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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

This study aims to examine the use of reflective pedagogies in sustainability leadership education by investigating two specific pedagogical tools—the Portfolio and Pod—employed by the Master’s in Strategic Leadership towards Sustainability (MSLS) program at Blekinge Institute of Technology in Karlskrona, Sweden. The study analyzed data gathered from student surveys, teacher interviews, and staff reflections to determine the benefits and challenges faced by students and staff in implementing and engaging with these pedagogical tools. Benefits include the provision of distinct structures to guide student reflection towards individual skill development and the use of collective reflection to encourage generative dialogue between students and staff. This holds benefits for collaboration, self-awareness, understanding of multiple perspectives, and creating self-directed graduates. Staff and students also, however, suggest a number of challenges. These include the ‘constrictive’ nature of guided reflection and the emotional and mental load faced by staff in hosting and holding students through often challenging personal reflective processes. For the potential of reflective pedagogies to be truly realized for Education for Sustainable Development in higher education institutions need to develop an understanding of the impacts that reflective pedagogies have on students and teachers and create institutional structures to support them.

In nursing education, simulation-based learning (SBL) is often used to bridge theoretical knowledge and practical application, supporting nursing students in developing their critical thinking (CT) skills. Despite the benefits of using SBL in nursing education, research gaps remain in understanding student learning outcomes. Furthermore, there is a lack of studies describing the specific use of technology in its application. The objective of this study was to explore strategies for learning and the use of technology to enhance nursing students’ CT within the SBL context. This research was conducted as a qualitative pilot study, using a semistructured interview technique to gather insights from teachers at 2 universities in the south of Sweden. The obtained data were analysed in accordance with the phenomenographic analysis introduced by Sjöström and Dahlgren. The results revealed participants’ perceptions of useful strategies for student learning and different ways of using technology. In particular, the results are reflected in 5 descriptions of categories: motivating environment, facilitating preparations, active participation, student-centeredness and reflective observations. While the findings may not be directly applicable to clinical practice, the study’s findings offer examples of effective strategies for student learning and technology use, thus providing valuable guidance for teachers implementing SBL in nursing education. To gain a more comprehensive understanding of using SBL as a teaching method, future research should aim to investigate nursing students’ experiences of how CT is promoted via simulations.

Background Generative Artificial Intelligence (GAI) has significantly impacted education at all levels, including health professional education. Understanding students’ experiences is essential to enhancing AI literacy, adapting education to GAI, and implementing GAI technology. Therefore, the aim was to explore physiotherapy students’ experiences of and thoughts on GAI in their education, and its potential implications for their future careers in healthcare. Methods Qualitative descriptive design. Focus groups were conducted, using a semi-structured interview guide, at the Physiotherapy program at Linköping University, Sweden, from March to April 2024. The 15 students were organized into three focus groups, one for each education year. The data was analyzed using inductive content analysis. Results An overarching theme “GAI—Great potential if navigating the challenges” emerged from three categories: 1) “Areas of GAI use in the learning process”: Students viewed GAI as a tool for introduction and inspiration, assimilating course content and enhancing clinical reasoning and problem-solving; 2) “Optimizing GAI use in education”: Students found GAI to be timesaving, tailored, and as a virtual study partner and teacher. They discussed the pros and cons of learning, concerns on permitted GAI usage, the need for a critical approach, and how individual experiences and interests influenced their interactions with GAI; 3) “Future with GAI in education and profession”: Students believed future GAI would be more reliable, use subject-specific GAI models and enhance health care delivery, but also pose risks related to profit motives and knowledge gaps. Conclusion Physiotherapy students found GAI beneficial for learning and clinical reasoning but expressed concerns about its impact on learning quality. They emphasized the importance of a critical approach when using GAI and the need for organizational support, including supporting permitted GAI use. Students believed that future advanced GAI models could provide accurate and reliable educational tools and healthcare tools supporting documentation and evidence-based decision-making. However, potential risks include business profit motives and knowledge gaps. Navigating these challenges is essential to fully leveraging GAI’s benefits in education and physiotherapy practice. Therefore, fostering a critical approach and ensuring robust organizational support is crucial for maximizing the positive impact of GAI in physiotherapy.

