Collaborative Learning in Practice (CLIP): Evaluation of a new approach to clinical learning

A cooperative learning intervention for improving a simulation-based paediatric nursing course: A quasi-experimental study

AIM

This study aimed to examine if a cooperative intervention improved outcomes for a simulation-based paediatric nursing course.

BACKGROUND

Fostering cooperative learning can enhance student engagement and improve learning. Simulation-based courses provide nursing students an opportunity to practice and hone nursing skills when hands-on experiences are limited. Providing instruction in cooperative learning could improve course outcomes.

DESIGN

A quasi-experimental study with pre-test/post-test assessments.

METHODS

Third-year nursing students enrolled in an 18-week paediatric simulation-based nursing course were purposively recruited (N = 110). One class (n = 55) received a researcher-developed cooperative learning program, which encouraged student support during class activities and simulations. The second class (control) received usual class instruction and simulations. The efficacy of the intervention was assessed by comparing mean scores at class enrolment (pre-test) and completion (post-test) for self-perceived problem-solving attitude, cooperative learning experience and knowledge of paediatric nursing. Paired t-tests compared pre-test with post-test scores for the two groups. ANCOVA examined differences in mean scores between groups. Correlations between differences in mean pre-test and post-test subscale scores for problem-solving attitude and cooperative learning experience were also examined.

RESULTS

There was no significant difference in age or gender between groups. Mean post-test scores on the final exam were significantly higher for students who received the intervention (85.26, 95 % CI 84.19, 86.33) compared with controls (83.61, 95 % CI 82.52, 84.69; F = 4.63, p = 0.034). There were no significant differences in total scores for problem-solving attitude or cooperative learning experience or between groups. For the intervention group, two problem solving subscales were correlated with two cooperative learning subscales: problem solving confidence with learning motivation, respectively (r = 0.302, p = 0.025) and personal control with classroom learning, respectively (r = 0.389, p = 0.003). For the control group, approach-avoidance problem solving was negatively correlated with cooperative learning efficacy (r = -0.343, p = 0.01).

CONCLUSIONS

Compared with the control group, nursing students who received the cooperative learning intervention had higher scores for knowledge of paediatric nursing, as well as learning motivation and attitude and problem-solving confidence, suggesting that the researcher-designed intervention facilitated simulation-based learning as well as confidence in problem-solving. Nurse educators could easily integrate the intervention into simulation-based paediatric nursing courses to enhance students' problem-solving abilities.

Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) - A mixed methods evaluation

AIM

To evaluate healthcare professional (HCP) students clinical learning experiences' whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence.

BACKGROUND

The English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions.

DESIGN

A mixed methods convergent design.

METHODS

An online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method.

RESULTS

Undergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations.

CONCLUSIONS

The SLCLE allocation enhanced students' confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students' professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.

A qualitative evaluation of a student midwife placement teaching English to speakers of other languages (ESOL)

INTRODUCTION

A shortage of UK midwives has put pressure on clinical placements and supervision of student midwives. Alternative placement solutions are needed to provide students with meaningful learning experiences. One such learning experience was a placement undertaken by student midwives who attended a program teaching English to speakers of other languages (ESOL). This study evaluated the impact of the placement on student midwife learning and experiences of the ESOL participants.

METHODS

The 2022 study employed a qualitative design using Kolb's model of experiential learning as a framework. Ten student midwives placed with the ESOL program and three women enrolled in the program participated. Data were collected via online focus groups with the student midwives and a face-to-face focus group with the women. Data were analyzed using thematic analysis and Kolb's model of experiential learning.

RESULTS

Four themes were constructed: 'Putting the scripts aside: expectations versus the reality of being an educator', 'Adapting and personalizing teaching', 'We are learning too: an environment for mutual learning', and 'Taking our learning forwards'. Students faced barriers during their placement and had to adapt their teaching accordingly. They gained crucial knowledge of the challenges faced by women who speak other languages. The women valued the students' input and together they forged a reciprocal learning environment.

CONCLUSIONS

This study demonstrates how placing student midwives in a unique non-maternity setting has benefits for student learning which are transferrable to future practice. Importantly, it confirms that quality of learning during a novel placement is not compromised for students or participants.

Student nurses as a future general practice nursing workforce. Implementing collaborative learning in practice: implications for placement learning and patient access. A mixed methods study

BACKGROUND

There is a global shortage of nurses, with particularly acute shortfall in General Practice Nursing in the United Kingdom estimated at as high as 50% vacancy rate by 2031 by some sources. There has previously been reluctance for General Practices to host student nurses on placement, but it has become imperative to increase placement capacity if practices are to be able to recruit a future workforce. Collaborative Learning in Practice is a means of organising placement learning for student nurses using a coaching model, that allows for leadership development, peer support and earlier engagement in patient care, and increases placement capacity.

