Preparing health students for interprofessional placements

Clinical education increasingly includes opportunities for interprofessional (IP) placements but few opportunities for students and supervisors to adequately prepare for such placements. The aim of this project was to further develop and evaluate an online multidisciplinary resource that was originally designed to prepare students for single-discipline placements. The revised resource aimed to prepare health students and their supervisors for IP placements. The resource was trialled in host organisations with participants from naturopathy, nursing, osteopathy and pharmacy. The resource used language that was common to all participants and comprised activities that had broad relevance such as orientating students to specific placements, developing learning plans, clarifying roles, rights and responsibilities, and clinical scenarios that raised ethical and professional issues. The effectiveness of the resource as an IP learning tool was evaluated using an E-survey, focus groups and feedback from the project team. According to participants, the resource afforded insights into what other disciplines do and opportunities for cross-disciplinary interactions, which helped break down stereotypes and misconceptions. Cross-disciplinary commonalities such as those pertaining to patient care, communication and ethics became evident. Collaborative projects involving academics, clinical supervisors and students from multiple disciplines provided an opportunity for culture change in an education organisation from single discipline to a more collaborative interdisciplinary one.     

Primary care clinical placements: The views of Australian registered nurse mentors and pre-registration nursing students (part 2)

An increased burden of chronic and complex conditions treated in the community and an aging population have exacerbated the primary care workload. Predicted nursing shortages will place further stressors on this workforce. High quality clinical placements may provide a strategic pathway to introduce and recruit new nurses to this speciality. This paper is Part 2 of a two part series reporting the findings of a mixed methods project. Part 1 reported on the qualitative study and Part 2 reports on the quantitative study. Forty-five pre-registration nursing students from a single Australian tertiary institution and 22 primary care Registered Nurse (RN) mentors who supervised student learning completed an online survey. Students largely regarded their primary care placement positively and felt this to be an appropriate learning opportunity. Most RNs were satisfied with mentoring pre-registration nursing students in their setting. Furthermore, the RNs desire to mentor students and the support of general practitioners (GPs) and consumers were seen as key enablers of pre-registration nursing placements. Findings from this study provide a preliminary impression of primary care clinical placements from the perspective of pre-registration nursing students and registered nurse mentors. Further research should examine whether a broader scope of non-traditional health settings such as non-government organisations, charities, pharmacies, welfare and social services can also provide appropriate learning environments for pre-registration nursing students.     

Developing mentorship in clinical practice: Psychometrics properties of the Mentors' Competence Instrument

Clinical placements are an important part of nursing education to developing nursing students' competencies. In enhancing clinical learning, to focus on mentors' competences is pivotal as they are the main role models and experts in guiding. This study is validated the Italian version of the Mentors' Competence Instrument. A sampling frame of 648 mentors was involved. The final sample included 291 mentors (response rate 45%). Confirmatory Factor Analysis was performed. Fit indices were also calculated to evaluate validity. The scale demonstrated optimal fit indexes and its validity was confirmed by psychometrical testing. In detail, Root Mean Square Error of Approximation is 0.058, Standardized Root Mean Residual is 0.046, Comparative Fit Index is 0.893 and Tucker-Lewis Index 0.886. Cronbach's alpha ranges from 0.77 to 0.95 among factors. This is the first validation of the scale performed in a different country from the original study. The performed psychometric testing showed that the scale is valid and reliable, as well as consistent with the theoretical structure reported for a different national context. This scale can be beneficial for comparing mentors' competencies across different clinical learning environments and could be used to build a broader model of mentors' competencies.     

