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Goers J, Humphrey K, Oja K, Mulkey D. Bridging the experience-complexity gap with longitudinal clinical placements. Nurs Outlook 2024; 72:102221. [PMID: 38905739 DOI: 10.1016/j.outlook.2024.102221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Clinical learning is a critical element to prepare nursing students for the profession. There is limited evidence on the experience-complexity gap among novice nursing students entering the workforce. PURPOSE This study aimed to implement a novel longitudinal clinical experience program and examined readiness for practice for undergraduate nursing students. METHODS We used a prospective cohort design using the Casey-Fink Readiness for Practice survey. FINDINGS There have been 2,004 clinical placements filled since the start of the program. Repeated exposure at one organization provided consistency and continuity while allowing students to develop relationships with patients and staff in a variety of settings. The medical-surgical two clinical experience was a pivotal course that influenced students' perception to enter the nursing workforce. DISCUSSION Clinical and academic partners must collaborate to provide the necessary competencies required to enter the workforce. Longitudinal clinical programs may improve nursing students readiness for practice. CONCLUSION The continous and immersive nature of the longitudinal clinical experience program facilitated the development of critical thinking skills and clinical competence, suggesting that longitudinal clinical placements can bridge the experience-complexity gap in nursing education.
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Affiliation(s)
- Jama Goers
- Denver Health and Hospital Authority, Nursing Education and Research Department, Denver, CO.
| | - Kale Humphrey
- Denver Health and Hospital Authority, Nursing Education and Research Department, Denver, CO
| | - Kenneth Oja
- Denver Health and Hospital Authority, Nursing Education and Research Department, Denver, CO; University of Colorado, College of Nursing, Auroroa, CO
| | - David Mulkey
- Denver Health and Hospital Authority, Nursing Education and Research Department, Denver, CO; University of Colorado, College of Nursing, Auroroa, CO
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Kamau S, Oikarainen A, Kiviniitty N, Koskenranta M, Kuivila H, Tomietto M, Kanste O, Mikkonen K. Nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings: An interview study. Int J Nurs Stud 2023; 146:104559. [PMID: 37523951 DOI: 10.1016/j.ijnurstu.2023.104559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/15/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023]
Abstract
AIM To describe nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings. DESIGN A qualitative descriptive study design. PARTICIPANTS A total of 13 nurse leaders were recruited from four primary and specialized healthcare organizations in Finland. METHODS Data were collected through individual semi-structured interviews and analyzed using inductive content analysis. RESULTS Nurse leaders' experiences were categorized into seven main categories as follows: leadership, which concerns a leader's roles, style, and experience; organizational strategy and culture, which includes structure, policies, and intra-organizational culture; support strategies, including workplace and outside-of-work integration strategies; relationships and interactions, which considers interpersonal relationships and interactions; nurse competence requirements and development, which concerns both organizational and ward level competence demands, and support for competence development; language competence, which concerns challenges relating to language proficiency and development of language competence; and cultural diversity, which considers the importance of competence development brought about through experiences of being in a multicultural workplace. CONCLUSIONS Culturally and linguistically diverse nurses are important within healthcare systems. These nurses constitute additional human resources, bring diverse experiences and expertise, and add to organizational cultural capital. Nurse leaders require competencies that are suitable for leading a diverse workforce, utilizing its competencies, establishing staff members' needs, and ensuring their continuous development. Resourcing, planning, and structuring the integration process affects nurses' experiences of the organizational socialization process. IMPACT The findings of our study can offer guidance to healthcare organizations with regard to structural integration strategies at an institutional level. Leadership and management educators can benefit from the findings towards developing a curriculum that supports leaders' diversity, equity and inclusion, knowledge management and formal leadership competencies. Finally, nurse leaders may benefit from this study through being more aware towards supporting a multicultural, cohesive, and competent workforce through strong social capital.
