prevention and control (IPC) is critical to avoid preventable infections and address the challenge of antibiotic resistance. IPC nurses empower healthcare professionals through education to improve patient safety. The basic IPC knowledge and skills acquired during their undergraduate courses would then be the basis to build on. Objective: To discuss the teaching of IPC to undergraduate nurses by IPC nurses. The SWOT analysis was used as a tool to evaluate the teaching of IPC to undergraduate students by IPC nurses. Senior IPC nurses have in depth knowledge, skills and expertise and are able to blend evidence with experience and knowledge of patients (Manley, K), human factors and management of outbreaks. IPC nurses are able to present infections not only from a statistical point of view where they are just numbers, but link them to patient stories to make a case for a change from the heart. Local IPC nurses are resourceful as they are part of the IPC team and are also very active at a European level. Two of the local senior IPC nurses have visiting posts at the Faculty of Health Sciences. The local hospital-based IPC nurses are few and face time restrictions due to their involvement in several projects and initiatives. The opportunities include their ability to raise questions for research and collaborate with other academics and departments within the University. Potential threats to teaching IPC include academics who do not give priority to IPC and who are not updated and hence confuse students. Senior IPC nurses might not be consulted in curriculum design while students seems to perceive the importance of IPC based on the frequency that IPC is included in assessments. Senior IPC nurses are more suited to teach IPC as they are motivated by the subject and are eager and willing to teach not only registered nurses but also undergraduate nurses.
	The Use of Graphic Medicine as a Teaching Tool in Mental Health Nursing A. Sammut [Abstract] Graphic Medicine is used to denote the role that the comics can play in the study and delivery of healthcare. There is increasing research that supports the use of comics as a resource material for educating. With today’s increase in a visual society, photographs and illustrations are key instructional material. It is surprising how, considering the illustrated nature of comics, this medium has received little attention from healthcare scholars, and has largely been avoided in the creation of instructional and teaching material. It must be noted that the idea of placing a sequence of images next to each other, at times accompanied by text but not necessarily, is used regularly to teach individuals. This might include furniture assembly and airline safety procedures. Gilies, Stork and Bretman (1990) highlight that there are a number of successful examples in health education textbooks using short comic strips to illustrate key concepts. Recent literature suggest that a growing number of comics are being published on mental health and social care. Such a medium is also increasingly being used in higher education settings as information resources. Such publications relating to Mental Health and mental health conditions include autobiographical and fictional material where the experience of living with a particular mental health condition is either at the core of the story or an underlying theme. Many have proposed that that such material might be useful for professional practice, both from an educational perspective: teaching patients about their condition as well as an educational medium to teach students about mental illness. This medium is not just limited to the education of patients and students, but can serve as a medium for anti-stigma campaigns to fight issues commonly represented in comics such as racism, bullying, depression, mania, dissociative personality and psychopathy

	Initial experiences of nursing students during their first clinical practice placements J. Axisa, M. Camilleri [Abstract] Clinical nursing practice has always been an indispensable component of pre- registration nursing education. It provides the medium through which students learn practical knowledge and learn to apply theory to practice. It also serves to help students develop the professional competencies that enable them to become practitioners. Whilst there is a wealth of literature that explores student learning, there is a scarce amount of literature that explores the very first practical experiences. An understanding of what students are experiencing in those early placements, may provide a useful foundation for their learning that will take place later on in the programme. Furthermore, it may provide information as to how educators may provide better support to students during those first clinical placements. Therefore the aim of this research study was to explore the initial clinical experiences of undergraduate nursing students after their first clinical placements in their first year of their programme. The methodology deemed the most appropriate to answer the research questions was the single case study method. The sample consisted of eighteen junior students who had recently completed their first clinical placements. Data was generated through three focus groups. The data was audio-recorded and analysed using thematic data analysis. The findings of this study explored a range of factors that positively as well as negatively impacted the transformational learning processes that students experience in practice. Furthermore, the findings showed that the very first clinical placements during the first year of studies are significant in terms of professional development and the development of a sense of belonging.
