Jorunn Aas Handeland

• Handeland, Jorunn Aas; Prinz, Andreas; Ekra, Else Mari Ruberg & Fossum, Mariann (2023). ‘I realised it when we played with the doll!’: nursing students’ learning from participation in an action research project that included manikins. Educational Action Research. ISSN 0965-0792. doi: 10.1080/09650792.2023.2242425. Full text in Research Archive Show summary

  This qualitative educational action research study aimed to gain knowledge about nursing students’ learning from participating in a developmental project that included human-like manikins. Twenty-three second-year Bachelor of Nursing students, one teacher, and one researcher participated in the study conducted at a Norwegian university. In collaboration, they planned and executed a developmental project with manikins in a nursing course. The project put manikins’ reflective, explorative, and experiential potentials into play. Two Action Research cycles were carried out. Data were collected using audio recordings, observations, and written responses. The concepts of sayings, doings, and relatings guided the analysis to identify how the modified learning conditions influenced and changed the students’ learning. The following four themes illustrate the students’ learning in the project: ownership of the learning process, collaborative learning, understanding theory’s significance for practice, and taking the patient’s perspective. The student’s participation in the project, including their independent use and exploration of the manikins, provided freedom and responsibility in decision-making, helped them experience problems, fostered creativity, and stimulated inner motivation. This moved their learning in a more practice-relevant direction.

• Handeland, Jorunn Aas; Prinz, Andreas; Ekra, Else Mari Ruberg & Fossum, Mariann (2022). The sense of a patient: An ethnographic multi-site field study exploring the influence of manikins on nursing students' learning. International Journal of Educational Research Open. 3. doi: 10.1016/j.ijedro.2021.100110. Full text in Research Archive Show summary

  The purpose of this ethnographic study was to gain insight into the influence of full-body human-like manikins on nursing students’ learning. The research question that guided the study was: How do the presence and use of human-like manikins influence nursing students’ learning? Data were collected during 15 educational sessions, using different manikins for various activities. Applying cultural-historical activity theory, this study explored the use of manikins as a mediated activity. The study’s main result was the interplay of five categories. In the first category, manikin as an object, manikins were used to teach and learn technical skills. In the second category, manikin as a subject, manikins were used to teach and learn to perform those skills with care. The third category, the interplay, illustrates how these two approaches were present in all sessions. Category four, the individual learning space, provided students with a feeling of working with a patient. Category five, the collective learning space, awarded collaborative and reflexive learning opportunities. We concluded from this study that manikins may introduce students to the balance between the technical and interpersonal aspects of nursing practice. Being aware of how manikins influence learning, educators can make more targeted use of manikins and support lower-grade nursing students in their learning process and professional development.

• Handeland, Jorunn Aas; Prinz, Andreas; Ekra, Else Mari Ruberg & Fossum, Mariann (2020). The role of manikins in nursing students' learning: A systematic review and thematic metasynthesis. Nurse Education Today. ISSN 0260-6917. p. 1–11. doi: 10.1016/j.nedt.2020.104661. Full text in Research Archive Show summary

  Objectives To summarise and synthesise findings from qualitative primary research studies of nursing students' experiences from educational activities using manikins to gain a deeper understanding of the role these manikins play in the students' learning. Design and data sources A systematic review and thematic metasynthesis were conducted. Cinahl+, Ovid Medline, ERIC and Embase were searched systematically. Review methods Sandelowski and Barroso's framework guided the review process. A comprehensive search to identify qualitative studies of nursing students' experiences from learning with manikins was performed in January 2019 and updated in April 2020. Study selection was guided by six screening questions derived from these inclusion criteria: qualitative primary studies, published from 2008, in English or Scandinavian, presenting findings of undergraduate nursing students' experiences with manikins at all fidelity levels. Thomas and Harden's method for thematic synthesis was followed. Results Twenty-eight articles of twenty-seven studies were included. We identified three synthesised analytic themes: Seeing the manikin as a doll or a patient, Experiencing yourself as a nurse caring for a patient, and Being a team member. Conclusions When it is perceived as a patient, a manikin can give students a realistic experience of what it means to behave like nurses. Consequently, this realism lets students practice and acquire relational, communicative, and collaborative nursing skills. Using a manikin can facilitate the development of students' professional identity.

