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.

Systematic Review on Characteristics and Effects of Leadership Development Interventions for Nursing Students

BACKGROUND

Effective nursing leadership improves health care quality, patient well-being, and nursing staff outcomes. Newly graduated nurses face challenges in transitioning into leadership roles. Thus, examining the leadership development interventions for nursing students is critical.

PURPOSE

This systematic review examined the characteristics and effectiveness of leadership development interventions designed for and implemented with undergraduate nursing students.

METHODS

A comprehensive search covered Scopus, CINAHL Ultimate, ScienceDirect, MEDLINE, WOS Core Collection, Journals@Ovid, JSTOR Journals, and ERIC databases. Included studies were assessed using the Mixed Methods Appraisal Tool.

RESULTS

The final review comprised 19 studies showcasing positive impacts on leadership development. The interventions varied in leadership approach, design and content, structure, qualifications, student involvement, and outcomes.

CONCLUSIONS

Leadership development interventions are effective in enhancing nursing students' leadership. Nevertheless, future interventions should prioritize well-structured content, and studies must incorporate robust methodologies.

Enhancing perceived leadership of nursing students through a student-led dedicated education unit in a community setting: A feasibility study

BACKGROUND

Leadership competence is important to ensure the provision of safe and high-quality care in hospitals.

PURPOSE

The aim was to demonstrate the feasibility of enhancing the perceived leadership competence of nursing students through an innovative health education strategy, consisting of a student-led dedicated education unit (DEU) informed by a service-learning approach in a community setting.

DESIGN

Feasibility study in a three-phase process: I: Design; II: Acceptability and implementation; III: Expansion to a different setting. In phase II the DEU was piloted with 62 students using a pretest/post-test with control group design. In phase III it was piloted with 20 students in the expansion setting.

METHODS

The DEU was implemented and tested in Barcelona (Spain) between 2014 and 2019. To assess acceptability and implementation, students' perceived leadership competence was measured using the Self-Assessment Leadership Instrument. We also obtained satisfaction ratings using an ad hoc questionnaire.

RESULTS

Satisfaction was high among students, as well as among service users who received health education. In phase II, students' post-test self-ratings of their leadership competence were higher in both the intervention and control groups, but the increase was significantly greater among students who participated in the DEU (25.84 % vs. 16.72 %, p = .012). Similar results were obtained in the expansion phase, with students in the intervention group once again showing a significant increase in perceived leadership skills (12.89 %, p = .005).

CONCLUSIONS

Student-led DEUs appear to be an effective way of enhancing perceived leadership competence among senior nursing students.

Characteristics and processes of the dedicated education unit practice education model for undergraduate nursing students: a scoping review

OBJECTIVE

The objective was to review literature related to the dedicated education unit practice education model for undergraduate nursing students, and identify common characteristics and processes for implementing and sustaining this model.

INTRODUCTION

Although practice education is central to undergraduate nursing education, evidence-informed practices for learning in the clinical setting remain elusive. Changes to health care over the past decades related to the role and scope of practice for nurses, gradual shifts to community- and population-based care delivery, and expectations for interprofessional practice require forward-looking education models. The dedicated education unit model was developed in 1997 as a potential solution to globally recognized challenges in nursing education amidst discourses of nursing resource scarcity. Despite more than two decades of innovation and expansion, there is still limited understanding of the effectiveness of the dedicated education unit as a solution to those challenges, or for the anticipated benefits for students and patients, through enhanced evidence-informed health care. This analysis of the characteristics and processes of the model is timely for evaluating and sustaining implementation of the dedicated education unit across nursing practice and education settings.

INCLUSION CRITERIA

English-only publications related to the dedicated education unit practice education model for undergraduate nursing students in baccalaureate and associate degree programs using qualitative, quantitative, or mixed methods research, and quality improvement, program evaluation, and opinion publications were included.

METHODS

Using selected keywords including "dedicated education unit," we searched CINAHL, Google Scholar, MEDLINE, Academic Premier Search, ERIC, Cochrane Database of Systematic Reviews, JBI EBP Database, and ProQuest Dissertations and Theses. Two independent reviewers screened titles and abstracts against inclusion criteria. We reviewed reference lists for gray literature and additional references. Data were extracted from the included articles and categorized for characteristics and processes. Eighty-two publications from January 1997 to May 2020 were included. The findings were presented descriptively with tables and figures to support the data.

RESULTS

Dedicated education unit models were based on five characteristics and four processes. Characteristics of the dedicated education unit model included effective academic-practice partnership, adaptability to diverse contexts, unit culture of educational excellence, responsive and supportive unit leadership, and clarity of roles and responsibilities. Processes included building nurse and faculty capacity, facilitating student learning, communicating regularly at systems and unit levels, and evaluating and sustaining the model.

