Preceptors' experiences of using structured learning activities as part of the peer learning model: A qualitative study

The clinical environment is a vital component of nurse education, constantly changing due to constraints of the current health care systems such as increasing number of students and a limited number of preceptors. Peer learning, is gaining momentum as an educational model highly suitable for clinical placements. The peer learning model incorporates structured learning activities that support student activity, but little is reported of the actual structure and content of those activities. Thereby, the aim of this study was to explore precepting nurses’ experience of using structured learning activities as part of the peer learning model during clinical placement. We used a qualitative research approach, using two open self-administered global questions. The result is based on the analysis of the written responses from 62 preceptors. Four categories followed the analysis: An opportunity for collaboration, An occasion for reflection, A new educational structure, and Recommendations for development. The preceptors perceived the structured learning activities as beneficial for increased collaboration and reflection among students. Moreover, utilizing the structured learning activities was perceived to be time saving for the preceptors, however this is an area where further research is needed.     

Maximising graduate status in pre-registration nursing programmes: utilising problem based learning

This paper debates the use of problem based learning in accelerated pre-registration nursing programmes that are specifically designed for candidates with ‘graduate status’. We discuss the benefits of using problem based learning (PBL) within a graduate entry nursing (GEN) curriculum and its effectiveness in producing dynamic nurses who are both capable and value-centred practitioners.     

护理本科生在客观结构化临床考试中出现的问题与原因分析

目的 通过总结客观结构化临床考试(OSCE)中学生出现的问题,分析其产生的原因,寻找解决问题的方法与途径.方法 应用OSCE出科考试观察和评价学生的综合表现.结果 学生OSCE出科考试总体水平不高.主要问题表现为规范性较差、临床思维尚未形成、人文关怀能力不强.结论 加强学生临床思维能力、临床实践能力和人文精神培养,必须着力做好医院护理临床带教教师的培训,改进带教方法,提高课堂教学质量,为培养学生的综合能力提供有利条件和环境.     

Online learning versus blended learning of clinical supervisee skills with pre-registration nursing students: A randomised controlled trial

BackgroundThe World Health Organisation amongst others recognises the need for the introduction of clinical supervision education in health professional education as a central strategy for improving patient safety and patient care. Online and blended learning methods are growing exponentially in use in higher education and the systematic evaluation of these methods will aid understanding of how best to teach clinical supervision.ObjectiveThe purpose of this study was to test whether undergraduate nursing students who received clinical supervisee skills training via a blended learning approach would score higher in terms of motivation and attitudes towards clinical supervision, knowledge of clinical supervision and satisfaction of learning method, when compared to those students who received an online only teaching approach.DesignA post-test-only randomised controlled trial.MethodsParticipants were a total of 122 pre-registration nurses enrolled at one United Kingdom university, randomly assigned to the online learning control group (n = 60) or the blended learning intervention group (n = 62). The blended learning intervention group participated in a face-to-face tutorial and the online clinical supervisee skills training app. The online learning control group participated in an online discussion forum and the same online clinical supervisee skills training app. The outcome measures were motivation and attitudes using the modified Manchester Clinical Supervision Scale, knowledge using a 10 point Multiple Choice Questionnaire and satisfaction using a university training evaluation tool. Statistical analysis was performed using independent t-tests to compare the differences between the means of the control group and the intervention group. Thematic analysis was used to analyse responses to open-ended questions.ResultsAll three of our study hypotheses were confirmed. Participants who received clinical supervisee skills training via a blended learning approach scored higher in terms of motivation and attitudes – mean (m) = 85.5, standard deviation (sd) = 9.78, number of participants (n) = 62 – compared to the online group (m = 79.5, sd = 9.69, n = 60) (p = .001). The blended learning group also scored higher in terms of knowledge (m = 4.2, sd = 1.43, n = 56) compared to the online group (m = 3.51, sd = 1.51, n = 57) (p = .015); and in terms of satisfaction (m = 30.89, sd = 6.54, n = 57) compared to the online group (m = 26.49, sd = 6.93, n = 55) (p = .001). Qualitative data supported results.ConclusionBlended learning provides added pedagogical value when compared to online learning in terms of teaching undergraduate nurses clinical supervision skills. The evidence is timely given worldwide calls for expanding clinical skills supervision in undergraduate health professional education to improve quality of care and patient safety.     

