Using Feedback to Improve Clinical Education of Nursing Students in an Academic-Practice Partnership

There is growing evidence to support partnerships between academic and practice institutions. In one of the Veterans Affairs Nursing Academic Partnerships (VANAP), nurses supervised undergraduate nursing students during the clinical practicum of acute care courses. To evaluate the partnership, faculty solicited feedback from nurses, clinical site leaders, and students. In this quality improvement project, feedback, in the form of written questionnaires and informal debriefing, was collected over four years at the end of sophomore and junior courses. Six site leaders, 71 students, and 34 nurses provided feedback. Common themes were: (1) all participants valued faculty presence during the clinical day, (2) students benefited from being paired with the same nurse throughout the course, (3) clinical teaching associates and site leaders suggested students be present for entire 12-hour shifts, and (4) clinical teaching associates, desired more training to address student needs. Several changes were made using this feedback: piloting a 12-hour shift and providing nurses with in-services on strategies to coach nursing students. Follow-up feedback showed high levels of satisfaction with these changes. Collecting feedback from students and staff provides guidelines for changing educational practices. Implementing changes based on the feedback strengthens partnerships, supports student learning needs, and improves student experiences.     

Using an admissions exam to predict student success in an ADN program

Nursing faculty strive to admit students who are likely to successfully complete the nursing curriculum and pass NCLEX-RN. The high cost of academic preparation and the nursing shortage make this selection process even more critical. The authors discuss how one community college nursing program examined academic achievement measures to determine how well they predicted student success. Results provided faculty with useful data to improve the success and retention of nursing.     

Faculty support and student retention

A study was conducted to explore the relationship between nursing students' perceived faculty support and nursing student retention. The 458 associate degree nursing students who participated were categorized according to their persistence-those who had persisted continuously throughout a nursing program, those who had withdrawn voluntarily at some time during a program, and those who had been required to withdraw because of academic failure. Perceived faculty support was measured by scores on the Perceived Faculty Support Scale, an instrument developed by the researcher for this study. A factor analysis of the instrument revealed two factors-psychological support, directed at promoting a sense of competency and self-worth, and functional support, directed at the achievement of tasks to reach the goals of persistence and academic success. Analysis of variance revealed persistence group differences in perceived faculty support. Students who reported greater perceived faculty support were more likely to persist throughout a nursing program than students who withdrew either voluntarily or because of academic failure. To promote retention of nursing students, faculty need to provide the caring atmosphere of a mentoring relationship and direct assistance to facilitate student learning.     

Can podcasts for assessment guidance and feedback promote self-efficacy among undergraduate nursing students? A qualitative study

BackgroundImproving assessment guidance and feedback for students has become an international priority within higher education. Podcasts have been proposed as a tool for enhancing teaching, learning and assessment. However, a stronger theory-based rationale for using podcasts, particularly as a means of facilitating assessment guidance and feedback, is required.ObjectiveTo explore students' experiences of using podcasts for assessment guidance and feedback.To consider how these podcasts shaped beliefs about their ability to successfully engage with, and act on, assessment guidance and feedbackDesign Exploratory qualitative study.Setting Higher education institution in North-East Scotland.Participants Eighteen third year undergraduate nursing students who had utilised podcasts for assessment guidance and feedback within their current programme of study.MethodsParticipants took part in one of four focus groups, conducted between July and September 2013. Purposive sampling was utilised to recruit participants of different ages, gender, levels of self-assessed information technology skills and levels of academic achievement. Data analysis was guided by the framework approach.FindingsThematic analysis highlighted similarities and differences in terms of students' experiences of using podcasts for assessment guidance and feedback. Further analysis revealed that Self-Efficacy Theory provided deeper theoretical insights into how the content, structure and delivery of podcasts can be shaped to promote more successful engagement with assessment guidance and feedback from students. The structured, logical approach of assessment guidance podcasts appeared to strengthen self-efficacy by providing readily accessible support and by helping students convert intentions into action. Students with high self-efficacy in relation to tasks associated with assessment were more likely to engage with feedback, whereas those with low self-efficacy tended to overlook opportunities to access feedback due to feelings of helplessness and futility.ConclusionsAdopting well-structured podcasts as an educational tool, based around the four major sources of information (performance accomplishments, vicarious experience, social persuasion, and physiological and emotional states), has potential to promote self efficacy for individuals, as well as groups of students, in terms of assessment guidance and feedback.     