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Affiliation(s)
- Suleiman Kamau
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Department of Healthcare and Social Services, JAMK University of Applied Sciences, Jyvaskyla, Finland.
| | - Ashlee Oikarainen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
| | - Nina Kiviniitty
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Miro Koskenranta
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
| | - Heli Kuivila
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
| | - Marco Tomietto
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Department of Nursing, Midwifery and Healthcare, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.
| | - Outi Kanste
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Wellbeing Services County of North Ostrobothnia, Oulu, Finland.
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Wellbeing Services County of North Ostrobothnia, Oulu, Finland.
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Hugo-Van Dyk L, Botma Y, Ndhlovu M, Nyoni CN. A concept analysis on the transfer climate in health sciences education. Heliyon 2023; 9:e14299. [PMID: 36967964 PMCID: PMC10036515 DOI: 10.1016/j.heliyon.2023.e14299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/18/2023] [Accepted: 03/01/2023] [Indexed: 03/09/2023] Open
Abstract
The transfer of learning is complex, with factors such as transfer climate influencing students' transfer of learning. This transfer climate will shape a student's experiences during work-integrated learning and can be modified to enhance the transfer of learning. However, studies on transfer climate are mainly reported from a human resource development context and the outcomes may not be transferable to health sciences education. Furthermore, there is no uniformity in defining and measuring transfer climate. Rodgers' evolutionary concept analysis approach was used to describe the antecedents, attributes, and consequences of a positive transfer climate. An information specialist assisted in developing a Boolean search string and searched 15 databases to identify relevant sources. In total, 156 relevant articles were selected from 1448 sources. Data were charted and thematically analyzed. Antecedents comprise interpersonal relationships and theory-practice correlation. The presence of student support, training programs, student characteristics, clinical facilitator characteristics and a well-resourced clinical environment are the attributes of a positive transfer climate and act as learning transfer mediators. Transfer climate consequently influences student, educational, and organizational performance. A conceptual definition for transfer climate was then proposed. It was subsequently concluded that developing competent healthcare professionals and providing support to students depend on the synergy and good working relationship between health services and educational institutions. The insights into modifiable elements to enhance transfer climate could benefit health sciences educators in reconsidering their clinical training models to ensure sufficient support during students' clinical placements to meet the demands for a better-qualified healthcare workforce.
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Ying W, Mingxuan L, Qian Z, Shuxian Z, Yufang G, Kefang W. The mediating role of professional commitment between the clinical learning environment and learning engagement of nursing students in clinical practice: A cross-sectional study. NURSE EDUCATION TODAY 2023; 121:105677. [PMID: 36473329 DOI: 10.1016/j.nedt.2022.105677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/27/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies have shown that learning engagement can significantly predict nursing students' academic achievement. Nursing educators put considerable effort into assessing and promoting students' engagement in school. However, nursing students' learning engagement in clinical practice has seldom been explored. OBJECTIVES To investigate nursing students' learning engagement and influencing factors in clinical practice and examine the effects of the clinical learning environment and professional commitment on learning engagement, specifically to verify the mediation effect of professional commitment. DESIGN A cross-sectional study. SETTINGS The participants were from five hospitals in Jining, Shandong, China. PARTICIPANTS A total of 318 nursing students who were at the end of clinical practice training (>8 months) were included in this study. METHODS The Utrecht Work Engagement Scale for Students, the Clinical Learning Environment for Nursing Scale, and the Professional Commitment Scale were used for data collection. Regression and mediating analyses were used to explore the influencing factors of clinical learning engagement and the potential mediating role of professional commitment. RESULTS The participants experienced moderate levels of engagement in clinical learning. The clinical learning environment indirectly affected nursing students' learning engagement in clinical practice through professional commitment. Night shifts and educational background also contributed to learning engagement. CONCLUSIONS The findings provide new perspectives on promoting nursing students' clinical learning engagement. Professional commitment might be an important mediating variable in nursing education. There is a need to take steps to improve professional commitment of nursing students.
