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O Sullivan G, Hegarty J, Landers M, Phillips G, Wills T. Clinical assessor's experiences of assessing undergraduate nursing and midwifery students who underperform on clinical placement: A qualitative systematic review and meta-summary. NURSE EDUCATION TODAY 2024; 141:106316. [PMID: 39084072 DOI: 10.1016/j.nedt.2024.106316] [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: 11/19/2023] [Revised: 06/23/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024]
Abstract
AIM To summarise the qualitative evidence exploring the clinical assessor's experience of assessing undergraduate nursing and midwifery students who underperform on clinical placement. DESIGN A qualitative systematic review and meta-summary was undertaken. DATA SOURCE Database searches included CINAHL Plus with full text; Academic Search Complete; MEDLINE; PsycARTICLES; PsychINFO; Social Sciences Full text; SocINDEX with Full Text; ERIC; Pubmed; Scopus and Web of Science. REVIEW METHOD Included studies were appraised using the CASP (Critical Appraisal Skills Programme) tool. A meta-summary was conducted using Sandelowski & Barroso's method. RESULTS The review included 18 studies reported across 25 papers. Eight themes and 37 thematic sentences were created from 403 extracted findings. CONCLUSION The management of underperformance on clinical placement by undergraduate nursing and midwifery students presents a challenge for those nurses and midwives, working on the frontline of patient care, who also take on the role of clinical assessor. Addressing these challenges is essential to support the assessor and the student. Sharing of the decision making with a colleague when there is evidence of underperformance could address many of the difficulties experienced by the clinical assessor.
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Affiliation(s)
- Gillian O Sullivan
- Munster Technological University, Academic Administration & Student Affairs Department, Kerry, Ireland; School of Nursing & Midwifery, University College Cork, Cork, Ireland.
| | - Josephine Hegarty
- School of Nursing & Midwifery, University College Cork, Cork, Ireland.
| | - Margaret Landers
- School of Nursing & Midwifery, University College Cork, Cork, Ireland.
| | - Grace Phillips
- School of Nursing & Midwifery, University College Cork, Cork, Ireland.
| | - Teresa Wills
- School of Nursing & Midwifery, University College Cork, Cork, Ireland.
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Alkhelaiwi WA, Traynor M, Rogers K, Wilson I. Assessing the Competence of Nursing Students in Clinical Practice: The Clinical Preceptors' Perspective. Healthcare (Basel) 2024; 12:1031. [PMID: 38786441 PMCID: PMC11121458 DOI: 10.3390/healthcare12101031] [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: 03/07/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Nursing students' integration of theoretical knowledge and practical abilities is facilitated by their practice of nursing skills in a clinical environment. A key role of preceptors is to assess the learning goals that nursing students must meet while participating in clinical practice. Consequently, the purpose of this study was to explore the current evidence in relation to competency assessment and assessment approaches, and the willingness of preceptors for assessing nursing students' competency in a clinical setting. The scoping review used the five-stage methodological framework that was developed by Arksey and O'Malley, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Relevant studies were searched by applying a comprehensive literature search strategy up to April 2024 across the following databases: CINAHL, OVID MEDLINE, EMBASE, and PUBMED. A total of 11,297 studies published between 2000 and April 2024 were revealed, and 38 were eligible for inclusion, which the research team categorised into three main themes: definitions of competence, tools for assessing competence and preceptors' and mentors' viewpoints in relation to the assessment of nursing students' competence. This review established that there are a multitude of quantitative instruments available to assess clinical competence; however, a lack of consistency among assessment instruments and approaches between countries and higher education institutions is prevalent. Existing research evidence suggests that the preceptors carried out the assessment process clinically and they found difficulties in documenting assessment. The assessing of nursing students' competency and the complexity of assessment is a concern for educators and mentors worldwide. The main concern centers around issues such as the interpretation of competence and complex measurement tools.