Purpose – The purpose of this paper is to investigate what are perceived to be the main challenges associated with the integration of social sustainability into engineering education at the KTH Royal Institute of Technology, Stockholm. Design/methodology/approach – Semi-structured interviews were conducted with programme leaders and teachers from four engineering programmes. The paper focuses on how the concept of social sustainability is defined and operationalised in the selected engineering programmes, how social sustainability is integrated and taught, and what resources are required to support teachers and programme leaders as social sustainability educators. Findings – The findings show that programme leaders and teachers at KTH struggle to understand the concept of social sustainability. The vague and value-laden nature of the concept is considered a challenge when operationalising educational policy goals on social sustainability into effective learning outcomes and activities. A consequence is that the responsibility for lesson content ultimately falls on the individual teacher. Study visits and role-play are seen as the most effective tools when integrating social sustainability into the engineering curriculum. Allocation of specific resources including supplementary sustainability training for teachers and economic incentives are considered crucial to successful integration of social sustainability. The findings indicate that social sustainability education needs to be built on a theoretical foundation. It is therefore suggested that a literature canon be established that clarifies the contours of social sustainability. Practical implications – The findings of the paper can be used as a basis for discussion regarding measures for improving social sustainability training in engineering education, a subject which has attracted relatively little attention, to date. Originality/value – There is a noticeable lack of empirical research on how technical universities integrate social sustainability into engineering education. The paper provides an account of how actors directly involved in this work – programme leaders and teachers – define and operationalise the social dimension of sustainable development in their engineering curricula, the pedagogical tools they consider effective when teaching social sustainability issues to engineering students, and the resources they believe are needed to strengthen those efforts.

Background Increased health research capacity is needed in low- and middle-income countries to respond to local health challenges. Technology-aided teaching approaches, such as blended learning (BL), can stimulate international education collaborations and connect skilled scientists who can jointly contribute to the efforts to address local shortages of high-level research capacity. The African Regional Capacity Development for Health Systems and Services Research (ARCADE HSSR) was a European Union-funded project implemented from 2011 to 2015. The project consortium partners worked together to expand access to research training and to build the research capacity of post-graduate students. This paper presents a case study of the first course in the project, which focused on a meta-analysis of diagnostic accuracy studies and was delivered in 2013 through collaboration by universities in Uganda, Sweden and South Africa. Methods We conducted a mixed-methods case study involving student course evaluations, participant observation, interviews with teaching faculty and student feedback collected through group discussion. Quantitative data were analysed using frequencies, and qualitative data using thematic analysis. Results A traditional face-to-face course was adapted for BL using a mixture of online resources and materials, synchronous online interaction between students and teachers across different countries complemented by face-to-face meetings, and in-class interaction between students and tutors. Synchronous online discussions led by Makerere University were the central learning technique in the course. The learners appreciated the BL design and reported that they were highly motivated and actively engaged throughout the course. The teams implementing the course were small, with individual faculty members and staff members carrying out many extra responsibilities; yet, some necessary competencies for course design were not available. Conclusions BL is a feasible approach to simultaneously draw globally available skills into cross-national, high-level skills training in multiple countries. This method can overcome access barriers to research methods courses and can offer engaging formats and personalised learning experiences. BL enables teaching and learning from experts and peers across the globe with minimal disruption to students’ daily schedules. Transforming a face-to-face course into a blended course that fulfils its full potential requires concerted effort and dedicated technological and pedagogical support.

