Margret Lepp

• Halabi, Jehad o.; Nilsson, Jan & Lepp, Margret (2023). The nurse professional competence scale: Self‑reported professional competence among newly graduated nursing students in Saudi Arabia. Saudi Journal for Health Sciences. ISSN 2278-1900. 12(1), p. 16–23. doi: 10.4103/sjhs.sjhs_151_22. Full text in Research Archive
• Berg, Eva & Lepp, Margret (2023). The meaning and application of student-centered learning in nursing education: An integrative review of the literature. Nurse Education in Practice. ISSN 1471-5953. 69(May 2023). doi: 10.1016/j.nepr.2023.103622. Full text in Research Archive Show summary

  Aim The aim of this study was to review empirical articles to explore the meaning and the application of student-centered learning in nursing education. Background Teachers in higher education are encouraged to adopt student-centered learning principles, but research shows that many still apply teacher-centered methods. There is therefore a need to clarify the meaning of student-centered learning, including how it is performed and the reasons to apply it in nursing education. Design This study employed an integrative review method, following Whittemore and Knafl’s framework. Methods The databases CINAHL, Education Database and Education Research Complete were searched for related literature published from 2010 to 2020. The initial search located 308 articles. After screening and checking for eligibility, 25 articles were critically appraised. Data were extracted from the articles and displayed in matrices to be categorized and compared. Results Three themes with attendant sub-themes emerged through the analysis: foundation, using core concepts to define and explain student-centered learning, eligibility, enhancing student knowledge, developing student abilities and supporting student self-reliance and realization, learning in interaction with peers, learning individually and learning in interaction with the teacher. Conclusion Student-centered learning in nursing education is an approach where the teacher is a facilitator of student learning and students are empowered to take control of their own studies. Students study together in groups; they are listened to by the teacher and their needs are taken into consideration. The main reasons to apply student-centered learning are to enhance students’ theoretical and practical learning; to improve their generic competencies, such as problem-solving and critical-thinking abilities; and to strengthen students’ self-reliance.

• Emgård, Matilda; Mwangi, Rose; Mayo, Celina; Mshana, Ester; Nkini, Gertrud & Andersson, Rune [Show all 9 contributors for this article] (2022). Antibiotic use in children under 5 years of age in Northern Tanzania: a qualitative study exploring the experiences of the caring mothers. Antimicrobial Resistance and Infection Control. ISSN 2047-2994. 11(1). doi: 10.1186/s13756-022-01169-w. Full text in Research Archive Show summary

  Background Antimicrobial resistance is a serious threat to the global achievements in child health thus far. Previous studies have found high use of antibiotics in children in Northern Tanzania, but the experiences of the primary care-givers, who play a key role in accessing and administering antibiotics for the sick child, have remained largely unknown. Therefore, the aim of this study was to understand mothers’ conceptions of antibiotic use in their children, which is of importance when forming strategies to improve antibiotic use in the community. Method A qualitative study including eight focus group discussions with mothers of under-five children in Moshi urban and rural districts, Northern Tanzania, was performed during 2019. The discussions were recorded, transcribed verbatim, translated into English and analysed according to the phenomenographic approach. Findings Three conceptual themes emerged during analysis; (1) conceptions of disease and antibiotics, (2) accessing treatment and (3) administering antibiotics. Antibiotics were often perceived as a universal treatment for common symptoms or diseases in children with few side-effects. Although mothers preferred to attend a healthcare facility, unforeseen costs, long waits and lack of financial support from their husbands, posed barriers for healthcare seeking. However, pharmacies were perceived as a cheap and convenient option to access previously used or prescribed antibiotics. Some mothers sought advice from a trusted neighbour regarding when to seek healthcare, thus resembling the function of the community health worker. Conclusions To improve antibiotic use in children under 5 years of age in Northern Tanzania, the precarious situation that women often find themselves in as they access treatment for their sick children needs to be taken into consideration. It is necessary to improve structures, including the healthcare system, socioeconomic inequalities and promoting gender equality both in the household and in the public arena to reduce misuse of antibiotics. Meanwhile, equipping community health workers to support Tanzanian women in appropriate healthcare seeking for their children, may be a feasible target for intervention.

