Facilitating practice learning in pre-registration nursing programmes – a comparative review of the Bournemouth Collaborative Model and Australian models

Experiences of preceptorship in Singapore: A qualitative exploratory study of preceptors' experience in precepting nursing students during pre-registration of clinical placement in an acute hospital

BACKGROUND

Preceptors play an important role in teaching and guiding nursing students to transit to the role of registered nurses. Nursing students are trained to acquire the skills and knowledge in providing good quality care to patients. However, the preceptors in the clinical area may face challenges in providing care to their patients in addition to their preceptor role. It is vital to explore and gain insights on the preceptorship experience to better understand their challenges and facilitate their preceptorships and the learning experience of the nursing students.

AIMS

This study explored the preceptors' experience to understand their challenges and support received in the facilitation of the preceptorship and learning experience of the nursing students in an acute care hospital in Singapore.

METHODS

Semi-structured interviews were conducted from June to October 2021 with ten registered nurses working in an acute hospital. Thematic analysis was conducted.

RESULTS

Three main themes emerged from the thematic analysis: (1) preceptor-student relationship; (2) barriers and challenges to successful preceptorship; and (3) outcomes of successful preceptorship.

CONCLUSIONS

This study provided valuable insights in the experience of the preceptors in Singapore. Recommendation for nursing management and leaders to establish support system in promoting recognition of preceptors, establish dialog sessions between stakeholders. Nursing education to provide support and to review the efficacy of the current preceptorship program to identify correlation with successful precepting experience for both preceptors and nursing students. Despite challenges faced by the preceptors, their experience had been positive and they are committed in precepting the nursing students.

Undergraduate student nurses' perspectives of an integrated clinical learning model in the mental health environment

Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement. The model offered students the flexibility of attending their clinical placement over a 16-week period instead of a traditional block of 4 weeks. The aim of this study was to evaluate the student perspective of this model and whether it prepared them for the nursing workforce. Focus groups were conducted with undergraduate nursing students following their mental health clinical placement at an acute and extended care inpatient unit. Data were analysed using thematic analysis. Main themes included preparedness for practice, maintaining a work-life balance, and perceiving they were part of a team. The ICLM deepened students' knowledge and had a positive impact on their overall clinical learning.

"Coaching and Peer-Assisted Learning" (C-PAL) - The mental health nursing student experience: A qualitative evaluation

WHAT IS KNOWN ON THE SUBJECT?: There is increasing demand for clinical placements for pre-registration nursing students. New models of mentorship have been developed to meet the demand for clinical placements by increasing the number of students within each placement. At present there are no published research studies into the effectiveness of team mentorship utilized by pre-registration nursing students within in-patient mental health settings. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper reports findings from a study that explored the experiences of mental health students within the social world of their clinical placement, adopting a new approach to practice learning where students support each other's learning. Students found their engagement in the pilot project as valuable as being exposed to the new team mentorship model which introduced them to peer-assisted learning. The learning that arose from peer-assisted learning within team mentorship appeared to provide learning opportunities that enabled students' to develop greater self-awareness and confidence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Peer-assisted learning where students support the learning of each other, can lead to a wider range of learning opportunities for, as well as between, nursing students. In order for students to participate in care and become a "learning team," suitable in-patient mental health wards need to be identified that can support this new approach to the supervision, assessment and support of students. The establishment of team mentorship within mental health in-patient settings is dependent on the support provided by practice educators and university link lecturers to nurse mentors and coaches which in turn, determines the quality of the student experience.

ABSTRACT

Introduction This paper presents findings from a study that evaluated mental health nursing students' experience of a team mentoring model called Coaching and peer-assisted learning (C-PAL). At present there are no published research studies into the effectiveness of team mentorship utilized by nursing students within in-patient mental health settings. Aim The study utilized an interpretivist methodology where the focus was on individuals in their social world. Method Two focus groups were held with fifteen students who had experienced C-PAL in four in-patient wards. Findings Students' overall experience of piloting C-PAL was positive. Learning opportunities (Theme 3) appeared to be dependent on the quality of peer support (Theme 5) which in turn, enhanced the learner experience and increased the level of student confidence (Theme 6). Less positive experiences included inadequate preparation (Theme 1), poor understanding of the model and competition for learning experiences. Implications for practice We tentatively suggest that team mentorship models such as C-PAL may be suitable for acute in-patient mental health settings. The success of C-PAL depends upon the preparation of nursing staff, mentors (Theme 4), coaches and students in relation to role expectations, shift rostering (Theme 2) and the implementation of "huddling" to promote opportunistic learning.

