Exploring how nurse lecturers maintain clinical credibility

‘Is the technology essential or emerging?’ Ways to keep radiation therapy curriculum agile amid rapidly advancing technology

Advancing technology in radiation therapy can significantly influence clinical practice and improvement of patient outcomes. In the process, innovations in technology require that changes to clinical practice are adopted within education settings. This commentary aims to describe the uptake of new technology and ways that academics provide an up-to-date curriculum when today's innovation is tomorrow's contemporary practice.

The relationship between clinical placement duration and students' satisfaction with the quality of supervision and learning environment: A mediation analysis

Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified, such as the clinical learning environment, the supervision provided by supervisors, and the level of cooperation with the nurse teacher. The objective was to examine whether the relationship between the clinical placement duration and overall satisfaction with clinical training is mediated by the supervisory relationship and learning environment. A secondary analysis was conducted using the data from a cross-sectional study conducted in 17 higher educational institutions in nine European countries with the Clinical Learning Environment, Supervision and Nurse Teacher scale (n = 1903 pre-registration nursing students). Satisfaction with the supervisor and a good learning environment mediated the relationship between clinical placement duration and overall satisfaction as perceived by the students. Nursing students with longer clinical placement durations were more satisfied with clinical training as a result of both their satisfaction with their supervisor and their perceptions of good learning environment. The optimal duration a nursing student should remain in the different practice settings is approximately 7 weeks.

How is clinical credibility defined in nursing? A concept mapping study

AIM

To develop a working definition of 'clinical credibility' in nursing science.

METHODS

This is stage 2 of a registered report. Concept mapping methodology, 1. Preparation, 2. Generation of statements (brainstorming), 3. Structuring of statements (prioritising/clustering), 4. Representation of statements, 5. Interpretation of maps and 6. Utilisation of maps were used. Part 1 of our registered report followed the required items on the SPIRIT 2013 checklist. Part 2 was reporting the results of our study adhered to the STROBE reporting guidelines.

RESULTS

Participants (n = 67) from three stakeholder groups participated in this study. Nursing students (n = 23), nurses and other healthcare professionals (n = 23), and patients (within the last 12 months) (n = 21). Participants (n = 62) generated statements (n = 429) in response to the question: 'What does clinical credibility mean to you?'. Following statement reduction, participants (n = 61) prioritised and clustered (n = 80) statements. The data were analysed using the concept mapping software, Ariadne. A visual 'concept map' was produced showing the importance and relationship of each statement as viewed by all participants. The final concept map had nine clusters. In order of importance these are as follows: 1. Safe practice, 2. Communication, 3. Patient-centred care, 4. Accountable, 5. Professional practice, 6. Clinical competence, 7. Teaching attributes, 8. Contemporary expert and 9. Leadership. This study was undertaken over an eight-month period.

CONCLUSION

Clinical credibility is not necessarily about contemporary clinical practice. It is a multidimensional construct of which current clinical practice is one element.

Designing, Implementing, and Evaluating a Practice Tutor Internship Model during an Acute Care Clinical Internship

Purpose: The purpose of this study was to implement and evaluate a novel internship model that incorporates a practice tutor in physiotherapy clinical education during an acute care cardiorespiratory internship at a large acute tertiary care teaching hospital in Canada. Method: A prospective evaluation of this model was conducted by means of a mixed-methods approach using surveys and focus groups. The participants were students and clinical instructors (CIs) who were taking part in the internship. Results: Half of the CIs agreed that the practice tutor model gave them more time to manage their caseload and work with the student than did the traditional model, and 63% would recommend the model for future internships. In reviewing the focus group and open-ended data, we identified four themes: benefits, tensions, critical logistics, and unforeseen blind spots. There was a trend for patient attendance to increase with the practice tutor model compared with the previous year's internship session and with the 5 weeks immediately preceding the internship. Conclusions: On the basis of CIs' and students' self-reports, the piloted practice tutor model was perceived to facilitate students' clinical reasoning and collaborative learning skills. In addition, during the 5-week internship, the number of patients seen each day by the individual CIs and their students was not reduced, with a trend toward increased patient attendance. There was also a trend toward CIs having the same or more time to manage their caseload and work with the students compared with a non-practice tutor internship model. Recommendations to improve this model in future implementations are made.

