Ingrid Femdal

Skikkethetsvurdering skal sikre at profesjonsstudenter har nødvendige forutsetninger for yrket de utdanner seg til og at de ikke utgjør en mulig fare for mennesker de møter i sin yrkesutøvelse. Norsk regelverk fastsetter at dersom det er tvil om en students skikkethet for yrket, skal det iverksettes en særskilt skikkethetsvurdering, og studenten skal tilbys utvidet veiledning (UV). Hensikten med studien er å utforske hvordan fagansatte i profesjonsutdanninger erfarer å veilede studenter ved UV i særskilt skikkethetsvurdering. Studien har et kvalitativ eksplorativt design og bygger på individuelle dybdeintervjuer. Dataanalysen bygger på Braun og Clarkes sekstrinns tematiske analyse. Resultatene viser at informantene anser relasjonen til, og samarbeidet med, studentene som avgjørende for veiledningen. Å skulle veilede og samtidig vurdere studenten beskrives som utfordrende. Informantene hadde ulikt syn på graden av taushetsplikt overfor skikkethetsansvarlig, noe som påvirket informasjonsflyten. Studien indikerer at utdanningsinstitusjonene bør gi utdypende informasjon til veiledere i UV om formelle rammer for en særskilt skikkethetsvurdering. Det bør diskuteres hvor grensene for veilederes veiledningsansvar kontra vurderingsansvar går. Forhold knyttet til informasjonsflyt mellom skikkethetsansvarlig og veileder bør avklares. Resultatene vil slik kunne få praktiske konsekvenser for gjennomføring av særskilt skikkethetsvurdering og UV. English abstract Extended Supervision During Special Suitability Assessment of Professional Students – Supervisors’ Experiences Suitability assessments are intended to ensure that students in professional study programs possess the necessary prerequisites for their respective professions, and that they do not pose a potential risk to individuals they encounter in their professional practice. Norwegian regulations stipulate that if there are doubts regarding a student’s professional suitability, a special suitability assessment must be initiated, and the student must be offered extended guidance. The purpose of this study is to explore how faculty members in professional study programs experience guiding students through extended guidance during special suitability assessments. The study is based on a qualitative exploratory design and individual in-depth interviews. Data analysis is conducted using Braun and Clarke’s six-step thematic analysis approach. The results show that informants consider the relationship and collaboration with students as crucial. Guiding whilst simultaneously assessing students is described as challenging. The informants had different views on the degree of confidentiality toward the competency assessment officer, affecting information flow. The study suggests that education institutions should provide information to supervisors about formal frameworks for suitability assessments. It should be discussed where the boundaries of supervisors’ supervisory responsibility versus assessment responsibility lie. The flow of information between the suitability officer and supervisor should be clarified. The results may have practical implications for the implementation of suitability assessments and the guidance process.

Current mental health policy emphasizes the importance of community-based service delivery for people with mental health problems to encompass personal recovery. The aim of this study is to explore how users and professionals construct the place’s influence on personal recovery in community mental health services. This is a qualitative, interpretive study based on ten individual, semi-structured interviews with users and professionals, respectively. A discourse analysis inspired by the work of Foucault was used to analyze the interviews. The findings show how place can be constructed as a potential for and as a barrier against recovery. Constructions of the aim of the services matter when choosing a place for the services. Further, constructions of user–professional relationships and flexibility are important in the constructions of an appropriate place for the services. The aim of the service, the user–professional relationship, and flexibility in choosing place were essential in the participants’ constructions. To find “the right place” for mental health services was constructed as context-sensitive and complex processes of assessment and co-determination. Trial registration The study is approved by the Regional Committee for Medical Research Ethics, Norway (REK-Midt 2011/2057)

Using focus groups, the group interaction provide an important source of data about the group process. The aim of this study is to explore how users and professionals in mixed focus groups interact when discussing power in user-professional relationships. By analysing three mixed focus group discussions where both mental health service users and professionals participate, the article contributes to the discussion on focus group interaction in mixed focus groups. The analysis is inspired by Stevens’ twelve-question guide for group interaction. The results show how the participants related to the vignettes, how they related to each other, and contradictions and disagreements in the focus groups discussing the vignettes. Despite the participant’s background as users and professionals, the vignettes engaged the group discussions and became a tool for equality within the groups. By discussing power in user-professional relationships in mixed focus groups, the vignettes were interpreted from perspectives as user, mental health workers and researchers. Mixed focus group interaction can make a valuable contribution to developing knowledge in the field of mental health service research.

