Student supervision: myth or reality?

This paper is based on the early findings of a qualitative longitudinal study using a grounded theory approach to analysis. A cohort of Project 2000 students and their clinical supervisors were observed in 10 different ward settings and interviewed prior to leaving the setting. A non-participant observation technique was utilized, noting the students' interactions with their deemed supervisors. The students and the supervisors were then interviewed using a semi-structured question format to explore supervision issues. The findings suggest that both students and supervisors in the study believe that supervision is an important learning strategy. However, what is believed in theory would not always appear to hold true in practice. The study identifies a limited knowledge by the supervisors of the skills and models of supervision, indicating the need for greater role preparation and a more clearly defined role specification. Supervision tended to focus upon tasks rather than issues. Furthermore, the role conflicts experienced by the supervisors was perceived as inhibiting facilitation of student learning. It is recommended that, for supervision to be more effective within the present operational constraints, it should utilize a more problem-solving approach, thus encouraging critical reflection on practice.     

Nursing students' perceptions of clinical experience

Senior nursing students were interviewed in this study to better understand the clinical learning experience from the students' point of view. Results of the study revealed that the nursing students were indeed learning in their clinical experience. The major categories of learning were classified as nursing skills, time management, and professional socialization. The quality of learning was reportedly affected by the quality of the student's preparation, characteristics of the instructor, and the variety of clinical opportunities to which students were exposed. The data also reflected a pattern of student development which was separated into three stages. The first stage was permeated with anxiety and obsession with the rules of task performance. The second stage was a difficult transition period where students struggled with identifying the roles of nurses. During the final stage, the students become more comfortable with performing nursing tasks and become interested in expanding their role and becoming more independent. As the students strived for independence, they identified more closely with staff nurses and withdrew from instructors.     

The clinical role of the nurse teacher: an exploratory study of the nurse teacher's present and ideal role in the clinical area

This paper describes a study which aimed to explore the present and ideal role of the nurse teacher in the clinical area from the perspective of nurse teachers, ward sisters/charge nurses, staff nurses and students nurses undertaking the 'traditional' and Project 2000 programmes of training The study adopted a qualitative design Findings from this study demonstrate that the clinical role of the nurse teacher lacks clarity, however, clear criteria emerged as to how trained nurses and student nurses perceived the ideal role Nurse teachers 'role in assuring the quality of the clinical learning environment emerged as a major area of criticism It was suggested that, if nurse teachers adopted a clinical role that was primarily concerned with supporting clinically based nurses in their teaching role, this served to assure the quality of students' clinical learning experience In conclusion, it is suggested that for nurse teachers to meet the needs of trained nurses and student nurses in the clinical area, the role must be diverse and flexible Attempts to prescribe a unimodel approach to deliver the service should be avoided Rather, the role must be negotiated between teachers, clinical nurses and students, and constructed in a way that best meets the needs of all parties concerned     

Preceptoring a student in the final clinical placement: reflections from nurses in a Canadian Hospital

Aim. To capture personal reflections on being a preceptor and to identify the supports and challenges to enacting the role. Background. Prior to graduation from a nursing programme, students begin the transition in roles from student to practicing health‐care professional. To ease this transition, preceptorship programmes have been implemented to foster professional socialization and help students achieve confidence in their practice during their final clinical placement (consolidation experience). Preparation for the preceptor role is dependent upon the information offered by the agency as well as by the educational institution. Nursing staff are requested for much of the calendar year to work with increasing numbers of undergraduate students at various levels, function as preceptors in the final clinical experience (consolidation) as well as be involved in the orientation of newly hired nurses. Methods. This qualitative study used one‐on‐one tape recorded interviews with nurses who had previous experience as a preceptor. Thematic analysis of the transcribed data resulted in the emergence of an overall theme and categories. Results. Eight nurses were interviewed from a variety of units including medical surgical as well as critical care. The overriding theme from the analysis was ‘safe passage’. This safe passage was for the patient and the student and was accomplished through the process of teaching and a clear view of the preceptor role. Challenges to the role were lack of recognition by other nursing staff as well as limited support from some faculty advisors. Supports for the role were the visible presence and ongoing support by faculty advisors as well as the hospital workshop. Conclusion. This study highlighted the importance of support from nursing faculty as well as recognition by fellow nurses of the workload involved when being a preceptor. Relevance to clinical practice. Preceptors play an important role with students prior to graduation. Both the hospital and educational institutions need to ensure that nurses are given the necessary support, recognition and resources.     

