A peer learning intervention for nursing students in clinical practice education: A quasi-experimental study

Effectiveness of Simulation-Based, Peer Learning Intervention in Continuing Nursing Education: An Explorative Study

BACKGROUND

Despite the vast research by nursing professionals on various methods of nursing education, little research has been conducted exploring the efficacy of peer learning as a teaching-learning tool amongst registered nurses. Hence, this study was conducted among in-service nursing officers to evaluate the usefulness of simulation-based peer learning sessions as an educational tool for capacity building.

MATERIAL AND METHODS

Using a pre-test and post-test design, the study was conducted among 150 in-service nurses at a tertiary care hospital. Five structured simulation-based, peer learning modules were designed. The nurses were divided into five groups using random and purposive sampling. Each group attended one session of the peer learning module on advanced nursing care by simulated clinical and nursing care 'demonstrate, observe, assist, and perform' (DOAP) activity. Pre-test, post-test, and retention tests (after two months) were conducted, and the results were compared.

RESULTS

There was a significant increase in mean knowledge (p-value < 0.05) in the post-test after all five sessions, which shows the effectiveness of such peer learning sessions in improving the baseline. There was a decline in mean scores in the retention test compared to that of the post-test, which was statistically significant in only the group of learners participating in the first session.

CONCLUSION

The study provides substantial evidence that simulation-based peer learning is an effective tool for continuing nursing education, and it can be used as a valuable tool to reduce the documented theory-practice gap.

Basic psychological needs satisfaction as a mediator between clinical learning climate, self-regulated learning and perceived learning in the nursing education context

PURPOSE

Self-regulated learning (SRL) can enhance students' learning process. Students need support to effectively regulate their learning. However, the effect of learning climate on SRL behavior, its ultimate effect on learning and the underlying mechanisms have not yet been established. We explored these relationships using self-determination theory.

MATERIALS AND METHODS

Nursing students (N = 244) filled in questionnaires about SRL behavior, perceived learning, perceived pedagogical atmosphere and Basic Psychological Needs (BPN) satisfaction after their clinical placement. Structural equation modelling was used to test a model in which perceived pedagogical atmosphere affects SRL behavior and subsequent perceived learning through BPN satisfaction.

RESULTS

The tested model had an adequate fit (RMSEA = 0.080, SRMR = 0.051; CFI = 0.972; TLI = 0.950). A positively perceived pedagogical atmosphere contributed to SRL behavior, which was fully explained by BPN satisfaction. SRL partially mediated the contribution of pedagogical atmosphere/BPN to perceived learning.

CONCLUSIONS

A learning climate that satisfies students' BPN contributes to their SRL behavior. SRL behavior plays a positive but modest role in the relationship between climate and perceived learning. Without a culture that is supportive of learning, implementation of tools to apply SRL behavior may not be effective. Study limitations include reliance on self-report scales and the inclusion of a single discipline.

Preceptors' experiences of supervising internationally educated nurses attending a bridging program: An interview study

BACKGROUND

Internationally educated nurses attending a bridging program must demonstrate clinical competence and meet requirements to apply for a nursing license in Sweden.

OBJECTIVES

To describe preceptors' experiences of supervising internationally educated nurses undergoing clinical practice education during a bridging program.

DESIGN

A qualitative descriptive study.

SETTINGS

Two universities offering the 1-year bridging program for nurses with a nursing degree from outside European Union/European Economic Area and Switzerland.

PARTICIPANTS

Fifteen preceptors, all registered nurses, who supervised internationally educated nurses were included.

METHODS

Semi-structured interviews were performed, and data were analyzed using qualitative content analysis.

RESULTS

Supervising internationally educated nurses was not the same as supervising nursing students and raised feelings of both joy and frustration. Preceptors had to adapt supervision to the student's nursing knowledge and skills. They had to help students communicate in Swedish and form good relationships with other students, patients, and other professionals. Most preceptors requested more information about the student's nurse education, country of education/cultural background, and previous work experiences. Mixed experiences of support from the university, first-line managers, and colleagues were reported.

CONCLUSIONS

Being a preceptor for internationally educated nurses is a challenge, and supervision training is important for managing preceptorship. To supervise students based on their level of knowledge and skills, more information must be shared with the preceptor. Encounters with others are of importance in the training, where teamwork and person-centered care must be in focus, both in prior theoretical education and in clinical practice education.

Nursing students' experience of an alternative model for supervision during practical studies in the municipal health service: A qualitative study

Aim

The aim of the study is to describe how Norwegian nursing students experience clinical practice when the Strengthened Supervision in Practice model is used together with peer learning.

Background

Clinical practice is one of the most important parts of nursing education and the nurse supervisor plays an important role in the education of nursing students. Challenges arise because nursing students do not always receive quality supervision in practice. The quality of supervision affects the learning outcomes and well-being of the students during clinical practice. To meet the challenge that students do not always receive high-quality supervision, we wanted to try out a new supervision model Strengthened Supervision in Practice. Peer learning was also tried out in clinical practice.

Method

The study used a qualitative design. Data were collected from three focus group interviews with a total of 11 nursing students participating.

Findings

Clinical nurses are the most competent to supervise and assess nursing students in clinical practice. Peer learning provides safety in a learning situation.

Conclusions

This study shows that the supervisor and their supervision competence are important for the student's learning. Cooperation with the lecturer in common meetings is important to make sure supervisors have quality guidance and assessment skills. The Strengthened Supervision in Practice model seems to meet expectations, but further research is necessary to develop the model further.

Understanding competency of nursing students in the course of case-based learning in Cambodia: a convergent mixed method study

BACKGROUND

In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching-learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings.

METHODS

This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays.

RESULTS

First, the quantitative and qualitative findings confirmed each other 's CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students' academic satisfaction with the programme.

CONCLUSIONS

The finding of CBL experiences in a group and students' satisfaction with faculty members' and preceptors' teaching improved nursing students' competency development. Meanwhile, students' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.

Hybrid Concept Analysis: Peer Collaborative Clinical Decision-Making in Nursing Simulation

BACKGROUND

Nursing students collaborate and make clinical decisions in simulation scenarios. However, the literature does not clearly define the concept of peer collaborative clinical decision-making (PCCDM). This hybrid concept analysis explored and established the definition of PCCDM among nursing students in simulation.

METHOD

A total of 19 articles were reviewed, and 11 dyads of nursing students were interviewed after participating in virtual reality simulation for their perspectives on PCCDM.