Supporting the midwifery practice-based curriculum: the role of the link lecturer

BACKGROUND

It is essential that Approved Education Institutions (AEIs) support practice learning to the education standards required by the Nursing and Midwifery Council (NMC, 2009). Evaluating whether midwife lecturers bring a unique contribution to the outcomes of preregistration midwifery education programmes was investigated through a national research project (Fraser et al., 2011). The study task addressed in this paper was to establish which roles and responsibilities of lecturers have most impact on student learning and capability as midwives and provide best support for mentors' teaching and assessment decisions.

METHODS

Data were collected through United Kingdom (UK) wide survey of Lead Midwives for Education, midwife lecturers and questionnaires and focus groups of student midwives from six case study sites. An activity analysis tool was completed by lecturers in these sites, as well as individual interviews with LMEs and Programme Leads.

FINDINGS

The nature of midwife lecturers' engagement with practice is variable and is determined by the particular organisation model used. There is an overall agreement that midwife lecturers have a vital role in supporting the practice based curriculum. Key findings highlight the link lecturer role in supporting students, participating in assessments, supporting mentors and maintaining clinical credibility. Enhancements and deterrents to undertaking the link role are also outlined. These findings are relevant to health care programmes worldwide where clinical practice is an essential component.

IMPLICATIONS

contribution to knowledge development about models to support and enhance practice-based learning.

"Relevant and Current": Radiation Therapy Students' Perception of Clinical Credibility in the CSRT as Lecturer

PURPOSE

To examine how radiation therapy students' perceive the clinical credibility of the clinical specialist radiation therapist who is serving as a lecturer. This lecturer is a clinically based radiation therapy staff member.

METHODS

Third-year radiation therapy students (n=16) attended a workshop designed and delivered by the breast-site clinical specialist radiation therapist. A web-based survey was distributed to all students. The survey contained a series of statements that the participants were asked to rate along a 4-point Likert scale. In addition, there was one open-ended question asking "How would you define clinical credibility?" The responses for each question were collated and analyzed for content and theme.

RESULTS

Fifteen of the possible 16 students participated. All of the participants viewed the clinical specialist radiation therapist as clinically credible and that clinical credibility added value to the content being delivered. As well, 53.8% agree and 46.2% somewhat agree that the learning experience would be different if the lecture was delivered by someone non-clinical.

CONCLUSION

Findings from the study indicate that radiation therapy students view current clinical experience as important and relevant, impacting their perception of clinical credibility in the lecturer. The results support further development of lecturing opportunities for clinically based staff.

The infection control education needs of nursing students: an interview study with students and mentors

AIM

To identify and explore the infection prevention and control education needs of nursing students as perceived by students and mentors.

METHODS

Semi-structured interviews were undertaken with 31 nursing students within one large university and 32 nurse mentors in one large NHS Trust. Interview transcripts were analysed using framework analysis.

RESULTS

There were perceived deficits in both levels of knowledge and clinical skills but the emphasis placed on these differed between nursing students and nurse mentors. The use of small group and interactive methods for teaching and learning was preferred, in particular to encourage less confident students to participate more. Assessments in practice placements of specific skills were identified as a good teaching and learning tool by both students and mentors. Infection prevention and control education was considered to be a joint responsibility between the university and Trust, though there was acknowledgement that this joint working was not always evident. Clinical credibility was considered particularly important by mentors in those who teach students.

CONCLUSION

There may be deficits in the education provided to nursing students in this area. Teaching and learning preferences and strategies for improving some areas of teaching and learning have been identified and several areas for future research have been suggested.

The duality of professional practice in nursing: academics for the 21st century

Although pre-registration nursing in the United Kingdom (UK) is moving towards a graduate exit, the vocational/professional debate is still live and continues to be played out in both popular and professional literature. This study considers the nature of contemporary academic communities and the challenge of duality in professional nursing life. More than a decade after the move into higher education (HE) however the role of the academic is still controversial, with much of the debate focussed on the nature of clinical credibility. This article considers the dimensions of academic nursing, reports the views of academics and clinicians and introduces a model of working that could potentially harness and blend the skills of academics and clinicians, nurturing a culture of applied scholarship throughout the professional/academic journey.

