Evaluation of a mentor-arranged clinical practice placement for student nurses

Second year nursing students evaluated a new initiative, the Mentor-Arranged Clinical Practice (MACP), which supplemented their other clinical experiences. Seventy-eight students (95.6%) returned their completed questionnaires. Results indicated that the MACP program was beneficial to the students in the acquisition of knowledge, improvement of basic nursing skills, time management, prioritisation in patient care, and improvement in their confidence and self-esteem. Students identified six positive aspects of the MACP program: continuity and consolidation of nursing skills, improved communication and reporting skills, working in a variety of shifts, and working as a team member. Characteristics of a good mentor encompassed four areas: personality traits, teaching ability, nursing competence and interpersonal relationship. Findings suggest that there is a need for the development of mentorship models in the clinical experiences of undergraduate nursing courses, and the importance of effective clinical teachers in preparing nursing students for the workforce.     

The lived experiences of general student nurses on their first clinical placement: A phenomenological study

This phenomenological study explores and describes the ‘lived’ experiences of general student nurses on their first clinical placement in an Irish School of Nursing. The research question: ‘What are the experiences of general student nurses on their first clinical placement?’ provided the focus for the study. In-depth interviews were conducted with nine female student nurses and one male student nurse. Data from the interviews were collected, recorded and analysed using Coliazzi’s (1978) framework (Coliazzi, P., 1978 . Psychological research as the phenomenologist views it. In: Valle, R.S., King, M. (Eds.), Existential Phenomenological Alternatives for Psychology, Oxford University Press, New York). Five core themes emerged: self-awareness, confidence, anxiety, facilitation and professional issues. The findings revealed that the standard of preparation for the placement was viewed positively though some aspects of preparation require a critical shift in thinking towards meeting the students’ needs in future curriculum planning. The conclusions of the study indicate that the presence of mutual respect and regard for others had a positive impact on the students’ self-esteem. The acquisition of knowledge led to an increase in confidence levels that subsequently reduced anxiety. This enhanced the learning process that was dependant upon the collaborative support and facilitation in the clinical learning environment. The findings prepare the way for further research that could continue to develop and maximise the educational value and clinical experience for undergraduate nursing students.     

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.     

Supporting student nurses on placement in nursing homes: the challenges for the link-tutor role

Practice-based learning has always been a key feature of nursing education, and the quality of student learning is heavily influenced by the quality of the clinical experience. In addition, with an ageing population, nurses will need to better develop the particular clinical skills related to meeting the needs of older people in diverse settings. Increasingly, health care faculties in universities are turning to nursing homes to provide clinical placements for student nurses. This paper examines the literature related to the benefits and challenges of using nursing homes as placement areas for student nurses, with particular reference to the challenges that nursing home placements present for link tutors. The paper concludes with a proposal for a model for the link-tutor role in nursing homes.     

Grading student clinical practice performance: the Australian perspective

Educators have long considered assigning a grade in the assessment of student clinical practice performance as too variable, too subjective, or educationally inappropriate. Consequently, most undergraduate nurse education programs have maintained non-graded pass/fail criteria assessment for evaluating and reporting student clinical performance. This paper argues that, while the varied clinical environments do make assessing students' clinical performance difficult, the reliability and validity of assessment practices should be maintained no matter what the grading system. Furthermore, many assumptions about criterion-referenced assessment, and the associated preclusion of graded assessment, are seen to be baseless when dealing with competencies rather than with traditional behavioural objectives. By combining both criterion-referenced and norm-referenced assessment, graded assessment can clarify and impress on students the minimal competency requirements, while at the same time describing and rewarding meritorious practice. It is argued that to do so would provide a more appropriate way of communicating the assessment of theory application in praxis, a highly relevant issue in a practice-based discipline such as nursing. It is now appropriate to reconsider the debate of graded student clinical performance assessments, and to investigate both the practicalities and benefits of this approach.     