RESULTS

Five major themes were identified: group (1) communication; (2) awareness; (3) regulation; (4) reasoning; and (5) emotion. The conceptual definition of PCCDM is a dynamic, nonhierarchical, and group-level process of cognitive and socioemotional interactions among peers about a clinical situation that involves group communication, awareness, and regulation of reasoning and emotion within the collaborative space.

CONCLUSION

This analysis provides a conceptual definition of PCCDM in nursing simulation as well as a pathway for developing a theoretical framework and instrument. [J Nurs Educ. 2023;62(5):269-277.].

Effects of BOPPPS combined with TBL in surgical nursing for nursing undergraduates: a mixed-method study

BACKGROUND

Surgical Nursing is a core subject for nursing undergraduates that requires active and effective learning strategies to cultivate students' autonomous learning competencies and critical thinking. The effects of BOPPPS (Bridge-in, Objectives, Pretest, Participatory Learning, Post-test and Summary) model combined with team-based learning (TBL) have rarely been explored in Surgical Nursing courses.

OBJECTIVE

To explore the effects of BOPPPS combined with TBL in Surgical Nursing for nursing undergraduates.

METHODS

A mixed research method of quasi-experimental study design and descriptive qualitative research was used. The control group included 27 nursing undergraduates who had finished the Surgical Nursing course using traditional learning. The experimental group included 36 nursing undergraduates were enrolled in to receive the Surgical Nursing course in the teaching mode of BOPPPS combined with TBL. The quantitative data of students' Surgical Nursing final scores, autonomous learning competencies and critical thinking ability of the two groups were collected and compared by t-test. Qualitative results were obtained through semi-structured interviews and data were analyzed by thematic analysis method.

RESULTS

Compared with the traditional learning mode, BOPPPS combined with TBL significantly improved nursing students' final examination scores, autonomous learning competencies and critical thinking ability (p < 0.05). Qualitative results from 14 undergraduate nursing students' interviews were summarized into five themes: (1) stimulating learning interest; (2) improving autonomous learning ability; (3) improving the sense of teamwork; (4) exercising critical thinking; and (5) suggestions for improvement.

CONCLUSIONS

The combination of BOPPPS and TBL positively impacted nursing students by improving their autonomous learning competencies and critical thinking ability. The study suggests BOPPPS combined with TBL learning as an effective, alternative learning mode.

The effect of professional portfolio learning on nursing students' professional self-concepts in geriatric adult internship: a- quasi-experimental study

BACKGROUND

Professional self-concept is one of the important outcomes of nursing professionalism. There is a lack of adequately planned curriculum may limit nursing students' practical knowledge, skills and professional self-concept in providing comprehensive geriatric-adult care and promoting nursing professionalism. Professional portfolio learning strategy has allowed nursing students to continue professional development and enhance nursing professionalism in professional clinical practice. However, there is little empirical evidence in nursing education to support the use of professional portfolios in blended learning modality among internship nursing students. Therefore, this study aims to examine the effect of the blended professional portfolio learning on professional self-concept among undergraduate nursing students during Geriatric-Adult internship.

METHODS

A quasi-experimental study two-group pre-test post-test design. A total of 153 eligible senior undergraduate students completed the study (76 in the intervention group and 77 in the control group). They were recruited from two Bachelor of Sciences in Nursing (BSN) cohorts from nursing schools at Mashhad University of Medical Sciences (MUMS), in Iran, in January 2020. Randomization was undertaken at the level of school via a simple lottery method. The intervention group received the professional portfolio learning program as a holistic blended learning modality, though the control group received conventional learning during professional clinical practice. A demographic questionnaire and the Nurse Professional Self-concept questionnaire were used for data collection.

RESULTS

The findings imply the effectiveness of the blended PPL program. Results of Generalized Estimating Equation (GEE) analysis was indicated significantly improved professional self-concept development and its dimensions (self-esteem, caring, staff relation, communication, knowledge, leadership) with high effect size. The results of the between-group comparison for professional self-concept and its dimensions at different time points (pre, post and follow up test) showed a significant difference between groups at post-test and follow up test (p < 0.05),while at pre-test there was no important dissimilarity between two groups (p > 0.05).The results of within-group comparison for both control and intervention showed that there were significant differences in professional self-concept and for all its dimensions across the time from pre-test to post-test and follow-up (p < 0.05), and also from post-test to follow-up it was significant (p < 0.05) for both groups.

CONCLUSION

This professional portfolio learning program demonstrates as an innovative and holistic blended teaching-learning approach to improve professional self-concept during professional clinical practice among undergraduate nursing students. It appears that the use of a blended designed of professional portfolio can promote a link between theory and the advancement of geriatric adult nursing internship practice. The data obtained from the present study can be useful for nursing education to evaluate and redesign a curriculum for development of nursing professionalism as a quality improvement process and groundwork to develop new models of teaching-learning and assessment.

Role of peer learning and self-efficacy in parasympathetic activity during the simulation learning process in nursing students

AIMS

This study aimed to investigate the stress level, including parasympathetic nervous activity, of students engaged in peer learning during simulations and the role of self-efficacy.

DESIGN

Observational-comparative study.

METHODS

The participants were 76 nursing students who were asked to evaluate a stable postoperative patient in Scene 1 and the same patient bleeding in Scene 2. In each scene, the students engaged in phases of repeated individual observations of the patient and discussions with peers. We compared each participant's parasympathetic activity during each observation in Scenes 1 and 2. Furthermore, the self-efficacy score before the simulation was used to divide the participants into 3 groups, and the self-efficacy and parasympathetic activity during the simulation were analysed.

RESULTS

The participants' parasympathetic activity decreased in both scenes with each phase of repeated observation. Two-way repeated-measures analysis of variance showed no statistically significant difference in parasympathetic activity during simulations among the three self-efficacy groups.

Impact of dyadic practice on the clinical self-efficacy and empathy of nursing students

BACKGROUND

Dyadic practice of learners creates supportive learning. So far, few studies have investigated the impact of this approach on students' empathy and self-efficacy. This study aimed to investigate the effect of dyadic practice on nursing students' clinical self-efficacy and empathy.

METHODS

This study was based on a pretest-posttest randomized group from September to December 2018. All the junior nursing students (n = 44) were divided into intervention (n = 22) and control groups (n = 22) using stratified random sampling. The intervention group was trained for 6 days as student dyads, while the control group was under the supervision of an instructor and worked individually. The students' levels of empathy and self-efficacy were evaluated on the first day (pretest) and the last day (post-test) by The Self-Efficacy in Clinical Performance Scale and Mehrabian and Epstein empathy scale. The data were analyzed using the SPSS software by Fisher's exact test, Mann-Whitney test, independent t-test paired t-test, Wilcoxon signed-rank, and Analysis of covariance.

