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Irwin P, Magee D, Weiley S, Teakel S, Linden K. Improving student success and retention in first-year nursing through embedded tutor support. NURSE EDUCATION TODAY 2024; 136:106134. [PMID: 38387213 DOI: 10.1016/j.nedt.2024.106134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 02/02/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Nursing students from diverse or equity backgrounds are less likely to possess the required skills to ensure success in their studies. This research explores the impact of embedded support on student learning in a first-year foundational subject, Contexts of Nursing, in an undergraduate nursing degree.t. METHODS The Embedded Tutor Program offers specialised tutoring support for first-year undergraduate students. Embedded tutors, with backgrounds as registered nurses and academics, provided online one-on-one feedback to students on draft assessment tasks. Outreach contact was provided to students at risk of failing. A Pearson's Chi-squared test was used to assess the impact of tutor support on grade distribution and a paired student t-test was used to assess the difference in cumulative marks for students from equity backgrounds. Statistical significance was set at p < 0.05. Feedback provided by students, tutors and staff in an online anonymous survey was thematically analysed. RESULTS There was a significant grade shift for the 267 students who met with an embedded tutor (p < 0.05). Students who were a member of an Australian Government identified equity group had a significant increase in their cumulative mark if they met with a tutor of 9-17 % (p < 0.05). This improvement in cumulative mark was maintained for students with cumulative equity factors. The overwhelming majority of students who were identified as at risk of failing and met with a tutor following outreach support received a passing grade. Students reported growing skills and confidence in academic literacy was a key benefit of the program. CONCLUSION A shared approach to delivering education has a positive effect on the experience of learning. The combined efforts of the subject convenor, embedded tutors, and extended student service roles within the University resulted in outcomes that were positive for student learning. Determining student capacity for learning extended beyond a student's consideration of grades or their progression in the program to include the development of self-efficacy.
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Affiliation(s)
- Pauletta Irwin
- Charles Sturt University, School of Nursing, Paramedicine and Healthcare Science, Port Macquarie, NSW 2444, Australia.
| | - Deborah Magee
- Charles Sturt University, School of Nursing, Paramedicine and Healthcare Science, Port Macquarie, NSW 2444, Australia.
| | - Shannon Weiley
- Charles Sturt University, School of Nursing, Paramedicine and Healthcare Science, Port Macquarie, NSW 2444, Australia.
| | - Sarah Teakel
- Charles Sturt University, Division of Student Success, Wagga Wagga, NSW 2650, Australia.
| | - Kelly Linden
- Charles Sturt University, Office of the Deputy Vice Chancellor Academic, Albury, NSW 2640, Australia.
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Simes T, Levett-Jones T, Harreveld B. Pre-assessment judgement framework for judging nursing students' performance in clinical placements: A qualitative case study. Nurse Educ Pract 2023; 73:103743. [PMID: 37951063 DOI: 10.1016/j.nepr.2023.103743] [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: 04/02/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 11/13/2023]
Abstract
AIM This study aims to better understand and articulate the pre-assessment judgement processes commonly used by experienced clinical facilitators when assessing nursing students undertaking clinical placement. BACKGROUND In the Australian context, clinical facilitators are registered nurses who primarily educate, monitor, support and assess groups of nursing students on clinical placements without carrying a patient load. The duties and scope of clinical facilitators may differ across international and institutional contexts. However, the core concepts of this paper will be relevant despite these differences as the importance of facilitators' confidence in making pre-assessment judgements of individual nursing student performance while on placement is universally acknowledged. Nursing students are often assessed on their provision of safe practice, patient task-orientated outcomes and professional behaviour. Clearly articulating performance judgements prior to formal assessment is vital to ensure progressive learning of students. Literature reports that many clinical facilitators lack confidence in the art of making performance judgements and call for targeted professional training and support in the clinical assessment of nursing students. To better understand and address this problem, clinical facilitators need a shared understanding of how individual nursing students' pre-assessment performance judgements are reached during placement experiences. DESIGN A qualitative case study was used, with data collected via semi-structured interviews. Fifteen Australian clinical facilitators participated, each with over six months of experience. METHODS Interview transcripts were analysed through an interpretive-constructivist paradigm. Thematic analysis revealed themes that were then deductively described through the application of the Cognitive Continuum Theory. RESULTS Six modes of pre-assessment judgement emerged from the data synthesis process: 1) Recognising patterns, 2) Acknowledging uncertainty, 3) Understanding key players, 4) Verifying or refuting the information, 5) Benchmarking performance and 6) Contextualising information. Each mode is validated through the deductive application of the Cognitive Continuum theory. CONCLUSIONS Understanding how experienced clinical facilitators make pre-assessment performance judgements has the potential to increase confidence in performance judgement decisions. In turn, confidence in judgements will increase clinical facilitator's capacity to give nursing students feedback that can be explained and justified. The pre-assessment judgement framework also provides a preliminary model for teaching the art of reaching accurate performance judgements to clinical educators in disciplines beyond nursing.