• Burton, Bruce; Femdal, Ingrid; Antonsen, Eva Bjørg & Lepp, Margret (2022). Transformative Impact of Drama in Mental Healthcare Education. In Prior, Ross W.; Kossak, Mitchell & Fisher, Teresa A. (Ed.), Applied Arts and Health : Building Bridges across Art, Therapy, Health, Education, and Community. Intellect Ltd.. ISSN 978-1-78938-625-7. p. 180–192.
• Bylow, Helene; Rawshani, Araz; Claesson, Andreas; Lepp, Margret & Herlitz, Johan (2021). Characteristics and outcome after out-of-hospital cardiac arrest with the emphasis on workplaces: an observational study from the Swedish Registry of Cardiopulmonary Resuscitation. Resuscitation Plus. ISSN 2666-5204. 5. doi: 10.1016/j.resplu.2021.100090.
• Wigert, Helena; Berg, Linda; Arveklev, Susanna H.; Morrison-Helme, Morag & Lepp, Margret (2021). Managing conflict situations nursing students encounter during their clinical practice, narrated and performed through Forum Play. Nurse Education in Practice. ISSN 1471-5953. 56. doi: 10.1016/j.nepr.2021.103177.
• Emgård, Matilda; Mwangi, Rose; Mayo, Celina; Mshana, Ester; Nkini, Gertrud & Andersson, Rune [Show all 10 contributors for this article] (2021). Tanzanian primary healthcare workers’ experiences of antibiotic prescription and understanding of antibiotic resistance in common childhood infections: a qualitative phenomenographic study. Antimicrobial Resistance and Infection Control. ISSN 2047-2994. 10(1). doi: 10.1186/s13756-021-00952-5.
• Bergbom, Ingegerd & Lepp, Margret (2021). Visual arts and drawings to communicate and explore authentic life situations, a data collection method in caring science – a hermeneutic perspective. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. p. 1–10. doi: 10.1111/scs.13040.
• Femdal, Ingrid; Antonsen, Eva Bjørg; Burton, Bruce & Lepp, Margret (2021). Building a learning environment in mental health care education through warm-upexercises. Nordic Journal of Arts, Culture and Health. 3(1-2), p. 21–33. doi: 10.18261/issn.2535-7913-2021-01-02-03.
• Gyberg, Anna; Henoch, Ingela; Lepp, Margret & Ulin, Kerstin (2021). Framing healthcare professionals in written adverse events: A discourse analysis. Nursing Inquiry. ISSN 1320-7881. doi: 10.1111/nin.12461.
• Halabi, Jehad O.; Nilsson, Jan & Lepp, Margret (2021). Professional Competence Among Registered Nurses Working in Hospitals in Saudi Arabia and Their Experiences of Quality of Nursing Care and Patient Safety. Journal of Transcultural Nursing. ISSN 1043-6596. 32(4), p. 425–433. doi: 10.1177/1043659621992845.
• Bylow, Helene; Karlsson, Thomas; Lepp, Margret; Claesson, Andreas; Lindqvist, Jonny & Svensson, L. [Show all 7 contributors for this article] (2020). Learning Outcome After Different Combinations of Seven Learning Activities in Basic Life Support on Laypersons in Workplaces: a Cluster Randomised, Controlled Trial. Medical Science Educator. 31, p. 161–173. doi: 10.1007/s40670-020-01160-3.
• Halabi, Jehad O.; Lepp, Margret & Nilsson, Jan (2020). Assessing Self-Reported Competence Among Registered Nurses Working as a Culturally Diverse Work Force in Public Hospitals in the Kingdom of Saudi Arabia. Journal of Transcultural Nursing. ISSN 1043-6596. 32(1), p. 69–76. doi: 10.1177/1043659620921222.
• van de Mortel, Thea F.; Nilsson, Jan & Lepp, Margret (2020). Validating the Nurse Professional Competence Scale with Australian baccalaureate nursing students. Collegian. ISSN 1322-7696. doi: 10.1016/j.colegn.2020.06.010.
• Arveklev, Susanna; Wigert, Helena; Berg, Linda & Lepp, Margret (2020). Specialist nursing students' experiences of learning through drama in paediatric care. Nurse Education in Practice. ISSN 1471-5953. 43, p. 1–6. doi: 10.1016/j.nepr.2020.102737.
