The establishment of structures and processes for the safe and effective clinical placement of nursing students

"Finding My Place in Academia": Understanding the Experiences of Novice Faculty

BACKGROUND

The current nursing faculty shortage rapidly has expanded the need to hire faculty. New faculty are clinical experts in their own practice; however, many lack formal knowledge about the academic setting, making the transition from practice to academia difficult.

METHOD

A qualitative descriptive study was developed to identify how new faculty transition into their academic positions. The sample consisted of 12 clinical nursing faculty participants.

RESULTS

A total of 12 themes emerged: awful day as faculty, career plans, compensation, finding my place in academia, great day at clinical, "I wanted to be successful," preparation for the faculty role, struggling, student experiences, support, lack of support, and surprise. Finding ways to recruit and retain qualified faculty is imperative.

CONCLUSION

Inadequate support for transitioning to the faculty role may contribute to faculty turnover; developing a strong mentoring program may help retain qualified faculty. [J Nurs Educ. 2023;62(8):433-442.].

How do we facilitate international clinical placements for nursing students: A cross-sectional exploration of the structure, aims and objectives of placements

BACKGROUND

International clinical placements provide undergraduate students with a unique and complex clinical learning environment, to explore cultural awareness, experience different health care settings and achieve clinical competencies. Higher education institutions need to consider how to structure these placements to ensure appropriate and achievable aims and learning outcomes.

OBJECTIVES

In this study we described the structure, aims and learning outcomes associated with international clinical placement opportunities currently undertaken by Australian undergraduate nursing students in the Asia region.

PARTICIPANTS

Forty eight percent (n = 18) of the institutions invited responded. Eight institutions met the inclusion criteria, one of which offered three placements in the region, resulting in 10 international placements for which data were provided.

METHODS

An online survey tool was used to collect data during August and September 2015 on international clinical placements conducted by the participating universities. Descriptive data on type and numbers of placements is presented, along with results from the content analysis conducted to explore data from open ended questions on learning aims and outcomes.

RESULTS

One hundred students undertook 10 International Clinical Placements offered in the Asian region by eight universities. Variations across placements were found in the length of placement, the number of students participating, facilitator to student ratios and assessment techniques used. Five categories related to the aims of the programs were identified: 'becoming culturally aware through immersion', 'working with the community to promote health', 'understanding the role of nursing within the health care setting', 'translating theory into professional clinical practice', and 'developing relationships in international learning environments'. Four categories related to learning outcomes were identified: 'understanding healthcare and determinants of health', 'managing challenges', 'understanding the role of culture within healthcare' and 'demonstrating professional knowledge, skills and behaviour'.

CONCLUSIONS

International clinical placements in the Asia region appear to vary greatly from one education institution to the next with no clear consensus from either this study's findings or the literature on which structure, support and assessments lead to greater student learning.

Patient safety content and delivery in pre-registration nursing curricula: A national cross-sectional survey study

BACKGROUND

Patient safety is a core principle of health professional practice and as such requires significant attention within undergraduate curricula. However, patient safety practice is complex requiring a broad range of skills and behaviours including the application of sound clinical knowledge within a range of health care contexts and cultures. There is very little research that explores how this is taught within Australian nursing curricula.

OBJECTIVES

To examine how Australian nursing curricula address patient safety; identify where and how patient safety learning occurs; and describe who is responsible for facilitating this learning.

DESIGN

A cross-sectional study.

SETTING

Eighteen universities across seven Australian States and Territories.

PARTICIPANTS

The sample consisted of 18 nursing course coordinators or those responsible for the inclusion of patient safety content within a Bachelor of Nursing course at Australian universities.

METHODS

An online survey was conducted to evaluate the patient safety content included and teaching methods used in Australian pre-registration nursing curricula.

RESULTS

Approaches to teaching patient safety vary considerably between universities where patient safety tended to be integrated within undergraduate nursing course subjects rather than explicitly taught in separate, stand-alone subjects. Three-quarters of the surveyed staff believed patient safety was currently being adequately covered in their undergraduate nursing curricula.

