Mariann Fossum

• Losada-Floriano, Diego; Thygesen, Elin; Sanfilippo, Filippo; Hansen, Michael Rygaard & Fossum, Mariann (2026). Service Robots as Work Support for Health Personnel in Long-Term Care: Protocol for a Scoping Review. JMIR Research Protocols. 15, p. 89435–89435. doi: 10.2196/89435. Full text in Research Archive Show summary

  Background Demographic shifts are increasing the global demand for long-term care services, coinciding with a worldwide shortage of health care personnel. Service robots, designed to perform tasks in both professional and personal use, are perceived as a potential solution to alleviate health care personnel’s workload and enhance the quality of care. However, the existing literature is fragmented and heterogeneous, with a limited emphasis on the role of service robots in supporting residents rather than health care personnel. Furthermore, there is a lack of consistent definitions of service robotic technologies and a scarcity of studies on implementation models and frameworks. Objective This scoping review aims to map and synthesize evidence regarding the implementation of service robots as work support for health care personnel in long-term care settings. Methods A comprehensive 3-step search will be conducted in Embase, MEDLINE, APA PsycInfo, CENTRAL, Scopus, and CINAHL, along with gray literature databases and institutional repositories. Eligible sources encompass empirical studies and gray literature involving service robots, health care personnel, residents aged 65 years or older, and stakeholders such as informal caregivers within institutional long-term care. Exclusions apply to studies on home care, medical or industrial robots, and nonrobotic technologies. Data will be extracted and analyzed using the Joanna Briggs Institute methodology, with findings presented in tables, diagrams, and narrative summaries to identify gaps and inform future research and implementation strategies. Results The project has been funded for a 4-year period starting in April 2025. This protocol was developed in October 2025 and subsequently registered in November 2025. A comprehensive search strategy was formulated and completely conducted on October 24, 2025. The screening of 4884 titles and abstracts was completed in December 2025, resulting in the retrieval of 64 (1.3%) full-text articles for eligibility assessment. Subsequent phases, including data extraction, analysis, evidence synthesis, and presentation of results, will be conducted sequentially. The scoping review is expected to be finalized by June 2026. Conclusions This scoping review is expected to delineate the extent and characteristics of the existing evidence on service robots as work support for health personnel in long-term care settings. It will highlight the key reported outcomes and challenges encountered in implementation studies, as well as the theoretical frameworks, models, and concepts applied to address these issues. Trial Registration Open Science Framework QWK58; https://osf.io/qwk58/ International Registered Report Identifier (IRRID) PRR1-10.2196/89435

• Laukvik, Lene Baagøe; Chomutare, Taridzo Fred; Hernandez, Miguel Angel Tejedor & Fossum, Mariann (2026). Time to Care-AI Supported Nursing Documentation. Studies in Health Technology and Informatics. ISSN 0926-9630. 336, p. 1551–1555. doi: 10.3233/SHTI260469. Full text in Research Archive Show summary

  This study conducted a needs assessment to evaluate contextual factors, adoption barriers, and overall readiness of municipal healthcare services to implement and utilize AI-supported documentation solutions. The study was carried out by a multidisciplinary team consisting of two municipalities in the South of Norway, data and artificial intelligence (AI) researchers, healthcare researchers, and a European health technology company. Three participatory workshops were conducted with healthcare professionals, ICT personnel, and legal experts, revealing overall optimism about the potential of AI to enhance documentation practices and facilitate more efficient information exchange. At the same time, the findings highlighted important challenges related to system integration, usability, and trust in AI-supported solutions within municipal healthcare services.

• Fossum, Mariann; Sanfilippo, Filippo; Hansen, Michael Rygaard; Enerstvedt, Camilla & Thygesen, Elin (2026). Exploring the Role of Robotics in Nursing Homes: Insights from Healthcare Professionals - PubMed. Studies in Health Technology and Informatics. ISSN 0926-9630. doi: 10.3233/SHTI260712. Full text in Research Archive Show summary

  This paper reports findings from a qualitative descriptive study exploring the potential use of service robots in nursing homes. Participants in three workshops expressed optimism and creativity regarding the role of robots in supporting a variety of tasks, including housekeeping, transportation, mo …

• Sanfilippo, Filippo; Fossum, Mariann & Hansen, Michael Rygaard (2025). Redefining Care and Work Practices: The Role of Autonomy in the Future of Nursing Homes. In Paolis, Lucio Tommaso De; Arpaia, Pasquale & Sacco, Marco (Ed.), Extended Reality. Springer. ISSN 9783031977817. p. 355–370. doi: 10.1007/978-3-031-97781-7_26. Full text in Research Archive Show summary

  Nursing homes face increasing challenges due to workforce shortages, ageing populations, and rising care demands. This paper explores the dynamics of human-robot interaction (HRI) in nursing home environments, focusing on how autonomous robots engage with nurses and residents in nursing homes. We examine the role of trust-building and emotional engagement in caregiving scenarios, where patient well-being depends on effective HRI. The potential for autonomous systems to support decision-making while maintaining human oversight is investigated. Using the Autonomy Levels for Unmanned Systems (ALFUS) framework, we assess care robots’ autonomy in terms of mission complexity (MC), environmental complexity (EC), and external system independence (ESI). Additionally, the Autonomy and Technology Readiness Assessment (ATRA) method supports gradual capability enhancement, providing a roadmap to higher autonomy while ensuring safety and reliability. Based on this established methodology, we introduce the Nursing Home Interaction Framework (NHIF), a novel conceptual framework defining the roles of actors involved, to connect theoretical insights with real-world applications. This work highlights the significance of human-robot trust in elderly care scenarios and proposes directions for future research on collaborative decision-making in nursing home HRI.

• Alexander, Gregory L.; Livingstone, Anne; Han, Soojeong; Chapman, Wendy; Comans, Tracy & Demiris, George [Show all 35 contributors for this article] (2025). Emerging Models of Care Using IT in Long-Term/Post-Acute Care: A Comparative Analysis of Human and AI–Driven Qualitative Insights. Journal of Gerontological Nursing. ISSN 0098-9134. 51(4), p. 6–11. doi: 10.3928/00989134-20250307-01. Full text in Research Archive Show summary

  PurposeAs the global population ages, long-term/post-acute care (LTPAC) systems face challenges in ensuring quality care for older adults with complex medical needs. Using health information technology (IT) is a promising strategy to address these challenges. However, evidence gaps remain regarding barriers and facilitators to technology integration in LTPAC. Thus, the current study explored barriers and facilitators to technology adoption in emerging models of care for older adults through the International Summit on Innovation and Technology for the Care of Older People (IS-ITCOP). MethodThe IS-ITCOP Summit, held in June 2024, brought together 47 interdisciplinary experts from eight countries. Qualitative data were collected via facilitated discussion groups and analyzed using two approaches: human-coded thematic analysis and ChatGPT 4.0-driven analysis. ResultsShared themes included technology barriers, ethical considerations, workforce challenges, and patient-centered care. Human analysis emphasized abstract themes, whereas ChatGPT provided granular insights on emerging technologies. ConclusionCombining human and artificial intelligence–driven analyses enriched understanding, highlighting opportunities and challenges for integrating IT into LTPAC systems. [Journal of Gerontological Nursing, 51(4), 6–11.]

• Rabben, Jannicke; Rohde, Gudrun Elin; Fossum, Mariann & Vivat, Bella (2025). Experiences and Perceptions of People With Advanced Cancer and Their Family Caregivers of Shared Decision-Making in Palliative Cancer Care. Journal of Advanced Nursing. ISSN 0309-2402. 81(8), p. 4976–4988. doi: 10.1111/jan.16705. Full text in Research Archive Show summary

  Aim: To explore the experiences and perceptions of people with advanced cancer and their family caregivers of shared decisionmaking, including how they and nurses are involved. Design: Exploratory interview study. Methods: Semistructured, individual interviews conducted in 2023 were analysed using reflexive thematic analysis. Results: Twenty-four participants (15 people with cancer and 9 caregivers) participated in this study. The analysis generated five themes; (1) Decisions are ultimately about living or dying, (2) Desires and expectations for involvement in decision-making, (3) Uncertainty about potential and capacity for shared decision-making, (4) Good quality information and communication are key for involvement and (5) Nurses' contributions are unclear. Conclusion: Overall, our participants were unsure about how decision-making about the complex and existential decisions in palliative cancer care was shared, or how it included them, or nurses. Implications for the Profession and Patient Care: People receiving care could benefit from more clarity on what shared decision-making is, how they can be involved and how nurses can facilitate and support shared decision-making. Impact: Part of the nursing role is to support and involve people with cancer and family caregivers in decisions about treatment and care. Our findings suggest that people receiving care may be unclear about the concept of shared decision-making, and so also about how nurses potentially or actually support decision-making. Our study further clarifies the challenges and possibilities for involving all stakeholders in shared decision-making. This additional insight may help in future development and implementation of shared decision-making. Reporting Method: COREQ. What Does This Paper Contribute to the Wider Global Clinical Community?Adds to knowledge and understanding of the complexity of shared decision-making in palliative cancer care and how nurses can contribute to this and advancing a person-centred approach.

• Rabben, Jannicke; Fossum, Mariann; Vivat, Bella & Rohde, Gudrun Elin (2025). Nurses' Perceptions of Their Involvement in Shared Decision-Making for Advanced Cancer Treatment and Palliative Care; a Qualitative Interview Study. Journal of Advanced Nursing. ISSN 0309-2402. 82(1), p. 719–731. doi: 10.1111/jan.16994. Full text in Research Archive Show summary

  Aim To explore nurses' perceptions of their involvement in shared decision-making for advanced cancer treatment and palliative care, and their contributions to patient involvement. Design Exploratory qualitative research. Methods In-depth interviews conducted in March–October 2023 with 15 nurses from two Norwegian hospitals were analysed using reflexive thematic analysis. Results Two broad themes were constructed: Theme (1) ‘Person-centredness; acquiring and sharing knowledge’; with subthemes; ‘Knowing and speaking for the person with cancer’, and ‘Providing informational, emotional and practical facilitation and support’, and Theme (2) Enacting the professional nurse role in complex situations'; with subthemes: ‘Palliative cancer care decision-making is particularly complex’, ‘Systems and cultures shape nurses’ roles and contributions', and ‘Balancing beneficence and patient autonomy’. Conclusion Participants perceived themselves as contributing to shared decision-making, while facing challenges and dilemmas in their professional roles. More supportive interprofessional working might improve how health professionals involve patients in shared decision-making. Implications for the Profession and Patient Care Increased development of nurses' contributions to shared decision-making about advanced cancer and palliative care could support their facilitation of patient involvement. Impact Although nurses can support people receiving palliative cancer treatment and care in shared decision-making, nursing's particular role and contribution has been unclear. Study findings suggest that nurses' important person-centred approach is challenging to maintain in treatment decision-making. These insights into nurses' involvement in shared decision-making could inform and contribute to the further development of interprofessional education, training, and leadership.

