Challenges to the provision of clinical education in nursing

Partnering With Clinicians Supporting Nursing Students' Clinical Placement at a Regional Hospital

BACKGROUND

Innovative models are required to maximize nursing student placements in environments of shrinking budgets, increasing hospital demands, and casualization and aging of the workforce. This article reports the success of a service-academic partnership in a dedicated education unit.

METHOD

This cross-sectional observational study in a regional hospital analyzed survey data using validated tools completed by buddy nurses (n = 80) and postplacement evaluation completed by students (n = 102) and the nurse leadership team (n = 17).

RESULTS

Postimplementation, nursing student placement days increased, and participants were positive about the partnership. Although most of the nursing students (n = 96) reported they were very or extremely satisfied with their placement, they rated student facilitators higher than their buddy nurses.

CONCLUSION

Increasing enrollments will not solve the nursing workforce shortage unless student placements of quality and quantity are provided. Partnership in support of clinical staff remains critical to create time to provide quality supervision. [J Nurs Educ. 2024;63(9):619-625.].

Nursing students' experiences from clinical education using the TPSN model

BACKGROUND

The TPSN model is an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. This model is done to reduce the theoretical-practical gap in nursing. The present study aimed to explore the experiences of nursing students.

METHODS

In a conventional content analysis, 11 undergraduate nursing students, 7 graduate nursing students, and 4 doctoral students were selected. Data was collected through focus group discussions and individual interviews.

RESULTS

The findings from analyzing the students' experiences who had received education using this model resulted in four main categories: the feeling of being a nurse, an integrated and collaborative clinical education platform, the development of nursing clinical education, and educational challenges.

CONCLUSION

The TPSN model provides a suitable platform for nursing clinical education. This model helps students integrate theoretical knowledge with clinical practice and helps them act as professional nurses in the future.

E-Learning Simulations for Teaching Clinical Decision-Making in an Audiology Training Program

PURPOSE

Clinical decision-making is an essential component of most clinical processes across the health sector and an ongoing challenge for clinical education programs to teach to students. The traditional methods of teaching these skills outside of lectures are mainly through clinical placements and problem-based learning (PBL) sessions, but availability and consistency can be variable and resource heavy. To address these challenges, an e-simulation module specific to pediatric infant diagnostic testing has been developed and implemented into the teaching program. We aimed to establish whether e-simulation resulted in student skill acquisition.

METHOD

Academic performance measures for 67 audiology students who used a traditional PBL and 108 students who used the e-simulation module were collected and analyzed. Student survey results generated both quantitative and qualitative data, which were analyzed using a thematic analysis with an inductive approach.

RESULTS

Findings indicated that the e-simulation platform introduced in this study yielded learning outcomes similar to the traditional PBL format previously used. Participants experienced a significant in situ increase in understanding of infant diagnostic testing concepts following the use of the e-simulation and evaluated the e-simulation platform positively.

CONCLUSION

The data support that an e-simulation-based approach in clinical education presents pedagogical benefits and can provide a meaningful sustainable inclusion in today's clinical teaching programs.

Surgical Nursing Students' Perception of Feedback in Clinical Education: A Mixed-method Study

BACKGROUND

Feedback is a critical component of education but may not always be delivered in a useful manner. This study assessed surgical nursing students' perception of the feedback they received on a clinical rotation.

METHODS

This is a sequential mixed-method study. The first stage surveyed surgical nursing students in surgical units about the feedback they received. In the second stage, participants' experiences receiving feedback were explored in interviews, and analyzed by a conventional content analysis approach.

RESULTS

The majority of nurses found that feedback was not helpful, citing a lack of constructive feedback. Negative feedback was often delivered in a public setting. Comments were frequently based on secondary information rather than direct observation.

DISCUSSION

Feedback to nurses on the surgical unit is not perceived by students as constructive. Clinical teachers did not appear to be aware of the educational effect of the feedback on the learning process of students. In addition, the setting for feedback often undermined its effectiveness. Staff development on effective feedback for teachers on the surgical unit is recommended.

Challenges to online education during the time of COVID-19: A focus group study

AIM

To explore the experience of online education during coronavirus disease 2019 (COVID-19) from the perspectives of nurse educators, postgraduate students, and undergraduate students in two universities in the Occupied Palestinian Territory (OPT). This article only highlights the challenges faced by nurse educators and students.

