Experiences of nursing students in A peer mentoring program during their clinical practices. A qualitative study

BACKGROUND

Clinical placements allow nursing students to develop the skills and attitudes necessary to provide care. Peer mentoring programmes seem to facilitate these achievements, but there are very few studies on the effects of peer mentoring on clinical placements and what it can bring to both mentors and mentees.

AIM

To describe the perspectives of nursing students on a peer mentoring programme during their clinical placements.

DESIGN

A qualitative descriptive and exploratory study.

SETTINGS AND PARTICIPANTS

First year and third year nursing students were included.

METHODS

Focus groups were conducted with students after they participated in a peer mentoring programme during their clinical practice rotation.

RESULTS

The support received from the student mentors was very important both academically and personally. Mentors also acknowledged having improved their teaching and leadership skills.

CONCLUSIONS

Our results can be applied to future studies to inform peer mentoring programmes as a complementary teaching tool in clinical placements to improve leadership and empowerment in nursing students.

Stressed and Short: Creating a Balanced and Innovative Preceptor Model in a Medical Intensive Care Unit

An innovative preceptor model (IPM) was developed to transition newly graduate nurses (NGNs) to practice. The imbalanced number of experienced nurses to NGNs during COVID-19 demonstrated a need for an "out-of-the-box" solution, one preceptor to two nurse residents, in the medical intensive care unit. The IPM was evaluated through surveys, postclinical immersion debriefs, and feedback sessions with the preceptors and NGNs. The IPM helped preceptors guide NGNs in their journey to independent practice.

Nursing Students' Perceptions Regarding Teaching and Learning Practices That Promote Safe Medication Administration

ABSTRACT

This article reports on a study conducted to explore what helps and what complicates learning safe medication administration. In this study, nurse educators explored students' perspectives on effective teaching practices, what influences medication errors and near misses, and strategies for improving students' learning about medication administration. Students ranked nursing instructors, peers, and staff nurses as having the greatest positive impact on both their learning and patient safety. Good relationships, an appropriate pace of learning, and practice were also beneficial. Noise, time constraints, and interruptions were negatively associated with learning and patient safety.

Online Group Supervision as Pedagogy: A Qualitative Inquiry of Student Mental Health Nurses' Discourses and Participation

This study explored online group clinical supervision participation, as a component of pre-registration education following mental health nursing students' clinical placements. Clinical supervision has historically been valued as a supportive strategy by healthcare professionals to develop practice and competence and prevent burnout. As many student nurses do not have access to clinical supervision via practice areas as a standardised process, their experiences of engaging in or benefitting from clinical supervision are wide-ranging. In view of this, we are identifying a theory-practice gap between theoretical knowledge and practice experience. This study incorporated a qualitative inquiry using reflexive thematic analysis and applying poststructural theoretical perspectives. Online group clinical supervision was delivered to student mental health nurses whereby focus groups followed to discuss their views, understandings and experiences of online group clinical supervision. This was against a back drop of Covid-19 lockdown restrictions. Thematic synthesis identified two main areas for improving participation and pedagogy comprising; Improving Confidence and Trust in (Online) Participation and The Need for Familiarity in CS Participation and Understanding. Thematic and poststructural analysis demonstrated participants' positive outlooks on the values of clinical supervision, whilst also identifying the finer nuances of the differences in accessing group clinical supervision through an online format. This study adds to the literature on using group clinical supervision within the student mental health nurse population by identifying the benefits of group clinical supervision for student nurses. It has additionally found that the silences and inhibitions surrounding online participation are important areas for further research.

Increasing capacity by moving away from one-to-one clinical supervision: using peer-assisted learning and a group model of student placements in community paediatric speech and language therapy to enable student-led service delivery

BACKGROUND

Health Education England (HEE) and the Royal College of Speech and Language Therapists (RCSLT) have identified the need to increase placement capacity. Speech and language therapy is a shortage profession in the UK, so services need to consider innovative placement models to increase their placement offers without increasing the time burden on speech and language therapists (SLTs).

AIMS

To increase capacity for pre-registration practice-based learning by using peer-assisted learning (PAL) in a group model of student placement to enable student-led service delivery which provides high standards of clinical care and student experience and is an efficient use of SLT time.