Accessible Summary: What is known on the subject?: Implementation of user participation is described as a change from a paternalistic healthcare system to ideals of democratization where users’ voices are heard in relational interplays with health professionals. The ideological shift involves a transition from welfare dependency and professional control towards more active service‐user roles with associated rights and responsibilities. A collaborative relationship between users and professionals in mental health services is seen as important by both parties. Nevertheless, the health professionals find it challenging in practice to reorient their roles and to find productive ways to cooperate. What this paper adds to existing knowledge?: This study illuminates how user participation is negotiated and involves multiple and shifting subject positions in the collaboration between users and professionals in community mental health care. By taking different positions, the relationship between users and professionals develops through dynamic interaction. This study challenges understandings of equality and implicit “truths” in user participation by illuminating subtle forms of power and dilemmas that arise in user–professional negotiations. What are the implications for practice?: Instead of denying the appearance of power, it is important to question the execution of power in the interplay between users and professionals. Focusing on the negotiation processes between users and professionals is important for increasing reflection on and improving understanding of the dynamic in collaboration and speech. By focusing on negotiations, power can be used in productive ways in user–professional relationships. Introduction: Implementation of user participation is considered important in today's mental health care. Research shows, however, that user participation lacks clarity and provokes uncertainty regarding shifting roles.Aim: To investigate negotiation of user participation in a microstudy of interplay between users and health professionals in community mental health care.Method: This qualitative study is based on semi‐structured in‐depth interviews, involving ten service users and ten professionals in community mental health care in Norway. The analysis is inspired by Willig's model for Foucauldian discourse analysis.Results: The study illuminates the dynamic nature of user participation that arises through negotiation between users’ and professionals’ positions as change enablers, dependents, resisters, persuaders and knowledge holders.Discussion: Discourses of user participation allow for different subject positions in mental health care. User participation also involves government and questions of power, as well as ambitions of change and control. Professionals act in different ways to make and keep users active, participating, enterprising and self‐governing, and users respond and take part within the same discursive framework.Implications for practice: Awareness of subjects’ positions in discourses is important to increase reflection on the dynamic interplay in user–professional collaboration.

Sykepleiestudenter i praksis i psykisk helsearbeid kan være usikre i samhandlingssituasjoner med pasientene. Å reflektere over praksis kan hjelpe dem og kan gjøres gjennom forumspill. Studiens hensikt er å beskrive anvendelsen av forumspill som en dramapedagogisk form for refleksjon med fokus på sykepleierstudenters praksiserfaringer i psykisk helsearbeid. Gjennom deltakende observasjon ble forumspill anvendt, beskrevet og analysert. Forumspill anvender virkelighetsnære, selvopplevde fortellinger som skaper engasjement og en følelse av autentisitet. Gjennom intervensjonene blir nye perspektiver som kan lede til empati og nye fortellinger, synlige. Forumspill kan være en pedagogisk form for å reflektere over og diskutere praksiserfaringer i grupper. To reflect on situations from practice can contribute to nursing students’ knowledge of how to encounter patients and relatives. The aim of the study is to describe the application of Forum Theatre as a drama pedagogical form of reflection focusing on nursing students’ practical experiences in mental health care. Using students’ experienced situations from their practice was of importance as it contributed to their engagement and learning, and resulted in authenticity and new stories. Conclusion: Forum Theatre can be used to enhance nursing students’ reflection and learning about managing situations in alternative ways.