• Opsal, Anne; Fossum, Mariann; Elf, Marie; Undheim, Marie & Johannessen, Terese (2025). Student nurses’ satisfaction and confidence: Blended learning skills training on satellite campuses. Teaching and Learning in Nursing. ISSN 1557-3087. 20(3), p. e705–e712. doi: 10.1016/j.teln.2025.02.010. Full text in Research Archive Show summary

  Abstract Background In response to rural nursing shortages, some traditional on-campus bachelor of science in nursing degree programs have transitioned to a blended learning approach at satellite campuses. This significant shift requires an understanding of how students view the learning activities involved in skills training. Aim The aim of this study was to assess students in an education program in Southern Norway regarding their satisfaction in and self-confidence with skills training using blended learning. The program was hosted at satellite campuses of two universities. Methods For this cross-sectional study, 54 students completed a Student Satisfaction and Self-confidence in Learning scale and open-ended questions. Quantitative data were analyzed with descriptive statistics and qualitative data assessed using content analysis. Results Students who completed skills training reported high levels of satisfaction with the learning activities and support from their teachers. In addition, they demonstrated high self-confidence in practicing skills. Conclusion The current findings indicate that students appreciate blended learning strategies and the availability of skills training on satellite campuses along with supportive teaching practices.

• Sanfilippo, Filippo; Fossum, Mariann & Hansen, Michael Rygaard (2025). Redefining Care and Work Practices: The Role of Autonomy in the Future of Nursing Homes. In Paolis, Lucio Tommaso De; Arpaia, Pasquale & Sacco, Marco (Ed.), Extended Reality. Springer. ISSN 9783031977718. p. 355–370. doi: 10.1007/978-3-031-97781-7_26. Full text in Research Archive Show summary

  Nursing homes face increasing challenges due to workforce shortages, ageing populations, and rising care demands. This paper explores the dynamics of human-robot interaction (HRI) in nursing home environments, focusing on how autonomous robots engage with nurses and residents in nursing homes. We examine the role of trust-building and emotional engagement in caregiving scenarios, where patient well-being depends on effective HRI. The potential for autonomous systems to support decision-making while maintaining human oversight is investigated. Using the Autonomy Levels for Unmanned Systems (ALFUS) framework, we assess care robots’ autonomy in terms of mission complexity (MC), environmental complexity (EC), and external system independence (ESI). Additionally, the Autonomy and Technology Readiness Assessment (ATRA) method supports gradual capability enhancement, providing a roadmap to higher autonomy while ensuring safety and reliability. Based on this established methodology, we introduce the Nursing Home Interaction Framework (NHIF), a novel conceptual framework defining the roles of actors involved, to connect theoretical insights with real-world applications. This work highlights the significance of human-robot trust in elderly care scenarios and proposes directions for future research on collaborative decision-making in nursing home HRI.

• Kristoffersen, Eirunn W; Fossum, Mariann; Tveit, Tor Oddbjørn; Berge, Geir Thore; Hagen, Milada & Opsal, Anne (2025). Comparison of elective hemicolectomy patients before and after establishment of a preoperative anaesthesia assessment clinic: A retrospective, observational study in a hospital in Norway. BMJ Open. 15(6). doi: 10.1136/bmjopen-2025-100922. Full text in Research Archive Show summary

  Objectives To compare outcome data of hemicolectomy patients before and after the establishment of a preoperative anaesthesia assessment clinic (PAC). Design This observational study was conducted retrospectively through an electronic health record review covering periods before (2014–2017) and after (2017–2022) the PAC was established. Setting An acute care hospital in Norway. Participants A total of 612 patients undergoing elective open or laparoscopic hemicolectomy were included, of whom 338 (55.2%) had attended the PAC. Primary and secondary outcome measures The primary outcome was the rate of cancellation of planned surgeries, and the secondary outcomes were length of hospital stay (LOS), unanticipated intraoperative anaesthesia-related events and the presence of documentation relevant to the planning of anaesthesia in the patient’s medical records preoperatively. Results Compared with the after-PAC cohort, the before-PAC cohort was numerically more likely to have their planned surgery cancelled (OR=1.97, 95% CI (0.84 to 4.61); p=0.12). The before-PAC cohort also had a numerically lower rate of unanticipated intraoperative anaesthesia-related events (18.6%) than the after-PAC cohort (22.5%; p=0.240). However, neither of these differences was statistically significant. Median LOS was significantly shorter in the after-PAC cohort (4.79 days, IQR (3.80–6.12)) than in the before-PAC cohort (5.16 days (4.09–7.18); p=0.001). Moreover, the presence of documentation relevant to the planned anaesthesia in the medical records was significantly more common for after-PAC patients. Conclusions The establishment of the PAC reduced the rate of planned surgery cancellations but increased the rate of recorded intraoperative anaesthesia events. Patients who attended the PAC had a significantly shorter LOS and more anaesthesia-related information in their medical records. Trial registration number NCT05520229.

• Rabben, Jannicke; Vivat, Bella; Fossum, Mariann & Rohde, Gudrun E. (2024). Shared decision-making in palliative cancer care: A systematic review and metasynthesis. Palliative Medicine. ISSN 0269-2163. 38(4), p. 406–422. doi: 10.1177/02692163241238384. Full text in Research Archive
• Kaldheim, Hege Kristin Aslaksen; Munday, Judy; Haddeland, Kristine & Fossum, Mariann (2024). Newly Graduated Perioperative Nurses' Experiences of Transitioning to Clinical Practice: A Qualitative Explorative Secondary Analysis. Journal of Advanced Nursing. ISSN 0309-2402. doi: 10.1111/jan.16537. Full text in Research Archive Show summary

  Aim The aim of this secondary analysis was to explore newly graduated perioperative nurses' experiences of transitioning to clinical practice to gain more in‐depth knowledge of this phenomenon. Design A qualitative explorative study of secondary data was used, and this study was reported following the Consolidated Criteria for Reporting Qualitative Research checklist. Methods A secondary analysis of data collected between March 2019 and November 2020 via 16 semi‐structured interviews with newly graduated perioperative nurses. The interviews were conducted 3 to 5 months after they graduated from five different educational institutions in Norway and entered clinical practice as perioperative nurses. A three‐step phenomenological hermeneutical analysis inspired by Ricoeur's theory was applied: naïve reading, structural analysis and comprehensive understanding. Results We identified three themes: expectations of competence, facilitation for newly graduated perioperative nurses and the transition from being a student to a newly qualified perioperative nurse. Conclusions Newly graduated perioperative nurses emphasised the critical role of supportive facilitation, manageable expectations and support from leaders and colleagues, which seemed essential for a successful transition to clinical practice. Impact This study addresses knowledge essential for universities, universities colleges and clinical practice, specifically healthcare organisations, to understand the transition process for newly graduated perioperative nurses. This can support the establishment of improved practices to ensure patient safety via more specific education and mentoring and more accurate expectations of competence.

• Johannessen, Terese; Fossum, Mariann; Elf, Marie & Opsal, Anne (2024). Exploring the undergraduate nursing students' experiences and learning strategies in distance nurse education: A qualitative study. Nurse Education Today. ISSN 0260-6917. 146, p. 1–7. doi: 10.1016/j.nedt.2024.106500. Full text in Research Archive Show summary

  Background Distance nurse education is an essential contribution to sustainable access for nurses in rural and remotes areas. However, distance nurse education requires pedagogical changes, and we need more knowledge to design education programmes that can accommodate students who study off-campus. Objective To explore how undergraduate nursing students experience a distance education programme. Methods A qualitative explorative design. Students in a distance nurse education programme participated in six focus group interviews from March to September 2022. Data were subjected to qualitative content analysis. Results Students had a generally positive experience of the distance nurse education programme and were especially pleased with its flexibility. The two main themes were students' sense of belonging and social interactions and their participation in learning activities. Students cited face-to-face meetings as an important factor in having a sense of community, involvement, and continuous motivation for their studies. Students found study groups to be useful for learning and progress in the study subjects. Physical teaching sessions at a non-university site facilitated and motivated them to follow live streaming of lectures at home and to collaborate online with the study group between those meetings. Social interaction with the educator and other students in physical teaching sessions was important for discussions of the subject matter and for assistance with technical challenges. A predictable timetable was essential for the students to balance time for their studies with family and work responsibilities. Conclusion Students in the distance nurse programme preferred a combination of face-to-face meetings and live streaming. Study groups contributed to motivation, understanding of the course content, and a sense of community. It also helped to improve students' collaboration skills. These students have many professional and family obligations, so a predictable course plan was important to them.

• Laukvik, Lene Baagøe; Lyngstad, Merete; Rotegård, Ann Kristin & Fossum, Mariann (2024). Utilizing nursing standards in electronic health records: A descriptive qualitative study. International Journal of Medical Informatics. ISSN 1386-5056. 184, p. 1–7. doi: 10.1016/j.ijmedinf.2024.105350. Full text in Research Archive Show summary

  Background The electronic health record (EHR), including standardized structures and languages, represents an important data source for nurses, to continually update their individual and shared perceptual understanding of clinical situations. Registered nurses’ utilization of nursing standards, such as standardized nursing care plans and language in EHRs, has received little attention in the literature. Further research is needed to understand nurses’ care planning and documentation practice. Aims This study aimed to describe the experiences and perceptions of nurses’ EHR documentation practices utilizing standardized nursing care plans including standardized nursing language, in the daily documentation of nursing care for patients living in special dementia-care units in nursing homes in Norway. Methods A descriptive qualitative study was conducted between April and November 2021 among registered nurses working in special dementia care units in Norwegian nursing homes. In-depth interviews were conducted, and data was analyzed utilizing reflexive thematic analysis with a deductive orientation.