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Affiliation(s)
- Watin Arif Alkhelaiwi
- Nursing Department, Faculty of Applied Medical Science, Jouf University, Sakaka 72388, Aljouf Region, Saudi Arabia
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (M.T.); (K.R.); (I.W.)
| | - Marian Traynor
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (M.T.); (K.R.); (I.W.)
| | - Katherine Rogers
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (M.T.); (K.R.); (I.W.)
| | - Iseult Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (M.T.); (K.R.); (I.W.)
- College of Nursing and Midwifery, Mohammed Bin Rashid University, Dubai P.O. Box 505055, United Arab Emirates
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MacLaren G. Defining dignity in higher education as an alternative to requiring 'Trigger Warnings'. Nurs Philos 2024; 25:e12474. [PMID: 38284805 DOI: 10.1111/nup.12474] [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: 07/30/2023] [Revised: 11/20/2023] [Accepted: 12/07/2023] [Indexed: 01/30/2024]
Abstract
This article examines trigger warnings, particularly the call for trigger warnings on university campuses, and from a Levinasian and Kantian ethical perspective, and addresses the question: When, if ever, are trigger warnings helpful to student's learning? The nursing curriculum is developed with key stakeholders and regulatory bodies to ensure graduate nurses are competent to deliver a high standard of care to patients and clients. Practical teaching practice and published research has uncovered an increasing use of 'Trigger Warnings' before a topic is discussed, or used as warnings on core module texts. It is appreciated that some students have personal experience of psychological or physical trauma. However, apart from identifying these students through Mitigating Circumstances committees, or when the student feels confident to share this information with a personal tutor, this information remains strictly confidential. There is the potential for covert skills such as critical analysis and skilful discussion not being attained by the student. With the assistance of Kants moral theory, an argument will develop that the insidious use of Trigger warnings and the embargo of recommended reading, requires critical discussion with the public. This would involve the rationale and pedagogical justification for the use of texts, and the necessity within nursing education to address challenging clinical topics. To support students with PTSD this may involve the research discussed on personal educational needs analysis.
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Affiliation(s)
- Gordon MacLaren
- School of Health Sciences, University of Dundee, Scotland, UK
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Natterøy CS, Tveit B, Raustøl A. Nurse mentors' experiences with suitability assessments in clinical placement: A qualitative study. Nurse Educ Pract 2023; 72:103755. [PMID: 37651957 DOI: 10.1016/j.nepr.2023.103755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/04/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
AIM This study aims to explore mentors' experiences with assessing the suitability of nursing students in clinical placements in a context where suitability assessment is required by law. BACKGROUND It is the schools' responsibility to assess students, but mentors play an important role when students are in clinical placements. Clinical placements are typical arenas for assessing suitability. DESIGN An explorative qualitative study METHODS: Participants were 17 registered nurses with experience as mentors for nursing students in clinical placement. The participants represented somatic and surgical wards from three different hospitals in Norway. Individual, semi-structured interviews were conducted. RESULTS The analysis revealed a total of four themes: 1) the understanding of suitability, 2) experiencing borderline performance, 3) the heavy responsibility of doing the assessment and 4) the importance of support. CONCLUSIONS The mentors found it difficult to assess suitability. They reported having little or no knowledge about leading rules and guidelines. The mentors experienced support from their colleagues, something which lightened the burden of assessing the students. This study indicates that mentors need more information about suitability and suitability assessments. REGISTRATION NUMBER To be included in abstract after acceptance.
