motivating health and social care students to choose a...

This project has been funded with support from the Lifelong Learning Programme of the European Commission. This publication (communication) reflects the views only of the author, and the Commission cannot be held

responsible for any use which may be made of the information contained therein.

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Motivating Health and Social Care students to choose a career

in Gerontology through innovative education

Authors:

G. Schoofs, (University College Leuven-Limburg, Belgium

A. Coffey, University College Cork, Ireland

P. Sourtzi, National and Kapodistrian University of Athens, Greece

A. Stitzel, Carinthia University of Applied Sciences, Austria

T. Žiljak, Public Open University Zagreb, Croatia



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Content table

Introduction 4

Aim and research question 4

1 Demographic changes in Europe increases the demand of caregivers in gerontology 5

2 Caring for older people, a bottleneck professional activity 6

3 Educating towards a career within gerontology 6

4 Methodology 7

4.1 Developing a template to collect innovative good practices 8

4.2 Analysis 10

5 Results 12

6 Conclusion 14

References 16

Innovative best practices 17

1 Gerondontology: Educational visits in older people day centers 17

2 The implementation of an intervention program for the tertiary prevention of

dementia and end of life care in a nursing home 19

3 Developing and implementing a holistic model of care during clinical training 22

4 The brain fitness method 25

5 sTimul 28

6 School street: simulation of ‘small scale’ care 31

7 One-on-one occupational therapy 34

8 The personal journey-method: 37

9 Problem based learning: Case studies 41

10 The intergenerational learn-cafe 44

11 Problem oriented learning: clinical reasoning in geriatric nursing 47

12 Virtual older patient case: Gerodontology 49

13 Technology to simulate the healthcare context and needs of older people 51

14 Outdoor-pedagogy: communication training 53



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15 Cross-generational and intercultural collaboration: learning through the use of

arts 56

16 Nursing humanities: enhance students’ perceptions of the lived experiences of

older people 60

17 Visual Thinking Strategies 63

18 Stimulated by Dimentia 66

19 Geragogy: a combination of gerontology and andragogy 69



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Introduction

Throughout Europe populations are ageing rapidly. This demographic trend presents society with enormous

challenges including a growing demand for care and caregivers with specific competencies in caring for older

adults. Therefore, developing an integrated view on care is advisable, placing the older person on the centre

stage. The European Later Life Active Network (ELLAN) is an EU-funded project that includes such integrated

view in developing European Core Competencies Framework (ECCF) for working with older people in the

horizon of positive ageing and social cohesion.

According to Doblhammer and Ziegler (2006), demographic insights can predict how informal and formal care

might evolve and consequently where the augmented demand for care might be situated, in the home situation or

the institutional setting. Due to the existence of important changes in modern societies it is expected that the

demand for formal care will increase, although regional differences in regard to the financial crisis might appear

and could cause a shift towards the informal care (Luijkx, 2001; Sapounntzi-Krepia et al., 2008).

Since nowadays caring for older people can be considered as a bottleneck professional activity and the situation

in the future might become worse, attention should be paid on how more professionals can be attracted towards a

career in the care for older people. One possible course of action is to motivate students to choose a career in

gerontology. Research suggests that students’ attitudes towards older people are shaped during their education

(Coffey et al., 2015). That implies that learning experiences can be one important factor that might contribute to

their willingness to choose a professional career within Gerontology.

It is unlikely that students with experiences in poor learning environments choose a career in gerontology

(Coffey et al., 2015; Haron, Levy, Albagli, Rotstein, & Riba, 2013; Brown, Nolan, Davies, Nolan, & Keady,

2008; Nolan, Brown, Davies, Nolan, Keady, 2006). Enriched learning experiences not only focus on knowledge

and skills, but also make the students aware about how challenging and rewarding the care for older people can

be. Nolan (2006) describes in a Six Senses Framework what students need during their education to have

positive learning experiences and Koh (2012) claims that innovation during the education is important to

improve the overall learning satisfaction.

Research about what undergraduates need to have positive learning experiences has been conducted in

the past, however concrete translations of these needs into best practices seems to lack. Since the

importance of stimulating undergraduate health and social care workers to choose a career in gerontology

it is worth to invest in innovative best practices for education.

This report presents the results of one study group within ELLAN that focused on innovative education within

gerontology.

Aim and research question

Because education can be an important contributing factor for undergraduates’ willingness to choose for a career

in gerontology, the aim for this research was to formulate an answer on following question: “Which innovative

learning/training methods in education can contribute to the willingness of students to work with older people?”.

To achieve this goal, the literature was consulted to gain insight in students’ needs and to retrieve criteria for



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innovation in education. Good practices for teaching and learning for gerontology, used in Belgium, Ireland,

Austria, Greece and Croatia were collected and analysed using the criteria found in the literature. Those good

practices, which comply with the criteria, will be called innovative best practices.

1 Demographic changes in Europe increases the demand of caregivers in gerontology

Throughout European countries populations are ageing. Consequently the proportion of older people, from 65

years and more, is bigger than the proportion of children younger than 15 years. By the year 2060 it is expected

there will be twice as many older persons than children. In the European Union, the number of older people is

estimated to rise from 87 million in 2011 to 151 million in 2060. The number of the oldest old (80 years and

older) will increase even more rapidly, from 23 million in 2011 to 61 million in 2060 (Amitsis, 2013). This

demographic trend puts society for an enormous challenge as an increasing share of older people most likely

results in a growing demand for care. The reason for this growing demand can be found in the fact that the

oldest old are often confronted with an accelerated decline of physical and mental health which results in higher

and more complex needs of care and assistance.

If the augmented demand for care will be situated in the home or institutional setting depends partially on older

peoples’ social relations, according to Doblhammer and Ziegler (2006). That means that based on demographic

insights a prediction can be made about how informal and formal care might evolve. It is stated by the

researchers that marital status and childlessness influence whether care is provided at home or in institutions.

When older people are in need of care the presence of a partner, children or other relatives determine whether the

older person can rely on informal care at home, formal home care or whether institutionalisation is needed.

Besides the presence of spouse or children as potential caregivers, cultural background considering other family

links also have a role in the choice for the type of care (Doblhammer & Ziegler, 2006).

Nowadays, due to social changes, informal care is not obvious anymore. Individualisation and the realisation of

the welfare state are examples of important changes that can be observed in the micro, meso and macro level of

modern societies (Luijkx, 2001). One example at the micro level is the liberation of people from their traditional

collective relationships that structure behaviour, values and norms. More concrete, women are more and more

liberated from traditional gender roles that mainly consist out of family responsibilities, and encourage them

towards self-development and participation in the paid labour market (Lammertyn, 2011a, 2011b; Lasch &

Reimann, 2006). Another factor making informal care more difficult, is situated at the meso level, and states that

the geographical mobility of people is increased whereby family networks are spread over a bigger geographical

area. An additional fact is that modern societies are also characterized by a strong specialization of tasks, thus

handing over the care for older people to professionals is an established option. That established option is

supported at the macro level, as governments create the right for professional support for older people in the

home situation (Luijkx, 2001).

Although the existence of these important changes in modern societies is evident, it can’t be neglected that the

financial crisis might lead to a decrease in formal care in favour of family care. Different reasons for a possible

shift can be found. The most obvious reason could be that institutionalisation becomes too expensive. Less

obvious, but possible is that due to the financial crisis, that partially results in economization by cut backs in

financial support for care facilities, leads to less staff in formal care units. This is already noticeable in Greece,



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where the nursing staff shortage is compensated by the ‘use’ of relatives (Sapountzi-Krepia et al., 2008; Lasch &

Reimann, 2006). The latter means that a link between formal and informal care exists, certainly in long-term care

processes. Therefore it is advisable not to maintain a strong boundary between these two concepts, but to look at

formal and informal care as two care sectors with blurring boundaries. These findings by Triantafillou et al.

(2010) should be integrated in the formal education of health and social care workers.

It can be stated that the changes in modern societies have an influence on the provision of care for older people,

strongly suggesting that the demand for professionals in working within gerontology will increase. On the other

hand regional differences due to the financial crisis exist and might lead to an increased demand of family

support. In case of the latter, formal education must pay attention about the role of formal and informal care

sectors without keeping strong boundaries between both.

2 Caring for older people, a bottleneck professional activity

Because ageing populations are expanding rapidly, it is expected the demand for caregivers of older people will

increase. To meet this demand will be no sinecure since there is already a shortage of skilled health care

professionals and a lack of interest in working with older people. According to the review by Coffey et al. (2015)

students’ attitudes about older persons are not necessarily negative but often undergraduates see gerontology as

unchallenging, as a domain with low economic reward where no special skills are required. In other words

gerontology is perceived as a dead end job. Undergraduates’ ideas about limited professional satisfaction in older

peoples care withhold them to choose a career in gerontology.

Therefore it is advisable to increase interest in working with older people and to tackle negative ideas about a

professional career in gerontology that are major causes for failure to recruit health and social care workers

within gerontology. Coffey et al. (2015) found in the literature, studies claiming, that poor knowledge about

ageing is linked with a lack of interest in working with older people. Undergraduates ideas about ageing can also

be cultural and social biased when their environment directly or indirectly states that being old has low social

and economic value. Education on ageing and rich learning environments are important examples of elements

which could redirect impaired visions on ageing and increase the interest in working with older people.

3 Educating towards a career within gerontology

Education has an important role to play in adjusting the distorted view about a professional career in older

persons care and to stimulate students towards a career in gerontology. Students who experience poor learning

environments are less likely to choose a career in gerontology and therefor the challenge might be identifying

teaching and training methods that contribute to an enriched learning environment of care (Coffey et al., 2015;

Haron, Levy, Albagli, Rotstein, & Riba, 2013; Brown, Nolan, Davies, Nolan, & Keady, 2008; Nolan, Brown,

Davies, Nolan, Keady, 2006). In order students can engage in enriched learning experiences and develop

positive attitudes in caring for older people in their professional practice, they need to be provided with support

and a relevant educational preparation (Koh, 2012). A good preparation for practical placement means that there

not only great attention should be paid on skills and knowledge, but also in making the student aware about how

challenging and rewarding the care of older people can be. Cruess et al. (2009) state that professionals in health

and social care not only should be experts and contributors to their professional communities, they should also



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be citizens who actively address health concerns of the larger society. That means that higher educational

institutions are confronted with the challenging task of creating experts in their domain in regard to their societal

responsibilities, which means linking education with expertise and citizenship. The result should be that higher

education is one factor that can contribute to an attractive image of gerontology. In order to do that Koh (2012)

states that the link between theory and practice has to be very clear. Another aspect is to involve teachers who

have practice experience in this field and who can inspire students to work with older people. When students

start their practical placement, stress and anxiety may occur. Being overwhelmed, feeling unsure, scared and

intimidated are a few examples of why emotional support is needed. Dialogue with lecturers, mentors and peers

allow expressing doubts and anxieties.

The points of consideration mentioned by Koh (2012) can also be found in Nolan’s et al. (2006) Senses

Framework. In order undergraduates gain positive learning experiences a sense of security, belonging,

continuity, purpose, achievement and significance should be perceived. These senses are important ingredients

for rich learning environments. In reality this means; feeling safe in an enabling and supportive learning

environment, where there is the opportunity of being part of a significant group that allows the student to

implement theoretical knowledge into practice while stimulating the student in setting and achieving new goals

and making them feel that their contribution matters for the older person.

Koh (2012) also describes the importance of innovation to improve the overall satisfaction with the practice

placement. According to Murray (2013), innovation is about thinking differently whereby five skills can foster

innovation in nursing education. Because of the more general description of these five skills we believe in the

applicability within this study, that not only concerns nurses. The first one is ‘associating’, whereby existing

ideas from unrelated fields are connected into something new. Questioning “why?” “why not?” and “what if?”

is the second skill. Asking provocative questions allows pushing boundaries in education. Observing to see what

works and what does not work is another important skill. In the process of observations students, staff and other

stakeholders can be involved. A fourth skill is experimenting. Interactive experiences and non-obvious methods

are used to emerge new insights. Finally networking, which can be understood as mixing diverse groups of

professionals, can give access to different ideas and perspectives.