• Dalsmo, Ingrid Espegren; Laugaland, Kristin Alstveit; Fossum, Mariann; Ravik, Monika; Gonzalez, Marianne Thorsen & Ekra, Else Mari Ruberg (2024). Student nurses' experiences with a digital educational resource supporting learning in nursing home placements: A qualitative study. Nurse Education Today. ISSN 0260-6917. 140, p. 1–7. doi: 10.1016/j.nedt.2024.106271. Full text in Research Archive Show summary

  Background: Nursing education should improve clinical placements in nursing homes to foster and enhance student nurses' learning experiences. Initiatives for digital educational resource used to teach and supervise students to complement learning are increasingly being adopted and considered important in nursing education. However, little is known about how digital educational resources can facilitate learning in placements. Research on the value of such resources from student nurses' perspective is required. Aim: To explore first-year student nurses' experiences with a digital educational resource developed to support learning in nursing home placements. Design: This study has a qualitative explorative design and is part of a larger research project in which a digital educational resource named DigiQUALinPRAX was developed. Settings: This study was conducted at three publicly funded nursing homes affiliated with one Norwegian university. Participants: Twenty-three first-year student nurses. Methods: Data was generated through pre- and post-placement group interviews and analysed using reflexive thematic analysis. Standards for Reporting Qualitative Research were applied in this stud. Findings: One overreaching theme and three subthemes related to student nurses' experiences with a digital educational resource were identified. The digital educational resource gave a feeling of being acknowledged as a learner by (1) providing a structure and preparation that made the placement feel less overwhelming, (2) supporting professional reflection and assessment practices, and (3) facilitating collaboration when all stakeholders used the resource actively. Conclusions: This study indicates that student nurses' learning process in nursing home placements can be supported through digital educational resources customised for this learning arena. The findings indicate that the digital educational resource facilitated pre-placement preparedness, provided structure and flexibility, and enhanced reflection and assessment practices during clinical placement. However, encouraging tripartite usage is essential to exploit the full potential of digital educational resources.

• Prado, Patricia Rezende do; Silveira, Renata Cristina Campos Pereira; Vettore, Mario Vianna; Fossum, Mariann; Vabo, Grete Lund & Gimenes, Fernanda Raphael Escobar (2023). Nursing interventions to prevent corneal injury in critically ill sedated and mechanically ventilated patients: A systematic review of interventions. Intensive and Critical Care Nursing. ISSN 0964-3397. 78. doi: 10.1016/j.iccn.2023.103447. Full text in Research Archive Show summary

  Objective: To identify the effectiveness of interventions to prevent corneal injury in critically ill, sedated, and mechanically ventilated patients. Research methodology: A systematic review of intervention studies was conducted in the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Embase, Latin American and Caribbean Literature in Health Sciences, LIVIVO, PubMed, Scopus and Web of Science, and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Study selection and data extraction were performed by two independent reviewers. Quality assessment of the randomized and non-randomized studies was performed using the Risk of Bias (RoB 2.0) and ROBINS-I Cochrane tools, respectively, and the Newcastle-Ottawa Scale for cohort studies. The certainty of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: 15 studies were included. Meta-analysis showed that the risk of corneal injury in the lubricants group was 66% lower (RR = 0.34; 95 %CI: 0.13–0.92) than in the eye-taping group. The risk of corneal injury in the polyethylene chamber was 68% lower than in the eye ointment group (RR = 0.32; 95 %CI 0.07–1.44). The risk of bias was low in most of the studies included and the certainty of the evidence was evaluated. Conclusions: The most effective interventions to prevent corneal injury in critically ill sedated mechanically ventilated, who have compromised blinking and eyelid closing mechanisms, are ocular lubrication, preferably gel or ointment, and protection of the corneas with a polyethylene chamber. Implications for clinical practice: Critically ill, sedated, and mechanically ventilated patients who have compromised blinking and eyelid closing mechanisms must receive interventions to prevent corneal injury. Ocular lubrication, preferably gel or ointment, and protection of the corneas with a polyethylene chamber were the most effective interventions to prevent corneal injury in critically ill, sedated, and mechanically ventilated patients. A polyethylene chamber must be made commercially available for critically ill, sedated, and mechanically ventilated patients.

• 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.

• Zlamal, Jaroslav; Gjevjon, Edith Roth; Fossum, Mariann; Steindal, Simen Alexander & Nes, Andrea Aparecida Gonçalves (2023). A Technology-Supported Guidance Model to Support the Development of Critical Thinking among Undergraduate Nursing Students in Clinical Practice: Concurrent, Exploratory, Flexible, and Multimethod Feasibility Study. JMIR Formative Research. 7. doi: 10.2196/43300. Full text in Research Archive Show summary

  Background: There is widespread recognition and acceptance of the need for critical thinking in nursing education, as it is necessary to provide high-quality nursing. The Technology-Supported Guidance Model (TSGM) intervention was conducted during clinical practice among undergraduate nursing students and aimed to support the development of critical thinking. A major element of this newly developed intervention is an app, Technology-Optimized Practice Process in Nursing (TOPP-N), combined with the daily guidance of nursing students from nurse preceptors and summative assessments based on the Assessment of Clinical Education. Objective: The main objective of this study was to assess the feasibility of a newly developed intervention, TSGM, among undergraduate nursing students, nurse preceptors, and nurse educators. Further objectives were to assess the primary and secondary outcome measures, recruitment strategy, and data collection strategy and to identify the potential causes of dropout and barriers to participant recruitment, retention, intervention fidelity, and adherence to the intervention. Methods: This study was designed as a concurrent, exploratory, flexible, and multimethod feasibility study of the TSGM intervention that included quantitative and qualitative data from nursing students, nurse preceptors, and nurse educators. The primary outcome measures were the feasibility and acceptability of the intervention. The secondary outcomes included the suitability and acceptance of the outcome measures (critical thinking, self-efficacy, clinical learning environment, metacognition and self-regulation, technology acceptance, and competence of mentors); data collection strategy; recruitment strategy; challenges related to dropouts; and hindrances to recruitment, retention, and intervention fidelity and adherence. Results: Nursing students, nurse preceptors, and nurse educators had varied experiences with the TSGM intervention. We identified factors that make the intervention feasible and challenging and may influence the feasibility, acceptability, dropout rate, adherence, and fidelity of the intervention. We also identified areas for future improvement of the intervention. Conclusions: The use of a newly developed intervention, TSGM, is feasible and accepted by undergraduate nursing students, nurse preceptors, and nurse educators; however, refinement and improvement of the intervention and the TOPP-N app, improvement in intervention management, and mitigation of negative factors are necessary before a randomized controlled trial can be performed.

• Kristoffersen, Eirunn W.; Opsal, Anne; Tveit, Tor Oddbjørn; Berg, Rigmor & Fossum, Mariann (2022). Effectiveness of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies. BMJ Open. 12(5). doi: 10.1136/bmjopen-2021-054206. Full text in Research Archive Show summary

  Objectives The aim of this systematic review was to examine the effectiveness of pre-anaesthesia assessment clinics (PACs) in improving the quality and safety of perioperative patient care.<p> <p>Design Systematic review. <p>Data sources The electronic databases CINAHL Plus with Full Text (EBSCOhost), Medline and Embase (OvidSP) were systematically searched on 11 September 2018 and updated on 3 February 2020 and 4 February 2021. <p>Eligibility criteria The inclusion criteria for this study were studies published in English or Scandinavian language and scientific original research that included randomised or non-randomised prospective controlled studies. Additionally, studies that reported the outcomes from a PAC consultation with the patient present were included. <p>Data extraction and synthesis Titles, abstracts and full texts were screened by a team of three authors. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies. Data extraction was performed by one author and checked by four other authors. Results were synthesised narratively owing to the heterogeneity of the included studies. <p>Results Seven prospective controlled studies on the effectiveness of PACs were included. Three studies reported a significant reduction in the length of hospital stay and two studies reported a significant reduction in cancellation of surgery for medical reasons when patients were seen in the PAC. In addition, the included studies presented mixed results regarding anxiety in patients. Most studies had a high risk of bias. <p>Conclusion This systematic review demonstrated a reduction in the length of hospital stay and cancellation of surgery when the patients had been assessed in the PAC. There is a need for high-quality prospective studies to gain a deeper understanding of the effectiveness of PACs.

• Laukvik, Lene Baagøe; Lyngstad, Merete; Rotegård, Ann Kristin; Slettebø, Åshild & Fossum, Mariann (2022). Content and comprehensiveness in the nursing documentation for residents in long-term dementia care: a retrospective chart review. BMC Nursing. 21. doi: 10.1186/s12912-022-00863-9. Full text in Research Archive Show summary

  Background: Insight into and understanding of content and comprehensiveness in nursing documentation is important to secure continuity and high-quality care planning in long-term dementia care. The accuracy of nursing documentation is vital in areas where residents have difculties in communicating needs and preferences. This study described the content and comprehensiveness of nursing documentation for residents living with dementia in nursing homes. Methods: We used a retrospective chart review to describe content and comprehensiveness in the nursing documentation. Person-centered content related to identity, comfort, inclusion, attachment, and occupation was identifed, using an extraction tool derived from person-centered care literature. The fve-point Comprehensiveness in the Nursing Documentation scale was used to describe the comprehensiveness of the nursing documentation in relation to the nursing process. Results: The residents’ life stories were identifed in 16% of the reviewed records. There were variations in the identifed nursing diagnoses related to person-centered information, across all the fve categories. There were variations in comprehensiveness within all fve categories, and inclusion and occupation had the least comprehensive information. Conclusion: Findings from this study highlights challenges in documenting person-centered information in a comprehensive way. To improve nursing documentation of residents living with dementia in nursing homes, nurses need to include residents’ perspectives and experiences in their planning and evaluation of care.

