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Academic writing among ﬁrst-term students in the nursing programme at the Swedish Red Cross University College – A description of a three-term transprofessional project in collaboration with the library and the student support unit at Södertörn University

Background and objectives: The academization of the nursing education has emphasized the need for students to acquire academic literacies both for educational and clinical reasons. However, for long being a practical profession, nurse students do not always reﬂect on the importance of being academic literate. This aim of this article was to describe the teaching of introductory academic writing to ﬁrst-term students in the Swedish Red Cross University College’s nursing programme, implemented as a transprofessional collaboration project involving the Swedish Red Cross University College and the library as well as the student support unit at Södertörn University. Methods: A model was used for implementing teaching of academic literacies to ﬁrst-term nursing students embedded in a discipline-speciﬁc course. The model consisted of two seminars, one introductory seminar focusing on academic writing and how to search for, read, appraise, and use research articles and one feedback seminar. Peer feedback was performed by the students. In between the seminars, the students began to work on their course assignment and later ﬁnalized the assignment using the feedback provided by teachers and peers. Results: The transprofessional collaboration in teaching academic literacies was described as successful. Teachers and students found the embedding of academic writing in a subject-speciﬁc course as useful, although – from a student perspective – demanding and partly difﬁcult. The provision of feedback was regarded as helpful and encouraged the students to ﬁnish their assignments. Although being a team of teachers, the large class sizes resulted in an extensive workload and stressful situations. Yet another challenge, important for the sustainability of the model, was to win support for teaching academic literacies among all teachers in the nursing programme. Conclusions: The transprofessional collaboration when teaching academic literacies to ﬁrst-term nursing students have indicated advantages and challenges, of which both are of importance to consider carefully in the further planning and implementation of the project.