METHODS & PROCEDURES

A paediatric speech and language therapy service hosted eight student speech and language therapists (SSLTs) for their final pre-registration placement. SSLTs completed pre- and post-placement confidence ratings for a range of clinical skills; SSLTs and SLTs rated how useful different types of support were, and education settings provided feedback about working with the SSLTs. The number of clinical sessions completed by the SSLTs and the percentage of outcomes achieved for children with speech, language and communication needs were calculated. SLTs completed time-trackers for placement-related activities.

OUTCOMES & RESULTS

The impact of the placements was assessed using a tri-vector methodology consisting of: self-reporting by the student (using an evaluation form), feedback from the placement sites (schools) and analysis of targets set for individual children. SSLTs reported increased confidence in all clinical areas in their post-placement evaluation form. SLTs reported increased confidence in SSLTs working independently and an increase in the perceived benefit to the service for having SSLTs in comparison with the time invested in supporting SSLTs. SSLTs and SLTs found all types of support provided during the placement useful. Schools reported high levels of satisfaction for working with SSLTs. SSLTs completed more clinical sessions than an SLT would have been able to in the time SLTs invested in placement-related activities. Children achieved 60% of the targets set by SSLTs.

CONCLUSIONS & IMPLICATIONS

This placement model increased the capacity for SSLT placements by using PAL in a group model of student placement to enable student-led service delivery. The model provided high standards of clinical care and student experience and was an efficient use of SLT time. Wider use of this placement model would increase placement capacity and could also address vacancies in services.

WHAT THIS PAPER ADDS

What is already known on the subject SSLTs and SLTs are positive about the benefits of paired placements in comparison with individual placements. Other allied health professions have demonstrated that larger placements can be an effective way to support students and have used students to deliver student-led services. What this study adds to existing knowledge This paper is the first to look at whether PAL in a group model of student placements can be used in speech and language therapy to enable student-led service delivery which provides high standards of clinical care, maintains high standards of student experience and is an efficient use of SLT time. What are the potential or actual clinical implications of this work? This paper demonstrates that PAL can be used effectively in a group model of student placements in a paediatric SLT service to increase student capacity and enable student-led service delivery. The proposed placement model provides a high-quality placement for SSLTs and the children they work with, and is also an efficient use of SLT time.

Understanding competency of nursing students in the course of case-based learning in Cambodia: a convergent mixed method study

BACKGROUND

In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching-learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings.

METHODS

This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays.

RESULTS

First, the quantitative and qualitative findings confirmed each other 's CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students' academic satisfaction with the programme.

CONCLUSIONS

The finding of CBL experiences in a group and students' satisfaction with faculty members' and preceptors' teaching improved nursing students' competency development. Meanwhile, students' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.

Interprofessional peer-assisted learning and tutor training practices in health professions education-A snapshot of Germany

Peer-assisted learning (PAL)-especially peer tutorials-are gaining momentum in health professions education, particularly in interprofessional education. As little is known about the use of peer tutorials or the preparation of tutors in this context in Germany and in other countries, this study aims to provide an overview of these interventions. A cross-sectional study with a descriptive-exploratory design was conducted. German institutions for health professions education were contacted, and individuals with pedagogical responsibilities were invited to participate in an online survey. The survey was informed by two studies in which seven domains were identified as important. These included facts about the institution, the offer of PAL, the use of tutorials, and the design of tutor training. The survey used mostly closed-ended questions. The questionnaire was completed by n = 100 participants. Overall, n = 46 participants indicated that PAL was offered at their institution. Of these 46 participants, 32 (70%) indicated that uniprofessional PAL was offered, 2 (4%) indicated that interprofessional PAL was offered, and 12 (26%) indicated that both forms of PAL were offered. Peer tutoring was the most common format in both cases (73% for uniprofessional and 64% for interprofessional PAL), and mandatory interventions were mostly used to prepare the tutors. These interventions were held by educators or lecturers and were offered mostly face-to-face as workshops or as discussions. Deepening the tutors' social competencies through training was given high relevance. Regarding content, focus was placed on communication, (self-)reflection, and group management. Eighty-eight participants expressed recommendations for future directions in terms of preparing tutors for interprofessional PAL. Minor differences between the use of uniprofessional and interprofessional PAL and tutor training were found. Nevertheless, implementation strategies varied. In future, preparatory measures for tutors should be more uniformly designed and geared to the specific requirements of uniprofessional and interprofessional learning, and that at best on an empirical basis.

