Enhancing nursing education via academic–clinical partnership: An integrative review

The opinions and experiences of nursing students, nurses, and patients regarding clinical practices: A mixed-methods study

The aim of this mixed-methods study was to examine the experiences of nursing students (NSs), nurses, and patients regarding the clinical practices of NSs and to determine NSs' stress levels regarding clinical practices. The quantitative part of the study was completed with 240 NSs, and the "Perceived Stress Scale for Nursing Students" was used. In the qualitative part, the focus group interviews were held with 24 NSs, and the individual interviews were conducted with 15 patients and 20 nurses. Descriptive and stepwise regression analyses were used to analyze quantitative data, and narrative analysis was used to analyze qualitative data. Regression analysis determined that the age, grade point average, and attitude of mentors were associated with the perceived stress levels of NSs. In the narrative analysis of the data obtained from the interviews with NSs and nurses, four categories were identified: Emotions, Facilitators, Barriers, Roles, and Competencies. Three categories (Emotions, Problems, Roles, and Competencies) were identified from patient interviews. This study showed that NSs' clinical practice experiences were affected by many factors and experienced high stress during clinical practice.

Development of collaboration guidelines for nursing education and related healthcare services

Background

A theory-practice gap in nursing education often occurs, and the staff from the nursing education institution and the associated healthcare services should find ways to improve their collaboration to reduce the gap during the training of nursing students.

Aim

This study aimed to develop context-specific collaboration guidelines for a nursing education institution and associated healthcare services.

Setting

Private hospital in the Gauteng province of South Africa.

Methods

Guidelines were developed from the findings of an integrative literature review. Thereafter, it was contextualised in a qualitative study with focus group discussions (FGDs) involving 9 theoretical lecturers and 10 clinical facilitators.

Results

In the partnership between the nursing education institution and the associated healthcare services, bilateral communication, cooperation between the theoretical lecturers and the clinical facilitators in delivering evidence-based patient care, intensified innovation in teaching and learning practices and an environment conducive to theory-practice integration should be emphasised.

Conclusion

A set of context-specific guidelines was developed to enable the theoretical lecturers and the clinical facilitators to collaborate in supporting nursing students to apply their theoretical knowledge in the development of clinical competencies.

Contribution

The guidelines can be adjusted to suit the context of other nursing education institutions and their associated healthcare services to improve collaboration between theoretical lecturers and clinical facilitators to the benefit students' skills development in theory-practice integration.

Effect of Online Case-Based Teaching Method on Professional Development of Nursing Students

Objective: This study was conducted to determine the effect of online case-based education, as part of distance education, on nursing students’ professional values, professional behavior, problem-solving, critical-thinking skills, and self-directed learning skills. Methods: The study was conducted using a single-group pretest-posttest quasi-experimental design. A total of 58 3rd grade nursing students participated in this study The data before the study were collected electronically with the Google forms application using the personal information forms and scales (Self-Directed Learning Skills Scale, Problem Solving Inventory, California Critical Thinking Disposition Scale, Nurses Professional Values Scale, Nursing Students Professional Behaviors Scale). Results: After online case-based nursing process teaching, the difference in the total mean score of the students in all scales was found to be statistically significant (p< 0.01). It was found that, after the training had been provided through case-based education, the score average of students’ professional values, professional behaviors, problem-solving, critical thinking skills and self-directed learning increased. Conclusion: Use of online case-based teaching is useful for increasing nursing students’ nursing skills in distance education.

Role and Function of the Clinical Tutor in Mental Health Nursing in Ireland

The clinical tutor (CT) in mental health nursing is a role aimed at supporting the learning needs of mental health nursing students undertaking a 12-month post-registration programme. This paper aims to examine the role of the clinical tutor in mental health nursing in Ireland by describing the experience of nursing students and key service stakeholders. A qualitative descriptive design was employed using focus group discussions and semi-structured interviews. Two focus groups were conducted with 14 nursing students in the final week of their one-year programme. Semi-structured interviews were undertaken with seven service stakeholders and service leaders. Participants reported positive experiences of working with the clinical tutor and valued the role in terms of educational and pastoral support. Participants suggested the role strengthened the link between theory and practice and enhanced the relationship between the higher education institute and clinical sites. However, a lack of clarity existed in terms of role description. Participants suggested the CT role enhanced the link between the university and clinical areas providing benefits to both student and service stakeholders. Implementing similar roles may benefit post-registration mental health nursing students in other jurisdictions. Further investigation on how the role operates from the perspective of those in the post may provide more clarity and enhance the development of such roles in the future.