The impact of ''Project 2000'' educational reforms on the occupational socialization of nurses: an exploratory study

There is much in both nursing and sociological literature concerning the socialization of students into health care professions. In the case of nursing, concern has been expressed at the disparity between the values espoused by the educational establishment and those in the clinical areas. This study aimed to explore the changes in nursing occupational socialization since the implementation of recent educational reforms. Ethical approval was obtained from the local Research and Ethics Committee. The sample (n = 18) was drawn from qualified nurses working in a range of departments within three Welsh hospitals, half had undergone traditional training and half had received Project 2000 education. Data collection and analysis techniques were based on a grounded theory approach; this approach was deemed appropriate in that it allows the possibility of developing fresh perspectives on the subject without being too constrained by earlier studies. A strongly emerging theme from the data was that the nature of nursing socialization was related to the work contexts in which it was experienced; in particular respondents offered sharply contrasting accounts of nursing culture in 'acute' and 'chronic' areas of health work. The process of socialization was found to be harsher in acute areas with numerous instances of negative sanctions used to ensure compliance to ward culture, whilst in chronic areas occupational socialization was a more satisfactory process and nurses experienced less dissonance between ward and educational establishments. The size of this study mitigates against any firm conclusions; however, the early indications suggest that it would be a fruitful area for further research with a wider sample group drawn from diverse areas. This exploratory study suggests that the location of nursing work, in terms of whether it is in acute or chronic areas, is a determining factor in the experience of contemporary occupational socialization of nurses.     

The professional socialization of diploma of higher education in nursing students (Project 2000): a longitudinal qualitative study

This paper presents a new theory of professional socialization in relation to diploma of higher education in nursing students (Project 2000). It was derived from a 3-year, grounded theory, longitudinal study exploring the effects of supernumerary status and mentorship on students undertaking practice placements. A purposive sample of 17 students was used. Ten students volunteered to be interviewed on five separate occasions throughout their course and to keep a diary to record their experiences of mentorship during their practice placements. Their diary acted as an aide memoir during their tape-recorded interviews. The other seven students participated by diary only and kept written accounts of their experiences of being supernumerary and having a mentor whilst on practice placements. Data were analysed with the aid of NUD.IST and subjected to the constant comparative method of analysis. Findings indicate that the mentor is the linchpin of the students' experience and that some students develop intuition much earlier than previous work has stated.     

Clinical role activities of nurse teachers in Project 2000 programmes

This paper presents the findings related to the clinical role activities of nurse teachers in Project 2000 programmes Data were collected by a Delphi survey of 25 colleges of nursing that had implemented Project 2000 between September 1989 and April 1991 The findings from the Delphi survey were explored more fully through in-depth interviews with a sample of the respondents The findings identified a very strong commitment of the respondents to a clinical liaison role But they did not perceive their role to be one of teaching students through 'hands on care', they felt this was the role of the qualified staff in the clinical areas The respondents considered it important to maintain their clinical credibility through theoretical updating rather than being able to perform as an expert practitioner     

Factors affecting student nurses' learning in community placements: a phenomenological study

The study aimed to explore the question, what factors affect student nurse learning in a community setting? A phenomenological approach was taken by carrying out in-depth interviews with eight Project 2000 students who had just completed 8 weeks of community placements The factors which emerged centred around three themes the students themselves, the mentors and the placements Students recognized that their own approach to the placement was important They found that the role they fulfilled in the placements affected their learning, preferring a participative role to observation only The role of the mentor was found to be crucial for learning Important factors were the mentors’ knowledge and attitude towards the Project 2000 course and their professionalism (particularly communication skills), as perceived by the students Also significant were the mentors’ skills at facilitating learning in the placements, by encouraging questions and reflection, and organizing a variety of experiences Factors relating to the placements concerned their relevance to the course (as perceived by the students) and the breadth of experience available Whilst this was a small sample, from which no generalizations can be made, the study gives insight into students, teachers and community staff of the experience of learning in the community setting     

Undergraduate nursing students' preparedness to "go rural"