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Affiliation(s)
- Wang Ying
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan 250012, China
| | - Li Mingxuan
- Department of Reproductive Medicine, Affiliated Hospital of Jining Medical University, 89 Guhuai Road, Jining 272029, China
| | - Zhang Qian
- Department of Intensive Care Unit, Shandong Provincial Third Hospital, 11 Wuyingshan Middle Road, Jinan 250031, China
| | - Zhang Shuxian
- Department of Intensive Care Unit, Shandong Provincial Third Hospital, 11 Wuyingshan Middle Road, Jinan 250031, China
| | - Guo Yufang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan 250012, China.
| | - Wang Kefang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan 250012, China.
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Prosen M. A systematic integrative literature review of the factors influencing the professionalization of midwifery in the last decade (2009-2019). Midwifery 2021; 106:103246. [PMID: 35007977 DOI: 10.1016/j.midw.2021.103246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/03/2021] [Accepted: 12/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The professionalization of midwifery is not only important for midwives themselves, but for women and society in general since professionalism is associated with high-quality services and moral and ethical standards. AIM This systematic integrative literature review seeks to investigate the factors that have affected the professionalization of midwifery in the last decade (2009-2019). METHODS Systematic searches were conducted in EBSCO, PubMed, ScienceDirect, SAGE and the Web of Science Core Collection. Critical appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). The findings were synthesised through a thematic analysis. The PRISMA statement was used to guide the reporting. FINDINGS Analysis of the 20 studies included detected two main themes: professionalization barriers and professionalization opportunities. The first theme includes issues concerning power imbalance, social recognition, conflicting perspectives on childbirth, professional autonomy, work characteristics, midwifery associations, and regulation. The second theme includes opportunity issues related to woman-centred care, expansion of professional competency, interprofessional collaboration, and education. KEY CONCLUSIONS Over the last decade, the midwifery profession has faced several barriers that seem to be historically entrenched in the professionalization of midwifery, yet changes in the professionalization process are visible in the shift towards elements of the 'new professionalism' that is rising to the surface during this process. IMPLICATIONS FOR PRACTICE The findings suggest the socialisation process of midwifery candidates must focus on raising their self-awareness, self-esteem and confidence in their professional role; woman-centred care needs to be further promoted and implemented; and interprofessional collaboration should be addressed in educational programmes for all health professionals.
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Affiliation(s)
- Mirko Prosen
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310 Izola, Slovenia.
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6
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Mulligan K, Frawley T. The lived experience of being an undergraduate midwifery student in the neonatal unit. Nurse Educ Pract 2021; 59:103273. [PMID: 35078070 DOI: 10.1016/j.nepr.2021.103273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/25/2021] [Accepted: 12/05/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study is to examine the experience of undergraduate student midwives in the neonatal unit. BACKGROUND Clinical experience is an essential component of education for the development of competent midwives. Literature has highlighted the pivotal effects of precepting and how it contributes to student experience. Although there is a plethora of research examining undergraduate student midwives' experience, to our knowledge this is the first study exploring their experience in the neonatal unit. DESIGN Based in phenomenology, eight semi-structured interviews were conducted producing rich data. METHODS Following informed consent and ethical approval, post transcription, the data were coded using Colaizzi's (1978) framework. RESULTS Significant themes and sub-themes emerged such as course design, environmental experience, sources of stress and preceptor experience. The student experience very much depends on the preceptor, how busy the environment is and if appropriately staffed. CONCLUSIONS Based on these findings there are suggested recommendations including adjusting the timing and length of the placement and how to improve the environment based on the preceptor-student relationship. Also, suggestions on how consistency and communication can be improved are proposed.
