Status of knowledge on student-learning environments in nursing homes: A mixed-method systematic review

Allied Health Student Placements in Residential Aged Care: Attitudes, Experiences and Impact

BACKGROUND

Despite clear needs to prepare allied health professionals to work in aged care to meet community needs, student placements in residential aged care are not commonplace. There is limited evidence that explores allied health students' attitudes to aged care placement learning experiences.

OBJECTIVE

This work aims to examine the attitudes, experiences and impact of a residential aged care placement on allied health professional students.

METHODS

The study employed an exploratory qualitative approach within an interpretative philosophy. Participants were 14 dietetics, occupational therapy and speech pathology students who had a placement experience in residential aged care in Australia. Students completed a demographics questionnaire, and either an online interview before and after their placement, or a group online interview after their placement. Verbatim transcripts were analysed thematically using an inductive approach.

RESULTS

Students acknowledged the usefulness of placement in 'Building Skills,' and proposed how they could translate these skills to future acute setting placements. However, the 'Legitimacy of the Learning Environment' was a concern given the limited in situ role modelling from their own profession. Students clearly identified how they had and could make a meaningful 'Contribution to Care' of the older person.

CONCLUSIONS

Placement experiences in residential aged care are a legitimate learning opportunity for allied health professional students to develop their capabilities to work with older people; however, the student sense of fit within the workplace was disconnected. Supporting effective student learning in the aged care setting is important to enable students to be prepared to enter the aged care workforce.

Perceptions of care homes as practice learning environments for pre-registration nursing students: A systematic-narrative hybrid literature review

BACKGROUND

The ageing population is increasing demand for skilled nurses in long-term care settings, such as care homes. However, attracting qualified nurses remains challenging. Pre-qualification experience could enhance skills, recruitment and retention, but requires greater understanding and support of care homes as learning environments.

AIM

To identify and synthesise research evidence related to care homes as learning environments, and to investigate factors influencing learning within such settings.

DESIGN

Systematic-narrative hybrid review.

DATA SOURCES

CINAHL, PubMed, Medline, Scopus, Web of Science, Nursing and Allied Health and Google Scholar were searched for research articles published between January 2014 and October 2023 which sought to explore the learning opportunities of nursing students in care homes. Studies published in English were considered.

REVIEW METHODS

Retrieved articles were assessed for suitability, quality and inclusion through title and abstract examination facilitated by the use of an appropriate critical appraisal tool (PICO). Articles were read, and re-read, evidence extracted, tabulated, and then synthesised using a thematic approach. Reporting is consistent with PRISMA guidelines for reporting systematic reviews.

RESULTS

4203 articles were screened, 31 studies matched the inclusion criteria. Three key themes were developed through thematic synthesis: (i) Positive but challenging experiences (ii) Barriers to learning include lack of registered nurses, time pressure and high workload, and lack of financial investment (iii) Facilitators of learning in care homes include positive supervisory relationship, effective orientation and reception, and partnership and collaboration between educational institutions and care home settings.

CONCLUSION

This review reveals the potential of care homes as settings that offer valuable learning opportunities for nursing students, as well as a sector that support the future needs of an ageing population. Advocating for policies that specifically address the support of nurse education and nurses in this environment is warranted.

Nurses' Experiences With Mentoring Nursing Students in Nursing Homes Where an Active, Collaborative Learning Model Is Introduced. A Qualitative Study

AIM

To explore the experiences of nurses mentoring nursing students who study in an active collaborative learning model in their first clinical placement in nursing homes.

BACKGROUND

Clinical nurses play a crucial role in providing a meaningful learning environment when mentoring nursing students. Active collaborative learning models are increasingly being implemented in clinical placements in nursing education and it is important to explore the experiences of mentoring nurses when implementing such models. In our study, a model where one mentor supports a learning cell of two students, again being supported by a team of two persons in joint positions, was explored.

DESIGN

The study had a qualitative design, interviewing mentors in focus groups about their experiences with mentoring nursing students in a new, collaborative model.

METHODS

Twenty-seven mentors were interviewed in six focus groups. The data from the interviews were analysed using thematic analysis.

RESULTS

Two main themes emerged from the analysis: (1) navigating to find the mentor role in a new approach and (2) sharing responsibility for student mentoring.

CONCLUSIONS

Mentors in active, collaborative learning models can experience a shift from emphasis on developing a close relationship with one student to emphasis on supporting a learning cell of two students in organising their learning. When introducing new models to practice learning it is essential to also provide a supportive structure for the mentors.