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Affiliation(s)
- Cathrine Selsvold Natterøy
- Centre of Diaconia and Professional Practice, VID Specialized University, P.O. Box 184 Vinderen, 0319 Oslo, Norway.
| | - Bodil Tveit
- Centre of Diaconia and Professional Practice, VID Specialized University, P.O. Box 184 Vinderen, 0319 Oslo, Norway
| | - Anne Raustøl
- Centre of Diaconia and Professional Practice, VID Specialized University, P.O. Box 184 Vinderen, 0319 Oslo, Norway
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Natterøy CS, Tveit B, Hunskår I, Raustøl A. Suitable, fit, competent and safe to practice nursing? Assessing nursing students' personal qualities in clinical placement-An integrative review. J Clin Nurs 2023; 32:6101-6119. [PMID: 37149742 DOI: 10.1111/jocn.16747] [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: 11/02/2022] [Revised: 03/11/2023] [Accepted: 04/20/2023] [Indexed: 05/08/2023]
Abstract
AIMS AND OBJECTIVES This study aims to explore, describe, and synthesize the personal requirements student nurses are assessed in their clinical placement to be suitable, fit, competent, and safe for the nursing profession. BACKGROUND There are different terms and concepts used when describing what nursing students are assessed by regarding personal requirements needed to be eligible to enter the nursing profession. This is regulated and enforced mainly by different standards and guidelines. DESIGN An integrative review using Whittmore and Knafl's (2005) methodology. METHODS Searches were systematically conducted in CINAHL, Education Source, ERIC, Academic Source Elite, MEDLINE and EMBASE, NORART, SveMed+, and Bibliotek.dk. The PRISMA checklist for systematic reviews was used. RESULTS Eighteen studies were included in the review. The results present various factors student nurses are assessed by in clinical placements, which were categorized into three themes: attitude and personal characteristics, behavior, and basic knowledge. Assessing students is a complex and subjective endeavor, and decisions are based on a holistic assessment of several different aspects of the student's performance and behavior CONCLUSIONS: The personal requirements to be deemed suited for det nursing profession are complex and composed of several different components. Assessments are often based more on assessors' subjective standards and intuition than on the provided guidelines and standards. There is no universal understanding of which characteristics or qualities are considered necessary for a student to be deemed suited for the nursing profession. RELEVANCE TO CLINICAL PRACTICE This study points at challenges with the assessment of nursing students today as there are no clear standards or understanding of the requirements needed.
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Affiliation(s)
| | - Bodil Tveit
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
| | | | - Anne Raustøl
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
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Mathisen C, Heyn LG, Jacobsen TI, Bjørk IT, Hansen EH. The use of practice education facilitators to strengthen the clinical learning environment for nursing students: A realist review. Int J Nurs Stud 2022; 134:104258. [DOI: 10.1016/j.ijnurstu.2022.104258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/17/2022]
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Abstract
Abstract
Objective
To ensure that only competent graduates are licensed to practice nursing, councils conduct licensing examinations, which may include among others clinical competency assessment. This review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based, context-specific framework for clinical competency assessment in a sub-Saharan African (SSA) country.
Methods
A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted.
Results
Findings from 28 out of 1151 studies identified from Scopus, PubMed, CINAHL, Wiley Online Library, and ProQuest were included and synthesized. Results show that a good assessment system must be valid, reliable, transparent, feasible, fair, objective, and must provide feedback and continually improve to have an educational impact. Clinical competency assessment systems must be developed on sound empirical evidence, pilot tested, and involve thorough training and evaluation of the examiners. Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system. Only one of the included studies was conducted in Africa.
Conclusions
The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context. Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.
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Psychometric Testing of a Theory-Based Measure to Evaluate Clinical Performance of Nursing Students. Nurs Educ Perspect 2021; 42:358-364. [PMID: 34516481 DOI: 10.1097/01.nep.0000000000000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study was to psychometrically test a clinical evaluation tool that measures instructors' gut feelings for placing students on a learning contract. BACKGROUND Evaluators feel unprepared or hesitant to fail students who do not meet professional and clinical expectations. METHOD A multiphase process was used to determine the reliability and validity of the Gut Feelings Scale. The first phase focused on item generation, the second phase focused on content validity and feedback from expert raters, and the third phase focused on psychometric evaluation to streamline the item pool and explore validity. RESULTS Correlations and descriptive statistics for each subscale were calculated. Reliability analyses revealed relatively strong estimates of internal consistency; specifically, the reliability estimates surpassed our criteria of >.70. CONCLUSION This pilot study established the validity and reliability of the scale and found it to be a reliable tool to guide instructors' evaluative decision-making.
