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

Factors influencing nursing student satisfaction in aged care placements: An Australian cross-sectional study

AIM

This study aimed to investigate factors influencing nursing students' satisfaction with aged care placements.

BACKGROUND

Providing positive clinical experiences in aged care is crucial for students to learn safe, quality care and to foster a sustainable workforce.

DESIGN

Cross-sectional study METHODS: Nursing students in nursing degrees participated in the national placement evaluation survey. A total of 2378 responses were extracted from the national clinical placement evaluation survey in 2023. Using multinomial logistic regression, demographics, academic, placement characteristics and placement education quality (clinical environment and learning support) were investigated in relation to three different levels of students' overall satisfaction (low, moderate, high).

RESULTS

Students reported overall satisfaction with their clinical placement, with a mean score of 7.9 (SD=2.1) on a 10-point scale. While most students agreed that they had achieved their learning objectives (90.0 %), they reported limited opportunities to interact with the multidisciplinary team (80.0 %). Further, students reported a relatively negative experience with staff, such as willingness to work with students (78.9 %) and being positive role models (78.9 %). Comparing the low satisfaction group to the moderate satisfaction group, male gender, identifying as an indigenous student and higher academic years increased the odds of being 'least satisfied', whereas international students, whose first language was not English and those with higher perceived placement education quality scores had lower odds of low satisfaction group membership. Conversely, compared with the moderate satisfaction group, those with the highest satisfaction with their clinical placement had a greater odds of being older, an international student and having higher scores in placement quality for the clinical environment and learning support. This model predicted 58.7 % of students' overall satisfaction.

CONCLUSIONS

Positive learning experiences in aged care may promote the importance of practice in this area to new graduates. Despite students' overall positive satisfaction with aged care placements, it is clear there are areas to address: a need to develop a structured approach to enhance aged care clinical experiences, progressive development of learning objectives, enhancing student career preparation and increasing participation in interprofessional collaboration may be useful approaches.

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.

Supporting the nurse educator in clinical education - a qualitative evaluation of a digital educational resource DigiVIS

BACKGROUND

Despite the increased use of technology for teaching and learning in clinical nursing education, relatively little attention seems to be directed toward the usefulness of digital educational resources (DERs) to support nurse educators' educational role in clinical nursing education.

METHODS

An interpretive descriptive qualitative study design was conducted to evaluate the usefulness of a DER to support nurse educators in clinical nursing education. Data were collected through two focus group interviews with part-time and novice educators (n = 5) and full-time, more experienced educators (n = 5), after they had overseen student nurses in nursing home placements. Data were analyzed using thematic analysis and Standards for Reporting Qualitative Research guidelines were used for this study.

FINDINGS

The analysis identified three themes related to nurse educators' experiences of the usefulness of a DER to support their educational role while overseeing first-year students on clinical placements in nursing homes: (1) Provides academic support and a sense of security (2) promotes pedagogical efficacy, and (3) represents a flexible resource for educational planning.

CONCLUSION

This study shows that a digital educational resource can be an efficient and useful supplementary strategy to support the nurse educator's role in clinical nursing education. Future research is required to systematize knowledge about the impact of DERs on orientation and training, as well as motivation and facilitators for, and barriers to, their use to enhance quality and strengthen the nurse educator's role in clinical nursing education.

Using Cultural Lens Theory to Investigate the Impact of a Nursing Education Practicum in Aged Healthcare: Aotearoa New Zealand's Bi-cultural Framework

Aim

The aim of this paper is to apply Cultural Lens Approach theory to data collected from third year nursing students related to an assignment undertaken during their month-long practicum placement in an aged residential care facility. We explore the extent to which a national vision of bi-culturalism and inclusivity is evident in students’ quality improvement project topic selection and practice.

Background

Aotearoa New Zealand is a nation of dual heritage, informed by the cultures of Māori as the indigenous tangata whenua (people of the land), and Pākehā, (European) settlers. All public sectors, including all higher education providers and the curricula they deliver, are required to incorporate and promote a contemporary, bi-cultural world-view.

Methods

Stage one of the research reported in this paper involved a) document analysis of 93 students’ quality improvement project reports; b) focus groups with 18 students; and c) an online questionnaire for 16 key stakeholders including aged care managers, clinical nurse leaders and student nurse educators. Stage two reviewed the above data through a five-step Cultural Lens Approach process to identify cultural biases and assumptions.

Results

Qualitative analysis revealed students’ increased professional confidence, improving communication and critical thinking skills. Responses as to development of cultural competence and cultural safety were mixed: a key barrier identified was that staff in the placement setting received minimal professional development to ensure appropriate tikanga (customary protocols and practice) for Māori residents was in place.

Conclusion

Viewed through a cultural lens, a westernized concept of aged healthcare provision continues to prevail in most settings. Nursing students noted gaps between cultural learning and practice.

Integrating simulation training during clinical practice in nursing homes: an experimental study of nursing students' knowledge acquisition, self-efficacy and learning needs

BACKGROUND

Limited access to supervision, feedback and quality learning experiences pose challenges to learning in the clinical setting for first-year nursing students who are beginning their clinical experiences. Prior studies have indicated that simulation training, as a partial replacement of clinical practice hours, may improve learning. However, there has been little research on simulation training integrated as a partial replacement during first-year students' clinical practice in nursing homes. The primary aim of this study was to examine first-year nursing students' knowledge acquisition and self-efficacy in integrating a partial replacement of clinical hours in nursing homes with simulation training. Its secondary aim was to examine perceptions of how learning needs were met in the simulated environment compared with the clinical environment.

DESIGN

The primary aim was addressed using an experimental design that included pre- and post-tests. The secondary aim was investigated using a descriptive survey-based comparison.

METHODS

First-year students at a Norwegian university college (n = 116) were asked to participate. Those who agreed (n = 103) were randomly assigned to the intervention group (n = 52) or the control group (n = 51). A knowledge test, the General Self-efficacy Scale and the Clinical Learning Environment Comparison Survey were used to measure students' outcomes and perceptions. The data were analysed using independent samples t-tests, chi-square tests and paired samples t-tests.

RESULTS

Knowledge scores from pre- to post-tests were significantly higher in the intervention group than in the control group with a medium to large effect size (p < 0.01, Hedges' g = 0.6). No significant differences in self-efficacy were identified. Significant differences (p <  0.05) were observed between the simulated and the clinical environment with regard to meeting learning needs; effect sizes ranged from small and medium to large (Cohen's d from 0.3 to 1.0).

CONCLUSION

Integrating the partial replacement of clinical hours in nursing homes with simulation training for first-year nursing students was positively associated with knowledge acquisition and meeting learning needs. These findings are promising with regard to simulation as a viable partial replacement for traditional clinical practice in nursing homes to improve learning.