4 Methodology

Qualitative research was conducted to discover innovative good practices for teaching and learning methods for

gerontology, used in Belgium, Ireland, Austria, Greece and Croatia, which can positively influence students’

ideas about a professional career in gerontology. Because as far as known, no tool exists to identify these

specific good practices, an important task in this research was to develop a tool, or as called later on a template,

to collect innovative good practices. Therefore the literature was consulted to get insight in what students need

during their education in order to have positive learning experiences. Besides that, criteria to decide whether the

learning or training method can be called an innovative good practice were found in the literature (Murray,

2013). These criteria were used during the analysis of the templates and will be explained later on. Nolan (2006)

states that in best care environments all participants, including undergraduate students, experience six senses;

security, belonging, continuity, purpose, achievement and significance. Definitions for the Six Senses were

formulated by Brown et al (2008) and used in this research to design a template for collecting the good practices.



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Because people think differently about innovation an open question about what the participant thought that was

innovative element of the reported practice was asked. The reason was to avoid missing interesting good

practices in case the respondent thought there was no innovative element present.

The template was distributed to partner countries; Belgium, Ireland, Greece, Croatia and Austria. Each country

distributed the template to higher educational institutions that provided gerontological education to health and

social care students aiming to collect 5 from each country. Twenty-tree templates were completed. The Senses

Framework and the criteria for innovation were used to develop a code necessary for the analysis, which was

conducted with Nvivo software. Results were presented using the educational model of Miller (1990), which is a

model for competence-based learning.

Miller (1990) states that four competences levels exist; does, show how, know how and know (figure 1). Since

learning is orientated at using knowledge in an integrated way in the professional and social life, “does” is

situated in the top of the pyramid. However, during the learning process the different competences levels are

equally important. The pyramid does not suggest a value judgement nor a chronology. Multiple levels can be

included in a course, just as a learning activity does not necessarily begin at the competence level of knowledge,

but can start from a whether or not simulated practice situation. The most important for competence

development is the interaction between the different levels of competence. Figure 1 shows that the learning

process can be seen as an undulating motion to a more professional, autonomous and value awareness act in

increasingly complex situations. Different teaching methods can be connected to the levels for competence-

based learning (O&O, 2005). The good practices, collected with the template, were structured, after analysis,

according to the Miller model. Only practices that according to Nolan (2006) can lead to rich learning

experiences and that were assessed as innovative were included.

Figure 1: Model for competence-based learning by Miller and teaching methods for each competence level

(O&O, 2005)

4.1 Developing a template to collect innovative good practices

As mentioned before, Nolan’s senses framework formed the basis for the template, so that best practices could

be collected in an objective and scientifically substantiated way. The aim of the questions in the template was

Does

show how

Know how

Know

Internship: functioning in a real professional

context

Simulation, role play: experiential learning in

simulated situations

Case study: applying knowledge in simple

assignments, search and update knowledge

Formal lecture: acquiring basic knowledge



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focused on detecting enriched learning environments and learning methods whereby the Senses Framework as

defined by Brown et al. (2008) was used as an analytic instrument to interpret students’ learning experiences.

Consequently the template can help revealing learning methods that contribute to a positive experience of

learning to care for older people.

Before distributing, the template was reviewed by project partners in Belgium, Ireland, Austria, Greece and

Croatia. Feedback was formulated within the project group, and several improvements were conducted. The

final version of the template was digitalised and, before sending out, validated by a lecturer in gerontology. No

further adjustments had to be made and thus the digitalised template, which allowed distributing and collecting

the templates in a simple manner, was ready to use.

Respondents were asked to describe their good practices and to answer the questions mentioned in table 1. Also

an open general question was formulated in order to get insight in what the respondent pointed out as being

innovative in their method. Criteria for innovation, associating, questioning, observing, experimenting and

networking, as formulated by Murray (2013) were used during the analysis.

Table1: Definitions of the Six Senses by Brown et al. (2008) and questions referring to the Six Senses as used in

the template

Sense Definitions and derived questions for the template

Security “The freedom to learn and explore roles and competencies within a supportive but enabling

environment which recognises the physical and emotional vulnerabilities of being a

student.”

In which way does this teaching/learning method offer the student the freedom to

learn and explore roles and competencies?

Is the teaching/learning environment supportive or enabling? Please explain.

How does this teaching/learning method recognise the physical and emotional

vulnerabilities of being a student?

Belonging “Feeling part of a defined group with a clear and valued role to play, mainly, but not

exclusively, within the clinical area. Identifying with a community of peers, belonging to a

cohort of students.”

Do you see possibilities for this teaching/learning method to make students feel part

of a defined group with a clear and valid role to play? Please explain.

Continuity “Being enabled to forge connections and make links between nursing as taught and nursing

as witnessed, having consistent relationships and advice, being exposed to good standards

of care based on a clear and agreed philosophy.”

Does this method stimulate students to make the connection between the theoretical

lessons, the practice as taught in school and the practice in real life? Please explain.

Purpose “Having something meaningful and important to aim for, identifying important personal

and professional goals, being able to feel that there is the potential to ‘make a difference’ to

the quality of care.”

Can this method empower students regarding their own personality, knowledge and

skills? Please explain.

Achievement “Being able to realize personal and professionally orientated goals, particularly in relation

to developing competence as a nurse, in a way that is consistent with self and significant

others’ definitions of what constitutes good care. Being able to feel that you have ‘made a



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difference’.”

How does this teaching/learning method give the students recognition for their

contribution and by whom is this recognition given?

Significance “The belief that you matter as a person and as a student, and that what you do is

recognised as making an important contribution, acknowledged by significant others,

individually and collectively. Developing a belief that gerontological nursing and older

people matter, and are accorded value and status.”

How does this teaching/learning method stimulate the belief that working in

gerontology is challenging, matters and gives accorded value and status?

4.2 Analysis

Twenty-three templates were completed. The analysis of the reported good practices was conducted twice. First

with pen and paper and secondly by using Nvivo software. The advantage of this method was that the material

was thought through thoroughly twice and findings from both analyses could be compared. A lecturer in

gerontology was asked to conduct some analyses as validation for the obtained results. In order to start the

analysis of the completed templates, Nolan’s Six Senses Framework and the criteria, as formulated by Murray,

were transformed into a code, which allowed coding the reported good practices in a uniform manner. The

development of the code was thus not done by allowing the code to arise from the data, in this qualitative study

was chosen for a deductive approach. The code based on Nolan’s Six Senses Framework can be found in table 2.

Table 2: The derived set of codes from Nolan’s Six Senses framework based on the definition as formulated by

Brown et al. in 2008

Sense Derived code

Security Enabling environment

Supportive environment

Enabling and supportive environment

Freedom to learn and explore roles and competences

Belonging Belonging to a cohort of students

Feeling part of a defined group

Identification with peers is possible

The student has a clear and valid role to play

Continuity Applying theoretical knowledge into practice

Being exposed to good standards of care

Making links between the practice as taught and the practice in real life

The standards of care are based on a clear and agreed philosophy

Purpose Enabling the identification of personal and professional goals

Experiencing the potential to make a difference to the quality of care

Having something meaningful and important to aim for

Achievement Being able to feel that you have made a difference

Being able to realize personal and professionally orientated goals

Realizing competences in a way that is consistent with self and significant others



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Significance Developing the belief that gerontology and older people matter

Developing the belief that working in gerontology gives accorded value and status

Giving acknowledgement by significant others in a individual way

Giving acknowledgement by significant others in a collective way

The belief that what you do is recognised as an important contribution

The belief that you matter as a person

The belief that you matter as a student

Because the criteria for innovation were not primarily used to develop the template, but to screen the completed

templates to detect innovative good practices during the analysis, an overview about those criteria and the

derived code can be found in table 3. According to Murray (2013), innovation is about thinking differently

whereby 5 skills can foster innovation.

The first skill, associating, is about being able to draw connections or ideas from unrelated fields. This cross-

pollination of ideas from different, unrelated, domains can provide new insights for education. Secondly,

questioning, which involves asking provocative questions like “why, why not and what if”, can challenge the

prevailing practice. Observing, as a third skill, is about detecting what works and what doesn’t work by

involving students, clinical partners and other stakeholders. The results of observations can lead to new ways of

doing things. Fourthly, experimenting with unorthodox approaches, interactive experiences and pilot educational

models in order to find out what insights might emerge. Because we searched for practices already implemented

during the education, this criterion mainly focused on the interactive experiences for the students. Finally,

networking or mixing with diverse groups of individuals gives access to new perspectives or ideas.

All twenty-three completed templates were first subjected to Nolan’s Senses Framework and secondly to the

criteria for innovation. Then the key partners received the initial analysis of all 23 methods and commented on it.

Table 3: The criteria for innovation as formulated by Murray (2013) and the derived code used during the

analysis

Criteria for innovation Derived code

Associating Connections or ideas from unrelated fields are drawn

Existing ideas are combined into something new

Ideas from other professions are used in the elderly education

Questioning Provocative questions challenge the student

Provocative questions push assumptions

Provocative questions push boundaries

Observing Identifying what works and what doesn’t to find new ways of doing things

Experimenting Interactive experiences

Networking Mixing with diverse groups



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5 Results

The twenty-three reported good practices contained items from the Nolan’s Six Senses Framework (2006) and

can be seen as good examples of best practices for educating future health and social care professionals. Since

the Senses Framework only gives an overview about what students need during their education and does not give

a value to each sense, it is not possible to claim that one best practice is better than another. This work will show

that some best practices cover more the different senses than others, but at the end no score will be given,

because the Senses Framework is not designed to be used in that manner.

After subjecting the twenty-three best practices to the criteria for innovation, twenty best practices were

maintained and are considered to be innovative best practices. The submitted good practices that didn’t pass the

selection, consisted of a classical internship or the elaboration of a case study were the only innovative element

was a flexibilisation of workplace and working time. Flexibilisation is in this study not a criterion for innovation

in education. An overview of the presence of the criteria for innovation and the Six Senses in the selected best

practices, can be found in table four.

The innovative elements, as defined by Murray (2013), in the selected innovative best practices lies in the way

students observe and examine older people in their real life environment and how students translate the

observations into needs for the older person. In order to do so, undergraduates learn to question themselves, the

environment and current practices. The criterion experimenting can be found in the way students are allowed to

develop new models or improve existing models of care and how they monitor the effectiveness of the

intervention. Networking as innovative element, results in a real multilateral group integration of the students in

the multidisciplinary professional domain, with the patient, the family and family context and peer environment.

Finally Murray (2013) described associating as an innovative element. In these reported best practices the

associative element is reflected by the use of arts and artistic technics as method to learn about intergenerational

and cultural contexts and to develop their own criticism and learn how to express their own opinion. Teachers

also challenge the students to make associations between knowledge and real life situations. Even sports as

method to better understand the meaning of trust and communication can be found in the reported innovative

best practices.

In order to better understand the retrieved results, the model of Miller was used to structure the innovative best

practices according to the four competences levels. Figure 2 shows how many innovative best practices were

collected for each competence level. After structuring the innovative best practices and making the comparison

with the coding density for the definition of each sense, it seems that the best practices on the competence level

of “show how” and “does” almost completely cover the definitions. The best practices on the level “know” and

“know how” mostly contain a part of the definition for each sense.

This project has been funded with support from the Lifelong Learning Programme of the European Commission. This publication (communication) reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information

contained therein.

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Table 4 : The presence of the criteria for innovation and the Six Senses in the selected innovative best practices



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Figure 2: The number and description of innovative best practices per competence level of the model of Miller

(O&O, 2005)

2x implementation of an intervention program or holistic

model during clinical placement

2x intervention in open or home care facilities

1x gerodontology in day centres

2x simulation lab

1x school street

1x one on one occupational therapy

1x the personal journey-method

2x case study

1x learn-café

1x clinical reasoning

1x using technology to train decision making skills

3x learning about generations by using arts

1x geragogy

1x outdoor pedagogy

As stated earlier, based on these findings it is not possible to appreciate one best practice above the other.

Nevertheless the conducted analyses can be used to draw the attention to some missing links concerning the

Senses Framework. Innovative best practices can be improved by paying extra considerations at those parts of

the definition for the different senses that are not covered.

The innovative best practices as summarised in figure 2, will be presented in a format uniformly. That

uniformity gives a clear view about the method and the goal and a description about how the method meets the

six senses will be described. Finally, the innovative element, according to Murray (2013), is explained. The

formats from the innovative best practices can be found as an addendum in this report and can be consulted on

the ELLAN website http://ellan.savonia.fi/index.php/news

On the website 19 innovative best practices can be found instead of 20, because the simulation lab has

been reported identically by two different partners.