• Zlamal, Jaroslav; Gjevjon, Edith Roth; Fossum, Mariann; Solberg, Marianne Trygg; Steindal, Simen Alexander & Strandell-Laine, Camilla [Show all 8 contributors for this article] (2022). Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Mixed Methods Systematic Review. JMIR Nursing. 5(1). doi: 10.2196/37380. Full text in Research Archive Show summary

  Background: Nursing education has increasingly focused on critical thinking among nursing students, as critical thinking is a desired outcome of nursing education. Particular attention is given to the potential of technological tools in guiding nursing students to stimulate the development of critical thinking; however, the general landscape, facilitators, and challenges of these guidance models remain unexplored, and no previous mixed methods systematic review on the subject has been identified. Objective: This study aims to synthesize existing evidence on technology-supported guidance models used in nursing education to stimulate the development of critical thinking in nursing students in clinical practice. Methods: This mixed methods systematic review adopted a convergent, integrated design to facilitate thematic synthesis. This study followed the guidelines of the Joanna Briggs Institute Manual for Evidence Synthesis. Results: We identified 3 analytical themes: learning processes implemented to stimulate critical thinking, organization of the learning process to stimulate critical thinking, and factors influencing the perception of the learning process. We also identified 4 guidance models, all based on facilitator or preceptorship models using tailored instructional or learning strategies and one or several technological tools that were either generic or custom-made for specific outcomes. The main facilitators of these technology-supported guidance models were nurse educators or nurse preceptors, and the main challenges in using technology-supported guidance models were the stress associated with technical difficulties or increased cognitive load. Conclusions: Although we were able to identify 4 technology-supported guidance models, our results indicate a research gap regarding the use of these models in nursing education, with the specific aim of stimulating the development of critical thinking. Both nurse preceptors and nurse educators play a crucial role in the development of critical thinking among nursing students, and technology is essential for such development. However, technology-supported guidance models should be supervised to mitigate the associated stress.

• 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.

• Glomsås, Heidi Snoen; Knutsen, Ingrid Ruud; Fossum, Mariann; Christiansen, Karin & Halvorsen, Kristin (2022). Family caregivers’ involvement in caring for frail older family members using welfare technology: a qualitative study of home care in transition. BMC Geriatrics. 22. doi: 10.1186/s12877-022-02890-2. Full text in Research Archive Show summary

  Background: Demographic, economic and organisational changes challenge home care services. Increased use of welfare technology and involvement of family members as co-producers of care are political initiatives to meet these challenges. However, these initiatives also involve ethical aspects. Method: The aim of this qualitative study was to explore family caregivers’ experience of involvement and possible ethical aspects of caring for frail older family members receiving home care services supported by welfare technology. This study used a qualitative explorative and descriptive design within a phenomenological-hermeneutical approach. Sixteen interviews with eighteen family caregivers were conducted. The participants were sons, daughters, siblings and spouses of frail older people receiving home care services with the support of welfare technology. Data were analysed using refexive thematic analysis. The COREQ checklist was used. Results: The analysis led to fve main themes. First, the family caregivers’ experienced caring as meaningful but increasingly demanding concerning the changes in home care services. Second, they experienced a change in relationships, roles, tasks, and responsibilities related to more family involvement and the use of welfare technology. This also challenged their sense of autonomy. However, welfare technology helped them deal with responsibilities, especially safety. The family caregivers requested early involvement, dialogue for care decisions, more cooperation and support from health professionals. Third, the participants experienced that health professionals decided the conditions for co-production without discussion. Their need for information and knowledge about welfare technology were not met. Fourth, the family caregivers felt that the health professionals did not adequately recognise their unique knowledge of the care receiver and did not use this knowledge for customising the welfare technology to the care receiver and their families. Fifth, the family caregivers expressed concern about service and welfare technology inequality in home care services. Conclusions: Co-production in the involvement of family caregivers in care is still not an integral part of home care service. Welfare technology was appreciated, but the family caregivers called for early involvement to ensure successful and safe implementation and use. More attention needs to be given to ethical concerns about the change in relations, transfer of tasks and responsibility, and risk of inequality.

• Kristoffersen, Eirunn W.; Opsal, Anne; Tveit, Tor Oddbjørn & Fossum, Mariann (2022). Knowledge, safety, and teamwork: a qualitative study on the experiences of anaesthesiologists and nurse anaesthetists working in the preanaesthesia assessment clinic. BMC Anesthesiology. 22. doi: 10.1186/s12871-022-01852-w. Full text in Research Archive
• Laukvik, Lene Baagøe; Rotegård, Ann Kristin; Lyngstad, Merete; Slettebø, Åshild & Fossum, Mariann (2022). Registered nurses’ reasoning process during care planning and documentation in the electronic health records: A concurrent think-aloud study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 32. doi: 10.1111/jocn.16210. Full text in Research Archive Show summary

  noAbstractAims and objectives: To explore the clinical reasoning process of experienced reg-istered nurses during care planning and documentation of nursing in the electronic health records of residents in long-term dementia care.Background: Clinical reasoning is an essential element in nursing practice. Registered nurses’ clinical reasoning process during the documentation of nursing care in elec-tronic health records has received little attention in nursing literature. Further re-search is needed to understand registered nurses’ clinical reasoning, especially for care planning and documentation of dementia care due to its complexity and a large amount of information collected.Design: A qualitative explorative design was used with a concurrent think-aloud technique.Methods: The transcribed verbalisations were analysed using protocol analysis with referring phrase, assertional and script analyses. Data were collected over ten months in 2019–2020 from 12 registered nurses in three nursing homes offering special de-mentia care. The COREQ checklist for qualitative studies was used.Results: The nurses primarily focused on assessments and interventions during documentation. Most registered nurses used their experience and heuristics when reasoning about the residents’ current health and well- being. They also used logi-cal thinking or followed local practice rules when reasoning about planned or imple-mented interventions.Conclusion: The registered nurses moved back and forth among all the elements in the nursing process. They used a variety of clinical reasoning attributes during care planning and nursing documentation. The most used clinical reasoning attributes were information processing, cognition and inference. The most focused information was planned and implemented interventions.Relevance to clinical practice: Knowledge of the clinical reasoning process of regis-tered nurses during care planning and documentation should be used in developing electronic health record systems that support the workflow of registered nurses and enhance their ability to disseminate relevant information.

• Fossum, Mariann; Opsal, Anne & Ehrenberg, Anna (2022). Nurses' sources of information to inform clinical practice: An integrative review to guide evidence-based practice. Worldviews on Evidence-Based Nursing. ISSN 1545-102X. 19(5), p. 372–379. doi: 10.1111/wvn.12569. Full text in Research Archive
• Kaldheim, Hege Kristin Aslaksen; Fossum, Mariann; Munday, Judy; Creutzfeldt, Johan & Slettebø, Åshild (2022). Professional competence development through interprofessional simulation-based learning assists perioperative nurses in postgraduation acute clinical practice situations: A qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. doi: 10.1111/jocn.16377. Full text in Research Archive
• Øgård-Repål, Anita; Berg, Rigmor; Skogen, Vegard & Fossum, Mariann (2022). Peer support in an outpatient clinic for people living with human immunodeficiency virus: a qualitative study of service users’ experiences. BMC Health Services Research. 22(1). doi: 10.1186/s12913-022-07958-8. Full text in Research Archive Show summary

  Background: Although human immunodefciency virus (HIV) has become a manageable condition with increasing life expectancy, people living with HIV (PLHIV) are still often isolated from society due to stigma and discrimination. Peer support provides one avenue for increased social support. Given the limited research on peer support from the perspective of PLHIV, this study explored their experiences of peer support organised by healthcare professionals in an outpatient clinical setting. Methods: The study used a qualitative, descriptive research design for an in-depth understanding of peer support provided to PLHIV in the context of outpatient clinics. Healthcare professionals contributed to the recruitment of 16 participants. We conducted in-depth interviews about participants’ experiences of peer support, and performed a directed content analysis of the data. Further, we sorted the data into pre-determined categories. Results: The pre-determined categories constituted attachment, social integration, an opportunity for nurturance, reassurance of worth, reliable alliance, and guidance. The identifed themes were: gained emotional support, disclosure behaviour allowed garnering of emotional support, non-disclosure promoted the need to meet a peer, experienced a sense of belonging, activated an opportunity for mutual support, means to re-establish belief in one’s own worth, perceived a positive afrmation of disease management, facilitated dialogue about disease management, the outpatient clinic as a safe place, and a setting for fexible, individualised support. Conclusions: This study highlights the peer support experiences of PLHIV in the context of outpatient clinics. The participants’ experiences align with previous fndings, showing that peer support contributes to mutual emotional support between peers. This is particularly important in cultures of non-disclosure where PLHIV experience inter‑ sectional stigma. Additionally, our results show outpatient clinics to be supportive surroundings for facilitating peer support, ensuring confdentiality in peer support outreach. Therefore, peer support contributes positively to individu‑ alising outpatient clinic services to meet the changing needs of PLHIV.

• Øgård-Repål, Anita; Berg, Rigmor; Skogen, Vegard & Fossum, Mariann (2022). “They make a difference”: a qualitative study of providers’ experiences of peer support in outpatient clinics for people living with HIV. BMC Health Services Research. 22. doi: 10.1186/s12913-022-08810-9. Full text in Research Archive Show summary

  Background Although the life expectancy of people living with HIV has increased, they are still often disconnected from society through stigma and discrimination. Peer support has been found to increase social support. Given the limited research on peer support from the providers’ perspective, this study explored how peer supporters experience their roles and contributions in outpatient clinics (OPCs). Additionally, healthcare professionals’ perceptions of working with peer supporters in OPCs were examined. Methods This qualitative study included purposively selected peer supporters (n = 10) and healthcare professionals (n = 5) from five OPCs in Norway in 2020. In-depth interviews and focus group discussions were conducted in Norwegian or English, using interview guides. Interview transcripts were analysed in NVivo 12 using reflexive and collaborative thematic analysis. Results The results show that peer supporters experience mutual support through emotional and honest interactions. Further, the peer supporters found it essential to negotiate with the service users about their preconception of HIV, confront their views through dialogue, and replicate positive experiences by being credible role models. The participants expressed that integrating peer support in the OPCs’ usual care processes increased the prospect of equitable services. Quality of peer support and role clarity were identified as critical components. The results demonstrate that emotional and honest conversations promote support between peers and that peer supporters identify a need for a reframed understanding of HIV by modelling plausible alternative interpretations and coping experiences. Conclusions This study contributes to knowledge on how peer support can meet the needs of people living with HIV. Incorporating people living with HIV in the co-production and distribution of healthcare services may improve the knowledge and perspectives in healthcare services. However, the skill standards of peer supporters should be addressed when implementing peer support in usual care.