METHOD

A qualitative design using a focus group strategy was employed. The data were collected from two universities in the OPT from September 2020 to October 2020. The maximum variation sampling strategy was used.

FINDINGS

Seven focus groups were conducted with nurse educators (n = 2), postgraduate students (n = 1), and undergraduate students (n = 4). The findings revealed that nurse educators and students faced several challenges when they were abruptly turned to online learning. These challenges included challenges concerning clinical courses, lack of resources, lack of interaction, evaluation, and their home environment.

CONCLUSIONS

This study is the first to demonstrate the challenges involved in nursing education in OPT during the COVID-19 pandemic.

IMPACT

The findings of this study can be used to improve the online learning experience during COVID-19. As a recent change to nursing education, it is vital to understand the nature of the problems related to this sudden change.

Back to Clinical Training during the COVID-19 Pandemic: Perspective of Nursing Students

INTRODUCTION

The COVID-19 pandemic has affected many areas of life, including the formation of nursing students. After the COVID-19 crisis, learning during clinical training created different challenges. Nursing schools are responsible for ensuring that structures are in place to facilitate coping in the changed clinical setting. This study aimed to analyze nursing students' perceptions during clinical training while caring for COVID-19 patients.

MATERIAL AND METHODS

A qualitative phenomenological study that explored nursing students' perceptions of learning in clinical settings with COVID-19 patients was performed. A total of 15 semi-structured face-to-face interviews were conducted with nursing students who carried out their clinical practices in COVID-19 units during February and April 2022.

RESULTS

Through content analysis, categorization, and the method of comparison constant, four categories emerged: feelings, challenges, coping methods, and clinical practices. The students had to learn to "work" with fear and uncertainty and self-manage the emotional burden using different coping techniques to deal with learning during their practices. Interacting with professors and clinical tutors during the clinical practice were positive experiences.

CONCLUSIONS

This study constituted an opportunity to build new and adapted educational approaches for teachers to train nursing students to deal with their emotions and thoughts in future pandemic situations.

Preceptors' perceptions of support, commitment to the preceptor role, and preferred incentives: A cross-sectional study

AIM

This study aimed to explore the perceptions of preceptors regarding the support they receive in the preceptorship role, their commitment to the role, and the incentives that are important to them.

BACKGROUND

Nurse preceptors in Ghana face numerous challenges in performing their roles as preceptors. Preceptors require support from hospitals and nursing schools to make the preceptorship experience more rewarding for both students and preceptors. However, the type of support that preceptors require and their commitment to the preceptor role have been scarcely investigated in Ghana.

DESIGN

This was a quantitative descriptive cross-sectional study.

METHODS

An online survey that incorporated three questionnaires and a demographic information section was used to collect data from 154 preceptors in four hospitals in the northern part of Ghana. Data was analyzed using the Statistical Package for Social Sciences (SPSS) for Windows, version 26. Descriptive statistics, correlations, and multiple linear regression were used to analyze the data.

RESULTS

Preceptors reported high levels of support in the preceptor role and perceived themselves to be highly committed to the role. Preceptors identified preceptor training, continuing education opportunities, and textbooks on effective preceptorship as the three most important incentives to them. No associations were found between perceived commitment and demographic characteristics of participants.

CONCLUSIONS

Although many preceptors in Ghana feel satisfied with the support they receive to perform their role as preceptors, a significant number of preceptors do not feel adequately supported. Preceptor support should be geared more towards the professional development of preceptors.

Learning on the periphery: a modified Delphi study of a nursing student communities of practice model

OBJECTIVES

To develop a contemporary student placement model to address current placement challenges, impact student learning, and alleviate supervisor burden.

METHODS

A modified Delphi technique was used to seek opinions, insights, and creative solutions.

RESULTS

A draft Communities of Practice placement model, based on a systematic literature review, was introduced to a heterogenous expert panel (n=12). A contemporary placement model was developed and refined via video conference and email over three rounds.

CONCLUSIONS

Despite initial reluctance concerning a new model, participants became conversant with the concept of peer-to-peer learning, where incidental, albeit essential, learning and support occurs between students, which also supports supervising staff. Greater flexibly and student screening were also incorporated to enable greater learning, confidence building, and reflection. The model's success is contingent upon students working within their scope of practice and provides a contemporary approach to best responds to student, education provider, and health service needs.