A phenomenographic study exploring the conceptions of stakeholders on their teaching and learning roles in nursing education

BACKGROUND

Nursing education involves a number of stakeholders in the teaching and learning process, and these are student nurses, lecturers, clinical instructors and nurses. The role that each of these parties play in the teaching and learning process is dependent on each other and is key to the development of competence among student nurses. However, there is scanty literature on the discourse of how these stakeholders conceptualise their roles to maximise student learning. The objective of this study was to explore the conceptions of stakeholders on their teaching and learning roles in nursing education.

METHODS

Thirty-eight semi-structured interviews and three focus group discussions were conducted with nursing students, lecturers, clinical educators at a Namibian nursing college and nurses at teaching hospitals. Phenomenographic data analysis approach was applied.

RESULTS

Four conceptions were constructed that described the level of involvement of the different parties in teaching and learning. These were initiating, supporting, becoming part of and owning the teaching and learning role. Three dimensions of variation marked the differences among the conceptions: responsibility and accountability, priorities and level of collaboration.

CONCLUSIONS

The parties involved in the teaching and learning in nursing education have qualitatively different understating of their roles and those of others. There is a pattern transcending from being at the periphery of teaching and learning to taking ownership of teaching and learning. And a movement from limited responsibility and collaboration to that of being responsible, accountable and high level of collaboration in the teaching and learning of nursing students. The conceptions in this study add more ways of enhancing collaboration between theoretical and clinical sites in nursing education, by ensuring that those involved are aware of their role and that of others and work collaboratively at the micro-level.

Clinical teaching practices of nurse educators: An integrative literature review

Clinical teaching practice of nurse educators is important in the development of clinical competence of undergraduate nursing students, but it is often not done according to best practice standards. This study aimed to summarise the best clinical teaching practices of nurse educators teaching undergraduate nursing programmes. An integrative literature review was conducted according to Whittemore and Knafl’s adapted stages. A systematic search of electronic databases, including EBSCOhost and ScienceDirect, for applicable papers from January 2001 to June 2021, was followed by a manual search. The review resulted in selection of 67 papers, and critical appraisal had been completed by two independent reviewers using relevant critical appraisal tools. Papers that were selected revealed six main themes, with sub-themes, outlining best practices for clinical teaching, namely: (1) planning for clinical teaching practice: self-preparation and planning for clinical placement; (2) facilitation of students’ clinical learning: orientation of students, planning for clinical teaching and the clinical teaching process; (3) evaluation of students’ clinical skills: reflection by the nursing student and feedback; (4) modelling professional clinical teaching practice: emotional intelligence, self-evaluation, role modelling and continuous professional development; (5) work-based assessment in the clinical environment: clinical assessment process and clinical assessment tools and (6) clinical teaching in the simulation laboratory. The six identified best practices could assist nurse educators to provide comprehensive clinical teaching.

Sustained impact of an academic-practice partnership

Academic-practice partnerships foster innovation and transition to nursing practice in healthcare systems. The purpose of this paper is to describe the impact of a public-private academic-practice partnership for Doctor of Nursing Practice (DNP) education designed to transform a large healthcare system's nursing workforce and model of care. The conceptual framework is organized around Rogers's (2003) principles of diffusion of innovation in organizations. A logic model illuminates how inputs, activities, outputs and outcomes resulted in sustained impact for graduates, the college and the healthcare organization. Partnership outcomes include education of baccalaureate and master's-prepared employed nurses (n = 95) in a DNP program for advanced practice nursing (APN) roles in the healthcare system; dissemination of scholarship; and revision of the healthcare system's research approval process. Sustained impact includes advancement of DNP-prepared graduates to complex leadership and practice roles; development of new programs and advanced practice roles based on scholarly project findings; expansion of population-specific patient programs; and extension of continuum- and access-to-care models in the healthcare organization. Recommendations include continuing development of academic-practice partnerships for transition to practice and advancement of roles and levels of champions to achieve sustained impact of academic-practice partnerships in healthcare organizations.