Experts by experience; the views of service user educators providing feedback on medical students' work based assessments

Assessment tools were designed to provide health and social care students with multi-sourced, interprofessional feedback in practice. This includes feedback from service users. Third year medical students at the University of Leeds were given accesses to 4 assessment tools whilst in practice. Completed assessments were then sent to the university where service users and carers worked with university tutors to give further feedback and comment on the overall development of students. Three service users then took part in a focus group and one provided written feedback. Four key themes were identified from the focus group: ? Preparation and support ? The design of the tools ? The process of using the tools in practice ? Feedback. We found that the project provided both challenges and rewards for all involved. The service user educators involved were able to bring a different and valuable perspective to formative feedback. The combination of their personal and professional experiences, along with the preparation they had received, helped bridge the gap between service users in practice and university based tutors. The findings from this study went on to inform a review of the assessment tools and revised versions are now being used.     

Translating an academic module into an online resource

Blended learning, which combines face-to-face sessions with online work, is used to provide flexible learning and courses for students who are geographically dispersed. Canterbury Christ Church University recognised the importance of developing an academic module for dispensing opticians across the UK and the requirement to address the needs of an increasingly diverse population of students. Following interest in the module from the Association of British Dispensing Opticians, a decision was made to reformat the module into an online resource. This article describes some of the pedagogical processes involved in developing the online resource. Quantitative and qualitative data are analysed to identify challenges and successes. The importance of developing an educational biography to achieve depth of understanding and thought is acknowledged. The article concludes that some face-to-face interaction is still necessary, not least for helping to reduce students' anxiety.     

Teaching on the spiritual dimension in care: the perceived impact on undergraduate nursing students

The aim of the study unit, delivered in 2004-2005, to a cohort group of nursing students (n=65), who undertook the Diploma in Health Science, was to increase students' awareness about the spiritual dimension in nursing care so as to enable them to implement holistic care. The aim of this paper is to reveal the perceived impact of the study unit on students' life. This was derived from a written self-reflection account, which was submitted on voluntary basis, additional to the written assignment. The majority of students (97%, n=63) performed this written exercise which seems to demonstrate the students' interest in this study unit. Excerpts from students' written personal reflection indicate the personal, academic and professional impact of the study unit on nursing students. The positive feedback from students sheds light on the importance of teaching undergraduate students on the spiritual dimension in care. This implies that such a study unit is to be integrated within the curriculum of nursing education for the benefit of the nurses themselves and to enable delivery of holistic care.     

Evaluating an academic writing program for nursing students who have English as a second language

Academic writing skills are essential to the successful completion of preregistration nursing programs, yet the development of such skills is a challenge for many nursing students, particularly those who speak English as a second language (ESL). It is vital to develop and evaluate strategies that can support academic writing skills for ESL nursing students. This qualitative study evaluated a four-day academic writing intervention strategy designed to support ESL first-year nursing students. Data from the program showed two major areas of difficulty for participants relating to academic writing: problems understanding course content in English, and problems expressing their understanding of that content in English. The participants noted a key benefit of this program was the provision of individual feedback. Programs such as this intervention successfully meet the demands of ESL nursing students, although ongoing support is also needed.     

Mentored residential writing retreats: a leadership strategy to develop skills and generate outcomes in writing for publication

There is an increasing expectation that academic and clinical nurses will contribute to disciplinary and professional discourses through scholarly writing. However, the difficulties and challenges associated with writing for publication mean that many papers will never be written. This current paper describes an innovative approach developed to support skill development and outcomes in writing for publication. Intensive residential writing retreats informed by the principles of servant leadership and incorporating strategies such as mentoring and peer learning were conducted in 2005 and 2007. Positive outcomes and benefits included publications submitted to peer-reviewed journals, as well as positive effects on collegial relationships, and team building. Novice writers benefited from intensive and sustained support and coaching by experienced writers. Organisational benefits included increased participation by staff and research higher degree students in publication activities, enhanced collegial relationships and opportunities for senior established writers to work with inexperienced writers.     