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Affiliation(s)
- Kevin Mulligan
- National Maternity Hospital, Holles Street, Dublin 2 D02 YH21, Ireland; Centre for Midwifery Education, Coombe Women and Infants University Hospital, Dublin 8 D08 XW7X, Ireland.
| | - Timothy Frawley
- Room C125, UCD School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4 D04 V1W8, Ireland
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Ryan L, Jackson D, Woods C, East L, Usher K. Intentional rounding in the context of student learning. Collegian 2021. [DOI: 10.1016/j.colegn.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Rodríguez-García MC, Gutiérrez-Puertas L, Granados-Gámez G, Aguilera-Manrique G, Márquez-Hernández VV. The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals. J Clin Nurs 2021; 30:986-994. [PMID: 33432645 DOI: 10.1111/jocn.15642] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/08/2020] [Accepted: 12/31/2020] [Indexed: 01/10/2023]
Abstract
AIMS AND OBJECTIVES To analyse nursing students' perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals. BACKGROUND Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace. DESIGN Cross-sectional, correlational study. METHODS One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students' satisfaction with the clinical learning environment and learning process was measured using a 4-point Likert scale developed by the researchers. The STROBE checklist was used in this paper. RESULTS Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction. CONCLUSIONS This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies. RELEVANCE TO CLINICAL PRACTICE Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.
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Affiliation(s)
- Mª Carmen Rodríguez-García
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, University of Almería, Almería, Spain
| | - Lorena Gutiérrez-Puertas
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain
| | - Genoveva Granados-Gámez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, University of Almería, Almería, Spain
| | - Gabriel Aguilera-Manrique
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, University of Almería, Almería, Spain
| | - Verónica V Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, University of Almería, Almería, Spain
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Rodríguez-García MC, Márquez-Hernández VV, Granados-Gámez G, Aguilera-Manrique G, Gutiérrez-Puertas L. Magnet hospital attributes in nursing work environment and its relationship to nursing students' clinical learning environment and satisfaction. J Adv Nurs 2020; 77:787-794. [PMID: 33210802 DOI: 10.1111/jan.14629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/07/2020] [Accepted: 10/23/2020] [Indexed: 11/27/2022]
Abstract
AIMS To analyse nursing students' perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated. DESIGN This study had a cross-sectional, correlational, design. METHODS Data were collected using self-reported questionnaires from 180 nursing students at a university in southeast Spain between September-October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students' satisfaction with the work environment and with the clinical learning process were measured using a four-point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ2 test, Mann-Whitney U test, Spearman and phi correlation were used to analyse the data. RESULTS Nursing students' perception of greater Magnet-like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22-0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02). CONCLUSION Magnet-like features at the work environment lead to superior clinical learning environment and higher students' satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation. IMPACT In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.
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Affiliation(s)
- M Carmen Rodríguez-García
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, Almeria, Spain
| | - Verónica V Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, Almeria, Spain
| | - Genoveva Granados-Gámez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, Almeria, Spain
| | - Gabriel Aguilera-Manrique
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain.,Research Group of Health Sciences CTS-451, Almeria, Spain
| | - Lorena Gutiérrez-Puertas
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria Sacramento S/N, Almería, Spain
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10
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Rodríguez-García MC, Márquez-Hernández VV, Granados-Gámez G, Aguilera-Manrique G, Gutiérrez-Puertas L. Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey. J Nurs Manag 2020; 29:477-486. [PMID: 33051929 DOI: 10.1111/jonm.13184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type. BACKGROUND Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date. METHODS The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha. RESULTS Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest. CONCLUSION The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.
