The project focuses on education if nursing students through innovative learning methods to intervene in multicultural contexts and with multicultural people. The project aims to educate the nursing students but extends its reach to the key-people in the health community and organizations, mentors and teachers.In Europe, a new approach in healthcare is needed to effectively face the growing prevalence of migratory flows, contributing to having in Europe minorities, migrants, refugees and asylum seekers in clinical settings. The World Health Organization (2019) emphasized the importance of social inclusion of migrants, refugees, and asylum seekers, reinforcing the needs of the development of health professionals' skills in multicultural contexts. The development of these skills should be core components of professional education, training, certification, continuing education, and development, reinforcing the role played by academia in generating such knowledge and translating it into practice.Current reports from major European entities sustain the need for early training of healthcare students and training courses for the development of professionals in the scope of caring for minorities, migrants, refugees, and asylum seekers. The European health care services have the challenge to provide more and better quality care in multicultural contexts and to a multicultural people within the same resources. The only approach to achieve the main goal to provide proper care is through the development of health professionals' skills highlighting the role of nurses in this field, as essential to achieve these societal goals. However, higher education institutions of health professionals must integrate caring for minorities, migrants and asylum seekers courses and learning methods into their curriculum, so that students will be future-proof and act as ambassadors in clinical settings who strive for the provision of quality care.Therefore, the main objective of the MulticulturalCare project is to develop the MulticulturalCare Model for nursing education in caring for multicultural people and in multicultural contexts. It will be a generic model containing the organizational, educational and professional elements for the development of students’ competences in this field. In addition to the clinical recommendations of best practices in this field, the MulticulturalCare Model will be composed of a pedagogical dimension that will stimulate nursing students the need to think critically about the realities around them. It will be possible through the Simulation Scenarios about this thematic, which will be made freely available to students, teachers, and nurses in an E-book format as a didactic learning tool.The MulticulturalCare Model is reinforced by a community of teaching, students and professionals in the field of nursing, designated as the MulticulturalCare Community. The community serves as a platform to spread their achievements and exchange good practices in the field of nursing that aim to educate for proper care to minorities, migrants, refugees, and asylum seekers.

In the degrees in health sciences (i.e. Nursing, Medicine or Midwifery), the acquisition of skills for the performance of invasive techniques or procedures (that is techniques that imply the “invasion” of some part of the body with needles, tubes or other devices) depends largely on practical training in simulation rooms. In these rooms, task trainers that reproduce a part of the human body are used. These task trainers are designed to provide as faithfully as possible the sensations that may be experienced when performing the procedure on a real person. However they do not incorporate any further technology beyond the materials with which they have been manufactured. When students practice invasive techniques using this type of task trainers, they make the effort of imagining the internal anatomical structures, something essential in order to perform this type of invasive techniques.The main purpose of this project was to integrate the HoloLens-based Augmented Reality (AR) technology in invasive procedures training, making possible the visualization of internal anatomical structures by the students while they are practising on the task trainers. The main feature of AR is the combination of the visualization of the real world together with the visualization of virtual images. To do that, an AR software, named ARSim2Care, has been developed, supplemented by a Manual of Clinical Procedures and the Educational Material associated with the software; all of these are available in four languages: English, Spanish, Portuguese and Nederlands.The project has been carried out by three higher education institutions, the UPNA in Spain, the ESEnfC in Portugal and the EhB in Belgium, in addition to a Spanish company, iAR. Moreover, the Sant Joan de Deu Campus Docent in Barcelona and the University of Manresa have adhered to the project. Different activities have been performed to complete the development of the different intellectual products, the training of teachers and students and the subsequent dissemination of the product and findings of the project. On one hand, different transnational meetings made possible the coordination of the intellectual outputs and the global management of the project. A total of 18 teachers from the partner universities and members of the technological company participated in these meetings. On the other hand, a five-days workshop was organised focussed on the AR application in the field of health sciences, in which 15 nursing students and 6 teachers from partner universities participated. In this workshop, a preliminary assessment of the functionality of the prototype of the software Arsim2care was performed. Additionally, a virtual workshop about AR and the software Arsim2care was held with the participation of 15 nursing teachers from the partner universities. In this meeting, the training material associated with the software was developed. Lastly, a multiplicator event, which consisted in a “Online workshop about the application of new technologies in Health Sciences Education”, offered the opportunity of presenting information about serius games, AR and virtual reality in Health Sciences Education, and the final results of the project. A total of 136 teachers and healthcare professionals from Spain and Lationamerica participated in this workshop. It should be noted that 50 nursing students from the universities associated with the project (Sant Joan de Deu de Barcelona Campus Docent and the University of Manresa) participated in the final assessment of the prototype of the software Arsim2care. The impact of the project has been important at different levels and for different groups. Numerous written media echoed the project and the project leaders participated in conferences and workshops expressly invited to talk about the project. The students who assessed the software considered that the impact of it on their training may be very beneficial, as it increases their motivation and stimulates their active learning, increasing their interest on the topic under study. Similarly, the teachers considered that the possibility of visualizing the anatomical internal structures during the training of clinical invasive procedures is an added advantage to the traditional training of this subject. In conclusion, this is a way to increase the quality of the training for future healthcare professionals, that will undoubtedly affect the care they will provide in their future professional activity. Indeed, these results will have a long-term benefit on the care offered to patients and their quality of life. The improvement of the technical skills and techniques provided by healthcare professionals should translate into excellent care.