CONCLUSION

Although there is consensus in relation to the importance of patient safety across universities, and similarity in views about what knowledge, skills and attitudes should be taught, there were differences in: the amount of time allocated, who was responsible for the teaching and learning, and in which setting the learning occurred and was assessed. There was little indication of the existence of a systematic approach to learning patient safety, with most participants reporting emphasis on learning applied to infection control and medication safety.

Educating for health service reform: clinical learning, governance and capability - a case study protocol

Background

The nurse practitioner is a growing clinical role in Australia and internationally, with an expanded scope of practice including prescribing, referring and diagnosing. However, key gaps exist in nurse practitioner education regarding governance of specialty clinical learning and teaching. Specifically, there is no internationally accepted framework against which to measure the quality of clinical learning and teaching for advanced specialty practice.

Methods

A case study design will be used to investigate educational governance and capability theory in nurse practitioner education. Nurse practitioner students, their clinical mentors and university academic staff, from an Australian university that offers an accredited nurse practitioner Master’s degree, will be invited to participate in the study.

Semi-structured interviews will be conducted with students and their respective clinical mentors and university academic staff to investigate learning objectives related to educational governance and attributes of capability learning. Limited demographic data on age, gender, specialty, education level and nature of the clinical healthcare learning site will also be collected. Episodes of nurse practitioner student specialty clinical learning will be observed and documentation from the students’ healthcare learning sites will be collected.

Descriptive statistics will be used to report age groups, areas of specialty and types of facilities where clinical learning and teaching is observed. Qualitative data from interviews, observations and student documents will be coded, aggregated and explored to inform a framework of educational governance, to confirm the existing capability framework and describe any additional characteristics of capability and capability learning.

Discussion

This research has widespread significance and will contribute to ongoing development of the Australian health workforce. Stakeholders from industry and academic bodies will be involved in shaping the framework that guides the quality and governance of clinical learning and teaching in specialty nurse practitioner practice. Through developing standards for advanced clinical learning and teaching, and furthering understanding of capability theory for advanced healthcare practitioners, this research will contribute to evidence-based models of advanced specialty postgraduate education.

Psychometric testing of the Persian version of the Belongingness Scale-Clinical Placement Experience

BACKGROUND

Belongingness has been identified both as a fundamental human need and as a prerequisite for nursing students' clinical learning. Belongingness has also been associated with students' academic achievement, retention, self-esteem, self-directed learning, and self-efficacy. The Belongingness Scale-Clinical Placement Experience is a valid and reliable measure of nursing students' belongingness scores; however, a Persian version of this scale is not currently available.

AIM

This study aimed to translate the Belongingness Scale-Clinical Placement Experience into Persian, to evaluate its psychometric properties, and to measure the belongingness experiences of Iranian nursing students.

METHODS

Following translation and initial validity and reliability testing of the scale, 300 nursing students from three universities in Iran completed the survey. Further psychometric testing was undertaken followed by analysis of descriptive statistics.

RESULTS

Based on the results of confirmatory factor analysis two items were removed from the scale. The mean score of Persian version of the Belongingness Scale-Clinical Placement Experience was 3.21 (0.57). The whole scale had a high internal consistency (Cronbach's alpha=0.92). The alpha coefficients of the subscales of "self-esteem", "connectedness", and "efficacy" were 0.85, 0.86, and 0.80 respectively.

CONCLUSION

Similar to previous versions of the Belongingness Scale-Clinical Placement Experience, the Persian version demonstrated strong psychometric properties with strong validity and reliability, indicating its utility and appropriateness when measuring Iranian nursing students' belongingness experiences. Further testing with other cohorts would strengthen these results.

Undergraduate midwifery students' sense of belongingness in clinical practice

BACKGROUND

Clinical placements form a large and integral part of midwifery education. While much has been written about nursing students' clinical placements, less is known about clinical experiences of undergraduate midwifery students. In nursing, belongingness has been demonstrated to be a key factor in clinical learning but little is known about this in midwifery education.

OBJECTIVES

This study sought to examine undergraduate midwifery students' sense of belongingness in their clinical practice.