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Affiliation(s)
| | - Verónica V Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Universidad de Almería, Almería, Spain.,Research Group for Health Sciences CTS-451, Almería, Spain
| | - Genoveva Granados-Gámez
- Department of Nursing, Physiotherapy and Medicine, Universidad de Almería, Almería, Spain.,Research Group for Health Sciences CTS-451, Almería, Spain
| | - Gabriel Aguilera-Manrique
- Department of Nursing, Physiotherapy and Medicine, Universidad de Almería, Almería, Spain.,Research Group for Health Sciences CTS-451, Almería, Spain
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How nursing students' placement preferences and perceptions of community care develop in a more 'community-oriented' curriculum: a longitudinal cohort study. BMC Nurs 2020; 19:80. [PMID: 32863761 PMCID: PMC7448334 DOI: 10.1186/s12912-020-00473-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/18/2020] [Indexed: 11/12/2022] Open
Abstract
Background Extramuralisation in healthcare has influenced medical and nursing curricula internationally with the incorporation of themes related to primary/ community care. Despite this, students do not easily change their career preferences. The hospital is still favourite, leading to labour market shortages in extramural care. This study investigates how baccalaureate nursing students’ perceptions of community care and placement preferences develop over time in a more ‘community-care-oriented’ curriculum, to gain insights on which curriculum elements potentially influence career choices. Methods A nursing student cohort of a University of Applied Sciences in the Netherlands (n = 273) underwent a new four-year curriculum containing extended elements of community care. The primary outcome was assessed with the Scale on Community Care Perceptions (SCOPE). Data were collected each year of study. Descriptive statistics were used to investigate students’ placement preferences and perceptions, and linear mixed model techniques (LMMs) for measuring how students’ perceptions develop over time. Patterns of placement preferences at individual level were visualised. Results Students’ perceptions of community care, as measured with SCOPE, show a slight decrease between year 1 and 4, while items mutually differ substantially. In contrast, the preference of community care for a placement increases from 2.6% in year 1 tot 8.2% in year 4. The hospital is favourite in year 1 (79.8%), and remains most popular. At individual level, students often change placement preferences, although a preference for the hospital is more consistent. The LMMs indicates that, at the four time-points, the estimated marginal means of students’ perceptions fluctuate between 6 and 7 (range 1–10). A placement in community care did not positively influence students’ perceptions, and an intensive 1 week theoretical programme was only temporarily influential. Conclusions Although interest for placement in community care increased substantially, it was not clear which curriculum elements stimulated this, nor did the curriculum positively influence students’ perceptions. As most students do not look forward to the high responsibility of the field, other curricula with educational tracks for more mature students/ nurses with a vocational training may be an alternative contribution to solving the labour market problems in community care.
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van de Mortel TF, Armit L, Shanahan B, Needham J, Brown C, Grafton E, Havell M, Henderson A, Grealish L. Supporting Australian clinical learners in a collaborative clusters education model: a mixed methods study. BMC Nurs 2020; 19:57. [PMID: 32607059 PMCID: PMC7318499 DOI: 10.1186/s12912-020-00451-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background Nursing student numbers have risen in response to projected registered nurse shortfalls, increasing numbers of new graduates requiring transitional support and pressure on clinical placements. A Collaborative Clusters Education Model, in which Entry to Practice facilitators coach ward-based registered nurses to support students’ and new graduates’ learning, may address placement capacity. The research aim was to evaluate the acceptability of the Collaborative Clusters Education Model to stakeholders by examining their perceptions of the facilitators and barriers to the model in its implementation. Methods A convergent mixed methods evaluation approach was adopted. The study took place in a large Australian health service in south-east Queensland. Participants included Bachelor of Nursing students, Entry to Practice facilitators, ward-based registered nurses, academics and new graduates. A mixed methods design was used. Elements included an online survey of nursing students, and interviews with new graduates, Entry to Practice facilitators, ward-based registered nurses, and academics. Descriptive statistics were calculated on quantitative data. Thematic analysis was conducted on qualitative data. Results Participants included 134 (of 990) nursing students (response rate 13.5%), five new graduates, seven Entry to Practice facilitators, four registered nurses, and three nurse academics. Students rated facilitators’ effectiveness highly (4.43/5 ± 0.75), although this finding is tempered by a low response rate (13.5%). For learners, the model provided access to learning experiences, although preferences for sources of support differed between students and new graduates, and further clarification of responsibilities was required. For other stakeholders, three themes emerged: students’ and new graduates’ integration into the workplace can promote learning; tensions arise in new ways to approach performance assessment; and aligning expectations requires high levels of communication. Conclusions This evaluation found that acceptability was good but at risk from limited clarity around roles and responsibilities. Further research into this model is recommended.