	Countering Burnout in Nursing M. Galea [Abstract] Nursing profession is a highly stressful vocation. Participants (N=241), who work in three different hospitals in Malta, were assessed on the impact of burnout on their holistic wellbeing. Nurses completed the Maslach Burnout Inventory-Human Services, the Satisfaction with Life Scale, the Faith Maturity Scale, the Positive and Negative Affect Scale, together with a personality assessment and demographic variables. Results from this cross-sectional correlational study indicated that: a) burnout is a reality among professional nurses in Malta. This is mostly evident from high exhaustion and depersonalization and from low professional accomplishment; b) as expected, burnout negatively correlated with subjective well-being; and c) a path analysis indicated the progressive impact of burnout, frst on one’s personality and affective mood, and eventually on one’s wellbeing and spirituality. The implications and recommendations from these results were discussed.
	Development and Psychometric Assessment of a Continuing Education Learning Needs Survey of Nurses in Lebanon S. Fares, N. Dumit, S. Dhaini [Abstract] Aim: In this methodological study, we developed and investigated the psychometric properties of the Basic and Continuing Education Learning Needs of Nurses in Lebanon (LEbANON) scale specifically developed for registered nurses in Lebanon to assess and identify their actual learning needs. Background: Continuing education is a process that enhances knowledge, modifies practices, and improves professional skills. However, the effective measurement of the basic nursing knowledge and skills of registered nurses and their readiness for continuing education depends on the use of psychometrically sound instruments. Assessment instruments should be culturally sensitive and conform to the country’s context, as cross-cultural influences may have an impact on perceptions and health practices. Methods: Items were devised from a comprehensive literature review guided by Morrel-Samuels guidelines. 29 knowledge items scored as 1 (insufficient), 2 (acceptable) and 3 (sufficient) were generated and divided under six dimensions. Construct validity was assessed Exploratory Factor Analysis (EFA) followed by Confirmatory Factor Analysis (CFA).The CFA goodness of fit indices used were RMSEA, NNFI and CFI. Reliability was assessed using Cronbach’s alpha α. Results: 3000 nurses participated in the survey. EFA revealed a first component with an eigenvalue of 10.523, more than four times that of the second component, suggesting that the scale is unidimensional. CFA was then run to assess the goodness of fit of the 1) one-dimensional model revealed by EFA and 2) six-dimensional model proposed theoretically by the authors. Fit indices of the six-dimensional model indicate very good fit with CFI = 0.880, TLI = 0.866 and RMSEA = 0.068. Fit indices of the one-dimensional model were less satisfactory. Cronbach’s alpha of the total scale was 0.93 and for the six dimensions 0.72- 0.84. Conclusions: Our study results showed that the (LEbANON) scale is suitable for assessing the basic and continuing education learning needs of nurses in Lebanon.

	In a world of motion: Can simulation shift the traditional paradigm of leadership within collaborative teams T. Holmes, C. Bruce, R. Lakshman [Abstract] AIM With the emergent need for a collaborative practice-ready workforce, the question arises how are roles delineated? Can interprofessional learning [IPL] in simulation shift the traditional paradigm from that of the most notably being the doctor as the undisputed leader, to that of where the context in which the team operates governs leadership? With healthcare becoming diversified this research specifically aimed to explore the role of simulation and integrated leadership within the diverse expertise of the team. METHODS Four IPL modules were developed based on identified national and international health priorities. The simulated scenarios were aimed at providing interprofessional learning opportunities for undergraduate students including; Medicine, Nursing, Physiotherapy, Pharmacy and Psychology participants. The modules were designed to immerse undergraduate students in team-based training that facilitated exposure to human factors, non-technical skills or sources of error such as communication, situation awareness, teamwork, leadership and decision making during critical events. RESULTS Two validated survey tools were implemented:Interprofessional Socialisation and Valuing Scale [ISVS] and the Readiness for Interprofessional Learning Scale [RIPLS]. RIPLS sub-scale 3 specifically looks at roles and responsibilities, which have been identified as a key issue in preparedness for collaborative practice. A comparative analysis of student perceptions towards interprofessional learning and their beliefs, behaviours and attitudes that underlie interprofessional socialisation will be presented. The study highlights that IPL embedded in simulation may facilitate a positive effect on the integration of autonomy in clinical decision making within the diverse expertise of the IP team. CONCLUSION Simulation provides a protective environment in which interprofessional teams explore role delineation and leadership. The context in which the team operates should govern leadership and this may not be the Medical Officer. Healthcare professionals should be engaged in IPL simulation that supports a practice-ready workforce, in which traditional boundaries of leadership are challenged.
