Ethically involving students in faculty research

Midwifery students' experiences of their clinical internship placement during the COVID-19 pandemic in Ireland: A qualitative descriptive study

OBJECTIVE

To explore the impact of the COVID-19 global pandemic on midwifery students' experiences of clinical internship placement in the final year of their midwifery programme.

DESIGN

A qualitative descriptive study was conducted following ethical approval. Four online focus groups were facilitated.

SETTING AND PARTICIPANTS

To prepare for autonomous practice, BSc Midwifery students in the Republic of Ireland (RoI) undertake a 36-week internship in the final year of their programme. Midwifery students (n = 15), from one Higher Education Institute (HEI), who were undertaking internship across two clinical practice sites volunteered to participate in the study.

FINDINGS

Four overarching themes were identified: Fear and uncertainty of internship in the context of a pandemic, Consequences of COVID-19 within the clinical environment, Student supports, Opportunities and challenges during internship. Working within a health care environment dominated by the presence of COVID-19 had significant consequences for the students and their provision of care for women and families. Students were challenged with managing increased responsibility within the context of COVID-19 practice requirements and restrictions. Students balanced their need to progress to autonomous practice, whilst acknowledging their needs as learners. COVID-19 also brought unexpected benefits, which included enhancing students' ability to develop relationships with women in their care, and students described a sense of belonging within the midwifery team.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Midwifery students identified internship, during the COVID-19 pandemic as challenging and stressful. However, students also portrayed a sense of pride in their achievements. Support structures assisted students to cope during this period which included peer support, protective reflective time (PRT) in the HEI and support from clinical placement coordinators in midwifery (CPC-Midwifery) within clinical placements sites. It is essential that these support structures continue within midwifery educational programmes. Promoting peer support in a more formal support structure may need consideration. These support structures need to be protected and enhanced during unprecedented times, such as the COVID-19 pandemic.

Development of clinical competence - a longitudinal survey of nurse practitioner students

BACKGROUND

In order to achieve a sustainable standard of advanced clinical competence for nurse practitioners leading to a credible role, it is important to investigate the development of clinical competence among nurse practitioner students.

AIM

The aim of the present study is to analyse the development of nurse practitioner students' self-assessed clinical competence from the beginning of their education to after completion of their clinical studies.

DESIGN

The study involved the application of a longitudinal survey design adhering to STROBE guidelines.

METHODS

The participants consisted of 36 registered nurses from a nurse practitioner programme at a Norwegian university. The Professional Nurse Self-Assessment Scale II was used for data collection during the period August 2015 to May 2020.

RESULTS

The students developed their clinical competence the most for direct clinical practice. Our findings are inconclusive in terms of whether the students developed clinical competence regarding consultation, coaching and guidance, and collaboration. However, they do indicate a lack of development in some aspects of clinical leadership. The students with the lowest level of clinical competence developed their clinical competence regarding direct clinical practice significantly more than the students with the highest level of clinical competence. The differences between students with high and low levels of clinical competence were levelled out during their education. Thus, the students as a whole became a more homogenous group after completion of their clinical studies. Previous work experience in primary healthcare was a statistically significant, yet minor, predictor of the development of clinical competence.

CONCLUSION

Our findings indicate that the students developed their clinical competence for direct clinical practice in accordance with the intended learning outcomes of the university's Master's programme and international standards for nurse practitioners. It is imperative that the clinical field supports nurse practitioners by facilitating extended work-task fits that are appropriate to their newly developed clinical competence. We refrain from concluding with a recommendation that prior clinical work experience should be an entry requirement for nurse practitioner programmes. However, we recommend an evaluation of the nurse practitioner education programme with the aim of investigating whether the curriculum meets the academic standards of clinical leadership expected in advanced level of nursing.

The self-assessment of clinical competence and the need for further training: A cross-sectional survey of advanced practice nursing students

AIMS AND OBJECTIVES

(a) To describe and analyse advanced practice nursing students' self-assessment of their clinical competence and need for further training and (b) to analyse the possible predictive variables in their self-assessment.

BACKGROUND

The self-assessment of clinical competence in nursing education is important for identifying professional development and educational needs to improve patient care.

DESIGN

A cross-sectional survey following STROBE guidelines was used.

METHODS

Ninety-nine students from three universities/university colleges in Norway participated in the study, and data were collected using a revised version of the Professional Nurse Self-Assessment Scale II. Descriptive, correlation and regression analyses were performed.

RESULTS

The students gave the highest self-assessment ratings for their clinical competence in taking full responsibility and for their need for further training in medication effects and interactions. Although the students gave themselves low ratings for the use of electronic devices, they assessed their need for further training in this area as average. Clinical work experience as a registered nurse and previous higher education level were not significant predictors of clinical competence nor the need for further training.

