The clinical role of the nurse teacher in the United Kingdom*

The focus of this paper is the clinical role of the nurse teacher. Using selected findings from a small exploratory study in which a questionnaire was used to gather quantitative and qualitative data from teachers about their role, three areas are discussed. Examination of the number of clinical areas teachers link with identified three different models of clinical contact. The frequency and timing of teachers’ visits to clinical areas are not evenly distributed and some of the reasons for this are discussed. The nature of the clinical role is explored with emphasis on liaison and teachers’ perceptions of support of students and clinical staff. Finally, teachers’ perceptions of their clinical skill and the implications of this is discussed. It is concluded that all three areas require further analysis if the role of the nurse teacher is to be clarified and made more effective in the future.     

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     

A study of nurse tutors'' conceptualization of their ward teaching role

It is generally agreed by the nursing profession that the art and science of nursing can only be learnt in the direct delivery of patient care and that, in order to do this, students need to identify with a practitioner role-model in the clinical area. This research arose from the belief that nurse educationalists are failing to provide these learning opportunities for their students. The focus of the study was to identify factors in the nurse teacher's work role which mitigate against their teaching in the clinical area. The methodology was chosen in order to demonstrate the nurse teacher's conceptualization of her work role. In the first stage of the project this involved the repertory grid technique. From the results, a semantic differential questionnaire was built up and used for an attitude survey of a second sample of nurse teachers. The research samples consisted mainly of nurse tutors but a small group of both clinical teachers and senior tutors was included for comparison studies. Results showed that the main factors leading to a lack of clinical teaching by educational staff include lack of control and a sense of conflict, stress and anxiety in the ward-teaching situation, lack of peer support and an inability to plan ahead for such work. The most pervasive feature which emerged, however, was the felt lack of available time for clinical work vis-a-vis their other duties. This is discussed in terms of role strain. Differences in response between teacher grades were studied and showed that all the problems found appear to be greater among the nurse tutor group. This may be a consequence of a further finding that clinical teachers are more likely to make finer and more frequent distinctions between the aims and problems of ward- and school-based teaching.     

Nurse teachers' feelings about participating in clinical practice: an exploratory study

The aim of this small study was to explore nurse teachers'feelings about participating in clinical practice An exploratory design was used entailing focused interviews with 10 nurse teachers which explored their current participation in clinical practice and their feelings about this Other areas addressed were the perceived benefits and negative effects of participating in practice, as well as the factors which may inhibit or enable teachers participating in practice It was found that while half the teachers had some participation in practice, only one participated on a regular basis The teachers were generally dissatisfied with their current level of clinical practice The teachers identified a number of potential benefits of practising, including keeping in touch with clinical practice, maintenance of clinical skills, improved relationships with trained staff and the opportunity to use knowledge and skills in practice Perceived negative effects were that their clinical participation may be misinterpreted, or may impinge on other aspects of the role Some also felt that the limited time which they would have available, would lead to their clinical practice being ineffective The two major factors which affected whether nurse teachers were able to participate in practice were time and the college philosophy/culture Other important factors were support from clinical staff, clinical confidence, and the teacher's role perception and attitude towards practice As recent publications have inferred the need for nurse teachers to remain involved in clinical practice, teachers need to identify how clinical practice may best be achieved, and clarify their aims for practising Different models of practice may be appropriate for individual teachers It seems that a supportive environment and a college culture which values nurse teachers practising would be beneficial if clinical practice is to become part of the teacher's role     

The changing academic role of the nurse teacher in the United Kingdom

This paper presents findings from a national study conducted over a 3-year period (1991–94) which examined the changing role of the nurse teacher The study used multiple methods to collect data from a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers) This paper presents the findings relating to the development of the nurse teacher's academic role following the introduction of Project 2000 The issues presented and discussed include specialization within the nurse teacher's role, the nature of this specialization and the development of academic credibility and scholarship The implications of these changes in terms of the development of nursing as an academic subject area and the opportunity to contribute to the establishment of research based practice are explored     

The clinical role of nurse teachers within a project 2000 course framework

This paper reports on part of a national study that was conducted over a 3-year period (1991–1994). The overall aim of the study was to explore the changing role of the nurse teacher. Multiple methods of data collection were used, including a modified Delphi survey, a case study and telephone interviews. The sample included a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers). Findings in relation to the clinical role of the nurse teacher within a project 2000 course framework are presented. This includes the nature of the clinical role, views on linking theory and practice, and potential barriers to the nurse teacher's clinical role. The future role of nurse teachers within the clinical area is discussed and this includes suggestions for the ways in which a nurse teacher's clinical commitment could be facilitated. Issues relating to the role of lecturer/practitioner are also highlighted.     