RELEVANCE TO CLINICAL PRACTICE

Active collaborative learning models have the potential to provide more clinical placements of high quality. Nurses who mentor students need support. A supportive environment being facilitated by academic-practice collaboration provide a community of practice on mentoring for nurses.

PATIENT OR PUBLIC CONTRIBUTION

The result of the research was shared and discussed with stakeholders prior to submitting the article for publication.

Experiences of Using a Digital Guidance and Assessment Tool (the Technology-Optimized Practice Process in Nursing Application) During Clinical Practice in a Nursing Home: Focus Group Study Among Nursing Students

BACKGROUND

Nursing students' learning during clinical practice is largely influenced by the quality of the guidance they receive from their nurse preceptors. Students that have attended placement in nursing home settings have called for more time with nurse preceptors and an opportunity for more help from the nurses for reflection and developing critical thinking skills. To strengthen students' guidance and assessment and enhance students' learning in the practice setting, it has also been recommended to improve the collaboration between faculties and nurse preceptors.

OBJECTIVE

This study explores first-year nursing students' experiences of using the Technology-Optimized Practice Process in Nursing (TOPP-N) application in 4 nursing homes in Norway. TOPP-N was developed to support guidance and assessment in clinical practice in nursing education.

METHODS

Four focus groups were conducted with 19 nursing students from 2 university campuses in Norway. The data collection and directed content analysis were based on DeLone and McLean's information system success model.

RESULTS

Some participants had difficulties learning to use the TOPP-N tool, particularly those who had not attended the 1-hour digital course. Furthermore, participants remarked that the content of the TOPP-N guidance module could be better adjusted to the current clinical placement, level of education, and individual achievements to be more usable. Despite this, most participants liked the TOPP-N application's concept. Using the TOPP-N mobile app for guidance and assessment was found to be very flexible. The frequency and ways of using the application varied among the participants. Most participants perceived that the use of TOPP-N facilitated awareness of learning objectives and enabled continuous reflection and feedback from nurse preceptors. However, the findings indicate that the TOPP-N application's perceived usefulness was highly dependent on the preparedness and use of the app among nurse preceptors (or absence thereof).

CONCLUSIONS

This study offers information about critical success factors perceived by nursing students related to the use of the TOPP-N application. To develop similar learning management systems that are usable and efficient, developers should focus on personalizing the content, clarifying procedures for use, and enhancing the training and motivation of users, that is, students, nurse preceptors, and educators.

Expanding student nurse placement activity in Welsh care homes: An evaluation study

AIM

Expanding and sustaining student nurse placements outside of the acute sector is a universal challenge. This paper aims to evaluate the Care Home Education Facilitator Role introduced in one area of Wales, United Kingdom, and to report on the outcomes achieved from this novel role.

METHODS

Semi-structured interviews were undertaken with key stakeholders including the Care Home Education Facilitator postholder leading the pilot, care home managers, higher education institutions' placement managers/coordinators, student nurses and national health service staff.

RESULTS

Five key areas were identified, which included timing of introducing the post and establishing a clear rationale and understanding of the intention of the role. The benefits, challenges and suggested improvements to the Care Home Education Facilitator initiative are provided.

CONCLUSION

Introducing the role of the Care Home Education Facilitator to work closely with key stakeholders resulted in increased placements for student nurses, but investing time in developing relationships with these stakeholders was critical to the success of the role.

Usefulness of pedagogical design features of a digital educational resource into nursing home placement: a qualitative study of nurse educators' experiences

BACKGROUND

The rapid advancement of technology-enhanced learning opportunities has resulted in requests of applying improved pedagogical design features of digital educational resources into nursing education. Digital educational resources refers to technology-mediated learning approaches. Efficient integration of digital educational resources into nursing education, and particularly into clinical placement, creates considerable challenges. The successful use of digital educational resources requires thoughtful integration of technological and pedagogical design features. Thus, we have designed and developed a digital educational resource, digiQUALinPRAX, by emphasizing pedagogical design features. The nurse educators' experiences of the usefulness of this digital educational resource is vital for securing improved quality in placement studies.

AIM

To obtain an in-depth understanding of the usefulness of the pedagogical design features of a digital educational resource, digiQUALinPRAX, in supporting nurse educators' educational role in nursing home placements in the first year of nursing education.