The effect of fear of COVID-19 on perceived clinical stress levels in senior nursing students: A cross-sectional study

Aim: This study aimed to examine the effect of fear of COVID-19 on the perceived stress levels in senior nursing students performing their clinical practice. Methods: A cross-sectional study was conducted with senior nursing students in a nursing facility in March 2021. The data were collected using an APP Application sent to the smartphones of students (n = 148) receiving clinical education. Results: With a mean score of 17.2 ± 7.0 on the Fear of COVID-19 Scale, it was determined that the senior nursing students’ COVID-19 fears were at a moderate level. Students’ mean score from the Perceived Stress Scale was 71.0 ± 25.7, which indicated a moderate level. A positive, weak, and significant correlation was found between the total scores of fear of COVID-19 and perceived stress level (r = 0.291, p < 0.001). Conclusions: In this study, the perceived stress of students in their clinical practice was at a moderate level, as it was before the pandemic. It appears that a moderate level of fear of COVID-19 during the pandemic does not affect perceived stress levels in the clinical education setting. Accordingly, we recommend that clinical education should be maintained by taking necessary measures and implementing good management during the pandemic.

The Effect of Managerial and Leadership Training and Simulation on Senior Nursing Students’ Career Planning and Self-Efficacy

Introduction

Enhancing nursing students’ professional knowledge and integrating simulation and clinical training into students’ education may affect their career planning and development.

Objectives

This study aimed to explore how managerial and leadership training and simulation affect career planning knowledge, career choice, and self-efficacy among senior nursing students. Additionally, it explored how students perceived the training they received.

Methods

This study employed a mixed methods design for collecting quantitative and qualitative data about the training. A quasi-experimental design using a pretest and posttest with a convenience sample of senior nursing students ( N = 80) at a Saudi nursing college guided the quantitative part. Nursing students were introduced to a managerial and leadership training and simulation intervention focused on career knowledge. The career planning questionnaire and a self-efficacy scale were used to collect quantitative data before and after the intervention, and the open-ended questions were used for qualitative data about the training they received. For the quantitative data, we used descriptive and inferential statistics, and for the qualitative data, we used content analysis.

Results

After the training sessions, nursing students’ career planning knowledge and self-efficacy scores were considerably enhanced, with a significant difference and positive associations ( p < .001). Four themes were driven from the qualitative analysis: student engagement, experiential learning and reflection, the teacher's role as facilitator, and teamwork.

Conclusions

Knowledge and preparedness are essential elements for career planning and development. Nursing curricula should provide students with ongoing educational opportunities to help them enhance their career planning and self-efficacy. As well, nurse managers play an important role in shaping the career paths of senior undergraduates and internship nurses. Career counseling sessions and career activities can be scheduled frequently before graduation and during the internship year, which is essential for prelicensure and orientation.

The impact of covid-19 on psychosocial well-being and learning for australian nursing and midwifery undergraduate students: a cross-sectional survey

Aim

To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university.

Background

The World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic.

Design

Cross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020.

Methods

A cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed.

Results

Of 2907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study.

Conclusions

Students were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.

The impact of an undergraduate students' culture on their learning about mental health: A scoping review

Mental disorders are highly prevalent. This necessitates undergraduate students in health-related courses are provided with the knowledge, skills, and attitudes to deliver safe care. Research confirms undergraduate health students maintain discriminative, stigmatizing, and inaccurate beliefs and attitudes toward those experiencing mental disorders. However, there is a paucity of research exploring how culture influences these beliefs. This scoping review addressed the question: 'What is the impact of an undergraduate student's culture on their learning about mental health?' A systematic search was undertaken of the MEDLINE, CINAHL, Scopus, PsycINFO, and ERIC databases. Results indicate variance between students' cultural beliefs in their attitudes toward and knowledge of mental disorders and understanding of interventions and treatment. None of the identified studies reviewed the ramifications for pedagogy beyond anecdotal suggestions. Educators need to acknowledge the potential impact that students' cultural beliefs have on their learning about mental health and consider appropriate learning activities to acknowledge the role of culture. Research of the impact of undergraduate students' culture on their learning about mental health will provide an evidence base for the development of these learning activities.