RESULTS

Dyadic practice increased empathy in the intervention group compared to the control group (P < 0.001). The adjusted mean of total empathy in the intervention group was 21.1 degrees higher than the adjusted mean of total empathy in the control group. However, no significant differences were found between the two groups in clinical self-efficacy (P = 0.762).

CONCLUSIONS

The employment of this approach seems helpful in creating an empathic atmosphere. However, further studies are required to prove the effectiveness of this method on self-efficacy.

A supportive clinical learning environment for undergraduate students in health sciences: An integrative review

BACKGROUND

The clinical learning environment is a platform where theory and practice should be integrated in a safe environment. However, many students experience the clinical learning environment as "stress provoking", because this environment is not always supportive.

OBJECTIVE

The aim of the article is to report on a study that synthesized the evidence on strategies for providing a supportive clinical learning environment for undergraduate students in health sciences.

DESIGN

The integrative review followed the methodology of Whittemore and Knafl (2005).

DATA SOURCES AND REVIEW METHODS

We searched MEDLINE with Full Text, CINAHL with Full Text, Academic Search Ultimate, PsycINFO, Health Source: Nursing/Academic Edition, ERIC, Africa-Wide Information, OpenDissertations, CAB Abstracts, MasterFILE Premier, SocINDEX with Full Text, SPORTDiscus with Full Text and PsycARTICLES. Other data sources included grey literature and reference lists. The filtering process, quality appraisal and data extraction were carried out by at least two independent reviewers. Thematic analysis was used to analyse the data.

RESULTS

The search yielded 500 studies, of which nine studies met the inclusion criteria. The generated data culminated in a clinical learning environment mindmap that highlights, firstly, a network of carefully selected supporters who may have specific clinical responsibilities while supporting undergraduate students in clinical learning. Secondly, the relationship between the student, student supporter and clinical staff should create a sense of belonging, self-efficacy and self-directedness. This relationship is influenced by the roster, the ratio of students to student supporters, and appropriate learning opportunities. Thirdly, higher education institutions and healthcare providers should support students and student supporters through formal partnerships.

CONCLUSIONS

The synthesis of the evidence provided new insights regarding creating and maintaining supportive clinical learning environment strategies for undergraduate students in health sciences. These strategies may be implemented in innovative ways to provide students with the best clinical learning opportunities.

Domains of competence in midwifery students: a basis for developing a competence assessment tool for iranian undergraduate midwifery students

BACKGROUND

Current study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students.

METHODS

Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth.

RESULTS

Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20-56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories.

CONCLUSION

The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.

Comparison of the effects of face-to-face and electronic peer mentoring on students' care plan preparation and motivation levels

BACKGROUND

It is a basic requirement in professional nursing education that nursing students learn the process of caring as the entity at the center of nursing practice. Peer mentoring programs can be beneficial for the mutual growth of mentors and mentees and improve the care competencies of nursing students.

OBJECTIVE

To compare the effects of face-to-face and electronic peer mentoring on students' nursing process-based patient care plan preparation and motivation levels for the course.

DESIGN

The study used an experimental three-group design.

SETTINGS AND PARTICIPANTS

This experimental study was conducted with 83 first- and 6 fourth-year nursing students.

METHOD

The data were collected with the information and opinion form, the Instructional Materials Motivation Survey (IMMS), and the Nursing Care Plan Rubric (NCPR). In the study, conducted with three subgroups of each group, the experimental group received electronic peer mentoring (EPM), and the experimental group 2 received face-to-face peer mentoring (FPM), while the control group did not receive any intervention.

RESULTS

It was statistically significant that the students in the EPM group had higher patient care plan preparation scores than the FPM and control groups, and the FPM group had higher patient care plan preparation scores than the control group (p < 0.05). Also, the students in the FPM group had statistically significantly higher confidence-satisfaction sub-dimension scores on the IMMS than those in the EPM and control groups (p < 0.05).

CONCLUSION

While electronic peer mentoring was effective on the patient care plan preparation levels of first-year nursing students, face-to-face peer mentoring was more effective in increasing the students' confidence and attitude levels and thus their motivation levels.

Fostering collaborative learning and leadership through near-peer mentorship among undergraduate nursing students

BACKGROUND

Innovative teaching strategies in nursing education are essential with increasing enrollment. Collaborative learning and leadership (CLL) activities encourage near-peer learning through mentorship between senior-level and novice students while supporting teaching ratios in lab and clinical. In this study, senior nursing students' perceptions and performance during CLL activities were explored.

METHODS

Final-semester senior students participated in CLL activities and were evaluated on their leadership and engagement. Grading rubric results were summarized using descriptive statistics. Thematic analysis of students' post-CLL reflections supported common themes.

RESULTS

Students' average scores (97.53%) confirm students were prepared and engaged in CLL activities. Senior students enjoyed "building confidence" through these activities, with a consistent theme of "becoming a leader," noted in reflections.

CONCLUSION

Near-peer learning activities assisted senior students in development of leadership and communication skills, preparing them for nursing practice. Recommendations include developing instructions for varied CLL activities and exploring faculty perspectives regarding this experience.

Impact of the peer education model on nursing students' anxiety and psychomotor skill performance: A quasi-experimental study

Background

Peer-assisted education (PAE) is a collaborative and active learning strategy in which another student or another student group teaches one group of students. This model is quite widely used in social and health science vocational education.

Aim

This study was carried out to determine the effect of peer education on clinical skill learning and anxiety in nursing students. A quasi-experimental and a single-blinded design were used.

Subjects and Methods

This study was conducted using experimental (n = 45) and control groups (n = 47) in a university in the Central Anatolia Region, Turkey. A total of 92 students were included. The experimental group received peer education nursing skills. The control group also received education in the traditional model. An Objective Structured Clinical Examination (OSCE) pretest and posttest were used to assess student performance.

Results

It was found that the total scores of posttraining exam success in both experimental and control groups increased (35.20 ± 4.63; 36.70 ± 5.36, respectively) and there was no statistically significant difference between the two groups (P > 0.264). The posttest scores of anxiety in the experimental group were less than the control group (30.18 ± 2.25; 41.21 ± 4.20, respectively).

Conclusions

The use of the peer education model in nursing education has been found to reduce the level of learning anxiety and positively affect psycho-motor skill acquisition. It is proposed to be used as an alternative method in vocational skills training within this context in this area.