Peer mentoring in nursing education: A concept analysis

AIM

This peer-mentoring concept analysis aimed to explore and define the concept of peer mentoring in nursing education and the impact it may have on nursing education.

BACKGROUND

A lack of literature exists explicitly defining peer mentoring in nursing education. The interchangeable use of processes, terms, and applications may contribute to the lack of consistency and obscurity of nursing education scholarship on peer mentoring. Since peer mentoring can be used to enhance student success, there is a need to clarify the concept of peer mentoring in nursing education for accuracy in future nursing education research.

DESIGN/REVIEW METHOD

Using Walker and Avant's framework, the authors identified defining attributes, antecedents, and consequences of peer mentoring.

DATA SOURCE

The literature search involved a combination of terms in the MEDLINE with Full Text, Academic Search Complete, Humanities International, ERIC, CINAHL, Health Source: Nursing/Academic Edition, and Consumer Health Complete-EBSCOhost databases.

RESULTS

This concept analysis revealed a consistent definition of peer mentoring for use in nursing education. The definition of peer mentoring in nursing education is a formal learning partnership between two individuals (mentor and mentee) with differing levels of nursing school experience. The peer mentor promotes a positive academic and emotionally supportive environment, decreasing stress and increasing the mentee's confidence and competency.

CONCLUSION

A shared definition and understanding of peer mentoring within nursing education can contribute to the consistent use of the concept in research and advance the scholarship of nursing education.

A peer learning intervention in workplace introduction - managers' and new graduates' perspectives

Background

Evaluation of a complex intervention are often described as being diminished by difficulties regarding acceptability, compliance, delivery of the intervention, recruitment and retention. Research of peer learning for nursing students have found several positive benefits while studies of peer learning for newly graduated nurses are lacking. This study aimed (1) to investigate the study process in terms of (a) first-line managers’ perspectives on the intervention study, the difficulties they face and how they handle these and (b) new graduates’ fidelity to the intervention and (2) to examine the effect of the peer learning intervention in workplace introduction for newly graduated nurses.

Methods

A mixed-methods approach using semi-structured interviews with eight managers, repeated checklist for fidelity and questionnaires conducted with 35 new graduates from June 2015 and January 2018, whereof 21 in the intervention group. The peer learning intervention’s central elements included pairs of new graduates starting their workplace introduction at the same time, working the same shift and sharing responsibility for a group of patients for 3 weeks. The intervention also included 3 months of regular peer reflection.

Results

Managers offered mostly positive descriptions of using peer learning during workplace introduction. The intervention fidelity was generally good. Because of recruitment problems and thereby small sample size, it was difficult to draw conclusions about peer learning effects and, thus, the study hypothesis could either be accepted or rejected. Thereby, the study should be regarded as a pilot.

Conclusions

The present study found positive experiences of, from managers, and fidelity to the peer learning intervention; regarding the experimental design, there were lessons learned.

Trial registration

Before starting data collection, a trial registration was registered at (Trial ID ISRCTN14737280).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00791-0.

How pre-registration nursing students acquire delegation skills: A systematic literature review

AIM

To discover what is known about how nursing students acquire delegation skills.

DESIGN

A systematic search was conducted utilising databases: CINAHL, AMED, MedLine, PsycINFO, Web of Science, PsychArticles, PubMed Central and Science Direct. The objectives were to: conduct a systematic literature review of the available literature on how nursing students acquire delegation skills; to identify factors that promote synthesis of delegation skills into clinical practice and understand how students learn these skills; and to identify any gaps in the literature.

RESULTS

Fifteen papers, which use a range of methodologies, were included in the review. The author identified that acquiring delegation skills is an ongoing process and cannot be fully learnt during a single intervention. Furthermore that there are multiple factors that may promote the acquisition of this skill. These include simulation, clinical practice and theoretical curriculum. Delegation links to other skills such as critical thinking, decision making, prioritisation and communication.

CONCLUSION

Delegation should not be considered in isolation to these underpinning skills. Furthermore, it is evident that delegation is an often-misunderstood concept and something that newly qualified nurses feel unprepared for. It is therefore vital that preregistration nursing education (as well as other pre- and post-qualification training) incorporate the development of this essential skill.

