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Implementing dedicated nursing clinical education unit: Nursing students' and preceptors' perspectives
Abstract
Background
The Dedicated Education Unit is a clinical learning model designated to deliver more targeted learning opportunities and enhance student nurses learning capacity. It provides students with more opportunities to develop their skills, experience different learning events, consolidate their knowledge, and build their professional nursing identity.
Methods
The study followed a convergent parallel mixed-method design to investigate the nursing students and the nursing preceptors' perceptions of the Dedicated Education Unit model at Mafraq hospital. Quantitative and qualitative data were collected from a sample of sixty-seven nursing students and 20 nursing preceptors from March to May 2019.
Results
The overall results of the study were positive. Nursing preceptors were confident to communicate and constructively interact, motivate, and facilitate students' learning. However, they requested better support and more free time to supervise and answer students' questions. Nursing students reported positive learning at the dedicated units. However, they requested more support from nursing preceptors.
Conclusion
Implementing a Dedicated Education Unit model supported the nursing preceptors' role and enhanced nursing students' learning opportunities and hands-on experiences. Achieving a positive effect of the dedicated nursing clinical education unit requires constant collaboration between healthcare facilities and nursing education programs to maximize nursing students learning.
... In the present study, the term "nursing preceptor" refers to a professional who voluntarily assumes the responsibility of facilitating the learning of clinical students and supports, educates, and helps their transition into clinical practice (Blevins, 2016;Kamolo et al., 2017;Mikkonen et al., 2020;Pramila-Savukoski et al., 2020;Tuomikoski et al., 2020;Ward & McComb, 2017). Furthermore, preceptorship differs from other educational methods because it requires an official assignment by a third party (usually the unit supervisor) to establish student-preceptor pairing (Chan et al., 2019;Williams, Al Hmaimat, et al., 2021;Yonge et al., 2007). ...
... However, previous studies have shown that this traditional learning model provides students with unequal learning opportunities and low satisfaction levels (Niederhauser et al., 2012;Quek & Shorey, 2018). Interestingly, despite having a modern and individualized learning model with satisfactory results (Dyar, 2019;Hooper et al., 2020;Williams, Al Hmaimat, et al., 2021), nurses who participated in this study advocated for the traditional model. However, as supported by previous studies, it should be noted that the quality and effectiveness of preceptorship are more closely associated with the attitudinal competencies of all individuals involved (Hilli, Melender, et al., 2014;. ...
... This program would include designated spaces for student preceptorship in daily practice, continuous preceptor training and updates, and strengthening the university-clinical collaboration. Training should provide preceptors with the knowledge, skills, and confidence to effectively supervise students at different learning levels, teaching techniques that promote reflection in practice, and integration of students into the clinical environment.New technologies, such as virtual simulation, should be considered for preceptor training because they allow flexibility and the development of nontechnical skills, including decision-making abilitiesWilliams, Al Hmaimat, et al., 2021).2. Promoting collaboration among peers: Collaboration and teamwork among nurse preceptors and their colleagues should be fostered to help share the workload and create a supportive environment during the preceptorship process. ...
Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open‐ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41‐50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.
... After duplicate and incomplete articles were eliminated, the abstracts of the remaining papers were separately assessed for each database, and journal articles were chosen to be included in the final review; 19 articles satisfy the study's eligibility requirements. On the other hand, this systematic review found nine qualitative studies (Farahani et al., 2020;Mahasneh et al., 2020;Mohammadi et al., 2021a;2021b;Niederriter et al., 2017;Rodger & Juckes, 2021;Sadeghi et al., 2019;Soroush et al., 2021;, eight quantitative studies (AlMekkawi et al., 2020;Ergezen et al., 2022;Kaldawi, 2022;Nguyen et al., 2017;Nguyen et al., 2018aNguyen et al., , 2018b and two mixed methods (Reising et al., 2018;Williams et al., 2021). The majority of these studies were cross-sectional descriptive studies, while one of them used a pretest-posttest quasi-experimental design (Kaldawi, 2022 Knox and Mogan (1985). ...
... Last but not least, the most notable differences in one mixed method study (Williams et al., 2021) used SPSS version 21 to enter and assess quantitative data. Preceptors and students' ...