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Almalkawi I, Jester R, Terry L. Developing a consensus-based scoring rubric to enhance practice-based assessment of student nurses' clinical competence: A Delphi study. NURSE EDUCATION TODAY 2021; 100:104859. [PMID: 33713987 DOI: 10.1016/j.nedt.2021.104859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/15/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Concerns about reliability and validity of practice-based assessment of professional competencies are frequently reported in the literature. Difficulty in understanding competency statements or distinguishing different achievement levels has been found to be a major factor. OBJECTIVES To develop a consensus-based scoring rubric based on stakeholders' interpretations of level descriptors for student nurses' professional values competencies. DESIGN Two rounds of Classic e-Delphi. SETTINGS This study was conducted in a London based university using Bristol Online Survey website as a host. PARTICIPANTS 100 stakeholders with vested interests in undergraduate pre-registration nurse education were purposefully invited to participate. METHOD Round one collected free-text interpretations of the United Kingdom Nursing and Midwifery Council professional values competency statements. Round two used a Likert scale questionnaire to measure the level of agreement to the level descriptor statements generated through round one. Responses were analysed through content analysis in round one and consensus measure in round two. A threshold of 70% agreement to determine consensus was set in advance. RESULTS In round one, 47 participants provided their interpretations of the competency statements. In round two, 51 participants completed the questionnaire. All 24 items achieved a strong consensus with 86%-100% of participants agreeing or strongly agreeing with the statements. CONCLUSIONS A Delphi study was successfully used to develop a consensus-based scoring rubric with clearly stated descriptors for professional values competency statements. This scoring rubric holds the potential to enhance practice-based assessment across all healthcare professional disciplines.
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Affiliation(s)
- Ibraheim Almalkawi
- School of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - Rebecca Jester
- University of Wolverhampton, Faculty of Education Health and Wellbeing, Gorway Road WS1 3BD, United Kingdom.
| | - Louise Terry
- School of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
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Fard ZR, Azadi A, Khorshidi A, Mozafari M, O'Connor T, Budri AMV, Moore Z, Patton D. A comparison of faculty led, mentorship program and peer mentoring on nursing students wound dressing clinical skills. NURSE EDUCATION TODAY 2020; 89:104378. [PMID: 32209490 DOI: 10.1016/j.nedt.2020.104378] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/07/2019] [Accepted: 02/15/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The promotion of clinical nursing education requires using modern educational methods to develop students' knowledge and skills. There are however many different models by which education can be delivered with a wealth of literature supporting varying approaches. This is of particular relevance to clinical education where to date no singular approach has been identified as being the most appropriate. OBJECTIVES This study aimed to compare and investigate the effect of a peer education method, a mentor-led education method versus a traditional faculty-led method for instruction regarding surgical wound care skills among nursing students. DESIGN This study used an experimental three-group pre- and post-test design. SETTINGS The research was conducted within two surgical wards of a university-affiliated hospital in the west of Iran. PARTICIPANTS A total of 102 nursing students (first and second year) were assigned to three groups; peer-led learning group (n = 34), mentorship-led group (n = 34) or a faculty-led control group (n = 34). METHODS To ascertain performance in surgical dressing skill, data was collected in each group before and after the respective educational intervention. Data was collected using a surgical dressing skills checklist made by the research team which was piloted prior to the study. All statistical analysis was performed using SPSS v.22.0 (SPSS Inc., Chicago, IL). RESULTS Based on findings, after the intervention, the mean (SD) scores of surgical dressing and wound care skills were 28.24 (4.63), 31.76 (4.89), and 29.12 (5.33) for the peer-led, mentor-led and faculty-led groups, respectively. There was no significant difference between mentor group and faculty group or between peer group and faculty group (P > 0.05). However, the findings did demonstrate statistical difference in performance in surgical dressings and wound care techniques in the mentorship group method compared to the peer method (P = 0.006). CONCLUSIONS Although participants in the mentor group performed best of all groups, our findings demonstrate that those in the peer method group performed as well as those in the faculty-led group in surgical dressing performance. Therefore, it is recommended that peer and mentor learning methods are given consideration by curriculum planners in for use in the development of student nurse clinical skill and competence in surgical wound care.