CONCLUSIONS

Evidence demonstrated that the dedicated education unit practice education model is well-established. However, there were existing gaps in this evidence, specifically evaluation and economic analyses. There was also limited attention to long-term sustainability of the model. The common characteristics and processes identified in this review may be used to support planning, implementation, and evaluation, including development and validation of evaluation tools. Although administrative infrastructure was noted as central to the dedicated education unit strategy, it was rarely acknowledged as part of management and thus also requires further study.

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.

Fostering leadership competence and satisfaction in nursing undergraduates through a student-led conference: A quasi-experimental pre-post study

BACKGROUND

Numerous benefits have been reported for student-led conferences, such as increased leadership. This competence has been recognized as important for nurses so as to ensure the provision of safe and high-quality care in complex environments. However, research has yet to examine empirically the impact of student-led conferences on students' leadership behaviours.

OBJECTIVES

To examine the impact that participation in a student-led conference had on the self-perceived leadership competence of nursing undergraduates.

DESIGN

Quasi-experimental single group pre-post intervention study.

SETTING

Faculty of Medicine and Health Sciences at the Universitat Internacional de Catalunya.

PARTICIPANTS

31 students enrolled in two elective modules offered during the final year (fourth year) of a nursing degree programme.

METHODS

Pre-post assessment of self-perceived leadership behaviours among nursing students involved in planning and organizing a scientific conference. In addition to carrying out the tasks of organizing the Conference, all students participated as co-authors of an oral communication, thus being able to develop both cognitive and non-cognitive domains. Leadership was measured using ES_SALI scale, the Spanish version of the Self-Assessment Leadership Instrument.

RESULTS

Involvement in the student-led conference led to a statistically significant increase in self-perceived leadership competence among nursing undergraduates (p < .001). Both the total ES_SALI score and scores on each of its four dimensions (Strategic thinking, Emotional intelligence, Impact and influence, and Teamwork skills) increased significantly, and the percentage change was above 8% in all cases (p < .01). The greatest increase (10.99%) corresponded to the 'Impact and influence' dimension of leadership.

CONCLUSIONS

The results suggest that student-led conferences are an effective way of helping nursing undergraduates to develop their leadership competence.

Undergraduate nursing student and preceptors' experiences of clinical placement through an innovative clinical school supervision model

This study explores final year undergraduate nursing and midwifery students and their preceptors' experiences of a newly introduced Clinical School Supervision (CSS) model, which was implemented to reduce a perceived disconnect between theory and practice. A descriptive design was used with qualitative data collected through open-ended survey questions. Respondents included 43 undergraduate nursing and midwifery students involved in the final year and 13 clinical preceptors from a large metropolitan tertiary health service in Victoria, Australia. Qualitative data were analysed using thematic analysis. Students described the CSS as a favoured supervision model with students being able to take advantage of support from both the academic supervisor and nursing staff in the clinical setting, a model which also supported student's sense of belonging. Students experiences indicated the CSS model facilitated consolidation of knowledge, reflective practice and transition to graduate nursing. The preceptors described a commitment to and preparedness for the role, although they found they had little break from teaching and their rosters did not always align with their students'. Preceptors also shared experiences of unfulfilled expectations, lack of recognition and incentives for supervising students. Further studies are needed to identify effective ways to support preceptors in their roles.

Effective academic-practice partnership models in nursing students' clinical placement: A systematic literature review

OBJECTIVES

This systematic review examines the effectiveness of academic-practice partnership models which include clinical faculty and clinical mentor roles in improving nursing students' clinical learning when compared with traditional models.

REVIEW METHODS

PubMed, CINAHL, PsycINFO and Cochrane Library were searched to locate Randomized Control Trials and quasi-experimental studies published from 1999 to 2020. The Joanna Briggs Institute critical appraisal tools were used to ensure methodological quality.

RESULTS

Fourteen studies were included in the review. The Collaborative Teaching Model and the Dedicated Education Unit model were tested in randomized controlled trials. Dedicated Education Unit, Dedicated Education Centre, Clinical Education Units, Education Partnership model, Collaborative educational-practice model and Collaborative clinical practicum model were evaluated in four experimental studies and ten quasi-experimental studies. Studies did not include patient participation, and staff and faculty had anecdotal presence.

CONCLUSION

There is limited evidence on the effectiveness of academic-practice partnership models. However, the complementary roles of clinical faculty and clinical mentor, in addition to education and health institutions managers commitment could successfully facilitate students' clinical learning.

The effectiveness of partnership models in clinical nursing education - A scoping review

OBJECTIVES

To examine the effectiveness of partnership models in clinical nursing education with regards to cost effectiveness; student employability, work-readiness, confidence, and competence; and stakeholders' satisfaction.

DESIGN

Scoping review.