... These articles were included in the final review process: PubMed nine articles (AlMekkawi et al., 2020; Hababeh & Lalithabai, 2020; Mohammadi et al., 2021a, 2021b; Nguyen et al., 2018a; Reising et al., 2018; Sadeghi et al., 2019; Soroush et al., 2021; Taylan et al., 2021). EBSCO-host (CINAHL) five articles(Farahani et al., 2020;Kaldawi, 2022;Nguyen et al., 2018b, Nguyen et al., 2017Niederriter et al., 2017).ScienceDirect five studies(Ergezen et al., 2022;Mahasneh et al., 2020;Rodger & Juckes, 2021;Williams et al., 2021). ...
Objective: The aim of the study is to investigate how students perceive the characteristics of clinical instructors that have an impact on their clinical experiences and aid programs in improving clinical education, and to evaluate the effectiveness of clinical instructor characteristics. Design: Study of a systematic review. Data sources: From three online web databases including PubMed, EBSCOhost (CINAHL), and Science Direct. In addition, searches for key article references were carried out. Review studies that were published from 2017 to 2022. Review methods: A five hundred sixty-two extracted literature from databased articles published in no more than five years, the PRISMA flowchart clarifying the data collection procedure which was manually reviewed, and the study included 19 documents for further analysis. Results: Through the investigation of 19 studies that met the criteria: nine qualitative studies, eight quantitative studies, and two mixed methods. The majority of these studies were cross-sectional descriptive studies while one of them was a quasi-experimental design a pretest-posttest. Two studies from quantitative design utilized the same instrument as a standardized tool used to measure the Nursing Clinical Teacher Effectiveness Inventory (NCTEI) survey tool developed by Knox and Mogan (1985). Conclusion: The experiences and opinions of many students’ nurses, faculties, and clinical instructors about the characteristics of CI is an ongoing and fluctuating process according to their perceptions of them. However, clinical instructors are crucial in helping student nurses develop the skills necessary to be effective and competent practitioners.
... According to Teferra and Mengistu (2017), clinical preceptorship, in nursing, is a clinical teaching and guidance program where nursing students are paired with an experienced nurse in the clinical environment to equip them with clinical skills, knowledge, attitude, and nursing values to be safe nursing professions at the end of pre licensure training. Williams et al. (2021) further highlights that clinical preceptor can help nursing students to establish meaningful experiences and can generally create a mutual supportive learning environment for students and to learn without causing errors that can compromise the well-being of the patients or communities. Therefore, it is essential that qualifying clinical preceptors are employed so that they can be able to provide clinical teaching to the R171 nursing students. ...
Background
Nurse educators must seek innovative frameworks for their curricula to prepare nursing students to meet evolving healthcare needs. The South African National Department of Health introduced the new nursing curriculum (R171) in 2013 with the aim of producing generalist nurses who can meet the health care needs of the patients and to align the nursing program with the relevant Higher Education Qualification Framework. R171 was implemented in the North-West Province in 2021.Therefore, the main purpose of this study was to explore and describe the experiences of nurse educators regarding the three-year R171 nursing curriculum in North-West Province, South Africa.
Methodology
The researcher used a descriptive phenomenology research design to achieve the aim and objectives. A nonprobability sampling approach was adopted for the study with use of a purposive sampling technique to select participants with insight and experience on the phenomenon in question. Semi-structured individual interviews, through Microsoft Teams, collected the data, with analysis using thematic analysis.
Results
Three themes emerged from the findings of this study, namely inadequate resources to implement the R171 nursing curriculum, teaching and learning challenges in implementing the R171 nursing curriculum, and the possible solutions for effective implementation of the R171 nursing curriculum.
Conclusion
To implement the R171 nursing curriculum effectively, it is necessary to include nurse educators in the development of the curriculum. There is also a need for comprehensive support that comprises all available essential resources.
... for both mentors and teachers and there is pressure on staff to take on an educational role, with insufficient preparation and support due to demand in working conditions that are not ideal (Macey et al., 2021;Williams et al., 2021). Teaching is a very time-consuming responsibility, with low recognition, and in some cases, it is not a priority concern of managers. ...
Aim
To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within “Dedicated Education Unit” model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment.
Design
A multi‐country, phenomenological, qualitative study.
Methods
Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives.
Results
Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment.
Conclusions
A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals’ education and development among others, are elements to set up a powerful clinical learning environment.
Implications for the profession
It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population.
Impact
Due to the close relationship between students’ learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes.
Public Contribution
Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.
... (2020) has demonstrated that students in DEUs experience a notable enhancement in self-efficacy. Additionally, Williams et al. (2021) found that these students also exhibit improvements in their perception of competence and confidence. Furthermore, Vnenchak et al. (2019) discovered that DEUs foster collaboration between nurses and nursing students, as well as among nurses themselves. ...