	L’annonce des dommages associés aux soins, une approche éthique par la simulation en santé en formation initiale infirmière et médicale : un projet innovant facilitant l’interprofessionnalité F. Cluzel, F. Guevara, V. Leroux [Abstract] L’information du patient en cas de dommage associé aux soins sera un enjeu majeur des pratiques professionnelles soignantes et nécessite des compétences spécifiques. Dans le cadre de l’appel à projet 2015  Soutien à l’innovation dans les formations paramédicales : Simulation en santé , le groupement universitaire Pierre et Marie Curie et les onze Instituts de formation en Soins Infirmiers partenaires ont souhaité travailler ensemble cette étape indispensable dans la relation soignant / soigné visant à maintenir ou restaurer une communication bien souvent mise à mal. L’intention pédagogique visée par ce projet est de permettre aux étudiants infirmiers et en médecine d’intégrer l’importance de la gestion des risques en situation critique, d’identifier ses enjeux éthiques et humains, ainsi que la place centrale de l’interprofessionnalité. 539 étudiants infirmiers 12 étudiants en médecine ont participé à ce projet. L’évaluation de ce projet montent que la simulation est un outil pédagogique performant. Il permet la confrontation aux situations réelles de travail, à leurs enjeux et à leur complexité. Les verbatim recueillis lors des évaluations auprès des apprenants sont très positifs. Les séquences de simulation atténuent les craintes face à la situation jouée. Les résultats sont en corrélation avec les données de la littérature en simulation et viennent renforcer les recommandations de la Haute Autorité en Santé en matière de sécurité des soins. L’expérience du binôme médecin - infirmier a été vécue par les étudiants comme une réelle plus-value, une richesse des rencontres entre apprenants. Le climat a été favorable à l’apprentissage, grâce à une bienveillance mutuelle. Les séquences ont permis la découverte des logiques d’apprentissage et des métiers. Les étudiants ont pu échanger et partager autour de leurs savoirs professionnels ainsi que leurs compétences métiers.
	Delivering palliative pain management in acute settings: implications for nurse education L. Galea, M. Cassar [Abstract] Aim: To explore the experiences of pain management when delivering palliative care, of nurses working in an acute hospital. Sample and Setting: Eight nurses from medical and surgical wards in an acute hospital in Malta. Method: Qualitative data was collected through recorded semi-structured interviews and analysed using Interpretative Phenomenological Approach (IPA). Findings: Experiences of sub-optimal management of pain were associated with palliative care delivery. These stemmed from (i) poor communication and limited decision-making processes, (ii) inadequate knowledge and training and (iii) inappropriate attitudes towards (a) the pharmacological and non-pharmacological pain management, and (b) the limited use of assessment tools and documentation. Challenges included; (i) lack of resources, and (ii) limited established hospital protocols and (iii) inadequate education and training offered by nurse education entities and clinical management tiers. Conclusions: Enhanced nurse education and Training is indicated for quality care in this specific regard. Improved communication is one of the main expected outcomes of the indicated enhanced education. (i) Inpatient palliative services in acute hospital settings, (ii) pain management protocols and (iii) privacy protection measures for palliative care delivery, in addition to (iv) further research in this area, are factors which will also contribute to quality care and which would effectively complement the outcomes of initiatives geared towards enhanced education opportunities in the section of palliative care and dying patients.
	Emerging Entry Points in Nursing: An Education Continuum S. Camilleri, G. Caruana, A. Portelli [Abstract] Education is a complex process of continuous learning. In the norm, this is experienced as a horizontal transition from primary school through secondary school onto post-secondary education. A subset of students, experience a vertical transition in later stages of their education. One common scenario is that of pursuing medical school after having graduated in nursing studies. This is the experience of the authors. Students undergoing such vertical transition often experience social, emotional, physical, mental and academic changes which may affect them in many way including their educational performance. Amongst nurses such education continuum is often less encouraged and perceived as turning one’s our back to a nursing career. Regardless of such issues and debate, we are proud to have chosen nursing as a first career choice and will always have profound respect for the field of nursing. We believe that we are privileged to have practised as safe keepers of patients and think we are better placed to deliver care to patient through a holistic approach. Having previous exposure to and experience with patient care delivery undoubtedly positions us at a favourable angle that benefits us as learning students and patient as recipients of care (once we complete our medical studies) . This paper will look into strengths, weaknesses, threats and opportunities offered by such a vertical transition as that of going through medical school after having completed a bachelor’s degree in nursing studies at the University of Malta.