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Affiliation(s)
- Zeynab Rezaei Fard
- Student research committee, Department of nursing, Faculty of Nursing and Midwifery, Ilam University of Medical sciences, Ilam, Iran
| | - Arman Azadi
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
| | - Ali Khorshidi
- Department of Community Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mosayeb Mozafari
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Tom O'Connor
- RCSI School of Nursing and Midwifery, Deublin Ireland; Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland; Lida Institute, Shanghai, China; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.
| | - Aglecia Moda Vitoriano Budri
- RCSI School of Nursing and Midwifery, Deublin Ireland; Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland
| | - Zena Moore
- Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland; Lida Institute, Shanghai, China; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University; University of Wales, United Kingdom
| | - Declan Patton
- RCSI School of Nursing and Midwifery, Deublin Ireland; Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Faculty of Science, Medicine and Health, University of Wollongong, Australia
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Nugent O, Lydon C, Part S, Dennehy C, Fenn H, Keane L, Prizeman G, Timmins F. Who is failing who? A survey exploration of the barriers & enablers to accurate decision making when nursing students' competence is below required standards. Nurse Educ Pract 2020; 45:102791. [PMID: 32428863 DOI: 10.1016/j.nepr.2020.102791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 03/18/2020] [Accepted: 04/16/2020] [Indexed: 11/30/2022]
Abstract
Healthcare practice supports the achievement of programme learning outcomes for nursing students internationally. Within this context the issue of reluctance to fail nursing students, when warranted, is extensively examined within the literature with few definitive solutions emerging. Little is known about the perceived barriers that exacerbate this reluctance, or about factors that might enable and support nurses to fail students. To address this issue our study employed a non-experimental cohort study of nurses (n = 365) from two large teaching hospitals in the Republic of Ireland (ROI). Preceptors in this study clearly enjoyed their role with students, and received positive feedback from students. However, findings suggest that preceptors require more support from colleagues in providing comprehensive evidence in assessment. They also require additional training for providing negative feedback to students. A collaborative approach to competence assessment is recommended, whereby the professional burden can be borne by the team, and where students can engage in a holistic, reflective, learning experience that will ultimately improve their competence.
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Affiliation(s)
- Orla Nugent
- Nurse Practice Development Coordinator, St. James's Hospital, James's Street, Dublin 8, Ireland.
| | - Christina Lydon
- Nurse Practice Development Coordinator, Tallaght University Hospital, Dublin 24, Ireland.
| | - Siobhán Part
- Nurse Practice Development Coordinator, St. James's Hospital, James's Street, Dublin 8, Ireland.
| | - Caitriona Dennehy
- Nurse Practice Development Coordinator, Children's Health Ireland (CHI) at Tallaght, Tallaght University Hospital, Tallaght, Dublin 24, Ireland.
| | - Helen Fenn
- Nurse Practice Development Coordinator, St. James's Hospital, James's Street, Dublin 8, Ireland.
| | - Lisa Keane
- Nurse Practice Development Coordinator, St. James's Hospital, James's Street, Dublin 8, Ireland.
| | - Geraldine Prizeman
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland.
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland.