6 Conclusion

According to the literature, it’s not students’ attitude towards older people, which restrains them from

choosing a career in older peoples care, but their perceptions about a job in gerontology. Education is

one possible way for adjusting students’ perceptions and to motivate them towards a professional

career in gerontology. Rich learning environments and innovation in education on ageing, with special

attention for knowledge, skills, challenges and rewards, could increase interest in working with older

people.

Does

show how

Know how

Know

http://ellan.savonia.fi/index.php/news



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Twenty examples of innovative best practices for educating undergraduate health care students were

found after performing a qualitative research. Each of these innovative best practices has the potential

to provide the students with positive learning experiences and to strengthen the believe that a career in

gerontology requires special skills, can be challenging and rewarding.

The innovative best practices reported in this study can be implemented in different levels of

competence based learning, creating a safe environment for students to learn, to experience, to try and

to do. The innovative element in the best practices can be found in the way students are stimulated to

participate in a multidisciplinary environment, how they are stimulated to observe situations and to

question not only themselves but also the current way of working. Students are allowed to experiment

in order to find better ways of care giving, in order to implement new good standards of care, placing

the older person on the centre stage.

This research shows possible methods not only to prepare undergraduates but also to stimulate them to

choose a professional career in gerontology. However because of the limitation of time and resources

in this project, the effectiveness of the innovative best practices could not be assessed.



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References

Amitsis, G. (2013). Challenging Statutory Pensions Reforms in an Ageing Europe: Adequacy Versus

Sustainability. In P. Constantinos (ed.), Ageing in European Societies, Healthy ageing in Europe (pp. 9-32).

New York: Springer Science + Business Media.

Brown, J., Nolan, M., Davies, S., Nolan, J., & Keady, J. (2008). Transforming students’ view of gerontological

nursing: Realising the potential of ‘enriched’ environments of learning and care: A multi-method longitudinal

study. International Journal of Nursing Studies, 45, 1214-1232.

Coffey, A., Buckley, C., Gaidys, U., Sasoni, J., Arola, M., Deimante-Hartmane, D., Corvo, E., auer, S.,Petersen-

Ewert, C., & Tyrell, M. (2015). Beliefs of students about growing older and perceptions of working in

gerontology. Nursing Older People, 27, 1, 33-37.

Cruess, R., Cruess, S., & Steinert, Y. (eds.) (2009). Teaching Medical Professionalism. New York:

Cambridge University Press.

Haron, Y., Levy, S., Albagli, M., Rotstein, R., & Riba, S. (2013). Why do nursing students not want to work in

geriatric care? A national questionnaire survey. International Journal of Nursing Studies, 50, 1558-1565.

Koh, L. (2012). Student attitudes and educational support in caring for older people – A review of literature.

Nurse Education in Practice, 12, 16-20.

Lasch, V., & Reiman, K. (2006). Ageing and Demographic Change: European Research Resources. In G.M.

Backes., V. Lasch., & K. Reiman (eds.), Gender, Health and Ageing. European perspectives on Life course,

Health Issues and Social Challenges (pp. 227-240). Wiesbaden: VS Verlag für Sozialwissenschaften.

Luijkx, K. G. (2001). Zorg; wie doet er wat aan?. Wageningen: Wageningen Universiteit.

Lammertyn, F. (2011a). Socioligische tijdsdiagnosen Deel1: Theoretische perspectieven. Leuven: Acco.

Lammertyn, F. (2011b). Sociologische tijdsdiagnosen deel 2: maatschappelijke domeinen. Leuven: Acco.

Miller, G. (1990). The assessment of clinical skills/Competence/Performance. Academic Medicine, 65, 9, S63-

S67.

Murray, T., (2013). Orthodoxy and Innovation: Next Practices for Nursing Education. Journal of Nursing

Education, 52, 12, 667-669.

Nolan, M., Brown, J., Davies, S., Nolan, J., & Keady, J. (2006). The senses framework: improving care for older

people through a relationship-centred approach. Getting research into Practice (GRiP) Report No 2.

Available from Sheffield Hallam University Research Archive at: http:/shura.shu.ac.uk/280/

O&O. (2005). Competentiegericht leren, ECTS-studie-informatie in competentiegerichte opleidingen. Retrieved

from ‘ed7é

Sapountzi –krepia, D., Raftopoulos, V., Psychogiou, M., Sakellari, E., Toris, a., Vrettos, A., & Arsenos, P.

(2008). Dimensions of informal care in Greece: the family’s contribution to the care of patients hospitalized

in an oncology hospital. Journal of Clinical Nursing, 17, 1287–1294. doi: 10.1111/j.1365-2702.2007.02033.x

Triantafillou, J., Naiditch, M., Repkova, K., Stiehr, K., Carretero, S., Emilsson, T., Di Santo, P., Bednarik, R.,

Brichtova, L., Ceruzzi, F., Cordero, L., Mastroyiannakis, T., Ferrando, M., Mignot, K., Ritter, J., & Vlantoni,

D. (2010). Informal care in the long-term care system, European Overview Paper. Athens/Vienna: retrieved

from http://interlinks.euro.centre.org

https://www.ehsal.net/ects/Piramide_van_Miller.pdf

http://interlinks.euro.centre.org/



17

Innovative best practices

1 Gerondontology: Educational visits in older people day centers

Discription

During visits at older people day centers, students perform dental examinations in a vulnerable

population. A population that often doesn’t receive proper dental care. The sessions include a

thorough interview about the medical, socioeconomic and dental history. Besides the interview an oral

examination in appropriate examination rooms is performed. The students discuss the findings with

members of staff of the Dental School and develop a treatment plan under the supervision of a faculty

member.

The six senses

Security

Supportive and enabling

The method enables the

student to practice practical

skills. While developing a

treatment plan the support

from a teacher is present

Freedom to learn and explore

roles

The students are free to learn

and explore the role of a

dentist because of the given

autonomy during the

examination and the

development of the treatment

plan

Recognition for the students’

vulnerability

When students have doubts or

find themselves in a difficult

situation, the can ask help

because of the presence of

staff members during the

entire process gives.

Belonging


The student becomes part of a team responsible

for the care of on older person in the day center.


In this team the student knows exactly what is

expected from him or her. The student knows

what can be done and what not.

Continuity

Applying theoretical knowledge

into practice

The theory learned during

their education will be

necessary to make appropriate

treatment plans.

Exposed to good standards of

care

The team where the student is

part from applies good

standards of care.

Standards of care are based on

a clear and agreed philosophy

Students have learned about

good standards of care and

have to implement these

during practice.

Purpose

Does



18

Enabling the identification of

personal and professional goals

The practice reveals strengths

and weaknesses and allows the

student to point out goals

Experiencing the potential to

make a difference to the quality

of care

By examining older peoples’

dental health, students are

confronted with the needs of

this group and they can

develop a plan for dental

health improvement.

Having something

meaningful/important to aim for

Students are pushed to achieve

the best possible result in the

care they give, because this

results in thankfulness from

the older person.

Achievement

Being able to feel you have

made a difference

The examined older person

often can’t effort dental care.

The students make a

difference in the oral health of

this population.

Being able to realize personal

and professionally orientated

goals

The student is allowed to

make a treatment plan in

which personal and

professional goals can be

included.

Realizing competences in a way

that is consistent with self and

significant others

Students work in a team and

can learn from other

professionals. Besides that

teachers can guide them in

developing their competences

in a consistent way.

Significance

Developing the belief

that gerontology and

older people matters

Working in the team

with the older persons

shows the students’

directly that working

with older people

matters.

Developing the belief

that working in

gerontology gives

accorded value and

status

The student is

allowed to make a

treatment plan in

which personal and

professional goals can

be included.

Significant others give

acknowledgement in an

individual way

For each decision

made by the student,

immediately feedback

is received from an

expert.

The belief that what

you do is recognized as

an important

contribution

This population often

doesn’t has the

resources to visit a

dentist, students

directly experience

their contribution as

being important.

The innovative element

Observing

Questioning

Experimenting

Students observe and examine older people in their real life environment.

They discuss and question their findings in group and decide about the dental

interventions. They gain a better insight in the need of the older person and

feel that helping this people gives accorded value.

Networking The student becomes part of the care team with different perspectives on the

view of care which enriches the students’ practice.



19

2 The implementation of an intervention program for the tertiary prevention of dementia and

end of life care in a nursing home

Description

Nursing students are responsible for the implementation of the intervention program. The students

work under the supervision of a tutor and a social worker. First the students conduct a screening to

decide which patients are good candidates to be included in the program. Secondly the students make

contact with the patients’ family to clarify the program. Thirdly the students run the daily routine of

the program. In addition they educate their younger peers when the older students complete their

involvement after one or two academic semesters.

In this program, nursing students create, in cooperation with social work students, context specific

activities for persons with dementia. Beside that the students must co-operate with professional social

workers and medical doctors in order to optimize the results from the intervention program. Because

of students autonomy, the method creates a superb real-world educational environment, in which the

undergraduate also experience the possibility to change the quality of life of the participating

individuals.

The six senses

Security



student to implement an

intervention program in order

to have a positive influence on

quality of Life. The student is

supported by a tutor and social

worker.


roles

The students learn in this

method what they can mean

for this population, but also

that they have an important

role as a teacher for their peers

and later on for new

undergraduates.


vulnerability


communicate boundaries.

They are not forced into

situations they’re not ready

for. Counseling and training is

provided in a weekly or on a

need-to-meet basis.

Belonging

Feeling part of a

defined group

The students work

closely with

professionals who are

involved with the

patients included in

the program.

Belonging to a cohort

of students

The students from

different domains

work together to gain

optimal results.

Identification with

peers

Students are

stimulated to work

together with their

peers in order to learn

from each other. Not

only practical skills

but also how to adapt

to different situations.

The student has a clear

and valid role to play

The students is

responsible for the

implementation of the

program and is good

informed about the

content of the task.

Does



20

Continuity


into practice

Because of the specific target

group, students need to study

more about dementia, end-of-

life and family involvement, in

comparison with their fellow

students. Knowledge needed

during the program.


care

In the care facilities involved

in this program, students are

exposed to good standards of

care.

Link between practice as taught

and practice in real life

Students have to apply their

knowledge in a real life

intervention and reflect on it.

Purpose



Because students have to take

full responsibility, they learn

about their strengths and they

get the chance to work on

them.



of care

Implementing new programs

to improve the quality of life

offers students the possibility

of experiencing the potential

to make a difference to the

quality of care.

Having something


Students goals here are to aim

on an improvement of the

quality of care and life, plus to

educate their younger peers.

Achievement


made a difference

By implementing something

new, that can improve the

quality of life, students feel to

have made a difference.



goals

The students develop their

autonomy, their initiatves and

their self- and professional

esteem



significant others

Students are working in a real

life environment, surrounded

by professionals. That allows

students to develop themselves

in a consistent professional

way.

Significance

Developing the belief that

gerontology and older people

matters

By better understanding the

challenges of the third and

fourth age and by reflecting

on the multifaceted and

multidisciplinary actions that

can be undertaken to improve

the quality of life.


working in gerontology gives

accorded value and status

The students can experience

that their contribution can

have a direct influence on

disease prevention, social

exclusion and loneliness in

these individuals. They have

learned that specific

knowledge and skills are



individual and collective way

The recognition is given on

different levels. In the nursing

home students receive

recognition from their peers,

the personnel and patients

family. Also the

improvements observed in the

patients is a recognition for



21

needed.

their work. The final

evaluation grade is the

recognition given by the

nursing department.

The belief that what you do is

recognized as an important

contribution

The results achieved by

implementing the program is a

direct recognition for the

importance of the students’

contribution.

The belief that you matter as a

person

Tutors and staff acknowledge

that every student has his/her

own specificities as a person.

Nobody is forced into

something and counseling is

present when needed.


student

Students get responsibility

about the program and about

teaching younger

undergraduates.


Observing

Questioning

Experimenting

Students start from the needs of the patient. They observe and question what

works and what doesn’t work. They ask themselves, what their contribution

could be or should look like to maintain or to improve the quality of life of

this patient. The students develop new models or improve existing models of

care and implement these. They also monitor the effectiveness of the

intervention.