• Gyberg, Anna; Henoch, Ingela; Lepp, Margret; Wijk, Helle & Ulin, Kerstin (2019). Written reports of adverse events in acute care—A discourse analysis. Nursing Inquiry. ISSN 1320-7881. 26(4), p. 1–8. doi: 10.1111/nin.12298.
• Gardulf, Ann; Florin, Jan; Carlsson, Marianne; Leksell, Janeth; Lepp, Margret & Lindholm, Christina [Show all 10 contributors for this article] (2019). The Nurse Professional Competence (NPC) Scale : a tool that can be used in national and international assessments of nursing education programmes . Nordic journal of nursing research. ISSN 2057-1585. 39(3), p. 137–142. doi: 10.1177/2057158518824530.
• Forsman, Henrietta; Jansson, Inger; Leksell, Janeth; Lepp, Margret; Sundin Andersson, Christina & Engström, Maria [Show all 7 contributors for this article] (2019). Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students. Journal of Advanced Nursing. ISSN 0309-2402. 76(1), p. 199–208. doi: 10.1111/jan.14222.
• Bylow, Helene; Karlsson, Thomas; Claesson, Andreas; Lepp, Margret; Lindqvist, Jonny & Herlitz, Johan (2019). Self-learning training versus instructor-led training for basic life support: A cluster randomised trial. Resuscitation. ISSN 0300-9572. 139, p. 122–132. doi: 10.1016/j.resuscitation.2019.03.026.
• Bylow, Helene; Karlsson, Thomas; Lepp, Margret; Claesson, Andreas; Lindqvist, Jonny & Herlitz, Johan (2019). Effectiveness of web-based education in addition to basic life support learning activities: A cluster randomised controlled trial. PLOS ONE. ISSN 1932-6203. 14(7). doi: 10.1371/journal.pone.0219341. Full text in Research Archive
• Nilsson, Jan; Mischo-Kelling, Maria; Thiekoetter, Andrea; Deufert, Daniela; Mendes, Aida Cruz & Fernandes, Ananda [Show all 8 contributors for this article] (2019). Nurse professional competence (NPC) assessed among newly graduated nurses in higher educational institutions in Europe . Nordic journal of nursing research. ISSN 2057-1585. 39(3), p. 159–167. doi: 10.1177/2057158519845321.
• Arveklev, Susanna H; Berg, Linda; Wigert, Helena; Morrison-Helme, Morag & Lepp, Margret (2018). Nursing students experiences of learning about nursing through drama. Nurse Education in Practice. ISSN 1471-5953. 28, p. 60–65. doi: 10.1016/j.nepr.2017.09.007.
• Femdal, Ingrid; Antonsen, Eva Bjørg & Lepp, Margret (2017). Studenters praksisrefleksjon med dramapedagogikk : ""det er noe annet å reflektere gjennom å gjøre enn å snakke om det"". Nordisk sygeplejeforskning. ISSN 1892-2678. 7(2), p. 152–165. doi: 10.18261/issn.1892-2686-2017-02-06. Full text in Research Archive
• Antonsen, Eva Bjørg; Femdal, Ingrid & Lepp, Margret (2017). Dramapedagogikk med fokus på forumspill i psykisk helsearbeid : sykepleierstudenters refleksjoner over praksiserfaringer. Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 14(2), p. 121–133. doi: 10.18261/issn.1504-3010-2017-02-04.
• Lundén, Maud; Lundgren, S M; Morrison-Helme, M & Lepp, Margret (2017). Professional development for radiographers and post graduate nurses in radiological interventions: Building teamwork and collaboration through drama. Radiography. ISSN 1078-8174. 23(4), p. 330–336. doi: 10.1016/j.radi.2017.06.005.
• Nilsson, Jan; Gardulf, Ann & Lepp, Margret (2016). Process of translation and adaptation of the Nurse Professional Competence (NPC) Scale. Journal of Nursing Education and Practice (JNEP). ISSN 1925-4040. 6(1), p. 100–103. doi: 10.5430/jnep.v6n1p100.
• Nilsson, Jan; Johansson, Eva; Carlsson, Marianne; Florin, Jan; Leksell, Janeth & Lepp, Margret [Show all 11 contributors for this article] (2016). Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters. Nurse Education in Practice. ISSN 1471-5953. 17, p. 102–108. doi: 10.1016/j.nepr.2015.09.012. Show summary