A qualitative study exploring the impact of student nurses working part time as a health care assistant

BACKGROUND

National and international evidence indicates that university students engage in employment whilst studying. Research has suggested that nursing students either enter training with previous care experience or tend to work part time in a health related area whilst undertaking higher education. The impact of this on the socialisation process remains unclear.

OBJECTIVES

Based on the symbolic interactionist framework, this paper reports on a theme from a large mixed methods study - the extent and implications of student nurses' work experience on learning and training.

DESIGN

One qualitative stage from a sequential exploratory mixed methods design.

SETTINGS

One higher education institution in the United Kingdom.

PARTICIPANTS

Forty-five pre-registration nursing students.

METHODS

Thirty-two students took part in four focus groups and 13 took part in individual interviews.

RESULTS

Findings revealed that 27 (60%) of students were in paid nursing related employment. This was reported to be advantageous by most participants with regards to enhancing confidence, skills and time spent in the clinical setting. However, it was also perceived by a small number of participants as being detrimental to subsequent learning resulting in role confusion, influencing placement behaviour, and preferences for future nursing practice. Student participants with no prior work experience believed this placed them at a disadvantage, negatively influencing their learning, ability to fit in, and adjustment on placement. Findings have suggested that student participants desire more recognition of the experience and skills they have gained from their employment.

CONCLUSIONS

Whilst care experience among the student nursing population is advocated, the results of this study show that it is perceived to impinged on their learning and educational journey. Policy makers, educationalists and health service providers need to be aware of the students who operate within the dual roles of student and health care worker so as to provide guidance and appropriate direction.

Importance of public health nurses precepting students in clinical practice: a qualitative study

BACKGROUND

Preceptors' working environment, support and competence affect how they perform the preceptor role, are therefore important for developing students and can influence students' roles as students and future professionals. Previous research has focused on precepting student nurses and not so much on public health nurses or other postgraduate students. Knowledge in this field is therefore lacking.

OBJECTIVE

The article aims to present a grounded theory of the role of public health nurses as student preceptors in Norway.

DESIGN

We conducted 20 interviews with public health nurses in addition to a focus group with four participants. We used classical grounded theory method to gather and analyze data.

FINDINGS

The preceptors were strongly concerned about invisibility and lack of recognition of the preceptor role. This main concern was resolved by the strategy of being obligated and included three patterns: optimistic, ambivalent and reluctant performance, all with differing motivation for being obligated. All stakeholders involved in clinical practice seem to contribute to making the preceptors' role invisible and thereby contribute to the lack of recognition, support and reward, which again seem to self-reinforce invisibility.

CONCLUSION

The study highlights the obligation of public health nurses in precepting students and increases the understanding of the challenges of this role. Ensuring education of a high academic standard requires paying more attention to developing effective support for the people involved.

Finnish and British mentors' conceptions of facilitating nursing students' placement learning and professional development

Pre-registration nursing students require varying levels of support during placement learning. Although they receive support from different stakeholders, the support provided by mentors is considered the most significant. Several challenges are encountered in the facilitation of students in placements, particularly in relation to mentors' roles in support and assessment. This phenomenographical study examines the conceptions of Finnish and British mentors regarding the facilitation of placement learning and professional development of pre-registration nursing students. The findings identified four main categories of description, which grouped the different ways mentors experienced the facilitation of students. Firstly, students should be the focus and respected as individual partners with personal learning goals. Secondly, placements must be fit for students' practice and learning. Thirdly, facilitation was seen as guided co-working and spurring to enable a student to attain stipulated nursing competencies. Finally, ongoing assessment of students' achievements, learning outcomes and professional attributes was viewed as significant. This study highlights the importance of human and pedagogical approaches in the facilitation of students' placement learning and professional development. Hence, mentors are required to have effective communication and evaluation skills, and should therefore be supported through mandatory mentor preparation programmes and updates developed in national and cross-cultural co-operation.

