Evaluation of clinical teaching models for nursing practice

Clinical placements provide opportunities for student nurses to learn experientially. To create a constructive learning environment staff need to be friendly, approachable, available and willing to teach. There must be adequate opportunities for students to develop confidence and competence in clinical skills with a focus on student learning needs rather than service needs of facilities.A popular model for clinical teaching of nursing students is the preceptor model. This model involves a student working under the supervision of individual registered nurses who are part of the clinical staff. This model was failing to meet students’ needs in acute nursing practice areas, largely due to Registered Nurse staff shortages and demanding workloads. The students’ evaluations led to the trial of a ‘cluster’ or group model of eight students, with a clinical facilitator who is paid by the university, in each acute nursing ward.Evaluation of twenty nursing students’ perceptions of their acute nursing practice clinical placements was conducted using a mixed method approach to evaluate the two models of student supervision. Results indicate that the students prefer small groups with the clinical facilitator in one area. Thus evaluation and feedback from students and the perceptions of their clinical placement is essential.     

Advanced practice nursing and conceptual models of nursing

This column focuses on advanced practice nursing. A definition and central competency of advanced practice are given and four roles assumed by advanced practice nurses are identified. Questions related primarily to the advanced practice role of nurse practitioner are raised. Two nurse scholars who teach and practice discuss their experiences as advanced practice nurses, with an emphasis on the importance of using a conceptual model of nursing as a guide for their practice.     

Characteristics of nursing practice models.

Are there differences among the nursing practice dimensions of the three major nursing practice models--team nursing, case management, and total patient care? The author, whose study found few differences, discusses reasons for the similarity among models and suggests approaches to designing future nursing practice models.     

Using evidence-based practice for managing clinical outcomes in advanced practice nursing

Preparation of advanced practice nurses to assume leadership positions for clinical decision making requires that traditional ways of solving clinical problems be augmented with information from relevant, research-derived evidence. In this article, the authors describe how one graduate program prepares advanced practice nurses to use the best scientific evidence with clinical expertise to influence patient outcomes. The assignments that students complete in their program provide examples of evidence-based practice that apply quality improvement principles and science-based nursing interventions to create best practices.     

Innovative nursing practice models and patient outcomes

The definition of patient outcome measures has broadened from the traditional ones of mortality, morbidity, and disability to those that include quality of life, length of stay, health status, and patient satisfaction. Three models of innovative nursing practice in Arizona, New York, and Baltimore, are currently being evaluated in terms of these new outcome measures.     

Using reflective practice in frontline nursing

Reflection on practice is a key skill for nurses. Engaging in regular reflection enables practitioners to manage the personal and professional impact of addressing their patients' fundamental health and wellbeing needs on a daily basis. This article briefly reviews the theoretical background underpinning the idea of reflective practice. A simple, three-step model for practical reflection is presented, which is based on theory and grounded in practice. The three-stage cycle is illustrated with a fictional clinical example to show how this reflective method can make a difference in busy practice settings.     

Using therapeutic touch in nursing practice

This article is an introduction to "therapeutic touch" and its implications for nursing. A case study provides an example of how therapeutic touch was used with an individual who fell from a ladder and injured his elbow. A brief history and assumptions that support the practice of therapeutic touch are discussed. Rogers' Science of Unitary Human Beings, a nursing theory, provides a theoretical basis for therapeutic touch. The method developed by Kunz and Krieger involves four phases and each of these is identified and described. General uses for therapeutic touch are presented and a variety of research studies validate the practice of therapeutic touch in nursing. Resources are provided for those who may be interested in learning more about therapeutic touch.     

Using videorecordings in pediatric nursing practice

This article explores the innovative uses of videorecordings in pediatric nursing practice. Social learning theory and primary nursing concepts provide the conceptual orientation. Creative uses of videorecordings include: enhanced family education; continuity of care through caregiver modeling and staff communication; audiovisual progress recording; and potential behavioral development in the pediatric client. Suggestions regarding technical aspects of videorecordings in the clinical area may facilitate videorecording application.