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Affiliation(s)
- Tracey Simes
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, 160 Ann Street, Brisbane, Queensland 4000, Australia.
| | - Tracy Levett-Jones
- School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, Australia. https://twitter.com/@Prof_TLJ
| | - Bobby Harreveld
- School of Graduate Research, Central Queensland University, Building 32, Bruce Highway, North Rockhampton, Queensland 4702, Australia
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Gray B, Grealish L, Ranse K, Terry V, Armit L, van de Mortel T, Del Fabbro L. The assessment of undergraduate bachelor of nursing students in the collaborative clusters education model: A qualitative descriptive design. Nurse Educ Pract 2023; 70:103675. [PMID: 37329827 DOI: 10.1016/j.nepr.2023.103675] [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: 01/27/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Worldwide, undergraduate Bachelor of Nursing students are required to complete experiential learning placements in health care settings as part of the curriculum. There are a variety of facilitation models that support student learning and assessment on clinical placement. As workforce pressures increase globally, innovative approaches to clinical facilitation are required. In the Collaborative Clusters Education Model of clinical facilitation, hospital-employed clinical facilitators work collaboratively within peer groups (clusters) to collectively participate in a process of facilitating student learning and conducting assessment and moderation of student performance. The assessment process in this collaborative clinical facilitation model is not well described. AIM To describe how the assessment of undergraduate nursing students is achieved in the Collaborative Clusters Education Model. DESIGN A qualitative descriptive approach was employed. METHODS In March 2021 individual and group interviews were conducted with seven clinical facilitators working in the Collaborative Clusters Education Model in one health service in southeast Queensland, Australia. Content analysis of transcribed interviews was performed. RESULTS Assessment was achieved through two processes, situational scoring and moderation. In the process of situational scoring, clinical facilitators balanced the students' perception of their role in assessment, accounted for the type of experiences available, considered multiple sources of evidence and used the Australian Nursing Standards Assessment Tool. In the process of moderation, clinical facilitators communicated with their cluster colleagues to determine a shared understanding of student history, considered data from multiple evidence sources and collaboratively evaluated the trustworthiness of student performance evaluation decisions. CONCLUSIONS In the Collaborative Clusters Education Model, the input of multiple assessors, working in a small team, ensured transparency in assessment processes. Furthermore, this transparency in assessment practices normalised on-going moderation, an in-built quality-check and, as such, an innovative component of assessment in the Collaborative Clusters Education Model. As nursing directors and managers seek to ameliorate the impact of nursing workforce pressures, this innovative model of collaborative assessment may serve as a valuable addition to nursing clinical assessment toolkits. TWEETABLE ABSTRACT The Collaborative Clusters Education Model of Clinical Facilitation enables transparency in assessment processes and normalises moderation.
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Affiliation(s)
- Belinda Gray
- Gold Coast Hospital and Health Service, Australia
| | - Laurie Grealish
- Gold Coast Hospital and Health Service, Australia; Menzies Health Institute Queensland, Griffith University, Australia
| | - Kristen Ranse
- School of Nursing & Midwifery, Griffith University, Australia
| | | | - Lyn Armit
- Gold Coast Hospital and Health Service, Australia
| | | | - Letitia Del Fabbro
- Gold Coast Hospital and Health Service, Australia; School of Nursing & Midwifery, Griffith University, Australia.