Implementation of the Clinical Facilitation Model within an Australian rural setting: the role of the Clinical Facilitator

Education providers globally use various models for undergraduate nurse clinical education. This paper presents the major findings of a research project conducted by a rural university in Australia that aimed to explore the Clinical Facilitation Model of undergraduate nursing education from a rural perspective. In particular how the Clinical Facilitators enacted their role within the rural environment and to identify any barriers to the provision of effective clinical learning during facilitated clinical experience within this context. This qualitative study used a phenomenological approach to explore the experiences of Clinical Facilitators. Individual in-depth interviews were conducted with eight Clinical Facilitators. Data was analysed using thematic analysis and several themes emerged from the study. This paper will report two of the major findings which are based on how Clinical Facilitators enacted their role within the rural environment. Whilst this study has a rural focus the findings will add to the limited body of knowledge internationally regarding the Clinical Facilitation model used as a result of balancing educational needs of the student with the care needs of the patients in the current health policy climate. The findings will be useful for informing undergraduate curricula, and will assist faculty and health services in planning and implementation of models of clinical education that meet the needs of the student and that are specific to the rural environment. In addition, the findings will provide insight into strategies that the rural Clinical Facilitator can utilise to assist in fulfilling their teaching role.

Quality clinical placements for undergraduate nursing students: a cross-sectional survey of undergraduates and supervising nurses

AIM

  This article is a report of a mixed method study of the quality of clinical placements for second year undergraduate nursing students in an acute care hospital.

BACKGROUND

  In response to the current and predicted workforce shortages, greater numbers of nursing undergraduate places are being offered at tertiary institutions. This means that requests for clinical places in hospitals to support undergraduate students has risen. Little is known about the impact of increased numbers on the quality of clinical placement as a learning experience and this is of concern as demand grows and the means of assessing capacity is still unknown.

METHODS

  A 5-point Likert Scale questionnaire, including free text fields, was administered to undergraduates (n = 178), clinical facilitators (n = 22) and supervising ward nurses (n = 163) at two time points in 2009. The survey targeted the quality of the clinical placement in four domains: welcoming and belongingness; teaching and learning; feedback; confidence and competence. Findings.  The findings demonstrated consistently high scoring of the clinical placement experience by both undergraduates and registered nurses. There were higher ratings of levels of support from clinical facilitators compared to supervising ward nurses evident in data associated with the items on the questionnaire relating to teaching and learning.

CONCLUSION

  The results are indicative of the professional commitment of nursing staff to support the next generation of nurses. The findings also give a mechanism to communicate outcomes of undergraduate support to nurses in practice, and highlight steps which can be taken to ensure high quality clinical placement continues.

Preceptors' experiences of clinically educating and assessing undergraduate nursing students: an Irish context

AIM

To explore preceptors' views and experiences of preceptoring undergraduate nursing students.

BACKGROUND

Undertaking a preceptoring role is acknowledged internationally as complex and challenging. With the introduction of the undergraduate degree programme in Ireland (2002), preceptors were assigned a more formal role in the teaching and assessing of students. As this was a new programme for students and an additional responsibility for preceptors, it was important to investigate how preceptors found this new experience.

METHODS

Data were collected using a mixed methods descriptive approach.

RESULTS

Many preceptors wanted to become a preceptor and enjoyed the role. The majority of preceptors found the role stressful and burdensome and did not feel adequately supported by their clinical managers. Preceptors expressed the need for protected time, support, feedback and recognition from management for undertaking this role.

CONCLUSION

Findings validate problems experienced with preceptoring in other English-speaking countries and contribute further to building a case for vital change in this component of nursing education and nursing practice.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers should focus on the challenges expressed by preceptors in this study and identify appropriate strategies to carefully select, monitor and support preceptors in this complex role.

Practice-based learning: the role of practice education facilitators in supporting mentors

Central to the provision of high quality clinical placements for nursing and midwifery students are mentors who help engender a positive learning environment. In 2004 the Scottish Executive Health Department (now Scottish Government Health Directorates), NHS Scotland, NHS Education for Scotland, NHS Boards and Higher Education Institutions initiated and supported the establishment of the Practice Education Facilitator (PEF) role whose purpose is to ensure that the student experience, at both pre- and post-registration level, is of the highest quality, primarily through the support of mentors. A 3-year project evaluated the implementation and impact of the PEF role across Scotland. The study utilised both quantitative and qualitative data collection, with a sample comprising mentors, PEFs, students and other key stakeholders. This paper reports on selected findings from that study, specifically the perceived impact of the PEF in supporting mentors. Findings indicate that the PEF role has been accepted widely across Scotland and is seen as valuable to the development of quality clinical learning environments. PEFs provide support and guidance for mentors when dealing with 'failing' students, and encourage the identification of innovative learning opportunities. PEFs play an active part in student evaluation of their placements, but further work is needed in order that the feedback to clinical areas and mentors is timely.