	Keeping up with the trends: Using an online social network group to enhance learning W. Vassallo, M. Begg [Abstract] Online social networking is a phenomenon which has evolved over time and has now become established as a central component of daily human interaction. This concept in relation to education is still emerging. Research on the use of online social networking as a component of education and professional development beyond formal education is limited, with literature mainly focusing on undergraduate education. The purpose of this paper is to present a qualitative case - study, in which a group of emergency nurses engaged in an exercise of online social networking to share knowledge and experiences. A purposive sample of eight nurses participated in online discussion using a ësecret Facebook group’ over a period of six weeks. During this period participant observation of the online interaction was conducted followed by individual face- to -face semi-structured interviews with all eight participants. Through Braun and Clarke’s (2006) method of thematic analysis, six themes emerged focusing mainly on the perceptions and actual usage of the group, the barriers encountered and suggestions for improvement. Findings revealed various ways how participants engaged with and used the online social network group. However, this exercise was mainly perceived as a trigger to seek further information after experiences and views were shared with and by the online group. A number of suggestions were also made by the participants with regards to how such an innovative approach to group learning can be made more effective and efficient in relation to professional practice. While findings from this paper support the use of online social networking as a platform for sharing knowledge and experience, further research is required to explore how learning occurs through this approach and how it can be further utilised for continuous professional development.
	Medication Passport: Innovative Method to Support the Development of Medication Competence of Nursing Students V. Sulosaari, R. Teuri, P. Ahonen [Abstract] Background Medication care has been found to be a high-risk treatment with risk of adverse events. Several international studies have highlighted issues concerning nursing students’ medication competence upon graduation. It is crucial to ensure that graduating students have developed adequate clinical competence. Aim The aim of the study was to evaluate Finnish ”Medication Passport” tool used to support nursing students’ medication competence development. Method Survey study Results The Medication Passport is a student’s personal document, which contains studies completed in pharmacology, medication management and medication calculations. It also contains medication skills practised in clinical practise. The tool has been in use in Finland from 2010. The results are combined from two studies (Sulosaari 2016 and Teuri & Sulosaari 2017). In Sulosaari study (n=666 students) there was a positive association with practice possibilities and the use of the tool and theoretical medication competence (p<0.05) Students perceiving that the tool supported their learning in clinical practice achieved higher scores (p<0.05, r 0.17). In Teuri & Sulosaari (2017) students (n=240) were quite critical towards on the utility of the Medication Passport due to the detailed content. However, majority of the students perceived it helps them to recognize the extent of the medication competence required from nurses and following their competence development. Conclusion Medication Passport is promising tool for supporting and ensuring the medication competence development. However, further research is needed to evaluate the relationship between active use of the tool and medication competence of the students. References Sulosaari V, Huupponen R, Hupli M, Puukka P, Torniainen K & Leino-Kilpi H. 2015. Factors associated with nursing students’ medication competence at the beginning and end of their education. BMC Medical Education 15(1), 223. Teuri R & Sulosaari V 2017. eMedication Passport - User experiences of students. (not published).