An observation of the peer-assisted learning (PAL) method in the clinical teaching of vertigo/dizziness-related diseases for standardized residency training (SRT) students in China: a randomized, controlled, multicenter study

BACKGROUND

Vertigo and dizziness (VD) are among the most frequently seen symptoms in clinics and are important for medical students, especially for those in Chinese standardized residency training (SRT). The aim of our study was to examine the PAL method's feasibility in the clinical teaching of VD-related diseases for SRT students in China.

METHODS

This is a randomized, controlled, multicenter study. A total of 228 residents were invited to participate in this study, of which 198 completed the program. The students were randomized into two groups, and VD-related diseases were taught using lecture-based learning (control group) or peer-assisted learning (PAL). An examination paper and a rating scale were used to evaluate students' performance in the mastery of VD-related theoretical knowledge and clinical skills, meanwhile students' perceptions, satisfaction, and risk of burnout were also analyzed using a questionnaire. Independent-samples t-test and chi-square analysis were performed to evaluate statistical significance for continuous variables and categorical variables, respectively, using SPSS 18.0 software.

RESULTS

The PAL group performed better in mastering theoretical knowledge and clinical skills than the control group. And more students believed that PAL could help improve their personal qualities such as teamwork skills. However, more students reported that PAL increased the risk of burnout.

CONCLUSIONS

PAL was a suitable and effective method in the clinical teaching of some specialized diseases, especially it was recommended for students who had gained initial knowledge and skills, such as Chinese SRT students. However, we should draw attention to the increased risk of burnout if PAL is intended to be widely used in clinical teaching.

TRIAL REGISTRATION

ISRCTN registry, ISRCTN53773239 , 05/07/2021, retrospectively registered.

Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study

AIM

The aim of the present study was to elucidate health-promoting and -impeding aspects of peer-learning by examining nursing students' descriptions of learning together as peers, and how this might interact with their health.

BACKGROUND

Peer-learning is a useful strategy for teaching and learning in nursing students' clinical practice education. In the research, benefits such as improved cooperation and increased self-confidence have been described and labelled as health-promoting.

DESIGN

A qualitative descriptive approach METHOD: Thirteen first-year nursing students aged 22-45 years, who had completed their first clinical practice education on a medical or surgical hospital ward, participated in one-on-one semi-structured interviews. The interviews were analyzed using qualitative content analysis.

RESULT

Working as a pair was primarily described as positive, as the peers felt basic support from each other, even though they described negative experiences that limited their own development and challenged their patience.

CONCLUSION

Peer-learning as a model for supervision in clinical practice incorporates valuable health-promoting aspects, as the students felt safe, supported, increased self-confidence, and participation. The interaction between peers helped them grow as human beings, and the mutual support the peers felt was a vital health-promoting aspect that limited the impact of the described health-impeding aspects, which included sometimes finding peer-learning trying, stressful and irritating.

Examination of nursing students' anxiety levels related to clinical practice with respect to peer support

PURPOSE

To investigate the relationship between stress and anxiety levels of nursing students at during their first clinical practice.

DESIGN AND METHODS

Designed as a quasi-experimental study with a study group (n = 13) and a control group (n = 13) among nursing students at a university.

FINDINGS

Students who practiced in the clinic for the first time experienced stress and anxiety, and their stress levels increased with high levels of state anxiety. The stress and anxiety decreased using peer support of the study group there was no change in the control group.

IMPLICATIONS FOR NURSING PRACTICE

It is recommended that nursing students who enter clinical practice for the first time use peer support to reduce stress and anxiety in clinical practice.

Preparing ABSN students for early entry and success in the clinical setting: flipping both class and skills lab with the Socratic Method

OBJECTIVES

Accelerated Second Degree BSN (ABSN) students have limited time to gain expertise. Reaching competency in skills takes weeks, delaying the application and mastery of skills in clinical practice. Our objective is to describe how our ABSN program fundamentals of nursing course enhances learning effectiveness and prepares students for successful entry into nursing.

METHODS

Using the Socratic Method and flipping the classroom and skills lab, with deliberate practice techniques, ABSN students quickly gain competence in core aspects of nursing. Rapid acquisition of competence early in the program allows for a meaningful clinical experience.