The effect of feedback on students’ abilities to write daily progress notes

Previous research has shown that the majority of medical schools do not formally teach medical writing, including writing of progress notes. The purpose of this research was to determine the impact consistently provided objective feedback has on enhancing the quality of student notes. A static group‐comparison design was used to determine the quality of progress notes written by students who received structured written feedback versus those given traditional feedback. Twenty patient names were selected from students’ logbooks from both groups, totaling 40 patient charts. Progress notes were blindly reviewed by 1 faculty member, using a checklist instrument, which was studied for evidence of reliability and validity. Results showed a statistically significant (p = .05) difference between the groups’ abilities to write assessment and plan portions of a progress note, but no differences were noted on student abilities to document subjective data. Findings suggest some students often have an inability to integrate subjective and objective data into a plan of care, which suggests structured feedback needs to be provided to ensure quality charting on the assessment and plan portion of the note.     

Feedback Board: An Innovative Way to Adapt Classroom Teaching

There is much discussion in the literature on the effectiveness of end of semester summative evaluations of teaching and those who teach. Educators cite many reasons why they are dissatisfied with summative student evaluations, but the most significant issues are related to the lack of specific constructive feedback, poor response rates, and lack of student engagement. Whereas, formative student feedback provided throughout the semester has been proven more effective at improving student learning and outcomes. Formative feedback provides educators with an opportunity to adjust teaching practices throughout the semester in response to student feedback thus creating a learner-center learning environment. The purpose of this article is to present the “Feedback Board” as means to collect formative feedback from students at the end of each class session throughout the semester and its role in improving learning.     

Exploring student's perceptions and experience of personal tutors

There are a variety of arrangements to support pre-registration nursing students whilst they engage with the theoretical and practical elements of their course; these includes academic supervisor and a personal tutor. The personal tutor system is recognized as an effective method of ensuring that each student has access to a wide range of support services and that the individual's academic progress and personal development are monitored by a skilled member of academic staff (Harrison, 1990). However, there is a dearth of studies relating to the role of the personal tutor in nurse education from the students' perspective. This study set out to explore the pre-registration students nurse's experience of personal tutoring at one School of Nursing and Midwifery in a Higher Education Institution (HEI) in the UK. Focus groups and a semi-structured questionnaire were used to collect data from pre-registration nursing participants. Data analysed revealed both positive and negative experiences; most rated their advice and support good with many positive aspects to their personal tutoring expressed however many felt the need for more contact time, more support academically and whilst on clinical placements, and more structured support with their personal development planning. This paper also describes how the study was conducted, the importance that students place on the role, and the need for further research and areas for improvement.     

A tailored program of support for culturally and linguistically diverse (CALD) nursing students in a graduate entry Masters of Nursing course: A qualitative evaluation of outcomes

This paper aims to firstly explain why a support program is necessary and describe briefly the support program for culturally and linguistically diverse (CALD) nursing students enrolled in a two year accelerated Master of Nursing program at the Faculty of Nursing and Midwifery, the University of Sydney. Secondly, it aims to address the underpinning pedagogical approach to delivery of the program and finally this paper reports the findings of a qualitative evaluation of the program. The program was introduced in semester 1, 2008 and aimed to facilitate improved student satisfaction by addressing the academic, communication and relational challenges identified as having a significant impact on both CALD students’ academic achievement and their performance on clinical placement. Teaching and support strategies included interactive delivery, activities in small groups and the use of video clips, reflective feedback sessions, and open discussions. An evaluation, based on 13 semi-structured interviews explored the consequences of the program on student satisfaction and to determine whether the student learning experience had been enhanced.     

Digital lecture recording: A cautionary tale

Increasing application of information technology including web-based lectures and live-lecture recording appears to have many advantages for undergraduate nursing education. These include greater flexibility, opportunity for students to review content on demand and the improved academic management of increasing class sizes without significant increase in physical infrastructure.This study performed a quasi-experimental comparison between two groups of nursing students undertaking their first anatomy and physiology course, where one group was also provided access to streaming of recorded copies of the live lectures and the other did not. For the course in which recorded lectures were available student feedback indicated overwhelming support for such provision with 96% of students having accessed recorded lectures. There was only a weak relationship between access of recorded lectures and overall performance in the course. Interestingly, the nursing students who had access to the recorded lectures demonstrated significantly poorer overall academic performance (P < 0.001). Although this study did not specifically control for student demographics or other academic input, the data suggests that provision of recorded lectures requires improved and applied time management practices by students and caution on the part of the academic staff involved.     