Networking The students are involved with the patient, the patients’ family, students from

a different domain, younger peers and different professionals.



22

3 Developing and implementing a holistic model of care during clinical training

Description

This training method is based on a multidisciplinary approach in which a clinical teacher from the

department acts as a connecting link of all professionals working in a nursing home, in order to

establish a new dynamic model of care which is person-centered, flexible and accumulating both

pharmacological and non-pharmacological therapies.

The student is expected to use his/her creativity and resourcefulness in order to empower the older

person and increase the quality of life according to the person’s needs and not according to a routine

that is often used in long term institutions.

All professionals of the team in the nursing home, are helping the undergraduates to understand the

needs of the older person, find effective communication skills and use all non-pharmacological

therapies.

All knowledge gained from interventions carried out with the help of different professionals such as,

psychologists (i.e. cognitive stimulation), physiotherapists (exercise) and social workers (recreational

activities, art therapy) is woven together towards the development of all the necessary skills required

for a holistic model of care.

The clinical teacher apart from helping students get over the stigma of old age and dementia, acts as a

role model himself/herself in order to encourage students to think of Gerontological Nursing as a

future career path.

The six senses

Security


The environment enables the

students to implement a

dynamic model of care,

because the care facilities, for

the clinical training, are

chosen based on the

willingness to use such a

dynamic model of care.During

the process, students are

supported by clinical teachers.


roles

The students use their own

creativity to increase the

quality of life of the older

person. By working closely

together with other disciplines,

students learn about the

importance of each role, what

aspects from the different

roles they can or cannot

conduct.


vulnerability

The teacher and staff make

sure that the student feels

supported at any time.

Debriefing is offered after any

difficult experience.

Belonging


The student works closely with other

professionals. Besides that the students are


The student knows that it is his or her task to

work on a new or improved model of qualitative

Does



23

Continuity


into practice

The clinical teacher makes

sure that the connection

between theory and practice is

made.


care

This learning approach is all

about the benefits of a

dynamic care model. The

involved institutions use this

model and therefor the

students are confronted with

these good standards of care.



Students need to implement a

dynamic model of care in a

real life situation. In that way

they are confronted with

limitations often present in the

care facilities.

Purpose



A multidisciplinary

environment and a holistic

approach demands to have a

broader range of knowledge/

qualifications. The students

are challenged to develop their

knowledge and skills. The

identification of new goals is

enabled by the exposure to the

other professionals and the

target group.



of care

This method allows the

students to experience that the

contribution of a health care

worker positively can

influence the quality of life.

Having something


The students want to be seen

as a team member. And when

they behave professional and

work in a constructive and

effective way towards the goal

of the training the will be

treated as a member of the

team.

Achievement


made a difference


new or to improve already

existing models, that can lead

towards an improvement of

life quality, makes students

feel to have made a difference.



goals

The clinical teacher knows the

student and the older persons

of the nursing home. Therefor

the teacher knows how to

stimulate the students to

develop their personal and

professional skills as well as to

point out new goals.



significant others






way.

recognized as future professionals, in that way

the feel part of the team

person centered care in order to optimize the

quality of life. The student will learn about

different tasks within the multidisciplinary

team and how this can be woven into a holistic

approach.



24

Significance



matters

By working closely together

with different professionals

and older people, the student

learn the importance of

gerontology and they see that

when you provide

personalized care the quality

of life improves.




When the chance is given to

Implement or improve

existing models for an

holistic, person centered

approach of care, the students

can directly experience the

value of their contribution.







recognition from the

personnel, patients and

teachers.



contribution


implementing or improving

existing models is a direct

recognition for the importance

of the students’ contribution.


person

Students are stimulated to use

their own personal creativity

in the program. Every person

has different experiences in

their life and those

experiences can be translated

into the professional setting.


student


about the improvement and

implementation. The student

is valued as a team member.


Observing

Questioning

Experimenting

Students starts from the needs of the patient. They observe and question how

an holistic approach can contribute towards a better quality of life. They ask

themselves, what their contribution could be or should look like for this

patient. The students develop new models or improve existing models of care

and implement these.

Networking The students are involved with the patient, and professionals from different

domains. Because of networking they can learn what actions can be included

in the holistic approach and where the boundaries are situated.



25

4 The brain fitness method

Description

The goal of this method is to stimulate mental abilities.

It is the task of the student to stimulate, in a funny way, older persons to preform regular exercises to

stimulate cognitive functions. The exercises can vary, depending on the abilities and work that are at

their disposal. University student takes notes regarding problems that have arisen during last exercises.

Simultaneously the role of the university student is to motivate the person to develop a habit of

independent exercising, and keeping a diary. Based on knowledge of the weakest areas, university

student makes an agreement with the person and create a plan of individual brain fitness.

The content of the brain fitness:

- exercising awareness, to perfect the awareness of five senses (sight, hearing, smell, taste and touch),

- exercising of visual ability;

- exercising of conclusory ability;

- exercising of the ability of expressing oneself.

This method includes the following activities-approaches:

- the client centered approach;

- occupational therapy interview;

- occupational therapy surveillance through the Canadian model – that is adjusted to institutional

welfare for persons of older age;

- evaluation of interests that is based upon the model of humane occupation;

- the insight into cognitive skills with the application of specific methodology evaluation;

- based on their observation and the information collected, students give their opinions and

suggestions

The six senses

Security



student to implement an

intervention program in order

to have a positive influence on

quality of Life. The student is

supported by a tutor and social

worker.


roles

The students learn in this

method what they can mean

for this population, but also

that they have an important

role as a teacher for their peers

and later on for new

undergraduates.


vulnerability


communicate boundaries.

They are not forced into

situations they’re not ready

for. Counseling and training is

provided in a weekly or on a

need-to-meet basis.

Belonging

Does



26

Feeling part of a

defined group

The students work

closely with

professionals who are

involved with the

patients included in

the program.


of students

The students from

different domains

work together to gain

optimal results.

Identification with

peers

Students are

stimulated to work

together with their

peers in order to learn

from each other. Not

only practical skills

but also how to adapt

to different situations.



The students is

responsible for the

implementation of the

program and is good

informed about the

content of the task.

Continuity


into practice

Because of the specific target

group, students need to study

more about dementia, end-of-

life and family involvement, in

comparison with their fellow

students. Knowledge needed

during the program.


care

In the care facilities involved

in this program, students are

exposed to good standards of

care.



Students have to apply their

knowledge in a real life

intervention and reflect on it.

Purpose



Because students have to take

full responsibility, they learn

about their strengths and they

get the chance to work on

them.



of care

Implementing new programs

to improve the quality of life

offers students the possibility

of experiencing the potential

to make a difference to the

quality of care.

Having something


Students goals here are to aim

on an improvement of the

quality of care and life, plus to

educate their younger peers.

Achievement


made a difference


new, that can improve the

quality of life, students feel to

have made a difference.



goals

The students develop their

autonomy, their initiatves and

their self- and professional

esteem



significant others






way.



27

Significance



matters

By better understanding the

challenges of the third and

fourth age and by reflecting

on the multifaceted and

multidisciplinary actions that

can be undertaken to improve

the quality of life.




The students can experience

that their contribution can

have a direct influence on

disease prevention, social

exclusion and loneliness in

these individuals. They have

learned that specific

knowledge and skills are

needed.







recognition from their peers,

the personnel and patients

family. Also the

improvements observed in the

patients is a recognition for

their work. The final

evaluation grade is the

recognition given by the

nursing department.



contribution


implementing the program is a

direct recognition for the

importance of the students’

contribution.


person

Tutors and staff acknowledge

that every student has his/her

own specificities as a person.

Nobody is forced into

something and counseling is

present when needed.


student


about the program and about

teaching younger

undergraduates.


Observing

Questioning

Experimenting

Students starts from the needs of the patient. They observe and question what

works and what doesn’t work. They ask themselves, what their contribution

could be or should look like to maintain or to improve the quality of life of

this patient. The students develop new models or improve existing models of

care and implement these. They also monitor the effectiveness of the

intervention.

Networking The students are involved with the patient, the patients’ family, students from

a different domain, younger peers and different professionals.



28

5 sTimul

Description

sTimul is a simulation lab where sessions about empathy and ethics take place.

The simulation exercises last two days and includes one overnight stay.

Participants are students and/or experienced care providers.

The experienced care providers play the part of an (older) resident or an hospital patient according to a

specific resident/patient profile in a simulation exercise. A group of nursing students are given full

autonomy in planning and carrying out the tasks on the ward.

Students and care providers participation in the empathy session is not obligatory, but is voluntary.

The simulation care receivers and the simulation care providers meet separately, each with an

educational assistant. The participants share their experiences and reflect on these experiences in a

group discussion.

The simulation care receivers provide face to face feedback to the students. Students afterwards make

the translation of this feedback into practice: what can they change in their clinical practice, what did

they learn from the simulation experience and how can they use it in their care practice in order to

provide good care.

The six senses

Security


Enables practicing different

competences because a safe

environment is realized, no

mark is given at the end of the

experience

Because of the feedback

moments the environment is

also supportive


roles

Students formulate a number

of competences they want to

achieve. Educators are present

but do not intervene in the

simulation experience.

The degree in which students

are learning depends on the

student himself: they have a

great responsibility about their

learning process during the

simulation experience.


vulnerability

For both groups, students and

care providers, participation in

the empathy session is not

obligatory, but is voluntary.

During reflection moments

attention is paid to physical

and emotional vulnerabilities.

Educational assistants from

the care-ethics lab prepare and

support the empathy session.

Belonging

Feeling part of a

defined group

Nursing students are

given full autonomy

in planning and


of students

A group of nursing

students are given full

autonomy in planning

Identification with

peers

The participants share

their experiences and

reflect on these



Initially students are

rather confused about

their role because of

Sh

ow

s



29

carrying out the care

process for the

simulation residents.

and carrying out the

same degree course.

experiences in a

group discussion.

Supervision at school

with the students in

small groups a few

weeks after the

experience take place.

the full autonomy but

after the first

reflection session,

they start to feel part

of the team and their

role becomes more

clear.

Continuity

Applying theoretical

knowledge into

practice

Students make a mind

map about good care

in order to support

their caregiving

process in the

simulation session.

For this they use the

courses: ethics,

communication and

nursing concepts.

The educational

assistant of the lab

refers to theoretical

concepts to frame the

experiences.

Exposed to good

standards of care

Students make a mind

map about good care,

implement the vision

of good care and

reflect about the care

given.

Students implement

the received feedback

into their care

practice in order to

provide good care.

Link between practice

as taught and practice

in real life

Students afterwards

make the translation

of this feedback into

practice.

reflect on their

experiences, to link it

with their internship

experiences and to

make conclusions

about how they can

use these experiences

into their practice.

Standards of care are

based on a clear and

agreed philosophy

Theoretical concepts

and practical skills

concerning good care,

are applied in the

simulation context.

Purpose



Students use the feedback to

identify strengths and

weaknesses which allows

them to formulate goals and

competences they want to

achieve.

during the experience.



of care

The students make a mind

map about good care and

implement these standards of

good care. In that way they

experience how to make a

different for the patient

Having something


Students can learn about their

knowledge and skills. They get

more insight in how to treat

someone respectfully. Students

know that this simulation will

help them further on in their

internship.

Achievement


made a difference

The simulation session is to

learn about providing good

care, about empathy, about the



goals

Students formulate

competences/goals on which



significant others

Students receive feedback

from the care receiver which



30

meaning of caregiving, to

stimulate a caring attitude-->

this allows the student to

experience that they can make

a difference.

they want to work.

By focusing on recognition of

strengths and areas of concern

students’ personal and

professional growth is

stimulated.

are professionals. In that way

they can work on their goals in

a consistent way. Feed back is

translated by the students into

their practice to enhence their

practice during the following

intership

Significance



matters

Students experience the

complexity of the context of

the older person/patient. They

learn about their vulnerability.

They get insight in how

professionals can offer a

surplus value in the life of an

older person.

Students seem to become

more positive towards care for

older patients




By giving full autonomy the

students experience that they

have a complex and important

task to conduct. By the

simulation they experience the

challenge of running a

geriatric ward

‘care takers’ acknowledge the

different tasks of the students

and give positive feedback on

their actions.