RESULTS

NCLEX pass rates for our ABSN graduates averaged 93.84% over the past 4 years, and students report high levels of satisfaction with the program.

CONCLUSIONS

Using the Socratic Method in a flipped classroom and skills lab provides an environment that engages students, fosters NCLEX success, and supports development of clinical judgment critical for positive patient outcomes.

Peer learning and collaborative placement models in health care: a systematic review and qualitative synthesis of the literature

AIMS

To summarise the international empirical literature to provide a comprehensive overview of peer learning and collaborative practice placement models in health care and to synthesise their benefits and challenges.

BACKGROUND

Practical placements for students are in high demand due to the need for an increased nursing, midwifery and health professional workforce, thus collaborative placement models are an attractive solution to potentially increase placement capacity and enhance the student learning experience.

DESIGN

A systematic search of the literature and qualitative data synthesis using the PRISMA checklist and ENTREQ guidelines.

REVIEW METHODS

MEDLINE and CINAHL searched in March 2020. Quality appraisal of studies conducted. Collaborative models and empirical findings summarised. Reported benefits, challenges and implementation recommendations synthesised. Two tables developed for data representation.

RESULTS

172 studies were identified by the search strategy. Of these, 47 articles were included for appraisal and synthesis. 30 articles employed qualitative, seven quantitative and ten mixed-methods approaches. Research took place in eight countries. The majority of studies employed focus groups, interviews as well as questionnaire design. The total participant sample was 3462 consisting of students and educators.

CONCLUSIONS

This review confirmed that any peer learning is beneficial in supporting students' confidence and team working skills. It is especially helpful when pairing first year with third-year students. The latter can demonstrate their clinical skills and prepare for working in practice. Simultaneously, expert-led learning is important for role modelling and for the recognition of acquired skills. Evidence on the optimal placement experience is inconclusive; however, it can be concluded that any form of collaborative placement model requires careful planning and continuous preparation for staff and students.

RELEVANCE TO CLINICAL PRACTICE

Decision makers should consider implementing at least some form of peer learning to assist students with peer support, and ideally work towards a collaborative learning environment.

Midwifery students' perceptions and experiences of learning in clinical practice: a qualitative review protocol

OBJECTIVE

This systematic review aims to investigate and synthesize qualitative evidence related to midwifery students' perceptions and experiences of learning in clinical practice.

INTRODUCTION

Midwifery students are required to develop strong competencies during pre-registration education for future practice. Clinical placements provide a good opportunity for students to build essential practice capacities. Understanding the perceptions and experiences of midwifery students in clinical practice helps develop effective midwifery clinical educational strategies. A qualitative systematic review is therefore proposed to improve midwifery clinical education.

INCLUSION CRITERIA

This proposed review will consider qualitative studies that have explored midwifery students' perceptions and experiences of learning in clinical practice in all degrees. The search will be limited to English-language published and unpublished studies to the present.

METHODS

This review will follow the JBI approach for qualitative systematic reviews. A three-stage search will be conducted to include published and unpublished literature. Databases to be searched include PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, American Nurses Association, Google Scholar, ProQuest Dissertation & Theses, and Index to Theses in Great Britain and Ireland. Identified studies will be screened for inclusion in the review by two independent reviewers. Any disagreements will be resolved through discussion. Data will be extracted using a standardized tool. Data synthesis will adhere to the meta-aggregative approach to categorize findings. The categories will be synthesized into a set of findings that can be used to inform midwifery education.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020208189.

Enhancing students learning experiences in nursing programmes: An integrated review

Nursing as a profession is both fragmented and complex. The education setting is demanding, and prepared students are more clinically and academically robust. Therefore, nursing programmes should implement high-quality teaching based on the best available scientific evidence to improve learning quality and students' experience. This study aimed to identify the teaching tools used to enhance students' perceived experiences in undergraduate nursing programmes. Nine databases were systematically searched to identify quantitative and qualitative studies regarding the teaching tools utilised across nursing education programmes. Results were summarised following a systematic integrated review framework. The searches identified 15,886 citations, and after title/abstract/full-text screening, 66 primary research studies were included comprising data from 4,411 participants with a mean sample size of 66 (range 6-447). Educators utilising a student-centred wrapping approach exploiting knowledge building and self-development were found to improve students' experiences; however, consensus on success factors was lacking. The findings indicate that educators' knowledge and pedagogical skills used in a flexible way, tailored and sensible to students and the learning context, enhance student experiences. Nursing educators should identify learning situations that make students vulnerable and pay particular attention to the students' learning experiences. We identified several tools accommodating the students' experience.

