Using meta-ethnography to develop a conceptual model of peer-assisted learning of nursing students in clinical practice

Peer assisted learning: a meta-ethnographic synthesis of qualitative studies and recommendations for cardiovascular training, practice, and research

INTRODUCTION

Peer assisted learning (PAL) is a common method to complement more traditional teaching. Several systematic reviews and meta-analyses described the most used ways of implementation and showed that it is effective in fostering learning. A synthesis of qualitative data is missing, to highlight the perceived value by the students and to drive a successful implementation.

EVIDENCE ACQUISITION

The search was performed in Pubmed, Scopus and ERIC databases, with a combination of the search strings. The quality of the retrieved articles was assessed through the Critical Appraisal Skills Checklist. The analysis was performed according to the meta-ethnographic method. Fifteen articles were considered for the analysis, saturation was reached after 12 articles.

EVIDENCE SYNTHESIS

Three main themes emerged from the analysis: PAL is effective when implemented in a safe environment, PAL is a driver of development of students' abilities and identity, and the "dark side" of PAL. Nine sub-themes emerged as components of the themes. The final line of argument highlighted the ambivalence of PAL, as an expression of the ambivalence of the still developing professional identity of students.

CONCLUSIONS

This meta-ethnographic synthesis summarizes the elements of success and the threats of PAL, a method that is particularly suitable for the cardiovascular domain. It must be implemented according to some precautions, such as organization and protected time, tutor selection, training and support, a clear integration and endorsement in the framework of the medical curriculum.

Effectiveness and experiences of integrating Mindfulness into Peer-assisted Learning (PAL) in clinical education for nursing students: A mixed method study

INTRODUCTION

Nursing students can find clinical learning to be challenging, unpredictable and stressful. To address this problem, this study integrated Mindfulness into Peer-assisted Learning (PAL) for nursing clinical education and investigated the feasibility and effectiveness on improving student participants' emotional reactions, and explored the perception and experience towards the programme.

METHOD

This quasi-experimental, repeated-measure, mixed methods study was conducted in a convenience sample of 126 Year 2 and Year 3 university nursing students. The participants engaged in an online mindfulness peer-assisted learning (PAL) programme that consisted of mindfulness practice, senior students sharing their experiences, and peer-assisted group learning. Emotional status (in terms of depression, anxiety and stress), burnout and self-efficacy were measured at baseline, 8 weeks after programme commencement and immediately after programme completion. Linear mixed-effects models and an intention-to-treat analysis were used to investigate changes in the dependent variables over time. Thirty-nine participants were also invited to engage in semi-structured interviews to explore their learning experiences in the programme.

RESULTS

The programme significantly improved the participants' self-reported self-efficacy (β = 1.44, 95 % confidence interval (CI): 0.58 to 2.30, p = 0.001) and decreased their level of burnout (β = -2.31, 95 % CI: -3.24 to -1.38, p < 0. 001) but did not significantly alleviate their depression, anxiety or stress across time (p > 0.05). Three themes emerged from the qualitative data, namely 1) nurturing self-care capacity through mindfulness; (2) empowering essential skills for clinical placement; (3) maintaining momentum alongside various challenges and enablers.

CONCLUSION

The mindfulness PAL programme may facilitate nursing students' clinical preparedness. Further trials are recommended to investigate its applicability and use in clinical nursing education.

Role of peer learning and self-efficacy in parasympathetic activity during the simulation learning process in nursing students

AIMS

This study aimed to investigate the stress level, including parasympathetic nervous activity, of students engaged in peer learning during simulations and the role of self-efficacy.

DESIGN

Observational-comparative study.

METHODS

The participants were 76 nursing students who were asked to evaluate a stable postoperative patient in Scene 1 and the same patient bleeding in Scene 2. In each scene, the students engaged in phases of repeated individual observations of the patient and discussions with peers. We compared each participant's parasympathetic activity during each observation in Scenes 1 and 2. Furthermore, the self-efficacy score before the simulation was used to divide the participants into 3 groups, and the self-efficacy and parasympathetic activity during the simulation were analysed.

RESULTS

The participants' parasympathetic activity decreased in both scenes with each phase of repeated observation. Two-way repeated-measures analysis of variance showed no statistically significant difference in parasympathetic activity during simulations among the three self-efficacy groups.

Exploring the barriers and gateways to intersubjectivity in dementia care: A meta-ethnography

BACKGROUND

Behaviours that challenge in dementia, often described and diagnosed as behavioural psychological symptoms of dementia, are experienced by 75% of people living with dementia in care homes or hospital environments, with 43% of nurses and care providers reporting these behaviours as moderately or severely distressing to them. During behaviours that challenge moments in dementia, there is the potential for an intersubjective relationship to take place between the people living with dementia and the nurse.

AIMS

This review explores and synthesises literature to consider the presence of intersubjectivity in people living with dementia. If the ability to be intersubjective remains present for people living with dementia, it will consider how its presence can be nurtured to offer a positive intersubjective communication between the person living with dementia and their carer/nurse.

METHODS

The review used meta-ethnography methodology to develop concepts that help us to understand the implications of existing research on the presence of intersubjectivity in people living with dementia, and its relationship to those providing their care. Sixteen electronic databases (including MEDLINE/PubMed, Wiley Online Library and Sage publications) and grey literature such as Alzheimer's Society and Department of Health across journals dating from 2000-2020 were searched. Eight studies were selected and reviewed for quality and relevance for a meta-ethnographic literature synthesis of intersubjectivity in dementia.

CONCLUSION

The meta-ethnography concluded that people living with dementia continue to have the capacity to be intersubjective on an emotional level. Nurses and other care providers need to acknowledge the presence of "personhood" and "personness" in people living with dementia to nurture positive intersubjective care relationships. The meta-ethnography has also been reviewed for reporting clarity against the EQUATOR checklist in the form of the eMERGe guideline (France et al., 2019).