  The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self-reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events

• Gardulf, Ann; Nilsson, Jan; Florin, Jan; Leksell, Janeth; Lepp, Margret & Lindholm, Christina [Show all 11 contributors for this article] (2016). The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation. Nurse Education Today. ISSN 0260-6917. 36, p. 165–171. doi: 10.1016/j.nedt.2015.09.013. Show summary

  Background International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. Objectives To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. Methods and participants The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20–56] years, 87.3% women) from 11 universities/university colleges participated. Results NSPGs reported significantly higher scores for Theme I “Patient-Related Nursing” than for Theme II “Organisation and Development of Nursing Care”. Younger NSPGs (20–27 years) reported significantly higher scores for the CAs “Medical and Technical Care” and “Documentation and Information Technology”. Female NSPGs scored significantly higher for “Value-Based Nursing”. Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on “Nursing Care”, “Medical and Technical Care”, “Teaching/Learning and Support”, “Legislation in Nursing and Safety Planning” and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). Summary and conclusion Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs

• Leksell, Janeth; Gardulf, Ann; Nilsson, Jan & Lepp, Margret (2015). Self-reported conflict management competence among nursing students on the point of graduating and registered nurses with professional experience. Journal of Nursing Education and Practice (JNEP). ISSN 1925-4040. 5(8), p. 82–89. doi: 10.5430/jnep.v5n8p82.
• Lundén, Maud; Lundgren, S M; Persson, Lars-Olof & Lepp, Margret (2015). Patients' feelings and experiences during and after peripheral percutaneous transluminal angioplasty. Radiography. ISSN 1078-8174. p. e9–e15. doi: 10.1016/j.radi.2014.06.006.
• Arveklev, Susanna H; Wigert, Helena; Berg, Linda; Burton, Bruce & Lepp, Margret (2015). The use and application of drama in nursing education - An integrative review of the literature. Nurse Education Today. ISSN 0260-6917. 35(7), p. e12–e17. doi: 10.1016/j.nedt.2015.02.025.
• Cirgic, E; Kjellberg, H; Hansen, K & Lepp, Margret (2015). Adolescents´experiences of using removable functional appliances. Orthodontics & craniofacial research. ISSN 1601-6335. 18(3), p. 165–174. doi: 10.1111/ocr.12093.
• Nilsson, Jan; Carlsson, Marianne; Johansson, Eva; Egmar, Ann-Charlotte; Florin, Jan & Leksell, Janeth [Show all 12 contributors for this article] (2014). Nursing in a Globalized World: Nursing Students with International Study Experience Report Higher Competence at Graduation. Open Journal of Nursing. ISSN 2162-5336. 4, p. 848–858. doi: 10.4236/ojn.2014.412090. Show summary

  Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas—“Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were living alone, not having children or other commitments in relation to family, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.

• Nilsson, Jan; Johansson, Eva; Egmar, Ann-Charlotte; Florin, Jan; Leksell, Janeth & Lepp, Margret [Show all 12 contributors for this article] (2014). Development and validation of a new tool measuring nurses self-reported professional competence - The nurse professional competence (NPC) scale. Nurse Education Today. ISSN 0260-6917. 34(4), p. 574–580. doi: 10.1016/j.nedt.2013.07.016. Show summary

  Objectives To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines. Design A methodological study including construction of a new scale and evaluation of its psychometric properties. Participants and settings 1086 newly graduated nurse students from 11 universities/university colleges. Results The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: “Nursing care”, “Value-based nursing care”, “Medical/technical care”, “Teaching/learning and support”, “Documentation and information technology”, “Legislation in nursing and safety planning”, “Leadership in and development of nursing care” and “Education and supervision of staff/students”. All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: “Patient-related nursing” and “Nursing care organisation and development”. In addition, evidence of known-group validity for the NPC Scale was obtained. Conclusions The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses.