• Fegran, Liv; Ham-Baloyi, Wilma ten; Fossum, Mariann; Hovland, Olav Johannes; Naidoo, Joanne R. & Rooyen, Dalena van [Show all 8 contributors for this article] (2022). Simulation debriefing as part of simulation for clinical teaching and learning in nursing education: A scoping review. Nursing Open. 9(5). doi: 10.1002/nop2.1426. Full text in Research Archive Show summary

  Aim: To map the evidence of the simulation debriefing phase in simulation activities of nursing education, to address and inform clinical teaching and learning in nursing.Design: A scoping review.Methods: A systematic review of literature published between 2008–2021 was conducted using CINAHL & ERIC, MEDLINE, EMBASE, APA PsycInfo, the Cochrane Library and JBI Evidence synthesis. Inclusion criteria were primary studies published in English on simulation debriefing at all levels in nursing education.Results: Of 140 included references, only 80% (N= 112) framed simulation debriefing theoretically either by specific theories/models or as a literature review of the topic. A variety of simulation debriefing methods were identified; however, debriefing methods were only described in 79% (N= 110) of the references. There appears to be a gap in consensus concerning the theoretical or methodological frameworks characterizing simulation debriefing in nursing education. The majority of studies (86%) were conducted at a bachelor's degree level (N= 121).

• Fossum, Mariann; Cohen, Marlene Z.; Tønnessen, Vivi Haavik; Hamre, Mette Dobler; Ødegaard, Agno Lisbeth Vabo & Lind, Ingjerd [Show all 8 contributors for this article] (2021). Clinical Nurses Research Priorities in Hospital Settings: A Delphi Survey. Western Journal of Nursing Research. ISSN 0193-9459. p. 1–8. doi: 10.1177/01939459211017919. Full text in Research Archive
• Glomsås, Heidi Snoen; Knutsen, Ingrid Ruud; Fossum, Mariann & Halvorsen, Kristin (2021). ‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services. BMC Health Services Research. 21(1). doi: 10.1186/s12913-021-06243-4. Full text in Research Archive
• Presno, Åsne Knutson De; Øgård-Repål, Anita & Fossum, Mariann (2021). Simulations with standardized patients for nursing students in preparation for clinical placements in mental health care. Clinical Simulation in Nursing. ISSN 1876-1399. 54, p. 70–76. doi: 10.1016/j.ecns.2021.01.009. Full text in Research Archive
• Haddeland, Kristine; Slettebø, Åshild & Fossum, Mariann (2021). Enablers of the successful implementation of simulation exercises: a qualitative study among nurse teachers in undergraduate nursing education. BMC Nursing. 20(1). doi: 10.1186/s12912-021-00756-3. Full text in Research Archive
• Zlamal, Jaroslav; Gjevjon, Edith Roth; Fossum, Mariann; Solberg, Marianne Trygg; Steindal, Simen Alexander & Strandell-Laine, Camilla [Show all 9 contributors for this article] (2021). Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Protocol for a Mixed Methods Systematic Review. JMIR Research Protocols. 10(1). doi: 10.2196/25126. Full text in Research Archive Show summary

  Background: Critical thinking is an essential skill that nursing students need to develop. Technological tools have opened new avenues for technology-supported guidance models, but the challenges and facilitators of such guidance models, as well as how they stimulate the development of critical thinking, remain unclear. Objective: We developed a protocol for a mixed methods systematic review to investigate the use of technology-supported guidance models that stimulate the development of critical thinking in nursing education clinical practice. Methods: A convergent integrated design following the Joanna Briggs Institute Manual for Evidence Synthesis will be employed. A pair of authors will select the articles by screening titles and abstracts, and the methodological quality of the articles included in the review will be assessed by a pair of authors according to checklists for specific study designs. The data will be extracted using the standardized Joanna Briggs Institute mixed methods data extraction form and following a convergent integrated approach. The thematic synthesis for data transformation will be used. Results: Development of a comprehensive systematic search strategy was completed in October 2020. The database searches were performed on October 21, 2020. As of January 2021, analysis and synthesis is ongoing. Completion of this review is expected by January 2021. Conclusions: By combining evidence from studies with varied methodological approaches, the results should provide broad insight into the use of technology-supported guidance models for clinical practice in nursing education with a focus on the development of nursing students’ critical thinking. The results of this mixed methods systematic review can also be used to develop or improve current technology-supported guidance models for clinical practice in nursing education.

• Øgård-Repål, Anita; Berg, Rigmor & Fossum, Mariann (2021). A Scoping Review of the Empirical Literature on Peer Support for People Living with HIV. Journal of the International Association of Providers of AIDS Care. ISSN 2325-9574. 20. doi: 10.1177/23259582211066401. Full text in Research Archive Show summary

  People living with HIV receiving antiretroviral therapy need support related to linkage to care and self-management in everyday life. Peer support has been found to provide varied support according to the unique needs of the group. This scoping review aims to provide an overview of research on peer support provided to people living with HIV. A search was conducted in eight databases until May 2021, and two reviewers independently screened all identified studies. We sorted the included studies into categories and conducted descriptive analyses. For this communication, we included 34 studies representing three study categories: the experiences of peer support (n=23), program descriptions (n=6), and training of peer supporters (n=5). The studies were published between 2000 and 2021 and included 4275 participants from 10 countries. The flexibility of peer support complements healthcare services, but there is a need to clarify and adjust the ongoing support when living with HIV.

• Frivold, Gro; Ågård, Anne-Sophie; Jensen, Hanne Irene; Åkerman, eva; Fossum, Mariann & Alfheim, Hanne Birgit [Show all 8 contributors for this article] (2021). Family involvement in the intensive care unit in four Nordic countries. Nursing in Critical Care. ISSN 1362-1017. 26. doi: 10.1111/nicc.12702. Full text in Research Archive Show summary

  Background - Relevance to clinical practice The findings from the study highlighting family involvement, high-quality communication and flexible visiting policy as central aspects of family care may inspire clinicians to identify aspects of everyday family care in their ICUs calling for further improvement.<p> <p>Aims and objectives - To describe family involvement, communication practices and visiting policies in adult ICUs.<p> <p>Design - A cross-sectional survey.<p> <p>Method - A questionnaire consisting of 11 sections was developed, pilot tested and e-mailed to 196 ICUs. The participants were intensive care nurses in adult ICUs in four Nordic countries.<p> <p>Results - The survey was conducted in October to December 2019. The response rate was 81% (158/196) of the invited ICUs. Most of the units had fewer than 11 beds. Family participation in patient care, including involvement in ward rounds and presence during cardiopulmonary resuscitation, varied between the countries, whereas most families in all countries were involved in decision-making. Family conferences were generally initiated by staff or family members. Children under 18 did not always receive information directly from the staff, and parents were not advised about how to inform their children. Although most respondents described open visiting, restrictions were also mentioned in free-text comments.<p> <p>Conclusions - The level of family care in ICUs in the four Nordic countries is generally based on nurses' discretion. Although most Nordic ICUs report having an open or flexible visiting policy, a wide range of potential restrictions still exists. Children and young relatives are not routinely followed up. Family members are included in communication and decision-making, whereas family involvement in daily care, ward rounds and family-witnessed resuscitation seem to be areas with a potential for improvement.

• Øgård-Repål, Anita; Berg, Rigmor & Fossum, Mariann (2021). Peer Support for People Living With HIV: A Scoping Review. Health Promotion Practice. ISSN 1524-8399. doi: 10.1177/15248399211049824. Full text in Research Archive Show summary

  Peer support for people living with HIV has gained increasing traction and is considered a way to take an active role in self-management. The existing research examining peer support interventions has reported promising evidence of the benefits of peer support. The purpose of our scoping review was to describe research on peer support for people living with HIV. We included 53 studies and sorted them into analytic categories and conducted descriptive analyses. The studies that were published between November/December 2000 and May 2021, had a range of study designs and heterogeneous priority groups, and included 20,657 participants from 16 countries. We identified 43 evaluations of the effect of peer support and 10 evaluations of implementation, process, feasibility, cost of peer support. We also categorized peer support by key functions, finding that the most common key functions were linkage to clinical care and community resources and assistance in daily management, with only one study directly related to chronic care. There is growing research interest in peer support for people living with HIV, particularly in high-income countries and related to the evaluation of effects. The revealed gaps of prioritized functions of peer support have implications for further research. Further focus on interventions addressing secondary prevention related to noncommunicable diseases as part of a care package is recommended to meet people’s needs and preferences and increase self-management related to a chronic lifelong condition.

• Sørensen, Heidi; Fuskeland, Rannveig; Fossum, Mariann & Hovland, Olav Johannes (2021). Anestesisykepleieres metoder for å kontrollere cufftrykk – en observasjonsstudie. Inspira – tidsskrift for anestesi-, operasjon- og intensivsykepleiere. ISSN 0809-9707. 16(1), p. 85–99. doi: 10.23865/inspira.v16.3322. Full text in Research Archive
• Vabo, Grete Lund; Fossum, Mariann & Slettebø, Åshild (2021). Nursing students’ professional identity development: An integrative review. The Nordic Journal of Nursing Research (NJNR). ISSN 2057-1585. 42(2), p. 62–75. doi: 10.1177/20571585211029857. Full text in Research Archive
• Berg, Geir Vegard; Slettebø, Åshild; Johnsen, Kjersti Marie Frivoll; Dahl, Aud Findal & Fossum, Mariann (2021). Interviews with Community Healthcare Registered Nurses in Norway: Examination Practices and Clinical Evaluation Processes. Nursing Open. 8(6), p. 3291–3298. doi: 10.1002/nop2.1045. Full text in Research Archive Show summary

  Abstract Aim This study describes the examination practices and clinical evaluation processes that Registered Nurses in Norway perform in the community healthcare sector. Design A qualitative exploratory design. Methods Twenty interviews were conducted with Registered Nurses employed in the community healthcare sector in Norway. The data were analysed using a thematic analysis. Results We found four major themes: (1) evaluations are embedded in nurses’ daily work, (2) significance of a Registered Nurse's clinical competency, (3) different tasks require various roles and (4) access to resources and equipment. Registered Nurses possess several skills in a range of different examination techniques and clinical evaluation processes in the community healthcare sector. They perform complex assessments in their daily work and must rely on other healthcare professionals, facilities and equipment to provide high-quality care. Ongoing education and training will enable Registered Nurses to complete accurate assessments in their community healthcare practice.