Building evidence-based practice competencies among rehabilitation students: a qualitative exploration of faculty and preceptors' perspectives

Medical education literature suggests clinically-integrated teaching may be the most effective approach to teach evidence-based practice (EBP). Before implementing this educational best practice in rehabilitation curricula, it is imperative to better understand the current context, barriers and facilitators to teach EBP in rehabilitation from the academic to the clinical setting. The aim of this study was to explore faculty and preceptors' experiences and perceptions of teaching EBP in rehabilitation professions, namely occupational therapy, physical therapy and speech-language pathology. We gathered data from seven focus groups and an individual interview with a sample of 24 faculty and 15 preceptors, i.e., clinical supervisors. Data collected were subjected to inductive thematic content analysis. We identified three overarching themes and corresponding strategies. First, "Recognizing EBP as a multifaceted concept" denoted participants' lack of consensus regarding the meaning and scope of EBP, and their awareness of such discrepancies. Second, "Complexity of EBP is at the core of teaching practices and experiences" referred to participants' perception of EBP as a complex process involving high-level cognitive skills, which influenced their teaching practices and challenged students and themselves. Third, "Connections and divides between research and practice" represented the limited and delicate connection between faculty and preceptors, the factors either bridging or maintaining the gap between them, and the impacts of such connections and divides on teaching. Improving collaboration between faculty and preceptors constitutes an essential first step towards more effective EBP training programs in rehabilitation that could be facilitated through online communities of practice or integrated knowledge translation research projects.

Wow, woo, win"- Healthcare students' and facilitators' experiences of interprofessional simulation in three-dimensional virtual world: A qualitative evaluation study

BACKGROUND

In an age disrupted by COVID-19 pandemic, three-dimensional virtual world (3DVW) offers an opportunity for healthcare students from different higher education institutions to participate in interprofessional education. Despite its growing evidence, there is a need to unravel the complex learning process in order to ensure high quality of interprofessional education delivery.

AIM

This study aimed to explore the experiences of healthcare students and facilitators on the use of 3DVW for interprofessional team-based virtual simulation.

METHODS

Interprofessional teams, each comprising six different healthcare students (Medicine, Nursing, Pharmacy, Physiotherapy, Occupational Therapy, and Medical Social Work) and two clinicians who acted as facilitators, logged into the 3DVW from their own remote locations to participate in team-based care delivery that included an interprofessional bedside round and a family conference. A qualitative descriptive study was conducted on a purposive sample of 30 healthcare students and 12 facilitators using focus group discussions and individual interviews.

RESULTS

Four themes emerged from their experiences: the "wow experience", authentic experience on collaborative care, ease of learning, and preeminent role of the facilitator. The simulation provided the "wow" experiences through contextual, collaborative and experiential learning approaches. Despite technical challenges, the participants were wooed by the comforts of learning from home and the psychological safety in virtual environment. The facilitators played a critical role in optimizing learning engagement to win learners over.

CONCLUSION

Our study explicates how attention to the "wow, woo and win" trilateral factors can transform the interprofessional learning experiences offered by 3DVW simulation. Future developments in the use of this learning technology should include developing the clinicians' facilitation skills and the provision of technical support to make this 3DVW a success calls in winning students' learning engagement.

Brilliant at the Basics: An Academic Practice Partnership to Build Nursing Management Expertise

This article describes the importance of building academic and practice partnerships, and the process in developing and implementing a successful leadership academy in transforming emerging nurse leaders. In addition, this article highlighted the value on the evaluation and outcomes of the educational program pertaining to positive changes in the workplace. In its initial phase, the health system conducted a needs assessment that provided vital information to enhance nursing management development skills through the initiation of a leadership training academy for nurse leaders. The vital information obtained in the needs assessment was used as a framework in working on topical outline and content objectives developed as a joint initiative between the university-based school of nursing and health professions and the health system that shared a similar mission, vision, and goals. Thus, "Brilliant at the Basics" nursing leadership academy was formed. [J Contin Educ Nurs. 2021;52(3):136-141.].