METHODS

An explorative and descriptive qualitative research design was used. Individual semi-structured interviews were conducted with six nurse educators working in first year of a Bachelor's of Nursing programme after using the digital educational resource, digiQUALinPRAX, during an eight-week clinical placement period in nursing homes in April 2022.

RESULTS

Two main categories were identified: (1) supporting supervision and assessment of student nurses and (2) supporting interactions and partnerships between stakeholders.

CONCLUSION

The pedagogical design features of the digiQUALinPRAX resource provided nurse educators with valuable pedagogical knowledge in terms of supervision and assessment of student nurses, as well as simplified and supported interaction and partnership between stakeholders.

Mapping interaction quality for nursing and medical students in primary care placement in municipal emergency care units: a systematic observational study

Introduction

Primary care placement for nursing and medical students is vital for developing the competence to accommodate the increasing number of patients with multimorbid and complex conditions. Prior studies have suggested that interaction quality in primary care placement empowers learning. However, research mapping interaction quality in primary care placements in municipal emergency care units is lacking. This study aimed to systematically map interaction quality for nursing and medical students in primary care placement in two municipal emergency care units.

Materials and methods

This study adopted a systematic descriptive observational design. Systematic observations (n = 201 cycles) of eight nursing students (n = 103 cycles) and six medical students (n = 98 cycles) were used to map interaction quality across six learning situations between March and May 2019. Observations were coded using the Classroom Assessment Scoring System-Secondary (CLASS-S). Data were analyzed using descriptive statistics and Spearman correlations.

Results

Interaction quality is described in three domains: (I) emotional support, (II) framework for learning, and (III) instructional support, and the overall measure, student engagement. The results indicated middle-quality interactions in the emotional and instructional support domains and high quality in the framework for learning domain and student engagement. Correlations exhibited similar patterns and ranged from non-significant to strong correlations.

Conclusion

The interaction qualities indicated a generally positive and supportive learning environment contributing to nursing and medical students' learning and active participation in work tasks related to their professional roles. Thus, this new form for primary care placement for nursing and medical students in the municipal emergency care units was found to be a positive learning arena. These results may enhance nursing and medical education programs in countries with similar health services and education. Health education, supervisors, peers, and others contributing to students' learning should recognize which interaction qualities may affect learning and how to improve quality, thus affecting supervisors' approach to training students. While the CLASS-S showed potential for mapping interaction qualities for nursing and medical students in primary care placement in municipal emergency care units, further studies are needed to validate the CLASS-S for use in clinical placement settings.

A digital educational resource to support and enhance effective mentorship practices of nursing students in nursing homes: a qualitative study

BACKGROUND

There is a grooving body of evidence emphasising the need to support and enhance effective mentorship practices for nursing students in nursing home placements, including strengthening of the pedagogical competence of registered nurse mentors. Owing to the necessity for multifaceted mentoring competence and the challenges of workload registered nurses are facing, the use of flexible digital educational resources has been suggested. However, current knowledge on the effectiveness of digital educational resources in enhancing mentorship practices in nursing homes is scarce. This study aimed to explore the perception of registered nurse mentors regarding the effectiveness of a digital educational resource, particular its usability and value-in-use in supporting and enhancing mentorship practices in nursing homes.

METHODS

The study applied an exploratory descriptive qualitative design. Pre- and post-mentoring semi-structured focus group interviews were conducted among a total of 23 registered nurse mentors across three Norwegian nursing homes. The transcribed interviews were thematically analysed. Standards for reporting qualitative research were followed.

RESULTS

The analysis yielded one pre-mentoring theme: (1) predominant enthusiasm and satisfaction and three post-mentoring themes: (2) enhanced confidence and motivation, (3) enhanced mentoring competence in supporting the nursing students' learning process, and (4) factors influencing the value-in-use of the digital educational resource.

CONCLUSIONS

Digital educational resources support effective mentorship practices by enhancing the confidence and motivation in the mentor role and by enabling more goal-oriented supervision and assessment tailored to the learning goals of students. The implementation of digital educational resources to support and enhance effective mentorship practices is an important avenue for further research towards achieving high-quality learning environments in clinical nursing education in general and nursing homes. Based on the study findings, nursing educational institutions should consider offering digital educational resources to develop, support, and advance mentorship training, which may more effectively impact and improve the quality of clinical nursing education.

Kickstart in nursing home-Nursing students experiences of a model for active and collaborative learning in clinical placement

AIMS AND OBJECTIVES

To explore students' experiences from a pilot project testing out a model for active, collaborative learning in first-year placement at a nursing home.