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Hagqvist P, Oikarainen A, Tuomikoski AM, Juntunen J, Mikkonen K. Clinical mentors' experiences of their intercultural communication competence in mentoring culturally and linguistically diverse nursing students: A qualitative study. NURSE EDUCATION TODAY 2020; 87:104348. [PMID: 32028100 DOI: 10.1016/j.nedt.2020.104348] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 12/03/2019] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Intercultural communication has become increasingly important in nursing due to the cross-border mobility of patients, health professionals and students. Development of cultural competence continues to be a challenge, particularly among professionals such as educators or healthcare providers who work in professions requiring communication across cultural boundaries. Despite challenges in nursing education related to cultural diversity, competence in intercultural communication has been proven to empower students and to help them grow professionally. OBJECTIVES The aim of this study was to describe clinical mentors' experiences of their intercultural communication competence in mentoring culturally and linguistically diverse nursing students during completion of their clinical practice. DESIGN Qualitative study design. PARTICIPANTS The participants were 12 nurses who had previously mentored at least two culturally and linguistically diverse nursing students. METHODS Data were collected during spring 2016 using semi-structured interviews of 12 mentors working in specialized nursing care at one hospital located in central Finland. Data were analyzed using deductive-inductive content analysis. The main concepts of the Integrated Model of Intercultural Communication Competence were used during the semi-structured theme interviews and during analysis. These concepts include empathy, motivation, global attitude, intercultural experience and interaction involvement. RESULTS Mentors stated that empathy motivates them in the development of intercultural communication. Mentors experienced a lack of resources and support from their superiors, which caused psychological and ethical strain and reduced mentors' motivation. Mentors openly admitted that they had experienced fear towards unknown cultures, but that this fear was reduced through positive mentoring experiences and cultural encounters. CONCLUSIONS Continuous education on intercultural communication competence could succeed to further develop clinical mentors' mentoring expertise, which could have the potential to greatly benefit students, patients and staff. Such education could be designed, implemented and measured for its effect in collaboration between health care organizations and higher educational institutions.
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Affiliation(s)
- Pia Hagqvist
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Healthcare Unit, Centria University of Applied Sciences, Finland
| | - Ashlee Oikarainen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Anna-Maria Tuomikoski
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Jonna Juntunen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
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Cassidy S, Coffey M, Murphy F. Transparency of assessment decision-making when students are not meeting required levels of proficiency in clinical practice. Nurse Educ Pract 2020; 43:102711. [PMID: 32106070 DOI: 10.1016/j.nepr.2020.102711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 11/24/2019] [Accepted: 01/19/2020] [Indexed: 11/25/2022]
Abstract
This paper discusses the context of assessing nursing and midwifery students who are not meeting required levels of proficiency in clinical practice. The paper then outlines an action plan protocol designed to assist supervisors and assessors examine the credibility of their assessment decisions in these circumstances. Development of the protocol draws on a comprehensive review of evidence and original research showing the personal, professional and organizational pressures faced when a student is failing to achieve proficiency in clinical practice. The action plan protocol is suggested as one way of addressing the need to document concerns to enable students to ultimately self-regulate their learning and professional development.
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Affiliation(s)
- Simon Cassidy
- Health Education and Improvement Wales, United Kingdom.
| | - Michael Coffey
- Public Health, Policy and Social Sciences, Swansea University, Wales, United Kingdom.
| | - Fiona Murphy
- Department of Nursing & Midwifery, Faculty of Education & Health Sciences, University of Limerick, Ireland.
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Hunt LA. Developing a 'core of steel': the key attributes of effective practice assessors. ACTA ACUST UNITED AC 2020; 28:1478-1484. [PMID: 31835941 DOI: 10.12968/bjon.2019.28.22.1478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND the Nursing and Midwifery Council has emphasised that its recently introduced standards for student supervision and assessment aim to 'ensure that no one gets onto the register who shouldn't be there'. A key element in achieving this is the new practice assessor role, implemented to bolster practical assessment processes. AIM to identify the key personal characteristics of robust practice assessors who are prepared to fail underperforming students. METHOD a national study, using a grounded theory approach. Thirty-one nurses were interviewed about their experiences of failing students in practice-based assessments. FINDINGS robust practical assessors have a 'core of steel', characterised as having five key features: solidarity, tenacity, audacity, integrity and dependability. CONCLUSION organisations should base their selection of practice assessors on how strongly they exhibit these five characteristics. Designating all current mentors as new practice assessors, when it is known that often they are reluctant to fail, could perpetuate failure to fail.