多媒体教学联合CBL教学方法在皮肤病科临床教学中的应用

目的探讨基于多媒体与案例学习(Cases-Based Learning,CBL)相结合的教学方法在皮肤病科临床教学中的应用。方法选取2017年1~12月在该院皮肤科实习的护生50名为研究对象,根据随机数字表法将护生分为观察组和对照组,各25名。对照组采用传统的带教方法进行教学,观察组采用多媒体联合CBL教学方法实施教学,比较两组护生对教学效果的评价及两组护生的综合能力。结果观察组的理论考核成绩、临床实操成绩均高于对照组,差异有统计学意义(均P<0.05)。观察组的病情观察、人文关怀、临床判断、沟通技巧、组织技能、整体表现等评分均高于对照组,差异有统计学意义(均P<0.05)。结论多媒体联合CBL教学方法能有效提高皮肤科的临床教学效果,有利于护生综合能力的培养,值得临床推广应用。     

PBL在内科护理课堂教学与临床见习中综合应用的研究

目的：探讨PBL教学法综合连续应用于内科护理学课堂教学与临床见习当中与传统教学模式的教学效果差异。方法：将120名护理专科学生随机分为实验组和对照组各60名,实验组在课堂教学和临床见习期间连续采用PBL的辅助教学,对照组用传统的教学方式即讲授法。采用理论分章节阶段测试、临床综合技能评价及问卷调查的方法分析教学效果。结果：实验组学生理论考试成绩及临床综合技能评价明显高于对照组（P〈0.05）。实验组学生对PBL模式的各项教学效果评价较好,它能有效激发学生的学习动机,理论密切联系实际,提高学生课堂学习效果和临床见习能力。结论：PBL教学法连续应用于内科护理学课堂教学与临床见习当中比传统教学模式具有更突出的优势,并能在问题解决过程中培养学生的多种能力和综合素质。     

Developing an audit tool for health promotion learning opportunities in clinical placements

Education audit has proved to be an effective way of reviewing current activities and learning opportunities available to health-care students during clinical placements. Despite the importance attributed to education audit in highlighting good practice, identifying where there is a need for change as well as providing information for future planning, there is no evidence in the literature to support its specific application to health-promotion learning opportunities. This paper describes a two-part study in which an education audit tool for use in evaluating health-promotion learning opportunities for students in clinical placements was successfully developed. This tool can be utilized by multiple stakeholders in a variety of clinical settings. Following a discussion of the background literature, the methodology (which involved the development of a series of dynamic relationships between researchers, commissioners and participants) is described. The aim of this article is to discuss the lessons learned from the process of developing the tool, including the problems that were encountered and how they were addressed. The authors conclude that their experiences in developing this tool can be usefully transferred to other educational and clinical settings.     

Using preceptors to improve nursing students' clinical learning outcomes: A Malawian students' perspective

ObjectiveClinical environment remains an important aspect in the development of student's competence, confidence and fulfillment of their expected learning outcomes. Preceptors and clinical teachers play a significant role in preparing students to achieve their professional goals through continuous support and resource provision. This study explored the students' perception of using clinical preceptors to improve their clinical learning outcomes.MethodsThe researchers used semi structured interviews to collect qualitative data. A total of 48 students were purposively and conveniently sampled from 8 hospitals to participate in the study. Content analysis was used to analyse the data.FindingsTwo themes emerged from the study findings namely: creating a positive clinical learning environment and facilitating academic clinical collaboration.ConclusionsThe findings of the study revealed that students gained more confidence and competence in clinical practice when supported by preceptors as well as achieved clinical learning outcomes. These findings suggest the need to train more clinical preceptors for improvement of students' clinical learning outcomes.     