The simulation care receivers

provide face to face feedback

to the students.

Feedback immediately during

the reflection session



contribution

The feed back empowers

students, it allows to let the

student feel that their

participation in the team is

valuable


person

The student is recognized as

being a unique individual,

who is allowed to make

personal boundaries. The

moments of reflection about

personal experiences makes

the student feel that he or she

matters.


student

Simulant care receivers must

give at least one example of

where they have experienced

good care provided by the

student


Questioning

Experimenting

During feedback moments in group sessions "why, why not and what if" can

be discussed and might lead to different approaches in the future.

The simulation of a care environment with real life experiences. The students

are entirely responsible for running the geriatric ward

Networking Students and professionals from different domains interact and learn from

each other. Different insights and approaches can lead to improved care.



31

6 School street: simulation of ‘small scale’ care

Description

Students walk through a two-day program to experience care for persons with dementia in all the

aspects. During the program students live in mimicked housing environment where they can

experience ‘small scale care’ for persons with dementia. The experience makes them reflect on: how

would I organize care? How can I get to know my older patient? How can u meet his or her needs?

A number of students get the opportunity to be in the shoes of the older person with dementia.

Simulated roles and descriptions of scenarios are incorporated in the training. To help students to

uptake the “role”, attributes such as clothing, glasses and technical aids, are offered. The student also

can experience receiving care first-hand.

The six senses

Security


supportive because the

emphasis is on reflection to

support students in their

learning process

Enabling because the student

gets the opportunity to explore

their personal skills.


roles

Students reflect on: how

would I organize care? How to

get to know the elderly

patient? How can a

professional meet his/her

needs?


vulnerability

Reflections on several moments

during the day. Both physical

and emotional vulnerabilities

are recognized in those

moments.

Belonging

Feeling part of a

defined group

The way the

simulation is

organized makes

students feeling part

of a group in the

setting of care. They

are part of the care

givers or receivers.


of students

Students reflect on

experiences they had as

an individual and as a

team in the class.

Identification with

peers

Reflections allows to

recognize themselves

in others



Descriptions about

the different roles are

present as well as

materials to perform

the role.

Continuity


knowledge into

practice

Exposed to good

standards of care

The trainers present



in real life



agreed philosophy

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They have to

implement theoretical

concepts and practical

skills in the

simulation context.

during the simulation

exercise are familiar

with the use of good

standards of care

The simulation is a

copy of real life.

Trainers are mostly

lectors of the

department which helps

to match theory in the

curriculum and skills in

practice. The trainers

use good standards of

care

Purpose



By making reflections on how

they would organize care and

how they could get to know

more about the older patient

they discover which goals they

must achieve to optimize care.

They apply personal and

professional skills during the

simulation and formulate new

learning goals.



of care

Students live in mimicked

housing environment where

the can experience ‘small scale

care’ for persons with

dementia.

Having something


Students can focus on strengths

and weaknesses which allows

them to improve in a personal

and professional way.

Achievement


made a difference

Students reflect about the

organization of care. The feed

back during the reflection

about the quality of care and

suggestions about

improvement are linked with

the well being of the older

person. That strategy allows

the student to feel the

possibility to make a

difference for the older person.



goals

Students reflect on: how

would I organize care? How

can I get to know my older

patient? How can u meet his or

her needs?

the student can apply both

personal and professional

knowledge and skills.

By focusing on recognition of

strengths and areas of concern

students’ personal and

professional growth is

stimulated.



significant others

Receiving feedback from

classmates gives insight in

their own attitude, skills and

knowledge. In addition, the

reflection process on their own

actions helps this process of

empowerment by focusing on

strengths and by working on

their weaknesses.

Significance



matters









33

he mimicked housing

environment and the role

playing allows the student to

learn about the different

aspects of the patient and the

importance of their future

profession.

The confronation with the

complex context of the patient

and the responsibilities you

have as a profeesionals can

contribute to the believe that

working with older persons

give acorded value and status

acknowledgement is given

during reflections by

classmates and teachers.



contribution

The feed back empowers

students, it allows to let the

student feel that their

participation in the team is

valuable


person

The reflections from each

student are recognized as

being valuable. Every student

is also treated as a person with

specific needs.


student

Through feedback and the

input each student can give

feed back to others. They feel

they can learn from each

other.


Questioning

Experimenting

How would I organize care? How can I get to know my elderly patient? How

can u meet his/her needs?

Students can experience receiving care first-hand



34

7 One-on-one occupational therapy

Description

During this one-on-one (student and person of older age) occupational therapy, the focus goes to the

realization of activities for function preserving within older people. Residents are selected to monitor

by the students. The monitoring includes several approaches or models. Students observe the person

and make reports about the activities the older person conducts: are they interested, involved, what is

the nature of the activity, what is the mental and physical status of the resident. The student gets to

know the person not only by interviewing and participating in everything the older person does but

also through the contacts with the family. The gathered information is used by the student for the

intervention planning

Students receive from their mentor recommended titles and advice to support them.

With the help of a physiotherapist, students are observing whether recently there has been any

progress after their intervention. They also express their observations about the resident, as well as

improvement suggestions at the ‘roundtable’, while social workers fulfil the role of their supervisors in

the nursing home.

The six senses

Security


The student is encouraged

for problem learning and

creative resolving of

problems.

During the work with

elderly persons, the student

is supervised by the mentor

and supported, when the

student encounters a

difficulty, or is in doubt on

how to approach the

specified steps within the

practical work.

Freedom to learn and explore roles

Students have the freedom of

independent engagement.

By the ‘one-on-one’ procedure, the

student independently decides on

the tempo of carrying out specific

steps, makes decisions on adjusting

the tempo according to abilities and

demands of the older person.


vulnerability

The mentor is aware of the

fact that at certain points

students can perceive

difficulties. They make sure

to be present when the

students need to rely on

them.

Belonging


The student is especially part/highly involved with

the caring team'.


The students know the task and what is

expected from them.

Continuity

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35


knowledge into

practice

Theoretical examples

or experiences of

good practices are

implemented by the

student into the

method along with

the adjustment to the

existing conditions.

Exposed to good

standards of care

The educational

assistent of the lab


concepts in order to

frame the experiences



in real life

Students learn that

the ideal working

format is not always

present in real life.

The institutional and

societal environment,

can be an obstacle for

an holistic approach

in care.



agreed philosophy

Good practice from

other countries are

consulted and give an

insight into

effectiveness.

Examples/experiences

of good practices are

implemented into the

method along with



Purpose



There is the possibility of

individual work, decision-

making and pleading with

specific steps. That along with

valid arguments, students can

adjust their direct work with

the older person.



of care

If students implement best

practices in real life situations,

they experience that making a

difference in the quality of

care is possible.

Having something


Students can improve the well

being of on older person by

giving good adjusted care.

Achievement


made a difference

Composing professional

advice finally develops a sense

of merit and competency

within the students



goals

Possibility of individual work,

decision-making and pleading

with specific steps.



significant others

Insight into the good practice

in other countries gained an

insight into effectiveness.

Feed back from the mentor

and others also helps to

develop competences in a

consistent way.

Significance









36

matters

Students gain a better insight

in the life and need of older

people in a nursing home

through interviews and by

participating in all the

activities performed by the

older person. The initial

stereotypes connected with

persons of older age, through

this form of work, looses

their original meaning.

Students report about

observations and make

suggestions for the care. The

implementation of these

suggestions make the

students belief that they

matter.


By first-hand experiences in

working and caring for senior

citizens in a positive

atmosphere and nurturing

environment, occupational

therapy students are

intrinsically and extrinsically

motivated to become sincerely

interested in working with older

people.

The sense that this kind of work

is challenging, stimulating and

that it matters both to the

nursing home residents and the

wider society is developed.


There are roundtable

discussions about care and

students can formulate

suggestions about organizing

care. Positive feed back

gives acknowledgement for

their contribution.

The belief that what you do is recognized as an

important contribution

Examples and experiences of good practices

as such are implemented into the method

along with the adjustment to the existing

conditions. Positive feed back gives

acknowledgement for their contribution.


Students report about observations and make

suggestions for the care. The implementation of

these suggestions make the students belief that

they matter.


Observing

Questioning

Experimenting

Students observe the older persons and make improvement suggestions. In the

next step the students will implement the suggestions and they evaluate if

their intervention has led towards improvement.

Associating

Different methods and approaches are used/combined/adjusted to the

institutional welfare for persons of older age.

Networking

Students interact with the patient, the family and professionals to better

understand the needs of the older person in order to formulate suggestions.



37

8 The personal journey-method:

Description

The journey stands for a metaphor for a person’s life, with a specific outer and inner morphology. The

outer morphology of a journey, gives an overview of one’s environment, meaning both the

institutional and social environment. The inner morphology of a journey is a description of the

components of that journey, represented by one’s personal attributes. By personal attributes is meant:

the system of values, the character of a person, the personality, special skills, non-material and

material goods at one’s disposal during one’s lifetime. Obstacles met on a journey are represented by

all the life’s situations, ‘problems’ to which one was or is exposed to. The vision of continuing the

journey, defines all of the above plus the current stance of a person toward ageing and the situation

which one is currently exposed to providing an insight into personal thinking of actions which must be

undertaken, so that one can continue the journey.

The personal journey-method provides basic insights into the person’s life cycles, with the emphasis

on particular life phases defined by his or her health and economy status. This way of working and

thinking brings nature and environment into the profession as defined by the Kawa model, developed

by Michael K. Iwama and claimed by him as the new conceptual practice model.

Following activities and approaches are used in this method:

- an approach directed toward a person, the so-called client centred approach;

- an occupational therapy interview;

- an occupational therapy surveillance through the Canadian model – that is adjusted to institutional

welfare for persons of older age;

- an evaluation of interests that is based upon the model of humane occupation;

- the insight into cognitive skills with the application of specific methodology evaluation;

- based on their observation and the information collected, students give their opinions and

suggestions for intervention, along with the attempt to realize the short-term goals.

The activities and approaches are similar to those of the one-on-one occupational therapy, as described

earlier.

The six senses

Security

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The student is encouraged

for problem learning and

creative resolving of

problems.

During the work with

elderly persons, the student

is supervised by the mentor

and supported, when the

student encounters a

difficulty, or is in doubt on

how to approach the

specified steps within the

practical work.


Students have the freedom of

independent engagement.

By the ‘one-on-one’ procedure, the

student independently decides on

the tempo of carrying out specific

steps, makes decisions on adjusting

the tempo according to abilities and

demands of the older person.


vulnerability

The mentor is aware of the

fact that at certain points

students can perceive

difficulties. They make sure

to be present when the

students need to rely on

them.

Belonging


The student is especially part/highly involved with

the caring team'.


The students know the task and what is

expected from them.

Continuity


knowledge into

practice

Theoretical examples

or experiences of

good practices are

implemented by the

student into the

method along with



Exposed to good

standards of care

The educational

assistent of the lab


concepts in order to

frame the experiences



in real life

Students learn that

the ideal working

format is not always

present in real life.

The institutional and

societal environment,

can be an obstacle for

an holistic approach

in care.



agreed philosophy

Good practice from

other countries are

consulted and give an

insight into

effectiveness.

Examples/experiences

of good practices are

implemented into the

method along with



Purpose



There is the possibility of

individual work, decision-

making and pleading with

specific steps. That along with

valid arguments, students can



of care

If students implement best

practices in real life situations,

they experience that making a

difference in the quality of

care is possible.

Having something


Students can improve the well

being of on older person by

giving good adjusted care.



39

adjust their direct work with

the older person.

Achievement


made a difference

Composing professional

advice finally develops a sense

of merit and competency

within the students.



goals

Possibility of individual work,

decision-making and pleading

with specific steps.



significant others

Insight into the good practice

in other countries gained an

insight into effectiveness.

Feed back from the mentor

and others also helps to

develop competences in a

consistent way.

Significance



matters

Students gain a better insight

in the life and need of older

people in a nursing home.

This method offers

possibilities to tackle

stereotype thinking by seeing

that their life is still valuable

and knowing that sometimes

small actions can lead

towards a longer independent

life. Students report about

observations and make

suggestions for the care. The

implementation of these

suggestions make the

students belief that they

matter.




