Undergraduate student nurses' perceptions of two practice learning models: a focus group study

A systematic scoping review of undergraduate nursing hub-and-spoke placement models

BACKGROUND

While nursing education has been forecast to continue to grow, placement capacity is now the key factor precluding growth in supply.

AIMS

To provide a comprehensive understanding of hub-and-spoke placements and their ability to increase placement capacity.

METHOD

A systematic scoping review and narrative synthesis were used (Arksey and O'Malley, 2005). PRISMA checklist and ENTREQ reporting guidelines were followed.

FINDINGS

The search returned 418 results. After a first and second screen 11 papers were included. Results suggest that hub-and-spoke models were generally evaluated favourably by nursing students, with a range of benefits reported. However, many of the studies included in the review were small and of low quality.

CONCLUSION

Given the exponential increase in applications to study nursing, hub-and-spoke placements appear to have the potential to better meet these increased demands, while also providing a number of benefits.

Undergraduate nursing student and preceptors' experiences of clinical placement through an innovative clinical school supervision model

This study explores final year undergraduate nursing and midwifery students and their preceptors' experiences of a newly introduced Clinical School Supervision (CSS) model, which was implemented to reduce a perceived disconnect between theory and practice. A descriptive design was used with qualitative data collected through open-ended survey questions. Respondents included 43 undergraduate nursing and midwifery students involved in the final year and 13 clinical preceptors from a large metropolitan tertiary health service in Victoria, Australia. Qualitative data were analysed using thematic analysis. Students described the CSS as a favoured supervision model with students being able to take advantage of support from both the academic supervisor and nursing staff in the clinical setting, a model which also supported student's sense of belonging. Students experiences indicated the CSS model facilitated consolidation of knowledge, reflective practice and transition to graduate nursing. The preceptors described a commitment to and preparedness for the role, although they found they had little break from teaching and their rosters did not always align with their students'. Preceptors also shared experiences of unfulfilled expectations, lack of recognition and incentives for supervising students. Further studies are needed to identify effective ways to support preceptors in their roles.

Strategies for retention of nursing students: A scoping review

Retention of students in nursing programs is a costly concern that affects the supply and demand of nurses to the healthcare system. Successful retention strategies require consideration of social and academic institutional systems with attention to student integration in a program. This systematic review explores implemented retention strategies in nursing programs worldwide and provides guidance for nursing programs and researchers considering the retention question. Joanna Briggs Institute scoping review methods informed this review. CINAHL, ERIC, PsychINFO, and MEDLINE, databases were searched from January 1998 to December 2019. Data was extracted from 112 full text papers and dissertations. Papers were of varying quality and inconsistently evaluated, usually lacking theoretical grounding. Student participants in strategies were preselected by racial minority status or through various markers of academic performance. Retention strategies described in the literature are single program and multifactorial, with mentorship, study skills, literacy and language approaches, and tutoring the most common components. Reports of graduation rates or attrition rates through comparison with a pre-strategy time period or a comparison group were the most informative evaluations. Whole-program strategies that provided pathway options to students based on reading assessments or other academic criteria were the most comprehensive and effective strategies presented in the literature.

A mapping review of models of practice education in allied health and social care professions

Introduction

Practice education is fundamental to pre-registration learning for many health and social care professions, yet finding sufficient opportunities for students is challenging. One-to-one student–educator pairings are common, and while different models could increase placement opportunities, the associated terminology is inconsistent and an overview of advantages, challenges and available evidence is missing. This mapping review identifies, categorises and critically considers the evidence for different models of practice education used by health and social care professions.

Method

Papers from 2008 onwards reporting on practice education approaches in allied health or social care profession courses were identified in three databases. Data was extracted, methodological quality categorised and a typology of practice education models developed.

Findings

Fifty-three papers were reviewed and developed into a typology of 14 models. Mapping indicated issues with a lack of high-quality research and limitations in available outcome indicators. Pre-requisites for the effective operation of different models include preparation, communication and allowing sufficient time for new ways of working.

Conclusions

Practice education discourse is characterised by varied terminology and practices. Various models for structuring practice education exist, though the evidence for their effectiveness and impact on capacity is limited. Using consistent language and considering wider impacts and outcomes is recommended in future study.

Development of resilience in nursing students: A systematic qualitative review and thematic synthesis

Resilience is a term commonly used to describe the ability to turn adversity into opportunities and learn from demanding situations. There seems to be a need to identify support strategies for developing resilience among nursing students in order to strengthen their professional practice. The aim of this review was to synthesize qualitative research exploring how resilience can be developed in nursing students. The review question was: How can nurse educators support students' development of resilience? Relevant publications were identified by systematic data searches in May 2017 in the following electronic databases: MEDLINE, CINAHL, Scopus, Embase, PubMed, PsycInfo, Webb of Science, ProQuest, Academic and Eric. Eight qualitative research studies in English that explored resilience in the context of nursing education were included. Five descriptive themes emerged: Demonstrating caring relationships, Recognizing resources and power, Acknowledging uncertainty, Reframing burdensome experiences and Adjusting frames for learning. In addition, two overarching analytic themes emerged: An educational culture of trustworthiness and Readiness to care. In conclusion, a learning culture characterized by trustworthiness appears to be a catalyst for developing resilience in nursing students. A variety of support strategies in nursing education contribute to resilience in nursing students, thus influencing their readiness to care.