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Affiliation(s)
- Thea F van de Mortel
- Professor & Deputy Head of School (Learning and Teaching), School of Nursing and Midwifery, Griffith University, Parklands Drive, Southport, QLD 4222 Australia
| | - Lyn Armit
- Director of Nursing, Nursing/Midwifery Education and Research Unit, Gold Coast University Hospital, Southport, Australia.,Adjunct Professor School of Nursing and Midwifery, Griffith University, Southport, QLD 4222 Australia
| | - Brenton Shanahan
- ADON Education Programs, Nursing/Midwifery Education and Research Unit, Gold Coast Health, Gold Coast, QLD Australia
| | - Judith Needham
- Director, Clinical Practice Office, School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD Australia
| | - Candy Brown
- Nurse Educator, Nursing/Midwifery Education and Research Unit, Gold Coast University Hospital, Gold Coast, QLD Australia
| | - Eileen Grafton
- School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD Australia
| | - Michelle Havell
- Nurse Unit Manager, C2E Digestive Health, Surgical, Anaesthetics, and Procedural Services, Gold Coast University Hospital, Gold Coast, Australia
| | - Amanda Henderson
- Professor, School of Nursing and Midwifery, Griffith University, Nathan, Australia.,Nursing Director, Nursing Practice Development Unit, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Laurie Grealish
- Associate Professor, School of Nursing and Midwifery, Griffith University & Gold Coast Hospital and Health Service, Southport, QLD Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD Australia
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Hill R, Woodward M, Arthur A. Collaborative Learning in Practice (CLIP): Evaluation of a new approach to clinical learning. NURSE EDUCATION TODAY 2020; 85:104295. [PMID: 31783268 DOI: 10.1016/j.nedt.2019.104295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/26/2019] [Accepted: 11/18/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND There are challenges in creating positive clinical learning environments. A new model of practice learning for pre-registration nurse education was pilot-tested in the East of England. The Collaborative Learning in Practice model (CLIP) was developed from a similar model of practice learning used in the Netherlands. OBJECTIVES We undertook an evaluation of a new approach to clinical learning. The aims of the project were to consider the challenges of implementation; consider the perception of gains and losses of students and stakeholders experiencing the new model of practice learning; and consider the sustainability of the new model in the context of service delivery. METHODS Mixed methods were used. Data were collected in three forms: (1) a survey of students undertaking the CLIP model and those learning within the existing mentorship model to assess the supervisory relationships and pedagogical atmosphere experienced; (2) student focus groups; and (3) qualitative one-to-one interviews with key stakeholders in the provision of practice learning environments. RESULTS A total of 607 questionnaires were returned out of the 738 distributed, five focus groups of a total of 30 students were undertaken, and 13 stakeholders were interviewed. Students who had experienced CLIP reported lower supervisory relationship scores compared with those without experience (mean difference = -0.24 points, 95% CI -0.21 to -0.094, p = 0.001). There was no difference in pedagogical atmosphere scores (mean difference -0.085 points, 95% CI -0.21 to 0.040, p = 0.19). Analysis of qualitative data produced two themes: 'Adapting the environment' illustrated the importance of learning context and 'learning to fly' highlighted the process of students gaining greater autonomy. CONCLUSION Our findings suggest that collaborative learning in practice offers many benefits as an approach to clinical learning but with important caveats. Attention needs to be paid to particular aspects of the model such as sufficient numbers of students, and an acknowledgement of perceived losses as well as gains.