By first-hand experiences in

working and caring for senior

citizens in a positive

atmosphere and nurturing

environment, occupational

therapy students are

intrinsically and extrinsically

motivated to become sincerely

interested in working with older

people.

The sense that this kind of work

is challenging, stimulating and

that it matters both to the

nursing home residents and the

wider society is developed.




There are roundtable

discussions about care and

students can formulate

suggestions about organizing

care. Positive feed back

gives acknowledgement for

their contribution.



Examples and experiences of good practices

as such are implemented into the method

along with the adjustment to the existing

conditions. Positive feed back gives

acknowledgement for their contribution.


Students report about observations and make

suggestions for the care. The implementation of

these suggestions make the students belief that

they matter.



40


Observing

Questioning

Experimenting

Based on their observation and the information collected, students give their

opinions and suggestions for intervention, along with the attempt to realize

the short-term goals.

Associating

Different methods and approaches are used/combined/adjusted to institutional

Welfare for persons of older age. A new model 'Kawa model' is introduced to

bring nature and environment into the profession. Aiming for a more holistic

and person centered approach.

Networking

Students spent time in an institution to gain insight into the person’s life

cycles and to learn about the physical, sociological and economic status and

the obstacles that might occur during their 'journey' and what they need to

continue their journey.



41

9 Problem based learning: Case studies

Description

Problem-based learning is a learner-centred approach and based on case studies. The students are

provided with relevant and real case-studies together with guiding questions to work them through the

cases in three steps. First the case studies are discussed in small groups, in order to raise awareness for

the know-how the students already posses. In a second step, theoretical input is given in reference to

the specific case study and, thus, interlinked with their know-how. Moreover, the students are

provided with according material for further self-directed exploration of the subject. Based on this, the

students further develop the solutions for the case-study again in groups. In a third step finally the

results of the group-work are presented to the plenum and discussed.

The six senses

Security


A teaching-learning-culture is

created, that allows openness

and a culture of error

tolerance. Teachers are present

during the reflections to

support students.


roles

This freedom is created

through the work in small

groups and self-directed

research sessions.

The didactic concept promotes

social competences and self-

reflexive skills.

This problem-based and

solution-oriented approach

raises awareness for an

individual’s strengths and

weaknesses on personal level

and on professional level.


vulnerability

Reflection on own know-how

and role-behavior in peer-

groups under professional

guidance is organized.

Students share their

experiences about difficult

situations in order to

collectively discuss solutions.

The reflection sessions and

the error tolerance makes it

possible for students to talk

about experiences and

difficulties. That makes it

possible for them to see that

difficult feelings are not

always personal but faced by

everyone.

Belonging


Group members are invited to

respectfully reflect on their

role and behavior in the group.

Belonging to a cohort of

students

Students reflect on experiences

they had.

Identification with peers

students are challenged to

reflect on their own know-

how in comparison to the

perspectives of their peers.

The participants reflect on

their own know-how and

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42

role-behavior in peer-groups

under professional guidance

Continuity

Applying theoretical knowledge into practice

The concept is based on the idea of interlinking

scientific-theoretical knowledge with practical

case studies. Case-studies sensitize the students

for comparable situations in the daily

professional life.

The case studies connect learning with practical

experience and raises awareness for individual

professional know-how.

Link between practice as taught and practice in

real life

The institution is integrated with an elderly care

home which allows to refer directly to the

learner personal challenges and experienced

limits in daily professional life.

Problem-based learning allows to integrate

professional experience and to reflect on

personal and professional concepts of care.

Purpose

Enabling the identification of personal and

professional goals

Freedom to learn and explore roles and

competences in small groups and self-directed

research sessions.

Problem-based and solution-oriented approach

raises awareness for an individual’s strengths

and weaknesses on personal level, in

professional care work and for theoretical

concepts.

Having something meaningful/important to aim

for

Each individual in the group has an influence

on the group performance. Working on personal

and professional skills lead towards a good

presentation.

Achievement

Being able to feel you have made a difference

This method is more about linking "old" and "new" knowledge. And students learn that every

individual contributing is an added value for the result of the work.

It is possible that without some ones input, the solution is less complete, in that way it is possible to

feel you have made a difference in the context of the groups' work.

Significance



matters

The EduCare-Institut is

integrated in an elderly care

home. The specific

challenges, values and

importance of gerontological

work are part of all the

educational programs offered.


person and as a student

An overarching goal of the

teaching-learning arrangement

is to strengthen the

participant’s professional

identity. That stresses their

ability to find recognition and

acknowledgement within

themselves




The presentations are

discussed in a collective way.

That could contribute to the

acknowledgement



43


Observing

Questioning

Associating

This learner-centered approach, combines dialogical case studies and

experienced based learning. The method promotes lifelong learning, social

skills and (self-)reflective-skills. The individual learner’s know-how is

integrated in solving the case and the ability and self-esteem to solve

problems is promoted. The cooperation between de school and the care

facility offers the opportunity to integrate authentic learning-environments

where the theory can be directly connected to professional know-how and

practical issues.

Networking The method sensitizes students for multi-professional cooperation and

possible difficulties that might arise during this cooperation.



44

10 The intergenerational learn-cafe

Description

The intergenerational learn-café stands for the co-creative development of an intergenerational and

interprofessional multiphase teaching and learning path. The method consists out of project-based

learning and research workshops, which takes place in different phases.

In phase 1 students are sensitized for intergenerational work by the development and preparation of

dynamic learning materials. The dynamic learning materials are the result of interaction between

learners and teachers which should enable the students to learn about generations in different contexts.

Because the development takes place in a co-creative way, reflexive skills about knowledge, empathy,

attitude, interaction skills and tolerance, are put in motion.

During phase 2, students are prepared to cooperate with professionals. The students design and realize

learn-cafes for people of older ages to teach them how to get access to modern information and

communication technologies. This phase takes place in cooperation with professional care workers.

The result of the actively integration of older people and professionals is the establishment of a

dialogue between generations (students/professionals and older people).

Phase 3 is the phase where the intergenerational learn-cafe actually takes place. The course material

for senior citizens is developed in the same way as the learning material for the students. The pre-

design is aiming at further development together with the individual senior citizens and, thus,

according to particular individual circumstances. The researchers/ lecturers accompany the entire

training process intervisory in the form of a mentorship and based on research-workshops.

The six senses

Security


There is study material

provided by the teachers

which can help the students to

start with the project.


roles

The multiphase teaching-

learning path offers the

students the freedom to learn

and explore different roles

and competences and allows

for an exchange of

perceptions and experiences

with professionals and clients.


vulnerability

The students are given

opportunity to reflect on their

own teaching and learning

competences and cooperative

competences in inter-

professionals and inter-

generational contexts.

Belonging


The students design the learn-


During reflection moments

The student has a clear and

valid role to play

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45

cafes together with

professional care workers and

adopt the role of a trainer.

The different learning phases

make the students experience

themselves in different roles

and different working groups.

B) During reflection moments

and the work in the groups,

identification with peers is

possible.

and the work in the groups,

identification with peers is

possible.

The different phases are

explained and the student

knows what role they play in

each phase: learner,

professional care worker,

developer, teacher. They also

understand that often the

have a double role to play,

since cooperation between

generations is important.

Continuity


The researchers/lecturers accompany students

during the training process as mentors. This

creates a theory-practice-circle in order to raise

awareness for and contribute to bridging the

theory-practice-gap.

Link between practice as taught and practice in

real life

The cooperative preparation of the ICT-

learning cafes and the realization of the learn-

cafes allows for experience-based learning and

direct application of theoretical knowledge

developed in advance and further developed

according to the concrete experiences made.

Purpose


professional goals

The students reflect on their own teaching and

learning competences and cooperative

competences in inter-professional and inter-

generational contexts. The concept of respecting

the multiplicity of life-worlds puts emphasize on

empathy and tolerance in diverse environments.

This promotes reflection on their own concepts of

professional behavior and role distance. Students

reflect on their own concepts of professionalism

and professional identity through cooperation

with professional care workers and in the

intergenerational learning café.


for

Students aim to successfully install the learn

cafe

Achievement

Being able to realize personal and professionally

orientated goals

Students reflect on: how would I organize care?

How can I get to know my older patient? How

can u meet his or her needs?

the student can apply both personal and

Realizing competences in a way that is

consistent with self and significant others

Receiving feedback from classmates gives

insight in their own attitude, skills and

knowledge. In addition, the reflection process

on their own actions helps this process of



46

professional knowledge and skills.

By focusing on recognition of strengths and areas

of concern students’ personal and professional

growth is stimulated.

empowerment by focusing on strengths and

by working on their weaknesses.

Significance



matters

Learning from each other,

with each other and about

each other helps to overcome

stereotypes about their own

profession and about older

people. The students are

challenged to reflect on their

own concepts of old age,

professionalism and

professional identity.



contribution

The goal of the teaching

learning proces is that the

students find recognition

within themselves




The students receive feed back

from the elderly in the learn

cafe. Feed back is given during

reflection moments


Students develop in cooperation with other

generations dynamic learning materials. By doing

so they also import a part of their own life

experiences/contexts which can be valuable.

They experience that their personal input can

have an important contribution in a team or in the

society.


Because the aim is to learn from each other,

the students experience that their own input

is valuable.


Questioning

Reflexive skills about knowledge, emphaty, attitude, interaction skills and

tolerance, are put in motion.

Networking

Dynamic learning materials as a result of interaction between learners and teachers

which should enable the students to learn about generations in different contexts.

Students cooperate with professionals.

Experimenting

Associating

The students really implement the intergenerational learn-café.

The course material for senior citizens is developed in the same way as the

learning material for the students



47

11 Problem oriented learning: clinical reasoning in geriatric nursing

Description

Where these classes used to offer the students a case related to a specific medical problem,

now a case with different and vague complaints is offered to the students.

Readers, by which are meant written text and power point presentations, are used to guide the

learning process of students. This course focuses on problem oriented thinking about an older

person with a complex amount of complaints in order to stimulate the making of differential

analysis in signals and symptoms. Students also learn to improve their searching skills in

databases and literature.

The six senses

Security


A) Supportive because the readers helps them.

Enabling because the possibility to use internet

sources and library books is offered.


The student must look at the case from one

setting and then explore the transmurale

possibilities, in that way the student thinks

about roles and the different competences

according to the different roles.

Belonging

Belonging to a cohort of students

A mixed group of students in acute care and

geriatric care work together


By working closely together students can

learn from each other.

Continuity


Integrating theory into learning goals as a

preparation for a practical period which is still to

come. The student applies theoretical knowledge

on the case.

Exposed to good standards of care

By using scientific literature students are

exposed to good standards

Purpose

Enabling the identification of personal and professional goals

The exercises enable the student to formulate learning goals which can be used to work on during

their practical training. Questionnaires allow students to make a personal evaluation about strengths

and weaknesses.

Achievement

Being able to realize personal and

professionally orientated goals

Realizing competences in a way that is consistent

with self and significant others

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48

Insights are used to formulate personal and

professional goals. Students will during their

internship achieve these goals.

This method allows to detect different

competences on which can be worked during

their internship.

Significance

Developing the belief that gerontology and older

people matters

The method is a tool to get an objective,

realistic, multiple image of the geriatric patient.

Significant others give acknowledgement in an


Teachers give recognition through feed back

during the exercise in the class.

During oral exam individual acknowledgement

has been given.


Questioning

Associating

The students don't get the problem served by the teachers. They get a case

with complaints and have to question themselves what is going on. They

search the literature and make associations between the literature and the

complaints. They learn how to recognize and interpret problems and how they

can find solutions to that problem



49

12 Virtual older patient case: Gerodontology

Description

This is an interactive computer simulation helping students to practice diagnostic skills and make

clinical decisions. The virtual patient is suffering from various systemic conditions and needs dental

care. The students can choose online from a variety of different clinical decisions the best available

ones. For each choice, immediate feedback is received from an “expert”. A summative self-assessment

is offered at the end. The case is used for self-training and group discussion making during seminars.

The six senses

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A) The simulation enables the

student in practicing diagnostic

skills and feedback supports them

Support to use the technology is

available.


roles

The students can follow all

existing nodes at their own

pace and time. The student is

the “virtual dentist”

responsible for the older

patient’s care.

Recognistion for students

vulnerability

Clinical decision making

and reasoning is promoted

in a safe environment.

