The clinical role of lecturers in nursing in Ireland: perceptions from key stakeholder groups in nurse education on the role

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.

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.

How is clinical credibility defined in nursing? Protocol for a concept mapping study

AIM

To develop a working definition of the concept of "clinical credibility" in nursing science.

BACKGROUND

In both academic and clinical settings, the phrase "clinical credibility" is used when discussing the education of health professionals. No clear definition for the concept is evident in the academic literature. To date, there has not been a study undertaken to develop a working definition of clinical credibility in nursing science.

METHODS

This protocol is stage 1 of a registered report. We will use concept mapping to compare and organise views of three stakeholder groups: nursing students (n = 20) from years 2 or 3 of a three-year Bachelor of Nursing Programme, nurses and other health professionals (n = 20) still practising within a clinical setting, and people who have recently been inpatients in hospital (n = 20). First, participants will take part in separate stakeholder focus groups to generate statements about "What is clinical credibility?". Second, the same participants will complete two tasks: (1) rank the importance of each statement (prioritising) and (2) put the statements that appear to go together into groups (clustering). The data will then be analysed using a specialised software program called Ariadne. A visual "concept map" will be produced showing the importance and relationship of each statement as viewed by the participants. The projected timeline for the study is one year. The paper complies with the SPIRIT 2013 guidelines for study protocols adapted for mixed methods research.

CONCLUSION

The findings of this study will provide a working definition of the concept of "clinical credibility" in nursing science.

RELEVANCE TO CLINICAL PRACTICE

The findings can be used to develop a measure of clinical credibility to predict student satisfaction and patient safety outcomes.

Evaluation of a national training programme to support engagement in mental health services: Learning enablers and learning gains

WHAT IS KNOWN ON THE SUBJECT?: Patient and public involvement (PPI) is recognized as an increasingly important feature of healthcare research, education and public policy. In mental health, PPI is increasingly seen as evidence of the further democratization of services, which started with de-institutionalization in the 1960s and the recovery movement in the 1990s. While much is known about learning enablers and learning gains on generic community-based training programmes, less is known about PPI-specific programmes in mental health. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Participants at a national training programme to support the engagement of service users, their families and carers in mental health services identified training topics of greatest importance to them and reported on what they learnt and what helped their learning. Patient and public involvement training initiatives aimed at supporting the engagement of service users, their families and carers should emphasize individual needs and local contexts. Training programmes should not make artificial or actual distinctions between the programme participants who are health professionals and those who are non-professionals, such as service users. To our knowledge, this PPI initiative is the first time a national health service provider has sought to develop an engagement structure in mental health on a state-wide basis. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Participants in training programmes designed to support patient and public involvement believe that such programmes should include understanding how conflict is resolved, how committees work effectively and how to develop interpersonal and facilitation skills. Training programmes in mental health involving both professional and non-professional participants requires all the participants to work together in particular at commissioning and design stages to achieve their desired outcome. The evaluation of the training programme to support the roll-out of this initiative offers lessons to others who may wish to pursue similar structures in other jurisdictions. Abstract Introduction The Irish national mental health service provider commissioned a national training programme to support a patient and public involvement (PPI) initiative in mental health services. The programme evaluation afforded an opportunity to describe the learning gains and learning enablers and the factors that support PPI in mental health. Aim We aimed to evaluate a PPI training programme across nine regional administrative units in a national mental health service. Methods We conducted a participant exit survey, using the Student Assessment of Learning Gains (SALG) instrument. We analysed the survey responses using SPSS version 24 software and applied directed content analysis to the narrative comments provided in open-ended questions. Results A total of 54 participants returned the completed questionnaire, yielding a response rate of 60%. The overall mean SALG score yielded was 3.97 (SD 0.66; range 1-5), indicating that participants reported very good to excellent gains in their learning from the programme. Participants who offered narrative comments indicated an overall positive experience but suggested that all stakeholders should work together to co-produce the training. Discussion All the stakeholders in a PPI training initiative to support the engagement of service users, their families and carers in mental health should work together to achieve their desired outcome. This requires co-production in the design, delivery and evaluation of the training initiative, and co-production can impact at both individual and local levels. Implications for Practice PPI training initiatives in mental health should retain a focus on understanding conflict resolution, committee effectiveness, interpersonal and facilitation skills. Ensuring a shared understanding of key concepts, such as co-production, is a necessary prerequisite at the co-commissioning, co-design, co-planning, co-delivery and co-assessment stages of programme development, as is the need to avoid artificial or actual distinctions between health professionals and those who are non-professionals, such as service users. Relevance statement Mental health engagement and PPI are key principles underpinning modern mental health services and may increasingly impact on wider health service provision including policy and research imperatives. This paper discusses the evaluation of a PPI training programme and offers practical insights as to how such initiatives can be improved.