Using portfolios for clinical practice learning and assessment: the pre-registration nursing student's perspective

Portfolios have been introduced to help to integrate theory and practice and thereby address the issue of the theory-practice divide. Although there has been much theoretical discussion about portfolio use in clinical placements, few studies have focused on the students' perceptions regarding their use. To obtain adult branch pre-registration nursing students' perspectives on using portfolios for their clinical practice learning and assessment, postal questionnaires were sent to 253 diploma of nursing students with a reminder to all students three weeks later. The response rate was 69% (174/253). This paper reports on the qualitative findings of the study, which employed both quantitative and qualitative methods. Although students stated that portfolios helped them in their development of self-awareness and independent learning, they indicated that portfolios do not sufficiently address the assessment of their clinical skills and the integration of theory and practice. They considered that portfolios could be greatly improved in three areas, namely in the conflict between using portfolios for both assessment and learning, the amount of support and guidance students feel they receive with their portfolio use and the portfolio design.     

应用客观结构化临床考试评价中医护理本科生临床综合能力

目的探讨客观结构化临床考试(OSCE)在中医护理本科生临床综合能力评价中的应用方法和作用。方法选取2009～2010年在我院实习的61名护理本科毕业生,运用OSCE进行毕业考核。结果 OSCE平均成绩为(79.21±4.81)分,平均难度为0.79,平均区分度为0.54。88.5%的学生和87.5%的教师认为OSCE考试内容的设置合理,有助于掌握临床技能,并且对今后的工作有帮助。结论 OSCE是科学有效的临床护理技能评价方法,能真实反映学生的临床综合能力,促进护理教育改革,应当推广使用。     

高职护理专业学生实习成绩与临床学习环境的分析

目的 了解高职护理专业学生实习成绩情况,以及其对临床学习环境的评价.方法 采用便利抽样方法,选择在浙江省36家二级甲等以上教学医院实习的高职护理学生为调查对象,应用临床学习环境(氛围)评价量表、学生成绩登记表对其进行调查.结果 学生对临床学习环境评价总分为(173.07±16.02)分,各维度评分由高到低为:任务定位(26.68±3.98)分,人际关系(26.01±4.60)分,学生参与性(25.64±4.44)分,工作氛围和团队文化(25.54±4.42)分,创新性(25.41±4.60)分,个性化(24.50±5.36)分.学生实习成绩最低分为60.00分,最高分为99.25分,呈偏态分布,偏态系数-2.22;三级甲等医院实习生实习成绩低于三级乙等、二级甲等医院.实习成绩与临床学习环境各维度无相关性.结论 护理专业学生实习成绩偏高,学生实习成绩与其对临床学习环境的评价不相关.建议引入形成性评价、第三方考核制度,重视学生个性化和创新性培养,加强细节管理,提高实习效果.     

Action learning sets in a nursing and midwifery practice learning context: A realistic evaluation

Action learning sets (ALS) are used widely for organisational and workforce development, including in nursing (Anderson and Thorpe, 2004, Pounder, 2009, Young et al., 2010). In the United Kingdom, a multi-faceted educational Pilot programme for new nurses and midwives was implemented to accelerate their clinical practice and leadership development (NHS Education Scotland, 2010). Action Learning Sets were provided for peer support and personal development. The Realistic Evaluation study reported in this paper explored issues of context, mechanism and outcome (Pawson and Tilley, 1997) influencing the action learning experiences of: programme participants (recently qualified nurses and midwives, from different practice settings); and programme supporters. A range of data were collected via: online questionnaires from 66 participants and 29 supporters; three focus groups, each comprising between eight and 10 programme participants; and one focus group with three action learning facilitators. The qualitative data pertaining to the ALS are presented in this paper. Thematic data analysis of context, mechanism and outcome configurations, generated five themes: creating and sustaining a collective learning environment; challenging constructively; collective support; the role of feedback; and effectiveness of ALS. Study outcomes suggest nursing and midwifery action learning should (a) be facilitated positively to improve participants' experience; (b) be renamed to avoid learning methodology confusion; and (c) be outcome focused to evidence impact on practice.     

