Developing intersubjectivity and teamwork skills through learning circles on clinical placement: A mixed methods study

AIM

To determine the efficacy of learning circles on developing intersubjectivity and teamwork skills and determine barriers to and facilitators of, learning circles as a learning tool.

BACKGROUND

Teamwork skills are vital for safe, effective nursing care and are dependent on individual team members' shared understandings or intersubjectivity. Work-based learning circles offer a potential pedagogic strategy to promote teamwork.

METHODS

In work-based learning circles conducted in 2018, students drew a concept map based on a clinical case and discussed an element of it with the group. Using a convergent parallel mixed methods design, a cross-sectional survey of students using a student clinical experience questionnaire and a qualitative descriptive approach for interviews with clinical facilitators was conducted.

RESULTS

Overall, 128 Bachelor of Nursing students (88.9% response) completed the survey and five facilitators (50%) attended group interviews. Students agreed that core teamwork skills were developed during their placement and clinical facilitators reported (1) student engagement in the learning circle processes; (2) learning much about students' abilities; and (3) developing subtle teaching skills to enhance discussion. Sharing experiences from different wards and clinical experiences was a platform for developing intersubjectivity.

CONCLUSIONS

To promote intra-professional teamwork skills, conducting learning circles with students from different disciplines may further enhance intersubjectivity and is an area for further research.

Learning through structured peer discussion: An observational study

BACKGROUND

Clinical experiences are an essential foundation of nursing education. While there have been many significant investigations into models of clinical education and student learning, how students 'make sense' of their experiences is less well investigated. Senior nursing staff in a tertiary health service partnered with nurse researchers to explore how students can learn more about practice through structured discussions with peers to promote shared understandings.

OBJECTIVES

The study aimed to evaluate the contributions to student learning from structured peer discussions about patient care.

DESIGN

Exploratory observational study of the effects of learning circle discussions on individual understanding of patient care.

SETTING

A metropolitan health service in southeast Queensland, Australia.

PARTICIPANTS

72 Bachelor of Nursing students in Years 2 and 3.

METHODS

Students developed concept maps about patient care prior to peer discussions, and subsequently added further concepts (in another colour of text) after those discussions. Researchers' review of student generated concept maps and coded concepts indicated a five a priori ways of knowing categories: empirical, aesthetic, ethical, personal and socio-political. Descriptive analysis of categories was then conducted.

RESULTS

Empirical knowing was high in both groups, with more concepts included in Year 3 student maps. Aesthetic knowing was relatively high in both groups. Socio-political knowing was lower than anticipated overall. Personal and ethical forms of knowing were rarely included on the concept maps.

CONCLUSIONS

While clinical placement is valued for developing empirical and aesthetic forms of knowing, the other forms of knowing have value for patient and family care and warrant strategies to improve their further development. Developing strategies to support student learning of ethical and personal forms of knowing deserves further investigation.

The "five senses of success" in nursing students: Assessing first-year support engagement

Objectives

This study aimed to identify School and University support services available and accessed by nursing students transitioning into a university environment as many struggle to adjust to competing demands of personal commitments and expectations at university.

Methods

A mixed methods design was used, based on activity theory and Lizzio's Five Senses of Success frameworks as exploratory guides. This study was conducted amongst the first year cohort at one campus of the Bachelor of Nursing (BN) program in Queensland, Australia. An initial baseline assessment of what University and School-based support services were on offer for students, and how the students interacted with the support services was conducted. This was followed by a survey to identify awareness and access to support services. Focus groups were then conducted to clarify the previous results and to determine engagement with these support services.

Results

A randomly selected number of students (n = 150) in the first-year 2014 cohort of the BN program (n = 300) were included in this study. The survey was completed by 54 students and three semi-structured focus groups were conducted. The analysis indicated that the support services in place were successful in reaching the majority of students and contributed to their sense of success at university. Specifically students identified that a whole cohort approach to support enhanced their transition to university.

Conclusion

Identifying lesser known services early in the first year will ensure that students are supported and encouraged to use all services, contributing to their sense of success at university.

Simulation videos presented in a blended learning platform to improve Australian nursing students' knowledge of family assessment

The provision of simulation to enhance learning is becoming common practice as clinical placement becomes harder to secure within Bachelor of Nursing programs. The use of simulation videos within a blended learning platform enables students to view best practice and provides relevant links between theory and practice. Four simulation videos depicting family assessment viewed by a cohort of Australian undergraduate nursing students were evaluated. These videos were professionally developed using actors and experienced family nurses. Surveys were used to explore the students' self-assessed knowledge, confidence and learning preferences before and after exposure to blended learning resources. Students' engagement with the simulated videos was captured via the Learning Management System. Time 1 survey was completed by 163 students and Time 2 by 91 students. There was a significant increase in students' perceived knowledge of family theory Item 1 from a mean 4.13 (SD = 1.04) at Time 1 to 4.74 (SD = 0.89) (Z = -4.54 p < 0.001) at Time 2; Item 2- Knowledge of family assessment improved from mean 3.91 (SD = 1.02) at Time 1 to 4.90 (SD = 0.67) (Z = -7.86 p < 0.001) at Time 2. Also a significant increase in their confidence undertaking family assessment Item 5 from a mean 3.55 (SD = 1.14) at Time 1 to 4.44 (SD = 0.85) (Z = -6.12 p < 0.001) at Time 2. The students watched the videos an average of 1.9 times. The simulated videos as a blended learning resource increases the students' understanding of family assessment and is worth incorporating into future development of courses.

Investigation of blended learning video resources to teach health students clinical skills: An integrative review

OBJECTIVES

The aim of this review is to inform future educational strategies by synthesising research related to blended learning resources using simulation videos to teach clinical skills for health students.

DESIGN

An integrative review methodology was used to allow for the combination of diverse research methods to better understand the research topic. This review was guided by the framework described by Whittemore and Knafl (2005), DATA SOURCES: Systematic search of the following databases was conducted in consultation with a librarian using the following databases: SCOPUS, MEDLINE, COCHRANE, PsycINFO databases. Keywords and MeSH terms: clinical skills, nursing, health, student, blended learning, video, simulation and teaching.

REVIEW METHODS

Data extracted from the studies included author, year, aims, design, sample, skill taught, outcome measures and findings. After screening the articles, extracting project data and completing summary tables, critical appraisal of the projects was completed using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Ten articles met all the inclusion criteria and were included in this review. The MMAT scores varied from 50% to 100%. Thematic analysis was undertaken and we identified the following three themes: linking theory to practice, autonomy of learning and challenges of developing a blended learning model. Blended learning allowed for different student learning styles, repeated viewing, and enabled links between theory and practice. The video presentation needed to be realistic and culturally appropriate and this required both time and resources to create.

CONCLUSIONS

A blended learning model, which incorporates video-assisted online resources, may be a useful tool to teach clinical skills to students of health including nursing. Blended learning not only increases students' knowledge and skills, but is often preferred by students due to its flexibility.