Supernumerary status--an unrealised ideal

Supernumerary status, for pre-registration student nurses, should have fundamentally changed the way they learn in practice. Research suggests, however, that for many students the apprenticeship model still exists and that supernumerary status has created new challenges for learning in practice. Common themes found in the literature on supernumerary status are: confusion over the meaning of supernumerary status, the effect of supernumerary status on becoming part of the team, importance of the mentor, power relationships and operationalising supernumerary status. These themes are explored further with reference to the international literature and recommendations made as to how nurse education can respond to the challenges posed in order to ensure the quality of student learning in practice.     

Raising awareness of learning disability needs in acute sector care: A reflective account of a workshop from the guest facilitator perspective

Nurse education has an essential role to play in reducing health inequality for people with learning disability [Michael, J., 2008. Healthcare for All: Report of the Independent Inquiry into Access to Healthcare for People with Learning Disabilities. Aldridge Press, London]. Many nurse education providers will need to use guest facilitators in order to raise awareness of best practice in caring for this client group for non learning disability branch students and their experiences as nurse educators will be of growing interest. This article critically reflects on an educational session for pre-registration adult branch nursing students which used a variety of teaching methods to facilitate a reflective, student centred, experiential learning approach. Self assessment based on the change between two self rating scales was used to assess learning, the session itself was evaluated by students using a feedback form and through the formal assessment of teaching by a nurse tutor. This article critically evaluates the preparation, delivery and evaluation of the session, emphasising the perspective of the guest facilitator – a practicing community learning disability nurse. The conclusion reflects on key learning from the teaching experience.     

Refocusing formative feedback to enhance learning in pre-registration nurse education

The essential feature of a teaching system designed to enhance learning and emulate professional practice is that the crucial assessments should be performance-based, allowing plenty of opportunity for students to offer their own ideas and solutions. This involves the use of formative assessment and feedback. High quality formative assessment has been linked to enhancement of learning and ultimately to higher student achievement. Although formative assessment is acknowledged as important in its effect on students’ approaches to learning, it appears that the assessment practice is under utilized in pre-registration nurse education. This paper refocuses on the purpose of formative assessment of theory. It examines, from educational literature, some of the benefits of formative assessment and its pedagogical implications on deep learning, motivation and self-esteem, self-regulated learning and employability. It discusses what constitutes quality feedback to highlight that it is not just an essential component but also a central feature of formative assessment. The extent to which formative assessment and feedback can be applied to pre-registration nurse education is also explored. If formative assessment and feedback is well planned and conducted in assessment practice, it is suggested that effective learning can be facilitated in everyday learning activity.     

Simulation: A shared learning experience for child and mental health pre-registration nursing students

Learning through the use of simulation is perceived as an innovative means to help manage some of the contemporary challenges for pre-registration nurse education. Mental health and child nurses need to have the knowledge and skills to effectively address the holistic needs of service users. This article reports on a pilot simulated learning experience that was designed with key stakeholders for pre-registration child and mental health nursing students. This involved young actors playing the role of someone who had self-harmed to help students develop their skills for working with young people who experience emotional distress. Focus groups and a questionnaire were used to evaluate the pilot. Students valued the practical approach that simulation entailed and identified the benefits of the shared learning experience across the different fields of practice of nursing. However, some students reported anxiety performing in front of peers and indicated they would perform differently in practice. The pilot identified simulation as a potentially useful approach to help child and mental health student nurses develop skills for caring for young people. However, there is a need for caution in the claims to be made regarding the impact of simulation to address gaps in nursing skills.     

Promoting active learning using audience response system in large bioscience classes

This paper considers the challenges of bioscience teaching and learning in pre-registration nurse education. Effective learning requires active student participation which is problematic when teaching large groups of students. New technologies, such as the audience response system (ARS), have been introduced to increase student participation and support them in the understanding of complex bioscience concepts. Within one university department, an evaluation was undertaken to identify the perceptions of pre-registration nurse students on the use of ARS in the teaching and learning of bioscience. Our findings concur with others that ARS increases student participation and aids in identifying misconceptions and in correcting them. Students found ARS very useful and wanted ARS to be used in additional modules too. Although ARS did not seem to motivate students to study adequately before attending the relevant sessions, it increased discussion among students and awareness of their level of knowledge compared to their peers. Further research is required to identify the effectiveness of ARS in the teaching and learning of bioscience and its impact on the performance of the students in their final assessments.     