DESIGN

A quantitative design using an online questionnaire was employed. A tool adapted by Levett-Jones (2009a), and previously used with nursing students, was utilised to examine sense of belonging in undergraduate midwifery students.

PARTICIPANTS

Sixty undergraduate midwifery students from two campuses at one Australian university participated in the study. Students were drawn from a single Bachelor of Midwifery degree and a double Bachelor of Nursing/Bachelor of Midwifery degree.

METHODS

On completion of a scheduled lecture, students were invited by one of the researchers to participate in the study by completing the online questionnaire and the link provided. Data were analysed using descriptive statistics.

RESULTS

Midwifery students generally reported similar perceptions of belongingness with previous studies on nursing students. However, a few differences were noted that require further exploration to fully understand.

CONCLUSIONS

Midwifery students experienced a sense of belonging in their clinical placements. The findings contribute to understandings of the experiences for midwifery students and provide a foundation on which to develop future clinical placement experiences.

First year nursing students' viewpoints about compromised clinical safety

OBJECTIVE

Undergraduate nursing students must uphold patient safety as a professional and moral obligation across all clinical learning experiences. This expectation commences at entry into the nursing program. As part of a larger study exploring undergraduate baccalaureate nursing students' understanding of clinical safety, this paper specifically focuses on first year students' viewpoints about unsafe clinical learning situations.

METHODS

Q-methodology was used. Sixty-eight first year nursing students participated in the ranking of 43 statements indicative of unsafe clinical situations and practices. Data was entered into a Q-program for factor analysis.

RESULTS

The results revealed a typology of four discrete viewpoints of unsafe clinical situations for first year students. These viewpoints included an overwhelming sense of inner discomfort, practicing contrary to conventions, lacking in professional integrity and disharmonizing relations. Overall, a consensus viewpoint described exonerating the clinical educator as not being solely responsible for clinical safety.

DISCUSSION

This information may assist students and educators to cooperatively and purposefully construct a clinical learning milieu conducive to safety.

A qualitative study on Iranian nurses’ experiences and perspectives on how to provide safe care in clinical practice

Nurses are the healthcare providers who are well positioned to strengthen patient safety through providing safe care in clinical practice. The purpose of this study was to explore and describe the experiences and perspectives of Iranian nurses in relation to how to provide safe care in clinical practice. A qualitative design by using a content analysis approach was applied for the data gathering and analysis. After employing a purposive sampling to choose 16 bachelor’s degree nurses working in the medical and surgical wards of a referral teaching hospital in an urban area of Iran, semi-structured interviews were conducted to collect data. During the data analysis, three main themes emerged: ‘providing safe care as the patient’s right’, with the subthemes: ‘feeling a personal commitment’ and ‘incorporating patients’ feelings of safety into providing safe care’, ‘encouraging reciprocal accountability in healthcare professionals’ and ‘leadership commitment to safe care’. The findings suggest that educators should provide more information during nurses’ education to focus on the moral duty to provide safe care. In addition, the provision of safe care needs the commitment and collaboration of all healthcare professionals, as well as the leadership of nursing for removing obstacles to nurses’ efforts to making the healthcare system safer.

Patient safety in an English pre-registration nursing curriculum

This study explored patient safety in an English pre-registration nursing curriculum. The need to improve patient safety has been recognised as a key priority, both nationally and internationally. Education has a crucial role in developing the knowledge, skills and attitudes that promote patient safety. However, evidence about how patient safety is addressed in healthcare professional curricula and how organisations develop safe practitioners is limited. An organisational case study identified factors affecting patient safety educational provision. Content analysis revealed what aspects of patient safety featured in the formal pre-registration nursing curriculum. Interviews were conducted with students, lecturers and key education stakeholders from various levels of the educational organisation, to explore their perceptions of patient safety and its location in the curriculum and practice. Patient safety was not explicit in the formal curriculum, but was included in teaching. Students reported gaining most knowledge and experience from clinical practice. The organisational culture of both education and practice was characterised as defensive and closed, and as having an individual versus a systems approach. Findings suggest the need for clarification of the concept of patient safety, as well as revision of curricula and teaching, learning and assessment strategies in order to address patient safety explicitly.