以问题为基础的学习模式与以授课为基础的传统学习模式在急诊重症监护临床示教中的应用效果比较

目的 观察以问题为基础的学习模式(PBL)和以授课为基础的传统学习模式(LBL)在急诊重症加强治疗病房(EICU)示教中的应用效果.方法 选择新疆医科大学2007级和2008级五年制临床医学专业本科生312名,2007级108名,2008级204名学生.按随机数字表法分为两组,2007级每组各54名, 2008级每组各102名,使用交叉配对方法,两组学生前半学期分别以PBL和LBL进行示教,期中采用笔试考试 (WES)、客观结构化临床考试(OSCE)及自我评价问卷调查的方法对学生学习效果进行评估;在后半学期将两组学生对调进行上述教学方法,同样在学期末进行考试.学期结束时比较两组学生的考试成绩及问卷调查分数.结果 2007级及2008级两种教学模式学生WES、OSCE考核成绩比较,PBL模式教学WES、OSCE明显高于LBL模式〔前半学期:2007级:WES(分):23.20±3.33比22.78±4.41,OSCE(分):27.60±6.44比25.45±6.35,2008 级:WES(分):24.45±2.65 比 23.02±3.67,OSCE(分):29.53±4.67 比 27.57±6.83;后半学期:2007级:WES(分):24.60±3.67比23.46±2.57,OSCE(分):28.50±4.78比28.01±5.78,2008级:WES(分):23.54±3.56比22.56±6.89,OSCE(分):28.08±2.15比27.43±7.23,P<0.05或P<0.01〕.对2007级和2008级学生两种教学模式自评问卷结果显示:PBL模式教学的自主学习能力、积极性、理论联系实际能力、团队动力、注意力均较LBL模式提高〔2007级前半学期:自主学习能力(分):4.20±0.67比3.32±0.71,积极性(分):4.15±0.98比2.01±0.81,理论联系实际能力(分):4.09±0.65比3.52±0.89,团队动力(分):4.43±0.56比3.08±0.43,注意力(分):4.25±0.77比2.98±0.67;2007级后半学期:自主学习能力(分):4.23±0.77比2.11±0.98,积极性(分):4.59±0.85比3.20±0.73,理论联系实际能力(分):4.23±0.71比2.88±0.87,团队动力(分):4.66±0.63比2.21±0.64,注意力(分):4.21±0.73比2.28±0.43;2008级前半学期:自主学习能力(分):7.60±0.64比5.62±0.41,积极性(分):7.23±0.47比5.07±0.51,理论联系实际能力(分):7.04±0.67比4.56±0.59,团队动力(分):7.33±0.55比5.06±0.47,注意力(分):6.21±0.87比4.88±0.37;2008级前半学期:自主学习能力(分):7.03±0.71比5.11±0.48,积极性(分):7.89±0.57比5.20±0.33,理论联系实际能力(分):7.63±0.25比4.88±0.57,团队动力(分):7.64±0.33比5.21±0.67,注意力(分):7.01±0.89比6.01±0.90〕.结论 PBL教学法是一个值得探索及推广的教学模式,尤其在运用于医学这一重视实践的学科上,更能体现其重要性.     

Developing professional identity in nursing academics: The role of communities of practice

This paper analyses the current standing of nursing within the wider United Kingdom (UK) higher education (HE) environment and considers the development of academic identity within the sector, introducing a technology mediated approach to professional learning and development. A community of practice (CoP) is a way of learning based on collaboration among peers. Individuals come together virtually or physically, with a common purpose, defined by knowledge rather than task [Wenger, E., 1998. Communities of Practice: Learning, Meaning and Identity, sixth ed. Cambridge University Press, Cambridge]. In 2008, a small team of academics at Glasgow Caledonian University, School of Nursing, Midwifery and Community Health created and implemented iCoP, a project undertaken to pilot an international CoP, where novices and expert academics collaborated to debate and discuss the complex transition from clinician to academic. Although not intended as a conventional research project, the developmental journey and emerging online discussion provide an insight into the collective thoughts and opinions of a multi-national group of novice academics. The article also highlights the key challenges, problems and limitations of working in an international online arena with professionals who traditionally work and thrive in a face to face, real time environment.     