BACKGROUND

There is a need for innovative learning activities and projects to improve clinical education in nursing homes. Active, collaborative approaches in placement learning may enhance students learning outcome.

DESIGN

The study had a qualitative and explorative design, in which the experiences of students participating in the pilot were investigated through paired interviews at the end of their placement.

METHODS

Twenty-two students participated in the study, and data from paired interviews were analysed using qualitative content analysis. COREQ reporting guidelines were used.

RESULTS

Three themes emerged from the analysis: (1) The learning cell as facilitator for learning; (2) Discovering learning possibilities in nursing homes and (3) Applying tools and resources for learning.

CONCLUSIONS

The model could reduce tension and anxiety while helping the students focus on learning options and use their environment more actively for learning. Working with a learning partner seems to increase student learning through common planning, feedback and reflection. The study emphasises the importance of facilitating active learning through the scaffolding structures and configuration of the students' learning space.

RELEVANCE TO CLINICAL PRACTICE

This study indicates the potential for introducing active and collaborative pedagogical models in clinical placement. The model can promote nursing homes as a conducive learning arena for nursing students and help prepare students for a future work role in a rapidly changing health care field.

PATIENT OR PUBLIC CONTRIBUTION

The result of the research is shared and discussed with stakeholders prior to finalising the article.

Nurse educators' suggestions for a digital educational resource suitable for undergraduate student nurses' placement studies: Qualitative empirical research

AIMS

To explore and describe nurse educators' suggestions regarding a digital educational resource addressing quality in placement studies for first-year student nurses in nursing homes.

DESIGN

A qualitative, explorative, and descriptive research design.

METHODS

Focus group interviews with eight nurse educators and individual interviews with six nurse educators. The interviews were audio-recorded and transcribed verbatim; subsequently, data were analysed in lines with content analysis as described by Graneheim and Lundman.

RESULTS

The analysis revealed three main categories: 'Suggestions for a digital educational resource to strengthen and support nurse educators' role in follow-up students', 'Suggestions for a digital educational resource to complement and support interaction between stakeholders in placement', and 'Suggestions for a digital educational resource to facilitate student nurses' learning processes'. The categories were captured by the overarching theme, 'A digital educational resource facilitating interaction between stakeholders and students' learning processes.

CONCLUSION

This study revealed nurse educators' suggestions regarding design elements, content, and use of a digital educational resource addressing placement studies for first-year student nurses' in nursing homes. Implications for the profession and/or patient care: Nurse educators should be involved in designing, developing, and implementing digital educational resources aiming to support student learning in nursing education placement studies.

IMPACT

This study explored nurse educators' suggestions for a digital educational resource. They suggested a digital educational resource to strengthen and support their role, support interaction between stakeholders, and facilitate student nurses' learning processes. Further, they suggested a digital educational resource to be used as a supplement rather than as a replacement for nurse educators' physical presence in placements.

REPORTING METHOD

The Consolidated Criteria for Reporting Qualitative Research reporting guidelines were used. No Patient or Public Contribution.

Understanding registered nurses' career choices in home care services: a qualitative study

BACKGROUND

The anticipated growth in number of older people with long-term health problems is associated with a greater need for registered nurses. Home care services needs enough nurses that can deliver high quality services in patients' homes. This article improves our understanding of nurses' career choices in home care services.

METHODS

A qualitative study using individual semi-structured interviews with 20 registered nurses working in home care services. The interviews were audio-recorded, transcribed and thematically analyzed.

RESULTS

The analysis resulted in three themes emphasizing the importance of multiple stakeholders and contextual factors, fit with nurses' private life, and meaning of work. The results offer important insights that can be used to improve organizational policy and HR practices to sustain a workforce of registered nurses in home care services.

CONCLUSION

The results illustrate the importance of having a whole life perspective to understand nurses' career choices, and how nurses' career preferences changes over time.

