Swedish student nurses' perception of peer learning as an educational model during clinical practice in a hospital setting-an evaluation study

BACKGROUND

Peer learning, a collaborative learning model has no tradition in clinical education for undergraduate student nurses in Sweden, and little is reported of the student experience. An increasing number of students have led to a pressing need for preceptors and clinical placements thus, highlighting the need for a supportive educational model. The objectives for the current study were to explore how student nurses' evaluated peer learning as an educational model during clinical practice in a hospital setting, and to compare perceptions among student nurses from year one and three.

METHODS

A questionnaire developed for the purpose of this study was developed and responded to by 62 (year one) and 73 (year three) student nurses. Data were collected between 2011 and 2013. The questionnaire contained six open- ended and eight closed questions on a four point Likert-scale. Written responses were analysed by content analysis and the closed questions by using descriptive statistics. Mann-Whitney U-test was used to examine differences in relation to students from year one and three.

RESULTS

The peer learning experience was evaluated in a positive way. Statistical significance differences were shown for two out of eight closed questions. The peer learning activities were evaluated as supportive and relevant for learning. Three categories emerged from the content analysis: "a feeling of safety", "a sense of competition" and "the learning experience".

CONCLUSION

A feeling of safety seems to be connected to students' perception of increased learning and independence. However, the sense of negative competition needs to be addressed when students are prepared for the teaching and learning activities in the peer learning model. Finally, what needs to be further investigated is what challenges and opportunities the peer learning model presents to preceptors.

Who wants to work with older people? Swedish student nurses' willingness to work in elderly care--a questionnaire study

BACKGROUND

The aging population is a globally recognized challenge for the health care service. The growing number of older people will probably lead to increased demands for nurses working in elderly care. Clinical practice has been shown to have an impact on how student nurses perceive a particular field of nursing.

OBJECTIVES

To compare perceptions of the clinical learning environment in nursing homes among students considering a career in aged care or not, and to examine the difference in age, gender and previous working experience as health care assistants in elderly care between the two groups.

DESIGN

This was a cross-sectional study using the Swedish version of the Clinical Learning Environment and Nurse Teacher evaluation scale.

METHODS

Consecutive sampling was performed over three semesters from September 2011 to December 2012. The survey was conducted with 183 student nurses. Mann-Whitney U-test was used to examine differences in relation to two groups namely student nurses who did or did not consider to work in elderly care. A chi-square test of independence was performed to examine the difference in age, gender and previous working experience between the two groups.

RESULTS

The analysis leaned towards an overall positive evaluation of the clinical learning environment with more positive values for students considering a career. There were no significant differences between younger students (18-23) and older students (24-50) regarding willingness to work in elderly care or not. Neither was any significant difference displayed between students, based on gender nor for previous work experience.

CONCLUSION

Age, gender and previous work experiences as health care assistants did not impact on students' willingness to work in elderly care. Future studies need to acknowledge the complexity of why student nurses choose a particular pathway in nursing by longitudinal studies following cohorts of students during the course of the nursing programme.

Student nurses' motivation to choose gerontological nursing as a career in China: a survey study

BACKGROUND

The world's population is aging, and the need for nurses is increasing. Working with older adults, however, has always been an unpopular career choice among student nurses. It is important to understand student nurses' motivation for choosing gerontological nursing as a career.

OBJECTIVES

The purpose of this study was to examine the motivation for choosing gerontological nursing as a career and to identify the associated factors among student nurses.

DESIGN

Cross-sectional survey.

SETTINGS AND PARTICIPANTS

Participants were last-semester student nurses from 7 universities offering nursing undergraduate programs in Shandong, China. Of the 1290 student nurses, 916 completed the survey (a response rate of 71.0%).

METHODS

The outcome variable was the motivation to choose gerontological nursing as a career. This was measured using a motivation questionnaire that included expectancy and value subscales. Other instruments included the Chinese version of the Facts on Aging Quiz I, the Geriatrics Attitudes Scale, the Anxiety about Aging Scale, a clinical practice environment questionnaire and a self-administered general information questionnaire.

RESULTS

Student nurses' expectancy and value aspects of motivation for choosing gerontological nursing as a career were both at a moderate level; the highest value they held was of personal interest. Clinical practice environment, anxiety about aging and the attitudes about geriatrics were the main factors influencing student nurses' motivation to choose gerontological nursing as a career in China.