Do hospital-based palliative care clinical nurse specialists de-skill general staff?

A large number of clinical nurse specialists work within the area of palliative care, particularly in the acute hospital setting. This article presents the qualitative findings of an evaluation study that looked at the impact of the clinical nurse specialist within a palliative care team in a large acute hospital in the North-West of England. A total of 31 interviews were conducted with stakeholders from across the hospital setting. The data were analysed for emerging themes using a case and cross-case analysis. The results indicated that the senior stakeholders and the palliative care team felt that the clinical nurse specialists might be de-skilling the general nursing and medical staff, while junior staff did not perceive that they were being de-skilled. This article discusses potential explanations for this, including the possibility that junior staff may not be fully aware of the role of palliative care clinical nurse specialist. The impact that clinical nurse specialists are having on empowering the junior staff is also discussed and recommendations for further research are suggested.     

The ideal role of the nurse teacher in the clinical area: a comparison of the perspectives of mental health, learning difficulties and general nurses

This paper reports findings from a study that explored trained nurses' and student nurses' perceptions of the nurse teachers' ideal role in the clinical area. Findings demonstrate a dichotomy of opinion regarding the ideal role of the nurse teacher in the clinical area that relates to the nursing specialities in which trained nurses work. Trained nurses working in general nursing areas favoured a product-focused, inspectorate supervisory role for nurse teachers. Conversely, trained nurses working in mental health and learning difficulties areas favoured a supportive, supervisory role for the nurse teacher that emphasized the learning process and encouraged reflection. The consequence of the different models used for student nurses' experience of supervision are discussed and the issue of nurse teachers' clinical credibility is explored. It is suggested that trained nurses, nurse teachers and student nurses should be involved in negotiating and constructing the role that nurse teachers play in the clinical area.     

What should nurse teachers be doing? A preliminary study

There is little doubt that the role of the nurse teacher is complex and multifaceted in nature. The apparently conflicting demands of NHS trusts and education in the United Kingdom, at the time of integration of nurse education into the higher education sector, further complicates the role. This recognition underlines the need to capture and measure key aspects of nurse teacher function in order to maximize educational gain. Using a comprehensive literature review, focus group discussions and a small number of individual semi-structured interviews, this preliminary study explored the issue of teacher workload, from the perspective of the principal stakeholders in nurse and higher education. Competing research and clinical practice objectives for nurse teachers are identified against a background of changing health care provision, reduced availability of placements and an increased need for evidence-based practice.     

The implications of Project 2000 and the formation of links with higher education for the professional and academic needs of nurse teachers in the United Kingdom

A national study was conducted between 1991 and 1994 to explore and describe the changing role of the nurse teacher following the introduction of Project 2000 pre-registration nursing courses. Multiple methods were used to collect data from a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers). This paper presents the findings relating to the impact of Project 2000 and the move into higher education on the continuing educational needs of nurse teachers. Views on college strategies for staff development, the changing nature of teachers'academic and professional development needs and the problems of the conflicting demands experienced are reported. The research highlights the need for clinical credibility to be clearly defined in relation to nurse teachers and for educational institutions to place more emphasis on teachers'clinical development if the rhetoric of policy is to become a reality.     

