An overview of practice education models

Student nurses' experiences with a digital educational resource supporting learning in nursing home placements: A qualitative study

BACKGROUND

Nursing education should improve clinical placements in nursing homes to foster and enhance student nurses' learning experiences. Initiatives for digital educational resource used to teach and supervise students to complement learning are increasingly being adopted and considered important in nursing education. However, little is known about how digital educational resources can facilitate learning in placements. Research on the value of such resources from student nurses' perspective is required.

AIM

To explore first-year student nurses' experiences with a digital educational resource developed to support learning in nursing home placements.

DESIGN

This study has a qualitative explorative design and is part of a larger research project in which a digital educational resource named DigiQUALinPRAX was developed.

SETTINGS

This study was conducted at three publicly funded nursing homes affiliated with one Norwegian university.

PARTICIPANTS

Twenty-three first-year student nurses.

METHODS

Data was generated through pre- and post-placement group interviews and analysed using reflexive thematic analysis. Standards for Reporting Qualitative Research were applied in this stud.

FINDINGS

One overreaching theme and three subthemes related to student nurses' experiences with a digital educational resource were identified. The digital educational resource gave a feeling of being acknowledged as a learner by (1) providing a structure and preparation that made the placement feel less overwhelming, (2) supporting professional reflection and assessment practices, and (3) facilitating collaboration when all stakeholders used the resource actively.

CONCLUSIONS

This study indicates that student nurses' learning process in nursing home placements can be supported through digital educational resources customised for this learning arena. The findings indicate that the digital educational resource facilitated pre-placement preparedness, provided structure and flexibility, and enhanced reflection and assessment practices during clinical placement. However, encouraging tripartite usage is essential to exploit the full potential of digital educational resources.

Perceived professional preparedness and identity among senior nursing students: a latent profile Analysis

BACKGROUND

Senior nursing students' perceptions of their professional preparedness help them for expectations of their future nursing role with more confidence, and professional identity may contribute to cultivating nursing students' perceptions of professional preparedness. In this study we applied latent profile analysis to identify the latent profiles of perceived professional preparedness among senior nursing students and to examine their identity and predictors.

METHODS

This was a cross-sectional descriptive study. A total of 319 senior nursing students from five universities in China were enrolled. Data were collected using the Perceived Professional Preparedness of Senior Nursing Students' Questionnaire and the Professional Identity Scale for Nursing Students.

RESULTS

Three latent profiles were identified and labeled as "low perceived professional preparedness" (n = 90, 28.2%), "low clinical competency-low EBP (Evidence-Based Practice)" (n = 190, 59.5%), and "high perceived professional preparedness" (n = 39, 12.2%). Place of residence, average clinical practicum hours per day, part-time experience, good relationships with classmates, and feeling nobility toward nursing due to COVID-19 significantly predicted profile membership. The average professional identity score was also statistically different across the three profiles (F = 54.69, p < 0.001).

CONCLUSIONS

Senior nursing students' perceptions of their professional preparedness were divided into three profiles, and out results show that promoting professional identity may effectively foster their perceived professional preparedness. This study therefore highlights the importance of targeted interventions by considering their distinct perceptions of professional preparedness patterns.

Connecting Actors With the Introduction of Mobile Technology in Health Care Practice Placements (4D Project): Protocol for a Mixed Methods Study

BACKGROUND

The learning process in clinical placements for health care students is a multifaceted endeavor that engages numerous actors and stakeholders, including students, clinical tutors, link teachers, and academic assessors. Successfully navigating this complex process requires the implementation of tasks and mentorships that are synchronized with educational and clinical processes, seamlessly embedded within their respective contexts. Given the escalating number of students and the rising demand for health care services from the general population, it becomes imperative to develop additional tools that support the learning process. These tools aim to simplify day-to-day clinical practice, allowing a concentrated focus on value-based activities. This paper introduces a project funded by the European Commission that involves 5 European countries. The project's objective is to comprehensively outline the entire process of development and ultimately implement mobile technology in practice placements. The project tackles the existing gap by constructing tailored mobile apps designed for students, teachers, tutors, and supervisors within each participating organization. This approach leverages practice-based learning, mobile technology, and technology adoption to enhance the overall educational experience.

OBJECTIVE

This study aims to introduce mobile technology in clinical practice placements with the goal of facilitating and enhancing practice-based learning. The objective is to improve the overall effectiveness of the process for all stakeholders involved.

METHODS

The "4D in the Digitalization of Learning in Practice Placement" (4D Project) will use a mixed methods research design, encompassing 3 distinct study phases: phase 1 (preliminary research), which incorporates focus groups and a scoping review, to define the problem, identify necessities, and analyze contextual factors; phase 2 (collaborative app development), which involves researchers and prospective users working together to cocreate and co-design tailored apps; and phase 3, which involves feasibility testing of these mobile apps within practice settings.

RESULTS

The study's potential impact will primarily focus on improving communication and interaction processes, fostering connections among stakeholders in practice placements, and enhancing the assessment of training needs. The literature review and focus groups will play a crucial role in identifying barriers, facilitators, and factors supporting the integration of mobile technology in clinical education. The cocreation process of mobile learning apps will reveal the core values and needs of various stakeholders, including students, teachers, and health care professionals. This process also involves adapting and using mobile apps to meet the specific requirements of practice placements. A pilot study aimed at validating the app will test and assess mobile technology in practice placements. The study will determine results related to usability and design, learning outcomes, student engagement, communication among stakeholders, user behavior, potential issues, and compliance with regulations.

CONCLUSIONS

Health care education, encompassing disciplines such as medicine, nursing, midwifery, and others, confronts evolving challenges in clinical training. Essential to addressing these challenges is bridging the gap between health care institutions and academic settings. The introduction of a new digital tool holds promise for empowering health students and mentors in effectively navigating the intricacies of the learning process.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53284.

Clinical education models in rural practice settings: A scoping review

AIM

The objective of this review is to identify and synthesize the literature on clinical nursing education models in rural settings, with the goal of developing a better understanding of effective clinical education models suitable for rural nursing education.

BACKGROUND

Clinical education is an integral part of nursing education, yet very little clinical education occurs in rural and remote areas. This leaves the rural landscape vulnerable to inadequate health care staffing because many graduates will begin their nursing practice in the geographical areas where they studied. The rural nursing workforce is currently insufficient to meet the health care needs of rural populations. This insufficiency is likely to worsen because statistical trends suggest that rural and remote communities might be among the worst affected by the global nursing shortage. Many new graduate nurses are ill prepared for rural nursing practice, primarily due to limited exposure to rural nursing content and rural clinical experiences in their entry-to-practice education. Increasing opportunities for nursing students to learn in rural clinical settings will likely support the recruitment and retention of nurses in rural practice. Despite the key role of rural nursing education in sustaining the rural health workforce, little is known about rural clinical learning in nursing education.