Mistakes in clinical

decision making are

allowed, because there are

no severe consequences

since this is a computer

simulation.

Belonging


They simulate an experienced

dentist who is part of the health

care team for an older patient.


Identification is possible

during the group discussions.

Student has a clear and valid

role to play

The student knows that he or

she is the virtual dentist and

that the expectations are to

perform as in real life

situations.

Continuity


Students learn about diagnostic skills and

clinical decision making and bring this into

practice.


Experts give immediately feedback assuring

the students apply good standards of care.

Purpose

Enabling the identification of personal and Having something meaningful/important to

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50

professional goals

This is a self-paced learning tool enabling

formative self-assessment. The students identify

their strengths and weaknesses and can formulate

goals based on that knowledge.

aim for

Good decisions lead towards good feedback.

Students aim for acknowledgement.

Achievement


What the student decides is followed with feed back from an expert. That way students realizes

competences in a consistent way with significant others.

Significance


people matters

By presenting real life challenges and issues that

are faced by older people, Students get a more

realistic image of older people. They will better

understand that working with this group is

challenging.



For each choice immediate feedback is

received from an expert.

When the activity is successfully completed,

interactive/electronic feedback follows.


Questioning

The virtual learning environment stimulates decision making. The students

must question themselves what the problems are and which actions should be

taken. They receive immediate feed back after each decision. They have to

question themselves about what is going on, what can I do, why do I do this,

could it be better if I do things differently?

Experimenting

The method allows students to have an interactive experience. They can

experiment with clinical reasoning and decision making in a safe environment

using simulated real life cases.



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13 Technology to simulate the healthcare context and needs of older people

Description

The online virtual learning environment is used for practicing decision making.

Cases based on real life situations are offered. This practice is similar to the innovative best practice

number 12, about gerodontology.

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The simulation enables the

student in practicing diagnostic

skills and feedback supports them

Support to use the technology is

available.


roles

The students can follow all

existing nodes at their own pace

and time. The student is

responsible for the older

patient’s care.

Recognistion for students

vulnerability

Clinical decision

making and reasoning is

promoted in a safe

environment. Mistakes

in clinical decision

making are allowed,

because there are no

severe consequences

since this is a computer

simulation.

Belonging


They experience through the simulation what

they need to know and do as being a member of

the health care team for an older patient.


Identification is possible during the group

discussions.

Continuity


Students learn about diagnostic skills and

clinical decision making and bring this into

practice.


Experts give immediately feedback assuring

the students apply good standards of care.

Purpose


professional goals

This is a self-paced learning tool enabling

formative self-assessment. The students identify

their strengths and weaknesses and can formulate

goals based on that knowledge.

Having something meaningful/important to

aim for

Good decisions lead towards good feedback.

Students aim for acknowledgement.

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Achievement


What the student decides is followed with feed back from an expert. That way students realizes

competences in a consistent way with significant others.

Significance


people matters

By presenting real life challenges and issues that

are faced by older people, Students get a more

realistic image of older people. They will better

understand that working with this group is

challenging.



For each choice immediate feedback is

received from an expert.

When the activity is successfully completed,

interactive/electronic feedback follows.


Questioning

The virtual learning environment stimulates decision making. The students

must question themselves what the problems are and which actions should be

taken. They receive immediate feed back after each decision. They have to

question themselves about what is going on, what can I do, why do I do this,

could it be better if I do things differently?

Experimenting

The method allows students to have an interactive experience. They can

experiment with clinical reasoning and decision making in a safe environment

using simulated real life cases.



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14 Outdoor-pedagogy: communication training

Description

Or this method we visit the local indoor climbing facility. The purpose is that students learn to

experience how it feels to trust someone when you are dependent. The student who takes care of the

climber can experience how it feels when you want someone to trust you who is afraid. Students can

experience how it feels to push boundaries and they learn to respect certain boundaries by saying no.

The method can be seen as a simulation of real life experiences about emotions, trust, knowing and

accepting others and own limits. It's about mindfulness, respect, empathy and an appreciating

communication.

Students experience theoretical concepts, to better understand these concepts.

Students experience for themselves what this feeling of dependence is like, as well as the safety

provided by the rope, understand that people who are in need of assistance and care are on the rope of

their competences

Fase 1: Theory: students learn about the person-centred approach and specific communication

features in working with the elderly.

Fase 2: students receive technical instructions in the climbing hall and try out the climbing

wall.

Fase 3: the students climb with physical restrictions (impaired sight, restricted mobility).

Fase 4: the students write each a reflection about the experience.

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The environment allows the

students to learn about trust,

boundaries and limits.

Professionals are present to

support the students technically

and emotionally.


Freedom to learn about own

boundaries, they can say no at

any time. Here is my limit. I will

not exceed this limit without

support. I will not exceed my

limit, even with support, because

I can’t or I don’t want to. The

experience is linked to the

professional everyday life: e.g.

the activation training for the

prevention of falls.

Recognition for students

vulnerability

Reflections insure that

crossing boundaries or

limits doesn't turn the

learning zone into a stress

zone. They learn that

employees need support

through reflection and

supervision. That they

have a responsibility

towards the older person

and members of the team,

including themselves.

Belonging

Feeling part of a Belonging to a cohort Identification with The student has a

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defined group

The students are all in

it together. They are

part of the group who

wants to be trusted or

of the group from

whom is asked to

give trust.

of students

The students see

themselves as a

climbing group, as

well as an informal

group.

peers

The reflection

happens individual on

paper, which makes it

more difficult to

compare your

feelings and

experiences with

peers.

clear and valid role to

play

The students are well

instructed before the

activity starts. They

do not only know the

technical instructions

but also the purpose

of the activity is

explained.

Continuity


The (in class) acquired knowledge and skills are needed, tested and extended during the session.

Purpose




Students learn about

themselves and their

boundaries. They learn that can

say stop and that they can be

supportive to another person.

They learn about personal and

professional strengths and

weaknesses.

Experiencing the potential to make

a difference to the quality of care

Students experience for

themselves what this feeling of

dependence is like, as well as the

safety provided by the rope.

Students learn to understand that

people who are in need of

assistance and care are on the

rope of their competences.

Having something

meaningful/important to

aim for

The learning objectives

are to understanding what

dependent elderly are

going through and to

understand that the health

care worker also needs

support.

Achievement


Probabilistic hypotheses. The thing that worked well for/with Mrs. Maier yesterday, can be totally

different tomorrow. According to this, the students learn to adjust their conduct reflexive to this. This

reflective conduct in the professional context forces a symbiosis of professionalism and personal

attitude based on the person-centered principles. Students learn that for the quality of work not only

reflection is important but also their own mental hygiene.

What the students learn in this course can lead to the feeling of making a difference during the

students internship.

Significance



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Significant others give acknowledgement in an individual and collective way

The students receive confirmation and feedback from the instructor.

The students are very proud of articles in different media

Students make a reflection on which they get feed back in an individual way


Questioning

They have to question themselves what they feel, why they feel this and they

have to ask themselves what this means for depended elderly. They have to

question themselves how they should handle with dependent older people

during care.

Associating

The use of sports to better understand what it means to be trusted by someone

else and trusting someone else. Learning about communication in a different

context. They make connections between their experience and what they have

learned during theoretical classes.



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15 Cross-generational and intercultural collaboration: learning through the use of arts

Description

Different students (health care students and art students) and different generations learn through the

use of arts about different life stages through cross-generational and intercultural collaboration. This

method emphasizes at exchanges of experiences, visions and ideas between generations and cultures”.

This project work aims to break boundaries between different groups in the population and aims at

implementing intergenerational learning spaces.

In preparation for their first meeting, students and older people in the nursing home create portraits of

themselves in separate work groups. These are then exchanged between the two groups without the

people actually meeting one another. In the (still) parallel work group sessions, fictional biographies

are then created to go with the portraits.

The project team provides the students with special icebreaker questions. Based on these icebreaker

questions, the students and the older people, in a joint effort, search for questions, experiences and

stories, which they perceive as particularly relevant for each of their lives.

The students and the older people meet again in small work groups. Each group picks one of the

identified topics and uses artistic techniques to express them in the form of “suitcases of memories and

themes” in a co-creative effort.

The collaboration takes place in both settings: in the educational institution, workshops take place and

in the nursing home a “studio week” is organized

Art lab students are asked to analyse the role of women and men in the world literature and theatre

literature and develop monologues, which they then perform for the health care students and older

people using theatrical techniques. Based on the interviews, the art students develop drama

productions. The theatrical techniques allow the students to examine the topic of ageing in close detail

and from a variety of perspectives in literary, fictional and real intergenerational and intercultural

contexts. This is an innovative way to learn about different life stages. The gained knowledge is

shared with others by the use of stage performance.

The health care students also use the interview material in other courses: In language courses, the

recorded interview conversations are used to practise listening comprehension, expression, writing and

language skills.

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The method is supportive in

that way that the topic and

expectations for the

educational process is

already given. The students

are enable to organize and

develop the specific contents

themselves.


roles

The learners analyze their own

life scripts and those of others,

regarding age- and culture-

specific role models and

expectations and diversity.

Students have opportunities to

develop their skills of

observation and sensitive

interaction.

Recognition for students’

vulnerability

On a regular basis and under

professional guidance,

reflection rounds are

organized. During these

sessions, emotional responses

are addressed. These sessions

can also be seen as a

recognition processes in

relation to identity formation

based on mutual

acknowledgement, respect

and safeguarding of

vulnerability.

Belonging


The learners initially perceive

themselves as part of a

homogeneous large group that

has a rather more non-

committal nature. As the project

work continues, the learners

grow out of this role and take on

an increasingly more

responsible role. In small,

heterogeneous work groups,

individual differences become

more evident and challenge the

learners to understand their role

within the group co-

constructively in comparison to

the other members of the group.


The students are challenged to

reflect on their own know-how

in comparison to the



valid role to play

The students are well

instructed, in order to

design the learn-cafes

together with professional

care workers and adopt the

role of a trainer

Continuity


The theatrical techniques allow the students to examine the topic of ageing in close detail and from

a variety of perspectives in literary, fictional and real intergenerational and intercultural contexts.

With the theme being closely connected to their experience and related to their own living

environment, the learners are highly motivated for formal learning and the exploration of theoretical

knowledge – theory becomes accessible in an application context.

They reflect upon their individual knowledge and link informal learning with formal learning

Students can think critically about practice issues with older adults.



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Purpose



professional goals

The participants learn how to break out of

restrictive perspectives and develop their own

goals with the help of artistic tools and

techniques.

Individual experiences, and established links to

role models in world literature, through an in-

depth analysis of role models, expectations and

experiences, creates awareness for one’s own

role.

The learning and exploration of one’s own role

behavior in varying contexts, and the

development of personal competence move to

the center of the educational process.

The creative work helps to reflect upon one’s

own personality, knowledge and personal

strengths; to formulate one’s own wishes and

question the expectations one has about

themselves.


for

Take first steps towards putting one’s own

ideas into practice.

Achievement


It is possible that without someone’s’ input the

performance is less complete, in that way it is

possible to feel you have made a difference in

the context of the groups' work.


orientated goals

Observing reality and interpret this together

with theory is also something a professional

must do.

Students make strong advances in interpersonal

skills as they consider the positions of others

and as they gain confidence in articulating their

own views and responses.

It enables students to express themselves better,

a result that can be observed in their writings

and discussions.

Significance



matter

Boundaries are broken and




Students learn about the



contribution

All participants will recognise



59

meetings are facilitated,

between different groups of

the population. It support and

enables intergenerational and

intercultural exchange.

The co-creative work in

intercultural and

intergenerational contexts

activates reflection and


relation to identity formation.

It is about building respect

between generations. To get

insight in the diversity of life

scripts to enhance people’s

understanding of other’s lives.

multidimensional problems

older people are dealing with.

In that way they learn that

gerontology is a challenging

and exciting area to work in.

pieces of their own “personal

stories”. This feeling of being

heard and seen is perceived

very strongly as appreciation

and acknowledgement



The recognition of one’s own work comes

from the participants themselves, from the

trainers and, most importantly, from being

noticed by the public. The exhibition and the

theatre performance are announced in the

public press and there are also newspaper

articles about the project


All participants are given the feeling of being

“heard and seen.”