Comparing Preferred and Actual Clinical Learning Environments and Perceptions of First-Year Nursing Students in Long-Term Care: A Cross-Sectional Study

The clinical learning environment, which includes the culture of clinical units, the mentoring process, and the different health organizations, influences the learning process of nursing students. However, scarce literature has been published on the impact of the clinical learning environment on first-year nursing students in long-term care. We aimed to assess first-year nursing students 'preferred' and 'actual' clinical learning environments when conducting their first placements in nursing homes within an innovative placement model that comprised the active participation of academic mentors. The validated Spanish version of the Clinical Learning Environment Inventory (CLEI) instrument was used in our study, and 99 first-year nursing students participated. The highest mean scores for the CLEI-Actual were found for the Satisfaction (22.7) and Involvement scales (19.09). The lowest mean scores were found for the Personalization (17) and Individualization (17.27) scales. The multiple correlation (R) between the Satisfaction and the other CLEI scales was 0.61 (p > 0.001), which means that in this study the association between student satisfaction and their perception of the clinical learning environment was strong. First-year students conducting their first clinical placements in nursing homes can have a positive learning experience considering a well-designed and organized pedagogical strategy, including constant support and feedback from academic and clinical mentors.

Learning in nursing home placement: A phenomenological study of student nurses' lived experience

AIM

To explore first-year student nurses' lived experience of learning in clinical placement in nursing homes.

BACKGROUND

Nursing homes traditionally represent students' first clinical placement sites during nurse education, and nursing home residents' care needs can provide opportunities for student nurses to acquire both fundamental and specialised nursing skills. In clinical placements, students have opportunities to apply and integrate theoretical knowledge, practical skills and ethical competence in a clinical setting.

DESIGN

A qualitative design with a hermeneutic phenomenological approach was employed and reported in accordance with the COREQ guidelines.

METHODS

The study was undertaken at three nursing homes affiliated with one Norwegian university. Close observation (173 h) and in-depth individual interviews (n = 7) with first-year student nurses were conducted to explore their lived experience of learning. Data analysis was guided by van Manen's hermeneutic phenomenological approach.

RESULTS

The essential meaning of the phenomenon of learning in clinical placements in a nursing home setting is characterised by four themes: (1) navigating a new and complex learning context, (2) being emotionally affected when facing sickness and frailty, (3) having a vital need for support and guidance and (4) being engaged in learning.

CONCLUSIONS

The findings are discussed against the backdrop of educational learning theory. Learning in clinical placements in nursing homes is a multi-faceted and complex phenomenon related to the students' lived experience on the contextual, relational and individual levels. Overall, our findings demonstrate that learning in clinical placements is part of the process of professional identity development.

RELEVANCE TO CLINICAL PRACTICE

The clinical practice arena should emphasise emotional support for student nurses, enhance their self-directed reflection and explicitly focus on the essence of nursing in nursing homes.

A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English-speaking countries

AIM

The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice.

BACKGROUND

Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future.

DESIGN

A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses Scoping Review extension (PRISMA-ScR) guidelines.

RESULTS

One hundred fifty-five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation.

CONCLUSION

There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work-ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work-ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence-based.

Bloom's Classification of Educational Objectives Based on Deep Learning Theory Teaching Design of Nursing Specialty

Through the effective integration of various teaching resources, carry out the teaching design of "basic nursing technology" for the nursing specialty in the information environment based on Bloom's education objective classification. Select 200 nursing students from two natural classes in the third year of undergraduate nursing major as the research objects with100 students in the experimental group and 100 students in the control group. The experimental group adopted Bloom's objective classification teaching mode, and the control group adopted the traditional teaching model. They have carried out the teaching intervention to ensure the consistency of teachers, textbook use, teaching hours, and teaching progress between the two groups. The evaluation model of the teaching design results is the RBF neural network. The model improves the convergence ability of the RBF network by dynamically changing the control parameters of the L-M algorithm. RBF realizes the goal of the comprehensive analysis of course teaching effects evaluation and various influencing factors. The results showed that the differences in self-management ability, information ability, cooperation score, and total score of the experimental group were significantly higher than those of the control group, with statistical significance (P < 0.01). The teaching of Bloom's educational objective model can enhance students' subjective consciousness and effectively improve their independent learning ability. The learning effect is improved obviously. This paper studies the teaching approaches to improve nursing students' comprehensive ability and humanistic care quality and provides a reference for deepening nursing undergraduate teaching reform.

Graduating nurse students' interest in older people nursing-A cross-sectional survey in six European countries

BACKGROUND

Countries vary in the number of qualified nurses employed in older adult services. Moreover, students' views of older people nursing as a career differ internationally. Studying future nurses and their career intentions for the field is warranted to meet the increased nurse workforce expectations in terms of quantity and competence.

AIM

To analyse graduating nurse students' interest in older people nursing and the factors associated with it.