The COVID-19 pandemic has posed unprecedented challenges to nursing education in the Philippines, prompting the exploration of innovative strategies to support students' self-efficacy. This study investigates the implementation of the Dedicated Education Unit (DEU) model in Filipino nursing education post-pandemic. Drawing from international research and theoretical frameworks such as Bandura's Social Cognitive Theory, the study explores the potential benefits of DEUs in enhancing students' self-efficacy. A pre-test, post-test experimental design was employed to evaluate the impact of DEU implementation on nursing students' self-efficacy levels. Statistical analyses reveal a significant increase in students' self-efficacy post-intervention (p-value=0.003), indicating the efficacy of the DEU model in fostering students' confidence and belief in their clinical abilities. The average score before the intervention was 2.81, while after the intervention, it increased to 3.67. Discussion highlights the positive outcomes associated with DEUs, including improvements in student self-efficacy, critical thinking, and successful transition to professional practice. The study concludes with implications for future research and practice, emphasizing the importance of continued exploration and adaptation of innovative clinical education models to meet the evolving needs of nursing students and healthcare systems.
... However, there is a significant problem we aim to address: there is limited research that explores the experience of preceptors in the workplace, creating a substantial gap in our understanding of their role and its impact on nursing education and patient care. This knowledge deficit hampers our ability to identify areas for improvement and provide better support for the crucial role that preceptors play in clinical education [12]. ...
Background
The role of preceptors is vital in the successful integration of new graduate nurses in hospital settings. This study aimed to explore the experiences of nurse preceptors in training newly joined nurses in Qatar.
Methods
Qualitative study was conducted between May 2022 and May 2023. Online semi-structured interviews were conducted through MS Teams with 13 nurse preceptors who had completed preceptorship training and trained at least one newly joined nurse. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis.
Results
The results of the study revealed several main themes: teaching strategies and progressive skill development in preceptorship, challenges faced by the preceptor and preceptor better supported in training new nurses. The preceptors utilized different techniques to support new nurses including demonstration, discussion, use of technology, application of real-life clinical scenarios, simulations, and a gradual decrease in supervision to promote independence. However, a significant challenge was also reported including preceptors experienced high levels of exhaustion from the dual responsibilities of training new staff while also performing their regular care duties.
Conclusions
The study underscores the fundamental role preceptors play in the training and development of newly joined nurses. While the challenges are considerable, particularly related to managing workload, the sense of achievement following the successful completion of training a new nurse suggests a strong commitment to this role. Despite the challenges, preceptors demonstrated innovative strategies to ensure the successful development of their preceptees, highlighting the importance of preceptorship in nursing education and practice.
... These titles are often used interchangeably (Sandy, 2014). Many practice learning models identified within the nursing literature-for example, the "clinical education unit" (Williams et al., 2021), "clinical partnership" (MacLean et al., 2018), "collaborative learning unit" (Marcellus et al., 2022), and "dedicated education unit" (Hooper et al., 2020) models, however, tend to concentrate on the nature of student supervision rather than addressing the potential effect of placement structure on learning. Since practicum design may significantly affect clinical learning experiences (Stephenson, 2016), however, it is arguably just as important to examine the scheduling structure to which students are exposed as it is to look at the model of supervisory support. ...
Abstract
This study sought to examine whether the consistent application of a specific placement design to student practice learning experiences within two pre-registration nursing degree programmes offered by a university in the United Kingdom (UK) affected retention and achievement levels. The quantitative analysis involved a sample of 460 employer-sponsored undergraduates, all of whom worked as non-registrant carers, within two cohorts of a part-time adult (physical) or mental health nursing degree programme, both of four years duration, offered by a large academic institution with a presence in all four UK nations. Cross-tabulation and multinomial logistic regression analyses found no statistically significant relationship between exclusive student exposure to either block or integrated practicum experiences in respect of programme withdrawal rates or the degree classification achieved by such learners.
Unlike pre-registration nurse education programmes offered within some other countries, for example Australia and Canada, most of those provided in the UK have traditionally been based solely on a block design. Nevertheless, recent changes in the programme options available to learners seeking to acquire registered nurse status, combined with growing demand for healthcare placements, have led some UK universities to now consider alternative practicum models and so optimize the use of available placement capacity. Internationally, no previous work investigating the potential impact of the two practicum designs on student retention and academic achievement appears to have been undertaken in respect of pre-registration programmes, either in nursing or any other health or social care discipline. The absence of any statistically significant effect of a practicum design upon the identified performance measures may therefore be both helpful and reassuring to academic institutions either using, or planning to implement, both models.