The problem why the project was created: “The study conducted in different European countries showed that the general prevalence of pressure sores among hospitalised patients is 18%...” (Lamatiste käsitlus … 2016). Level of knowledge about the prevention and treatment of ulcer is low among the nurses. The study conducted in Sweden highlighted the fact that the average level of prevention of pressure sores among nursing staff was 58.9% (Gunningberg 2015: 462) and about the treatment of pressures sores (cleaning, choosing suitable patch dressings, assessment) was 51.4% (Galvão et al 2017: 295). The awareness about the prevention of pressure sores was 65.5% among the nurses in Estonia, the level of knowledge about the pressure sore risk was 67%. The level of knowledge about the conservative treatment was 53.48% (Eensoo et al 2017). Tallinn Health Care College Development Plan 2017–2021 states that the mission of the College is to train innovately and critically thinking health professionals with technological competences. The vision is to address current challenges in collaboration with national and international partners involving the learners. Skills for using the methods of simulation modelling, proficiency in foreign languages, skills for working in the multicultural environment and digital competences form an important part of the competences of nurses. Based on lifelong learning strategy, the project promotes international collaboration, during which common challenges are addressed, innovative practices are being shared and developed (Erasmus+ strategic collaboration within education 2018). The aim of the project was to create attractive e-learning course to cover the topic of the care of chronic wounds, based on the latest research results thus supporting the transfer of latest research outputs into education. The added value of such a course is that the prepared e-learning materials are based on the long-term practical experiences of lecturers. The use of digital technologies and animations make the course innovative, improve teaching pedagogies and support the acquisition of new knowledge and skills. The project is much more effective in case it is implemented internationally, as different countries have different experience in the treatment of chronic wounds. VOHRA - the largest, most active physician wound management group- highlights that harmonization of the treatment of ulcers at the international level is extremely important for the improvement of the quality of nursing care.The project participants were partner institutions from Finland, Portugal, Hungary and Turkey. The main target group was nursing students of Tallinn Health Care College and partner universities; and Erasmus+ exchange students. The wider target group for follow-up activities were and are hospital nurses and home caregivers in Estonia and abroad.Modern teaching methods and aids have to be attractive due to the rapid development of the digital world and the changed expectations of learners. As a result of the project an interactive e-learning course (course and 5 practical simulation tasks), 2 questionnaires and a mobile application were created. The interactive web environment in English enables learners to watch study videos, get acquainted with study materials about pressure sores and venous ulcers and fill in tests.The questionnaires enable to assess students´ knowledge before and after passing the course. The results have shown significant improvement of students´ knowledge, especially about the different stages of chronic wounds. The e-course and mobile app enable to follow the course and learn wherever the learner is and whenever he or she has time. The e-learning course is supplemented by live animations, enabling to demonstrate the different forms and stages of a chronic wound and the process of ulcer healing, i.e. how granulation tissue is formed and how it covers the base of the ulcer. The use of animation in studies makes it possible to teach safely, without harming anybody. An additional value is that one can compare, repeat, complement and adjust the current methodologies in simulation environment. The course is integrated into the nursing curricula and is used for the preparation of nursing students by all participating institutions. As it is in English, it can also be offered for exchange students and as an additional training course for practicing nurses and other interested stakeholders, thereby ensuring longer-term benefits and sustainability of the course.The results of the project are important both for nurses in Estonia and abroad, raising the level of their professional preparation. The needs of aging population make such knowledge and practical experiences especially important to be able to provide high quality services. The College plans to apply for the approval from VOHRA in order to get the course approved by a professional international organization.