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Affiliation(s)
- Louise A Hunt
- Director of Practice, Leicester School of Nursing and Midwifery, De Montfort University
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15
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El Hussein MT, Fast O. Gut feeling: A grounded theory study to identify clinical educators' reasoning processes in putting students on a learning contract. J Clin Nurs 2019; 29:75-84. [PMID: 31512306 DOI: 10.1111/jocn.15058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/06/2019] [Accepted: 08/31/2019] [Indexed: 12/01/2022]
Abstract
AIM To develop a substantive theoretical explanation that makes sense of the decision-making process that clinical instructors use to place students on a learning contract. BACKGROUND Clinical instructors are challenged with the task of objectively evaluating students using subjective tools such as anecdotal notes, diaries, unstructured observations and verbal feedback from other nurses. Clinical instructors' assessment decisions have a considerable impact on a variety of key stakeholders, not least of all students. DESIGN Grounded theory method and its heuristic tools including the logic of constant comparison, continuous memoing and theoretical sampling to serve conceptualisation were used in the process of data collection and analysis. METHODS Seventeen individual semi-structured interviews with clinical instructors in one university in Western Canada were conducted between May 2016-May 2017. Data were analysed using open, axial and selective coding consistent with grounded theory methodology. The study was checked for the Standards for Reporting Qualitative Research (SRQR) criteria (See Appendix S1). FINDINGS Three subcategories, "brewing trouble," "unpacking thinking" and "benchmarking" led to the study's substantive theoretical explanation. "Gut feeling" demonstrates how clinical instructors reason in their decision-making process to place a student on a learning contract. CONCLUSION Placing a student on a learning contract is impacted by personal, professional and institutional variables that together shift the process of evaluation towards subjectivity, thus influencing students' competency. A system-level approach, focusing on positive change through implementing innovative assessment strategies, such as using a smart phone application, is needed to provide some degree of consistency and objectivity. RELEVANCE TO CLINICAL PRACTICE Making visible the objective assessments currently being done by clinical instructors has the potential to change organisational standards, which in turn impact patient and clinical outcomes.
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Affiliation(s)
- Mohamed Toufic El Hussein
- School of Nursing and Midwifery, Faculty of Health, Community & Education, Mount Royal University, Calgary, AB, Canada.,Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Acute Care Nurse Practitioner Medical Cardiology Coronary Care Unit, Rockyview General Hospital, Calgary, AB, Canada
| | - Olive Fast
- School of Nursing and Midwifery, Faculty of Health, Community & Education, Mount Royal University, Calgary, AB, Canada
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Bradshaw C, Pettigrew J, Fitzpatrick M. Safety first: Factors affecting preceptor midwives experiences of competency assessment failure among midwifery students. Midwifery 2019; 74:29-35. [DOI: 10.1016/j.midw.2019.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/14/2019] [Accepted: 03/17/2019] [Indexed: 10/27/2022]
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Goodwin J, Kilty C, Harman M, Horgan A. "A great stress among students" - mental health nurses' views of medication education: A qualitative descriptive study. NURSE EDUCATION TODAY 2019; 77:18-23. [PMID: 30925342 DOI: 10.1016/j.nedt.2019.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/19/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Registered mental health nurses report dissatisfaction with the level of medication knowledge demonstrated by undergraduate nurses. However, little is known about which particular areas staff nurses are concerned about, and how they feel education can be enhanced in both academic and clinical settings. OBJECTIVE To investigate the views of staff nurses on the delivery of medication education to undergraduate mental health nurses. DESIGN A qualitative descriptive design was adopted. METHODS Two focus groups were held with registered nurses in two acute mental health facilities. Data were analysed using qualitative content analysis. RESULTS The first theme reports on the difficulties staff nurses observed with both undergraduate and newly qualified nurses around medication. It was noted that these individuals had difficulties interpreting medication charts/Kardexes, and were unable to provide medication-related education to service users. The second theme reports on strategies to enhance medication education, as recommended by participants. It was suggested that more practical education should be delivered in academic settings, with a focus on simulation and presentations from clinical staff. In the clinical settings, it was suggested that preceptors should provide education at less busy times on the ward. CONCLUSIONS This study gives insight into areas in which education needs to be strengthened, in order to improve the medication knowledge of undergraduate and newly qualified nurses. Further research is needed to develop evidence-based strategies to enhance this education.