Towards an understanding of the attributes of simulation that enable learning in undergraduate nurse education: A grounded theory study

BackgroundSimulation has become an established feature of nurse education yet little is understood about the mechanisms that lead to learning.ObjectivesTo explore the attributes of simulation-based education that enable student learning in undergraduate nurse education.Methods and ParticipantsFinal year students drawn from one UK University (n = 46) participated in a grounded theory study. First, nonparticipant observation and video recording of student activity was undertaken. Following initial analysis, recordings and observations were deconstructed during focus group interviews that enabled both the researcher and participants to unpack meaning. Lastly emergent findings were verified with final year students drawn from a second UK University (n = 6).ResultsA staged approach to learning emerged from engagement in simulation. This began with initial hesitation as students moved through nonlinear stages to making connections and thinking like a nurse. Core findings suggest that simulation enables curiosity and intellect (main concern) through doing (core category) and interaction with others identified as social collaboration (category).Summary and ConclusionThis study offers a theoretical basis for understanding simulation-based education and integration of strategies that maximise the potential for learning. Additionally it offers direction for further research, particularly with regards to how the application of theory to practice is accelerated through learning by doing and working collaboratively.     

Factors affecting the programme completion of pre-registration nursing students through a three year course: A retrospective cohort study

Students who leave pre-registration nurse education having failed to complete remain a concern for higher education institutions. This study identifed factors influencing completion using a retrospective cohort analysis to map student characteristics at entry against Year 3 completion data. The study was set in a nursing faculty in a higher education institution in northern England. Data were collected between 2009 and 2014 with five cohorts of students participating (n = 807).Multinomial logistic regression was used to model the dependent variable Progression Outcome with categories of; completion and non-completion (academic and non-academic reasons). Predictors included cohort, programme, branch, gender, age on entry, ethnic group, disability status, domicile, change of home postcode, change of term-time postcode, entry qualifications, previous experience of caring, and dependents.Age on Entry and Domicile or alternatively Dependents and Domicile emerged as statistically significant (p < 0.05) in the multivariable analysis. Older students were less likely to be lost from the programme, as were students who lived locally at all times and those with dependents.There is currently little reliable, consistent information on nursing student attrition, progression and completion. This study contributes to the evidence base by identifying some of the factors that may contribute to successful programme completion.     

An investigation of the lived experiences of registered nurses facilitating supernumerary nursing students

The aim of this study was to explore and describe the everyday lived experiences of registered nurses facilitating supernumerary diploma student nurses in the clinical area. The research question; 'How do registered nurses perceive their role in relation to supernumerary students?' provided the central focus for the study. Using purposive sampling, 10 participants were chosen for the research. Semi-structured interviews were used to collect the data. The themes that emerged from the data are 'supernumerary status', 'facilitating students', 'rewarding experience', 'student interest', 'the diploma programme' and 'issues in nurse education'. The findings revealed positive and negative experiences of facilitating supernumerary students. Since the diploma programme of pre-registration nurse education was in its inaugural stages in Ireland at the time of this study, a foundation for further research is established. The conclusion indicates that facilitating supernumerary student nurses at diploma level can be a complex phenomenon for registered nurses.     

Safety in numbers 4: The relationship between exposure to authentic and didactic environments and Nursing Students' learning of medication dosage calculation problem solving knowledge and skills

Advancing the art and science of education practice requires a robust evaluation of the relationship between students' exposure to learning and assessment environments and the development of their cognitive competence (knowing that and why) and functional competence (know-how and skills). Healthcare education translation research requires specific education technology assessments and evaluations that consist of quantitative analyses of empirical data and qualitative evaluations of the lived student experience of the education journey and schemata construction (Weeks et al., 2013a). This paper focuses on the outcomes of UK PhD and USA post-doctorate experimental research. We evaluated the relationship between exposure to traditional didactic methods of education, prototypes of an authentic medication dosage calculation problem-solving (MDC-PS) environment and nursing students' construction of conceptual and calculation competence in medication dosage calculation problem-solving skills.Empirical outcomes from both UK and USA programmes of research identified highly significant differences in the construction of conceptual and calculation competence in MDC-PS following exposure to the authentic learning environment to that following exposure to traditional didactic transmission methods of education (p < 0.001). This research highlighted that for many students exposure to authentic learning environments is an essential first step in the development of conceptual and calculation competence and relevant schemata construction (internal representations of the relationship between the features of authentic dosage problems and calculation functions); and how authentic environments more ably support all cognitive (learning) styles in mathematics than traditional didactic methods of education. Functional competence evaluations are addressed in Macdonald et al. (2013) and Weeks et al. (2013e).     