Questioning

Intensive observations which has to be transformed into art are articulated

through art can lead to questions like 'why', why not' and 'what if'.

Associating

Art is used to get insight in gerontology. Existing art and the use of artistic

techniques is integrated in the learning process of health care workers to learn

about cultural and intergenerational contexts. Art is used to facilitate

discussions and helps the students to develop a criticism attitude and learn to

express their own opinion. .

Networking

Health care students and students from the school of Art and even older

people participate together in the same project and learn from each other.

Observing

The observations in this method make students to think differently about

older people and makes them think differently about care in this domain.



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16 Nursing humanities: enhance students’ perceptions of the lived experiences of older people

Description

This innovative best practice is similar to previous example. Here also arts-literature, visual arts and

performing arts are used in order students’ perceptions of the lived experiences of older people can be

improved.

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The method is supportive in that way that the

materials and professional support for the

educational process is present. The students are

enabled to express their own perceptions and to

engage in arts-based activities.


Students have opportunities to develop their

skills of observation. They learn that

observing is very important. The students

discover points of consideration in care and

sensitive interactions.

Belonging


Students devise and perform

drama and other art making in

groups and this demands

teamwork and sensitivity to

others' positions.


The students are challenged to

reflect on their own know-how

in comparison to the



valid role to play

The students know what

role they have to play in the

group. Without making this

clear at the beginning, they

will not succeed in the task.

Continuity


Participating students claim that this course is very powerful in helping them to become more

insightful about the lived experiences, emotions and perceptions of older people.

Purpose

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professional goals

The participants learn how to break out of

restrictive perspectives and develop their own

goals with the help of artistic tools and

techniques.

Individual experiences, and established links to

role models in world literature, through an in-

depth analysis of role models, expectations and

experiences, creates awareness for one’s own

role.

The learning and exploration of one’s own role

behavior in varying contexts, and the

development of personal competence move to

the center of the educational process.

The creative work helps to reflect upon one’s

own personality, knowledge and personal

strengths; to formulate one’s own wishes and

question the expectations one has about

themselves.


for

Take first steps towards putting one’s own

ideas into practice.

Achievement


It is possible that without someone’s’ input the

performance is less complete, in that way it is

possible to feel you have made a difference in

the context of the groups' work.


orientated goals

Observing reality and interpret this together

with theory is also something a professional

must do.

Students make strong advances in interpersonal

skills as they consider the positions of others

and as they gain confidence in articulating their

own views and responses.

It enables students to express themselves better,

a result that can be observed in their writings

and discussions.

Significance



matter

The module stimulates a

bigger interest and insightinto

older people as individuals

who have rich and interesting

perceptions to share.












contribution

All participants will recognise

pieces of their own “personal

stories”. This feeling of being

heard and seen is perceived

very strongly as appreciation

and acknowledgement



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The recognition of one’s own work comes

from the participants themselves, from the

trainers and, most importantly, from being

noticed by the public because of an exhibition

about their work.


All participants are given the feeling of being

“heard and seen.”


Questioning

Intensive observations which has to be transformed into art are articulated

through art can lead to questions like 'why', why not' and 'what if'.

Associating

Art is used to get insight in older peoples life. Existing art and the use of

artistic techniques is integrated in the learning process of health care workers

to learn about cultural and intergenerational contexts. Art is used to facilitate


express their own opinion.

Observing

The observations in this method make students think differently about older

people and makes them think differently about care in this domain.



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17 Visual Thinking Strategies

Description

Visual Thinking Strategies (VTS) is a method initiated by teacher-facilitated discussions of art images

and documented to have a cascading positive effect on both teachers and students. Thinking skills that

become habitual and transfer from lesson to lesson, oral and written language literacy, visual literacy,

and collaborative interactions among peers.

Students cultivate a willingness and ability to present their own ideas, while respecting and learning

from the perspectives of their peers. Engaged by contributing observations and ideas.

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It enables students to express

themselves. Students write

more and better as a result of

their VTS discussions.

Writing assignments are

collected and analysed and

provide evidence of growth

in writing and critical

thinking skills in relation to

their topic.


roles

Students are engaged by

contributing observations and

ideas through the medium of art.

They are guided by trained staff to

use their observations to discuss

issues around older age and

society. Images are especially

selected and sequenced in order to

challenge viewers appropriately.

Questions are asked of viewers

that most effectively engage their

cognitive thinking skills.


vulnerability

This is a suitable strategy for

students of all levels of ability.

It allows for different levels of

engagement. The students'

application of these skills

transfer to other subject areas

across the academic

curriculum.

Belonging


The students are part from a homogeneous group

where the discussions take place. As the work

continues, the students cultivate a willingness and

ability to present their own ideas, while

respecting and learning from the perspectives of

their peers


The students are challenged to reflect on their

own know-how in comparison to the


It cultivates a willingness and ability to present

their own ideas, while respecting and learning

from the perspectives of their peers.

Continuity

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Students can think critically about practice issues with older adults. Dealing with loneliness and

isolation. The older person with dementia in the hospital environment. Visual thinking strategies

can provide a vehicle for class discussions and sharing problems and issues that arise in the practice

environment.

Purpose


professional goals

VTS promote creative and critical thinking skills.

Students' transfer these crucial 21st century skills

to other subject areas across the academic

curriculum.

.


for

Take first steps towards putting one’s own ideas

into practice.

Achievement


made a difference

It is possible that without

someone’s’ input the

performance is less

complete, in that way it is

possible to feel you have

made a difference in the

context of the groups'

work.

Being able to realize personal and

professionally orientated goals

Observing reality and interpret

this together with theory is also

something a professional must do.

Students make strong advances in

interpersonal skills as they

consider the positions of others

and as they gain confidence in

articulating their own views and

responses.

It enables students to express

themselves better, a result that can

be observed in their writings and

discussions.



significant others

It cultivates a willingness and

ability to present their own

ideas, while respecting and

learning from the perspectives

of their peers.

Significance



matter

Students engage in new ways of

problem solving in challenging






person

All participants are given the

feeling of being “heard and



65

situations. Solutions to

problems in gerontology are

multidimensional and is an

exciting area to work. There is

room for creativity and

innovation in the way we

approach working with older

people.






seen.”


Recognition for student contribution is given through feedback from tutors and peer to peer feedback.


Questioning

Intensive observations, by a group ‘problem-solving’ process, which has to be

transformed into art are articulated through art can lead to questions like

'why', why not' and 'what if'.

Associating

Art is used to get insight in gerontology. Existing art and the use of artistic

techniques is integrated in the learning process of health care workers to learn

about cultural and intergenerational contexts. Art is used to facilitate


express their own opinion.

Observing

The observations in this method make students to think differently about

older people and makes them think differently about care in this domain.



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18 Stimulated by Dimentia

Description

students step in the shoes of persons with dementia and experience by role-playing games the

consequences of the dementia process and the impact of care on the well-being.

Thoughts and feelings of the care givers and receivers are the most important focus. Students have to

get outside their comfort zone and are confronted with known and unknown situations. They learn

questioning their behaviour and attitudes by means of observation and reflection. Learning is a

reciprocal process. How do they feel when being fed by caregivers? How do they feel when being

washed?

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Supportive because there are

moments of reflection on

their feelings and thoughts.

Enabling because students

get the opportunity to explore

their personal and

professional skills.


roles

They learn questioning their

behavior and attitudes by means

of observation and reflection.

In the caregiver role, students

can explore different

competencies and strategies of

care (creativity and problem

solving)

Students take charge of their

own learning.


vulnerability

The emphasis lies on the

learning curve not on being a

‘perfect’ nurse.

There is time to discuss

physical and emotional

vulnerabilities

Belonging


All the students go through the

same learning process. The

student is once part of the

group of caregivers and once

of the receivers


Students learn from each other


valid role to play

The get a description of the

role they have to play.

Every aspect of care is

explored in a valid role

Continuity


Theoretical concepts and practical skills are

applied.

In the caregiver role, students can explore

different competencies and strategies of care

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Purpose



goals

A) the method allows

students to learn about the

care for a specific group of

patiënt. The learn to think

about feelings, actions and

impact of certain actions.

That way they can discover

goals.

Having something


The aim is to better understand

the impact of care on the well-

being of a person.

experiencing the potential to


of care

By experiencing the impact of

the caregiver on the receiver,

students can feel that by acting

good they can make a

difference to the quality of care.

Achievement


Personal and professional knowledge and skills

can be applied and practiced in the training.


orientated goals

The emphasis lies on the learning curve not on

being a ‘perfect’ nurse. Personal and

professional knowledge and skills can be

applied and practice in the training.

Significance



matter

Boundaries are broken and

meetings are facilitated,

between different groups of

the population. It support and

enables intergenerational and

intercultural exchange.

The co-creative work in

intercultural and

intergenerational contexts

activates reflection and


relation to identity formation.

It is about building respect

between generations. To get

insight in the diversity of life

scripts to enhance people’s

understanding of other’s lives.




Experiencing the different

aspects of care, students get

insight in the complexity of

the care, the various

components and the skills

needed

By stepping in the shoes of the

care receiver the experience

the impact of care on their

own well-being. This

exercises gives students an

impression of how their own

acts impact the patient



contribution

By experiencing the impact

action can have on well-being,

students can belief they can be

important for elderly



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Recognition of their contribution is given by their classmates and by the teacher of the course in

the reflection moments.


Questioning

They have to question themselves what they feel, why they feel this and they

have to ask themselves what this means for depended elderly. They have to

question themselves how they should handle with dependent older people

during care.

Experimenting The role play helps the student to gain certain insights, and allows the student

to act differently and to evaluate if the other approach is better.



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19 Geragogy: a combination of gerontology and andragogy

Description

Direct contact with practice of learning in later life, in-service training at universities of the third age,

or other forms of learning in later life are promoted and motivated. This University syllabus, training

courses and courses at Third Age University are focused to self-empowerment, development of life

skills and social competences and all students are affected by those approaches.

Study analyses of specific educational needs of elderly people are used, as well as personal

experiences gained by the study projects. Very important is the combination of educational and other

expert knowledge, concerning special target groups – in this specific case, elderly people.

Students combine competences needed to work with older people and their own other specific

professional competences and try to find the best way to implement their expert knowledge (for

example: expert in social care, health care, psychological treatment).

Within carrying out the teaching, trainers include the students: they design syllabuses together, as well

as additional programmes that are of interest for older people.

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It is a supportive and enabling learning

environment, because it is not a compulsory

course and depends on students' interests, which

is supported by motivated teachers and the

environment which is still open for a lot of new

approaches.

syllabuses together, as well as additional

programmes that are of interest for elderly

people.


Students can combine gerogogist competences

with other professional competences (expert in

social or health care, psychological treatment)

and try to find the best way of implementing

their expert knowledge.

Within carrying out the teaching, trainers

include the students: they design

Belonging


Students are part of a group co-responsable for the development of educational material. Students

belong to a professional community.

Continuity

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Applying theoretical knowledge into practice and making links between practice as taught and

practice in real life

By individual tasks, using interactive connection with other professionals who are included in

the treatment.

Upgrading basic professional knowledge with skills needed for learning in later life.

Purpose



goals

A) Students design together

with teachers the syllabuses,

which means that personal

and professional goals can

be included in the material.

Having something


Improving professional skills

for using late life factors which

shape the transformative

learning process in different

health and social environment

experiencing the potential to

make a difference to the quality of

care

When students can add their

expertise into the learning

program in order to improve the

care, they experience the

potential to make a difference.

Achievement


Being able to facilitate learning in later life for

improving quality life in the third age


orientated goals

Focused to self-empowerment, development of

life skills and social competencies and all

students are affected by those approach.

Significance

Developing the belief that working in

gerontology gives accorded value and status

Students combine geragogist competencies

with other professional competencies and try

to find the best way of implementing their

expert knowledge.



Students combine geragogist competencies

with other professional competencies and try

to find the best way of implementing their

expert knowledge.


A) Recognition is given by the teachers, colleagues/professionals and elderly participants

(students)


Associating

Combination of educational and other expert knowledge. Students combine

competences needed to work with older people and their own other specific

professional competences and try to find the best way to implement their

expert knowledge



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Networking plus

Experimenting

Trainers include the students with different back grounds: they design

syllabuses together, as well as additional programs that are of interest for

older people.

motivating health and social care students to choose a...

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