CONCLUSION

The findings indicate that self-assessment is appropriate for students in advanced practice nursing programmes. This study implies that programmes in advanced practice nursing need to familiarise students with the possibilities of information technology. It questions the entry requirement that stipulates that prospective students must have several years of clinical work experience as registered nurses before entering advanced practice nursing programmes. These programmes need to communicate that competencies other than direct clinical practice are also needed for students' future roles.

RELEVANCE TO CLINICAL PRACTICE

The study contributes to the exploration of how students self-assess own clinical competence and need for further training in advanced practice nursing programmes. Further research should evaluate the development of clinical competence.

Exploring perinatal death with midwifery students' using a collaborative art project

OBJECTIVE

To explore the influence of the Amulet artwork and exhibition on midwifery students' perceptions of caring for parents experiencing perinatal death.

DESIGN

A descriptive qualitative design involving face-to-face semi-structured interviews following institutional ethical approval.

SETTING

A regional Maternity Hospital in Ireland which hosted the National Artwork and Exhibition exploring the hidden world of infant death.

PARTICIPANTS

A purposive sample of six consenting post registration midwifery students who had attended the Amulet artwork and exhibition.

FINDINGS

Four core themes emerged and these were i) entering the mother's world and hearing her pain; ii) the journey of grief and connecting with the bereaved parent's unique experience; iii) facing the challenge of providing effective perinatal bereavement care; and iv) maintaining a journey of compassionate practice.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Exposure to, and reflection on the Amulet artwork and exhibition increased students' awareness and insight into the non-linear nature of the grieving process, and to the importance of maintaining a journey of compassionate care for parents experiencing perinatal death. The findings suggest that the use of creative women-centered strategies promote affective learning in relation to perinatal death and so may be of use to educators and maternity care providers.

The caring concept, its behaviours and obstacles: perceptions from a qualitative study of undergraduate nursing students

Developing caring competences is considered to be one of the most important aims of undergraduate nursing education and the role of clinical placement is recognised as special in this regard. Students' reflection on caring, their experience and obstacles in being caring is recommended as a key strategy in the process of teaching and studying the nursing discipline. Therefore, the aim of this study was to describe the concept of caring, its manifestations and possible obstacles while caring, as perceived by first-year nursing students before and after their first clinical placement. Qualitative content analysis of 15 Polish students' narratives written before and after their clinical experience in the form of text-diaries was undertaken. The findings revealed that students entered their nursing education with a deep humanistic vision of caring both on theoretical and practical levels and the first clinical placement has enriched this vision. Expressive caring was more appreciated by students than the instrumental one and their concept of caring was coherent with the caring behaviours as described in their narratives. Several internal and external obstacles for caring have been reported by students, indicating a specific tension between their ideal of caring and their practical experience of caring in the clinical reality.

An exploration of student midwives' experiences of the Objective Structured Clinical Examination assessment process

This paper reports on a qualitative descriptive study that explored student midwives' experiences of the Objective Structured Clinical Examination assessment process for obstetric emergencies within a university setting. The development of fundamental clinical skills is an important component in preparing students to meet the responsibilities of a midwife. There is an international concern that the transfer of midwifery education into universities may impact on the development of midwifery clinical skills. Objective Structured Clinical Examinations (OSCEs) have the potential to promote integration and consolidation of skills prior to clinical placement. Twenty six students (n=36) from two midwifery programmes (BSc and Higher Diploma) participated in four focus groups and Burnard's (2006) framework was used for data analysis. Three main themes emerged following analysis: preparation for the OSCE assessment, the OSCE process and learning through simulating practice. Preparation for the OSCE's which included lectures, demonstrations, and practice of OSCE's facilitated by lecturers and by the students themselves, was considered central to the process. Learning via OSCEs was perceived to be more effective in comparison to other forms of assessment and prepared students for clinical practice. Positive aspects of the process and areas for improvement were identified. Using OSCE's increased the depth of learning for the students with the steps taken in preparation for the OSCE's proving to be a valuable learning tool. This study adds to the evidence on the use of OSCE's in midwifery education.

Reality of undertaking research: the experience of novice researchers

The reality of conducting research can pose many challenges for novice researchers. The aim of this article is to describe novice researchers' experience of conducting their first collaborative study and shows the difference between research as presented in texts and the reality of the experience. These differences include the policy-practice gap, which impacts on sample size; the reaction and motivation of nurses to be part of the study sample; and the collaboration between lecturers and clinicians. A brief overview of the research study is provided with a discussion of successes and challenges encountered.