Whilst the results are institutionally and geographically specific and derived exclusively from only two nursing programmes, they still make an important contribution to a seriously under-researched field. It is hoped that the work will stimulate further investigation regarding the impact of undergraduate experience within different placement models both within and beyond nursing education. The literature review associated with this study also identified widespread inconsistent use of terminology to describe the two practicum models; a situation which may be adversely affecting efforts to consolidate the body of knowledge related to the effect of different placement designs.
Résumé
Cette étude visait à examiner si l’application cohérente d’une conception de stage particulière pour les expériences d’apprentissage pratique par le corps étudiant dans le cadre de deux programmes de grade en sciences infirmières menant au droit de pratique, offerts par une université du Royaume-Uni, avait un effet sur les niveaux de rétention et de réussite. L’analyse quantitative a porté sur un échantillon de 460 membres du corps étudiant de premier cycle, parrainés par un employeur, qui travaillaient tous comme soignants non-inscrits, au sein de deux cohortes d’un programme de grade en sciences infirmières à temps partiel pour soins aux adultes (physique) ou en santé mentale, tous deux d’une durée de quatre ans, offerts par une grande institution universitaire présente dans les quatre pays du Royaume-Uni. Les tableaux croisés et les analyses de régression logistique multinomiale n’ont trouvé aucune relation statistiquement significative entre l’exposition exclusive du corps étudiant à des expériences de stage en blocs ou intégrées en ce qui concerne les taux d’abandon du programme ou le classement obtenu par ces stagiaires qui ont réussi.
Contrairement aux programmes de formation en sciences infirmières menant à la pratique offerts dans certains autres pays, par exemple l’Australie et le Canada, la plupart de ceux dispensés au Royaume-Uni ont traditionnellement été basés uniquement sur une conception en blocs. Néanmoins, des changements récents dans les options de programme pour stagiaires cherchant à acquérir le statut d’infirmière ou infirmier, combinés à la demande croissante de stages en soins de santé, ont conduit certaines universités britanniques à envisager désormais d’autres modèles de stage et ainsi optimiser l’utilisation de la capacité de places disponibles. À l’échelle internationale, aucune étude antérieure portant sur l’impact potentiel des deux conceptions de stage sur la rétention du corps étudiant et la réussite scolaire ne semble avoir été entreprise en ce qui concerne les programmes menant à la pratique, que ce soit en sciences infirmières ou dans toute autre discipline de la santé ou des services sociaux. L’absence de tout effet statistiquement significatif d’une conception de stage sur les mesures de rendement identifiées peut donc être à la fois utile et rassurante pour les établissements universitaires qui utilisent ou prévoient mettre en œuvre les deux modèles.
Alors que les résultats sont institutionnellement et géographiquement spécifiques et proviennent exclusivement de seulement deux programmes de sciences infirmières, ils apportent tout de même une contribution importante à un domaine sérieusement sous-étudié. Nous espérons que l cette étude stimulera une recherche plus approfondie concernant l’impact de l’expérience de premier cycle dans différents modèles de stage à la fois au sein de la formation en sciences infirmières et au-delà. L’analyse documentaire associée à cette étude a également identifié une utilisation incohérente généralisée de la terminologie pour décrire les deux modèles de stage; une situation qui peut nuire aux efforts visant à consolider l’ensemble des connaissances liées à l’effet de différentes conceptions de stage.
... A key challenge in nursing education is thus to provide the tools, opportunities and environment for students to develop caring skills based on compassion and craftmanship (Adamson, 2018). Furthermore, previous research has shown that student learning in clinical practice has mostly been described from the perspective of students and supervisors (Pålsson et al., 2021;Williams et al., 2021) and only rarely from the patient perspective (Suikkala et al., 2018). ...
The aim was to describe and gain a greater understanding of the phenomenon “caring-learning space” based on the perspectives of patients, nursing students, and supervisors in clinical practice contexts.
A general structure of the phenomenon “caring-learning space” was created based on essential structures from five empirical studies. The analysis is based on a reflective lifeworld research approach (RLR).
The “caring-learning” space shows itself in terms of interpersonal relationships between patients, students, supervisors, and other actors in the care environment. It is first when the learning space is accepted as a part of caring, that a “caring-learning space” is created. A flexibility and a receptivity are seen where the learning is allowed to become visible and be integrated in the caring processes when caring and learning to interact.