情景模拟教学在眼科临床带教中的应用

目的探讨改进教学方法对提高教学质量的意义。方法将情景模拟教学应用到眼科临床带教中。结果2组护生操作考试成绩、心理紧张程度和病人满意度有显著性差异。结论情景模拟教学法在眼科临床带教中的实施,减轻了护生的紧张心理,提高了教学质量与病人的满意度。     

Friendship fosters learning: The importance of friendships in clinical practice

This paper reports on one of the key findings from a recent ethnographic study (Roberts, D., 2007. Friendships and the community of students: peer learning amongst a group of pre-registration student nurses. Unpublished PhD Thesis, University of Salford, UK) and aims to highlight the importance of friendships for student nurses in clinical practice. An interpretive ethnographic approach was taken in order to reveal the student experience during their pre registration programme. Data was collected using ethnographic interviewing (Sorrell, J.M., Redmond, G.M., 1995. Interviews in qualitative nursing research: differing approaches for ethnographic and phenomenological studies. Journal of Advanced Nursing 21, 1117–1122.) and participant observation. Within this paper I argue that student nurses exist on the edge of the community of practice (of the qualified staff) and therefore form their own parallel community where students are all seen as being in the same boat. In particular students use the friendships they develop in clinical practice to enable them to learn; developing an ‘ask anything’ culture where all students are perceived as valuable sources of knowledge. Furthermore, it appears that knowledge is contextually bound and not therefore linked to seniority, or length of time served on the course.     

Development through self-assessment: strategies used during clinical nursing placements

The question asked for this small research project was ‘how do senior students judge their progress towards being a ‘‘good nurse’’?’ A qualitative approach was taken and a convenience sample of 10 student midwives identified. Interviews were the main source of data collection. Since the method of analysis was that of grounded theory, the interviews became more focused as themes emerged. Results demonstrated that each student developed a range of self-assessment strategies which were used in any clinical placement. Some techniques were used only at a certain stage in a clinical placement while others were used throughout. Cyclical techniques were related to the achievement of short-term goals; strategies used for the duration of the placement had more long-term significance. Highlights of the findings were explored in the literature. These features included models of professional development, the need to feel part of a team, the necessity of identifying a role model, and the significance of the length of a clinical placement. Conclusions related to the duration of a clinical placement and the necessity for the student to have the opportunity to complete the cycle. The value of acquainting new students with self-assessment strategies is suggested.     

International clinical placements for undergraduate students

This paper reports the findings of a study that sought to gain insight into the experiences of third year nursing students who participated in a 4-week clinical placement in an international setting. This study is different from many studies describing international placements for undergraduate nursing students as it concentrates on clinical experiences on placement. Students' reflective journals and face-to-face discussions were used to collect data, which were analysed by thematic content analysis. Categories were identified describing a focus on micro clinical-based issues that expanded over time to a focus on broader issues reflecting the "nursing culture" of the placement. Students described both positive and negative aspects of being placed in an international clinical setting, with the concept of "being different" emerging. Whilst the findings cannot be generalized beyond the sample, the study highlights the importance of adequate preparation and support for students on international clinical placements, with emphasis on attention to clinical detail.     

Improving the quality of nursing students' clinical placements in nursing homes: An evaluation study

The aim of this study was to explore students' experiences during their clinical placements in five nursing homes after implementing measures to improve the learning environment.It is vital to stimulate more future nurses to consider a career within geriatric wards and nursing homes. One way to achieve this, is to enhance nursing students' learning experiences during clinical placements in these settings.Measures to improve the learning environment were implemented as a result of a joint effort between a university college and five nursing homes. An explorative design was developed to collect empirical data concerning the students' experiences expressed through questionnaires and logs.The results generally conveyed more positive than negative experiences. Students expressed most satisfaction with peer collaboration, the placement's contribution to awareness of future nursing role and described the learning arena as exciting and interesting. They expressed less satisfaction with supervision from preceptor and how the practice site was prepared for and organized students' placements.Clinical placement arenas and educational institutions should collaborate closely to explore and develop models of supervision appropriate for the nursing home context, to build on existing potentials and resolve the issues that represent barriers for creating interesting and effective learning environments.