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Affiliation(s)
- Rebekah Hill
- University of East Anglia, Norwich, United Kingdom of Great Britain and Northern Ireland.
| | - Michael Woodward
- University of East Anglia, Norwich, United Kingdom of Great Britain and Northern Ireland
| | - Antony Arthur
- University of East Anglia, Norwich, United Kingdom of Great Britain and Northern Ireland
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Nursing students' perceptions of a clinical learning assessment activity: 'Linking the puzzle pieces of theory to practice'. Nurse Educ Pract 2019; 36:85-90. [PMID: 30889469 DOI: 10.1016/j.nepr.2019.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/24/2019] [Accepted: 03/09/2019] [Indexed: 11/23/2022]
Abstract
The nursing profession struggles with providing a bridge to close the theory to practice gap for students. Students are expected to graduate with competencies that promote their safe and comprehensive nursing care provision in accordance with professional standards. This paper reports on students' a simulated clinical educational intervention embedded into a second-year nursing student clinical topic offering experiential learning opportunities for a large cohort. Feedback was analysed using Braun and Clarke's (2006) thematic qualitative process to investigate student-learning experiences and present student perceptions of this experience. Three key themes were identified: support promoted learning, focus on the bigger picture and practice clarifies puzzle pieces. Students perceived the simulated clinical experience as beneficial to their confidence, learning and ability to develop their professional practice. Promotion of learning outcomes facilitated by the structured, supportive and educational approach was important for students. Nurse educators have a responsibility to develop learning experiences that enable student's ability to link theory to practice in context. Ongoing exploration and evaluation of this intervention is required however, such an approach appears to support student's knowledge development for transference across situations and within large student cohorts.
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Carr J, Taylor R, Pitt M. Supporting student nurses who have their first clinical placement in the community nursing team. Br J Community Nurs 2018; 23:496-500. [PMID: 30290729 DOI: 10.12968/bjcn.2018.23.10.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
First year student nurses are increasingly undertaking their first placement with community nurses. The importance of how this initial learning experience is introduced by the higher education institution, as well as how the student is welcomed and integrated into the community nursing team, cannot be underestimated. Following positive anonymous feedback from students, which indicated that they had benefitted from the introduction, welcome and integration they experienced, the university and mentors reviewed how this had been done to identify good practice to share with colleagues. Students indicated that their welcome and integration had helped them to feel part of the team and enhanced learning, because they were so well supported, and mentors had facilitated learning experiences by acknowledging that this was their first placement experience. It is notable that mentors were committed to the students' learning and used workplace social capital to optimise the student experience. At a time when retention of students is essential to increase the future workforce, mentors dedicated to student learning are acting as ambassadors for the community workforce, and may well encourage students to have a career in community nursing.
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Affiliation(s)
- Jacqui Carr
- Assistant Professor. The School of Health Sciences, The University of Nottingham
| | - Rachel Taylor
- Community Nurse, Nottinghamshire Healthcare NHS Foundation Trust, Local Partnerships Nottingham West
| | - Margaret Pitt
- District Nurse, Practice Teacher, Queens Nurse. Nottinghamshire Healthcare NHS Foundation Trust, Local Partnerships Nottingham West
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Gao J, Wang J, Yu D, Dai J, Zhu Y, Fu H. Associations between psychosocial work environments and social capital: a multilevel analysis study in a Chinese context. BMC Public Health 2018; 18:976. [PMID: 30081887 PMCID: PMC6090743 DOI: 10.1186/s12889-018-5916-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the determinants of social capital is the prerequisite to building social capital. However there was few studies to explore factors related to workplace social capital. We aim to examine associations between psychosocial work environments and social capital in a Chinese context through a cross-sectional study. METHODS A cross-sectional study was conducted in Shanghai, China from December 2016 through March 2017. In total, 2380 workers from 32 workplaces were randomly sampled by a two-stage sampling procedure. Workplace social capital (WSC), psychosocial work environments (PWEs), and workplace Chinese Confucian values (CCVs), were assessed using validated and psychometrically tested measures. Multilevel ordinal regression models were used to examine the associations of WSC with individual- and workplace-level PWEs and workplace CCVs after controlling for individual socioeconomic characteristics. RESULTS After controlling for individual socioeconomic characteristics, all individual-level PWEs (unstandardized coefficients [B] ranging from 0.280 to 2.467) were positively associated with WSC. Individual-level workplace CCVs had mixed associations with WSC-high individual levels of respect for authorities (B: 0.325; 95%CI: 0.134, 0.516) and altruism (B: 0.347; 95%CI: 0.155, 0.539) were associated with high WSC, while high individual levels of acceptance of authorities (B: - 0.214; 95%CI: - 0.381, - 0.046) and the mianzi rule (B: - 0.258; 95%CI: - 0.435, - 0.080) were associatecd with low WSC. No workplace-level variable was associated with WSC. CONCLUSION These findings suggest that workplace social capital associates with multiple factors. Psychosocial work environments and cultural context are important in understanding variations in workplace social capital between individuals.