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4
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Feasibility of supporting newly qualified nurses: Nominal group technique of the perspectives of nursing stakeholders. Collegian 2022. [DOI: 10.1016/j.colegn.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Nyoni CN, Dyk LHV, Botma Y. Clinical placement models for undergraduate health professions students: a scoping review. BMC MEDICAL EDUCATION 2021; 21:598. [PMID: 34863178 PMCID: PMC8642754 DOI: 10.1186/s12909-021-03023-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/08/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Clinical learning is fundamental to undergraduate health professions students. There are several calls for the transformation of health professions education, which have direct implications on clinical learning. Clinical placement models provide structure to clinical learning. Therefore, this scoping review could contribute to supporting curriculum transformation to enhance learning in the clinical environments for undergraduate health professions students. OBJECTIVES This scoping review identified the characteristics of research evidence related to mapping the purpose, methodologies used, outcomes, and specific recommendations associated with clinical placement models in undergraduate health professions education. DESIGN A scoping review method was used in this study. A search string developed from the title of the review was used to search online databases to identify research published between January 2000 and March 2020. RESULTS Forty-eight articles reporting on ten clinical placement models were included in this review. The majority of these articles originated from Australia and predominantly report on nursing. The aims of these articles aligned with the evaluation of the implementation of a clinical placement model. Seven categories of outcomes of the clinical placement models are reported namely, relationships, influence, environment, facilitation, inputs, knowledge scores, and student perceptions. CONCLUSIONS As clinical learning is fundamental to undergraduate health professions education, clinical placement models should prioritise the development of competence among undergraduate students. Insights into outcomes reported in literature could guide educators in fostering optimal learning in students who may then be able to influence community health outcomes positively.
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Affiliation(s)
- Champion N Nyoni
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - Lizemari Hugo-Van Dyk
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Yvonne Botma
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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Bøe SV, Debesay J. The Learning Environment of Student Nurses During Clinical Placement: A Qualitative Case Study of a Student-Dense Ward. SAGE Open Nurs 2021; 7:23779608211052357. [PMID: 34722877 PMCID: PMC8554561 DOI: 10.1177/23779608211052357] [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: 08/09/2021] [Revised: 09/12/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Ensuring the quality of clinical placements has long been a challenge in nursing education. This is partly due to a growing aging population requiring health services, and an increased need for nursing workforce. Both in Norway and internationally, there is a rise in the use of student-dense models, wherein several students are placed together on the same ward at the same time where the supervision of the students is the collective responsibility of the nurses. Objective The aim of this study was to explore factors that promote or inhibit learning in a student-dense ward when used as a model for clinical placement in hospitals. We examined how clinical placement is experienced in a student-dense ward, as well as how learning is facilitated. Methods A qualitative case study design was used to capture the learning environment on the student-dense ward in a comprehensive way. We used focus group interviews, in-depth interviews, and observations with students and employees at a major hospital in Norway. Results Our findings showed that the orientation days and the teaching activities in student-dense wards, the feedback students receive, the clinical facilitator's role and the student community were factors that had particular importance for good learning environments in this placement model. Conclusions To ensure the quality of clinical placements, more attention should be paid to these factors in the planning, organization, and facilitation of new and existing student-dense wards. It is paramount to provide students with thorough written feedback and to secure the clinical facilitators with enough time to conduct student supervision when organizing clinical placement as student-dense wards.
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Affiliation(s)
- Siri Vestby Bøe
- OsloMet - Oslo Metropolitan University, Department of Nursing and Health Promotion, Postboks 4, St. Olavs plass, 0130 Oslo
| | - Jonas Debesay
- OsloMet - Oslo Metropolitan University, Department of Nursing and Health Promotion, Postboks 4, St. Olavs plass, 0130 Oslo
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KARACAN Y, YILDIZ H. Nursing education and stress. TURKISH JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.46310/tjim.879755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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van de Mortel T, Billett S, Armit L, Frommolt V, Mitchell C, Mitchell M, Shaw J, Grealish L. Developing intersubjectivity and teamwork skills through learning circles on clinical placement: A mixed methods study. Nurse Educ Pract 2021; 56:103214. [PMID: 34592490 DOI: 10.1016/j.nepr.2021.103214] [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: 07/07/2021] [Revised: 08/31/2021] [Accepted: 09/19/2021] [Indexed: 11/25/2022]
Abstract
AIM To determine the efficacy of learning circles on developing intersubjectivity and teamwork skills and determine barriers to and facilitators of, learning circles as a learning tool. BACKGROUND Teamwork skills are vital for safe, effective nursing care and are dependent on individual team members' shared understandings or intersubjectivity. Work-based learning circles offer a potential pedagogic strategy to promote teamwork. METHODS In work-based learning circles conducted in 2018, students drew a concept map based on a clinical case and discussed an element of it with the group. Using a convergent parallel mixed methods design, a cross-sectional survey of students using a student clinical experience questionnaire and a qualitative descriptive approach for interviews with clinical facilitators was conducted. RESULTS Overall, 128 Bachelor of Nursing students (88.9% response) completed the survey and five facilitators (50%) attended group interviews. Students agreed that core teamwork skills were developed during their placement and clinical facilitators reported (1) student engagement in the learning circle processes; (2) learning much about students' abilities; and (3) developing subtle teaching skills to enhance discussion. Sharing experiences from different wards and clinical experiences was a platform for developing intersubjectivity. CONCLUSIONS To promote intra-professional teamwork skills, conducting learning circles with students from different disciplines may further enhance intersubjectivity and is an area for further research.