CONCLUSIONS

It is imperative for nurse educators to improve the gerontological nursing clinical practice environment for student nurses. Moreover, cultivating student nurses' positive attitudes about geriatrics and relieving anxiety about aging could be beneficial.

Working with the disabled patient: exploring student nurses views for curriculum development using a SWOT analysis

BACKGROUND

Increased longevity will mean an increase in people presenting with cognitive and physical disabilities, such as sight loss or dementia. The Patient Rights (Scotland) Act 2011 states that health care should be patient-focussed, taking into account patient needs. This will necessitate nursing curricula to reflect the needs of people who have disabilities and equip the future workforce with knowledge and skills to provide appropriate care. This study explores student nurses' strengths and weakness when working with people with disabilities and identifies opportunities and threats to developing their knowledge and skills to meet the needs of this population.

METHODS

As part of a study day, students from the year one Nursing programme were asked to take part in a SWOT analysis and post comments under the categories: strengths, weakness, opportunity and threats on a central wall about working with people with disabilities.

RESULTS

Students acknowledged some of the challenges of being disabled especially in a health setting but also believed they were developing their skills to provide holistic care that ensured autonomy. Communication was viewed as both a strength and weakness and was identified as an essential skill to working effectively with people who had a disability. Students acknowledged that clinical staff were not always experts in working with people who were disabled and welcomed the opportunity to work with experts and clients as well as being directed to resources to increase their knowledge.

CONCLUSIONS

Integration of disability into the nursing curriculum is needed to ensure students have awareness of and the confidence to work effectively with people who have a range of cognitive and physical disabilities alongside other medical problems.

A contemporary examination of workplace learning culture: an ethnomethodology study

BACKGROUND

Creating and maintaining a sustainable workforce is currently an international concern. Extensive literature suggest that students and staff need to be 'engaged', that is they need to interact with the health team if they are to maximise learning opportunities. Despite many studies since the 1970s into what creates a 'good' learning environment, ongoing issues continue to challenge healthcare organisations and educators. A 'good' learning environment has been an intangible element for many professions as learning is hindered by the complexity of practice and by limitations on practitioners' time available to assist and guide novices.

OBJECTIVES

This study sought to explore the nature of the learning interactions and experiences in clinical nursing practice that enhance a 'good' workplace learning culture for both nursing students and qualified nurses.

DESIGN

An ethnomethodology study.

SETTING

A range of clinical settings in Victoria and Queensland, Australia.

PARTICIPANTS

Students and registered nurses (n=95).

METHODS

Fieldwork observations were carried out on student nurses and registered nurses, followed by an individual interview with each participant. An iterative approach to analysis was undertaken; field notes of observations were reviewed, interviews transcribed verbatim and entered into NVivo10. Major themes were then extracted.

RESULTS

Three central themes: learning by doing, navigating through communication, and 'entrustability', emerged providing insights into common practices potentially enhancing or detracting from learning in the workplace.

CONCLUSIONS

Students' and registered nurses' learning is constrained by a myriad of interactions and embedded workplace practices, which can either enhance the individual's opportunities for learning or detract from the richness of affordances that healthcare workplace settings have to offer. Until the culture/or routine practices of the healthcare workplace are challenged, the trust and meaningful communication essential to learning in practice, will be achievable only serendipitously.

Compassionate Care: Student nurses' learning through reflection and the use of story

INTRODUCTION

Current concern in health care about delivering care that is compassionate has important implications for how compassion is taught and made explicit in nurse education curricula. This paper will describe the use of stories within the curricula to enhance knowledge and skills in compassionate caring.

METHODOLOGY

The Leadership in Compassionate Care Programme (LCCP) was a 3-year action research project that sought to capture what compassionate care means within practice and utilise this learning within education. Stories gathered within clinical practice were used to stimulate reflective learning as part of a nursing module that teaches recognition of acute illness and deterioration at Edinburgh Napier University. Students listened to stories which included experiences of staff, students, patients and relatives and related these to their own experiences in practice. In this paper, examples from the online discussions are discussed with reference to one of six themes that emerged from the LCCP, that of caring conversations.

FINDINGS

The discussions suggest that reflective learning and the use of stories about the experience of giving and receiving care can contribute to the development of the knowledge, skill and confidence that enable student nurses to provide compassionate relationship centred care within practice.