DESIGN

A scoping review.

METHODS

This scoping review was conducted using the steps outlined by Arksey and O'Malley with updated methodological guidance from the Joanna Briggs Institute.

RESULTS

Of 1880 potential data sources, 82 were included in data analysis. Although no distinct model of rural clinical nursing education could be identified, several features of clinical nursing education were described in the context of rural clinical learning. Preceptorship was the most used mentorship/clinical supervision model (n=41). The most common placement design was a block model design (n=41) lasting between one and 16 weeks, with most learners engaging in episodic care with individual clients (n=42). Interestingly, 24 sources reported learners engaging in rural clinical education across multiple contexts (e.g., acute care, home care, and primary care).

CONCLUSION

These findings suggest there exists great variability in rural clinical learning opportunities for nursing students. Academic practice partnerships could continue to be leveraged to provide learners with rural clinical education that meets the needs of both the educational institution as well as the rural communities in which learning takes place. An area of further research would be to focus on formal evaluation of the effectiveness of clinical education models in the rural context.

Learning in nursing home placement: A phenomenological study of student nurses' lived experience

AIM

To explore first-year student nurses' lived experience of learning in clinical placement in nursing homes.

BACKGROUND

Nursing homes traditionally represent students' first clinical placement sites during nurse education, and nursing home residents' care needs can provide opportunities for student nurses to acquire both fundamental and specialised nursing skills. In clinical placements, students have opportunities to apply and integrate theoretical knowledge, practical skills and ethical competence in a clinical setting.

DESIGN

A qualitative design with a hermeneutic phenomenological approach was employed and reported in accordance with the COREQ guidelines.

METHODS

The study was undertaken at three nursing homes affiliated with one Norwegian university. Close observation (173 h) and in-depth individual interviews (n = 7) with first-year student nurses were conducted to explore their lived experience of learning. Data analysis was guided by van Manen's hermeneutic phenomenological approach.

RESULTS

The essential meaning of the phenomenon of learning in clinical placements in a nursing home setting is characterised by four themes: (1) navigating a new and complex learning context, (2) being emotionally affected when facing sickness and frailty, (3) having a vital need for support and guidance and (4) being engaged in learning.

CONCLUSIONS

The findings are discussed against the backdrop of educational learning theory. Learning in clinical placements in nursing homes is a multi-faceted and complex phenomenon related to the students' lived experience on the contextual, relational and individual levels. Overall, our findings demonstrate that learning in clinical placements is part of the process of professional identity development.

RELEVANCE TO CLINICAL PRACTICE

The clinical practice arena should emphasise emotional support for student nurses, enhance their self-directed reflection and explicitly focus on the essence of nursing in nursing homes.

LEARNS Model as Perioperative Education Strategy for Patients with Laryngeal Tumors

Objective

To evaluate LEARNS model as a perioperative strategy for health education and nursing supervision of patients with laryngeal tumors.

Methods

LEARNS scheme based on the best practice guidelines was applied to patients in the observation group: (1) analyze the needs of patients (Listen_L); (2) establish therapeutic partnership (Establish_E); (3) adopt intentional intervention (Adopt_A); (4) reinforce health awareness (Reinforce_R); (5) implement feedback assessment of knowledge (Name_N); (6) strengthen self-management based on community resources (Strengthen_S). In the control group, traditional medical care instructions were provided to the patients by medical staff. Parameters such as anxiety status, treatment compliance, nursing satisfaction, self-care ability, and life quality were compared between the observation and control groups.

Results

Upon admission, there was no significant difference in self-care ability and anxiety level between two groups. However, the anxiety level of observation group was significantly lower than that of the control group 1 day before operation and 7 days after operation. Postoperative treatment compliance and nursing satisfaction were also improved in the observation group. In addition, self-care ability and life quality in the observation group were significantly enhanced as compared to the control group.

Conclusion

As a mutual learning process between nurses and patients, LEARNS model motivates nurses to assess the needs of patients voluntarily. Furthermore, evidence-based education reinforces the self-care ability and health awareness of the patients. Our data suggests that LEARNS model is of great value in improving the life quality of the patients with laryngeal tumors and nursing satisfaction.

Undergraduate Supervised Clinical Practicum Activities: An Enlightening Exploration

BACKGROUND

Clinical nursing practice is the hallmark of nursing education providing for the application of nursing knowledge to the care of patients in a contextual clinical environment. There is no universal method for educating students in the clinical arena. The literature has been limited to the evaluation of clinical education models and student perceptions of learning; however, there is a gap in the literature regarding the daily clinical activities of faculty and students.

METHOD

This exploratory descriptive study examined the explicit undertakings of a clinical day among faculty and students in the southeastern United States.

RESULTS

Responses from 61 survey participants described detailed activities of a clinical day including preclinical preparation, prebriefing, student and faculty clinical activities, and postconference structure.

CONCLUSION

This foundational knowledge provides insight for improving clinical education with the goal of educators connecting clinical activities to the development of student competencies. [J Nurs Educ. 2022;61(10):591-593.].

An introduction to the TPSN model: a comprehensive approach to reducing the theory-practice gap in nursing

Background

There are still concerns about the effectiveness of clinical education models which are done with the aim of reducing the theoretical-practical gap in nursing. In this article, we intend to describe an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. The basis of this work is the full-time presence of nursing teacher in the clinical settings and the development of their role to improve the education of students and nurses and the quality of nursing services.

Methods

This was a participatory action research. This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Clinical Learning Environment Inventory (CLEI), Job Satisfaction in Nursing Instrument questionnaires and Patient Satisfaction with Nursing Care Quality Questionnaire were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis.

Results

The academic-practice integration Model of TPSN is a dynamic and interactive model for accountability in nursing Discipline. Unlike the medical education model that includes patients, students, and physicians as the three points of a triangle, this model, which is shaped like a large triangle, places the person in need of care and treatment (patient, client, family, or society) in the center of the triangle, aiming to focus on the healthcare receiver. The model consists of three components (Mentoring component, Preceptorship component, and integrated clinical education component). Each of the components of this model alone will not be able to eliminate the ultimate goal of bridging the theory-practice gap.

Conclusions

A new and innovative model was proposed to reduce the theory-practice gap in the present study. This model increases the collaboration between educational institutions and healthcare settings compared with the previous models. The TPSN model helps students, nurses, and nursing instructors integrate theoretical knowledge with clinical practice and act as professional nurses.

The Learning Environment of Student Nurses During Clinical Placement: A Qualitative Case Study of a Student-Dense Ward

Introduction

Ensuring the quality of clinical placements has long been a challenge in nursing education. This is partly due to a growing aging population requiring health services, and an increased need for nursing workforce. Both in Norway and internationally, there is a rise in the use of student-dense models, wherein several students are placed together on the same ward at the same time where the supervision of the students is the collective responsibility of the nurses.

Objective

The aim of this study was to explore factors that promote or inhibit learning in a student-dense ward when used as a model for clinical placement in hospitals. We examined how clinical placement is experienced in a student-dense ward, as well as how learning is facilitated.

Methods

A qualitative case study design was used to capture the learning environment on the student-dense ward in a comprehensive way. We used focus group interviews, in-depth interviews, and observations with students and employees at a major hospital in Norway.

Results

Our findings showed that the orientation days and the teaching activities in student-dense wards, the feedback students receive, the clinical facilitator's role and the student community were factors that had particular importance for good learning environments in this placement model.

Conclusions

To ensure the quality of clinical placements, more attention should be paid to these factors in the planning, organization, and facilitation of new and existing student-dense wards. It is paramount to provide students with thorough written feedback and to secure the clinical facilitators with enough time to conduct student supervision when organizing clinical placement as student-dense wards.

'Working as a Real Nurse': Nursing Students' Experiences of a Clinical Education Ward in Psychiatric Care

Although the concept of clinical education wards has shown encouraging outcomes regarding nursing students' satisfaction with clinical placements in somatic care, the existing research in a psychiatric context is sparse. This study aims to explore nursing students' experience during clinical education at a psychiatric clinical education ward. A qualitive descriptive study with content analysis, using interviews with 16 bachelor's degree nursing students was conducted. The results indicated that an enriched and adapted learning environment focusing on psychiatric nursing with peer learning supported independence and progression into the future nursing role.

Characteristics and processes of the dedicated education unit practice education model for undergraduate nursing students: a scoping review

OBJECTIVE

The objective was to review literature related to the dedicated education unit practice education model for undergraduate nursing students, and identify common characteristics and processes for implementing and sustaining this model.

INTRODUCTION

Although practice education is central to undergraduate nursing education, evidence-informed practices for learning in the clinical setting remain elusive. Changes to health care over the past decades related to the role and scope of practice for nurses, gradual shifts to community- and population-based care delivery, and expectations for interprofessional practice require forward-looking education models. The dedicated education unit model was developed in 1997 as a potential solution to globally recognized challenges in nursing education amidst discourses of nursing resource scarcity. Despite more than two decades of innovation and expansion, there is still limited understanding of the effectiveness of the dedicated education unit as a solution to those challenges, or for the anticipated benefits for students and patients, through enhanced evidence-informed health care. This analysis of the characteristics and processes of the model is timely for evaluating and sustaining implementation of the dedicated education unit across nursing practice and education settings.

INCLUSION CRITERIA

English-only publications related to the dedicated education unit practice education model for undergraduate nursing students in baccalaureate and associate degree programs using qualitative, quantitative, or mixed methods research, and quality improvement, program evaluation, and opinion publications were included.

METHODS

Using selected keywords including "dedicated education unit," we searched CINAHL, Google Scholar, MEDLINE, Academic Premier Search, ERIC, Cochrane Database of Systematic Reviews, JBI EBP Database, and ProQuest Dissertations and Theses. Two independent reviewers screened titles and abstracts against inclusion criteria. We reviewed reference lists for gray literature and additional references. Data were extracted from the included articles and categorized for characteristics and processes. Eighty-two publications from January 1997 to May 2020 were included. The findings were presented descriptively with tables and figures to support the data.

RESULTS

Dedicated education unit models were based on five characteristics and four processes. Characteristics of the dedicated education unit model included effective academic-practice partnership, adaptability to diverse contexts, unit culture of educational excellence, responsive and supportive unit leadership, and clarity of roles and responsibilities. Processes included building nurse and faculty capacity, facilitating student learning, communicating regularly at systems and unit levels, and evaluating and sustaining the model.

CONCLUSIONS

Evidence demonstrated that the dedicated education unit practice education model is well-established. However, there were existing gaps in this evidence, specifically evaluation and economic analyses. There was also limited attention to long-term sustainability of the model. The common characteristics and processes identified in this review may be used to support planning, implementation, and evaluation, including development and validation of evaluation tools. Although administrative infrastructure was noted as central to the dedicated education unit strategy, it was rarely acknowledged as part of management and thus also requires further study.

Whole of Community Facilitators: An Exemplar for Supporting Rural Health Workforce Recruitment through Students' Professional Experience Placements

The Whole of Community Facilitator model provides support for healthcare students’ professional experience placements (PEP) in rural regions in Tasmania. In Tasmania, rural PEP is challenged as healthcare facilities are often small and have limited capacity for staff to devote considerable time to supervising students during PEP. Recruitment and retention of the rural health workforce in Tasmania is sometimes difficult because the island State is geographically distant from mainland Australia, and predominantly classified as a regional, rural, or remote area. The University of Tasmania, College of Health and Medicine (the College) explored various initiatives to support rural workforce sustainability, and the project discussed addresses this issue by promoting rural healthcare facilities as potential employment destinations for students upon completion of their course. The model supports the delivery of high-quality supervision to students whilst undertaking rural PEP, to foster positive experiences and potentially influence their future career choices. A successful exemplar was trialled in 2012 and implemented statewide in 2017 using a Whole of Community Facilitation (WOCF) model. The initiative supports host facilities, supervisors, host staff, and students and promotes positive placement experiences. The initiative was designed in consideration of Tasmania’s rurality, and uses a flexible and responsive framework.

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.

Chinese version of the clinical supervision self-assessment tool: Assessment of reliability and validity

BACKGROUND

Cultivating the professional knowledge and professional identity of nursing students is important for nursing education. The degree of professional identity of nursing students will directly affect their career options and work performance after graduation. Clinical practice is a learning process of combining the knowledge and the practical techniques of nursing. It is the important way to cultivate the students' comprehensive ability, professional attitude and professional emotion. Effective clinical supervision during the clinical practice plays an important role in guaranteeing clinial practice quality and cultivating professional nursing students. Active teaching supervision is helpful to achieve the expected learning effect. Therefore, it is vital to evaluate the clinical supervision ability of the clinical nursing teachers. However, there is no special assessment instrument available in China.

OBJECTIVES

To assess the validity and reliability of the Chinese version of the modified Clinical Supervision Self-Assessment Tool (mCAST).

DESIGN

A cross sectional survey design with a convenience sample was used in this study. This cross-sectional psychometric instrumental study determined the reliability and validity of the Chinese version of the modified Clinical Supervision Self-Assessment Tool (mCAST).

SETTINGS

Twelve hospitals in Tianjin, China.

PARTICIPANTS

A total of 350 registered nurses who perform teaching tasks in clinical practice were recruited.

METHODS

The Chinese version of the mCSAT was translated and tested by obtaining the authorization of the developer of the mCAST using Brislin's model (that is, translation, back translation, cultural adaptation and pilot study). A total of 350 registered nurses who perform teaching tasks in clinical practice were recruited by convenience sampling for the assessment of construct validity using exploratory factor analysis (EFA). Moreover, item analysis, internal correlation coefficients, Cronbach's alpha coefficients, test-retest realibility and split-half reliability were conducted to test the psychometric properties of the Chinese version of the mCSAT.

RESULTS

The Chinese version of the mCSAT contained 2 subscales, namely, mCSAT-Knowledge and mCSAT-Skills. Exploratory factor analysis of the knowledge and skills subscales explained 63.26% and 63.60% of the total variances, respectively. The mCSAT-Knowledge subscale contains 3 dimensions, namely, evaluating learning (10 items), facilitating learning (9 items) and problem solving (10 items); the mCSAT-Skills subscale contains 3 dimensions, namely, evaluating learning (10 items), facilitating learning (9 items) and problem solving (10 items). The Cronbach's α coefficients of the mCSAT-Knowledge and mCSAT-Skills subscales were both 0.95. The split-half reliability of the mCSAT-Knowledge and mCSAT-Skills subscales were 0.88 and 0.89, respectively.

CONCLUSION

The Chinese version of the mCSAT was reliable and valid in the evaluation of the knowledge and skills for the clinical supervision of registered nurses. Further validation of the Chinese version of the mCSAT requires a more representative and larger sample. Also, the confirmatory factor analysis should be conducted in future study.

Traditional Clinical Outcomes in Prelicensure Nursing Education: An Empty Systematic Review

BACKGROUND

Effectiveness of traditional apprenticeship models used in undergraduate nursing education has been questioned in the literature for over 50 years. This systematic review aimed to examine best evidence available upon which to base decisions regarding use of traditional clinical experience with prelicensure nursing students.

METHOD

A systematic review was conducted following Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Nine electronic databases were searched. Full-text review was completed for 118 articles meeting inclusion criteria.

RESULTS

No studies reported learning outcomes attributed to clinical education models, resulting in an empty review. Studies were commonly self-reports of perceptions and confidence, lacking quantitative outcomes.

CONCLUSION

No sufficient evidence was found to support traditional clinical models. The scope of nursing practice and patient complexity requires higher order thinking skills, ability to prioritize, and leadership in interdisciplinary care environments. This review raises serious concerns about how nurse educators assess learning in traditional clinical environments. [J Nurs Educ. 2021;60(3):136-142.].

Peer learning in clinical placements in psychiatry for undergraduate nursing students: preceptors and students' perspective

Aim

To describe the experiences of peer learning in psychiatric inpatient settings during clinical placement of undergraduate nursing students and to highlight the possibility for peer learning in psychiatric outpatient settings.

Design

A qualitative inductive design.

Method

Questionnaires with 14 students and 12 preceptors in inpatient and outpatient care and interviews with one student and one preceptor in outpatient care were analysed with content analysis.

Results

Students and preceptors perceived learning benefits with peer learning. They described how learning increased through exchange of knowledge and how collaboration created security and independence, structured learning activities were appreciated as a learning tool. Incompatibility of students was an issue that could be overcome. Peer learning was perceived to contribute to a secure learning atmosphere, increased self-confidence and to provide a deeper understanding of psychiatric nursing. Peer learning was described as promoting discussion and reflection on practice and preparing nursing students for their future profession.

Effective academic-practice partnership models in nursing students' clinical placement: A systematic literature review

OBJECTIVES

This systematic review examines the effectiveness of academic-practice partnership models which include clinical faculty and clinical mentor roles in improving nursing students' clinical learning when compared with traditional models.

REVIEW METHODS

PubMed, CINAHL, PsycINFO and Cochrane Library were searched to locate Randomized Control Trials and quasi-experimental studies published from 1999 to 2020. The Joanna Briggs Institute critical appraisal tools were used to ensure methodological quality.

RESULTS

Fourteen studies were included in the review. The Collaborative Teaching Model and the Dedicated Education Unit model were tested in randomized controlled trials. Dedicated Education Unit, Dedicated Education Centre, Clinical Education Units, Education Partnership model, Collaborative educational-practice model and Collaborative clinical practicum model were evaluated in four experimental studies and ten quasi-experimental studies. Studies did not include patient participation, and staff and faculty had anecdotal presence.

CONCLUSION

There is limited evidence on the effectiveness of academic-practice partnership models. However, the complementary roles of clinical faculty and clinical mentor, in addition to education and health institutions managers commitment could successfully facilitate students' clinical learning.

The Challenge of Increasing the Effectiveness of Learning by Using Active Methodologies

One of the most important objectives of the Sustainable Development Goals (SDGs) is quality education, which is related to reducing school dropouts. To this end, the use of active learning methodologies improves the motivation, facilitating the learning process and, hence, reducing the dropouts. The present study proposes a methodological approach based on collaborative learning, titled: Presentation–Questions–Answers (PQA). The aim of the research is to determine whether the use of a collaborative learning methodology affects the motivation and learning of students studying theoretical content. An analytical experimental linear study was developed, whereby students were distributed across two groups, (i) a control group, which employed a lecture-based traditional approach, and (ii) an experimental group, which employed a collaborative methodology. Pre-and post-tests were carried out to assess the knowledge and motivation of students using the Situational Motivation Scale (validated scale) and a specific knowledge scale. Improvement was found in the effectiveness of the experimental group regarding the control group, with findings showing that the group utilizing the collaborative methodology acquired 64% more knowledge than the control group during the same period. However, no significant changes were found in either the intrinsic or the extrinsic motivation of the students in either group. The results prove that the use of collaborative learning maintains students’ motivation and is more effective than lecture-based methods in learning theoretical content.

The effectiveness of partnership models in clinical nursing education - A scoping review

OBJECTIVES

To examine the effectiveness of partnership models in clinical nursing education with regards to cost effectiveness; student employability, work-readiness, confidence, and competence; and stakeholders' satisfaction.

DESIGN

Scoping review.

DATA SOURCES

Research studies published in English were searched electronically through EbscoHost (CINAHL and ERIC), Scopus, Medline (via Ovid), ProQuest Central, and Web of Science databases. Criteria were developed to guide the selection of original studies published in English before 2019 for review.

REVIEW METHODS

Arksey and Malley's framework (2005) and relevant enhancements guided the conduct of the review. An informal appraisal of selected studies was applied.

RESULTS

Two theses and 31 articles with a variation in methodologies, methods, sample sizes, research populations and quality of evidence were included for review. Four themes were identified: (i) Description of partnership models in clinical education, (ii) length of model implementation prior to evaluation, (iii) positive qualitative findings, and (iv) quantitative findings limited by data collection periods and methods.

CONCLUSIONS

Shared among the reviewed studies is stakeholder view of the positive impacts of partnership models on the clinical learning environment, and the increased level of support and individualised instruction for students. However, the use of not fully validated survey instruments and the lack of description about the implementation period before evaluation in many reviewed studies limit the interpretation of quantifiable effect of the partnership models. This review identifies a lack of attention on student employability, work-readiness, cost evaluation, patient perspective, and partnership models in low-income countries. Future research to address these knowledge gaps using high quality data collection methods and rigorous research design is warranted.

Collaborative learning in practice: A systematic review and narrative synthesis of the research evidence in nurse education

Collaborative Learning in Practice is a model of placement learning for student nurses that is currently being implemented in the United Kingdom, apparently originating in Amsterdam. Potential benefits are reported to be increased placement capacity, reduced burdens on mentors as practice assessors, improvements in qualified nurses' job satisfaction, recruitment and retention, and better-developed preparedness for registrant practice amongst student nurses. We conducted a thorough, rigorous systematic review between October and December 2018 of the literature on Collaborative Learning in Practice to discover whether there was a research evidence base for these claims. We found nothing published in English in peer reviewed journals. We found 14 related papers, although these were about the Dedicated Education Unit concept, and we have conducted a narrative synthesis of them. Key findings support the assertions related to Collaborative Learning in Practice, albeit in different models of placement learning. Further research is necessary with Collaborative Learning in Practice stakeholders including staff and students, and regarding patient care metrics, to demonstrate benefits or otherwise and until that research takes place potential gains remain unproven.

Understanding the needs of nurse preceptors in acute hospital care setting: A mixed-method study

Nurse preceptors play an important role in supporting newly qualified nurses during transition periods. However, limited attention is given to the needs and experience of nurse preceptors with expected responsibilities. This study aimed to examine the perceived needs of nurse preceptors in three public acute hospitals by using a sequential mixed method approach conducted between March and August 2017. A questionnaire that comprised socio-demographic data, Clinical Teaching Behaviour Inventory (CTBI), and RN Preceptor Learning Needs Assessment, was distributed to all nurse preceptors. Semi-structured qualitative interviews were conducted with a purposive sample of 10 informants to complement the quantitative findings. We received 260 completed questionnaires, giving a response rate of 78.8%. The highest mean CTBI domain score was "Using appropriate teaching strategies" (Mean = 3.65, SD = 0.56), whereas the lowest was "Providing feedback and evaluation" (Mean = 3.51, SD = 0.60). The top five topics identified as the most important in nurse preceptor training were critical thinking, prioritising, teaching techniques, conflict management and teamwork. Qualitative findings revealed that the informants experienced tension with their dual roles and strained relationships with co-workers. The expectations of the informants for support were recognition from management level and highlighting coaching tactics, reciprocal learning and collegiate support.

Characteristics of the collaborative learning unit practice education model for undergraduate nursing students: a scoping review protocol

What evidence on characteristics and processes of the collaborative learning unit practice education model for undergraduate nursing students is available?

Learning relationships in community-based service-learning: a social network analysis

BACKGROUND

Little is known about the social learning of students within community-based clinical placements and ways in which it can be supported. In an allied health service-learning program, we analysed students' learning relationships to quantify what, and from whom students learnt.

METHODS

We conducted a social learning network survey in four domains of learning (clinical knowledge, procedural skills, professional development, and complex determinants of health) to explore learning relationships (ties) with other people (alters) that students (egos) formed during their placement. We quantified how different roles (supervisors, health professionals, administrators, peers, schoolteachers, and clients) contributed to the students' learning in each of the four domains. We used exponential random graph models (ERGMs) to test which relational processes contributed to the structure of the observed learning networks.

RESULTS

Data was available from a complete cohort of 10 students on placement in a network of 69 members, thus providing information on 680 potential learning relations. Students engaged in similar ways in the domains of clinical knowledge, procedural skills, and professional development. Learning relations with academic supervisors were significantly more likely. Also students reported reciprocal learning relations with peers - i.e. they formed learning pairs. This effect was absent in learning networks about complex determinants of health (including socio-economic and cultural factors). Instead, local administrative staff were significantly more often the source of learning about the local contextual factors.

CONCLUSIONS

Understanding the structure of student learning networks through social network analysis helps identify targeted strategies to enhance learning in community-based service-learning programs. Our findings suggest students recognised important learning from each other and from administrative personnel that is unrelated to the content of their placement. Based on this insight clinical educators could prepare students to become agentic learners, learning with each other and from sources outside their program.

Preceptorship during health personnel students' clinical studies in nursing homes-An institutional perspective on an intervention

AIM

The recruitment and retention of preceptors to mentor health professional students and apprentices in their clinical studies are not easy. The aim of this study was to investigate factors that hindered the implementation of an intervention intended to improve the working conditions for preceptors in nursing homes. The preceptorship was related to clinical studies for health professional students and apprentices.

DESIGN

A qualitative, explorative design was applied.

METHODS

Qualitative data were collected in September 2014 by means of focus groups with preceptors and key informant interviews. The data were prepared by thematic analysis and interpreted in the light of institutional theory.

RESULTS

The intervention to improve the working conditions for preceptors was hampered by institutional traits involving rule-like perceptions of "want to," "ought to" and "have to." Precepting was preserved as an individual task of the preceptors and was not considered a daily activity in nursing homes.

CONCLUSIONS

To improve the working conditions for preceptors in nursing homes and thus improve recruitment and retention among preceptors, the nursing home leaders should address institutional traits related to preceptorship.

Clinical learning experiences of nursing students using an innovative clinical partnership model: A non-randomized controlled trial

BACKGROUND

Clinical practicum is a major learning component for pre-registration nursing students. Various clinical practicum models have been used to facilitate students' clinical learning experiences, employing both university-based and hospital-based clinical teachers. Considering the strengths and limitations of these clinical practicum models, along with nursing workforce shortages, we developed and tested an innovative clinical partnership model (CPM) in Hong Kong.

OBJECTIVE

To evaluate an innovative CPM among nursing students actual and preferred clinical learning environment, compared with a conventional facilitation model (CFM).

DESIGN

A non-randomized controlled trial examining students' clinical experiences, comparing the CPM (supervised by hospital clinical teacher) with the CFM (supervised by university clinical teacher).

SETTING

One university in Hong Kong.

PARTICIPANTS

Pre-registration nursing students (N = 331), including bachelor of nursing (n = 246 year three-BN) and masters-entry nursing (n = 85 year one-MNSP).

METHODS

Students were assigned to either the CPM (n = 48 BN plus n = 85 MNSP students) or the CFM (n = 198 BN students) for their clinical practice experiences in an acute medical-surgical ward. Clinical teachers supervised between 6 and 8 students at a time, during these clinical practicums (duration = 4-6 weeks). At the end of the clinical practicum, students were invited to complete the Clinical Learning Environment Inventory (CLEI). Analysis of covariance was used to compare groups; adjusted for age, gender and prior work experience.

RESULTS

A total of 259 students (mean age = 22 years, 76% female, 81% prior work experience) completed the CLEI (78% response rate). Students had higher scores on preferred versus actual experiences, in all domains of the CLEI. CPM student experiences indicated a higher preferred task orientation (p = 0.004), while CFM student experiences indicated a higher actual (p < 0.001) and preferred individualization (p = 0.005). No significant differences were noted in the other domains.

CONCLUSIONS

The CPM draws on the strengths of existing clinical learning models and provides complementary methods to facilitate clinical learning for pre-registration nursing students. Additional studies examining this CPM with longer duration of clinical practicum are recommended.

'It's complicated': Staff nurse perceptions of their influence on nursing students' learning. A qualitative descriptive study

BACKGROUND

During both teacher-led clinical practica and precepted practica, students interact with, and learn from, staff nurses who work on the clinical units. It is understood that learning in clinical practice is enhanced by positive interactions between staff nurses and nursing students. While much is known about preceptors' experiences of working with nursing students, there is little evidence to date about staff nurses' perspectives of their interactions with students in teacher-led practica.

PURPOSE

To understand teacher-led clinical practica from the perspective of staff nurses.

METHOD

A qualitative descriptive approach answers the question: How do staff nurses perceive their contributions to nursing students' learning during teacher-led practica? Nine staff Registered Nurses (RNs) working within a regional acute care hospital in western Canada were interviewed using semi-structured interviews. Interview transcripts were analyzed using cross case analysis to discover themes and findings were checked by several experienced RNs.

RESULTS

Analysis showed that nurses' interactions with nursing students are complicated. Nurses want to "train up" their future colleagues but feel a heavy burden of responsibility for students on the wards. This sense of burden for the staff nurses is influenced by several factors: the practice environment, the clinical instructor, the students themselves, and the nurses' understanding of their own contributions to student learning.

CONCLUSIONS

Staff nurses remain willing to support student learning despite multiple factors that contribute to a sense of burden during teacher-led practica. Workplace environment, nursing program, and personal supports are needed to support their continuing engagement in student learning. Nurses need to know how important they are as role models, and the impact their casual interactions have on student nurses' socialization into the profession.

Healthcare students' evaluation of the clinical learning environment and supervision - a cross-sectional study

BACKGROUND

The purpose of clinical placements and supervision is to promote the development of healthcare students´ professional skills. High-quality clinical learning environments and supervision were shown to have significant influence on healthcare students´ professional development.

OBJECTIVES

This study aimed to describe healthcare students` evaluation of the clinical learning environment and supervision, and to identify the factors that affect these.

DESIGN

The study was performed as a cross-sectional study.

METHODS

The data (n = 1973) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale during the academic year 2015-2016 from all healthcare students (N = 2500) who completed their clinical placement at a certain university hospital in Finland. The data were analysed using descriptive statistics and binary logistic regression analysis.

RESULTS

More than half of the healthcare students had a named supervisor and supervision was completed as planned. The students evaluated the clinical learning environment and supervision as 'good'. The students´ readiness to recommend the unit to other students and the frequency of separate private unscheduled sessions with the supervisor were the main factors that affect healthcare students` evaluation of the clinical learning environment and supervision. Individualized and goal-oriented supervision in which the student had a named supervisor and where supervision was completed as planned in a positive environment that supported learning had a significant impact on student's learning.

CONCLUSIONS

The clinical learning environment and supervision support the development of future healthcare professionals' clinical competence. The supervisory relationship was shown to have a significant effect on the outcomes of students' experiences. We recommend the planning of educational programmes for supervisors of healthcare students for the enhancement of supervisors' pedagogical competencies in supervising students in the clinical practice.

Comparing student clinical self-efficacy and team process outcomes for a DEU, blended, and traditional clinical setting: A quasi-experimental research study

BACKGROUND

Clinical education is vital to both the development of clinical self-efficacy and the integration of future nurses into health care teams. The dedicated education unit clinical teaching model is an innovative clinical partnership, which promotes skill development, professional growth, clinical self-efficacy, and integration as a team member. Blended clinical teaching models are combining features of the dedicated education unit and traditional clinical model.

OBJECTIVES

The aims of this study are to explore how each of three clinical teaching models (dedicated education unit, blended, traditional) affects clinical self-efficacy and attitude toward team process, and to compare the dedicated education unit model and blended model to traditional clinical.

METHODS

A nonequivalent control-group quasi-experimental design was utilized. The convenience sample of 272 entry-level baccalaureate nursing students included 84 students participating in a dedicated education unit model treatment group, 66 students participating in a blended model treatment group, and 122 students participating in a traditional model control group. Perceived clinical self-efficacy was evaluated by the pretest/posttest scores obtained on the General Self-Efficacy scale. Attitude toward team process was evaluated by the pretest/posttest scores obtained on the TeamSTEPPS® Teamwork Attitude Questionnaire.

RESULTS

All three clinical teaching models resulted in significant increases in both clinical self-efficacy (p=0.04) and attitude toward team process (p=0.003). Students participating in the dedicated education unit model (p=0.016) and students participating in the blended model (p<0.001) had significantly larger increases in clinical self-efficacy compared to students participating in the traditional model.

CONCLUSIONS

These findings support the use of dedicated education unit and blended clinical partnerships as effective alternatives to the traditional model to promote both clinical self-efficacy and team process among entry-level baccalaureate nursing students.

The effectiveness of clinical education models for undergraduate nursing programs: A systematic review

Clinical nurse education is a major part of all undergraduate programs preparing nurses for competent professional practice. While research mostly evaluated specific clinical education models, few studies compared different type of models and limited attention has been given to the effect on student learning outcomes. This systematic review aimed to examine the effectiveness of clinical education models for undergraduate nursing programs. This systematic review utilised the Joanna Briggs Institute systematic review approach (JBI, 2014). A web-based literature search was conducted to identify research studies published from 2002 to 2015 using a three-step search strategy. All selected papers were assessed by at least two independent reviewers for inclusion criteria, methodological validity, and data extraction in the review. This systematic review included nine studies including two pre-post-test studies with a control group totalling 1893 participants including 1286 nursing students. The evidence regarding the effectiveness of clinical education models for undergraduate nursing programs is notably weak; however this review found limited evidence that the clinical facilitator model is preferable to the preceptor model and the Clinical Education Unit (CEU) model provided greater engagement and an enhanced learning environment compared with the standard facilitation model.

Innovative Approach to Senior Practicum Students

BACKGROUND

Traditional senior practicum experiences (SPEs) are microsystem based-they allow senior nursing students the opportunity to build professional nursing competencies as they transition into practice. As health care transformation continues unabated, there is a need to work toward closing the gap between nursing academia and nursing practice.

METHOD

A cardiovascular service line created an innovative SPE to better prepare senior nursing students for working as professional nurses in a service line model.

RESULTS

The Senior Practicum Immersion Experience (SPIE) proved to be beneficial to senior practicum students and offered firsthand experience of the role professional nurses play in a service line model. This model increased the number of senior practicum students accepted into the cardiac service line by 50%.

CONCLUSION

The SPIE creates an innovative solution to increasing the number of senior practicum students while allowing students the ability to learn and practice in a service line model. [J Nurs Educ. 2017;56(12):745-747.].

Effect of a clinical skills refresher course on the clinical performance, anxiety and self-efficacy of the final year undergraduate nursing students

Although the final year of nursing undergraduate programs that focus on clinical education are planned to prepare nursing students to better transition to the real world of health care service; evidence has shown that this program is not sufficient to reach this end goal. This controlled trial study was to investigate the effectiveness of a basic clinical skills refresher course for nursing students before entering the internship program. The sample consisted of 160 undergraduate nursing students assigned into two groups. The intervention was a three-day refresher course directed by nurse instructors for intervention group focused on 10 basic nursing procedures in the clinical skill lab. The control group did not receive any intervention. The students' anxiety, clinical self- efficacy and clinical skills practice were measured before and after intervention in both groups. The results indicated that the students who took part in the refresher course experienced lower anxiety levels, higher levels of clinical self-efficacy, and have better clinical skills during their internships. The undergraduate nursing curriculum can be strengthened by the basic clinical skills refresher course. This refresher course can bridge the theory - practice gap and provide a better transition from the student to nurse role.

In pursuit of an optimal model of undergraduate nurse clinical education: An integrative review

Clinical learning experiences are an essential part of nurse education programs. Numerous approaches to clinical education and student supervision exist. The aim of this integrative review was to explore how studies have compared or contrasted different models of undergraduate nurse clinical education. A search of eight databases was undertaken to identify peer-reviewed literature published between 2006 and 2015. Eighteen studies met the inclusion criteria. A diverse range of methodologies and data collection methods were represented, which primarily explored student experiences or perceptions. The main models of undergraduate nurse clinical education identified were: traditional or clinical facilitator model; the preceptorship or mentoring model; and the collaborative education unit model in addition to several novel alternatives. Various limitations and strengths were identified for each model with no single optimal model evident. Thematic synthesis identified four common elements across the models: the centrality of relationships; the need for consistency and continuity; the potential for variety of models; and the viability/sustainability of the model. The results indicate that effective implementation and key elements within a model may be more important than the overarching concept of any given model. Further research is warranted to achieve an agreed taxonomy and relate model elements to professional competence.

Taken-for-granted assumptions about the clinical experience of newly graduated registered nurses from their pre-registration paid employment: A narrative inquiry

Paid employment within clinical setting, such as externships for undergraduate student, are used locally and globally to better prepare and retain new graduates for actual practice and facilitate their transition into becoming registered nurses. However, the influence of paid employment on the post-registration experience of such nurses remains unclear. Through the use of narrative inquiry, this study explores how the experience of pre-registration paid employment shapes the post-registration experience of newly graduated registered nurses. Repeated individual interviews were conducted with 18 new graduates, and focus group interviews were conducted with 11 preceptors and 10 stakeholders recruited from 8 public hospitals in Hong Kong. The data were subjected to narrative and paradigmatic analyses. Taken-for-granted assumptions about the knowledge and performance of graduates who worked in the same unit for their undergraduate paid work experience were uncovered. These assumptions affected the quantity and quality of support and time that other senior nurses provided to these graduates for their further development into competent nurses and patient advocates, which could have implications for patient safety. It is our hope that this narrative inquiry will heighten awareness of taken-for-granted assumptions, so as to help graduates transition to their new role and provide quality patient care.

Work Role Perspectives of Clinical Instructors From Three Countries

BACKGROUND

Educational institutions partner with health facilities to provide clinical education, but the impact of these partnerships on clinical instructors is rarely examined.

METHOD

A cross-sectional study was used to obtain surveys from a convenience sample of clinical instructors (n = 135) working in Israel, Norway, and the United States. The Nursing Clinical Instruction Role Assessment Tool (N-CIRAT) was developed to elicit clinical instructors' perspectives on the importance and nature of their work roles.

FINDINGS

The N-CIRAT exhibited good reliability and revealed three different work roles: educator, hospital partner, and patient advocate. The educator work role did not differ by primary employer; it did for the work role of hospital partner (p < .05) and patient advocate (p < .05). Patient advocate work role importance was rated high for all clinical instructors.

CONCLUSION

The educator role of clinical nurse educators, including being a role model and encouraging reflection, is universal among clinical instructors.

Patterns of clinical mentorship in undergraduate nurse education: A comparative case analysis of eleven EU and non-EU countries

BACKGROUND

In spite of the number of studies available in the field and policy documents developed both at the national and the international levels, there is no reliable data available regarding the variation of roles occupied by clinical mentors (CMs) across countries.

OBJECTIVES

To describe and compare the CM's role; responsibilities; qualifications; employment requirements and experience in undergraduate nurse education as enacted in 11 European Union (EU) and non- EU countries.

DESIGN

A case study design.

PARTICIPANTS AND SETTING

A panel of expert nurse educators from 11 countries within and outside of the EU (Croatia, Czech Republic, England, Iceland, Ireland, Italy, Poland, Serbia, Slovenia, Spain, and the USA).

METHODS

A questionnaire containing both quantitative and qualitative questions was developed and agreed by the panel using a Nominal Group Technique (NGT); four cycles of data collection and analysis were conducted involving key experts in nursing education in each country.

RESULTS

In all countries, there are at least two types of clinical mentorship dedicated to undergraduate nursing students: the first is offered by higher education institutions, and the second is offered by health care providers. Variation was noted in terms of profile, responsibilities and professional requirements to act as a CM; however, the CM role is mainly carried out by registered nurses, and in most countries there are no special requirements in terms of education and experience. Those who act as CMs at the bedside continue to manage their usual caseload, thus the role adds to their work burden.

CONCLUSIONS

Whilst it is imperative to have respect for the different national traditions in undergraduate nurse education, the globalisation of the nursing workforce and greater opportunities for student mobility during the course of their undergraduate education suggests that in areas such as clinical mentorship, jurisdictions, particularly within the EU, should work towards greater system harmonisation.

The context, influences and challenges for undergraduate nurse clinical education: Continuing the dialogue

INTRODUCTION

Approaches to clinical education are highly diverse and becoming increasingly complex to sustain in complex milieu

OBJECTIVE

To identify the influences and challenges of providing nurse clinical education in the undergraduate setting and to illustrate emerging solutions.

METHOD

A discursive exploration into the broad and varied body of evidence including peer reviewed and grey literature.

DISCUSSION

Internationally, enabling undergraduate clinical learning opportunities faces a range of challenges. These can be illustrated under two broad themes: (1) legacies from the past and the inherent features of nurse education and (2) challenges of the present, including, population changes, workforce changes, and the disconnection between the health and education sectors. Responses to these challenges are triggering the emergence of novel approaches, such as collaborative models.

CONCLUSION(S)

Ongoing challenges in providing accessible, effective and quality clinical learning experiences are apparent.

A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim

The Triple Aim unequivocally connects interprofessional healthcare teams to the provision of better healthcare services that would eventually lead to improved health outcomes. This review of the interprofessional education (IPE) and collaborative practice empirical literature from 2008 to 2013 focused on the impact of this area of inquiry on the outcomes identified in the Triple Aim. The preferred reporting items for systematic reviews and meta-analyses methodology were employed including: a clearly formulated question, clear inclusion criteria to identify relevant studies based on the question, an appraisal of the studies or a subset of the studies, a summary of the evidence using an explicit methodology and an interpretation of the findings of the review. The initial search yielded 1176 published manuscripts that were reduced to 496 when the inclusion criteria were applied to refine the selection of published manuscripts. Despite a four-decade history of inquiry into IPE and/or collaborative practice, scholars have not yet demonstrated the impact of IPE and/or collaborative practice on simultaneously improving population health, reducing healthcare costs or improving the quality of delivered care and patients' experiences of care received. We propose moving this area of inquiry beyond theoretical assumptions to systematic research that will strengthen the evidence base for the effectiveness of IPE and collaborative practice within the context of the evolving imperative of the Triple Aim.

Identifying clinical learning needs using structured group feedback: first year evaluation of pre-registration nursing and midwifery degree programmes

BACKGROUND

Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports.

METHODS

The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme.

RESULTS

Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students.

CONCLUSIONS

The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning.

Application of Heideggerian phenomenology to mentorship of nursing students

AIM

To discuss interpretations of the lived experience of mentoring based on Heidegger's concept of dasein. The focus is on one main theme identified in an in-depth study of the lived experience of nurses mentoring students in their workplace: a world of hope for the nursing profession.

BACKGROUND

This article focuses on dasein's 'existence', which is temporally aligned with having a future. Data relating to this theme are presented and interpreted with respect to the temporal aspect of dasein pertaining to 'having a future' and the Heideggerian existentials of existence and verstehen (understanding).

DESIGN

The research design was based on hermeneutic phenomenology, exploring the mentors' 'being'.

METHODS

Data were gathered during 2008 through hermeneutic interviews, event diaries and participant drawings. Analysis occurred through sustained hermeneutic engagement with the data and application of an interpretive lens provided by Heidegger's care structure.

RESULTS

Three sub-themes are identified: 'being a gatekeeper', 'sustaining a professional will', and 'passing on the special things'.

CONCLUSIONS

Mentors can and need to engage on a deep personal level with their students if they are to intervene appropriately as gatekeepers to the profession.

Maximizing the benefit of health workforce secondment in Botswana: an approach for strengthening health systems in resource-limited settings

To address health systems challenges in limited-resource settings, global health initiatives, particularly the President’s Emergency Plan for AIDS Relief, have seconded health workers to the public sector. Implementation considerations for secondment as a health workforce development strategy are not well documented. The purpose of this article is to present outcomes, best practices, and lessons learned from a President’s Emergency Plan for AIDS Relief-funded secondment program in Botswana. Outcomes are documented across four World Health Organization health systems’ building blocks. Best practices include documentation of joint stakeholder expectations, collaborative recruitment, and early identification of counterparts. Lessons learned include inadequate ownership, a two-tier employment system, and ill-defined position duration. These findings can inform program and policy development to maximize the benefit of health workforce secondment. Secondment requires substantial investment, and emphasis should be placed on high-level technical positions responsible for building systems, developing health workers, and strengthening government to translate policy into programs.

Does the choice of pre-registration paid employment impact on graduate nurse transition: an Australian study

The process of transition for newly qualified registered nurses in their first year of practice remains a difficult and onerous proposition. Aside from well-documented issues pertaining to orientation, preceptorship, appropriate patient allocation, indifferent communication and feedback from senior nursing staff, other influences can determine how new graduates adjust to the role of beginning registered nurse. The dataset from a large Australian study, that examined the impact of pre-registration paid employment on graduate nurse transition, contained a significant amount of data that indicated that undergraduate work choice might influence how senior colleagues view graduate nurses during their transition to registered nurse practice. Although this issue was beyond the scope of the original study, the volume of data and recurrence of this issue provided a strong rationale for further exploration. A secondary study was designed to explore the research question does previous undergraduate work choice influence how graduate nurses are viewed by senior colleagues during their transition to registered nurse? Using secondary analysis, and an interpretive descriptive approach, two qualitative data sets arising from focus groups and open ended questionnaire responses were analysed and three organising themes identified; drawing on prior learning, the burden of employment choice and outside the setting. The global theme "confidence and perceptions" describes graduate nurses' views about their prior paid employment choice being beneficial to them and perceived to assist them in the process of transition. Findings suggest that depending on the choice of prior paid employment, new graduates (particularly those who were formerly enrolled or second level nurses) are treated differently by their senior colleagues; in terms of the level of support offered in transition, whether prior skills and experiences from previous paid employment are acknowledged, made light of or dismissed. For successful transition to registered nurse practice it is recommended that senior nursing staff treat each new graduate equally, not based on prior paid employment experiences, and that all new graduates regardless of their prior work experiences require a period of adjustment to their new role.