• Svenberg, Kristian; Mattsson, Bengt & Lepp, Margret (2013). Encounters with patients from Somalia: experience among vocational trainees in Swedish general practice. International Journal of Medical Education. ISSN 2042-6372. p. 162–169. doi: 10.5116/ijme.51fc.dc05.

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• Skott, Carola; Dellenborg, Lisen; Lepp, Margret & Nässén, Kristina (2013). Människan i vården. Etnografi, vård ovh drama. Carlsson Bokförlag. ISBN 9789173316125. 239 p.
• Leksell, Janeth & Lepp, Margret (2013). Sjuksköterskans kärnkompetenser. Liber. ISBN 9789147105687. 345 p.

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• Foss, Espen Marius; Lepp, Margret; Svalastog, Anna Lydia & Dahl, Ulf Peter (2023). The use of drama for exploring research questions in master thesis´s in psychosocial work, in Norway.
• Halabi, Jehad O.; Nilsson, Jan & Lepp, Margret (2023). Professional Competence of Registered Nurses Working in Saudi Arabian Hospitals and their Experiences of Nursing Care Quality and Patient Safety.
• Halabi, Jehad O.; Nilsson, Jan & Lepp, Margret (2023). Assessing Self-Reported Competence among Registered Nurses Working in Public Hospitals in the Kingdom of Saudi Arabia as a Culturally Diverse Workforce.
• Femdal, Ingrid; Antonsen, Eva Bjørg & Lepp, Margret (2023). «Vurderte å late som om jeg var syk i dag» Betydningen av et trygt læringsmiljø som grunnlag for å delta i forumspill for videreutdanningsstudenter innen psykisk helsearbeid .
• Antonsen, Eva Bjørg; Femdal, Ingrid & Lepp, Margret (2022). Å lære psykisk helsearbeid ved bruk av dramapedagogikk.
• Femdal, Ingrid; Lepp, Margret & Antonsen, Eva Bjørg (2022). Å lære psykisk helsearbeid ved bruk av dramapedagogikk.
• Femdal, Ingrid; Antonsen, Eva Bjørg & Lepp, Margret (2022). To reflect on practical experiences from mental health work using drama. Show summary

  To reflect on practical experiences from mental health work using drama Background: Nursing students are expected to become reflective practitioners, who can handle complex clinical situations as professional nurses. Applied drama can be one way to learn from experiences through reflection. This presentation is based on four studies where drama has been used to reflect on practice experiences. Aim: To use drama as a method for learning about mental health work through reflecting on practice experiences. Method: The studies are based on interviews and field studies and have a phenomenographic approach. Result: Study 1 and 2 from the bachelor's level has focus on the use of forum play to reflect on practice experiences in mental health work. Study 1 shows that using students’ experienced situations from their practice was important as it contributed to their engagement and learning, and resulted in authenticity and new stories. In study 2 the importance of feeling safe participating in forum play, the meaning of using authentic situations as focus of the forum play, how spectators become participants and scope of application are emphasized. Studies 3 and 4 are from advanced level mental health work. Study 3 illuminates the importance of warm-up exercises for involvement in drama, emphasizing the importance of creating a positive learning environment, and to be involved and engaged in the experience. Study 4 shows that students can learn about conflict management in mental health services by alternating between exercises and forum plays, and through reflection. Students managed to look at a conflict from the perspectives of the various parties involved, and this could be valuable in finding the right words in challenging situations. Discussion and conclusion: The four studies show that drama can be used as a method where students can increase their competence in mental health care services by reflecting on practice experiences.

• Femdal, Ingrid; Antonsen, Eva Bjørg & Lepp, Margret (2019). «It is something else to reflect by doing than by talking». Nursing students’ reflections on clinical studies using drama.
• Lepp, Margret; Femdal, Ingrid & Antonsen, Eva Bjørg (2019). Drama and forum-play in Nursing Education reflecting on practice in mental health care.
• Antonsen, Eva Bjørg; Femdal, Ingrid & Lepp, Margret (2017). "Det er noe annet å reflektere gjennom å gjøre enn å snakke om det".
• Antonsen, Eva Bjørg; Femdal, Ingrid & Lepp, Margret (2017). "Det er noe annet å reflektere gjennom å gjøre enn å snakke om det".

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