Nurse education--the role of the nurse teacher

Aim. To explore and analyse the role of the nurse teacher. Background. This paper examines the issue of clinical credibility among nurse teachers which has been ongoing for over a decade. The move of nurse education from colleges of nursing to the Higher Education Institutes was seen in 1992. Since then, nurse teachers have been faced with the need to juggle the roles of teaching, administration, research and clinical support for students. Nursing students within these Higher Education Institutes require more than the traditional theoretical classroom teaching. Nurse teachers have a role beyond this in encouraging students to link theory with practice, and practice with theory. Therein lies a challenge for nurse teachers to ensure they remain credible within the clinical setting and continue to provide education and support, which is firmly grounded in both practice and theory. Method. The authors have critically reviewed the evidence related to the role of the nurse teacher in an attempt to identify key concepts and ideas, assumptions, supporting examples and the implications for their role. Conclusion. The role of the nurse teacher, it would appear, is a dynamic one that needs to engage actively the needs of the student. Nurses therefore need to be dynamic in their approach in order to respond to both local and global demands and ensure that students become competent, professional, knowledgeable and caring in their approach. Relevance to clinical practice. This paper demonstrates the complex and ever changing role of the nurse teacher. This paper attempts to help nurse teachers understand the complex nature of their role.     

Nurse teacher's clinical work: a survey report

This paper reports on the results of a survey of nurse teachers in four colleges of nursing in England (n = 126) Data were collected using a questionnaire survey In this survey a five-point Likert scale was developed from an earlier study, to explore nurse teachers' perception of their clinical role The findings indicate that a number of factors may be influential in the way in which nurse teachers approach their clinical activity This includes personal factors such as age, educational grade and the length of time spent working in nurse education Organizational factors also appear to make a difference in the teacher who worked in an organizational model which ensured a smaller number of link ward areas were more likely to exhibit a positive orientation towards clinical work Factor analysis of the clinical scale resulted in loading of items relating to confidence in clinical role, preparation for the role, influence in clinical area and supervision of students in clinical areas The implications of these findings are discussed     

The emerging role of the nurse teacher in Project 2000 programmes in England: a literature review

This paper explores the literature on the role of the nurse teacher in the United Kingdom, in order to support a research study on the role of the nurse teacher as it emerges in Project 2000 programmes in England. Explicit within the reform of nurse education is a change in the role of the teacher. It is being influenced, first, by the creation of colleges of nursing and midwifery and their links to higher education, secondly, by the content and academic level of the course and, thirdly, by the supernumerary status of the student. Studies carried out on the activities nurse teachers undertake highlight the complex and multifaceted nature of the role. Excessive paper work, meetings and lack of autonomy are given as dissatisfying aspects of their work leaving only a small proportion of their time for classroom and clinical teaching. The literature suggests that the nurse teacher is required in Project 2000 to be a nurse, a teacher, a graduate in a specialist subject and clinically and academically credible. The study, which is mentioned briefly in this paper, will critically analyse the key components of the role of the nurse teacher as it emerges in the Project 2000 courses in England. The methodology and findings will be discussed in a later paper.     

Nurse teachers in higher education – Without clinical competence, do they have a future?

The practice-theory divide between that which is taught in the classroom and which is performed in practice, is well documented. The role of the Registered Clinical Nurse Teacher was an attempt to overcome this, which failed. In many areas practitioners are being encouraged to become more educationally aware. However, many of the institutions which influence nursing in the United Kingdom expect teachers to be more clinically aware. This has led to a debate about the level of clinical competence or credibility a teacher requires. In this paper, two methods of achieving this are examined. First, the role of the Lecturer Practitioner, which provides clinical competence for a minority but which may not be appropriate for the majority, and can lead to isolation from other teachers. Second, the role of Link Teacher, which can provide clinical credibility, but where there are several reasons why the role is not being fulfilled adequately. The impending changes in the organisation of nurse education will affect teachers ability to bridge the practice-theory divide, as has already occurred in America. It is suggested that the role of the nurse teacher in the UK is being eroded by highly qualified specialists in higher education and more knowledgeable, articulate practitioners. Teachers need to establish their unique role which must lie in showing how academic knowledge can be integrated and applied to nursing practice. However, if nurse teachers do not maintain their clinical ability they will not be able to support their claim to do this, and not only will the practice-theory divide increase, but in the very near future nurse teachers will find it extremely difficult to justify their existence.     

Concept-based learning activities in clinical nursing education

Few substantive changes are evident in clinical learning activities. This article reports the development, use, and beginning research on the Concept-based Learning Activity (CBLA), an innovative clinical learning activity. The main difference between this and current clinical learning activities is the relationship between student and client. Students study and perform selected aspects of the client's nursing management. Focus on specific objectives and best use of clinical time can be achieved with this model. Implementation of the CBLA requires collaboration with nursing staff. Students, staff, and teachers indicate many advantages to the CBLA, including flexibility, focus on learning, efficacy in use of clinical time, and recognition of the student as a capable learner. Formal evaluation of CBLA use indicates positive staff nurse perceptions. Statistically significant results were found when staff nurse groups who used the CBLA were compared with those who did not. Further studies are needed to evaluate learning outcomes.     