Lecturers' reflection on the three-part assessment discussions with students and preceptors during clinical practice education: A repeated group discussion study

Assessment of students' learning and achievement requires active involvement of participating students, preceptors and lecturers. The lecturers have overall responsibility for both the content of the assessment and students' learning. The aim of the present study was to investigate lecturers' reflections on the mid-course discussion and final assessment that are part of nursing students' clinical practice education. The design was descriptive and had a qualitative approach. Repeated group discussions were undertaken with 14 lecturers at two university campuses in Norway. Five categories were identified: preparing for the three-part discussion, creating a collaborative atmosphere, facilitating student learning, verifying student learning, using the assessment tool to create the assessment discussion; one theme emerged: 'being able to see and justify students' learning processes'. Lecturers' reflections on both assessment discussions and students' learning proceeded from a clear pedagogical viewpoint.

The Capabilities of Nurse Educators (CONE) questionnaire: Development and evaluation

BACKGROUND

To inspire excellent clinicians to become educators, the role of the nurse educator needs to be more fully defined. Capabilities rather than competencies may better describe advanced professional practice.

OBJECTIVES

To develop an effective measure of the multifaceted complexity of the nurse educator role, which will enable nurse educators to (1) self-assess their capability set, (2) identify areas for professional development, and (3) evaluate professional development interventions.

METHOD

A questionnaire (with 6 subsets) interrogating nurse educator capabilities was developed through wide professional consultation and an expert working group, and evaluated. Statistical analyses investigated internal consistency, internal correlation of items, relationship to professional practice data (also collected via questionnaire), and test-retest reliability of the questionnaire and subsets.

PARTICIPANTS

Nurse educators (266) working within universities and health services in Australia and New Zealand.

RESULTS

Analyses resulted in a 93-item Capabilities of Nurse Educators (CONE) questionnaire, with six subsets measuring Teaching Knowledge and Practice, Drawing from Nursing Knowledge, Teaching Relationships, Leadership, Research Orientation and Research Action. The questionnaire and subsets demonstrated internal validity (Cronbach's α ≥ .9). Reliability in this population was supported via significant differences between ranked questionnaire scores in ordinal categories of data collected about professional practice. The 8-week test-retest analysis supported the reliability of the CONE over time and suggested the questionnaire could be useful to evaluate the success of professional development activities.

CONCLUSIONS

The CONE questionnaire proved useful for measuring the complex capabilities of nurse educators in the academic and health service contexts studied and may assist educators to self-assess their capability sets and identify areas for professional development. It also shows promise as an evaluation tool for professional development. The utility of CONE as a self-diagnostic tool in career advancement, particularly in novice educators and educators outside Australia, requires further confirmation.

The link lecturer role; inconsistent and incongruent realities

BACKGROUND

The United Kingdom (UK) Nursing and Midwifery Council (NMC) suggest that the link lecturer role which is intended to support student nurse practice-based learning should account for 20% of the university-based nurse lecturer's remit. Meantime, a long-standing academic discussion indicates that this role lacks clarity.

OBJECTIVE

Nurse lecturer (provider) and final year undergraduate student nurse (intended beneficiary) experiences and perceptions of the link lecturer role were explored and compared.

METHODOLOGY

Data from four focus groups with nurse lecturers and four with student nurses were thematically analysed. These groups were carried out in a Scottish university where link lecturers visit student nurses in clinical placements.

FINDINGS

Three themes were identified from a multitude of perceived link lecturer responsibilities; information, advice and support, professional development and partnership working. The link lecturer role was experienced as ad hoc and varied, while dialogue about its purpose, objective and contribution to learning revealed inconsistencies and incongruence at an individual level and within and across the homogenous participant groups.

CONCLUSIONS

Narrowing the inconsistent and incongruent realities highlighted firstly in participant dialogue, and secondly in relation to policy directive versus practical application is important for reducing the confusion that surrounds the link lecturer role. Formalising the role in terms of a universally recognised and workable model of practice has potential to reduce future debate.