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Affiliation(s)
| | - Stephen Billett
- Mt Gravatt Campus, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD 4122, Australia
| | - Lyn Armit
- Gold Coast Health, 1 Hospital Blvd, Southport Q 4215, Australia
| | - Valda Frommolt
- Logan Campus, Griffith University, 68 University Dr, Meadowbrook, QLD 4131, Australia
| | - Creina Mitchell
- Gold Coast Campus, Griffith University, Southport, QLD 4215, Australia
| | - Marion Mitchell
- Nathan Campus, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia
| | - Julie Shaw
- CQUniversity Brisbane Campus, Level 20, 160 Ann St, Brisbane, QLD 4000, Australia
| | - Laurie Grealish
- Gold Coast Campus, Griffith University, Southport, QLD 4215, Australia; Gold Coast Health, 1 Hospital Blvd, Southport Q 4215, Australia
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Kenny A, Dickson-Swift V, McKenna L, Charette M, Rush KL, Stacey G, Darvill A, Leigh J, Burton R, Phillips C. Interventions to support graduate nurse transition to practice and associated outcomes: A systematic review. NURSE EDUCATION TODAY 2021; 100:104860. [PMID: 33751999 DOI: 10.1016/j.nedt.2021.104860] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/29/2020] [Accepted: 01/18/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The aim of this mixed methods systematic review was to: i) document the interventions that support and facilitate graduate nurse transition from university to practice in a diversity of healthcare settings and ii) to identify outcomes from graduate nurse transition interventions for the graduate, patient or client, and health service. DESIGN This mixed methods systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. All quantitative, qualitative, and mixed methods studies were included if they met the inclusion criteria. DATA SOURCES Primary research studies located in Medline, EmBase, CINAHL, Prospero, Cochrane Library, PsycInfo, and Web of Science (Social Science Citation Index). All quantitative, qualitative, and mixed methods studies were included if they met the inclusion criteria. REVIEW METHODS Using a comprehensive search strategy, retrieved articles were screened by two reviewers at the title, abstract, and full-text stage. Reviewer disagreements were discussed until consensus was achieved. The well-validated Mixed-Methods Appraisal Tool was used to assess quality of the quantitative, qualitative, and mixed methods studies. RESULTS A total of 130 studies were included as the review dataset. There was a myriad of terms used to describe transition interventions, and programme length and settings varied. The content of transition interventions was not well defined, and there was a lack of studies outside acute hospital settings. Data collection methods varied widely. The majority of authors reported outcomes for the graduate or the graduate and service, with only one reporting outcomes for the patient or client. There was a significant variation in quality across the studies. CONCLUSIONS This review addresses a significant gap in the literature by documenting transition interventions in a diversity of health settings and outcomes from these interventions. Interest in transition to practice continues to rise, but there is an urgent need to conduct well designed, robust, and larger-scale studies at the national and transnational levels.
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Affiliation(s)
- Amanda Kenny
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, P.O. Box 199, Bendigo, VIC 3552, Australia.
| | - Virginia Dickson-Swift
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, P.O. Box 199, Bendigo, VIC 3552, Australia.
| | - Lisa McKenna
- School Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Martin Charette
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Kathy L Rush
- School of Nursing, University of British Columbia - Okanagan, ART 150-1147 Research Road, Kelowna, BC V1V 1V7, Canada.
| | - Gemma Stacey
- Florence Nightingale Foundation, Deans Mews, 11-13 Cavendish Square, London, England W1G 0AN, UK.
| | - Angela Darvill
- Children's Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK.
| | - Jacqueline Leigh
- School Health & Society, Room MS 1-43 Mary Seacloe Building, University of Salford, M6 6PU, UK.
| | - Rob Burton
- School of Nursing and Midwifery, Griffith University, Singapore.
| | - Craig Phillips
- Clinical and Health Sciences Unit, University of South Australia, City East Campus (C5-35), GPO Box 2471, Adelaide, SA 5001, Australia.
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McLeod C, Jokwiro Y, Gong Y, Irvine S, Edvardsson K. Undergraduate nursing student and preceptors' experiences of clinical placement through an innovative clinical school supervision model. Nurse Educ Pract 2021; 51:102986. [PMID: 33621926 DOI: 10.1016/j.nepr.2021.102986] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/13/2021] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Abstract
This study explores final year undergraduate nursing and midwifery students and their preceptors' experiences of a newly introduced Clinical School Supervision (CSS) model, which was implemented to reduce a perceived disconnect between theory and practice. A descriptive design was used with qualitative data collected through open-ended survey questions. Respondents included 43 undergraduate nursing and midwifery students involved in the final year and 13 clinical preceptors from a large metropolitan tertiary health service in Victoria, Australia. Qualitative data were analysed using thematic analysis. Students described the CSS as a favoured supervision model with students being able to take advantage of support from both the academic supervisor and nursing staff in the clinical setting, a model which also supported student's sense of belonging. Students experiences indicated the CSS model facilitated consolidation of knowledge, reflective practice and transition to graduate nursing. The preceptors described a commitment to and preparedness for the role, although they found they had little break from teaching and their rosters did not always align with their students'. Preceptors also shared experiences of unfulfilled expectations, lack of recognition and incentives for supervising students. Further studies are needed to identify effective ways to support preceptors in their roles.
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Affiliation(s)
- Carmel McLeod
- La Trobe University, School of Nursing and Midwifery, College of Science Health and Engineering, Northern Clinical School, Level 2, Northern Centre for Health Education and Research, 185 Cooper Street, Epping, Vic, 3076, Australia.
| | - Yangama Jokwiro
- La Trobe University, School of Nursing and Midwifery, College of Science Health and Engineering, Northern Clinical School, Level 2, Northern Centre for Health Education and Research, 185 Cooper Street, Epping, Vic, 3076, Australia
| | - Yuhua Gong
- La Trobe University, School of Nursing and Midwifery, College of Science Health and Engineering, Northern Clinical School, Level 2, Northern Centre for Health Education and Research, 185 Cooper Street, Epping, Vic, 3076, Australia; Monash University, School of Nursing and Midwifery Wellington Road, Clayton, Vic, 3800, Australia
| | - Susan Irvine
- Victoria University, First Year College, Ballarat Road, Footscray, Vic, 3011, Australia
| | - Kristina Edvardsson
- La Trobe University, School of Nursing and Midwifery, College of Science Health and Engineering, Northern Clinical School, Level 2, Northern Centre for Health Education and Research, 185 Cooper Street, Epping, Vic, 3076, Australia
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Lin FF, Del Fabbro L, Needham J, Sidwell D, Shaw J. Supporting culturally and linguistically diverse (CALD) undergraduate nursing students undertaking clinical placements in Australia: An exploratory qualitative study of clinical facilitator and CALD student perceptions. NURSE EDUCATION TODAY 2021; 97:104712. [PMID: 33341067 DOI: 10.1016/j.nedt.2020.104712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/19/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Internationalisation of higher education has contributed to the increasing number of culturally and linguistically diverse students in higher education programs worldwide. While there is some literature on the experiences and needs of these students, there is little evidence on what resources can be used to support these students when learning in the clinical setting. AIM This study aimed to evaluate the usefulness of an existing handbook developed for clinical facilitators to enhance culturally and linguistically diverse nursing students' learning, and to explore the facilitator and student perceptions of their clinical placement support needs. DESIGN This exploratory qualitative study, involving culturally and linguistically diverse Bachelor of Nursing students and clinical educators, was conducted in a multi-campus School of Nursing and Midwifery at Griffith University, Australia, in collaboration with health services. Focus groups and individual interviews with clinical facilitators and culturally and linguistically diverse nursing students were conducted. Activity theory provided the conceptual framework for this study and the qualitative data analysis was informed by grounded theory. RESULTS Clinical facilitator focus groups and interviews generated three themes: understanding culturally and linguistically diverse students' needs; supporting culturally and linguistically diverse students; and improving learning resources for facilitators and students. Student focus groups generated three themes: wanting to be more prepared for clinical placement; feeling supported by facilitators and interacting with others in a different context; and creating resources to support learning. CONCLUSIONS Supportive clinical environments are key to the work-integrated learning success of culturally and linguistically diverse nursing students. The findings of this qualitative research study, involving clinical educators and culturally and linguistically diverse Bachelor of Nursing students identify the pressing need to develop readily accessible resources to support the clinical learning of culturally and linguistically diverse students and their educators. Resources development should be attentive to complexities at the intersection of workplace culture and students' developing understanding.