Using individual and group reflection in and on assessment as a tool for effective learning

Although clinical education has been acknowledged as being the 'heart' of all nursing education programmes, the role of the nurse teacher in relation to the clinical learning experience of the student nurse is an area of long-standing confusion and dispute This unresolved problem has led to the lack of a concerted effort in the provision of educational input in the clinical area and the quality of patient care is indirectly being affected This paper presents a comprehensive review of this dispute, with an attempt to unravel how the debate could be moved forward It is found that the clinical role of the nurse teacher appears to be implicit and 'hidden', resulting in a wide difference in the interpretation of the extent, purpose and nature of that role The controversies surrounding these issues were then traced and possible directions for future research are outlined     

The nurse teacher's clinical role now and in the future

The role of the nurse teacher in relation to the clinical setting has been debated for 20 years, yet it has been the subject of relatively few large studies. Recent studies led to inconclusive results, hence the nurse lecturer's clinical role remains an area of long-standing dispute. Changes in nurse education United Kingdom Central Council (UKCC) and the amalgamation of nurse education into higher education as part of the Strategy for Nursing, as well as the expansion of supernumerary status for student nurses, gave impetus to the search for a new clinical role for nurse lecturers. Research suggests that nurse teachers wish to maintain clinical contact, but the nature of this contact is vigorously debated at present. Lee, in reviewing the literature, concluded that this topic is highly contentious in terms of its nature, extent and purpose. She goes as far as to suggest that there is a need for empirical research to address the question as to whether there is a role for nurse lecturers in the clinical area. This paper examines some of the factors which influence the development of the clinical aspect of the role of nurse lecturers, explains how the author performed this role and the perceived benefits to students, mentors and the lecturer. It proposes a clinical role model based on the literature and the author's own personal experience as a 'clinical liaison lecturer' since the integration of nursing education into higher education. Key points The clinical role of the nurse teacher remains an area of long standing dispute Nurse lecturers wish to maintain clinical contact and maintain clinical competence, but in reality no consensus exists as to its meaning The mentor's role can be complemented by a clinically competent nurse lecturer who arguably should be able to teach in the classroom and the practice settings Using a triangular approach to reviewing student's experience, lecturers can update their clinical knowledge, demonstrate credibility, promote education-practice relations and ensure classroom teaching is relevant to current practice The establishment of guiding principles (recognized and agreed upon by service and educational managers) serves as a framework which nurse teachers can use to establish their own clinical role for each of their 'link' areas The nurse lecturer is in a good position to influence and maintain standards in nursing practice.     

Benefits of nurse teachers returning to clinical practice.

This article outlines an action research study developed to facilitate nurse teachers returning to clinical practice. The article explores how the teachers established partnerships with clinicians through which they were able to share the experience of returning to an area of nursing that they had previously only visited. It discusses four categories: expectations of self and others; entering someone else's world; more awareness of student needs; and teaching theory and practising nursing. These categories emerged following the analysis of journals, focus group interviews and individual interviews and led to a number of recommendations concerning the implications for other teachers wishing to return to clinical practice.     

Implementing supernumerary learning in a pre-registration diploma in nursing programme: an action research study

The purpose of this study was to develop a framework for implementing supernumerary learning in a preregistration Diploma in Nursing programme in an Irish hospital. Experiences of student nurses (n = 31), clinical nursing staff (n = 8) and nurse teachers (n = 4) were explored, regarding the introduction of supernumerary status in this programme. An action research approach, employing phenomenological methods for gathering and analysing the data, was used to carry out the study. A framework for implementing supernumerary learning in a Diploma in Nursing programme was developed, based on the study. This framework reflects the level of knowledge, skills and attitudes of individuals partaking in supernumerary learning, and the role of the supervisor in the clinical area at each level. Possible implications of the changing role of the student nurse for nursing practice for education, management and research are suggested.