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

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

The who and where of clinical skills teaching: a review from the UK perspective

Over the years, the debate on clinical skill acquisition in Nursing is one that has been subject to constant scrutiny within educational settings, locally and globally. Indeed, the Nursing and Midwifery Council (NMC) have endeavoured to provide some clarity with the publication of the Essential Skills Cluster statements [NMC, 2006. Advance Information Regarding Essential Skill Clusters for Preregistration Nursing Programmes (NMC Circular 35/2006). NMC, London] and the recently updated Standards to Support Learning and Assessment in Practice [NMC, 2008. Standards to Support Learning and Assessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers, second ed. NMC, London]. In this paper, we seek to provide a review of the evidence and debate produced thus far surrounding skills acquisition in general and the role of the nurse lecturer in particular from a UK perspective.

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

The clinical role of lecturers in nursing has been a focus of debate since the integration of nurse education into higher education institutions. The purpose of this paper is to report the findings from the preliminary phase of a study, undertaken to investigate the perceptions of key stakeholder groups in nurse education, regarding the current clinical role of nurse lecturers in Ireland. A descriptive exploratory design was used involving focus group and individual interviews, soliciting views of purposefully selected educationalists, clinicians, policy formulators and students. The issue was examined from a policy perspective, aiming to collectively represent views of all participant groups. This approach facilitated a more complete picture of perceptions of the role to emerge, to better inform future decision making. Twenty two focus group interviews and twenty one individual interviews were conducted. Content analysis was used to identify themes. All groups were in agreement that role definition was urgently required to dispel ambiguities surrounding what the clinical role should involve. Conflicting views were evident among groups regarding lecturers' clinical credibility, visibility and teaching effectiveness. Findings highlight the essential nature of nurse lecturers engaging with clinical areas to maintain their skills, demonstrate a value for the practice component of the role and provide a link between education and practice.

The effectiveness of the lecturer practitioner role in clinical practice: an Irish perspective

BACKGROUND

Demands within academia such as teaching, publishing, research activity and generating grant income can make it difficult for nurse educators to protect time for clinical practice. In an effort to overcome this problem lecturer practitioner posts have been introduced with designated responsibilities in both clinical and educational settings.

METHODS

Using a mixed method descriptive methodology student nurses and registered nurses completed a modified questionnaire to examine the impact of lecturer practitioners (LPs) in clinical practice. Focus groups were also conducted with lecturer practitioners themselves.

RESULTS

The results identified that by having a clinical remit, LPs forged good relationships with student nurses and registered nurses in clinical practice, who considered the LP as being a learning resource with realistic expectations of the clinical environment.

DISCUSSION

The results provide further evidence to support the continuation of nurse educators in clinical practice for their own development, their students and registered nurses.

An investigation of nurse educator's perceptions and experiences of undertaking clinical practice

Educational policy (DOH, 1999. Making a difference: strengthening the nursing, midwifery and health visiting contribution to health and healthcare. Department of Health, London; UKCC, 1999. Fitness for Practice. United Kingdom Central Council for Nursing, Midwifery and Health Visiting, London; Nursing and Midwifery Council, 2006. Standards to support learning and assessment in practice. Nursing and Midwifery Council, London) and current nursing literature (Griscti, O., Jacono, B., Jacono, J., 2005. The nurse educator's clinical role. Journal of Advanced Nursing 50 (1), 84-92; Owen, S., Ferguson, K., Baguley, I., 2005. The clinical activity of mental health nurse lecturers. Journal of Psychiatric and Mental Health Nursing 12, 310-316), place increasing emphasis on nurse educators undertaking clinical practice to facilitate their clinical confidence and competence. This study investigated nurse educators' perceptions and experiences of undertaking clinical practice. A qualitative design and descriptive, exploratory approach were used. A purposive sample of 11 nurse educators in one nursing department, took part in two focus group interviews, one with 5 and the other with 6 respondents, to identify and discuss their perceptions and experiences of undertaking clinical practice. A process of thematic content analysis revealed three broad themes relating to the meaning and importance of clinical practice, perceived benefits and barriers which are examined and discussed. The paper concludes that despite policy recommendations, barriers highlighted in this study such as insufficient time, heavy workload and a lack of valuing of the clinical role have been raised over the past few decades. The effect of undertaking clinical practice, particularly on the quality of teaching is argued to be valuable armoury in the battle to secure sufficient resources to support engagement in clinical practice. Financial and organisational commitment; valuing of clinical practice and research evidence are crucial to realising clinical practice for nurse educators. Alternative interpretations of what may constitute the clinical role such as joint research projects and supporting and supervising students are offered, which need to be assessed against clear, specific and realistic aims for the clinical role of the nurse educator.