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Affiliation(s)
- Junling Gao
- School of Public Health, Fudan University; Fudan Health Communication Institute, PO Box 248, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Jing Wang
- Pudong Center of Disease Control and Prevention, Shanghai, 200136, China
| | - Denglai Yu
- Pudong Center of Disease Control and Prevention, Shanghai, 200136, China
| | - Junming Dai
- School of Public Health, Fudan University; Fudan Health Communication Institute, PO Box 248, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Yongkai Zhu
- School of Public Health, Fudan University; Fudan Health Communication Institute, PO Box 248, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Hua Fu
- School of Public Health, Fudan University; Fudan Health Communication Institute, PO Box 248, 138 Yixueyuan Road, Shanghai, 200032, China.
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Mueller G, Mylonas D, Schumacher P. Quality assurance of the clinical learning environment in Austria: Construct validity of the Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T scale). NURSE EDUCATION TODAY 2018; 66:158-165. [PMID: 29704703 DOI: 10.1016/j.nedt.2018.04.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 02/26/2018] [Accepted: 04/17/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Within nursing education, the clinical learning environment is of a high importance in regards to the development of competencies and abilities. The organization, atmosphere, and supervision in the clinical learning environment are only a few factors that influence this development. In Austria there is currently no valid instrument available for the evaluation of influencing factors. OBJECTIVES The aim of the study was to test the construct validity with principal component analysis as well as the internal consistency of the German Clinical Learning Environment, Supervision and Teacher Scale (CLES+T scale) in Austria. METHOD The present validation study has a descriptive-quantitative cross-sectional design. The sample consisted of 385 nursing students from thirteen training institutions in Austria. The data collection was carried out online between March and April 2016. Starting with a polychoric correlation matrix, a parallel analysis with principal component extraction and promax rotation was carried out due to the ordinal data. RESULTS The exploratory ordinal factor analysis supported a four-component solution and explained 73% of the total variance. The internal consistency of all 25 items reached a Cronbach's α of 0.95 and the four components ranged between 0.83 and 0.95. CONCLUSION The German version of the CLES+T scale seems to be a useful instrument for identifying potential areas of improvement in clinical practice in order to derive specific quality measures for the practical learning environment.
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Affiliation(s)
- Gerhard Mueller
- UMIT - The Health & Life Sciences University, Department of Nursing Science and Gerontology, Eduard Wallnoefer-Zentrum 1, A-6060 Hall in Tyrol, Austria.
| | - Demetrius Mylonas
- Nursing School Feldkirch, Dorfstrasse 13 b, A-6800 Feldkirch, Austria.
| | - Petra Schumacher
- UMIT - The Health & Life Sciences University, Department of Nursing Science and Gerontology, Eduard Wallnoefer-Zentrum 1, A-6060 Hall in Tyrol, Austria.
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