This article reports on a theme emerging from a focused ethnography examining the professional socialization of undergraduate fourth year nursing students during a rural hospital preceptored clinical experience. Nursing students and preceptors geographically dispersed over a 640,000 square kilometer rural area participated in this study. Students report student preparedness for the rural hospital setting means to "know what you are getting into". Assisting nursing students to prepare for the rural hospital preceptorship facilitates a positive experience thus increasing the effectiveness of the preceptorship model of clinical teaching. Having a positive rural-based experience also has the potential for recruiting new staff. These preliminary findings suggest that student preparation for the rural hospital preceptorship includes cognitive and psychological preparation, as well as the acquisition of common advanced clinical skills.     

Elective preceptorship: a cooperative opportunity for baccalaureate nursing education and nursing service

The elective summer preceptorship described in this article has been successful in facilitating socialization into professional nursing. The professional socialization process for students is described as "a sense of identity and commitment to the profession by internalizing the norms, values, knowledge, skills, and behaviors shared by members of that profession" (American Association of Colleges of Nursing, 1986, p. 3). Review of the evaluative data from students and preceptors has validated that the preceptorship contributes to the professional socialization of students. Preceptors have also indicated that they experienced personal growth and satisfaction in their educational role with students. The experience has served to enhance their own professional development. Clinical agency staff and the students have been involved in a collaborative learning opportunity which fostered interagency relationships and has taken a step in improving health care.     

Student nurses' experiences of Project 2000

AIM: The aim of the study was to investigate student nurses' experiences of Project 2000. METHOD: A sample of 76 students completed a questionnaire twice, once at the beginning of the course and again after one year. A second questionnaire comprising rating scales of how stressed they felt, was completed by a sample of 30 students weekly for the first year of the course. RESULTS: Seven areas of concern were identified: the theory component of the course, assessments, clinical practice, financial pressures, time management, personal development and personal difficulties. CONCLUSION: Sufficient data were generated to suggest that the experiences of Project 2000 students in other institutions are likely to be similar to those reported in the study. Recommendations for teachers, clinical staff and students are made.     

Patients to people

The ideas discussed in this paper are derived from a longitudinal study of student nurse socialization. The emergent views of a cohort of student nurses were explored by the researcher, over a period of 3 years, utilizing the approach referred to as grounded theory. 'Patients to people' represents a continuum of changing perceptions about those whom the students were nursing. It seemed that the cohort had to move along this continuum in order for them to be able to empathize with those they nursed. In the context of the students' changing perceptions, several things were of significance. For example, encounters with individuals who failed to demonstrate the passive and compliant attitude associated with 'typical patients', such as children, challenged the cohort's thinking about those they nursed. During their training the students matured as both nurses and adults and this was also important, as was their recognition of their own 'personhood'. The cohort's emergent views suggested that there was a reciprocity between the way they viewed themselves and the perceptions they held about those they nursed. Such findings are important to people involved in preparing individuals to enter the caring professions. However, it should be noted that the experiences described in this study represent those of 'traditionally' trained rather than of Project 2000 students. The names used to describe people involved in this research are pseudonyms.     

Student and staff relationships in a clinical practice model: impact on learning

This qualitative study describes the perspectives of diploma nursing students and staff nurses on the student-staff relationship and the impact this relationship has on student learning. Staff and students, working in a clinical practice model setting in a large urban hospital, participated in focused interviews following a 15-week clinical practice assignment. Findings revealed there were several commonalities in staff and student perceptions of the relationship. Both staff and students described role perception, staff characteristics, and the workplace environment as important factors influencing the relationship and student learning. Students also identified working in a collegial relationship as being important to learning and their socialization into the nursing profession.     

Student reflective groups at a Scottish College of Nursing

In this paper student views on reflective groups, set up as an important element of the new Project 2000 course in a Scottish College of Nursing, are reported. A random sample of 19 students were interviewed. While the reflective groups were very popular with students because they provided support, there was little evidence of a linkage between theory and practice. It was clear that the ambitious objective of stimulating reflection-on-action was not attained. Practice certainly was discussed, but it tended to be dominated by dramatic and emotionally charged aspects of care rather than the more frequent routine concerns. There were, however, indications that the original aim of the reflective groups could be achieved if tutors could establish a common understanding of the purpose of the groups and of reflection, and if the practices on which students reflected consisted less of single day visits where the students saw themselves as non-participant outsiders.     