Addressing the Perioperative Nursing Shortage Via a Perioperative Nursing Preceptorship for Baccalaureate Nursing Students

A growing demand for perioperative nurses, insufficient interest in the perioperative nursing specialty, and nurse retirements have resulted in a perioperative nursing workforce shortage. Undergraduate nursing students' limited exposure to perioperative content, along with facility hiring practices that exclude recently graduated nurses, further contribute to this shortage. To address these concerns, a large health care system in the midwestern United States partnered with a college of nursing to institute a perioperative preceptorship for baccalaureate nursing students during their final semester. After completing the preceptorship, students reported increased understanding of perioperative nursing roles and responsibilities, time management, and patient safety skills; ability to work effectively as a part of an interdisciplinary team; and independence in the perioperative setting. Future study is needed to examine rates of matriculation among program graduates into perioperative nursing positions and the program's effect on the length of orientation for recently graduated nurses and nurse retention.

Implementing dedicated education units in 6 European undergraduate nursing and midwifery students clinical placements

Background

Undergraduate students’ clinical experience, working directly with patients and the healthcare team is essential to ensure students acquire the necessary competence for practice. There are differences in the quality of clinical environments and in students’ clinical placement experiences and not all clinical sites are optimal learning environments. The Dedicated Education Unit clinical education model allows students to develop the practical knowledge, skills and professionalism they will need as nurses/midwives.

Methods

We employed the Consolidated Framework for Implementation Research to identify and compare barriers and facilitators in the implementation of the Dedicated Education Unit in 6 European undergraduate nursing/midwifery student clinical placement settings and to describe the experience of nurses/midwives involved in the Dedicated Education Unit model implementation and evaluation. A pre-post implementation interpretive assessment was based on participants’ responses to the Consolidated Framework for Implementation Research construct questions.

Results

Although Dedicated Education Unit model implementation in our project was heterogeneous, no main implementation barriers were perceived. Qualitative data showed that educational-service collaboration, including a focus on mutual goals, organizational communication and networking, satisfaction of educational and healthcare professionals, and the establishment of a safe space for professional discussion and feedback, were considered facilitators.

Conclusions

This study describes the key elements guiding educational and healthcare stakeholders in Dedicated Education Unit implementation, engaging participants in the entire process, and offering other organizations the opportunity to consider the benefits of this clinical education model.

A "Co-CREATES" framework to foster a positive learning environment for nursing students' professional development in Rwanda

AIM

The future of the nursing profession in Rwanda in large part depends on the students who join the workforce and the education they have received. Preparing students with the necessary knowledge, values and judgement requires practice settings to be learner-centered. This study aimed at exploring strategies that might improve the current practice-based learning environment.

DESIGN

A focused ethnographic approach was used.

METHODS

Nursing students, staff nurses, clinical instructors and nurse leaders from three hospitals and an educational program participated in individual interviews.

RESULTS

Five key areas of improvement emanated from study data: 1) strengthening institutional support; 2) improving school-hospital collaboration; 3) building the capacity of nurses and clinical instructors; 4) restructuring clinical placement; and 5) reviewing the current supervision model. Based on these findings a "Co-CREATES" framework grounded in the actions of collaboration, care, recognizing, empowering, actively engaging, transforming, enhancement and support was developed. The framework offers a collaborative approach that engages every stakeholder in "cocreating" conditions that build positive practice environments which are conducive to preparing students as professional nurses.

CONCLUSION

The positive outcomes stemming from such a collaborative approach can further enhance a positive culture of collaboration in nursing education and practice.

Transitioning Newly Licensed Nurses Into Practice Through an Academic-Practice Partnership

ABSTRACT

Research illustrates a clear gap between academic and practice facilities concerning new graduate nurses. Nursing programs are charged with training nursing graduates who can provide safe, quality patient care. One way to enhance the quality of patient care and aid with retention of new graduate nurses in health care facilities is through academic-practice partnerships. This article describes the planning, implementation, and evaluation of a partnership between a health care facility and an associate of applied science nursing degree program to aid with registered nurse retention and quality patient care.