BACKGROUND
Academic literacies refer to skills in academic writing within a specific discipline and/or genre [1,2] and the acquisition of such competence during tertiary studies is highly valued, regardless of academic discipline. [2] This article aimed to describe a project for teaching introductory academic writing to first-term students in the Swedish Red Cross University College's [SRCUC] nursing programme, implemented as a transprofessional collaboration project involving the SRCUC and the library as well as the student support unit [SSU] at Södertörn University [SöU].
Embedding academic literacies into an undergraduate nursing programme provides future nurses with knowledge and skills of how to embrace and use research results, i.e. to provide an evidence-based care. [3] Garling (2008) [4] and Borglin (2012) [2] add the importance for student nurses to study academic writing as correct written communication is essential for the safety of the patient. Nursing students who joined academic teaching early in their education showed improved confidence in academic writing and subsequently improved their academic grading. [5] Likewise, these students were far more likely to continue their studies. [6] Jefferies et al. [3] agree and emphasize the need to address a consistency, and frequent practice, to enhance student progression and acquisition of academic literacies, not just when taught in a special course but also when embedded in subjectspecific tasks and contexts. [1,7,8] First-year student nurses perceived that targeted and repeated teaching regarding academic literacies, involving practical tasks, was required to achieve relevant knowledge and skills [9,10] and a majority of the students favoured the adding of academic writing into the education due to its relevance for their clinical future. [9,11] However, not all students were aware of the close connection between academic literacy skills and skills needed in clinical practice [12] and students generally found the gaining of this knowledge difficult, [9,13] regardless of whether instructions were offered in their mother tongue or in a second language. [9] Feedback, advice, guidance and encouragement from teachers improved student learning and self-efficacy, and had a positive effect on their ability to handle academic texts. [3,9] However, contentment was not shown by all students. Some preferred a more intense focus on the gaining of clinical, and not academic, skills. [3] From a Swedish perspective, the academization of the nursing education has shifted the focus from practical training to a professional education emphasizing scientific knowledge. A vast majority of nursing students lack prior experience of tertiary level studies, and thus have had no prior opportunities to acquire academic writing skills, a situation Sweden shares with other countries. [3,14,15] A recent government proposal has called for widening participation in university education nationwide. Altogether, these changes have resulted in a demographic change in the applicants to nursing programmes. [14] The curriculum of the SRCUC nursing programme [16] is based on the goals for undergraduate education set out in the Swedish Higher Education Act and the Higher Education Ordinance [17,18] stating that education is to be based on scholarship and proven experience. Additionally, the Swedish competence description for registered nurses outlines requirements for nurses' knowledge, for instance scientific ditto, [19] i.e. the competence and skills needed for using research in the ongoing generation of evidence-based knowledge. At SRCUC, the first-term students are introduced to academic literacies embedded in a course focusing on basic nursing. [20] This article aimed to describe a transprofessional collaboration project regarding the teaching of introductory academic writing to first-term nursing students. Co-teaching and transprofessional collaboration have proven useful for helping nurse academics to feel confident in teaching academic literacies. [2] First-year students are not always aware of the importance of acquiring academic literacies. Given that, there is a pedagogical challenge that can be eased by a transprofessional collaboration, [3] a collaboration also appreciated by students. [21] 2. ACADEMIC WRITING AT THE SRCUC 2.1 A brief description of the project Since 2013, a transprofessional collaborative three termproject in academic writing has been underway at SöU, involving the Department of Teaching and Learning in Higher Education, the library, the SSU and approximately 20 programmes or subjects. The theoretical underpinnings of the project derived from Lea and Street (1998) [1] and Gee (2012), [22] regarding academic literacies as a combination of skills in writing, reading and information seeking and that students benefit from gaining these skills in relevant and authentic contexts. The project itself has a two-fold aim: (1) to introduce students to academic writing and provide them with practical training in how to search for, read and write academic texts and (2) to focus on teachers and their acquisition of useful tools for teaching academic literacies to students.
In short, the teaching model consists of two seminars, one held at the beginning of the course and the second after two weeks. Each seminar is led by two teachers, one teacher from the SSU and one librarian. After the first seminar, the students begin their writing process. Prior to the second seminar, the students submit a 'work-in-progress'-text for individual feedback. These texts also provide a foundation for group-level feedback and discussion during seminar two. Based on the combined feedback provided, the students then finalize the assignment. For more detailed descriptions of the model, see Eklund Heinonen and Sköldvall (2015) [23] and Sköldvall, Rising, and Danielsson (2017). [24] In the text below, the SRCUC adaptation of the project is described.
The SRCUC entered this collaborative project as the first college outside the SöU-organisation. A detailed planning and the implementation of the project was executed by three nurse academics from the SRCUC collaborating with library and SSU representatives. During the planning process, the curriculum and syllabuses played important roles in ensuring that the teaching and assignment would correspond to the subject-specific course content and to the aims of the project respectively. Although most of the initial project plan was followed, adaptions were made, both prior to initial launch of the project and during the implementation phase. In the text below (section 2.3), these adaptations are described more detailed. Prior to launching, all teaching staff at the SRCUC were invited to an informative lecture on the project.

Participants
During the three term-project, nurse academics from the SR-CUC and teachers from the SSU (teaching Swedish) and the library participated (referred to as teachers in the text below), although in different numbers. Throughout project term I and II, 13 teachers participated: three from the SRCUC, seven from the SSU and three librarians. During the third and last term, most teaching was performed by two nurse academics at the SRCUC due to ease the transition from a collaboration to a solely SRCUC-run project. However, these two nurse academics were backed up by representatives from the library and the SSU.
As the project was embedded within a mandatory course of the nursing programme, all enrolled students joined the project, regardless of earlier experience. In total, 380 students participated, distributed as follows: 129 (term I), 139 (term II) and 112 (term III). Due to the widening participation, there was a heterogeneity among the students. Approximately one in six students was male, the age ranged from 19 to 50+ and there was an ethnic diversity represented among the students.