METHODS

This was a mixed methods study using qualitative data from focus groups to evaluate the implementation of Collaborative Learning in Practice, and routinely collected audit data on numbers of clinic appointments to investigate the potential impact an increased capacity of student nurses might have on patient access to services. The aims of this study were: to implement and evaluate Collaborative Learning in Practice in General Practice Nursing settings; to explore issues of interprofessional learning; to explore patient access to services related to increased student nurse capacity.

RESULTS

Our qualitative data indicated the following themes as important to students and staff: Peer Support; Interprofessional Learning; and the Importance of 'own clinics' for students to see patients. The audit data indicated that having students leading their own clinics increased the clinic numbers available by approximately 20% compared to when students were not in placement.

CONCLUSIONS

This study shows that student nurses increased clinic capacity and improved access for patients. Students valued their placement, felt that they were more 'part of the team' than in other placements and consequently had a greater sense of belonging. This was multifaceted, coming in part from the welcoming practice staff, in part from the opportunities for peer support engendered by the collaborative learning in practice model, and in part from the interprofessional learning opportunities available. General Practice Nursing placements for students are important for future workforce recruitment and can help meet Quality and Outcomes Framework targets for General Practices.

Kickstart in nursing home-Nursing students experiences of a model for active and collaborative learning in clinical placement

AIMS AND OBJECTIVES

To explore students' experiences from a pilot project testing out a model for active, collaborative learning in first-year placement at a nursing home.

BACKGROUND

There is a need for innovative learning activities and projects to improve clinical education in nursing homes. Active, collaborative approaches in placement learning may enhance students learning outcome.

DESIGN

The study had a qualitative and explorative design, in which the experiences of students participating in the pilot were investigated through paired interviews at the end of their placement.

METHODS

Twenty-two students participated in the study, and data from paired interviews were analysed using qualitative content analysis. COREQ reporting guidelines were used.

RESULTS

Three themes emerged from the analysis: (1) The learning cell as facilitator for learning; (2) Discovering learning possibilities in nursing homes and (3) Applying tools and resources for learning.

CONCLUSIONS

The model could reduce tension and anxiety while helping the students focus on learning options and use their environment more actively for learning. Working with a learning partner seems to increase student learning through common planning, feedback and reflection. The study emphasises the importance of facilitating active learning through the scaffolding structures and configuration of the students' learning space.

RELEVANCE TO CLINICAL PRACTICE

This study indicates the potential for introducing active and collaborative pedagogical models in clinical placement. The model can promote nursing homes as a conducive learning arena for nursing students and help prepare students for a future work role in a rapidly changing health care field.

PATIENT OR PUBLIC CONTRIBUTION

The result of the research is shared and discussed with stakeholders prior to finalising the article.

The Impact of Cooperative Learning Method on the Oral Proficiency of Learners of the Training Program for English Tourist Guides

Oral proficiency is the core element of training courses for English tourist guides. This ability needs to be addressed in training program for English tourist guides. Cooperative learning method is widely used by educators as a teaching method, but rarely used to improve oral proficiency. A quasi-experimental design involving 60 participants was conducted to investigate and examine the effectiveness of cooperative learning method on the oral proficiency of learners in the English tourist guide training program. There were 30 learners in the control group and the experimental group, respectively. The experimental group adopted cooperative learning method, while the control group adopted traditional approach, in both of which pre-test and post-test were conducted. The results of the study showed that the impact of teaching with the cooperative learning method on the oral proficiency of learners of the training program for English tourist guides was higher than that of teaching with the traditional approach. The importance of the cooperative learning method in the training program for English tourist guides is highlighted as a reference for educational institutions.

Towards a sustainable online peer learning model based on student's perspectives

The outbreak of the COVID-19 pandemic has fundamentally shifted learning from the traditional classroom approach to online learning. As such, this study used a revision centre as a case study to develop the factors that contribute to the theoretical framework of online peer learning in the higher education sector due to COVID-19. This study also explores the integrated effects of online peer learning on students and investigates whether advanced information technology creates new opportunities or additional burdens for students in adopting online peer learning environments. Descriptive statistical analysis, factor analysis, and correlation analysis were conducted on survey data gathered from 204 sub-degree students in Hong Kong. The results addressed four main factors developed from 39 variables: enhancement of learning ability, the attitude toward learning, motivation for learning, and interpersonal relationship which were closely associated. The study findings provide strategies and constructive recommendations for educators to develop a new online learning pedagogy, construct sustainable online peer learning, and effectively manage students' online learning to meet the needs for post-COVID online education.