CONCLUSIONS

Reflective learning can be a valuable strategy for students to ponder new knowledge and allow predetermined ideas to be challenged. Stories can initiate this process and help student nurses to understand not only the needs of others, but their own expectations and values, which in turn can inform how they plan and deliver person centred compassionate care.

The diversity of Iranian nursing students' clinical learning styles: a qualitative study

BACKGROUND

Numerous factors, including learning styles, affect the learning process of nursing students. Having insights about students' learning styles helps promoting the quality of education. The aim of this study was to explore the Iranian baccalaureate nursing students' learning styles in clinical settings.

METHODS

A qualitative design using a content analysis approach was used to collect and analyze data. Semi-structured interviews were conducted with fifteen Iranian baccalaureate nursing students selected using a purposive sample method.

FINDINGS

During data analysis, it was found that nursing students employed different clinical learning styles such as 'thoughtful observation,' 'learning by thinking,' and 'learning by doing'.

CONCLUSION

Students adopt different learning strategies in clinical practice. Designing teaching strategies based on students' learning styles can promote students' learning and maximize their academic and clinical practice success. Nursing educators, curriculum designers, and students can use the findings of this study to improve the quality of nursing education in both the classroom and clinical settings.

Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: a questionnaire survey

AIM

The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized.

BACKGROUND

The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models.

METHOD

A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire.

RESULTS

In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p<0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship.

CONCLUSION

The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

Student nurses' views on respect towards service users - an interpretative phenomenological study

AIM

To explore student nurses' understanding and behaviours of respect towards patients in order to inform educational strategies to optimise respectful care.

BACKGROUND

There is a causal relationship between the perception of being treated with respect and patient satisfaction. Concerns over standards of care prompted a commissioned report into the quality of nurse education in the United Kingdom.

DESIGN

A hermeneutic phenomenological interview study was used to identify and interpret student nurses' behaviours and understanding of respect towards patients.

SETTING

University health and social care faculty in the north-west of England, United Kingdom.

PARTICIPANTS

Eight third-year student nurses (adult branch), on different university sites, with practice placements across different healthcare trusts.

METHODS

Interviews about their understanding of respect and their behavioural intentions of respect towards patients were recorded and transcribed, then analysed using interpretative phenomenological analysis (IPA) to produce themes from the data.

FINDINGS

Three themes of relevance to nurse education were identified. Respect is a complex concept that is difficult to apply in practice. Students are not always aware of incongruence between their feelings of respect towards patients and their behaviours towards them. Role-modelling of respectful care is variable, and essential care is often learned from healthcare assistants.

DISCUSSION

Awareness of emotional responses and their relationship to patient perceptions of respect should be facilitated in theory and practice. Rehearsal of the application of respect involving emotional labour, and reflection in and on the practice of respectful care, are needed to address student learning needs. The theory-practice gap in relation to respect, variation in professional practice and the under-recognised importance of healthcare assistants in student nurse education, are barriers to the learning of respect to patients.

CONCLUSIONS

Interactive education experiences are important to develop self-awareness and insight into respectful care. Mentorship in practice should encourage reflection in and on the practice of respect towards patients.

Occupational safety training and education for needlestick injuries among nursing students in China: intervention study

OBJECTIVES

To confirm the effect of occupational safety training and education programs (OSTEP) on needlestick injuries (NSIs) among nursing students in China.

METHODS

Compare the rates and the nature of NSIs before and after OSTEP among the nursing students in China. Firstly, questionnaires were delivered to 248 randomly selected nursing students from seven training hospitals to obtain basic information concerning relevant occupational NSIs. Then regular intervention measures through OSTEP on 246 nursing students had been introduced for four years. And the resultant information concerning relevant occupational NSIs was obtained afterwards. Finally, the data analysis was performed using SPSS software, version 11.5.

RESULTS

The rate of NSIs among these nursing students was relatively high before the OSTEP in China (average, 4.65 events/nurse). However, it decreased rapidly to 0.16 events/nurse average after the OSTEP. Occupational safety awareness and behavior in handling NSIs was improved in China. There was a significant difference in the results of Chi-square value (P<0.005).

CONCLUSIONS

NSIs are common in nursing students in China. The OSTEP can reduce NSIs and change practical behavior markedly among nursing students in China. We should perform OSTEP on nurse students before and during the clinical practice. We must also provide effective preventive measures to reduce this kind of problem in future.

Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation

BACKGROUND

Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations.

AIM

The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum.

METHOD

A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach.

RESULTS

Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff.

CONCLUSION

Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential.