Clinical nurses as teachers: insights from students of nursing in their first semester of study

The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study

BACKGROUND

Clinical practice is a core component of nurse education. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, satisfaction, as well as influence their choice of future career. To examine nursing students' perception of clinical learning environment and mentoring in hospital where they perform their clinical placement and the connection of these factor with intention to work as a nurse once graduated.

METHODS

Nursing students enrolled in clinical practice at least 6 months in hospitals in China were surveyed between January-March 2021. Percentages, frequencies, mean, standard deviation, t-test, ANOVA, and regression analysis were used to analyse the data.

RESULTS

Of the five scales in the CLES+T, 'Leadership style of the ward manager' scored the highest mean while 'Pedagogical atmosphere at the ward' scored the lowest. Nursing students with lower educational level, those supervised by fixed preceptor, and those intent to be a nurse in the future were significantly more satisfied with the CLES+T. Most of the nursing students are intent to work as a nurse in the future. CLES+T total scores and sub-dimensions (Premises of nursing on the ward) have significantly effectiveness on the intention to be a nurse in the future.

CONCLUSIONS

Given the significant correlation of between learning environments and nursing students intention to be a nurse in the future, ward managers need to build a good clinical teaching atmosphere and promote opportunities for theoretical and practical connections among students through effective feedback mechanisms, which can enable students to experience a better clinical learning environment and meaningful experiences to build their professional roles and competencies, thus helping to enhance students' willingness to pursue nursing careers in the future.

The Medical Training Evaluation Questionnaire (MeTrE-Q): a multidimensional self-report instrument for assessing the quality of midwifery students' education

This study aims to understand the factors that can hinder Italian midwifery students' educational process, what messages are given to students during their clinical practice, and how students interact with tutors and other professionals. Seven hundred and eighty Italian students of midwifery were asked to answer an Internet-based questionnaire regarding their own opinions concerning their theoretical-practical formative path. For male Italian students, satisfaction is lower than female students as well as for students from Southern than Northern Italy. Students are dissatisfied with the quality of their academic and practical training, particularly regarding recognising their professional role and their relationship with tutors. Based on these data, it is essential to design a formative path for midwives that considers students' opinions and the positive experiences of other countries.Impact StatementWhat is already known on this subject? Several studies underscore the poor preparation of students for learning in clinical settings. The current reality of the Italian academic path in most universities disregards midwifery students' expectations and formative needs.What do the results of this study add? For male Italian students, satisfaction is lower than for female students and students from Southern than Northern Italy. Students are dissatisfied with the quality of their academic and practical training, particularly regarding recognising their professional role and their relationship with tutors.What are the implications of these findings for clinical practice and/or further research? It is essential to design a formative path for midwives that considers students' opinions and other countries' positive experiences.

Challenges Faced by Nursing Students to Work with Nursing Personnel: A Qualitative Study

PURPOSE

Nursing is a practice-based discipline. Clinical education is one of the most important parts of nursing education; nurses play an important role in the learning of nursing students. This study was carried out to unveil the challenges of nursing students' learning through working with nurses.

METHODS

A qualitative design was used to conduct the study in city of Khalkhal, Ardabil province, Iran. In order to collect data through purposive sampling, twenty students were interviewed using in-depth semi-structured individual techniques. Data analysis was done using MAXODA 12.

RESULTS

Challenges of nursing students' learning were generally categorized into three main themes including inappropriate social norms, inadequate organizational atmosphere, and inadequate resources.

CONCLUSION

It seems that inappropriate organizational culture in the clinical setting and wrong distribution of resources will lead to disruption of student-nurse relationships and ultimately disruption of clinical education.

Nursing students' stress and coping strategies during clinical training in KSA

Objective

Nursing students are exposed to several stressors during their studies and training. The aim of this study is to assess the degree of stress experienced by nursing students at Albaha University, KSA and the coping strategies they subsequently employ.

Methods

A descriptive cross-sectional study was conducted by a simple random sampling technique on 125 nursing students during their clinical practice. The data were collected by a self-administered questionnaire consisting of demographic variables, the Perceived Stress Scale, and the Coping Behavior Inventory.

Results

Of the 125 participants, 48% were male and 52% were female. The mean age was 21 ± 1.56 years, and they were mostly single 110 (88%). Approximately 65 (52%) were very satisfied and 41 (32.8%) were satisfied with their clinical practice. The main stressors were noise (20; 16%), moving location (nine; 7.2%), social interaction (seven; 5.6%), and personal illness (seven; 5.6%). The perceived stress provoking factors included taking care of patients (1.56 ± 0.45), assignments and workload (1.60 ± 043), lack of professional knowledge and skills (1.24 ± 0.45), field of practice (1.47 ± 0.49), peers and daily life (1.89 ± 0.67), and teachers and nursing staff at hospitals (1.45 ± 079). The strategies used by students to minimise stress included taking a problem-solving approach (1.84 ± 067), staying optimistic (1.56 ± 076), transference (1.34 ± 1.20), and avoidance (1.23 ± 056).

Conclusion

The nursing students in the study cohort were exposed to moderate stress due to different stressors. In response, they frequently used a problem-solving approach and avoidance. However, a standard protocol by institutions is required to help reduce stress among nursing students.

The effect of an enrolled nursing registration pathway program on undergraduate nursing students' confidence level: A pre- and post-test study

BACKGROUND

In the latter half of the 20th century, registered nurse education moved to university degree level. As a result, there has been a reduction in access for students to clinical experience. In numerous studies, nursing graduates have reported that they do not feel prepared for practice. The importance of maximising every learning opportunity during nursing school is paramount. At Edith Cowan University, a program was initiated that allows students to become enrolled nurses at the midway point of their degree to enable them to work and therefore gain experience in the clinical practice setting during their education. This study investigated the effect of the program on the nursing students' perception of their clinical abilities and explored their ability to link theory to practice.

METHODS

The research design for this study was a quasi-experimental, prospective observational cohort study. The study included 39 second-year nursing students not enrolled in the program (Group 1), 45 second-year nursing students enrolled in the program (Group 2), and 28 third-year nursing students who completed the program and are working as enrolled nurses (Group 3). Participants were asked to complete a Five Dimension of Nursing Scale questionnaire.

RESULTS

The quantitative analyses showed that students in Group 1 had statistically significant higher pre-questionnaire perceived abilities across all domains, except in two dimensions when compared to Group 2. The post-questionnaire analysis showed that Group 1 had statistically significant lower perceived abilities in four of the five dimensions compared to Group 2. Group 1 also had significantly lower abilities in all dimensions compared to Group 3. Group 3 had a significantly higher perception of their clinical abilities compared to Group 2.

CONCLUSION

This study highlights the value of meaningful employment for undergraduate nursing students by providing opportunities to increase confidence in clinical abilities.

Thai nursing students' experiences when attending real life situations involving cardiac life support: A Phenomenological study

BACKGROUND

During the last few years, manikin simulations have been used for cardiac life support training procedures in medical and nursing education. However, some nursing students have experienced attending real events involving cardiac life support during their clinical practice.

OBJECTIVE

This study aims to describe the meaning of experience of Thai nursing students when attending real situations of cardiac life support.

METHODS

A hermeneutic phenomenological study was used. Third and fourth year bachelor of nursing students at a university in the southern region of Thailand who had the experience of attending real situation of cardiac life support were purposely selected as the informants. The data were generated from individual in-depth interviews with eighteen nursing students. Van Manen's approach was used to analyze the data. Trustworthiness was established using the criteria set out by Lincoln and Guba.

RESULTS

Essential themes situated in the context of the four existential grounds of body, time, space, and relation emerged. These were: being worried and fearful while desiring to participate in cardiac life support procedures; enhancing self value; knowing each moment is meaningful for one's life; having time to understand the reality of life; being in a small corner; appreciating such opportunities and the encouragement given by nurses and the healthcare team; and feeling empathy.

CONCLUSIONS

Besides learning in classrooms and practicing in labs, experiencing real situations is beneficial for nursing students in learning cardiac life support. This study provides information that can be used for clinical teaching management in the topics relating to cardiac life support.

The diversity of Iranian nursing students' clinical learning styles: a qualitative study

BACKGROUND

Numerous factors, including learning styles, affect the learning process of nursing students. Having insights about students' learning styles helps promoting the quality of education. The aim of this study was to explore the Iranian baccalaureate nursing students' learning styles in clinical settings.

METHODS

A qualitative design using a content analysis approach was used to collect and analyze data. Semi-structured interviews were conducted with fifteen Iranian baccalaureate nursing students selected using a purposive sample method.

FINDINGS

During data analysis, it was found that nursing students employed different clinical learning styles such as 'thoughtful observation,' 'learning by thinking,' and 'learning by doing'.

CONCLUSION

Students adopt different learning strategies in clinical practice. Designing teaching strategies based on students' learning styles can promote students' learning and maximize their academic and clinical practice success. Nursing educators, curriculum designers, and students can use the findings of this study to improve the quality of nursing education in both the classroom and clinical settings.

The use of cognitive reappraisal and humour as coping strategies for bullied nurses

This article explores the repercussions of workplace bullying on nurses and the health-care profession as a whole. I discuss the nature of workplace bullying and draw upon prior studies to explore some of the barriers that prevent witnesses to bullying from intervening, as well as barriers faced by targets in taking action to stop the bullying. As overt forms of resistance are often not feasible in situations where nurses occupy subordinate positions to their bullies, I propose that cognitive reappraisal can be an effective coping strategy, and situate this perspective within the research on humour, hope and optimism.

First year nursing students' viewpoints about compromised clinical safety

OBJECTIVE

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

METHODS

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

RESULTS

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

DISCUSSION

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

Valuing teamwork: Insights from newly-registered nurses working in specialist mental health services

In this qualitative study, the experiences of a small cohort of registered nurses (RN) during the first 2 years of mental health employment were documented. A total of 13 semistructured interviews were completed from within a specialist mental health setting. Eleven issues were identified: (i) teamwork; (ii) experiential learning; (iii) self-development; (iv) confidence; (v) listening; (vi) rapport; (vii) keen observation; (viii) patience; (ix) empathy; (x) learning from colleagues; and (xi) maintaining a positive approach towards patients. The nurses focused on the here-and-now circumstances, rather than on future plans, or past preparation, and were able to elucidate the qualities and skills that they brought to their clinical work. Participants were most proud of achievements that bridged the personal and professional, such as self-development, working closely with patients to develop rapport, experiential learning, and teamwork. Findings highlight the importance of teamwork to newly-graduated RN entering the mental health environment. It is known that teamwork can convey a sense of belonging and help create an environment in which applied experiential clinical learning can occur. Therefore, it is important that efforts are made to facilitate team building and opportunities for teamwork when new graduates are transitioning into the mental health clinical practice environment.

Nursing students' perceptions of tutorial strategies during clinical learning instruction: A descriptive study

CONTEXT

Teaching strategies and methodology used in clinical training are varied and have different levels of outcome.

METHODS

A descriptive study was carried out in Italy on a convenience sample of third year students at four campuses of the Verona University, using a questionnaire divided into four sections: trainees' perception of the levels of usefulness of various teaching strategies, the levels of effectiveness, the level of supervision and the perceived complexity.

RESULTS

308 students compiled the questionnaire. All the tutorial strategies included were perceived as having medium to high levels of usefulness, ten out of the eleven learning strategies were found to be very useful. A medium-high level of usefulness was perceived for supervision (M 2.9±1). The two skills recorded as needing the most supervision were the management of therapy (M 3.8±1.03; Me 4) and performing nursing techniques (M 3.7±0.95; Me 4). The most complex activities were considered to be confronting an emergency situation (M 3.8±1.03) and the planning of care for a group of patients (M 3.3±0.941), and these two activities had had the least amount of supervision.

CONCLUSIONS

A tutoring model emerged that was centred on learning by experience and with guidance.

"This is nursing": nursing roles as mediated by precepting nurses during clinical practice

In nursing education, it has been argued that professional socialization is facilitated by clinical experiences where students work together with precepting nurses. However, few studies found have focused on how nurses think and act as preceptors, hence providing a base for professional socialization to occur. Therefore; this study aimed to describe how preceptors mediated nursing as a profession to undergraduate nursing students during clinical practice. This was an ethnographic study guided by symbolic interactionism. A purposeful sampling of 13 precepting nurses was observed during the field work period. In addition, 16 staff nurses, purposively selected, and experienced in precepting, participated in focus group interviews. All text from field notes and interviews were read as a whole and analyzed following the ethnographic approach. Findings illustrated how nursing was mediated as the medical-technical, the administrative, and the caring role. Preceptors aimed for professionalism in their students by teaching the students to reflect on what they can do independently as nurses. Preceptors strived to verbalise their practical knowledge to make theory explicit and contextualize to student nurses. This knowledge can guide implementation of preceptor programmes focusing on the meaning and implications of professionalism.

Empathic anger in junior nursing students

The ideal clinical experience fosters development of psychomotor, cognitive, and affective skills while affording initial socialization into the profession. It is expected that during these experiences, nursing students will encounter illustrative exemplars of caring and professional values. The primary stressors during initial clinical experiences arise from issues related to performance and socialization. Nursing students view a good relationship with the RNs at the clinical site as the most crucial influence on their professional growth and development. Even more distressing to students than being treated poorly themselves is watching patients receive uncaring treatment. Students' sadness and anger provoked by perceived uncaring treatment blends to form empathic distress. A content analysis of an assigned narrative from junior nursing students explores empathic anger experienced by the students during their initial clinical rotations.

'Investing in the future': residential aged care staff experiences of working with nursing students in a 'community of practice'

AIMS AND OBJECTIVES

This paper aims to discuss the implementation of a 'community of practice' model of clinical teaching into four residential aged care facilities.

BACKGROUND

There is increasing international evidence that aged care is a burgeoning health issue, particularly in developed countries. Recruitment and retention of nurses is problematic in residential aged care. Nursing students maintain negative perceptions of aged care and dislike clinical placements in that area. Additionally, supporting students in residential aged care is difficult considering the staffing mix of skilled/unskilled staff. Innovative educational strategies are needed to manage the increasing shortages of clinical placements for nursing students in all clinical areas.

STUDY DESIGN

Staff experiences were elicited through four focus groups onsite at the residential aged care facility where students had been placed, one year after implementation of a 'communities of practice' clinical model. Data analysis used a qualitative, thematic approach.

RESULTS

The staff in the residential aged care facilities expressed that work was involved in supporting students in the workplace, but that the additional workload was a valuable investment.

CONCLUSIONS

Staff in residential aged care see working with students as a local investment, where students' fresh eyes, recent knowledge and questioning behaviours are a worthy investment of staff time and effort. Staff also valued the investment in the future, where working with students now creates future nurses sensitive to aged care issues.

RELEVANCE TO CLINICAL PRACTICE

In a 'communities of practice' model of clinical experience for students, there are benefits for staff as well as students. The implementation of this clinical model in residential aged care was relatively low in cost, a benefit in this sector and has the potential to address the critical issues of recruitment and retention.

Strengthening and updating supervising staff nurses in educational workshops--an international partnership project

As part of a collaborative project involving Tanzania and Sweden, workshops were arranged for staff nurses in order to develop a forum for discussing the raised demands for supervision of nursing students during their clinical education. The aim was to meet nurses in educational workshops to initiate a dialogue on their views and experiences of supporting and supervising nursing students in their clinical studies. Their experiences of the workshops were also requested. Two groups of nurses in Tanzania (n=30), and six groups in Sweden (n=60) participated. The content, which was agreed between the project leaders in Tanzania and Sweden was carried out either on a whole day workshops or divided at three different occasions. Questionnaires were given before and about two months after, and workshops were also evaluated with an open-ended question immediately after. The nurses both in Tanzania and in Sweden appreciated the workshops as a possibility to create a dialogue and to discuss challenges in the supervision of students. Their views and experiences of the supervision role showed awareness of staff nurses as role models and teachers. Accomplishment of this partnership co-operation through arranging workshops has shown to be an easy and simple way of giving support to staff nurses for the supervision task.

Italian nursing students' perception of their clinical learning environment as measured with the CLEI tool

CONTEXT

The quality of clinical learning environment is an important factor for nursing students' clinical experience and it is determined above all by a good atmosphere in the ward. The Clinical Environment Inventory (CLEI) has been developed to evaluate clinical learning environments. The CLEI has been found to be homogeneous and its validity has been established in several countries (Australia, England and China).

METHODS

An exploratory study about Italian nursing students' perceptions of their learning environment was carried out using Chan's Clinical Learning Environment Inventory. The CLEI was translated into Italian and administered to 232 students from three levels of the nursing program in Trento hospital. The tool was administered after they finished the clinical placements.

RESULTS

All of the questionnaires distributed were returned completed. The students overall perceived their clinical learning environment as good. Third year's students were extremely satisfied (94%) with activities done on the ward, while second year's students reported less satisfaction (88%). All the students (99%) agreed that practical work experience was useful and not a waste of time.

CONCLUSIONS

This study shows that Italian nursing students have a positive perception of the clinical learning environment, although there remains room for improvement.

Bachelor of Midwifery students’ experiences of achieving competencies: The role of the midwife preceptor

OBJECTIVES

to explore and describe Bachelor of Midwifery students' learning experiences, specifically the role of the midwifery preceptor in learning and development of competency, from the students' perspective. The findings reported are taken from a wider investigation into Bachelor of Midwifery student's achievement of competency.

DESIGN

grounded theory methodology using in-depth interviews for data collection.

SETTING

school of nursing and midwifery of one university, and associated clinical teaching hospitals in Victoria, Australia.

PARTICIPANTS

eight Bachelor of Midwifery students completing their final clinical placement.

FINDINGS

data analysis in the broader study identified the categories of: hands-on practice; reflecting on practice; building confidence; gaining knowledge; working with midwives; and constructing a sense of self as a midwife. This paper focuses on one category 'working with midwives', which encompasses the therapeutic, interpersonal and clinical characteristics of the preceptor and their impact on student learning. Generally speaking, students identified midwife preceptors as helpful and unhelpful, and students indicated that they prefer to work with a caring midwife preceptor, who enjoys teaching, answers questions fairly and is philosophically similar. Students also felt that they benefited from opportunities for responsibility for care under supportive supervision, hands-on learning and debriefing. Midwife preceptors described as unhelpful were poor role models, did not allow the space for 'hands-on' practice or 'took over', were generally unsupportive and operated in a hierarchical system within the clinical agencies.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

a positive midwife preceptor-student relationship is an integral part of successful student midwife learning, and preceptors with helpful qualities enhance learning. Hands-on learning was emphasised as the most beneficial learning experience and students sought opportunities to work with midwives who imbued the philosophy they admired rather than becoming desensitised or socialised into a midwifery culture that was at odds with the course's philosophy. These findings are potentially useful to inform midwives and agencies teaching student midwives about preceptor behaviours helpful for student midwife learning.

RN as gatekeeper: gatekeeping as monitoring and supervision

AIMS AND OBJECTIVES

To understand the variation of ways that students understand the informal or buddy registered nurse role during facilitated clinical experience, and to identify the relationship between student learning and student understanding and experience of the registered nurse role during clinical experience.

BACKGROUND

Student clinical experience is an essential aspect of all undergraduate nursing programs. Students expect registered nurses to supervise and support them and to provide learning experiences during clinical placement. Both positive and negative experiences have been reported in the research literature. The quality of the relationship between the registered nurse and the student directly affects the learning outcome for students.

DESIGN

Qualitative research using a phenomenographic approach.

METHODS

Semi-structured individual interviews with 24 students from all three years of an undergraduate nursing program at a metropolitan university in Brisbane, Queensland, Australia, who voluntarily participated in this study. Interviews were conducted at the completion of a recent clinical experience.

RESULTS

While adequate monitoring and supervision is an expectation of students, there is a wide variation in the way registered nurses appear to understand this aspect of student learning. In the category of description, 'registered nurse as gatekeeper: gatekeeping as monitoring and supervision', student conceptions were identified as: registered nurse awareness, registered nurse vigilance, promoting learning/developing learning and growing (as) students. Students identified their experiences and the strategies they used when monitoring and supervision were lacking or limited.

CONCLUSIONS

The findings of this study illuminate the need for recognition of the complexity of the informal registered nurse role with students and highlight the areas that should be addressed to promote quality student learning experiences.

RELEVANCE TO CLINICAL PRACTICE

Registered nurses need adequate preparation for their informal role to support and supervise undergraduate students in clinical placement to ensure the safe development of student competence and confidence for their graduate registered nurse role.

Improving the undergraduate clinical placement experience in mental health nursing

Recruitment in mental health nursing is an international problem. Improving the undergraduate clinical placement experience may help to attract students into mental health nursing. In this paper, the authors describe the development and evaluation of a clinical facilitation program aimed at improving the placement experience. Students were surveyed about their attitudes to mental health nursing before and after placement. Based on the results from 254 pre-placement and 248 post-placement surveys there was a large significant increase in students' interest in mental health nursing following clinical placement. Data collected from focus groups also indicated that facilitators, students, and clinical nurses all viewed the program positively.

Learning safe patient handling skills: student nurse experiences of university and practice based education

INTRODUCTION

Poor patient handling practices increase nurse injuries and reduce patients' safety and comfort.

BACKGROUND

UK Universities have a duty to prepare student nurses for patient handling activities occurring during clinical placements. This study examines students' experiences of moving and handling education in academic and clinical settings.

METHODS

A 34 item questionnaire was distributed to student nurses at one School of Nursing (n=432, response rate of 75%).

RESULTS

Many students undertook unsafe patient handling practices and provided reasons for this. There was a medium statistically significant correlation between the variables 'provision of supervision' and 'awareness of patient handling needs' (r(s)=.390, p=.000). 40% of students stated that their M&H competency was assessed through direct observation. Twenty six percent of the total sample (n=110), said they had begun to develop musculo-skeletal pain since becoming a student nurse. Forty-eight stated that this was caused by an incident whilst on placement.

DISCUSSION

Inadequate patient handling practices threaten student nurse safety in clinical settings. Although some students may be overly confident, they should be supervised when undertaking M&H activities.

CONCLUSIONS

Though important, University based M&H education will only be beneficial if students learn in clinical settings that take safe patient handling seriously.

Exploring the transition and professional socialisation from health care assistant to student nurse

BACKGROUND

Minimal research is available examining the socialisation process from the perspective of students with health care knowledge who prior to undertaking their training worked as a health care assistant (HCA). The transition and professional socialisation process undertaken by students is an important factor in contributing to the successful completion of a pre-registration nursing programme. Despite this, limited empirical research explores the impact prior health care knowledge plays in this process.

OBJECTIVE

The studies aim was to determine the transitional processes associated with moving from a HCA to Student Nurse.

DESIGN

A descriptive qualitative study undertaken over an 8-month period at a university in the northeast of England.

POPULATION, SAMPLE, SETTING

A homogeneous sample of 14 students with previous experience as a HCA within the field of adult nursing was used.

METHODS

Data were collected through 4 focus group interviews and analysed using [Burnard, P., 1991. A method of analysing interview transcripts in qualitative research. Nurse Education Today 11, 461-466.] thematic content analysis.

FINDINGS

The main themes that emerged around culture shock and clinical issues identified both positive and negative perceptions upon this process. Equally a new concept is introduced from the findings, that of 'the comfort zone', which explores the intentional reversal into the HCA role by the participants of the study. From the findings a framework for the transition and professional socialisation from HCA to student nurse is provided. The findings will assist the university and others in identifying, addressing and aiding the socialisation needs of these students into their new role as a student nurse.

Nursing students? perceptions of learning in the clinical setting of the Dedicated Education Unit

AIM

This paper reports a study to explore nursing students' experience of learning in the clinical setting of a Dedicated Education Unit using a communities of practice framework.

BACKGROUND

The Bachelor of Nursing curriculum at the University of Canberra is clinically focused, recognizing the importance of learning to be a nurse in and from practice. A communities of practice framework underpins the philosophy of the Dedicated Education Unit model of clinical practicum.

METHOD

In this exploratory qualitative study, a convenience sample of 25 second and third year nursing students participated in focus group discussions, conducted in 2004, to share their views of learning in the Dedicated Education Unit, a newly established model of clinical education.

FINDINGS

Three major themes were identified: acceptance, learning and reciprocity, and accountability. Acceptance of students by clinicians assisted students to engage in nursing work. Students acknowledged the importance of peer learning in sharing experiences, reinforcing knowledge and enhancing confidence. Students accepted responsibility for their work and they valued this responsibility, but some questioned whether participation in all aspects of work constituted a learning opportunity.

CONCLUSION

Engagement and participation in the clinical workplace are valuable for nursing students. Strategies to support learning in the workplace can be shared with students and clinicians. Further research to test the theoretical premises of the communities of practice framework in clinical nursing education is required.

Student nurses' experiences of caring for infectious patients in source isolation. A hermeneutic phenomenological study

AIM

To illuminate issues central to general student nurses' experiences of caring for isolated patients within the hospital environment, which may assist facilitators of learning to prepare students for caring roles.

BACKGROUND

Because of the development of hospital-resistant micro-organisms, caring for patients in source isolation is a frequent occurrence for supernumerary students on the general nursing programme. Despite this, students' perceptions of caring for this client group remain under researched.

DESIGN AND METHODS

Through methods grounded in hermeneutic phenomenology, eight students in the second year of the three-year undergraduate programme in general nursing were interviewed using an un-structured, open-ended and face-to-face interview approach. Data analysis was approached through thematic analysis.

RESULTS

Four themes emerged: The organization: caring in context, Barriers and breaking the barriers, Theory and practice, Only a student. The imposed physical, psychological, social and emotional barriers of isolation dramatically alter the caring experience. Balancing the care of isolated patients to meet their individual needs while preventing the spread of infection has significance for students. Applying infection control theory to the care of patients in source isolation is vital for students' personal and professional development. Perceptions of supernumerary status influence students' experiences of caring for these patients.

RELEVANCE TO CLINICAL PRACTICE

Designating equipment for the sole use of isolated patients assists students in maintaining infection control standards. Balancing the art and science of caring for patients in source isolation is important to reduce barriers to the student-patient relationship and to promote delivery of holistic care. Staff nurses should consider using available opportunities to impart recommended isolation practices to students thereby linking the theory of infection control to patient care. Providing structured, continuing education for all grades of staff would acknowledge the interdependence of all healthcare workers in controlling hospital-acquired infection.

Facilitating undergraduate nurses clinical practicum: the lived experience of clinical facilitators

Clinical practicum experience for undergraduate nurses remains undisputed as an essential component of any program. Exposure to the reality of professional practice and its integration of explicit, with tacit knowledge, is invaluable in producing skilled clinicians. Currently there are many issues that have arisen regarding clinical practice education for undergraduate nurses in Australia including; ongoing financial support and resourcing of clinical placements. Developing an understanding of these issues is central to the provision of quality clinical education. The aim of this study is to reveal dimensions of the lived experience of being a clinical facilitator, a popular model of nursing clinical education, to come to an understanding of how facilitation actually takes place in the clinical environment. The Hermeneutic phenomenological approach used in this study has brought to light five essential themes that elucidate the phenomena of facilitation. Those themes have been identified as; knowing your own limitations, employing the notion of stepping in or stepping back, developing alliances, acknowledging the reciprocity of the learning experience, and identifying appropriate clinical buddies. The recommendations from this study will have an impact on current issues and will inturn, influence the quality of clinical education for all stakeholders.

Clinical teaching and support for learners in the practice environment

The purpose of planned clinical experience for students of nursing is primarily to provide students with the opportunity to develop their clinical skills, integrate theory and practice, and assist with their socialization into nursing. Nursing, in the main, is a practice-based profession. To this extent, it is essential that nurse education continues to have a strong practical element despite its full integration into higher education institutions (Department of Health, 1999). However, providing adequate support and supervision for learners is challenging. Undoubtedly, exacerbated by increasing numbers of learners, staff shortages and mentors training deficits. This article aims to critically analyse several strategies, which can be used to promote clinical learning.

The role of mentors in supporting pre-registration nursing students

Students' practice experience is one of the most important aspects of their preparation for registration. There is currently considerable emphasis on improving this practice experience with adequate support and supervision. Mentors play a vital role in supporting, teaching and assessing students in practice. This article offers a literature-based discussion of the development and current practice of the mentor role in the support and assessment of students undertaking pre-registration programmes. The development of the mentor role is discussed. Issues relating to the role in nurse education today are addressed in relation to supporting, teaching and assessing students in practice and mentor accountability. This article discusses how Higher Education Institutions and universities and service managers might support mentors in their role. The implications for practice are outlined and include the NMC standards to support learning and assessment in practice due for publication in 2006.

Using clinical skills laboratories to promote theory-practice integration during first practice placement: an Irish perspective

AIMS AND OBJECTIVES

This aim of this study was designed to investigate how a select cohort of nursing students experienced their first practice placement in a large Irish teaching hospital. The objectives of this study were to investigate whom do students learn from, what skills they learnt during their first practice placement and to identify if the use of clinical skills laboratories before their first practice placement helped students relate theory to practice during their first practice placement. The aim of this paper is to discuss if the sessions taught in the clinical skills laboratory prior to the first placement helped students integrate theory to practice during their first practice placement.

BACKGROUND

The debate regarding theory-practice integration has been ongoing in nursing for decades. Many studies across Europe have consistently demonstrated that the use of clinical skills laboratories have helped students integrate theory to practice during practice placements. Others have identified the difficulty students have relating theory to practice. However, as there appears to be a gap in current literature, from an Irish perspective, it is essential to highlight if Irish students can integrate theory to practice during their first practice placement.

DESIGN

A qualitative method incorporating the Heideggarian approach of phenomenology was utilized.

METHODS

A purposeful sampling technique was used to select six participants from all first year students. Interviews were conducted using a semi-structured interview schedule. Data were analysed using the Giorgi method of analysing phenomenological data.

RESULTS

The participants identified that sessions taught in the clinical skills laboratory before the first practice placement, which they identified as 'basic nursing skills such as taking and recording vital signs and hygiene needs of patients were useful and helped them to integrate theory to practice during their first practice placement. These results are relevant to this paper as they identify the use of teaching sessions in the clinical skills laboratories, enabling students to link theory to practice during practice placements.

CONCLUSIONS

Nursing students must be adequately prepared to carry out clinical skills competently and efficiently. Educators and practitioners must display the knowledge and skills required to promote theory-practice integration, to enhance nursing students education, which in turn will optimize high standards of patient care. Relevance to clinical practice. Clinical skills laboratories are essential to help students develop the collaborative skills required for a profession like nursing. It is essential that students are adequately prepared to carry out clinical skills during their first practice placement, and have the ability to link theory to practice.

Promoting Effective Preceptorship Experiences

Preceptors and students alike want and need a positive preceptorship experience. There are some factors, however, that must be considered when arranging such experiences, including sufficient time, workload management, use of space, monetary payment for preceptorship, preparation for the role, the one-to-one relationship, and the learning environment. This article concludes with specific strategies that address these factors. The first uses a theoretical model, one advocated by the authors, the Preceptor Enabling Model. This model delineates the roles and responsibilities of students, preceptors, staff, and faculty. Preceptors, too, need preparatory workshops, paid time for orientation to the role, evaluation of preceptors, and finally, support.

The impact of clinical placement location on nursing students' competence and preparedness for practice

The challenges confronting nurses in today's health care environments have highlighted the necessity for graduating students to feel both competent and prepared for practice. The aim of the aspect of the study reported in this article was to determine the relationship between the location of clinical placements and competence and preparedness for practice from the perspective of the nursing students. A quasi-experimental design using a pre-test post-test survey was used. The population consisted of all final year Bachelor of Nursing students at Queensland University of Technology, who undertook their clinical placement in either a rural or metropolitan location. The response rate was 65% in the pretest (n = 137) and 57% in the posttest (n =121). The results of the study highlight the importance of both rural and metropolitan clinical environments in developing not only student competency but also students' satisfaction with their clinical experience. The results suggest that the selection of a rural placement is more likely to occur when students feel competent, confident and organised about their clinical experience. Strategies to increase students' perceptions of competence and confidence to undertake a rural placement are likely to increase students' selection to 'go rural'.