Nursing students' perceptions of clinical supervision: the contributions of preceptors, head preceptors and clinical lecturers

AIM

The aims of the study were 1) to investigate to what extent nursing students were satisfied with the supervision provided by facilitators (preceptor, head preceptor, and clinical lecturer), 2) to compare nursing students' ratings of facilitators' contribution to supervision as supportive and challenging, and 3) to examine relationships between facilitators' supportive and challenging behavior in supervision and nursing students' perception of fulfillment of expected learning outcomes in clinical education.

BACKGROUND

Although there are many studies on support of students in clinical education, few have addressed this from the students' point of view or made comparisons between different facilitators.

METHODS

A cross-sectional survey study was conducted during April to November 2010, where 107 nursing students, from a university in central Sweden, answered a questionnaire about supervision immediately after their period of clinical education.

RESULTS

Supportive behavior in supervision was rated higher by students for all facilitator groups as compared with challenging behavior. The students rated preceptors and clinical lecturers as more supportive than head preceptors and clinical lecturers as providing more challenges than the two other facilitator groups. Supportive and challenging behavior in supervision explained 39% of the variance in students' overall learning outcomes. However, the regression coefficient was only significant for students' ratings of supportive behavior for the preceptor.

CONCLUSIONS

Nursing students were satisfied with facilitators' supervision and by their contribution to fulfillment of overall learning outcomes. Comparisons showed that preceptors in a higher degree were perceived as supportive while clinical lecturers were perceived as more important as challengers for critical thinking, reflection and exchange of experiences between students. The model of supervision seems to be promising, but the roles across facilitators need to be made clearer, especially the head preceptor's role, which seemed to be the most unclear role in this model.

Reflecting on holistic nursing: the contribution of an academic with lived experience of mental health service use

The educational preparation of registered nurses is presumed to reflect a holistic approach with emphasis on the bio-psycho-social model of care. The broader literature suggests this goal is not always realised. The aim of this study is to present the views, experiences, and perceptions of undergraduate nursing students who were taught by an academic with a lived experience of mental health service use. In particular, we wanted to look at the expected impact of this approach to learning on their nursing practice. A qualitative, exploratory approach was used, involving in-depth individual interviews with 12 undergraduate nursing students completing the course, "recovery for mental health nursing practice," as part of a major in mental health nursing in a university in Queensland, Australia. Students were asked to reflect upon and discuss their experiences of being taught by a person with lived experience of mental health service use. Data were analysed following Colaizzi's steps to identify the main themes. The three main themes were (1) recovery--bringing holistic nursing to life; (2) influencing practice; and (3) gaining self-awareness through course assessment: challenge and opportunity. These themes suggest an appreciation for holistic nursing and an increased capacity for reflective understanding. The responses from participants suggest the Recovery course had a significant impact on their attitudes to nursing and that their nursing practice would be positively enhanced as a consequence.

Supporting students in clinical practice: pre-registration nursing students' views on the role of the lecturer

Learning in clinical practice is an essential aspect of student nurse education yet debate persists in the United Kingdom regarding the role of the lecturer in supporting the student within clinical practice. This debate has been rekindled with developments in mentorship and establishment of a clinical role designed to facilitate and support mentors; the Practice Education Facilitator. Hence it is timely to re-examine the role of the lecturer in providing clinical support to students. This article discusses nursing students' views of clinical support provided by lecturers on a Diploma/Degree programme. Qualitative and quantitative data was obtained from an online questionnaire which indicated that students thought the most important part of the lecturers' role was to provide academic support for assignments. The students also appreciated lecturers visiting them in clinical placement to facilitate the student-mentor relationship and to provide personal support. It is argued, that with the enhancement of other supportive mechanisms for students and mentors and the current economic climate, lecturers should work in partnership with mentors and practice education facilitators to avoid duplication of effort. The students in this evaluation suggested that academic support for assignments should be the main focus for lecturers.

The clinical credibility of nurse educators: time the debate was put to rest

The proverbial discussion surrounding the clinical credibility of nurse lecturers has almost become a preoccupation within the nursing literature and professional circles. It is not coincidental that it this has occurred alongside the cessation of hospital-based training and the associated reassignment of the responsibility for nurse education to institutes of higher education. This paper aims to put the debate to rest and proposes that the focus of the nurse lecturer should not be on establishing clinical credibility but on developing strong partnerships between academic and service areas. Such partnerships or communities of practice are more likely to facilitate high quality preparation of nursing students for future roles within a diverse and dynamic profession.