The Predictive Strength of Students' Self-Efficacy, Problem Solving Skills to Perform Catheter Care

PURPOSE

The aim of this study was to determine the predictive strength of students' self-efficacy, problem-solving skills, and other characteristics in performing intravenous practices and monitor phlebitis and infiltration.

METHODS

This cross-sectional study was carried out with 736 third and fourth-year students studying at the Health Sciences Faculties of Balikesir and Sakarya universities. The data were collected using the Self-Efficacy Scale, Problem-Solving Inventory and Catheter Care and Infiltration Monitoring Questionnaire.

RESULTS

The participants' mean Catheter Care and Infiltration Monitoring Questionnaire score significantly and positively correlated with their mean Self-Efficacy Scale score on a moderate level (r=.25; p <.001) but significantly and negatively correlated with their mean Problem-Solving Inventory score on a moderate level (r=-.21; p <.001). In other words, because a low Problem-Solving Inventory score indicates that the person's problem-solving skill is high, the Care and Infiltration Monitoring Questionnaire score increased as the problem-solving skill increased. While the Self-Efficacy Scale predicted the year of study and catheter care and infiltration monitoring variables positively, the Problem-Solving Inventory predicted the satisfaction with the profession variable negatively.

CONCLUSION

Self-efficacy, problem-solving, liking the profession, and year of study predict success in catheter care and infiltration monitoring. For this reason, guidance may be provided in the development of a comprehensive education system toward increasing students' problem-solving skills, self-efficacy, and professional knowledge and skills.

Clinical placement experience of nursing students during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

The impact of the COVID-19 pandemic on our society is profound, not least for the healthcare sector. On the one hand, this exceptional situation created unprecedented learning opportunities for nursing students. Yet, on the other hand, this situation can jeopardise nursing students learning trajectory.

OBJECTIVES

To study nursing students' experiences during clinical placement during the COVID-19 pandemic.

DESIGN

Cross-sectional survey design.

SETTINGS

Clinical placements during the COVID-19 pandemic.

PARTICIPANTS

Nursing students from nine Belgian nursing schools.

METHODS

All students enrolled in nursing education are eligible to participate. The survey consists of five dimensions: demographics, risk perception, self-efficacy, support and communication, and resilience.

RESULTS

The gaps that were identified by students focused on the need for more psychosocial support, establishing (regular) contact with their clinical placement supervisor, recognition of the difficult work situation, and the need for more space to unwind.

CONCLUSIONS

Nursing students expressed a strong need to be heard, prepared, and supported. Most students felt supported by their nursing schools. Because of COVID-19, the role of the preceptor became more important. However, due to several reasons, the perceptor did not always meet the student's expectations. Preparing students for specific competencies is needed. In spite of the efforts of nursing schools and clinical sites, students often got lost in the chaos of the pandemic. This resulted in practical worries, fewer learning opportunities, and even fundamental doubts about their choice to become a nurse. Finally, it crucial that nursing schools and clinical sites communicate about matters such as the responsibility for testing nursing students, the provisions of uniforms and personal protective equipment, and structurally sharing guidelines with students to provide safe patient care.

Interprofessional, student-led community health clinic: expanding service provision and clinical education capacity

Student-led interprofessional health clinics offer valuable opportunities for student learning and meeting the health care needs of the community. This case study describes the operation of a new interprofessional student-led community health service over its initial 13-month period of operation. This case study also presents an overview of the service provision, student placement opportunities and focuses on the challenges associated with the service and the impact on future planning.

Conflict, confusion and inconsistencies: Pre-registration nursing students' perceptions and experiences of speaking up for patient safety

There is growing evidence demonstrating that nursing students encounter unsafe and poor clinical practice when on clinical placement. The impact on nursing students remains relatively under-explored, especially in the Australian context. This two-phased qualitative study used Interpretive Description to explore 53 pre-registration nursing students' perceptions and experiences of speaking up for patient safety. Results of the study identified students believe speaking up is the right thing to do, and their professional responsibility. The study results add to previous research by describing the dissonance students experience due to the inconsistencies between what is taught at university and performed in practice. Student's distress arises when observing nurses taking short cuts, justifying such actions and making excuses about poor practice. Students report experiencing dissonance, bewilderment and confusion and at times, anger when observing poor practice. The clinical environment culture influences students' decisions to speak up or remain silent. Understanding students' perceptions and responses will promote awareness and discussion essential to the future development of curricula and clinical support strategies that will enable students to speak up.