Discourse tensions: Professional socialisation into nursing within the university education system

Starting university brings expectations of new experiences and a good social life (Morton and Tighe, 2011), however student nurse experience may not mirror these expectations. The aim of this study was to identify any indications of ‘differentness’ expressed in students talk, track development and changes in student language over the duration of their programme, and explore how language might situate lecturers and students within a professional socialisation process.Using Discourse Analysis (Potter and Wetherell, 1987), interviews (n = 17) were conducted with 8 lecturers and 7 volunteer student nurses multiple times over 3 years (April 2013 – August 2016). Analysis uncovered three discourse tensions, each showing resonance with students and their lecturers: The university student and the student nurse; The Nursing and Midwifery Council registrant and the lecturer; Student nurses as consumers of their university education.Students did not appear to align themselves with the university after experiencing clinical practice, and lecturers' language attempted to position students away from traditional student experiences to protect professional standards.     

Revisiting our roots: caring in nursing curriculum design

It is widely accepted that a caring curriculum is integral to nursing education. Caring as a concept is extensively cited in the literature as a core value in nursing education and nursing practice. What is not evident is the curricular designs used by nurse educators to enable students to internalize caring behaviors. The literature supports the internalization of affective learning through hierarchically structured learning objectives, and the movement from emotional to reflexive responses through critical reflection. Krathwohl, Bloom, and Masia’s (1964) taxonomy of affective objectives and concepts from Mezirow’s (2000) transformational learning theory were used to synthesize the integration of caring affective objectives into the design of the nursing curricula. The expected outcome of such integration is a nursing curriculum that progressively supports the development of nursing students’ caring behaviors that are consistent with the ideals of the profession. Examples of hierarchically leveled caring objectives are provided.     

Mental Health Education and Virtual Learning Environments (VLEs) in Pre-registration Nursing Degrees: Follow the Leaders?

Virtual learning environments (VLEs) are now commonly used, worldwide, as teaching and learning platforms for pre-registration nursing education. However, there is only limited evidence in the research literature to suggest that VLEs are employed to support the education of student nurses about mental health and illness. This article describes the work of mental health nurse educators who have taken the lead by providing case-based simulations on VLEs, thereby enabling students to acquire knowledge and develop the clinical skills required for practice in mental health settings. Benefits of VLEs include their flexibility and accessibility, and also the opportunity they provide for students to engage with Web 2.0 technologies. Leadership in education must include the utilization of the most current pedagogical tools and strategies, as well as staying abreast of contemporary evidence-based practices in clinical settings, to support the knowledge acquisition and practice-based learning of the registered nurses (RNs) of the future.     

An international exploration of blended learning use in pre-registration nursing and midwifery education

AimTo explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy.BackgroundThe global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere.DesignCross-sectional, sequential, mixed methods studyParticipants/settingsNursing/nurse education leaders from across International Council of Nurses regionsMethodsExploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants’ knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes.ResultsParticipants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation.ConclusionsBlended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact.Tweetable abstractBlended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.     

Effectiveness and value of massage skills training during pre-registration nurse education

BACKGROUND: The integration of Complementary and alternative medicine (CAM) interventions into healthcare practices is becoming more popular and frequently accessed by patients. Various disciplines have integrated CAM techniques education into the preparation of their practitioners in response to this, but this varies widely, as does its success. Students'experiences of such education in pre-registration is largely unknown in the UK, and methods by which to successful achieve effective learning within this arena are largely unreported within the literature. AIMS AND OBJECTIVES: This study highlighted three specifics aims; to examine the perspectives of pre-registration nursing students on being taught massage skills during pre-registration nurse education; to identify the learning and development that occurs during massage skills training; and to identify methods of enhancing the provision of such skills training and its experience. CONCLUSION: This paper demonstrates the value of integrating complementary therapies into nurse education, developing the holistic approach of student nurses and their concept of caring. In addition it contributes significantly to the knowledge base of the effectiveness of the value of CAM education in nurse preparation, highlighting the high value students place on CAM education and demonstrating notable development in the preparation of holistic practitioners. The method utilised also yielded ways to improve the delivery of such education, and demonstrates how creative teaching methods can motivate and enhance effective learning.