Observational Study Exploring the Efficacy and Effectiveness of a New Model of Peer-Assisted Simulation-Based Learning Clinical Placement

(1) Background: Immersive simulation-based learning is relevant and effective in health care professional pre-licensure training. Peer-assisted learning has reciprocal benefit for the learner and the teacher. A fully simulated model of fieldwork placement has been utilised at Curtin University since 2014, historically employing full-time faculty supervisors. Due to the COVID-19 pandemic in 2020, traditional clinical placement availability diminished. (2) Methods: This mixed-methods prospective observational study aimed to translate the existing faculty-led placement for penultimate-year physiotherapy students to a peer-taught model, thereby creating new teaching placements for final-year students. Final- and penultimate-year physiotherapy students undertook the fully simulated fieldwork placement either as peer learners or peer teachers. The placement was then evaluated using four outcome measures: The ‘measure of quality of giving feedback scale’ (MQF) was used to assess peer learner satisfaction with peer-teacher supervision; plus/delta reflections were provided by peer teachers and faculty supervisors; student pass/fail rates for the penultimate-year physiotherapy students. (3) Results: For 10 weeks during November and December 2020, 195 students and 19 faculty participated in the placement. Mean MQF scores ranged from 6.4 (SD 0.86) to 6.8 (SD) out of 7; qualitative data reflected positive and negative aspects of the experience. There was a 4% fail rate for penultimate-year students for the placement. Results suggested that peer learners perceived peer-led feedback was of a high quality; there were both positives and challenges experienced using the model. (4) Conclusions: Physiotherapy students effectively adopted a peer-taught fully simulated fieldwork placement model with minimal faculty supervision, and comparable clinical competency outcomes.

Why do nursing students leave bachelor program? Findings from a qualitative descriptive study

Background

Over the past few years, the phenomenon of “nursing student attrition” has been unevenly studied. Investigators often focused on independent predictors as age, family obligations, final grade of high school, demanding physical and mental workload and others. Specifically, just a few studies applied qualitative methods to better comprehend the very needs of first year students enrolled in a bachelor’s degree in nursing sciences (BSN), to sustain their learning process and define effective strategies to reduce student drop-out.

Methods

We conducted a qualitative descriptive study. Thirty-one nursing students at Verona University were interviewed using a semi-structured guide. Data analysis was performed according to a descriptive approach by Sandelowski & Barroso (2000).

Results

A total number of 31 students were interviewed. The most recurrent themes regarding the reasons behind BSN drop-out were: understanding that they were not suited to be nurses, perception of missing/lack of psychological, physical and practical resources needed to successfully cope with both nursing school and the nursing profession, inconsistencies between the image of the profession and the reality of the job, feelings of disappointment for the experiences of internship, perceived lack of support from the clinical teacher while going through difficult experiences.

Conclusions

We can consider a part of these drop-out decisions normal, even physiological when students come to realise that they are not suited for the nursing profession. However, it’s important to guide nursing students with adequate counselling in order to give them the essential tools to cope with the training and the future as health professionals.

Preceptors' and nursing students' experiences of using peer learning in primary healthcare settings: a qualitative study

BACKGROUND

Due to the need for students to integrate theory with practice, current research seeks the best learning and teaching models in primary healthcare settings. The aim of this study was to explore preceptors' and nursing students' experiences of using peer learning during clinical practice in primary health care.

METHODS

A qualitative research approach was used based on semi-structured interviews with seven preceptors and ten nursing students. The interviews were transcribed and analyzed by using content analysis based on an inductive reasoning.

RESULTS

Preceptors and students perceived peer learning as an educational model to be beneficial for learning in primary care settings. They found the model to be stimulating, challenging, and leading to development of professional identity and nursing skills. All informants were positive towards the peer learning experience, with students reporting they were seen as individuals, despite working in pairs. However, the physical environment was demanding with regards to telephone counseling issues, limited opportunities for using computers, and the use of small examination rooms.

CONCLUSION

This study shows that, despite the complex learning environment, peer learning as an educational model appears to work well in a primary healthcare setting. However, much improvement is needed to facilitate the students' learning process. Consequently, conditions for clinical practice and learning beneficial to both students and preceptors should be prioritized by management.

Effects of high-fidelity simulation teaching on nursing students' knowledge, professional skills and clinical ability: A meta-analysis and systematic review

OBJECTIVE

This meta-analysis was designed to systematically determine the effect of high-fidelity simulation teaching on nursing students' knowledge level, professional skill level and clinical ability.

BACKGROUND

High-fidelity simulation is an increasingly popular pedagogical approach in nursing education. It provides students with opportunity to practice in a variety of simulations before entering clinical practice through a variety of real-life situational experiences and many institutions and educators have embraced this method for enhancing access to clinical skills. However, evidence for the effectiveness of the method in nursing teaching remains scarce.

DESIGN

A meta-analysis and systematic review.

METHODS

The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wangfang. The search encompassed the establishment of these databases up until November 2021. Two reviewers separately entered the data into Review Manager Software 5.3.

RESULTS

A total of 15 studies were included in this study. High-fidelity simulation significantly increased nursing students' knowledge acquisition (SMD = 1. 37, 94％CI:0. 73-2. 00，P ＜0. 0001), enhanced nursing students'professional skills (SMD = 0. 90, 95％CI:0. 36-1. 44，P = 0. 0001). In terms of clinical practice ability outcomes, high-fidelity simulation significantly improved the levels of critical thinking ability (SMD = 0. 58, 95％CI:0. 09-1. 07，P ＜0. 00001), Clinical judgement ability (SMD = 1. 34, 95％CI:0. 38-2. 31，P＝0. 006) and communication skills (SMD = 2. 62, 95％CI:1. 84-3. 40，P ＜0. 001) of nursing students.

CONCLUSIONS

We found that high-fidelity simulation have strong educational effects in nursing education, helping nursing students to increase knowledge acquisition, enhance professional skills and cultivate their clinical practice ability (critical thinking ability, communication skills and clinical judgement ability). These findings can provide guidance for nursing educators, indicating that the use of High-fidelity simulation teaching represents an effective solution for transitioning students from the learning environment to clinical practice.

A peer learning intervention in workplace introduction - managers' and new graduates' perspectives

Background

Evaluation of a complex intervention are often described as being diminished by difficulties regarding acceptability, compliance, delivery of the intervention, recruitment and retention. Research of peer learning for nursing students have found several positive benefits while studies of peer learning for newly graduated nurses are lacking. This study aimed (1) to investigate the study process in terms of (a) first-line managers’ perspectives on the intervention study, the difficulties they face and how they handle these and (b) new graduates’ fidelity to the intervention and (2) to examine the effect of the peer learning intervention in workplace introduction for newly graduated nurses.