• Handeland, Jorunn Aas & Tveit, Bodil (2015). "Du må bare skrive ut, ønske lykke til, og stole på at det går bra!" : en kvalitativ undersøkelse av sykepleieres muligheter og begrensninger for skjønnsutøvelse når pasienter skal utskrives fra sykehus til kommunale helse- og omsorgstjenester. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 11(1), p. 35–48. doi: 10.7557/14.3478. Full text in Research Archive Show summary

  The aim was to investigate nurse’s experiences of the possibilities to act according to their professional discretion in the process where patients are transferred from hospital to primary health services. Six in-depth interviews and one focus group interview with hospital nurses were conducted. The theoretical framework was based on Dworkin’s concepts of discretion and Martinsen’s description of prerequisites for discretion. Nurses collected and assessed complex information about the patients to be able to define the necessary level of care after discharge. Prerequisites for a robust assessment were adequate time, and the relationship to patients. Focus on effectivity, medical treatment, and limited possibilities to hand over their assessments to the municipal health services, created challenges. Nurses were negotiating between professional ideals and requirements from regulations. This created a potential conflict within the nurses between a professional role and a performer role, which in turn can lead to problematic consequences, both for nurses and for patients.

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• Handeland, Jorunn Aas & Presno, Åsne Knutson de (2026). Omsorg er verken passivt eller passiviserende. Full text in Research Archive Show summary

  Hvilke holdninger og handlinger vokser fram, når språket ikke lenger anerkjenner ordet omsorg?

• Handeland, Jorunn Aas (2025). Hvordan bruk av simuleringsdukker påvirker studentens læring - "Simuleringsdukker medierer livslange læringsferdigheter i sykepleierutdannelsen”. Full text in Research Archive
• Handeland, Jorunn Aas (2025). The sense of a patient: An ethnographic exploration of manikins’ influence on nursing students learning through the lens of CHAT. Full text in Research Archive Show summary

  Background: Simulation-based activities with human-like manikins are invaluable in nursing education, fostering essential competencies. However, understanding of manikins’ contribution to learning remains limited. Objective: To gain insight into manikins’ influence on nursing students’ learning. Method: An ethnographic study involving 204 first-year nursing students and 18 educators across four campuses. Data collection through observations and interviews during 15 sessions featuring various manikins. Thematic analysis using CHAT as framework. Results: Five identified categories: (1) Manikin as an object for learning technical skills; (2) Manikin as a subject, for integrating care into skills; (3) The interplay between technical and caring approaches; (4) Individual learning space providing a feeling of working with a patient; (5) Collective learning space offering collaborative and reflective opportunities. The dynamic between these categories introduced students to the balance between technical and interpersonal skills. Conclusion: Manikins serve as mediators, bridging technical proficiency and relational care. Tensions in manikins’ dual nature can drive change. Focusing on patients’ well-being as the primary objective of activity, can promote expansive learning, infusing learning with deeper meaning and connect the educational and clinical system. Implications: Raising awareness among educators about targeted manikin usage can enhance educational practices. This study invites exploration on how tools mediate learning.

• Dalsmo, Ingrid Espegren & Handeland, Jorunn Aas (2022). Dukker kan ikke erstatte pasienter. Full text in Research Archive
• Handeland, Jorunn Aas (2021). Følelsen av en pasient. Full text in Research Archive
• Handeland, Jorunn Aas; Prinz, Andreas; Ekra, Else Mari Ruberg & Fossum, Mariann (2021). The role of manikins in nursing students' learning - A systematic review and thematic metasynthesis. Full text in Research Archive
• Handeland, Jorunn Aas (2024). Manikins Mediate Lifelong Learning Skills in Nursing Education: A Qualitative Exploration of How Manikins Influence Nursing Students’ Learning. Universitetet i Agder. ISSN 9788284271866. Full text in Research Archive Show summary

  Background: In today’s healthcare system, nurses face considerable demands, necessitating adaptability, situational awareness, decision-making, and critical thinking. The transition from student to newly qualified nurse presents challenges, leading some nurses to leave the profession early and intensifying challenges in recruiting and retaining health personnel. Managing this transition requires continuous competence development and learning skills. There is a need to facilitate a learning process that prepares nursing students for professional practice by fostering lifelong learning skills. This thesis builds on a doctoral project exploring human-looking, full-bodied manikins as learning tools in nursing education. The literature indicates a gap in the knowledge of nursing students’ experiences working with manikins and how manikins influence their learning. The rationale of this thesis is how nursing education can use manikins to support students’ development of lifelong learning skills that can ease their transition into clinical practice and help them function as nurses. Aim: The aim of this thesis is to develop new knowledge and understanding of how manikins influence nursing students’ learning, which can guide nursing education in developing educational strategies that support practice-relevant learning.

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