METHODS

A cross-sectional multicountry survey design was applied. Data were collected between May 2018 and March 2019 from several educational institutions in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Non-probability convenience sampling was used to recruit graduating nurse students (n = 1796). The data were collected with a structured questionnaire comprising background factors and the Willingness sub-scale (six items) of the Students' Interest in Nursing Older People Scale. Data were analysed using a linear mixed model including relevant background variables.

RESULTS

Overall, students' interest in older people nursing was low (score 20.5, on a 0-100 scale). Among the studied countries, Spanish students scored the highest (38.8) and German students the lowest (3.6). Students' interest in older people nursing was associated with country (p < .001), the length of work experience (p = .006), plans for further study (p = .007), competence (p < .001) and the extent that nursing is valued by society (p < .001). The students who were most interested in older people nursing had higher self-reported competence level (p < .001).

CONCLUSION

In the studied sample of future nurse professionals, interest in older people nursing is low at a time when the field suffers from workforce shortage. As for quality workforce, it was promising that the students who considered working in the field also evaluated themselves as competent.

IMPLICATIONS FOR PRACTICE

Multidimensional actions are required to promote interest in the field, including continued development of competence in both undergraduate education and workplaces, and investing in various career pathways to envisage potential opportunities.

Mentoring of nursing students-A comparative study of Japan and five European countries

AIMS

This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan.

METHODS

The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis.

RESULTS

Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring.

CONCLUSION

Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses.

Nursing students' experience with clinical placement in nursing homes: a focus group study

Background

A renewed interest in nursing homes as clinical placement settings for nursing students has been prompted by the growing healthcare needs of an ageing population. However, if future nurses are to be enthusiastic about working in this healthcare context, it is essential that higher education institutions that educate nurses and nursing homes that provide placement experiences to students do so with a supportive, positive, and enriched approach.

Methods

To explore first-year nursing students’ placement experience in nursing homes, we conducted an exploratory qualitative study in three city-based nursing homes in western Norway. Thirteen first-year nursing students participated in the study. Three focus group interviews were conducted to explore the students’ placement experiences. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR).

Results

The analysis describes five themes relating to first-year students’ placement experience in nursing homes; (1) variations in utility of pre-placement orientation and welcome at placement site; (2) a challenging learning environment; (3) spending considerable placement time with non-registered nurses; (4) considerable variability in supervision practices; and (5) a vulnerable and demanding student role.

Conclusions

The research provides insight into the contextual characteristics encountered by first-year students that influence the quality of their placement experiences. Consequently, these characteristics impede access to important role models who lend support to a student’s growth and professional development, preventing full utilisation of the learning potential offered in nursing homes. Hence, we propose that targeted efforts are warranted to foster positive placement experiences and enhance students’ clinical education in nursing homes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00690-4.

Preceptorship of clinical learning in nursing homes - A qualitative study of influences of an interprofessional team intervention

This study aimed to explore the influences of an interprofessional preceptor-team intervention (IPPT) on interprofessional collaboration, preceptors' role, confidence, and motivation to precept health care students (nursing, physiotherapy) and apprentices in a Norwegian nursing home.

METHODS

Qualitative data were collected by two focus group discussions: possible gains and pitfalls of the IPPT-intervention were focused. The group-discussions were tape-recorded, transcribed verbatim and analysed by means of qualitative content analysis.

FINDINGS

The IPPT-intervention influenced positively on preceptors' confidence and motivation to work as a preceptor and facilitated interprofessional collaboration between the health professionals. The preceptors' role in the ward became clearer and more visible to the peers. Perceived lack of time, a heavy workload, the ward hierarchy, and lack of managerial support were key barriers for preceptorship.

CONCLUSIONS

To enhance preceptors' work and thus student's learning, the ward hierarchy should be limited and interprofessional collaboration further developed. Enhanced visibility and acknowledgement of the preceptors' role and increased managerial support can reduce barriers for preceptorship.

Enhancing student nurses' clinical education in aged care homes: a qualitative study of challenges perceived by faculty staff

Background

Ageing populations are increasing the demand for geriatric care services. As nursing schools respond to this demand, more high-quality clinical placements are required, and aged care homes offer suitable placement sites. Although an aged care experience for students is beneficial, the basis for effective implementation of these placements is yet to be fully established. The aim of this study was to explore faculty staff perspectives on the challenges associated with providing effective clinical education in aged care homes for first-year student nurses.

