The clinical teaching partnership

An emancipatory praxis study of nursing students on clinical practicum in New Zealand: pushed to the peripheries

The purpose of this qualitative study was to gain a better understanding of the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalization; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalization. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability. An emancipatory praxis methodology was used to guide the research and hence Habermasian critical theory underpinned this study. It has demonstrated within this research the necessityfor strategic action, by exposing the current situation to create an awareness for favourable change. The findings from this research will enable educators and clinical practitioners to have a clearer understanding of the needs of nursing students in clinical practice. Recommendations from this study included the need for further research into nursing students clinical supervision models, and the identication of the special learning needs of indigenous nursing students.

Activities and interactions of baccalaureate nursing students in clinical practica

Basic nursing education is governed by individual state rules and regulations lacking in uniformity across the United States and based on unstated and perhaps mistaken assumptions. At the same time, there is increasing evidence of problems and difficulties with the current traditional model of nursing education. Before proposing changes in said model, the authors chose to examine what it is that a nursing student does in a clinical area. The perspective of activities and interactions was chosen to illustrate, through a nonparticipant observation study, the patterns and utilization of time during a scheduled clinical experience for baccalaureate nursing students. The goal of the study was to determine who, other than the client/patient, influences the student learning at the clinical site and how learning time is spent. Two schools (one private and one public) and nine clinical sites with 37 observations were used to collect the data for this study. Findings are best summarized in four (overlapping) categories of school time, registered nurse (RN) staff time, hospital staff time, and supervised time. School time, or time spent interacting with the instructor, another student, and/or the student on his/her own in the practice setting (time exclusive of staff input) constituted 84 per cent of all time. RN staff time that was time spent with either the primary nurse or other RNs on the unit used 10 per cent of the student time, Fourteen per cent of student time was spent in hospital staff time, which includes interactions with any nursing staff or other hospital personnel.(ABSTRACT TRUNCATED AT 250 WORDS)