Methods

A mixed-methods approach using semi-structured interviews with eight managers, repeated checklist for fidelity and questionnaires conducted with 35 new graduates from June 2015 and January 2018, whereof 21 in the intervention group. The peer learning intervention’s central elements included pairs of new graduates starting their workplace introduction at the same time, working the same shift and sharing responsibility for a group of patients for 3 weeks. The intervention also included 3 months of regular peer reflection.

Results

Managers offered mostly positive descriptions of using peer learning during workplace introduction. The intervention fidelity was generally good. Because of recruitment problems and thereby small sample size, it was difficult to draw conclusions about peer learning effects and, thus, the study hypothesis could either be accepted or rejected. Thereby, the study should be regarded as a pilot.

Conclusions

The present study found positive experiences of, from managers, and fidelity to the peer learning intervention; regarding the experimental design, there were lessons learned.

Trial registration

Before starting data collection, a trial registration was registered at (Trial ID ISRCTN14737280).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00791-0.

Professional nurses' perceptions regarding clinical competence of community service nurses in North West province, South Africa

Background

South African Nursing Council requires nurses who successfully complete their training to perform a year of community service before obtaining registration as professional nurses (Regulation 425). Community service for health professionals was introduced as a strategy to retain newly qualified professionals within the country. The premise is that community service for newly graduated nurses gives them the opportunity to develop skills and acquire knowledge critical in their professional development.

Aim

To explore and describe the perceptions of professional nurses as the supervisors of community service nurses (CSNs) during their 12 months of community service.

Setting

Selected hospitals of the North West province, South Africa.

Methods

A qualitative, exploratory and descriptive design was used. The study was conducted between September and November 2018 at three public hospitals in the North West province. Through purposive sampling, 15 professional nurses who supervise CSNs participated in the study. Data were collected in three focus group discussions using semi-structured questions. All focus group discussions were recorded and transcribed for analysis. Data were analysed using Pienaar’s four steps of thematic analysis.

Results

Three themes emerged: perceptions of clinical competence, challenges impacting clinical competence and suggestions to improve clinical competence.

Conclusion

It is suggested that even though the majority of CSNs were perceived to be competent and capable of working independently, they still required supervision and mentorship to refine their competency. Furthermore, the study reported similar challenges noted from previous studies that were perceived to be affecting CSNs’ ability to deliver quality health care, and therefore recommendations for improvement were made.

Contribution

The study contributed to the developed the clinical competence evaluation tool which will be of benefit to the future community service nurses in the province.

Effect of guided reciprocal peer questioning strategy on pediatric nursing students' self-esteem and metacognitive awareness: Current approach and future directions

BACKGROUND

Guided Reciprocal Peer Questioning Strategy (GRPQS) restructures the classroom context from a passive into an engaging environment, where the students are empowered to actively participating in their learning process.

OBJECTIVE

To investigate the impact of GRPQS on the pediatric nursing students' self-esteem and metacognitive awareness.

DESIGN

A Quasi-experimental, pre-posttest, two groups research was carried out at University of Bahrain. A sample of 89 out of 112 pediatric nursing-students were divided into two groups.

METHOD

Through GRPQS, the students mutually generated and responded to questions, activated their critical thinking, elicited ideas, and shared learning experiences within the team and the teachers act as facilitators.

RESULTS

It is revealed that 75% of the students in the study group developed high self-esteem after their engagement in the GRPQS compared to only 48.8% among those in the control one. Students who practiced GRPQS showed an improvement in their knowledge about cognition. As the mean score of students in the study group is increased from 2.16 ± 0.45 to 2.89 + 0.35 for the procedural knowledge, from 2.33 ± 0.56 to 2.86 ± 0.41 for declarative and from 2.18 + 0.53 to 3.09 ± 0.29 for the conditional knowledge (p < 0.001 for each). Concerning the regulation of cognition, the mean score of the planning dimension was improved from2.21 ± 0.46 to 3.10 ± 0.31 among the students in the study group. Moreover, it is clear that applying GRPQS in the lectures helped in improving the students' information management strategies, comprehension monitoring, debugging strategies and evaluation (p < 0.001 for each) compared to the control group p = 0.169, p = 0.009, p = 0.117 and 0.887 respectively).

CONCLUSION

The application of GRPQS provided an interactive and engaging learning experience that helped the students to develop the habit of organizing, judging, and summarizing information as well as focusing on the significant portions of the learning materials. Moreover, exchanging questions between the nursing students was effective in enhancing their self-esteem and metacognitive awareness. Hence, incorporating this innovative pedogeological approach in the nursing curricula is recommended.

Reflection as a learning strategy for the training of nurses in clinical practice setting: a scoping review

OBJECTIVE

The objective of this review is to identify and map the tools and approaches used for reflection as a learning strategy for nurses and nursing students in clinical settings.

BACKGROUND

Several types of reflection interventions exist to develop nurses' reflective competencies in clinical practice. This scoping review mapped the available literature on the use of reflection in the education of nurses and nursing students in clinical settings. Three questions guided the review: i) What tools and approaches for reflection have been reported? ii) What levels of reflection have been identified (low/descriptive, middle/application, or high/evaluative)? iii) What outcomes of reflection have been reported?

INCLUSION CRITERIA

Studies investigated nursing students or nurses working in clinical settings involved in patient care, and described reflective interventions and definitions of reflection, descriptions of the contents reflected on, measurement instruments, and outcomes of interventions.

METHODS

MEDLINE (PubMed), Emcare (Ovid), MEDLINE (Ovid), ERIC (ProQuest), CINAHL (Ovid), and Web of Science databases were searched for full-text studies published in English, Danish, Swedish, or Norwegian. Studies from any country and published from 2007 to September 2020 were eligible for inclusion. The review followed the JBI methodology for scoping reviews and was based on an a priori protocol. Two independent reviewers assessed studies against the inclusion criteria and extracted data. Inclusion for review was determined according to the pre-determined eligibility criteria and consensus between researchers. Data were extracted using a standardized data extraction table and results were summarized narratively with accompanying tables.