An Innovative Concept-Based Learning Activity to Identify and Educate Veterans at Risk for Amputation

ABSTRACT

Nurse educators must create meaningful learning for students while addressing the needs of a rapidly changing health care system. Academic-practice partnerships help ensure that students are up-to-date on current practices while faculty and students partner to support the needs of the practice institution. To address a health care system's high amputation rates, school of nursing faculty developed a concept-based learning activity to assess and educate patients at risk for amputation. Results included increased student learning that can be applied to other practice settings and improved outcomes for the health care system.

Including administrators in curricular redesign: How the academic-practice relationship can bridge the practice-theory gap

AIM

Health care administrators provided information through semi-structured interviews as to how one faculty of nursing (FoN) was preparing students for practice.

BACKGROUND

There is a long-standing disconnect between the nursing education and the clinical arena known as the theory-practice gap. The FoN wanted to redevelop their curriculum to better prepare students for practice and bridge the gap.

METHOD

Using developmental evaluation, 36 administrators were interviewed and asked about their expectations of newly graduated nurses, the FoN curriculum, and changes to be made.

RESULTS

Four themes were identified: entry to programme; curricular content, delivery and structure; clinical recommendations; and stronger relationships.

CONCLUSION

Strong academic-practice partnerships are still needed. The current lack of communication and partnership has compromised students' quality of education and their transition into the workforce.

IMPLICATIONS FOR NURSING MANAGEMENT

Leaders in both the education and practice settings can better prepare newly graduated nurses and bridge the theory-practice gap by co-creating a joint committee and creating more touchpoints with one another. A joint committee can develop appropriate entry-to-programme guidelines, discuss relevant trends in practice and shape the curriculum. Clinical experiences for students may also act as extra touchpoints whereby the two groups can discuss clinical mentorship needs and build stronger academic-practice relationships.

Embedding skin tone diversity into undergraduate nurse education: Through the lens of pressure injury

OBJECTIVE

To explore health disparity in on-campus undergraduate nurse education through the analysis of teaching and teaching material exploring pressure injuries.

BACKGROUND

As a discipline, nursing espouses ideologies of inclusion, equity and valuing diversity. However, little is known about how these ideologies translate into clinical care. Pressure injury prevention is a routine aspect of nursing care; yet, there is evidence of inequity in relation to clinical care and patient assessment, as people with darker skin tones have a higher prevalence of severe pressure injuries before detection of damage occurs. Despite limited literature being available surrounding the topic of pressure injuries and skin tone diversity, it remains the responsibility of nurse educators to address contemporary issues and health disparity within the nursing curriculum.

DESIGN

A multiple method collective case study. The STROBE checklist was followed in reporting this study.

METHODS

Documentary and observational data of lectures regarding pressure injuries were collected during 2017 and 2018 from five Higher Education Institutes in England delivering approved nursing undergraduate programmes.

RESULTS

Documentary analysis confirmed all Higher Education Institutes overwhelmingly directed teaching and learning activities about pressure injury towards people with Caucasian skin tones. Observation of teaching indicated all teaching sessions only contained brief, separate and superficial information on people with pressure injuries and darker skin tones. There was no discursive language or awareness of colour or colour blindness.

CONCLUSION

Radical critique of all teaching and learning activities needs to occur, to help explore, improve and meaningfully and authentically include diversity and inclusivity in nurse education, and in particular, how people across the skin tone spectrum are included and represented in teaching and learning activities.

RELEVANCE TO CLINICAL PRACTICE

Critical examination of current teaching practice is crucial to address disparity and ensure care for people with darker skin tones is optimised. Nurse educators have a responsibility to educate for the care needs of all, as the quality of nurse education has a direct impact on care delivery and health disparity. This paper highlights the importance of addressing skin tone diversity and offers the opportunity for reflective practice, not just in formal education, but in clinical settings by preceptors and senior staff.

Veteran-Centric Content Integration Into a Baccalaureate Nursing Curriculum

BACKGROUND

Nurse educators frequently search for innovative ways to address specific population needs such as those presented by veterans.

METHOD

To integrate veteran-centric content into undergraduate nursing curriculum, Veterans Affairs Nursing Academic Partnership (VANAP) faculty conducted a literature review, collaborated with stakeholders, developed veteran-centric competencies, identified natural areas in existing curriculum for content integration, developed learning activities, and created a content integration map.