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Affiliation(s)
- John Goodwin
- School of Nursing and Midwifery, University College Cork, Ireland.
| | - Caroline Kilty
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Mark Harman
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Ireland
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18
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Affiliation(s)
- Ian Peate
- Editor in Chief, British Journal of Nursing
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Grealish LA, Shaw JM. Introducing a design exigency to promote student learning through assessment: A case study. NURSE EDUCATION TODAY 2018; 61:225-230. [PMID: 29248840 DOI: 10.1016/j.nedt.2017.11.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/29/2017] [Accepted: 11/23/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Assessment technologies are often used to classify student and newly qualified nurse performance as 'pass' or 'fail', with little attention to how these decisions are achieved. Examining the design exigencies of classification technologies, such as performance assessment technologies, provides opportunities to explore flexibility and change in the process of using those technologies. OBJECTIVE Evaluate an established assessment technology for nursing performance as a classification system. METHODS A case study analysis that is focused on the assessment approach and a priori design exigencies of performance assessment technology, in this case the Australian Nursing Standards Assessment Tool 2016. FINDINGS Nurse assessors are required to draw upon their expertise to judge performance, but that judgement is described as a source of bias, creating confusion. The definition of satisfactory performance is 'ready to enter practice'. To pass, the performance on each criterion must be at least satisfactory, indicating to the student that no further improvement is required. The Australian Nursing Standards Assessment Tool 2016 does not have a third 'other' category, which is usually found in classification systems. DISCUSSION Introducing a 'not yet competent' category and creating a two-part, mixed methods assessment process can improve the Australian Nursing Standards Assessment Tool 2016 assessment technology. Using a standards approach in the first part, judgement is valued and can generate learning opportunities across a program. Using a measurement approach in the second part, student performance can be 'not yet competent' but still meet criteria for year level performance and a graded pass. CONCLUSION Subjecting the Australian Nursing Standards Assessment Tool 2016 assessment technology to analysis as a classification system provides opportunities for innovation in design. This design innovation has the potential to support students who move between programs and clinicians who assess students from different universities.
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Affiliation(s)
- Laurie A Grealish
- Gold Coast Hospital and Health Service, Hospital Boulevard, Southport, Qld 4215, Australia; Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4215, Australia.
| | - Julie M Shaw
- Gold Coast Hospital and Health Service, Hospital Boulevard, Southport, Qld 4215, Australia; Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4215, Australia
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Timmins F, Cassidy S, Nugent O, Lydon C, Part S, Keane L, Dennehy C, Fenn H, Prizeman G, Murphy F, Coffey M. Reluctance to fail nursing students in practice-implications for nurse managers. J Nurs Manag 2017; 25:489-490. [DOI: 10.1111/jonm.12508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Fiona Timmins
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - Simon Cassidy
- Abertawe Bro Morgannwg University Health Board; Wales UK
| | | | | | | | | | - Caitriona Dennehy
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | | | | | - Fiona Murphy
- Department of Nursing & Midwifery; Faculty of Education & Health Sciences; University of Limerick; Limerick Ireland
| | - Michael Coffey
- College of Human and Health Sciences; Swansea University; Wales UK
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