The role of the nurse teacher in clinical practice: an empirical study of Finnish student nurse experiences

This paper focuses on the role of the nurse teacher (NT) in supporting student nurse education in clinical practice. The paper draws on the outcomes of a study aimed at exploring student nurse experiences of the pedagogical relationship with NTs during their clinical placements. The participants (N=549) were student nurses studying on pre-registration nursing programmes in Finland. Data were analysed using descriptive statistics, cross-tabulation and ANOVA. The study showed that the core aspect of NTs work in clinical practice revolved around the relationship between student, mentor and NT. Higher levels of satisfaction were experienced in direct proportion to the number of meetings held between the student and NT. However, whilst the importance of this relationship has been reported elsewhere, an additional aspect of this relationship emerged in the data analysis. Those NT who facilitated good face to face contact also used other methods to enhance the relationship, particularly e-mail, virtual learning environment and texting. This outcome suggests that NT's interpersonal and communicative skills are as important as their clinical knowledge and skills in promoting effective learning in the clinical practice area. The paper argues for such approaches to be utilised within the emergent opportunities afforded by new communication and educational technologies.

'Don't rock the boat': Nursing students' experiences of conformity and compliance

AIM

This paper profiles a cross national case study that examined nursing students' experience of belongingness when undertaking clinical placements. The aim of the paper is to present selected findings that focus on the relationship between belongingness, conformity and compliance.

BACKGROUND

Literature from the disciplines of psychology, social science and nursing is presented as a background to the study.

METHODS

This was a mixed methods case study; in this paper the qualitative phase is described. Eighteen third year nursing students from two universities in Australia and one in the United Kingdom were interviewed and the data thematically analysed.

FINDINGS

Three sub themes emerged within the category of conformity and compliance. These included: Don't rock the boat; getting the RNs offside; and speaking up. Students described how and why they adopted or adapted to the teams' and institution's values and norms, rather than challenging them, believing that this would improve their likelihood of acceptance and inclusion by the nursing staff.

CONCLUSION

Further research is required to examine the subtle interplay of factors that influence nursing students' attitudes and behaviours in relation to their need to belong, how conformity and compliance are acculturated in practice, and how students can be empowered to speak out against poor practice to become assertive and confident practitioners.

An overview of practice education models

Educating nursing students for entry level practice in complex health care settings is a concern in Canada and many other countries. National groups have called for improved practice education to better prepare students for actual practice. The purposes of this paper are identification and critical analysis of current practice education models. Ten basic model types were identified in the literature: faculty-supervised practicum, preceptorship, education unit, joint appointment, secondment, affiliate position, internship, co-operative education, work-study and undergraduate nurse employment. Key features, benefits and limitations of each model are discussed. Emerging developments in practice education are increased inter-professional and community-based practice education, and new partnerships among academic and practice organizations. These developments are intended to alleviate model limitations, ease pressures from organizational contexts and respond to large integrated health care systems. Evidence-based research for practice education is beginning to be apparent. Further research is needed that compares models and examines learning, patient care outcomes and costs.

'New professionalism'-shifting relationships between nursing education and nursing practice

New professionalism values egalitarian professional-client partnerships and considers competence integral. Within nursing competence has been accepted as the legitimate indicator of professional practice. There is a growing emphasis on instrumental competence and this has been accompanied by some erosion of relational care. In this paper I argue that new professionalism is problematic and nursing education faces particular challenges. These include negotiating service-education partnerships which reflect service user involvement and enable the integration of wider notions of competence.

Plugging a hole and lightening the burden: a process evaluation of a practice education team

AIM

To investigate the perceptions of clinical and senior managers about the role of practice educators (PEs) employed in one acute hospital in the UK.

BACKGROUND

Producing nurses who are fit for practice, purpose and academic award is a key issue for nurse education partnership providers in the UK. Various new models for practice learning support structures and new roles within health care institutions have been established. To sustain funding and policy support for these models, there is a need for evaluation research.

DESIGN

A process evaluation methodology was employed to determine the current value of a practice education team and to provide information to guide future direction.

METHODS

Data were collected through semi-structured telephone interviews using a previously designed schedule. All senior nurse managers (n = 5) and a purposive sample of Clinical Managers (n = 13) who had personal experience of and perceptions about the role of PEs provided the data. Interview notes were transcribed, coded and a thematic framework devised to present the results.