The psychometric validation of the quality practical experience (QPE) instruments (nurses and student nurse) to evaluate clinical supervision of undergraduate student nurses

It is important to evaluate stakeholder feedback regarding any change to a clinical supervision model to maintain quality. The Quality Practical Experience (QPE) instruments offer both the nurse on the ward involved with supervising student learning and the student nurse the opportunity to evaluate their satisfaction with the supervision model.This paper reports on the evaluation of the construct validity and the reliability of the QPE instruments measuring nurse and nursing student satisfaction with the clinical supervision model. Methodological design for the reliability and validation of a measuring instrument.The nurse and the student QPE instruments were tested with convenience samples of 488 nurses and 1116 student nurses, respectively. Psychometric tests included internal reliability, test-retest reliability and factor analyses. Exploratory factor analysis for both QPEs supported a three-factor solution; the nurse QPE explained 48% and student nurse QPE 45% of variance. Internal reliability and test-retest reliability were stable over time (nurse QPE ICC = 0.82; student nurse QPE ICC = 0.71).Both QPE instruments were found to be valid and reliable. Feedback from all stakeholders involved with supporting student nurses during clinical placement is important.     

Exploring clinical nursing experiences: listening to student nurses

Student nurses spend one half of their educational programme in the clinical area. The success of an educationally sound clinical placement is crucial to forming a professional nursing identity that will encompass the seen and 'unseen' aspects of the nurses' role. The aim of this study was to explore the clinical nursing environment through the perceptions of first year student nurses. Semi-structured interviews were used to collect data from 12 student nurses who each had four weeks clinical experience, representing 21 wards and five hospitals. Results suggest that these student nurses were disillusioned with the reality of clinical nursing and that their expectations of nursing were not realised. They perceived that paperwork, completing tasks and meeting targets were dominant features of nursing work at the expense of patient contact and communication. A majority indicated that nursing was not as caring as they expected and vowed to hold on to their personal values of caring about patients and forming communicative, interpersonal relationships with them.     

A new clinical career structure for nurses: trial and evaluation. The South Australian experience

A new clinical career structure for nurses was planned, introduced, implemented and evaluated in South Australia in 1986. The new structure was based on the Royal Australian Nursing Federation (South Australian Branch) Model, and its trial took place in 11 health units, involving 5000 registered nurses, or one-third of the nurse workforce in South Australia. The findings of the evaluation research were utilized by Government. The sociopolitical context within which the evaluation of the new clinical career structure was implemented is re-examined in this paper.     

The lived experiences of newly qualified nurses on clinical placement during the first six months following registration in the Republic of Ireland

Aim. To explore the lived experiences of newly qualified nurses on clinical placement, during the first six months following registration, in the Republic of Ireland. Background. The subject of the experiences of newly qualified nurses is not generally well researched, although anecdotal articles are plentiful. In particular, the lived experiences of newly qualified diploma nurses in the Republic of Ireland are not reflected in the research literature. However, available literature on the subject clearly demonstrates that being a newly qualified staff nurse is particularly stressful and many nurses feel unprepared for the staff nurse role. Design. A phenomenological, Heideggerian, hermeneutic approach was used for this study. Methods. Ten diplomate staff nurses were interviewed and the data were analysed using a thematic analysis framework. Results. Newly qualified nurses in the Republic of Ireland describe their initial experiences of being on the ward as stressful. This stress is primarily related to the multi‐dimensional responsibilities associated with the new role and to managerial/organizational/clinical skills deficits. The allocation of students and dealing with situations that they felt unprepared for added to their anxieties. However, diplomate nurses were willing to acknowledge these limitations and seek help when appropriate. Feeling valued, making a difference and financial reward were cited as being the positive aspects of the new role. Relevance to clinical practice. The preregistration nurse education curriculum needs to be developed further to help alleviate the problems associated with the initial transition to the staff nurse role. In addition, effective supportive systems need to be introduced for newly qualified nurses to help ensure that they are prepared for and supported in their professional role.     

Developing clinical leadership skills in student nurses

A number of policy documents in recent years have identified the need for strong leadership within the NHS. The NHS Plan (2000) states that nurses need to take a lead role in the running of local health services. It also suggests that strong leadership is needed at a clinical level. The literature identifies a number of skills deemed to be essential for clinical leadership, some of these are difficult to achieve through pre-registration nurse education as they relate to an awareness of the structures and processes of the NHS and the ability to visualise or predict the future. Other skills relate to personal traits and qualities and it is these skills that are discussed. Four skills are identified for discussion; self-knowledge, communication skills, risk taking, and keeping informed. This paper analyses the way these skills are currently developed in one University's pre-registration nursing curriculum and concludes that although many opportunities are available to develop these skills in the classroom environment, there are many pressures that prevent use of these skills in a practice environment.