'How families live …' - the views and experiences of parent-carers who provide family placements to intellectual disability nursing students

AIM

We aimed to learn about the value of family placements from the perspective of parent-carers who provide them to nurse students via a Scottish university Family Placement Scheme.

METHOD

Qualitative interviews were conducted with seven parent-carers who provided a family placement over two academic years. Descriptive data was analysed, organized into themes and subject to content analysis: parents' descriptions of caring; their perceived value of family placements; and their views and experiences of participation in intellectual disability nurse education.

RESULTS

Family placements are beneficial to nurse students and families with children with an intellectual disability. Description of wider aspects of caring was provided, offering insight into learning experiences of students on placement.

CONCLUSION

This model of learning provides opportunities for students to appreciate the reality of caring for a relative with an intellectual disability at home. Students develop their practice skills for working in partnership with family carers.

Student experience of hub and spoke model of placement allocation - An evaluative study

An evaluative project was undertaken at the University of Wolverhampton centring on the Hub and Spoke model utilised for organisation of placement allocation across the BNurs programme for all fields of nursing. Student experience was of particular interest throughout the evaluation with the research team focusing on the views, feelings and experiences of student nurses in relation to the hub and spoke model applied for practice. A qualitative approach was adopted, initially using Survey Monkey to collect student views through a series of open questions, and further enhanced by focus groups. These were transcribed and together with the data from the surveys, data was categorized and themed. Themes were analysed and conclusions drawn. The hub and spoke method for placements was found to enhance student understanding of the whole patient journey which offered students a wide breadth of experience and development of transferable skills such as communication and adaptability. A sense of increased belonging was highlighted by students which encouraged the development of strong effective relationships positively affecting their learning. Some less positive aspects were apparent revolving around personality difficulties and organisational problems, in particular relating to spoke placements. The purpose of spoke placements was not always apparent and sometimes there was a lack of appropriate student placement experiences provided by spoke mentors. Overall the hub and spoke model for organising placement was found to be beneficial and enhanced the student's experience, satisfaction and learning, which in turn had a positive effect on practice.

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.

Identifying student knowledge and perception of what is valuable to professional practice: A mixed method study

BACKGROUND

Bachelor of Nursing programmes are designed to prepare Registered Nurses for professional practice. The Bachelor of Nursing curriculum under discussion was shaped by the conceptual framework of primary health care philosophy, including themes of social justice, Indigenous health, caring philosophy, and the advancement of the discipline through research, scholarship and application of nursing knowledge and evidence-based practice.

OBJECTIVES

This study was designed to identify what students and graduates found valuable in a Bachelor of Nursing curriculum conceptual framework and what value they placed on a conceptual framework and underpinning themes.

DESIGN

A small study was designed to identify the student perceptions of themes which may be valuable to the new curriculum of the Bachelor of Nursing. A mixed methodology was selected as being appropriate to allow students to indicate the value that previous and completing students placed on each of these items and to explore their perceptions.

SETTINGS

The setting for this small study was a regional university in NSW, Australia.

PARTICIPANTS

Previous and completing (final year) students were invited to complete the online survey and any who were willing to be interviewed were asked to provide their contact details.

METHODS

The research was conducted via a questionnaire through Survey Monkey, using a Likert scale and open responses and follow up interviews were conducted with willing participants.

RESULTS

A total of 128 responses to the survey were received and ten were interviewed. Overall responses were positive. Students were aware of and valued all aspects of the current and proposed conceptual framework. There were some themes; however which were better understood than others.

CONCLUSIONS

The majority of graduated students indicated that they were well prepared for the workforce. All aspects of the conceptual framework of the curriculum were valued by the majority of students.

When practice precedes theory - A mixed methods evaluation of students' learning experiences in an undergraduate study program in nursing

A key area for consideration is determining how optimal conditions for learning can be created. Higher education in nursing aims to prepare students to develop their capabilities to become independent professionals. The aim of this study was to evaluate the effects of sequencing clinical practice prior to theoretical studies on student's experiences of self-directed learning readiness and students' approach to learning in the second year of a three-year undergraduate study program in nursing. 123 nursing students was included in the study and divided in two groups. In group A (n = 60) clinical practice preceded theoretical studies. In group (n = 63) theoretical studies preceded clinical practice. Learning readiness was measured using the Directed Learning Readiness Scale for Nursing Education (SDLRSNE), and learning process was measured using the revised two-factor version of the Study Process Questionnaire (R-SPQ-2F). Students were also asked to write down their personal reflections throughout the course. By using a mixed method design, the qualitative component focused on the students' personal experiences in relation to the sequencing of theoretical studies and clinical practice. The quantitative component provided information about learning readiness before and after the intervention. Our findings confirm that students are sensitive and adaptable to their learning contexts, and that the sequencing of courses is subordinate to a pedagogical style enhancing students' deep learning approaches, which needs to be incorporated in the development of undergraduate nursing programs.