Background The tutorial group and its dynamics are a cornerstone of problem-based learning (PBL). The tutor’s support varies according to the setting, and it is pertinent to explore group effectiveness in relation to different settings, for example online or campus-based. The PBL groups’ effectiveness can partly be assessed in terms of cognitive and motivational aspects, using a self-report tool to measure PBL group effectiveness, the Tutorial Group Effectiveness Instrument (TGEI). This study’s aim was to explore tutor participation in variations of online and campus-based tutorial groups in relation to group effectiveness. A secondary aim was to validate a tool for assessing tutorial group effectiveness in a Swedish context. Methods A cross-sectional study was conducted with advanced-level nursing students studying to become specialised nurses or midwives at a Swedish university. The TGEI was used to measure motivational and cognitive aspects in addition to overall group effectiveness. The instrument’s items were translated into Swedish and refined with an expert group and students. The responses were calculated descriptively and compared between groups using the Mann–Whitney U and Kruskal–Wallis tests. A psychometric evaluation was performed using the Mokken scale analysis. The subscale scores were compared between three different tutor settings: the tutor present face-to-face in the room, the tutor present online and the consultant tutor not present in the room and giving support asynchronously. Results All the invited students ( n  = 221) participated in the study. There were no differences in motivational or cognitive aspects between students with or without prior PBL experience, nor between men and women. Higher scores were identified on cognitive aspects (22.6, 24.6 and 21.3; p  < 0.001), motivational aspects (26.3, 27 and 24.5; p  = 002) and group effectiveness (4.1, 4.3, 3.8, p  = 0.02) for the two synchronously tutored groups compared to the asynchronously tutored group. The TGEI subscales showed adequate homogeneity. Conclusions The tutor’s presence is productive for PBL group effectiveness. However, the tutor need not be in the actual room but can provide support in online settings as long as the tutoring is synchronous.

Purpose: The aim of this study is to contribute to the quality improvement and long-term strategic development of education for sustainable development (ESD) in engineering education curricula. Design/methodology/approach: The content in 70 courses in environment and SD were characterized and quantified using course document text analysis. Additionally, two questionnaires were sent to students and alumni at Chalmers, and interviews and focus group discussions were conducted with representatives from 16 Swedish companies and five organizations. Findings: It was found that industry demands a broader range of competences in SD amongst engineers in general than what is currently provided. In total, 35 per cent of alumni claim they encounter sustainability issues from sometimes to daily in their work. However, only half of them believe they possess enough competences to make decisions from a sustainability perspective. Quantity, coverage and the level of integration in the educational programme all appear to be important for the students' perceived competences on SD and for the importance that they put on achieving SD. Originality/value: Earlier research has reported on how to further develop the idea and design of ESD and on competence needs in general. Few attempts have been made to assess industry's needs of competences in SD. This paper sheds light on how engineering universities educate for SD and benchmarks this to industry's needs in an exploratory case study, using Chalmers as an example.

Venepuncture and the insertion of peripheral venous catheters are common tasks in health care, and training in these procedures is included in nursing programmes. Evidence of nursing students' knowledge and skills in these procedures is limited. The main aim of this study was to assess nursing students' knowledge and skills when performing venepuncture and inserting peripheral venous catheters. Potential associations between level of knowledge and skills, self-training, self-efficacy, and demographic characteristics were also investigated. The assessment was performed by lecturers at a university college in Sweden using the two previously tested instruments “Assess Venepuncture” and “Assess Peripheral Venous Catheter Insertion”. Between 81% and 100% of steps were carried out correctly by the students. The step with the highest rating was “Uses gloves”, and lowest rating was ‘Informs the patients about the possibility of obtaining local anaesthesia’. Significant correlations between degree of self-training and correct performance were found in the group of students who registered their self-training. No associations between demographic characteristics and correct performances were found. Assessing that students have achieved adequate levels of knowledge and skills in these procedures at different levels of the nursing education is of importance to prevent complications and support patient safety. •Learning of practical skills should consists of theoretical and practical introduction, training and compulsory assessments.•Nursing students' practical skills can be assessed when validated instruments are used in systematic assessment situations.•The validated instruments can be utilized at different levels in the programme.