• Zlamal, Jaroslav; Gjevjon, Edith Roth; Fossum, Mariann; Steindal, Simen Alexander & Nes, Andrea Aparecida Gonçalves (2021). Technology–supported guidance model to support the development of critical thinking among undergraduate nursing students in clinical practice: protocol of an exploratory, flexible mixed methods feasibility study. JMIR Research Protocols. 10(10). doi: 10.2196/31646. Full text in Research Archive Show summary

  Background: Critical thinking is an essential set of skills in nursing education, and nursing education therefore needs a sharper focus on effective ways to support the development of these skills, especially through the implementation of technological tools in nursing education. Objective: The aim of this study protocol is to assess the feasibility of a technology-supported guidance model grounded in the metacognition theory for nursing students in clinical practice. Methods: Both quantitative (research questionnaires) and qualitative (focus group interviews) approaches will be used to collect data for a feasibility study with an exploratory, flexible mixed methods design to test a newly developed intervention in clinical practice. Results: The intervention development was completed in December 2020. The intervention will be tested in 3 independent nursing homes in Norway. Conclusions: By determining the feasibility of a technology-supported guidance model for nursing students in clinical practice, the results will provide information on the acceptability of the intervention and the suitability of the outcome measures and data collection strategy. They will also identify the causes of dropout and obstacles to retention and adherence.

• Haddeland, Kristine; Slettebø, Åshild; Svensson, Elisabeth; Tosterud, Randi Beate; Wangensteen, Sigrid & Fossum, Mariann (2021). The Effects of Using High-Fidelity Simulation in Undergraduate Nursing Education: A Multicenter Randomized Controlled Trial with a Process Evaluation. International Journal of Educational Research. ISSN 0883-0355. 109. doi: 10.1016/j.ijer.2021.101813. Full text in Research Archive
• Kaldheim, Hege Kristin Aslaksen; Fossum, Mariann; Munday, Judy; Creutzfeldt, Johan & Slettebø, Åshild (2021). Use of interprofessional simulation-based learning to develop perioperative nursing students' self-efficacy in responding to acute situations. International Journal of Educational Research. ISSN 0883-0355. 109, p. 1–12. doi: 10.1016/j.ijer.2021.101801. Full text in Research Archive

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• Sanfilippo, Filippo; Fossum, Mariann & Hansen, Michael Rygaard (2026). Redefining Care and Work Practices: The Role of Autonomy in the Future of Nursing Homes | Springer Nature Link. Springer. ISBN 9783031977817. doi: 10.1007/978-3-031-97781-7_26. Full text in Research Archive Show summary

  Nursing homes face increasing challenges due to workforce shortages, ageing populations, and rising care demands. This paper explores the dynamics of human-robot interaction (HRI) in nursing home environments, focusing on how autonomous robots engage with nurses and...

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• Fossum, Mariann; Hansen, Michael Rygaard; Thygesen, Elin; Tørresen, Jim; Melkas, Helinä & Losada-Floriano, Diego (2026). SAKO project seminar. Full text in Research Archive Show summary

  Seminar June 2026 for all participants involved in the project with invited presenters.

• Enerstvedt, Camilla; Fossum, Mariann & Thygesen, Elin (2026). Robotteknologi kan gi sykepleiere mer tid til pasientene. Sykepleien Forskning. ISSN 1890-2936. 114. doi: 10.4220/sykepleiens.2026.109539. Full text in Research Archive Show summary

  Robotteknologi kan endre hvordan sykepleiere jobber og hvilke oppgaver de utfører. Men det er fortsatt sykepleierne som må vurdere pasientens behov og gi omsorg.

• Fossum, Mariann; Hansen, Michael Rygaard; Thygesen, Elin; Leifson, Ragni MacQueen; Giil, Elisabeth & Enerstvedt, Camilla [Show all 7 contributors for this article] (2026). SAKO Supplier Dialogue. doi: https:/www.uia.no/english/about-uia/centres-and-networks/centre-for-e-health/events/sako-supplier-dialouge.html. Full text in Research Archive Show summary

  The University of Agder invites suppliers and technology providers to a dialogue meeting as part of the research project SAKO. The aim of the meeting is to explore potential technological solutions and collaboration related to the development of a service robot solution for use in nursing homes, with a particular focus on relieving staff from heavy and repetitive transport tasks in their daily work.

• Fossum, Mariann; Dalsmo, Ingrid Espegren; Kirkevold, Marit; Jeppestøl, Kristin & Strøm, Benedicte Sørensen (2026). Universitetssykehjem kan bli nøkkelen til en styrket eldreomsorg under press. Show summary

  KRONIKK: Vi blir flere eldre og omsorgstrengende samtidig med at vi blir færre sykepleiere, helsefagarbeidere og annet helsepersonell. Spørsmålet er derfor hvordan kan vi sikre sårbare eldre gode tjenester også i fremtiden?

• Gjevjon, Edith Roth & Fossum, Mariann (2026). The Nordic state of nursing research: The case of Norway. The Nordic Journal of Nursing Research (NJNR). ISSN 2057-1585. 46. doi: 10.1177/20571585261444195. Full text in Research Archive Show summary

  The evolution of research into nursing in Norway began in the 1950s, driven by pioneering individuals who sought to establish a foundation for systematic inquiry in nursing. However, it was not until the 1980s that research into nursing gained real momentum and became recognised as an academic domain.1 This development is closely linked to the institutionalisation of nursing science within higher education. Key milestones include the establishment of the Nursing Teacher Education programme at the University of Tromsø in 1977, the Department of Nursing Science at the University of Bergen in 1979 and the Department of Nursing Science at the University of Oslo in 1985. Together, these institutions played a decisive role in formalising nursing science as an academic discipline, creating a foundation for advanced education and sustained research activity.1 Since the 1990s, there has been a steady and substantial increase in the number of registered nurses (RNs) pursuing advanced academic qualifications, including master's and doctoral degrees, within Norwegian higher education institutions (HEIs). This growth has contributed to the broader recognition of nursing as a scientific discipline and strengthened the knowledge base underpinning clinical practice. The cumulative effect of these developments has been the gradual establishment of evidence-based nursing practice and meaningful contributions to the quality and organisation of healthcare services. Nevertheless, we appear to be standing at a critical crossroads. In recent years, nursing science environments have increasingly been dismantled or absorbed into broader health science structures. Today, research into nursing at Norwegian universities is largely conducted under the umbrella of health sciences rather than within dedicated nursing science units. This structural shift is not without consequences. McKenna and Thompson2 have warned that the future of nursing research is under threat in several countries. Although it may be premature to claim that Norwegian nursing research faces an imminent crisis, the erosion of independent nursing science environments should be a cause for concern. Complacency at this stage risks undermining decades of progress. In this editorial, we identify three interrelated challenges currently facing nursing research in Norway and propose strategic directions to mitigate their consequences and strengthen the future of nursing science.

• Fossum, Mariann (2026). Robot i sykehjem? Full text in Research Archive
• Fossum, Mariann (2025). SAKO prosjektet for Digin medlemmer. Full text in Research Archive Show summary

  Presentasjon av SAKO prosjektet for Digin medlemmer

• Fossum, Mariann & Hansen, Michael Rygaard (2025). Lørdagsuniversitetet; Serviceroboter som Arbeidsstøtte i Kommunale helse- og Omsorgstjenester. Full text in Research Archive Show summary

  Presentasjon på lørdagsuniversitetet

• Fossum, Mariann (2025). Service Robots as Work Support in Municipal Health and Care Services. Full text in Research Archive
• Fossum, Mariann (2025). Serviceroboter i kommunal helse- og omsorgstjeneste. Full text in Research Archive Show summary

  Presentasjon for Norsk Sykepleierforbund og UNIO

• Fossum, Mariann (2025). Service Robots as Work Support in Municipal Health and Care Services. Full text in Research Archive Show summary

  Presentation for researchers from University of Glasgow, Scottland

• Fossum, Mariann & Hansen, Michael Rygaard (2025). Hva kan serviceroboter bidra med i helsetjenesten? Full text in Research Archive Show summary

  Presentasjon av SAKO prosjektet på Lørdagsuniversitetet i Risør.

• Hakestad, Anita Moen; Valaker, Irene; Valen, Kristin; Fossum, Mariann; Øygard, Sissel Hjelle & Pannekoeke, Lotte [Show all 8 contributors for this article] (2025). Ny praksismodell- praksis i sykehus. Full text in Research Archive Show summary

  Poster på FHS sin forskningskonferanse. En formidling av midlertidige resultat i forskningsprosjektet på langpraksis i medisinsk og kirurgis praksis inne på sykehus.

• Hakestad, Anita Moen; Valaker, Irene; Valen, Kristin; Øygard, Sissel Hjelle & Fossum, Mariann (2025). Langpraksis i sykepleierutdanningen. Full text in Research Archive Show summary

  Presentasjon av poster på FOU prosjektet på ny praksismodell

• Laukvik, Lene Baagøe; Brandal, Annika & Fossum, Mariann (2025). Strukturerte og standardiserte data gir bedre sykepleiedokumentasjon. Sykepleien Forskning. ISSN 1890-2936. 113. doi: 10.4220/sykepleiens.2025.101775. Full text in Research Archive
• Fossum, Mariann (2025). Fremtidens sykepleier: utdanning i en digital tid. Full text in Research Archive Show summary

  Teknologi utgjør en sentral del av helsetjenesten og sykepleiernes kompetanse. Forskriften om nasjonal retningslinje for sykepleierutdanning inkluderer et eget kompetanseområde knyttet til teknologi og digital kompetanse. Det er avgjørende at utdanningsinstitusjonene tar dette på alvor for å sikre at utdanningen er i samsvar med samfunnsmandatet og møter fremtidens behov i helsesektoren.