RESULTS

A number of key themes emerged including: qualities needed for being a successful practice educator; visibility and presence of PEs; providing a link with the university; 'plugging a hole' in supporting learning needs; providing relief to practitioners in dealing with 'the burden of students;' alleviating the 'plight of students;' and effects on student attrition.

CONCLUSIONS

Findings provided evidence for the continued funding of the practice educator role with improvements to be made in dealing with stakeholder expectations and outcomes.

RELEVANCE TO CLINICAL PRACTICE

In the UK, there still remain concerns about the fitness for practice of newly Registered Nurses, prompting a recent national consultation by the professional regulating body. Despite fiscal pressures, recommendations for further strengthening of all systems that will support the quality of practice learning may continue to sustain practice learning support roles.

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.

Clinical education: A review of the literature

In 2005, the University of Sheffield was commissioned to research the role, function and perceived impact of the clinical nurse educator role in a National Health Service Primary Care Trust. This paper presents the results of Phase I of the study, a review of the literature on clinical education and the series of research questions that were indicated. The importance of clinical education for quality nursing care has long been agreed but has gained increasing attention over the last two decades. This increased attention is the result of policy directives that place work based learning at the centre of health and social care practice. The literature is less equivocal, however, concerning the responsibility for clinical education and asserts various roles including; the lecturer employed by the University; joint appointments; mentors; ward sister; specialist and advanced practitioners including the nurse consultant; and more recently the clinical nurse educator. Clinical educators have reported to have been introduced to meet the professional educational needs of the workforce but there is little empirical or theoretical evidence to support or refute this. This paper is an attempt to begin to address this.

New roles to support practice learning - can they facilitate expansion of placement capacity?

The National Health Service (NHS) Plan [Department of Health, 2000. The NHS Plan: A Plan for Investment, a Plan for Reform, The Stationery Office, London] set out an ambitious programme of growth for the number of students undertaking health professional education programmes. To meet this demand there is a growing and widely acknowledged need to increase the number of clinical placements needed by these students. This paper outlines the findings from a regional project that aimed to map the current pattern and availability of clinical placements for healthcare students by the collection of quantitative placement data (such as location, specialty, and number of mentors) as well as in-depth interviews with Clinical Placement Managers (CPMs). This article will focus on the findings from interviews with CPMs and their views and experiences of what role they can play in increasing placement capacity. The study revealed that the introduction of this role had facilitated the development and expansion of placement capacity, as the CPMs filled a gap in the form of up-to-date local knowledge about the clinical areas. The CPMs provided a much needed 'bridge' between the Higher Education Institution (HEI), the student and the clinical area. Recommendations are made in relation to future introduction of similar roles that aim to support student learning in practice. Furthermore, useful insights for ongoing policy implementation and development are highlighted.

Belongingness: A critique of the concept and implications for nursing education

Clinical experience is recognised as central to nursing education. Quality clinical placements across a range of venues are vital to the development of competent and confident professionals. However there is evidence, both empirical and anecdotal, suggesting that nursing students' clinical placement experiences are often fraught with problems. These problems are long standing and multi-dimensional. For many students clinical placements are typified by feelings of alienation and a lack of belongingness. This paper proposes that the problematic nature of clinical placements may be better understood through the lens of 'belongingness'. A critical review of selected studies drawn from the psychological and social science literature provides insight and useful direction for a more focused review of the nursing literature. The potential relationships between belongingness, nursing students, and their clinical placement experiences are then exemplified by excerpts taken from the nursing literature (including unpublished material). Finally, an ongoing study that seeks to address the paucity of empirical research in this area is highlighted.

Issues in practice based learning in nursing in the United Kingdom and the Republic of Ireland: Results from a multi professional scoping exercise

The first year (2003-2004) of a three year nationally funded project focused on completing a scoping exercise on the nature of practice education in five selected health care professions: Dietetics, Nursing, Occupational Therapy, Physiotherapy and Radiography (). A survey questionnaire, focus groups and secondary sources were used to collect data. Profession specific contributors completed the analysis of results. Resulting case studies were combined to produce a cross-professional overview of current issues in practice-based learning. The nursing case study identified areas of good practice such as; the mentorship model; the development of new support roles; and joint responsibility between Higher Education Institutes (HEIs) and Health Service areas for practice assessment. However, there were variations in the application of these areas of good practice throughout the United Kingdom (UK). Issues included; an inadequate supply of qualified mentors; formal recognition of the mentor role; and lack of knowledge of the relative impact of the differing mentor preparation programmes. In comparing the five professions, all had statutory requirements regarding the nature of practice learning but each profession differed in how this was managed and organised. The need for formal preparation, recognition and reward for the mentor/practice educator role was recognised with collaborative working across the professions a recommendation in order to achieve national improvement in the quality of practice learning support for health care professions.