RESULTS

Seventeen articles were included; nine quantitative studies and eight qualitative studies. Findings are presented separately due to varying study designs and outcomes. Most studies used physical tools and reflective dialogues in clinical settings. Some tools included specific questions for participants to reflect on, while others included open questions or no questions. Reflective approaches included lectures, workshops, or reflection with supervisors or peers in clinical settings. None of the 17 studies included the same combination of tools and approaches. Measurement of reflection was varied across articles, and there was a lack of standardization in how reflection outcomes were classified.

CONCLUSIONS

Interventions, tools, approaches, and the measurement of nurses' reflection in clinical settings are highly varied, and none of the included studies had the same combination of elements. The studies indicate that reflection skills are achieved potentially according to the tools and approaches used, and the foci for reflection. There is little agreement among the research community on how best to assess the measurement and quality of reflection. It is recommended that future studies are explicit on the classification of low-, middle-, and high-level reflection according to standardized criteria.

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.

When student midwives are present during labour and childbirth in a peer-learning model: An interview study of parents in Sweden

OBJECTIVE

For peer learning to be useful in clinical practice, we need to know how parents experience peer learning during labour and childbirth. This study explored how parents experienced having two students present during labour and childbirth in a peer-learning model.

DESIGN

A qualitative approach using individual interviews followed by thematic inductive analysis.

SETTING

Three hospitals and obstetric units in Stockholm, Sweden.

PARTICIPANTS

Eleven women and nine partners.

FINDINGS

The overarching theme was that of a fruitful model of health care, in which there were gains for both parents and students. Parents described feeling seen and cared for, being made aware of what was going on, and never being left alone (subtheme 1, Trustful relationship). Parents appreciated being able to observe student midwives' attendance to the tasks at hand and that they, the two students, learned from each other (subtheme 2, Advantages for students).

CONCLUSIONS

The parent couple was able to build a trustful relationship with both students. Furthermore, could parents only see advantages for students in a peer-learning model. Parents reported generous support and were willing to contribute to student education. Parents took advantage of the learning taking place between the two students. The model deserves to be incorporated in the midwifery-student internships to complement more individually assisted births.

Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study

AIM

The aim of the present study was to elucidate health-promoting and -impeding aspects of peer-learning by examining nursing students' descriptions of learning together as peers, and how this might interact with their health.

BACKGROUND

Peer-learning is a useful strategy for teaching and learning in nursing students' clinical practice education. In the research, benefits such as improved cooperation and increased self-confidence have been described and labelled as health-promoting.

DESIGN

A qualitative descriptive approach METHOD: Thirteen first-year nursing students aged 22-45 years, who had completed their first clinical practice education on a medical or surgical hospital ward, participated in one-on-one semi-structured interviews. The interviews were analyzed using qualitative content analysis.

RESULT

Working as a pair was primarily described as positive, as the peers felt basic support from each other, even though they described negative experiences that limited their own development and challenged their patience.

CONCLUSION

Peer-learning as a model for supervision in clinical practice incorporates valuable health-promoting aspects, as the students felt safe, supported, increased self-confidence, and participation. The interaction between peers helped them grow as human beings, and the mutual support the peers felt was a vital health-promoting aspect that limited the impact of the described health-impeding aspects, which included sometimes finding peer-learning trying, stressful and irritating.

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.

What about the supervisor? Clinical supervisors' role in student nurses' peer learning: A phenomenographic study

INTRODUCTION

Peer learning is increasingly used for healthcare students in the clinical setting. However, as peer learning between students involves students taking a teaching role, it is unclear what the supervisor's role then becomes. It is vital to determine the role of the supervisor in student peer learning to ensure high quality learning and patient safety.

METHODS

Semi-structured interviews were performed with 15 student nurse supervisors (nurses and assistant nurses) from two hospital wards that practice peer learning to investigate the different ways clinical supervisors view their role in students' peer learning. Transcribed data were coded and analysed using a phenomenographic approach.

RESULTS

Four hierarchical levels of the supervisor's understanding of their role in students' peer learning were identified: the teacher; the facilitator; the stimulator; and the team player. These categories represent an increasingly inclusive view of which people present on the ward play a role in enabling effective peer learning.

CONCLUSIONS

The various understandings of supervisor roles have implications for how supervision of peer learning could be implemented in the future.

Peer learning and collaborative placement models in health care: a systematic review and qualitative synthesis of the literature

AIMS

To summarise the international empirical literature to provide a comprehensive overview of peer learning and collaborative practice placement models in health care and to synthesise their benefits and challenges.

BACKGROUND

Practical placements for students are in high demand due to the need for an increased nursing, midwifery and health professional workforce, thus collaborative placement models are an attractive solution to potentially increase placement capacity and enhance the student learning experience.

DESIGN

A systematic search of the literature and qualitative data synthesis using the PRISMA checklist and ENTREQ guidelines.

REVIEW METHODS

MEDLINE and CINAHL searched in March 2020. Quality appraisal of studies conducted. Collaborative models and empirical findings summarised. Reported benefits, challenges and implementation recommendations synthesised. Two tables developed for data representation.

RESULTS

172 studies were identified by the search strategy. Of these, 47 articles were included for appraisal and synthesis. 30 articles employed qualitative, seven quantitative and ten mixed-methods approaches. Research took place in eight countries. The majority of studies employed focus groups, interviews as well as questionnaire design. The total participant sample was 3462 consisting of students and educators.

CONCLUSIONS

This review confirmed that any peer learning is beneficial in supporting students' confidence and team working skills. It is especially helpful when pairing first year with third-year students. The latter can demonstrate their clinical skills and prepare for working in practice. Simultaneously, expert-led learning is important for role modelling and for the recognition of acquired skills. Evidence on the optimal placement experience is inconclusive; however, it can be concluded that any form of collaborative placement model requires careful planning and continuous preparation for staff and students.

RELEVANCE TO CLINICAL PRACTICE

Decision makers should consider implementing at least some form of peer learning to assist students with peer support, and ideally work towards a collaborative learning environment.

Student midwives' perception of peer learning during their clinical practice in an obstetric unit: A qualitative study

BACKGROUND

Evidence supports peer learning in clinical settings, but it has not been studied in obstetric units. In Sweden, obstetric units are a challenging learning area for student midwives because of the lack of attention to student needs and the stress of attaining the final number of 50 assisted births.

OBJECTIVES

To explore how student midwives experienced peer learning during clinical placement in an obstetric unit.

DESIGN

Qualitative approach.

SETTINGS

Three hospitals and obstetric units in Stockholm, Sweden.

PARTICIPANTS

Fifteen student midwives in a peer-learning model during clinical placement.

METHODS

Individual interviews followed by deductive content analysis using Boud's (2001) theoretical descriptions of peer learning.