Methods

An exploratory qualitative study was performed. Fifteen in-depth interviews were conducted with program leaders of nursing degree programs (n = 4), course leaders (n = 6) and practice coordinators (n = 5) in three Norwegian universities. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR).

Results

Five themes were identified regarding the perceived challenges to implementing effective clinical education in aged care homes: (1) low staffing levels of registered nurses limit the capacity to effectively host students; (2) prevalence of part-time teachers can compromise the quality of students’ learning experiences; (3) tensions about the required qualifications and competencies of nurse teachers; (4) variation in learning assessments; and (5) lack of quality assurance.

Conclusions

These challenges signal key areas to be addressed in quality assurance for effective aged care placements. Further research into the minimum staffing levels required to support student learning in the aged care setting is required. Methods for developing shared practices to facilitate learning in aged care homes need to address the prevalence of part-time teaching appointments. Further research into the levels of qualification and competence required to support student learning in aged care facilities can assist with setting standards for this sector. Finally, academic-practice institutions must engage with government officials and national nursing bodies to develop national standards for clinical education in aged care homes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00632-0.

Simulation as a joint learning activity in clinical placement-interaction between first-year nursing students and qualified nurses

AIMS

The purpose of the study was to explore students' experiences from joint simulation training with qualified nurses that took place in students´ first-year placement at a nursing home.

BACKGROUND

Nursing students' clinical placement in nursing homes has been pictured as inadequate, boring and irrelevant. There is a need for innovative learning designs that include increased collaboration between the educational institution and clinical placement site to support student learning in practice. Simulation training is highlighted as a learning activity that enhances practical skills and reflection.

DESIGN

The study had a qualitative evaluation design to explore and capture students' experiences and provide an understanding of the impact of the joint simulation activity during placement.

METHODS

Three retrospective focus group interviews were conducted with a total of twenty nursing students. Written reflective notes from sixteen of the students were included in the study. The data were analysed by means of a thematic content analysis. COREQ reporting guidelines were used.

RESULTS

Four themes were identified as follows: (a) anxiety and arrangements, (b) realistic scenarios-real nurses, (c) debriefing and reflection and (d) the aftereffect of the simulation training for the clinical placement.

CONCLUSIONS

The joint simulation training gave the students an opportunity to actively participate in a complex clinical learning situation together with qualified nurses and within a safe environment. This learning activity provoked feelings and stress within the students. However, it also enriched the students' learning experience and strengthened the outcome of the clinical placement through an improved relationship between the students and qualified nurses.

RELEVANCE TO CLINICAL PRACTICE

Creating collaborative learning activities between nursing homes and universities, such as joint simulation, can increase relevance and enhance learning and student satisfaction in their clinical placement. It can also promote nursing homes as interesting learning arena and future workplace for nursing students.

Improving clinical experiences for nursing students in nursing homes: An integrative literature review

Well-organized clinical placements in older adult care settings will prepare nursing students to provide care for this growing population and may influence career choices. The purpose of this integrative review is to identify strategies that can be used to provide student nurses with effective clinical education experiences in residential aged care facilities offering skilled nursing (RACF-SNs). Twenty-three studies evaluating teaching and learning models and experiences were reviewed. Four themes were identified related to effective strategies for providing gerontological clinical education to students in residential aged care environments, principally nursing homes. These were: developing a partnership, comprehensive orientation, effective supervision for students, and supporting staff. Eight different models were described for enhancing clinical learning experiences in these environments. These models reflect the themes highlighted in the review. Relevance of the findings to a conceptual framework for evaluating gerontological clinical placements, the Senses Framework, is considered. Strong partnerships between schools of nursing and residential aged care environments can provide well-organized clinical education to undergraduate nursing students. To be sustainable, these partnerships must be developed in ways that do not require significant additional resources. A guideline for this process based on findings of the review has been developed.

Improving quality in clinical placement studies in nursing homes (QUALinCLINstud): the study protocol of a participatory mixed-methods multiple case study design

INTRODUCTION

Improved quality in clinical supervision and assessment of student nurses in nursing home clinical placements is vitally important to effective recruitment and preparation for this healthcare sector. Knowledge regarding supervision and assessment practices within these settings is limited. Also, knowledge of evolving e-learning tools on the quality and effectiveness of these educational practices seems to be absent.