A phenomenographic study of registered nurses’ understanding of their role in student learning—An Australian perspective

BACKGROUND

Students may be 'buddied' with registered nurses during their clinical experience since the designated clinical facilitator cannot be available for each student at all times. Little is known about the way registered nurses understand this informal role.

OBJECTIVES

The rationale for this study was to gain an insight of the variation of understanding registered nurses have of their role with students, and explored the qualitatively different ways registered nurses perceive their role with students on clinical experience and the implications of this understanding for student learning.

DESIGN

A phenomenographic approach was used to identify the variation of understanding and meaning of the role of the registered nurse with students on clinical practice from the perspective of the registered nurse. Phenomenography is a field of descriptive research concerned with the variation in ways people experience and understand similar phenomena.

SETTINGS AND PARTICIPANTS

A purposive sample of 30 registered nurses from 15 public and private hospitals in central and south eastern Queensland, Australia.

METHODS

Individual semi-structured interviews from a final sample of 28 interviews were analysed to identify Categories of Description.

RESULTS

Eight variations of understanding registered nurses have of their informal role with students were identified. The registered nurses' understanding varies from a focus that is 'student-centred', to 'completion of workload-centred', to 'registered nurse control', to a preference for no contact with students. As a consequence some students may have positive learning experiences while others will have limited learning opportunities.

CONCLUSIONS

The research highlights the varied ways registered nurses understand their role with students that may promote or impede the quality of student learning and development to meet professional competency standards. Formal recognition of the complexity of the registered nurse role by health care agencies and tertiary education providers is essential to ensure registered nurses have adequate preparation for their role with students.

Learning in practice--practice educator role

Learning in practice is increasingly becoming the focus of attention for higher education institutions, commissioners of health care education and the National Health Service in the United Kingdom. This article describes an evaluation of an initiative to provide specific support for pre qualifying nursing students in the practice environment. The initiative was the establishment of a new role, titled practice educator. The aim of the study was to evaluate the effectiveness of the practice educator role from the perspective of the three main constituent groups, practice educators themselves, mentors and students. Both qualitative and quantitative methods were used. The views of all three groups were that the role of practice educator was an important link between the University and practice providers. The issue of high credibility, accessibility and approachability was highlighted by post holders and reinforced by both students and mentors. The study indicates that practice educators are seen as supportive to both mentors and students and are perceived as a vital link between the University and practice environment.

Academic performance in nursing students: influence of part-time employment, age and ethnicity

AIM

This paper reports a study examining the influence of age, ethnicity and part-time employment on nursing students' academic performance for second year pathophysiology and nursing practice subjects.

BACKGROUND

Age and ethnicity are known to be significant predictors of academic achievement among nursing students. The endemic nursing shortage has increased the impetus to diversify, resulting in more mature-age students and students from diverse ethnic and cultural groups in nursing programmes. There is increasing pressure for nursing students to participate in part-time employment whilst undertaking higher education, and this may affect their academic performance.

METHODS

A prospective, quantitative survey design was used to collect data from a regional university in Australia over a 2-year period from 2001 to 2002. A total of 267 nursing students were included in the study.

FINDINGS

More than three-quarters (78%) of second year students were participating in paid employment, with the majority in nursing-related jobs. Of those working, half did so more than 16 hours per week during the semester. Students who were not in paid employment had the highest academic achievements in both pathophysiology and nursing practice. Age was positively related with academic performance, but hours of part-time employment and ethnicity were negatively associated with academic performance, with the amount of time spent in paid employment being the strongest predictor of academic performance in both pathophysiology and nursing practice.

CONCLUSION

Working more than 16 hours per week had a detrimental impact on the academic performance of nursing students. More importantly, this study shows that nursing-related employment is not advantageous to students' academic performance, even for a nursing practice-based subject. If the current practice of employing nursing students in clinical settings is to continue, this experience needs to be aligned to the academic curriculum if it is to be beneficial to students' knowledge and skill acquisition.