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Affiliation(s)
- Frances F Lin
- School of Nursing, Midwifery, and Paramedicine, The University of the Sunshine Coast, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Australia; Sunshine Coast Health Institute, Queensland, Australia.
| | - Letitia Del Fabbro
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Australia; Gold Coast Health, Gold Coast University Hospital, Queensland, Australia.
| | - Judith Needham
- School of Nursing and Midwifery, Griffith University, Queensland, Australia
| | - Danny Sidwell
- School of Nursing and Midwifery, Griffith University, Queensland, Australia
| | - Julie Shaw
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; School of Nursing, Midwifery & Social Sciences, CQUniversity, Australia
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Abstract
Reflective practice is a common feature of nurse education. Indeed, the development of nursing practice is associated with being a 'reflective practitioner'. However, how we see ourselves or interpret past events is often influenced by our own unconscious biases. While it is reasonable to hold favourable views of one's ability, biased or lack of self-insight might mean that one is actually unskilled and unaware of it. In the ambiguous clinical context where an act or omission can have potentially devastating consequences, the implications of this are significant. The questions of whether and how reflection addresses unconscious biases are relatively unexplored in the nursing literature. Given that accurate self-assessment is integral to reflective practice, this article attempts to explore the potential impact of unconscious bias on reflection. The authors conclude that while biases may limit our ability to learn from reflection, this is not a reason to dispense with reflective practice, but rather, is even more reason to critically engage with the process. Nurses of all levels must be encouraged to reflect on both their practice, and their reflection.
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Affiliation(s)
- Paul Mahon
- Senior Education Coordinator, Beaumont Hospital, Dublin, Ireland
| | - Mary O'Neill
- Honorary Research Associate, Faculty of Nursing and Midwifery, RCSI, Dublin; MSc Supervisor/Facilitator, Institute of Leadership, RCSI, Dublin
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13
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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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Santos WMD, Jayasekara R. Dedicated Education Unit is a cost-effective clinical education model for undergraduate nursing programs. EINSTEIN-SAO PAULO 2020; 18:eGS5328. [PMID: 32578686 PMCID: PMC7299527 DOI: 10.31744/einstein_journal/2020gs5328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/29/2019] [Indexed: 11/05/2022] Open
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Goodwin J, Kilty C, Harman M, Horgan A. 'There need to be a balance': Mental health nurses' perspectives on medication education in university and clinical practice. Int J Ment Health Nurs 2020; 29:177-186. [PMID: 31498552 DOI: 10.1111/inm.12657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2019] [Indexed: 01/29/2023]
Abstract
Working with medication is an important role of the mental health nurse. However, little research has focused on staff nurses' perspectives on where the responsibility lies for preparing student nurses for safe, competent medication management. This study investigated mental health nurses' perspectives on medication education. An interpretive descriptive approach was used. Two focus groups were conducted, and data were analysed using inductive content analysis. It was found that participants embraced a medical approach to servicer user care, with less positive attitudes demonstrated towards psychosocial approaches. There were also tensions expressed between clinical practice and the university, with uncertainty voiced about whose responsibility it was to educate students about medication management. It is important that both environments complement each other in order to enhance the student nurse educational experience. While mental health nurses should be educated in this area to practice in a safe and competent manner, it is also key that a holistic approach to care is considered.
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Affiliation(s)
- John Goodwin
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Caroline Kilty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Mark Harman
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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16
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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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17
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Takashima M, Burmeister E, Ossenberg C, Henderson A. Assessment of the clinical performance of nursing students in the workplace: Exploring the role of benchmarking using the Australian Nursing Standards Assessment Tool (ANSAT). Collegian 2019. [DOI: 10.1016/j.colegn.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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