Implementation of the project
A written subject-specific (nursing) assignment formed the basis of the project, although the content was slightly changed during the project period. In broader terms, the implementation of the project consisted of the following four phases: 1) Initially, all students were made acquainted with the topic at a lecture introducing academic writing including how to search for, appraise and read scientific articles. The lecture was held jointly by SRCUC and SSU and library representatives. Each profession was responsible for the parts of the lecture corresponding with their specific competence (subject, language, or article search/references), offering the students a high-quality teaching session. The lecture was interactive as to increase the students' engagement and to adapt the teaching to their needs. In term I and II, the assignment involved article searches which the students were to perform individually. Due to being a rather complex task, and that the course was the very first of the first term, that task was removed in project term III and introduced in a course read in the end of the first term instead. In term III, due to an identified hardship among the students regarding how to read and adequately use the course literature in relation to the assignment, two teacher-led workshops focusing on subject related content, were added to the first phase.
2) During the second phase, the students initiated their writing process by immersing themselves in the course assignment. As guidance, they received a template, aligned with the IMRaD structure, providing relevant headings to use.
3) A third phase, following halfway through the writing process, involved a mandatory feedback seminar led by SR-CUC, library and SSU representatives. Prior to that seminar, the students submitted rough drafts of their written assignments. In term I and II, individual formative feedback was provided. A template was used in which the nurse academics provided subject-related response, while language, search approaches, and references were commented on by the library and the SSU representatives respectively. In term III, the individual formative feedback was removed due to the smaller number of nurse academics involved. However, the mandatory feedback seminar was kept, and the students were still encouraged to submit their rough drafts which were used (confidentially) to provide formative feedback, although on a group level. In all formative feedback, regardless of which term, strengths and problematic parts of the texts were identified, presented, and discussed to support and encourage the students in their continued writing process. Apart from the teacher feedback, the students provided each other peer feedback.

4)
In the fourth and final phase, supported and encouraged by all feedback given, the students continued their writing process until the final submission after which summative feedback (grading) was provided.

Teacher reflections on the project
At the end of each project circle, the teaching staff met for an evaluation meeting. The transprofessional collaboration was described as rewarding, stimulating, and educational. In general, the students were perceived as ambitious and talented, though some of them showed signs of ignorance and confusion when it came to writing the assignment. Additionally, some students were perceived as insecure and in want of detailed instructions.
Practical teaching problems were noted. Large class sizes and a low number of teachers involved were factors perceived to influence the teaching negatively. Although given careful considerations during planning, the timeframes of the project were proved to be tight, due to not being directly applicable to the course provided at the SRCUC. Extensive work was necessitated to ensure that feedback and grading was made on time. However stressful it may have been, the teachers involved believed the time invested to be 'paid back' later. Likewise, all teachers valued the project assignment as all parties realised that many of the students needed practising the tasks involved. However, placing a rather complex assignment at the very beginning of the first term, when the students hardly had had enough time to familiarize themselves with university studies, was perceived as challenging.
Outside the framework of the project, two major themes were reflected on. At first, the sustainability of the project as there had been a challenge to win support for the project among the other teaching staff at the SRCUC, a factor of importance as to prevent students' acquisition of academic literacies to end in the first term. Of importance to mention is that also structural and organisational factors embedded in the nursing programme hindered the teachers from applying the project ideas in other courses during the nursing programme. Secondly, the project resulted in students requesting support provided by the library and the SSU in a larger scale than before. Although appreciated, this intensified need for support pointed to the importance of planning and coordination as to respond to the needs of the students in the best way.

