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      When caring becomes an art - how clinical gaze are perceived to be developed

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          ABSTRACT

          Purpose

          This qualitative study describes nurses’ experiences and perceptions of how they develop the clinical gaze.

          Methods

          This qualitative study used an inductive approach and content analysis to assess the experiences of newly graduated nurses, nurse managers, and nursing teachers. Nineteen interviews were conducted. To achieve credibility, the study followed the guidelines of the Consolidated Criteria for Reporting Qualitative research (COREQ).

          Results

          Two themes emerged: nurses’ personal abilities and the learning culture. Learning culture was considered the foundation of the development of the clinical gaze. The clinical gaze was found to be developed in relationships with patients and when learning together with colleagues, in which the opportunities for reflection are central. To develop the clinical gaze, structures for learning activities, such as reflection, communication exercises, and simulation, are needed so that they become a natural part of daily work. This can also be achieved through supervision and skills training both at university and in a care context.

          Conclusions

          Prerequisites for the development of the clinical gaze include physical presence with the patient combined with learning activities such as conscious reflection with others in a safe learning culture.

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          Most cited references51

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          Using thematic analysis in psychology

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            Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

            Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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              World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

              (2014)
              Published research in English-language journals are increasingly required to carry a statement that the study has been approved and monitored by an Institutional Review Board in conformance with 45 CFR 46 standards if the study was conducted in the United States. Alternative language attesting conformity with the Helsinki Declaration is often included when the research was conducted in Europe or elsewhere. The Helsinki Declaration was created by the World Medical Association in 1964 (ten years before the Belmont Report) and has been amended several times. The Helsinki Declaration differs from its American version in several respects, the most significant of which is that it was developed by and for physicians. The term "patient" appears in many places where we would expect to see "subject." It is stated in several places that physicians must either conduct or have supervisory control of the research. The dual role of the physician-researcher is acknowledged, but it is made clear that the role of healer takes precedence over that of scientist. In the United States, the federal government developed and enforces regulations on researcher; in the rest of the world, the profession, or a significant part of it, took the initiative in defining and promoting good research practice, and governments in many countries have worked to harmonize their standards along these lines. The Helsinki Declaration is based less on key philosophical principles and more on prescriptive statements. Although there is significant overlap between the Belmont and the Helsinki guidelines, the latter extends much further into research design and publication. Elements in a research protocol, use of placebos, and obligation to enroll trials in public registries (to ensure that negative findings are not buried), and requirements to share findings with the research and professional communities are included in the Helsinki Declaration. As a practical matter, these are often part of the work of American IRBs, but not always as a formal requirement. Reflecting the socialist nature of many European counties, there is a requirement that provision be made for patients to be made whole regardless of the outcomes of the trial or if they happened to have been randomized to a control group that did not enjoy the benefits of a successful experimental intervention.
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                Author and article information

                Journal
                Int J Qual Stud Health Well-being
                Int J Qual Stud Health Well-being
                International Journal of Qualitative Studies on Health and Well-being
                Taylor & Francis
                1748-2623
                1748-2631
                8 December 2022
                2023
                8 December 2022
                : 18
                : 1
                : 2156659
                Affiliations
                [a ]Källestedt Clinical Skills Center, Region Västmanland; , Västerås, Sweden
                [b ]School of Health, Care and Social Welfare, Mälardalen University; , Västerås, Sweden
                [c ]School of Health, Care and Social Welfare, Mälardalen University; , Eskilstuna, Sweden
                [d ]Department of Medicine Solna, Karolinska Institutet; , Stockholm, Sweden
                Author notes
                CONTACT Marie-Louise Södersved Källestedt marielouise.sodersved.kallestedt@ 123456regionvastmanland.se School of Health, Care and Social Welfare, Mälardalen University; , Västerås SE-721 23, Sweden
                Author information
                https://orcid.org/0000-0001-6605-4528
                Article
                2156659
                10.1080/17482631.2022.2156659
                9744224
                36482509
                270abb5d-1cc3-45dd-ac3c-314a64bde508
                © 2022 Region Västmanland and Mälardalens universitet. Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 1, Tables: 1, References: 53, Pages: 1
                Categories
                Research Article
                Empirical Studies

                Health & Social care
                clinical gaze,clinical skills,education,health care,learning,patient safety,professional competence,reflection

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