• Fossum, Mariann (2025). Oversiktsartikkel om OSKE. Full text in Research Archive Show summary

  Presentasjon av en scoping review studie

• Fossum, Mariann (2025). Hvordan sikre at forhåndssamtaler gjennomføres i fremtidens helsetjenester? Full text in Research Archive
• Fossum, Mariann (2025). Serviceroboter som arbeidsstøtte i kommunale helse – og omsorgstjenester. doi: https:/digiagder.no/sova-konferanse. Full text in Research Archive
• Alexander, Gregory L; Fossum, Mariann; Livingstone, Anne & Demiris, George (2025). Outcomes of an International Summit on the Use of Information Technology in Care of Older People. Full text in Research Archive Show summary

  Long-term care requires innovative solutions and collaborations to improve the services of older adults. To address this our team convened an International Summit on Innovation and Technology in Care of Older People (IS-ITCOP) at Columbia University in New York City on June 6-7, 2024. 47 attendees participated in four in-depth group discussions on the use of technology in the care of older people in emerging models of care, workforce, transparency in quality measurement and, privacy and safety. For each discussion group there was a lead facilitator, and a staff support person assigned. Lead facilitators stimulated discussion using a semi-structured interview guide recommended by the Scientific Program Committee (SPC). Shared core themes emerging from qualitative analyses conducted by two coders will be discussed by panelists who attended IS-ITCOP.

• Fossum, Mariann (2025). Forskning og innovasjon i offentlig sektor. Full text in Research Archive
• Rabben, Jannicke; Fossum, Mariann & Rohde, Gudrun E. (2025). Nurses' experiences and perceptions of involvement in shared decision-making in palliative cancer care; a qualitative interview study. Full text in Research Archive
• Rabben, Jannicke; Fossum, Mariann & Rohde, Gudrun E. (2025). The 19th World Congress of the European Association for Palliative Care 29 – 31 May 2025 Helsinki, Finland: Nurses’ experiences and perceptions of involvement in shared decision-making in palliative cancer care; a qualitative interview study. Palliative Medicine. ISSN 0269-2163. 39(2_suppl), p. 490–490. doi: 10.1177/02692163251335482. Full text in Research Archive
• Dalsmo, Ingrid Espegren; Johnsen, Kjersti Marie Frivoll; Holm, Bjørn Morten; Økshoff, Cathrine; Fossum, Mariann & Tveide, Marit Bolstad (2025). Utdanningsinstitusjoner må styrke endringskompetansen i helsefagene. Full text in Research Archive
• Fossum, Mariann (2025). Prosjekt Universitetssykehjem- fremtidens muligheter. Full text in Research Archive
• Prado, Patricia; Silveira, Renata; Gimenes, Fernanda; Vettore, Mario Vianna & Fossum, Mariann (2025). Corneal injury in critically ill sedated and mechanically ventilated patients: Reflections on a meta-analysis – Response to Xu and Long et al. Intensive and Critical Care Nursing. ISSN 0964-3397. 90. doi: 10.1016/j.iccn.2025.104093. Full text in Research Archive
• Rabben, Jannicke; Vivat, Bella; Fossum, Mariann & Rohde, Gudrun Elin (2024). The 13th World Research Congress of the European Association for Palliative Care: Patients and family caregivers are unsure about how they or nurses are involved in shared decision-making. Palliative Medicine. ISSN 0269-2163. doi: 10.1177/02692163241242338. Full text in Research Archive
• Kaldheim, Hege Kristin Aslaksen; Munday, Judy; Creutzfeldt, Johan & Fossum, Mariann (2024). Perioperative nurses’ development of professional competence from interprofessional simulationbased learning to meet acute clinical practice situations. Full text in Research Archive Show summary

  Symposium 1: Education 148 Perioperative nurses’ development of professional competence from interprofessional simulationbased learning to meet acute clinical practice situations. Hege Kristin Aslaksen Kaldheim1 , Judy Munday1 2 , Johan Creutzfeldt3 , Mariann Fossum1 1 University of Agder - Grimstad Campus, Department of Health and Nursing Science, Grimstad, Norway,2 QUT Kelvin Grove Campus, School of Nursing/Centre for Health Transformation, Kelvin Grove, Australia,3 Karolinska Institutet Clintec, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden Background: Perioperative nurses require professional education (1) to ensure high-quality perioperative care and patient safety in acute situations. Interprofessional simulation-based learning exposes perioperative nursing students to acute situations in a safe environment without the risk of harming the patient and can prepare them for clinical practice (2). There is a need for studies about perioperative students’ professional development (3) and how interprofessional simulation-based learning influences future practice (4). Objectives: This study explored recently graduated perioperative nurses’ experiences of interprofessional simulationbased learning during their education and their development of professional competence to meet acute situations after graduation. Methods: We utilised a qualitative and explorative design. Between March 2019 and November 2020, sixteen semistructured individual interviews were conducted with perioperative nurses three to five months after they graduated from five different educational institutions in Norway. Data analysis applied a phenomenological hermeneutical method (5). Results: Perioperative nurses reported they experienced the development of competency in handling acute situations (e.g., prioritising, working in stressful situations) and contingency planning. They also expanded their interprofessional communication and collaboration competence as they experienced the value of clear communication, repetitive messages, and conciseness. Being in an interprofessional context created an awareness of their dependence on each other and an understanding of team dynamics. This enabled them to meet acute situations with insight and preparedness as recently graduated. Self-confidence developed through increased competence and mastery resulted in a belief that they would handle (future) acute situations. Professional identity was developed in conjunction with a rise in self-confidence as they became more aware of their professional role and the sense of belonging to their future profession. Conclusion: Participating in interprofessional simulation-based learning during education developed essential competencies for dealing with acute situations, supported incipient professional identity and strengthened their courage to speak up in interprofessional teams as recent graduates.

• Kaldheim, Hege Kristin Aslaksen; Fossum, Mariann; Munday, Judy; Johnsen, Kjersti Marie Frivoll & Slettebø, Åshild (2024). How to use inter professional simulation-based learning to prepare preoperative nursing students for clinical practice. Full text in Research Archive Show summary

  Introduction Interprofessional simulation-based learning (ISBL) is incorporated as an educational tool to prepare students for the complexities and challenges they will meet in clinical practice. Previous studies indicate that ISBL outcomes are promising. Still, additional research is needed to improve ISBL and ensure good learning processes (Dahlgren, Rystedt, Felländer-Tsai, & Nyström, 2019), especially within perioperative nursing (Kaldheim et al., 2019). This study explored perioperative nursing students' experiences of interprofessional simulation-based learning (Kaldheim, Fossum, Munday, Johnsen, & Slettebø, 2021). Method Employing a qualitative explorative design, we conducted, between May and October 2019, six focus-group interviews with thirty-four perioperative nursing students from five higher educational institutions in Norway. Data were subjected to phenomenological hermeneutical analysis (Lindseth & Norberg, 2004). Results Three themes emerged: 1) Customised ISBL: created a structure that contributed to order, less chaos, and made participants feel mentally prepared, obtain knowledge and learning outcomes. 2) The experience of reality in ISBL: was essential for the participants to create constructive learning processes and outcomes. 3) Participants felt prepared for clinical practice: transferring knowledge and skills to clinical practice and gaining valuable non-technical and technical skills. Conclusion It is essential that ISBL supports and promotes learning processes to gain intended learning outcomes. Customised ISBL ensures mental preparedness and a realistic experience and impacts perioperative nursing students’ sense of preparedness for clinical practice. We believe that ISBL is an educational approach for a golden future since it integrates practical and theoretical learning, equipping perioperative nursing students with valuable non-technical and technical skills.

• Fossum, Mariann; Opsal, Anne & Ehrenberg, Anna (2024). Sources of information used by nurses to inform clinical practice. Full text in Research Archive Show summary

  Background: Studies have identified that nurses are relying on coworkers as a source of information to inform clinical practice. Knowledge about what sources of information nurses used in clinical practice is important to increase use of evidence-based practice (EBP) and improve healthcare services. An integrative review from 2008 was updated in the present study to identify any changes of sources of information used in clinical practice. Purpose and Aim: The purpose of the study was to describe the information sources used by registered nurses to inform their clinical practice. Methods: An integrative review was conducted. Empirical studies in English or Scandinavian language with registered nurses as the main participants (>50%) from January 2007 and June 2021 were included. Studies collecting qualitative, quantitative, and mixed-method data were included. Three different checklists were used depending on the study design for appraisal. The sources of information used by registered nurses were reviewed and ranked. Results: A total of 54 articles with 52 studies were included. The included studies were conducted in all five continents with variation in the sample size from 17 to 6317. The quality of the studies was overall assessed as fair. Low response rate, weak designs and poor statistical analysis were the major concerns of the quantitative studies. In general, the qualitative studies were assessed with a higher score indicating a better quality. Colleagues were still the most frequently used source of information in the quantitative data but the second most used were computers. In the qualitative data, reference materials were the most used. Conclusions: An increase in use of digital sources and reference materials to inform clinical practice is promising. However, the results are important for further planning how sources of information can be integrated in implementation of clinical decision support, electronic healthcare records and other electronic sources for clinical practice.