METHODS AND ANALYSIS

The aim of the "Improving quality in clinical placement studies in nursing homes" (QUALinCLINstud) study is to develop and evaluate how a web-based programme can optimise supervision, assessment and learning during nursing home placements. The study applies a participatory, mixed-methods case study design, organised in four work packages (WPs). WP1 will explore how the nurse education institution address the quality of student nurses' clinical placements in nursing homes. In WP2, clinical supervision and assessment practices will be explored, and described from multiple stakeholder perspectives. In WP3, based on the findings from WP1 and WP2, a web-based pedagogical supervision and assessment programme will be developed through a developmental co-productive process between nurse education institutions, practice settings and student nurses. In WP4, the web-based programme will be pilot-tested and evaluated through a mixed-methods approach. A range of data collection procedures will be used throughout the project, for example, questionnaires, interviews, observations and workshops.

ETHICS AND DISSEMINATION

The ethical conduct of the study is approved by the Norwegian Centre for Research Data (2018/61309 and 489776). The results will be disseminated through scientific articles, three PhD theses, presentations at national and international conferences, and through publicly accessible trade journals and newspapers. The results will generate knowledge to inform supervision and assessment practices in nursing home placements. Moreover, the study will generate knowledge concerning the developmental process of a web-based supervision and assessment programme, and the value of e-learning tools applied in clinical nursing education.

Nursing home staff experiences of implementing mentorship programmes: A systematic review and qualitative meta-synthesis

AIM

To determine nursing home staff experiences in mentorship programmes, and staff perceptions of the enablers and barriers to implement mentorship programmes.

BACKGROUND

Mentorship programmes are perceived as playing an important role in improving the quality of care in nursing homes. However, little is known about research evidence across the global about staff's experiences in the programmes.

METHODS

A search for studies published from the earliest available date to April 2019 was undertaken. Two reviewers performed data extraction and an appraisal of eight studies using tools from the Joanna Briggs Institute. A pragmatic meta-aggregative approach was applied to synthesise the findings. The qualitative research that was included was analysed to identify 63 findings that were organised into 12 categories and combined into three syntheses.

RESULTS

The implementation of effective mentorship programmes is influenced by three factors: mentor capability, opportunity in the mentorship programmes, and motivation in the mentorship programmes.

CONCLUSIONS

There are a number of studies of nursing home staff experiences of mentorship programmes. However, systematic reviews that synthesise findings in this field are lacking. It is crucial to tailor the programme design to suit each unique nursing home care setting. We identified barriers and enablers, and learned that no barriers are insurmountable.

IMPLICATIONS FOR NURSING MANAGEMENT

Findings will inform nurse managers of an ideal environment for the implementation of a successful mentorship programme. Nursing homes need to establish and sustain mentorship programmes to help improve workforce capacity in delivering high-quality care for residents.

Teaching Basic Nursing Care: Nurse Preceptors' Perceptions about Changing the Teaching Context from the Clinical Setting to a School Simulation Lab

Research demonstrates that basic nursing care receives less attention in clinical settings and has become visually less prominent in nursing education curriculums. While much is known about the importance of preceptorship in clinical settings, little is known about how preceptors teach basic nursing care to students in a school simulation lab. This study explores the preceptors' perceptions of teaching basic nursing care to nursing students in the school simulation lab compared to clinical settings. Data were collected through focus group interviews and participant observation and analyzed by using qualitative content analysis. Three main categories emerged: (i) Perceived advantages and disadvantages, (ii) Positive attitudes - remembering being a student, and (iii) Knowing what to do and showing how to do it. Awareness of the importance of having knowledge about basic nursing care may contribute to counterbalancing the devaluation of basic nursing care among nursing students.

Piloting a practice model in a Norwegian nursing home- A student-managed ward: A way to empower students for the nursing role

This paper focuses on the experiences of nursing students on a student-managed ward, the purpose of which was to empower students for the nursing role. Five nursing students operated and managed a nursing home ward for eight weeks during their final year of nursing education. The students claimed that a group of five students was beneficial. However, a group of five was too large for one nurse to follow up. The students reported that they needed visible supervisors in order to develop professional nursing skills, both in terms of knowledge and practical implementation. The students argued that they became more independent through this form of organisation, since the supervisor was not constantly watching everything they did. The students felt more responsible for the daily running and follow-up of the patients because they were in charge. Peer-assistant learning was highly recommended in relation to self-esteem, and improved results and skills in the students' practice. Collaboration with some of the assistant nurses was challenging. The results indicate that this kind of clinical training can contribute to more empowerment and better preparation for the nursing role than the traditional way.