A caring-learning space is established by the patient being the focal point, but also a co-creator in caring as well as learning regardless of her/his health status. This entails that the ”caring-learning space” exists when patients, students, supervisors and other healthcare professionals interact based on their ability and role in the space.
... This variation may be related to the UAE students' perceptions of the professional nursing role and their allocation at health care facilities following the DEU model rather than the traditional preceptorship model of clinical learning. This assumption is supported by the findings from 2 recent studies by Hooper et al 26 and Williams et al,27 who studied the effectiveness of the DEU model in the UAE. These 2 studies found that nursing students had positive learning experiences in the DEU model and expressed their readiness for practice after graduation. ...
Background:
Nursing literature identifies difficulties facing new graduates in managing their responsibilities as registered nurses. The ability of new graduates to be practice-ready upon entry to the workplace remains a challenging concern for nurse educators.
Purpose:
This study investigated the perceptions of senior students toward their readiness to practice safely and independently and perform registered nurses' job-specific requirements upon graduation.
Methods:
A descriptive design using quantitative and qualitative methods was used to conduct the study. Data were collected from a sample of 117 senior nursing students in the United Arab Emirates using the Casey-Fink Readiness to Practice Survey.
Results:
Senior students felt confident to manage the care of 2 to 3 patients, communicate with patients and interdisciplinary teams, solve clinical problems, prioritize patients' care, and recognize significant changes in patient conditions. Areas of concern were their ability to care for more than 3 patients, among others, such as caring for dying patients and performing catheter insertion/irrigation.
Conclusions:
Students need better learning opportunities and closer guidance, support, and on-time feedback in clinical set-tings.
Background: Clinical teaching and supervision of undergraduate nursing students is one continuous, high volume, high impact responsibility of registered nurses at clinical environment. Objective: The objective of the study was to identify the level of preparedness, recognition and support in their role to teach and supervise the nursing students. Methodology: A cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan, from July to October, 2023. The convenient sampling technique was used to collect data followed by written informed consent, calculated sample size was 81. All the RN, GBSN, Post-RN BSN, MSN nurses having valid PNC license and working at clinical setting were included and those nurses who were already involved in teaching were excluded. Data were analyzed via SPSS version 26.0. Results: Among all participants, 51% (n=41) were aged between 25-45 years, 48.1% (n=39) were males and 51.9% (n=42) were females participated in the study. Out of the total participants, 37.0% (n=30) of participants from Post RN BSN and 4.9% (n=4) of the participants from Master of Science in Nursing (MSN). 43.2% (n = 35) was the number of respondents who had previous experience of supervising. Conclusion: The current model of clinical placement has to be revised due to the growing difficulty of the practice environment, the rise in need of the nursing student’s professional growth and the hopes placed on RNs.
Background
Innovative models are required to maximize nursing student placements in environments of shrinking budgets, increasing hospital demands, and casualization and aging of the workforce. This article reports the success of a service-academic partnership in a dedicated education unit.
Method
This cross-sectional observational study in a regional hospital analyzed survey data using validated tools completed by buddy nurses ( n = 80) and postplacement evaluation completed by students ( n = 102) and the nurse leadership team ( n = 17).
Results
Postimplementation, nursing student placement days increased, and participants were positive about the partnership. Although most of the nursing students ( n = 96) reported they were very or extremely satisfied with their placement, they rated student facilitators higher than their buddy nurses.
Conclusion
Increasing enrollments will not solve the nursing workforce shortage unless student placements of quality and quantity are provided. Partnership in support of clinical staff remains critical to create time to provide quality supervision. [ J Nurs Educ . 2024;63(9):619–625.]
Background
Despite available training programs for neonatal advanced practice providers (Neo APP), including neonatal nurse practitioners and physician assistants, it is difficult to meet the demand for these providers. There are no publications regarding training models with greater than 1 Neo APP learner per mentor.
Purpose
To create and measure outcomes of a 12-month program to educate Neo APP “Super-Mentors” able to train 2 Neo APP learners simultaneously.
Methods
Super-Mentors were selected and attended monthly classes to learn mentorship concepts and receive support. Learners received didactic content and support through a Fellowship program. Quantitative data regarding recruitment and retention, as well as Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) results were compared pre- and postprogram. Qualitative satisfaction measures via survey from 21 stakeholders were analyzed through a phenomenological approach.
