Factors influencing partnerships between higher education and healthcare

Advanced practice and clinical supervision: An exploration of perceived facilitators and barriers in practice

AIM AND OBJECTIVES

The aim of this study was to investigate current advanced practice Masters students' experience of clinical supervision, to explore how clinical supervision works in practice and to identify students' perceptions of the facilitators and barriers to clinical supervision in their workplace.

BACKGROUND

Advanced practitioners, and in particular nurses, play a pivotal role in delivering health care across acute and primary care settings. These non-medical professionals fulfil a rapidly expanding proportion of roles traditionally undertaken by medically qualified staff within the National Health Service in the United Kingdom and often lead specialist clinics and services. To prepare for the advanced practice role, individuals are required to undertake a Master's in advanced practice to develop the required skills and knowledge and work in clinical practice with a clinical assessor/supervisor to demonstrate competence and performance.

DESIGN

A mixed method study using an online descriptive cross-sectional survey and qualitative data were collected via focus groups and has been reported using the Good Reporting of a Mixed Methods Study checklist.

RESULTS

A total of 79 students completed the online survey (from 145 AP students), a response rate of 55%. Most respondents were nurses (n = 73) with 49 (62%) in a formal advanced practice trainee role, and the majority believed their clinical supervisor had a good understanding of advanced practice and the advanced practice role. Two focus groups were held with 16 participants in total. Thematic analysis revealed five themes: (a) perceived level and amount of support from clinical supervisors, (b) skill level of clinical supervisors, (c) physicians and their perceptions on supervising, Advanced practitioners (d) clinical supervisors' preparation for the role and (e) transition from trainee to qualified advanced practitioner.

CONCLUSION

The survey revealed that advanced practitioner students perceived that clinical supervisors and workplace colleagues had a good understanding of the advanced practice role with good levels of support in practice. A more coherent approach is required for clinical supervision and an implementation framework that can be formally evaluated.

RELEVANCE TO CLINICAL PRACTICE

Several significant barriers to clinical supervision for advanced practitioner students were identified, and there are currently more barriers (including COVID-19) than facilitators.

A Continued Professional Development Nursing Partnership in a Remote Bolivian Hospital

Bolivia's recent enactment of universal health care to increase access and delivery of health services can increase health care demands in underresourced, rural communities. We describe how a global intradisciplinary partnership assessed changing health care needs in a recently expanded hospital in the Bolivian Amazon Basin. The collaboration resulted in designing and implementing an evidence-based triage training program to improve rapid assessment and health outcomes. The interdisciplinary triage training of 19 nurses and physicians showed a significant improvement in their knowledge and implementation capacity, as demonstrated by pre- and posttest scores. As an intradisciplinary team, trainees significantly increased consistency in triage assignments in nine of 10 clinical triage posttraining vignettes. We share insights to overcome unseen challenges and improve future data-driven, evidence-based global implementation projects. [J Contin Educ Nurs. 2021;52(3):142-149.].

Model for Improvements in Learning Outcomes (MILO): Development of a conceptual model grounded in caritative caring aimed to facilitate undergraduate nursing students' learning during clinical practice (Part 1)

AIM

The aim was to describe the development of a caritative caring conceptual model aimed to facilitate undergraduate nursing students' learning during clinical practice.

DESIGN

An explorative design was used.

METHODS

The Delphi method with a panel of 12 experts together with a literature search with a systematic approach were used and data were analysed according to content analysis.

RESULTS

The Model for Improvements in Learning Outcomes (MILO) consists of eight core concepts divided into four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety) and four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision, a good learning environment). MILO is grounded in the theory of caritative caring with a hermeneutic approach and the understanding of caring and learning as parallel processes. Tools such as reflection, structure and guiding pm are used to intertwine caring, nursing, pathophysiology and medicine.

CONCLUSIONS

MILO intertwines didactics with concepts important for nursing students' learning with a foundation in caritative caring and may facilitate undergraduate nursing students' learning in clinical practice.

The experiences of nurses who studied abroad with The Erasmus program during undergraduate education: A qualitative study

The globalization of healthcare systems and information has increased the importance of international learning and mobility programs in nursing education. This research aimed to explore and describe the lived experiences of nurses studying abroad with the Erasmus program during their undergraduate education. This is a descriptive phenomenological study. The study sample consisted of 12 nurses who studied abroad during their undergraduate education. The data were collected through semi-structured, face to face in-depth interviews. Colaizzi's seven-step method and NVivo12 software were used to evaluate the data. The study results had five main themes: (1) adaptation process, (2) sources of support, (3) differences, (4) difficulties, and (5) benefits. The nurses considered studying abroad with the Erasmus program as an important opportunity. They reported that this experience made significant positive contributions to them in the personal, professional, cultural, and social aspects.

Validation of the MidACE tool - Students' perceptions of the Midwifery Academic role in clinical environments

BACKGROUND

Situating Midwifery Academics in clinical environments can have an important impact on students' clinical learning. Students' perceptions of this support role in the clinical environment using standardised measures has been under-investigated.

AIMS

To develop and test a tool that measures midwifery students' perceptions of the Midwifery Academic role on clinical learning and development of professional knowledge, skills and clinical capability.

METHODS

A staged process for tool development included draft item generation, review by expert panel for face and content validity and pilot testing with a convenience sample of undergraduate midwifery students. Dimensionality, internal consistency and test-retest reliability were evaluated.

RESULTS

Two hundred and seventy-nine midwifery students completed an online survey (74% response rate). Responses on the ten-item tool loaded strongly on one factor, explaining 69.6% of variance. Cronbach's alpha (0.94) and test-retest reliability (intraclass coefficient=.92; 95%CI .89-.95) were good. Most students agreed that the Midwifery Academic role supported the integration of midwifery theory and practice and critical self-reflection. Areas for improvement included working in partnership with preceptors; assessing students' development; and increased presence in the clinical environment.

CONCLUSIONS

This study established reliability and validity of the Midwifery Academic in Clinical Environments (MidACE) tool. Students perceived Midwifery Academics could contribute further to their professional knowledge, skills and clinical capability through a strong collaborative presence in the clinical environment.

Communities of practice and the construction of the professional identities of nurse educators: A review of the literature

OBJECTIVES

To comprehensively review the Community of Practice literature from nursing contexts to explore whether and how these communities contribute to the social construction of nurse educator professional identity.

DESIGN

Due to the wide scope of predominately qualitative literature on the topic, papers were analysed and themed inductively.

DATA SOURCES

CINAHL, MEDLINE, COCHRANE, EBSCO databases, Emerald, Proquest & Google Scholar.

REVIEW METHODS

These online databases were searched for relevant peer-reviewed journal papers in the English language with no date range specified. The search terms 'nurs* educator' and 'nurs* teacher' were combined with each of the terms 'communit* of practice', 'identity' and 'role' resulting in 293 peer-reviewed journal papers. Where abstracts were missing, introductory and background sections were skimmed for related content. Papers that made incidental reference to either professional identity or a Community of Practice were excluded.

RESULTS

In total, 63 primary study or discussion papers were found to have a focus on nurse educator identity and/or communities of practice in healthcare contexts. Papers specifically focused on communities of practice in nursing (n=33) could only be found from the last 10 years (2005-2015). Only five of these focused on nurse educators.

CONCLUSIONS

Community of Practice theory and the professional teaching literature offers collaborative and active ways for nurse educators to further develop their professional identities. Despite the emergence of communities of practice in the nursing literature, further studies are required to explore how such a construct can facilitate the social construction of nurse educator professional identity.