Nursing student-patient relationship - a 10-year comparison study in Finland

Objective This study aimed to describe and compare the group-level findings from 2005-2006 and 2015-2016 regarding students' and patients' views of the nursing student-patient relationship and associated factors. Methods The data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically. Results In both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship. Conclusion In order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.

Strategies to optimize implementation of novel preceptorship models: Peer-assisted learning and near-peer teaching

INTRODUCTION

Hospital experiential placements have traditionally used a 1:1 (student to preceptor) ratio. Two models, peer-assisted learning (PAL) and near-peer teaching (NPT), have been described in the literature for education of health professions. This research explored the use of PAL and NPT, as well as advantages, challenges, and strategies to address challenges for implementation.

METHODS

This study used an anonymous survey to solicit feedback from staff pharmacists and pharmacy leaders about their use of PAL and NPT models in hospital settings in Alberta, Canada. Using closed and open-ended questions, experience with each model and implementation considerations were explored.

RESULTS

The survey was completed by 115 hospital pharmacists (11% response rate). PAL and NPT were utilized by 25% and 8% of respondents, respectively, and 10% had experience with both models. Advantages of these models include promoting teamwork and clinical independence, learners supporting each other, and fostering active learning. The highest ranked challenges were space/technology/computer access limitations and additional time to complete learner assessments. Many strategies were provided to address challenges, and facilitate implementation and utilization.

CONCLUSION

In the hospital setting, pharmacists used PAL more commonly than NPT. Feedback from pharmacists and leaders affirmed the advantages and challenges associated with use of these precepting models. Strategies to facilitate and optimize use were provided, which will guide faculty, pharmacy leaders, and preceptors in efforts to support implementation to increase capacity and expand the practice of precepting.

'Thinking like a nurse'. Changing the culture of nursing students' clinical learning: Implementing collaborative learning in practice

This article reports a study evaluating the implementation of Collaborative Learning in Practice models at a university School of Nursing and Midwifery with practice partners across the South West of England. We conducted four focus group interviews with 40 students with experience of Collaborative Learning in Practice placements, and two focus groups with eight clinical practice staff with responsibility for implementing and supporting such models in their areas. Data were transcribed and analysed using the Framework Method. Key themes were 'Real time' Practice of Collaborative Learning Implementation, Collaborative Learning as Preparation for Registrant Practice, and the Student/Mentor Relationship. We conclude that Collaborative Learning in Practice utilising models of coaching and peer support, offers benefits to students who are exposed to the reality of nursing practice from the beginning of their placement experiences, enabling them greater responsibility and peer support than under normal mentoring arrangements. Furthermore, there are benefits to the registrants because the burdens of supervising students are spread more widely. This is timely given the review of Nursing and Midwifery Council standards for programmes and student support and the need to increase placement capacity as a response to global nursing shortages.

Using meta-ethnography to develop a conceptual model of peer-assisted learning of nursing students in clinical practice

AIM

The study presents the findings of a meta-ethnographic study, developing a conceptual model for peer-assisted learning for undergraduate nurses in clinical practice.

DESIGN

Qualitative meta-ethnography.

METHODS

Meta-ethnography was used to synthesize the findings of two ethnographic studies and a qualitative review related to the influence of peer-assisted learning on student nurses in clinical practice.

RESULTS

Four key themes were identified underpinned by six sub-themes: (a) "Social" whereby "connecting with peers" is an important part in peer-assisted learning. (b) "Enabling" peers through "collaborative support for advice and guidance" and "reducing anxiety/increasing confidence." (c) "Organizational" aspects in peer-assisted learning in "establishing structure and navigating practice" and "establishing the role of the PAL." (d) "Learning" as a product of developing knowledge and skills through "sharing of practice experience" and "enhancing knowledge of care." The conceptual model presents a structure outlining elements required for developing effective knowledge and skills through peer-assisted learning.