The experience of faculty practice: developing and evaluating a newly established program

While the notion of faculty practice, that is clinical practice by an academic in a health service environment, is not new, Australian Universities have been slow in providing practice environments where academics' theoretical understanding is informed through the service environment. Although there is a plethora of published academic opinion on the benefits, there is a dearth of meaningful data describing the subjective experience of academics that participate in faculty practice. Developing an understanding of the issues academics experience, while on faculty practice, provides a vital opportunity for those seeking to adopt a faculty practice model in their institution. The paper describes the genesis of the faculty practice program and outlines both the benefits and challenges that were encountered during implementation. A program evaluation conducted by an independent consultant indicated that all faculty practice participants found the process to be empowering and revitalising, despite their initial apprehension. The personal and professional gains achieved while on faculty practice were considered to compensate for the additional workload involved. The immediate dividends of enhanced self-esteem, classroom practices and credibility with students for faculty practice participants were outcomes achieved.

Should nurse academics engage in clinical practice?

The education of nurses has traditionally been conducted in the hospital based setting. This changed over the last few decades, with nursing education now being a tertiary based course in many countries. There were numerous reasons for this move, the main goal being to improve the educational experience of students and thus the competence of graduates. Nurse academics whose role is to educate students are faced with the challenge of ensuring their teaching reflects the contemporary nursing environment. One way of doing this is by actively engaging in clinical practice. However there are arguments for and against (as well as barriers to) them doing so and little empirical evidence to support either argument. Individually, nurse academics must make a decision about whether engaging in clinical practice is beneficial to their career and the students they teach.

Managerial perceptions of mentor, lecturer practitioner and link tutor roles

Educating pre-registration nurses in clinical practice is a global issue. Within different countries problems exist in educating and supervising students in clinical practice and various models of clinical education are employed. In Wales, United Kingdom, this responsibility is divided between mentors, lecturer practitioners and link tutors. This paper reports on the third phase of a three-phase study in Wales to explore differences between mentors, lecturer practitioners and link tutors, and how they work together to assist students to integrate theory and practice. Four focus group interviews of National Health Service managers and Higher Education managers (n=22) were conducted. Qualitative content analysis revealed four themes: role characteristics and competencies, role differences, role conflict, and future options. The findings suggest a theory-practice continuum along which mentors, lecturer practitioners and link tutors occupy different positions. The article explores these different positions and offers suggestions for future role development.

Filipino nursing students' views of their clinical instructors' credibility

BACKGROUND

Although the concept of clinical credibility has attracted the interest of some researchers in the field, it is interesting to note the substantive paucity of literature on this since the mid 1990s [Fisher, M., 2005. Exploring how nurse lecturers maintain clinical credibility. Nurse Education in Practice 5, 21-29.] specifically from an Asian context.

OBJECTIVE

This qualitative study purports to capture how a select group of senior nursing students view their clinical instructors' credibility.

METHOD

A total of 22 senior nursing students recruited from a comprehensive university in the capital of the Philippines participated voluntarily in this qualitative study.

FINDINGS

With the use of individual indepth interview as a qualitative tool, findings of the study yielded three significant themes that elucidate the essence of credibility from the lens of Filipino nursing students. These include (1) credibility as an image building activity; (2) credibility as a work in progress; and (3) credibility as an influencing agent.

The clinical role of nurse lecturers: Past, present, and future

The clinical role of nurse lecturers has been the subject of much debate since the transfer of nurse education into Higher Education Institutions within the United Kingdom. This article provides a critical evaluation of the clinical role of nurse lecturers in terms of policy drivers and strategies for implementing national guidelines. Policies from the initiation of Project 2000, through to recent consultation documents on the support of students in practice, are evaluated. Formal aspects of the nurse lecturer remit, such as link tutor and personal supervisor roles, are discussed in terms of their impact on clinical practice. There is also a brief review of the development of the lecturer practitioner role as a bridge between education and practice. The fundamental arguments in support of nurse lecturers maintaining a clinical role in practice are analysed. This analysis includes consideration of the concept of 'clinical credibility' in terms of the impact on teaching and the closure of the theory-practice gap. The article concludes with suggestions for strategies to resolve the ongoing debate surrounding the clinical role of nurse lecturers. These recommendations include a review of staff:student ratios in nurse education, re-evaluation of the need for a clinical role, and the use of innovative recruitment and development strategies by higher education institutions.