Learning to nurse in the clinical setting

The findings reported in this paper are part of a larger study examining student socialization into nursing In analysing the data, it became evident that two major factors influenced the students' learning in the clinical setting the first was the clinical instructor, the second peer support Instructors who were organized, encouraging, outgoing, and who had good relationships with students, patients and nursing staff were seen as'good' role models When instructors were unable to establish rapport on a unit, negative feedback from nursing staff could be detrimental to student learning Peer support encompassed three dimensions facilitating learning, providing emotional support, and assisting with physical tasks There was evidence that practising faculty had a stronger influence in shaping students' attitudes towards nursing than classroom teachers     

Situating theory in practice: student views of theory-practice in Project 2000 nursing programmes

In this paper the views of student nurses taking Project 2000 at a Scottish College of Nursing are reported A random sample of 19 students were interviewed The interviews focused on the relationship between the college course and the students'experiences on placement The majority had difficulty in relating the college course to their practice, except when it came to very specific parts of the programme, for example basic medical procedures Only a minority could integrate the broader aspects of the course to their practice, largely because there was such a long period of time between studying a topic in college and the related placement It is tempting to see the results as supporting the situated cognition hypothesis that theory loses meaning out of context, and it is evident, even from this limited study, that the success of Project 2000, with its emphasis on the'knowledgeable doer', could depend, to a great extent, on the careful phasing of college coursework and placement to enable students to integrate theory and practice more effectively     

The first year as a staff nurse: the experiences of a first cohort of Project 2000 nurses in a demonstration district

This paper describes the experiences of eight staff nurses who were students in the first cohort of a Project 2000 course in a pilot district during their post–qualification year A qualitative approach, informed by phenomenological methodology, was adopted in order to present these experiences alongside the meaning attributed to them by the nurses Taped, focused group discussions, using semi-structured interviews, were analysed This yielded five themes which describe the structure of these experiences from'coming out of school' through to the acknowledgement and confidence in themselves as a different kind of nurse to those trained on previous traditional courses The findings suggest that the vision of the United Kingdom Central Council in proposing Project 2000 courses is likely to be realized These nurses had gained the competent technical and clinical skills expected of any nurse However, they also displayed skills previously absent in newly–qualified nurses, such as evidence of analytical decision–making and confident interpersonal skills, which are likely to enable them to take an equal place amongst other members of the multindash;professional team in the future Although competent practitioners, the process they had undergone to reach this had, at times, been traumatic The implications arising from the study are that more attention needs to be paid to the personal and professional development needs of Project 2000 nurses, both at the end of the course and in their first post-qualifying year     

Staff nurses' perceptions of supernumerary status compared with rostered service for Diploma in Nursing students

BACKGROUND/RATIONALE: In the Republic of Ireland, the amount of clinical teaching expected of staff nurses has increased substantially in the wake of the transfer of nursing education to universities, and the advent of supernumerary status for students. A modicum of previous research noted that staff nurses are unclear about their role in relation to facilitating the clinical learning of supernumerary students. AIMS OF THE PAPER: To explore staff nurses' perceptions of their role in the facilitation of learning for university-educated diploma students in the clinical area and their attitudes towards these students. DESIGN/METHODS: Sixteen staff nurses were interviewed in depth using semi-structured interviews. Data were analysed qualitatively, using content analysis, with the help of the software package NUD*IST. FINDINGS: Among the central themes to emerge, upon which this article is focused, was participants' perceptions of supernumerary status compared with rostered service for diploma students. Data suggested that the rostered status of students was generally favoured by staff nurses over and above supernumerary status because, unlike supernumerary students, rostered students did not disrupt the existing social structure within the clinical setting. Both structuration theory and role theory are drawn upon to explain the reproduction of the prevailing social structure, where the concentration is on getting through nursing work with little emphasis on the supervised learning of supernumerary students. STUDY LIMITATIONS: This study is constrained by eliciting only the views of staff nurses. Further studies are required of student nurses' experiences of rostered service and supernumerary status. CONCLUSIONS: Because staff nurses are part of the system within which they work, they need to modify their role to include active student teaching as a legitimate component of that role.