"The Facilitators’ network aims to be a programme that promotes the social and educational function of sport. On this basis, we intend to create the FIT2FIT campaign. This is a transnational project organised by IUNA in partnership with several organisations interested in promoting sport as a means for professional and personal growth and the civic participation of young people by means of training young university students to create social entrepreneurship projects.The title of the campaign is a pun on the word ""Fit"" which in English has two meanings ""Fit” as in keeping ""Fit"" and “fitting in”. Within this context it conveys 2 messages: 1) promotion of healthy lifestyle habits and, 2) the need for inclusion within society. It reminds us of the idea that through sport it is possible to “fit in” or include young people in society.Sport must be seen as much more than just physical activity. As non-formal education it can help young people to develop healthy lifestyles and also teach valuable life skills and help in the process of personal and professional development. This is particularly true for young people from disadvantaged backgrounds.For these reasons the FIT2FIT campaign will be created. It offers 16 young people aged between 18 and 25 pedagogical training, professional preparation and education in leadership and business skills using the topic of inclusion through sport. At the end of the training, the young people will be integrated into a Group of Facilitators who will facilitate the construction of social and sports entrepreneurship which will be part of the FIT2FIT campaign. The facilitators will act as multipliers at 9 Portuguese, Italian and Croatian higher education institutions. The purpose of the organisation of 8 seminars is to train around 240 young volunteers who are invited to gain organisational and social entrepreneurship competencies which will lead to the implementation of at least 20 new educational and social sport projects aimed at 3000 young people at social risk.By promoting the multiplication and civic participation of young facilitators and young volunteers using a sustainable business model, we believe we are promoting the employment and inclusion of young people on the job market and at the same time, involving them in the resolution of social and educational issues via the use of the practice of inclusive sport for young people at social risk."

The primary context of the project is nursing education and it is focused on curriculum development. The need for patients’ self-management support is increasing in the current aging Europe. Therefore, a new approach in health care is needed to effectively face the growing demand for tailor-made and patient-centered care in the coming years, by providing smarter care, from a distance (online or digital), with more focused on prevention and early detection of chronic conditions as well as treatment compliance. The project consortium consisted of five institutions and 12 participants, all were teachers from various fields of nursing education. The teachers were from Portugal, Slovenia, Finland (Karelia, TAMK), and Belgium. In the consortium, Southern, Eastern, Middle and Northern areas of Europe were present. The main objective of the project was to develop the DigiNurse Model (IO1) for nursing education. The model offers a formally structured concept for incorporation of learning of the digital skills into the nursing curriculum. In addition, it consists of concrete objectives for students' learning digital skills needed in coaching of self-management of patients with chronic condition. Furthermore, evaluation criteria for digital skills and coaching of self-management are developed. The objectives included teachers' and students' training to use the model. In the Kick off meeting, November 2017 (M1, WP1, WP2), the consortium chose the tools and methods for communicating and started to prepare the quality plan of the project. The development of the model started and the concepts for literature review were chosen. TAMK conducted the review on the best practices in teaching and learning digital nursing, Karelia on the concept of digital coaching in health care, TMK on coaching techniques, Slovenia on supporting self-management, digital coaching and empowerment and ESEnfC on the experimental research applied to health care technologies. The next step was the development of a questionnaire for students on their perceptions of digital competences. The questions were elaborated based on the conceptual models used, namely the Technology Acceptance Model and pedagogical models. The results provided conceptual support to the DigiNurse model. The project participants chose the pedagogical bases and the key concepts of DigiNurse model, defined digital learning goals of the model and prepared piloting plans. The consortium defined evaluation criteria for digital competencies, too. Pilots of the components of the model started with students at a national and later at an international level. Feedback on pilots was collected both orally and using questionnaires. Finally, the DigiNurse model was ready and got its visual appearance (WP2,3,4). The number of trained students was N=552 (including international pilot), and the number of trained teachers, mentors and researchers N=165. DigiNurse Model is supported by the DigiNurse Community, the second intellectual output (IO2, WP5). DigiNurse The Community consists of teaching and training professionals in the field of nursing. It brings together the professionals and experts who are interested in modern digital methods of nursing education. The community serves as a platform to spread new ideas and digital innovations in the nursing field. At the end the DigiNurse community consisted of a. 50 professional members. Due to the new community members of DigiCare (started 2019) and SmartNurse projects (started 2020), education and curriculum development of students and teachers continues through the community for several years. This supports the sustainability of the project. Invitations for membership from other institutions and countries has been initiated through social media. The third project result (intellectual output) included guidelines (IO3) that offer online information about the application of the model and tools and methods for teaching and learning digital nursing. The guidelines form a guide document to get the most benefit out of the DigiNurse model. In the second project year the project members decided to publish an e-book. It includes the best practices in using the model, practical advice on how to apply the model and embed the model into the curriculum. At the beginning of the project, the consortium members started dissemination activities (WP5, see Annex Dissemination). Also, social media was used; DigiNurse Community and DigiNurse Community Group websites, WhatsApp, face-book (TAMK), Intranets, etc. Multiplier events for dissemination were held during the third year. DigiNurse Community workshop was organised by ESEnfC and DigiNurse Community Seminar by Karelia, both of them in 2020. Management and Quality Assurance meeting was held as a webinar Nov 30 to Dec1 (WP6).According to students and teachers feedback the model provides a good way to learn and teach digital coaching of patients. A long-term impact is neither possible nor relevant to measure during this project.