录像反馈法在护生临床处置能力培养中的实践

目的：探讨录像反馈法在护生临床处置能力培养中的实践效果。方法选取606名护生作为研究对象,将2011级246名护生作为研究组,2010级360名护生作为对照组。在以护理技能实训基地为载体的护生临床处置能力培养中,对照组按传统方法练习,研究组采用录像反馈法练习,比较两组护生的临床处置能力。结果研究组护生临床处置能力总分为（110．36±6．59）分,对照组护生为（105．39±3．81）分,差异有统计学意义（t＝3．54,P＜0．01）。临床处置能力中的病史采集、护理体检、辅助检查、基础护理操作、专科护理操作、心理护理以及统筹安排方面的得分研究组均高于对照组,差异有统计学意义（t值分别为4．40,4．20,3．15,6．24,4．15,2．24,2．16;P＜0．05）。结论录像反馈法可显著提高护生的临床处置能力。     

Primary care clinical placements: The views of Australian registered nurse mentors and pre-registration nursing students (part 2)

An increased burden of chronic and complex conditions treated in the community and an aging population have exacerbated the primary care workload. Predicted nursing shortages will place further stressors on this workforce. High quality clinical placements may provide a strategic pathway to introduce and recruit new nurses to this speciality. This paper is Part 2 of a two part series reporting the findings of a mixed methods project. Part 1 reported on the qualitative study and Part 2 reports on the quantitative study. Forty-five pre-registration nursing students from a single Australian tertiary institution and 22 primary care Registered Nurse (RN) mentors who supervised student learning completed an online survey. Students largely regarded their primary care placement positively and felt this to be an appropriate learning opportunity. Most RNs were satisfied with mentoring pre-registration nursing students in their setting. Furthermore, the RNs desire to mentor students and the support of general practitioners (GPs) and consumers were seen as key enablers of pre-registration nursing placements. Findings from this study provide a preliminary impression of primary care clinical placements from the perspective of pre-registration nursing students and registered nurse mentors. Further research should examine whether a broader scope of non-traditional health settings such as non-government organisations, charities, pharmacies, welfare and social services can also provide appropriate learning environments for pre-registration nursing students.     

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.     

肿瘤专科医院实习护生职业价值观与临床学习环境评价相关性研究

目的：调查肿瘤专科医院护理实习生的护理职业价值观与临床学习环境评价状况,探讨二者之间的关系为实习护生教学管理提供依据。方法：应用一般情况调查表、护理职业价值观量表、护理临床学习环境评价量表对肿瘤专科医院的216名护理实习生进行问卷调查。结果：护理职业价值观总分（100.10±13.80）分,临床学习环境评价总分（157.87±25.07）分。实习护生临床学习环境评价与护理职业价值观呈正相关（r=0.282,P<0.05）。结论：肿瘤医院实习护生职业价值观与临床学习环境评价处于较高水平。他们二者之间是相互促进的。护理教育者和管理者可以通过改善实习护生的实习环境来提高其职业价值。     

The use of team-based learning in a second year undergraduate pre-registration nursing course on evidence-informed decision making

More engaging teaching and learning strategies are needed to teach research-related courses to pre-registration nursing students. Team-based learning was implemented within a second year pre-registration nursing evidence-informed decision making course. Results from a questionnaire survey indicated that 70% believed team-based learning was appropriate for the course, 60% that it was an effective and motivating learning strategy, and 54% recommended using team-based learning in other courses. The results from ten student interviews illustrated the positive way in which team-based learning was perceived, and how the students thought it contributed to their learning. Test results were improved with an increase in the numbers of students achieving 70% or higher; and higher scores for students in the lowest quartile. Team-based learning was shown to be an effective strategy that preserved the benefits of small group teaching with large student groups.     

Mental health pre-registration nursing students' experiences of group clinical supervision: A UK longitudinal qualitative study

There is widespread international interest in the use of clinical supervision in nursing as well as recognition of the need to introduce nursing students to its concepts and value. This article reports on a three-year longitudinal qualitative focus group study which explored students' views and experiences of a group clinical supervision initiative. Students attended supervision groups facilitated by teaching staff over their three year pre-registration mental health nursing course, with a main aim of developing skills, knowledge and attitudes as supervisees. The findings showed that students derived benefit from the experience, gained greater awareness of the nature of supervision and became active supervisees within their groups. These benefits took time to emerge and were not universal however. While the findings support the value of exposing students to the experience of group clinical supervision educators wishing to implement such a programme need to address a host of issues. These include; the preparation of students, structural and resource concerns, and issues relating to group dynamics.