RESULTS

The students shared skills, experience, and knowledge as equals and took responsibility for their peers' learning while supporting women in labor and childbirth. Students shared ideas, thoughts, and knowledge and gained perspective while learning as peers on an equal level. Students used each other to work independently without much involvement from the preceptor. Feedback was welcomed as encouragement.

CONCLUSIONS

Peer learning had positive consequences as an educational model in the clinical context in obstetric units.

Use of a flipped classroom "Leadership in Nursing" course on nursing students' achievement and experiences: A quasi-experimental study

BACKGROUND

Providing the undergraduate "Leadership in Nursing" course using an innovative approach is regarded to be very important in terms of enhancing leadership skills.

PURPOSE

The purpose of this study was to evaluate the effect of using the "flipped classroom" strategy on nursing students' learning achievements and to describe their experiences of this technique.

METHOD

The course of "Leadership in Nursing" was delivered in flipped classroom format for 20 students while another 19 were exposed to traditional teaching methods. Therefore, the study was completed with 39 students. Data was collected using "Student Introductory Information Form", "Exams (a midterm exam, a final exam and 4 assignments)", "In-Class Observation Form" and "Student Feedback Form".

FINDINGS

Students in the flipped classroom group had obtained significantly higher scores than the students in the traditional teaching group regarding the assignments, the final exam, and overall grade. Concerning the flipped classroom, students reported flexibility as the most positive aspect and problems related to the system infrastructure as the most negative aspect.

CONCLUSION

The usage of a flipped classroom for nursing students in the leadership course provided valuable results in terms of the students' exam scores and achieving course objectives. The flipped classroom strategy for the "Leadership in Nursing" course was shown to be effective in improving abilities such as distinguishing leadership skills, visioning, developing a new perspective, willingness to share experiences regarding leadership, also enabling students to work in harmony in group activities and to participate in classroom discussions, which are all essential elements of leadership.

Integrating Peer Learning Activities and Problem-Based Learning in Clinical Nursing Education

INTRODUCTION

The implementation of nursing clinical learning in Indonesia has several challenges that require innovation in the learning method strategy. The method that has been used so far focuses on the hierarchical relationship between lecturers/preceptors and students, so that there are many shortcomings in learning outcomes. The application of the method of active learning with Peer Learning (PL) and Problem Based Learning (PBL) techniques has proven effective in classroom learning, but its rarely found in clinical learning.

OBJECTIVE

The purpose of this study was to determine the effectiveness of the PL and PBL towards the achievement of clinical learning in nursing students.

METHODS

The research method used a true experiment with a posttest only control group design, the sampling technique was taken by randomize control trial. An instrument for clinical learning achievement using AssCE.

RESULTS

The analysis was carried out as descriptive and bivariate. The results showed the mean in the experimental group was 7.059 and the control group was 6.325. Further statistical test results were obtained p-value = 0.001 (p < 0.05) which showed that the average score there were differences in clinical learning achievement development scores.

CONCLUSION

Clinical learning using peer learning and PBL methods can directly improve various aspects of student competency achievement.

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.

Clinical facilitators' experience of near peer learning in Australian undergraduate nursing students: A qualitative study

BACKGROUND

To mitigate escalating costs in clinical supervision of undergraduate nursing students and alleviate clinical facilitators' teaching burden, the near-peer learning model has become popular. Studies on near-peer learning have been on students' views of the model with a paucity of literature on clinical facilitators' experiences.

AIM

To explore clinical facilitator experiences of the near-peer learning model.

DESIGN

A qualitative descriptive design was used with a purposeful sample of clinical facilitators involved in near-peer learning of nursing students.

SETTING

Two teaching hospitals participated. Two medical and two surgical wards were selected from each.

PARTICIPANTS

Eleven clinical facilitators who had experienced using near-peer learning.

METHODS

Focus group and individual interviews were conducted with clinical facilitators using a semi-structured interview guide following ethics approval. Data were analysed using content analysis.

RESULTS

Four themes emerged: 1) Congruent student dyad characteristics 2) Clinical facilitator attributes of confidence in students' knowledge and effective time and conflict management, 3) Availability of suitable skills, and 4) Facilitator support and preparation on the model. These themes appear to promote optimum learning outcomes of the near-peer model including empowering students, junior students gaining practice in foundation skills and senior students gaining competence in leadership, mentoring and nurturing skills. Barriers included incongruent student characteristics resulting in conflict and trust issues, senior student not knowing how to teach, give feedback or teaching inaccurate information; facilitator's lack of confidence in students' knowledge level, inadequate time to manage the student dyad and resolve conflict; inadequate support and preparation from university staff; and unavailability of suitable skills.

CONCLUSION

Successful implementation requires careful selection of student dyads, appropriate clinical environment and support for clinical facilitators. Our findings provide a better understanding of the near-peer model for future implementation.

First-year nursing students' collaboration using peer learning during clinical practice education: An observational study

The purpose of this observational study was to describe the collaboration between first-year nursing students using peer learning during their first clinical practice education. In earlier, predominantly interview studies, peer learning has been described as a model with several positive outcomes. However, no studies on how students act in collaboration in a real-life context have been found. The present study observed sixteen arbitrarily paired nursing students (eight pairs) on three to five occasions per pair, in total 164 h from September 2015 to March 2016. Repeated unstructured observations including informal conversations were used. Using qualitative content analysis, one theme 'Involuntary collaboration leads to growth in different competencies' emerged and three categories 'Practising nursing skills and abilities when working together', 'Establishing knowledge by helping each other to understand' and 'Sharing thoughts, feelings, and knowledge and put them into words'. In conclusion, nursing students using peer learning were observed practising several competencies, some of them not so easily elicited according to earlier research as organization, nursing leadership, teaching, and supervision.

A Qualitative Approach to Understanding the Effects of a Caring Relationship Between the Sonographer and Patient

BACKGROUND

The concept of caring is rapidly becoming an area of interest in healthcare research, especially in medical imaging. While patients, academic institutions, hospitals and policy makers have an expectation for healthcare professionals to be caring, the effects of such a relationship between patient and professional is equally important to understand. Within sonography, a discipline of radiography, there is limited literature on this concept.

PURPOSE

The purpose of the main study was to explore and describe the sonographers' experiences of being caring professionals within private practices in the province of Gauteng, South Africa. This paper focuses on one essential theme that emerged from the study: the effects of a caring relationship between sonographer and patient. Guidelines to enhance caring relationships are also provided.