To what extent does the use of a coaching-based style of student supervision in clinical practice impact experiences of placements for staff and students: A state-of-the-art literature review

BACKGROUND

The one-to-one style of mentorship of pre-registration nursing students has been identified across the globe as not always fulfilling the requirements of the profession or the individual. In recent years, there has been a move toward a coaching-based style of student supervision. This shift in supervision is welcomed by regulatory bodies and is supported in the UK by the NMC (2018).

METHODOLOGY

A structured state-of-the-art review was used to assess the impact of a coaching-based style of student supervision on staff and students' experiences of clinical placements. 14 papers, published between 2007 and 2020 were reviewed, and data was extracted using thematic analysis.

FINDINGS

Three themes were established; a, the relationship between students and registered staff in clinical practice, b, student autonomy and c, change management.

CONCLUSION

The use of a coaching style of student supervision is widely beneficial to nursing culture. The enhanced quality of the working relationship between staff and students serves to create more autonomous, critical, and skilled staff nurses 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.

The effect of cooperative learning on critical thinking of nursing students in clinical practicum: A quasi-experimental study

Critical thinking is a core element of higher nursing education that needs to be promoted during university study. However, lecturing as a teaching method is still heavily used by nurse educators, and nursing students have few opportunities to develop critical thinking skills. This study evaluated the impact of cooperative learning on critical thinking. A quasi-experimental study was conducted (n = 50). Students in the experimental group were arranged into small cooperative groups and completed the clinical practice together, whereas those in the control group practiced individually. After the intervention, total and subscale scores of critical thinking dispositions were significantly higher in the experimental rather than in the control group. The percentage for experiencing positive inclinations or strong dispositions toward critical thinking was 100% among the experimental group, whereas it was 85% among the control group. It is concluded that the cooperative learning-based clinical practicum is helpful for promoting students' critical thinking dispositions.

Factors Influencing SDL Readiness and Self-Esteem in a Clinical Adult Nursing Practicum after Flipped Learning Education: Comparison of the Contact and Untact Models

This study aimed to evaluate the effects of a flipped learning contact model and a flipped learning “untact” model with Korean nursing students undergoing a clinical practicum, and to examine the factors of self-directed learning readiness and self-esteem considering these learning models. The participants included 85 students. Participants were randomly allocated to two models. This study measured self-directed learning readiness, self-esteem, learner motivation, professor–student and clinical instructor–student interactions, confidence in performing core skills, participating in online activities, clinical practice stress, and the friendliness of the two models. Participants’ characteristics were analyzed using frequencies and percentages, and between-group differences regarding characteristics were analyzed using the χ² test, independent t-test, and one-way ANOVA with a Scheffe test. This study conducted independent t-tests for comparison of the between-group adjusted mean difference of the pretest and posttest scores. The influence of the dependent variables on self-directed learning readiness and self-esteem was measured using a stepwise multiple regression method. Among the two models in the practicum, the flipped-mastery contact model (FMCM) showed higher self-directed learning (SDL) readiness and professor–student interaction than those of the flipped-mastery untact model (FMUM) after the clinical practicum was completed. The three influencing factors of SDL readiness were FMCM, learner motivation, and ward friendliness, with an explanatory power of 31.6% (F = 13.96, p < 0.001). Learner motivation, professor–student interaction, and ward friendliness influenced self-esteem, with an explanatory power of 54.7% (F = 34.86, p < 0.001).

Nursing Students’ Perception of the Clinical Learning Environment

Introduction:

Clinical learning environment placements provide opportunities for students to develop their skills, socialize to the profession and bridge the gap between academic and workplace learning. This study was conducted to investigate Saudi nursing students’ perceptions of their clinical learning environment and supervision in the hospital setting.

Methods:

A sample of 90 final year student nurses completing practicums at a tertiary hospital in Riyadh was included in this cross-sectional study utilizing the Clinical Learning Environment and Supervision plus Nurse Teacher scale.

Results:

Overall, students perceived their clinical learning environment positively. Among sub-scores, that for the leadership style of ward manager was the highest. Supervision types, nursing-teacher teacher-visit frequency and grade point average positively and significantly impacted student’s perceptions, while university type and practicum duration did not.

Conclusion:

Students confirmed the ward manager’s leadership style as the most significant influencing their perceptions. However, the nursing teacher’s role had the lowest mean score, suggesting the need for its enhancement and clarification and indicating the need for better communication and collaboration between nursing schools and the clinical training hospital.