RESULTS

Eight VANAP competencies were developed to guide content integration. A map of veteran-centric content integration into the baccalaureate curriculum was created, and content was integrated into theory and clinical courses, and simulation experiences in the undergraduate program.

CONCLUSION

The strategies for incorporating veteran-centric care into a curriculum can be used by all nurse educators to integrate and maintain various population-specific content. [J Nurs Educ. 2020;59(7):400-404.].

Who is failing who? A survey exploration of the barriers & enablers to accurate decision making when nursing students' competence is below required standards

Healthcare practice supports the achievement of programme learning outcomes for nursing students internationally. Within this context the issue of reluctance to fail nursing students, when warranted, is extensively examined within the literature with few definitive solutions emerging. Little is known about the perceived barriers that exacerbate this reluctance, or about factors that might enable and support nurses to fail students. To address this issue our study employed a non-experimental cohort study of nurses (n = 365) from two large teaching hospitals in the Republic of Ireland (ROI). Preceptors in this study clearly enjoyed their role with students, and received positive feedback from students. However, findings suggest that preceptors require more support from colleagues in providing comprehensive evidence in assessment. They also require additional training for providing negative feedback to students. A collaborative approach to competence assessment is recommended, whereby the professional burden can be borne by the team, and where students can engage in a holistic, reflective, learning experience that will ultimately improve their competence.

Nursing student and faculty perceptions of reciprocity during international clinical learning experiences: A qualitative descriptive study

BACKGROUND

Exposure of nursing students to global health care systems and cultures that are vastly different from which they are accustomed allow them to gain a unique perspective of our global village. A plethora of research has studied the lived experiences of visiting students during international clinical placements. Many studies have noted a multitude of benefits for visiting students. However, very little research examined the perspectives of host participants.

OBJECTIVES

This study explores both visiting and host students and faculty's perceptions of reciprocity during international learning experiences.

DESIGN

A qualitative descriptive design was utilised.

SETTING

Intercultural collaboration between visiting and host participants occurred over a two week clinical learning experience in a regional hospital in Jamaica.

PARTICIPANTS

Ten third year undergraduate Bachelor of Nursing students and two faculty from Canada engaged in clinical learning experiences with twelve fourth year host nursing students and three faculty from Jamaica.

METHOD

Visiting students submitted reflective papers, participated in interviews, and a focus group two months later. Two separate focus groups were held to gather data from the hosting students and faculty. All data was analysed using thematic analysis for recurring themes.

RESULTS

The findings of this study show that both host and visiting students and faculty mutually gain benefits from intercultural exchange and collaboration. Reciprocity was noted in experiential knowledge acquisition, cultural awareness from educational and professional perspectives, and personal and professional transformative learning. Although notable differences from contrasting health care worlds were identified, the recognition of similarities and opportunities for transformative learning greatly outweighed the differences.

CONCLUSION

There are reciprocal benefits to be gained in nursing education for visiting and host participants through the development of collaborative international partnerships. More research is required to further explore mutuality for students and faculty from different countries.

A model of collaboration between nursing education institutions in the North West Province of South Africa

Background

Professional nursing in South Africa is obtained through a 4-year diploma offered at nursing colleges, or a 4-year degree in universities, and the South African Nursing Council (SANC) registered both for professional nursing. New SANC legislation now requires a bachelor’s degree for registration as professional nurse.

Objectives

The aim of the study was to explore and describe perceptions of nurse educators and stakeholders to develop a model of collaboration for joint education and training of nursing professionals by colleges and universities through a bachelor’s degree.

Method

A mixed methods approach was used to explore perceptions of nurse educators utilising a questionnaire, and perceptions of other nurse training stakeholders through interviews, about a model of collaboration between the college and the university.

Results

Themes that emerged from the interviews included identifying collaboration goals, establishing a conducive environment, maximising exchange of resources, role clarification and perceived challenges. Quantitative results showed high agreement percentages (84.13%–100%) on most basic concepts and themes. A model of collaboration was developed indicating a framework, agents, recipients, procedure, dynamics, and terminus.

Conclusion

A model of collaboration was acceptable to the majority of nurse education stakeholders. Other implications are that there was a need for the improvement of scholarship among nurse educators and clinical mentors, sharing rare skills, and addressing perceived challenges.