MATERIALS AND METHODS

A qualitative, exploratory, descriptive, contextual, phenomenology research design was utilised. Four focus group interviews (n = 14) were conducted with qualified sonographers working in the private sector, in Gauteng. Data collection took place until data saturation was reached.

RESULTS

Sonographers described caring for their patients as having both positive and negative effects on themselves. Sonographers explained having developed protective mechanisms to help them when caring for tenacious patients. There was also a sense of emotional and psychological strain identified. Despite this, sonographers displayed a sense of professional pride for their careers.

CONCLUSION

Guidelines were developed to alleviate the emotional and psychological strains sonographers are burdened with. These guidelines included; the facilitation of a supportive and healing environment through reflective practice, availability of a psychologist, and having a tea garden at work.

A comparison of faculty led, mentorship program and peer mentoring on nursing students wound dressing clinical skills

BACKGROUND

The promotion of clinical nursing education requires using modern educational methods to develop students' knowledge and skills. There are however many different models by which education can be delivered with a wealth of literature supporting varying approaches. This is of particular relevance to clinical education where to date no singular approach has been identified as being the most appropriate.

OBJECTIVES

This study aimed to compare and investigate the effect of a peer education method, a mentor-led education method versus a traditional faculty-led method for instruction regarding surgical wound care skills among nursing students.

DESIGN

This study used an experimental three-group pre- and post-test design.

SETTINGS

The research was conducted within two surgical wards of a university-affiliated hospital in the west of Iran.

PARTICIPANTS

A total of 102 nursing students (first and second year) were assigned to three groups; peer-led learning group (n = 34), mentorship-led group (n = 34) or a faculty-led control group (n = 34).

METHODS

To ascertain performance in surgical dressing skill, data was collected in each group before and after the respective educational intervention. Data was collected using a surgical dressing skills checklist made by the research team which was piloted prior to the study. All statistical analysis was performed using SPSS v.22.0 (SPSS Inc., Chicago, IL).

RESULTS

Based on findings, after the intervention, the mean (SD) scores of surgical dressing and wound care skills were 28.24 (4.63), 31.76 (4.89), and 29.12 (5.33) for the peer-led, mentor-led and faculty-led groups, respectively. There was no significant difference between mentor group and faculty group or between peer group and faculty group (P > 0.05). However, the findings did demonstrate statistical difference in performance in surgical dressings and wound care techniques in the mentorship group method compared to the peer method (P = 0.006).

CONCLUSIONS

Although participants in the mentor group performed best of all groups, our findings demonstrate that those in the peer method group performed as well as those in the faculty-led group in surgical dressing performance. Therefore, it is recommended that peer and mentor learning methods are given consideration by curriculum planners in for use in the development of student nurse clinical skill and competence in surgical wound care.

Investigating The Implementation of a Collaborative Learning in Practice Model of Nurse Education in a Community Placement Cluster: A Qualitative Study

Background:

Attracting new graduate nurses to work in the community is problematic, and this has contributed to shortages in this sector in the United Kingdom and internationally. This paper reports the findings of a pilot study to implement Collaborative Learning in Practice in one region of the United Kingdom, which was intended to increase placement capacity, introduce students to this sector, and accelerate their learning and development of key skills and behaviors.

Study Aim:

To investigate the views of student nurses and the staff supporting them on placement about their experiences of implementing Collaborative Learning in Practice.

Methods:

We conducted four focus group interviews between winter 2018 and spring 2019, with 31 staff and students in two English counties in the South West of England. These were transcribed and analysed using the Framework Method; themes were discussed and agreed by the research team.

Results:

Three themes emerged: Peer support, which concerned the benefits of being in placement with other students; Developing and learning, which was about the acquisition of skills including leadership; and Organisation, which related to issues and concerns involved in the preparation and daily management of the collaborative learning in practice experience.

Conclusion:

Some positive aspects were reported, particularly in relation to hospice and General Practice Nursing placements. Most clear was the supportive potential for peer learning fostered by Collaborative Learning in Practice. Less positive aspects were the potential for horizontal violence and some aspects of nursing home experiences. We believe more work needs to be done to make nursing homes an attractive option for students and new graduates, and regarding visual materials for pre-placement preparation.

Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students

AIMS

To identify clusters based on graduating nursing students' self-reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students' perceptions of overall quality of the nursing programme, and students' general self-efficacy (GSE).

DESIGN

A cross-sectional study combining survey data and results from a national examination.

METHODS

Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the GSE scale, and results from the National Clinical Final Examination. A two-step cluster analysis was used to identify competence profiles, followed by comparative analyses between clusters.

RESULTS

Three clusters were identified illustrating students' different competence profiles. Students in Clusters 1 and 2 passed the examination, but differed in their self-assessments of competence, rating themselves under and above the overall median value, respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.

CONCLUSION

The study illustrates how nursing students' self-assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self-evaluation is a key learning outcome and is, in the long run, essential to patient safety.

IMPACT

The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their GSE lower than other students. The findings illuminate the need for student-centred strategies in nursing education, including elements of self-assessment in relation to examination to make the students more aware of their clinical competence.

Preceptors' experiences of using structured learning activities as part of the peer learning model: A qualitative study

The clinical environment is a vital component of nurse education, constantly changing due to constraints of the current health care systems such as increasing number of students and a limited number of preceptors. Peer learning, is gaining momentum as an educational model highly suitable for clinical placements. The peer learning model incorporates structured learning activities that support student activity, but little is reported of the actual structure and content of those activities. Thereby, the aim of this study was to explore precepting nurses' experience of using structured learning activities as part of the peer learning model during clinical placement. We used a qualitative research approach, using two open self-administered global questions. The result is based on the analysis of the written responses from 62 preceptors. Four categories followed the analysis: An opportunity for collaboration, An occasion for reflection, A new educational structure, and Recommendations for development. The preceptors perceived the structured learning activities as beneficial for increased collaboration and reflection among students. Moreover, utilizing the structured learning activities was perceived to be time saving for the preceptors, however this is an area where further research is needed.

Self-Directed and Lifelong Learning: A Framework for Improving Nursing Students’ Learning Skills in the Clinical Context

Self-directed lifelong learning is an important competency for nursing students to meet their professional development, yet it can be challenging for some students to acquire self-directed learning skills in a clinical context. A framework based on Hiemstra and Brockett’s “Person, Process, Context” model was developed to promote nurses' self-directed lifelong learning. The implication stems from our expectation that the framework can accelerate the development of interpersonal and intellectual skills valuable to a nursing student’s lifelong learning process.