Developing a 'model of transition' prior to preceptorship

It has long been recognized (Kramer, 1974) that the transition from student to qualified nurse or midwife is a steep learning curve which Kramer famously described as a 'reality shock'. The University Hospital of North Staffordshire (UHNS) NHS Trust has recently taken its established preceptorship programme a step further by integrating 'key' components into the final module (module 9) of nurse/midwifery training, now referred to as the 'transition' module. The development of this new and exciting 'shared learning' approach has been the result of collaborative working with the tutors at Keele University and the clinical education team at the UHNS Trust. The subject material introduced into module 9 aims to both reflect and support the current university curriculum. Initial verbal and written feedback from students who have progressed through the 'transition' module has been both positive and encouraging. Students have identified that they feel more prepared to take on their new roles, confident in the knowledge that they can seek support from the lead preceptor nurse/midwife prior to qualifying.     

Initial experiences of interprofessional problem-based learning: a comparison of male and female students' views

Few studies have considered the contribution of problem-based learning (PBL) to interprofessional education, and even fewer have examined whether women and men evaluate PBL differently. This paper examines first year occupational therapy and physiotherapy students' evaluations of their initial participation in PBL, during an interprofessional module focusing on communication skills and patient-focused approaches to care. Questionnaire data included attitude ratings and qualitative evaluations of PBL. A total of 133 females and 24 males responded (comprising 83% of the total cohort). Most students were positive that PBL contributed to both personal learning and team-working skills. Both female and male students felt able to express their opinions within the seminar groups and were positive that their understanding of therapists' roles within the multidisciplinary team had increased. However, women expressed rather more trust in the information provided by other students, confirmed greater enjoyment in taking responsibility for their own learning and had more positive views about working with students from another course. In their qualitative comments, more women made reference to enjoying the social aspects of PBL (such as group work, support and collaboration). The gender differences were not substantial but those that were observed support previous researchers' arguments that women are more inclined to be 'connected learners' who value the social aspects of learning contexts. The findings overall suggested that PBL made a positive, well-received contribution to learning during an interprofessional module.     

An exploration of student nurses’ experiences of formative assessment

The idea that formative assessment has the potential to prepare students, not only to succeed in summative assessments during the course, but also in the world beyond the classroom [Melland, H., Volden, C., 1998. Classroom assessment: linking teaching and learning. Journal of Nursing Education 37(6), 275–277] fuelled the desire to explore student nurses experiences of being assessed formatively. Focus group discussion, within a UK Higher Education setting, captured the holistic, dynamic and individual experiences student nurses (n = 14) have of formative assessment. Ethical approval was obtained. Findings from three separate focus group discussions indicate that lecturers do not use the term “formative assessment” in their communication with the student nurses; student preparation and effort is greater when assessment is for summative purposes; oral feedback is preferable to written feedback which can, at times, be illegible and utilise unfamiliar vocabulary; lecturer comments are regarded as being more valuable than grades; student nurses are not being prepared for the critical feedback associated with peer review and they may, therefore, be vulnerable to the process and outcome of peer review. Thus, the UK centric focus of this small qualitative research study need not detract from its ability to add to the global knowledge base on formative assessment in nursing.     

Online support for medicine dosage calculations

This article reports findings from a small project run within the Robert Gordon University that aims to provide nursing students with online support for medicine dosage calculations through formative assessment. The project motivation is discussed together with an evaluation of a subset of data from 177 student participants. This evaluation focuses on the 20 or so students who have engaged most with the project, and assesses the extent to which these students have been able to transfer benefits derived from formative assessment of their skills to summative assessment. Evidence is presented that shows: students who do well formatively do not seek individual tuition, those who truly engage with the formative online assessment subsequently pass their summative assessment, students agree or strongly agree that the formative assessment helped them pass their summative assessment and students making multiple attempts do not simply copy the correct answers given in feedback, but retry the assessment.