Student reflections on the project
At the end of each course, a student evaluation was conducted using an anonymous online questionnaire as to get knowledge, from a student perspective, on the course in general and the project specifically, to use as foundation for further planning and implementation. Some of the student reflections are viewed in the Figures 1 and 2 and the free text answers below. In project term II and III, this specific question was removed from the evaluation template. Instead, student satisfaction emerged implicitly in some of the other questions. Hence, only project term I results are displayed in this Figure. Most students were satisfied with the project and perceived the teaching and assignment as rewarding and fruitful for their studies, although the assignment, for some, was found difficult to deal with. However, most students mentioned that they valued that challenge, as they perceived that the bar being set high indicated a high-quality education.
At first, the assignment felt impossible, but you grew into it bit by bit. I think the level of dif-ficulty was all right, considering the time provided. So, overall, the assignment was a good [preparation] for the future education. [student, project term II] When writing assignments like this, students need teachers to explain and give much more examples than those we got. Do not forget that students feel bad and will lose their self-confidence when having to work on an assignment repeatedly. It was soooooo difficult! [student, project term I] Figure 2. The students' views on the value, for their future studies, to receive skills in academic writing The instructions for the assignment were perceived differently, although all students had access to the same written and verbal information.
The information was good, and it was clearly stated when the assignment was to be submitted.
[student, project term II] The template for the assignment was clear, as was the response template. Information regarding references and CINAHL was less clear. The assignment was relatively difficult, however there was enough time to finish it. [student, project term II] It was hard to understand the instructions. [student, project term II] The feedback on the students' rough drafts was perceived as an opportunity for skill development, both in the present and for the future, for instance regarding how to apply a critical approach and how to use academic language and references. Regarding the provision of peer feedback, some students found it hard to provide qualitative feedback, because of their self-perceived lack of knowledge about what to provide feedback on and how.
During the third project-term, teacher-led workshops were held to stimulate the students' learning and understanding.
The workshops were rewarding and challenging in a way that made us think more. In our group, we discussed a lot, and it contributed to all voices being heard. Thanks to listening to other students you got new insights and perspectives. I like this way of working! [student, project term III]

DISCUSSION
In the text below, advantages and challenges identified when planning for and implementing the academic writing-project at the SRCUC are discussed. The section ends with suggestions to use if/when planning and implementing similar projects.

Advantages
The project model, i.e. a transprofessional way of working to enhance students' acquisition of academic literacies, has proven useful in many ways. From a teacher perspective, thanks to the joint planning and implementation of seminars, all parties involved described an ongoing learning throughout the project period. For instance, the SRCUC nurse academics valued the competence of the librarians and SSU teachers as they, prior to project start, had no experience in teaching academic literacies. Another aspect of importance for the positive result, however not due to the project model itself, was that throughout the planning and implementation of the project, the group of teachers was steady. Given that continuity, the cooperation between the parties could develop positively and changes and improvements for the coming term, based on what had happened in former teaching sessions, could be suggested.
Both teachers and students found the combination of nursing and academic writing useful and rewarding as two essential areas for education and clinical practice were introduced early on. Other examples of embedding academic writing in subject specific assignments have been described in the literature. [7,8,13] As to increase the focus on the subject of interest, workshops on nursing were added as to stimulate and improve the students' learning. Although not part of the initial project model, that adaptation served the students' requirements well. However, the acquisition of subject-specific knowledge and academic literacies is to be finally tested when the students write their bachelor thesis at the end of the nursing programme. The first cohort of students having participated in the project are halfway through their education meaning that no final evaluation of their academic knowledge and skills has yet been made.
Teacher feedback to students is valuable as it creates opportunities for learning and serves as a tool both on an individual and a group level. [24] Within the project model, feedback was provided half-way. This approach allowed the teachers to identify strengths and weaknesses in the students' texts viewed as 'work-in-progress'. The written feedback was meant to encourage, guide, and support the students in their writing process. As was the verbal feedback provided at the seminar. The students valued the feedback given. However, it was proven that the feedback was not enough to finalize the assignment correctly. A large proportion of the final texts received failing grades, indicating a need to provide additional teaching measures before submission of the final text version.