• Kristoffersen, Eirunn W; Opsal, Anne; Tveit, Tor Oddbjørn & Fossum, Mariann (2024). Exploring the Professional Experiences of Anaesthetist and Nurse Anaesthetist working in Preanaesthesia Assessment Clinics: A qualitative study. Full text in Research Archive
• Laukvik, Lene Baagøe; Lyngstad, Merete; Rotegård, Ann-Kristin & Fossum, Mariann (2024). Nursing standards in electronic health records. Full text in Research Archive
• Fossum, Mariann (2024). Profesjonsmeldingen, ny modell for opptak i høyere utdanning og nasjonal helse- og samhandlingsplan 2024-2027. Får meldingene og planen noen føringer for RETHOS og forskriften for bachelorutdanning i sykepleie? Full text in Research Archive
• Øgård-Repål, Anita; Fossum, Mariann; Skogen, Vegard & Berg, Rigmor (2023). Kan livskvaliteten til de som lever med hiv påvirkes av å treffe andre som lever med hiv? Full text in Research Archive
• Zlamal, Jaroslav; Gjevjon, Edith Lillian Roth; Fossum, Mariann; Steindal, Simen Alexander & Nes, Andréa Aparecida Goncalves (2023). A Technology-Supported Guidance Model to Stimulate Nursing Students’ Development of Critical Thinking in Clinical Practice. Full text in Research Archive Show summary

  Abstract: Introduction Critical thinking is a crucial set of skills and abilities in nursing. Earlier research has identified the challenges inherent in stimulating the development of critical thinking due to its multifaceted nature, so the need exists to explore ways to nurture critical thinking. Methods A complex technology-supported guidance model (TSGM) intervention was developed, tested, and evaluated in four sub-studies: (1) a mixed-methods systematic review that explored similar interventions in the field; (2) a developmental study in which a mobile application that constitutes an integral part of the intervention, Technology Optimized Practice Process in Nursing (TOPP-N), was co-created with key stakeholders; (3) a feasibility study that tested the intervention in a real-life setting; and (4) a pragmatic, mixed-methods randomized controlled trial that evaluated the intervention’s effectiveness. Results Over a one-year timeframe, a multidisciplinary team of nursing students, nurse preceptors, nurse educators, and app developers codeveloped a complex intervention and a working prototype of the TOPP-N application (sub-study 1,2). The intervention, which aims to support the development of critical thinking, was deemed feasible among first-year undergraduate nursing students in clinical practice (sub-study 3). The randomized controlled trial (sub-study 4) showed that the intervention performed as expected in a larger setting, but, while some promising results emerged, we have not yet confirmed the intervention’s effectiveness in developing critical thinking. Conclusion The TSGM intervention has the potential to support the development of critical thinking among undergraduate nursing students in clinical practice, but further investigation is needed to explore its effect.

• Laukvik, Lene Baagøe; Rotegård, Ann-Kristin; Lyngstad, Merete & Fossum, Mariann (2023). Registered nurses’ reasoning process during care planning and documentation in the electronic health records: A concurrent think-aloud study. Full text in Research Archive
• Rabben, Jannicke; Fossum, Mariann; Vivat, Bella & Rohde, Gudrun Elin (2023). Patients’, relatives’, and healthcare professionals’ experiences and perspectives of shared decision-making in palliative cancer care: A systematic review and meta-synthesis. Annals of Oncology. ISSN 0923-7534. 34 (Supplement 2), p. S1234–S1234. doi: 10.1016/j.annonc.2023.09.1625. Full text in Research Archive
• Lyssand, Anita; Kalkvik, Ragnhild S.; Rustad, Else Cathrine Lütcherath; Fossum, Mariann; Brandstrup, Peter & Hegdal, Tone [Show all 8 contributors for this article] (2023). Høyskoler og universiteter vil senke kravene til praksis. [Internet]. sykepleien.no. Full text in Research Archive
• Opsal, Anne & Fossum, Mariann (2023). Flexibel utbilding på distans, ett exempel från Agder. Full text in Research Archive
• Fossum, Mariann & Laukvik, Lene Baagøe (2022). Dokumentasjon av sykepleie - grunnlag, struktur, innhold og terminologi. In Bjørnnes, Ann Kristin; Gjevjon, Edith Roth; Grov, Ellen Karine & Holter, Inger Margrethe (Ed.), Sykepleieboken 1, Sykepleiens fundament. Cappelen Damm Akademisk. ISSN 9788202673543. p. 175–196. Full text in Research Archive
• Kaldheim, Hege Kristin Aslaksen; Fossum, Mariann; Munday, Judy; Creutzfeldt, Johan & Slettebø, Åshild (2022). Developing self-efficacy in responding to acute situations amongst perioperative nursing students' through interprofessional simulation-based learning. Full text in Research Archive
• Kaldheim, Hege Kristin Aslaksen; Fossum, Mariann; Munday, Judy; Johnsen, Kjersti Marie Frivoll & Slettebø, Åshild (2022). Interprofessional simulation-based learning and its impact on developing perioperative nursing students' professional identity. Full text in Research Archive
• Fossum, Mariann; Førland, Georg & Kirkevold, Marit (2022). Regjeringen byr på politisk pynt, men vi trenger langsiktig plan. Full text in Research Archive
• Johnsen, Hege Mari; Fossum, Mariann; Fruhling, Ann; Vivekananda-Schmidt, Pirashanthie & Slettebø, Åshild (2022). A Serious Game for Use in Nursing Education. Full text in Research Archive Show summary

  5 minutters presentasjon

• Zlamal, Jaroslav; Gjevjon, Edith Roth; Fossum, Mariann; Steindal, Simen Alexander & Nes, Andrea Aparecida Gonçalves (2021). The use of technology to improve nursing students' guidance and support the development of critical thinking skills in clinical practice: a feasibility study. 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
• Fossum, Mariann (2021). Hva fremmer rekruttering og varig kompetanseutvikling? Mulige løsninger i utdanningssamarbeidet mellom univer- sitet og helseforetak. Full text in Research Archive
• Fossum, Mariann (2021). Sykepleier for fremtiden! Full text in Research Archive
• Fossum, Mariann (2021). Sikrer læringsutbyttene tilstrekkelig kompetanse i legemiddelhåndtering/legemiddelregning? Full text in Research Archive
• Laukvik, Lene Baagøe; Slettebø, Åshild; Lyngstad, Merete; Rotegård, Ann Kristin & Fossum, Mariann (2021). Person Centered Care in The Nursing Documentation for Residents in Long-term Dementia care: A retrospective chart review. Full text in Research Archive
• Øgård-Repål, Anita; Fossum, Mariann & Berg, Rigmor (2021). ‘How do I handle it all’: Systematic scoping review as a possibility to get an overview when the scope is broad. Full text in Research Archive
• Glomsås, Heidi Snoen; Knutsen, Ingrid Ruud; Fossum, Mariann & Halvorsen, Kristin (2021). Brukermedvirkning og velferdsteknologi. Full text in Research Archive
• Fossum, Mariann; Prinz, Andreas & Ekra, Else Mari Ruberg (2024). Manikins Mediate Lifelong Learning Skills in Nursing Education: A Qualitative Exploration of How Manikins Influence Nursing Students’ Learning. Universitetet i Agder. Full text in Research Archive
• Kaldheim, Hege Kristin Aslaksen; Fossum, Mariann & Munday, Judy (2023). Interprofessional simulation-based learning used to prepare perioperative nursing students for acute situations. Universitetet i Agder. ISSN 9788284271156. Full text in Research Archive Show summary

  Background: Perioperative nursing focuses on care for patients with life-threatening crisis, illness or injury undergoing planned or acute surgery, treatment and/or examination. Performing care requires advanced knowledge and skills to ensure safe outcomes for surgical patients. Perioperative nurses work in interprofessional surgical teams and must develop team skills, such as communication and interprofessional collaboration, as teamwork is an essential component of patient safety. Therefore, perioperative nurses need a distinct form of higher education that builds a close relationship between higher education, science and the profession’s occupational field. Interprofessional simulation-based learning is a pedagogical approach that integrates learning as a task performance, communication technique and collaboration. It involves higher-level learning, such as analysis and problem-solving in problematic scenarios or care settings. Although interprofessional simulation-based learning is an often-used pedagogical approach in nursing programmes, it still seems under-researched and under-theorised, especially in educating perioperative nurses. Therefore, there appears to be a need for explorative research on arranging interprofessional simulation-based learning to facilitate perioperative nursing students’ learning, create good learning processes and obtain attended learning outcomes. Furthermore, there is a need for more in-depth knowledge about the learning processes in interprofessional simulation-based learning. There also seems to be scarce knowledge concerning students’ transfer of professional competence to clinical practice and how interprofessional simulation-based learning influences future practice. Aim: The overarching aim of this PhD thesis is to gain knowledge and insight into perioperative nursing students’ learning and development of professional competence using interprofessional simulation-based learning as a pedagogical approach. Conclusion: Interprofessional simulation-based learning is an essential pedagogical approach in perioperative nursing education, as it develops professional competence and self-efficacy in meeting acute clinical situations. It is vital to use effective pedagogical approaches to build competencies that are transferable to clinical practice and to improve perioperative nurses’ performance as recent graduates. Therefore, it is crucial to implement interprofessional simulation-based learning in perioperative nursing education.

• Øgård-Repål, Anita; Fossum, Mariann; Berg, Rigmor & Skogen, Vegard (2023). Peer support in healthcare services for people living with HIV. Experiences of peer support in outpatient clinics from the perspective of service users, peer supporters, and healthcare professionals. Universitetet i Agder. ISSN 9788284271217. Full text in Research Archive Show summary

  Aims: The overall aim of this thesis was to explore peer support as a service for people living with HIV. This study aimed to describe and get an overview of peer support interventions for people living with HIV worldwide. Furthermore, how peer support was experienced by service users, peer supporters, and healthcare professionals in outpatient clinics was examined. Designs, methods, and samples: This PhD consists of three studies. Study 1 was a scoping review, where descriptive analyses and a simplified manual thematic analysis were performed to summarize the findings across the dataset. In Study 2, in-depth interviews were conducted with 16 service users living with HIV. The collected data were analyzed using directed, qualitative content analysis to organize and report the findings. Study 3 was a qualitative study involving 15 indepth individual interviews, ten peer supporters, and five healthcare professionals. In addition, two focus group discussions with 4–5 participants were conducted. An inductive approach was followed when patterns in the empirical data were identified, analyzed, and reported following a reflexive and collaborative thematic analysis. Conclusions: This thesis provides knowledge of peer support as a low threshold intervention to meet the need for social support to enhance the quality of life for people living with HIV. The project provides increased knowledge of a peer supporter's contribution to the existing outpatient clinics to respond to the multiple challenges faced by people living with HIV. The increased recognition of peer support worldwide and the supporting literature demonstrate the flexibility of peer support, adjusted to the needs of the service users. These findings indicate that peer support contributes to a more person-centered approach in outpatient clinics. Improved understanding of the providers' experiences found in this study calls for the greater availability of peer support and the development of peer support programs as a part of usual care in outpatient clinics in Norway. An increased formalization of the peer supporter role will benefit service users, peer supporters, and healthcare professionals by informing expectations. Furthermore, it seems crucial to consider the increased exchange of knowledge at outpatient clinics when incorporating people living with HIV into the development and distribution of services.

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