DATA SOURCES

Research studies published in English were searched electronically through EbscoHost (CINAHL and ERIC), Scopus, Medline (via Ovid), ProQuest Central, and Web of Science databases. Criteria were developed to guide the selection of original studies published in English before 2019 for review.

REVIEW METHODS

Arksey and Malley's framework (2005) and relevant enhancements guided the conduct of the review. An informal appraisal of selected studies was applied.

RESULTS

Two theses and 31 articles with a variation in methodologies, methods, sample sizes, research populations and quality of evidence were included for review. Four themes were identified: (i) Description of partnership models in clinical education, (ii) length of model implementation prior to evaluation, (iii) positive qualitative findings, and (iv) quantitative findings limited by data collection periods and methods.

CONCLUSIONS

Shared among the reviewed studies is stakeholder view of the positive impacts of partnership models on the clinical learning environment, and the increased level of support and individualised instruction for students. However, the use of not fully validated survey instruments and the lack of description about the implementation period before evaluation in many reviewed studies limit the interpretation of quantifiable effect of the partnership models. This review identifies a lack of attention on student employability, work-readiness, cost evaluation, patient perspective, and partnership models in low-income countries. Future research to address these knowledge gaps using high quality data collection methods and rigorous research design is warranted.

Collaborative learning in practice: A systematic review and narrative synthesis of the research evidence in nurse education

Collaborative Learning in Practice is a model of placement learning for student nurses that is currently being implemented in the United Kingdom, apparently originating in Amsterdam. Potential benefits are reported to be increased placement capacity, reduced burdens on mentors as practice assessors, improvements in qualified nurses' job satisfaction, recruitment and retention, and better-developed preparedness for registrant practice amongst student nurses. We conducted a thorough, rigorous systematic review between October and December 2018 of the literature on Collaborative Learning in Practice to discover whether there was a research evidence base for these claims. We found nothing published in English in peer reviewed journals. We found 14 related papers, although these were about the Dedicated Education Unit concept, and we have conducted a narrative synthesis of them. Key findings support the assertions related to Collaborative Learning in Practice, albeit in different models of placement learning. Further research is necessary with Collaborative Learning in Practice stakeholders including staff and students, and regarding patient care metrics, to demonstrate benefits or otherwise and until that research takes place potential gains remain unproven.

"Feeling part of a team" a mixed method evaluation of a dedicated education unit pilot programme

The clinical learning environment is integral to the sustainability of the nursing workforce. Traditionally undergraduate nursing students were preceptored one-to-one with a registered nurse. With an increasingly complex clinical environment and more RNs working part-time, that model has become problematic. The Dedicated Education Unit (DEU) is a model of student learning whereby students are nurtured by all staff in a clinical area, clinical and academic staff collectively support the student and student learning is a collaborative process. In this study, a pilot DEU model in three clinical areas of one District Health Board in New Zealand was evaluated. These DEU are different from others reported in the literature as three unique nursing programmes from two Tertiary education providers (TEPs) in an urban area in New Zealand were involved in the pilot. The approach in this study was a mixed method descriptive evaluation design, undertaken in two phases: phase one was an online anonymous survey completed by 42 nurses and nurse managers employed in three DEUs and 24 undergraduate third year nursing students who were completing their final nine week pre-graduate placement. Phase two was six separate focus groups with registered nurses and undergraduate nursing students. Students (91%) and staff (85%) were satisfied with their participation in the DEU. Students described feeling part of the health care team and staff reported enjoying working with students from different programmes, also noting the supportive DEU structure gave them more opportunity to engage with student learning. Role clarification was an issue which needs to be resolved. Staff from three units at a District Health Board and three unique nursing programmes were able to develop learning partnerships, collaborating together to provide a positive, nurturing learning environment for nursing students and a clinical setting where nurses enjoyed their teaching/coaching roles.

Lateral Violence in Nursing: Implications and Strategies for Nurse Educators

Lateral violence among nurses persists as a prevalent problem, contributing to psychological distress, staff turnover, and attrition. Newly graduated nurses are at particular risk for being targets of lateral violence and experiencing its negative sequelae. Preparing student nurses to respond to lateral violence prior to entering the nursing may alter this scenario. A review of the literature was conducted to determine the potential for nursing faculty to change the cycle of lateral violence. Based on this review, we recommend 3 main strategies, specifically for nursing faculty, aimed at reducing incidences of lateral violence and preparing students to manage this phenomenon. First, curricular content can address integrating lateral violence content into simulation experiences and facilitating this knowledge into clinical experiences. Second, codes of conduct should guide behaviors for both students and faculty. Finally, as role models, faculty should be aware of their own behaviors, role model respectful communication, facilitate a courteous academic environment, and develop nurses capable of identifying and appropriately responding to lateral violence.