	Instituts de formation aux métiers de la santé en France : quels directeurs pour demain ? F. Girard, J.L. Herce [Abstract] La SANTÉ est au cœur des préoccupations de nos concitoyens. Les évolutions rapides actuelles (scientifiques, technologiques, pédagogiques, sociétales) nous imposent de proposer aux futurs professionnels une offre de formation à la hauteur de ces enjeux. En France, l’ANdEP (Association nationale des directeurs d’école paramédicale) se positionne comme acteur et auteur de ces changements afin de mettre en œuvre des organisations nouvelles dirigées par des directeurs aux compétences affirmées et reconnues. A la suite des travaux prospectifs menés sur les évolutions du champ de la formation paramédicale, sur les scenarios d’organisation des instituts de formation aux métiers de la santé, l’association s’interroge sur le futur du métier de Directeur. Cette démarche prospective part des besoins de la population (procédure bottom-up). Le rapport engagé entre janvier- septembre 2017 a défini les contours des métiers de directeur au regard de trois dimensions : les tendances d’évolution de l’environnement professionnel ; les besoins et attentes des tutelles et des partenaires des Instituts ; les aspirations et ambitions des directeurs eux-mêmes. Le rapport formalise des fiches métiers en lien avec les scénarii prospectifs d’organisation. L’association développe un leadership afin de faire émerger les évolutions possibles en devenant un acteur incontournable auprès des décideurs. L’orientation stratégique vise à répondre aux besoins des usagers, au plus près des territoires, tout en anticipant le cap et les orientations qui seront fixées dans les politiques de santé publique dans un processus d’universitarisation où la recherche garantit l’excellence du soin à prodiguer à la personne.
	Professional competence in nursing – a European research project L. Salminen, S. Koskinen, C. Strandell-Laine, G. Ayerle, C. Richter, A. Scott, D. Lehwaldt, N. Istomina-Fatkulina, A. Rauckienė-Michaelsson, P.M. Fuster, M. Cerezuela Torre, H. Leinoi-Kilpi [Abstract] This research project, Professional Competence in Nursing (ProCompNurse), focuses to nurses in the transition period from education to working life in health care. Competence of nurses is important for improving the safe, high-quality, patient-centered and affordable care for health care users. This importance is increasing in the future, due to changing sociodemographics, increasing chronic conditions and new technology, needs for health promotion and counselling of population. It is important also due to the labour mobility. The aim of this presentation is to describe the research protocol of the research project. The objectives of this four year project (2017-2020) are to assess and compare the level of competence of the nurses at the transition period in five European countries (Finland, Germany, Ireland, Lithuania, Spain) and to explore individual, educational, organizational and value-based factors connected with the level of competence. The follow-up research design will be used. The data will be collected twice: at the time of graduation of nursing students (2018, n=500/country) and as a follow-up one year after (2019, n=500/country) in working life in all participating countries. In data collection, self-assessments and objective knowledge tests will be used. The data will be also collected from administrators (n=100/country) and patients (n=300/country). The data will be analyzed statistically. According the results it is possible to model the factors contributing high level competence and successful transition period and the nurse career. The research project also products the validated instruments to assess the quality and learning outcomes of nursing education. Moreover, it facilitates the European wide recognition of competences and education. The study has potential to scientific breakthroughs by combining research in education and working life, which combination in existing literature is scarce. The study is funded by the Academy of Finland.
	Building a Smartphone Application to Improve Moroccan Maternal and Infant Health Outcomes L. Amahdar, D. Achaak, H. Houradi, S. Naam, O. Changuiti, M. Kouiti, A. Boutib, M.A. Al Alaoui, M. El Hail, R. Freeland, I. Youlyouz-Marfak, A. Gantare, M. Hilal, E.M. Saad, A. Hilali, J. Turman Jr [Abstract] Morocco is in great need of mHealth technology, especially for maternal and child health in urban and rural areas. To meet this need, we developed a team to create the nation’s first smartphone application called ”YMA” in 3 languages and 4 Moroccan dialects. It aims to promote preconception, prenatal, labor and delivery and postpartum health. We have completed the first round of beta testing of the application, with 271 women and 9 men from across Morocco participating in testing. Participants represented different urban and rural areas, as well as diverse ethnic groups of the country. The beta testing results revealed After using the YMA application that 96.8% reported willingness to use the application, with 94.9% of our sample reporting a good impression of the application. We will incorporate suggestions (reducing text amount, more images and videos, adding more information about contraception and menopause). provided by participants and then submit the application to the Ministry of Health for validation. We plan on cooperating with public and private agencies to distribute the application to women and midwives across Morocco and then implement studies to determine its impact on women’s and infant’s health. Keywords: mHealth, Smartphone application, maternal and child health, promoting health