Challenges
Although several advantages were identified, the project encounter challenges as well. During the first two project terms, large groups of students were admitted to the SRCUC, meaning that approximately 130 students/term participated in the project. The introductory seminar targeted the entire student group and given that, there was a challenge to successfully 'reach out' to all students. However, the group size was not the main problem. Instead, the low teacher-student ratio turned out to be a bigger problem. When carrying out projects such as this, a large proportion of time and teacher resources needs to be allocated for planning and qualitative implementation which implies a need for the management of the nursing education to realise the importance for student nurses to acquire academic literacies, both for educational and clinical reasons.
The planning and implementation of the project demanded time, engagement, and a willingness of all parties involved to work hard. The latter two factors were not a problem; time, however, did pose a general challenge in various ways. Academic writing has been identified as challenging for new students as they have to learn to master new skills and genres. [1,13] Through the provision of individual feedback students are enabled to acquire knowledge and skills and improve the quality of their production. Although being aware of its importance, the large number of students put the teachers in stressful situations to provide qualitative feedback and to grade assignments on time. In project term III, fewer students were admitted to SRCUC. Although fewer, the limited teacher resources that term resulted in that the individual feedback halfway was turned into group-level feedback. However, the students' poor knowledge in how to structure and write assignments indicated that individualized feedback, preferably provided on multiple occasions, was still much needed. Likewise, there was an inherent pedagogical challenge to overcome to persuade student nurses, who were not always prepared for, or aware of, the importance of acquiring academic literacies.
As being the first partner off the SöU organisation, the SR-CUC project hit an until then unknown, or at least not considered, problem due to the two organisations using different online platforms for education. The collaborative way of working required a common platform, both for planning and implementation. The two-platform situation created technical obstacles that had to be solved before the joint work could proceed smoothly.

Limitations
When introducing such a project, with an implicit intention of turning it into a regular part of the education, some infor- mation is relevant to gain for further planning and implementation. In the end of each course/project, the students were asked to fill in an anonymous online questionnaire including various questions regarding the course/project. The questionnaire provided quantitative and qualitative data. However, no statistical calculations were performed. Instead the data were used descriptively and illustratively. Likewise, the qualitative data were not analysed but used to provide a rough understanding of the students' opinions and views. Yet another limitation was that the initial project was slightly converted during the three-term period. Due to that, an evaluation of the project itself was not possible. Instead, evaluations were made from term to term, resulting in no overall knowledge of the project being implemented.

CONCLUSION
The aim of this article was to describe the implementation of a transprofessional collaboration project addressing the acquisition of academic literacies among first-term students at the SRCUC nursing programme. According to the two-fold aim of the project itself, namely, to introduce students to academic writing and to support nurse academics' acquisition of useful tools for teaching academic literacies to students, the project can be viewed as successful. However, apart from the positive aspects, several challenges and limitations were encountered pointing at the importance of receiving adequate resources of various kinds, including management support and goodwill. Additionally, data gained from the students' project evaluations were not statistically analysed. Given that, the project success can solely be addressed on a descriptive and illustrative level. Further research is needed to gain knowledge of the students' knowledge gain after participating in the project. Of similar interest is to gain understanding of the students' perspectives on the acquiring and using of skills in academic writing and reading.

Suggestions for planning and implementation of similar projects
After the three-term project period, the SRCUC is now solely administering the introductory teaching in academic litera-cies. Along the project implementation, interested and engaged nurse academics at the SRCUC have been involved. In the future, the handing over to colleagues could be challenging. How is the teaching best described? How can present accomplishments be taken forward in the best way? Another question of importance is how to maintain the acquired knowledge and skills of the first-term students during the rest of their education. Söderlundh et al. (2017) [25] have summarized aspects of importance for projects like this to continue to thrive. Additional to their descriptions, the author has, based on the many valuable experiences made during the implementation of the SRCUC project, listed some suggestions for consideration when initiating similar projects: 1) Gain support for the project within the university management as to receive adequate time and teacher resources to enable project implementation.
2) Gain support for the project among colleagues to enable sustainable implementation of academic writing throughout the educational programme.
3) Start planning at an early stage to ensure that teaching and assignments correspond to the course curriculum and are relevant for the acquisition of academic literacies. 4) A steady group of teachers ensures a necessary continuity. 5) A transprofessional collaboration is advantageous and improves knowledge, competence, and skills of each profession, let alone the students. 6) Schedule several feedback sessions during the students' writing process. If possible, provide individual feedback and encourage the students to provide peer feedback.