Results
Six Super-Mentors trained 14 Neo APPs, as compared to 7 in the previous year. One Neo APP left after training. Summative preprogram MNPJSS scores were better (5.1 ± 0.37) than postprogram (4.7 ± 0.47) ( P < .001). The most important preprogram subscale item was “vacation” versus “quality of assistive personnel” postprogram. Both pre- and postprogram scores reflected positive job satisfaction so differences may not be clinically significant. Qualitative program benefits included faster and increased onboarding, stronger relationships, and dedicated time. Challenges included role clarity among other stakeholders, learning culture, and spacial/technological logistics.
Implications for Practice
Super-Mentors can train twice the number of Neo APP learners, with optimal preparation and support of all stakeholders, adequate space, and appropriate technology.
Introduction: Nurses constitute the majority of health care personnel, and the high turnover and instability of nurse staffing can affect patient outcomes. Systematic education and the support of co-workers and organization are imperative to maintain the current nurse workforce. 1 As nurses are frontline staff in most healthcare contexts, their contribution is essential to the delivery of safe and effective patient care, it is essential that nurses are trained to a high standard. The quality of nursing education, including the clinical placement, is of outmost importance, and research indicates that it influences intent to stay in the nursing profession at a time when nursing shortages are a concern worldwide. 2 The clinical placement is a central component of nursing education. The clinical placement involves learning under the supervision of a healthcare professional within a healthcare organisation and it has been described as a social process requiring active participation. Clinical placements provide the opportunity for nursing students and new nurses to apply theoretical knowledge obtained during their campus-based learning. Furthermore, the clinical placement enables students to develop cognitive and affective skills, to acclimatise culturally) and to develop their professional identity. 3
Using a structured approach to improvement that integrates methodological frameworks and commonly used improvement tools and techniques allows an improvement team to systematically implement and evaluate an intervention. Authors from one academic medical center will describe our four-step structured improvement approach in the design of a dedicated education unit (DEU) pilot to potentially meet a critical post-COVID-19 workforce need. Using our structured improvement approach, we successfully piloted a DEU with a unit-based clinical educator and 16 nursing students over 26 clinical days and received 13 preintervention surveys from participants. Although the DEU pilot was small with limited data, the structured improvement approach resulted in an organized and systematic way of designing, implementing, and evaluating improvement.
Background: Initially developed in Australia, Dedicated Education Unit (DEU) is an innovative approach to support the growth and development of nursing students while on clinical placement in the hospital setting. With the increasing number of nursing students requiring clinical placement, nursing needed to explore further ways to support students and preceptors in the clinical area. Methods: The study followed a sequential explanatory mixed-methods design to investigate participants’ perceptions of the effectiveness of the DEU model in improving nursing students’ learning experiences. The DEU model was implemented in 2 Abu Dhabi Health Services Company (SEHA) hospitals in Al Ain City, and feedback was obtained from both students and their preceptors via survey and focus group sessions. Results: The study showed positive results with students feeling supported to learn new knowledge and skills by their preceptors. Preceptors reported that they were better able to facilitate student placements in an environment that supported learning. Conclusion: The introduction of the DEU model has supported increasing numbers of students in the clinical area and provided an improved environment for learning.
Introduction
Worldwide, a growing number of healthcare students require clinical environments for learning. Some wards have become adapted ‘student wards’ to meet this demand. Benefits have been reported from the students’, supervisors’ and patients’ perspectives. There is no definition of a student ward, and little research on what the term means. A deeper understanding of the characteristics of student wards is needed to support their use. The aim of this study is to describe what characterises the learning environment on one student ward.
Methods
An ethnographic approach was used for an observational study on a student ward in a hospital in Sweden. Student nurses, supervisors and others on the ward were observed. Field notes were thematically analysed.
Results
Four themes were identified: ‘Student-led learning’ described students learning by actively performing clinical tasks and taking responsibility for patients and for their own learning. ‘Learning together’ described peer learning and supervision. ‘Staff’s approach to learning’ described personalised relationships between the students and staff and the build-up of trust, the unified inter-professional approach to teaching, and the supervisors’ motivation for teaching and for their own learning. ‘Student-dedicated space’ described the effect of the student room on the learning environment.
Discussion and conclusions
This study describes the characteristics of a student ward that centred around a community of practice that shared a view of learning as a priority, allowing staff to provide clinical care without compromising students’ learning. This qualitative study at a single centre lays the groundwork for future research into other student wards.
Background
In accordance with the process of nursing globalization, issues related to the increasing national and international mobility of student and qualified nurses are currently being debated. Identifying international differences and comparing similarities for mutual understanding, development and better harmonization of clinical training of undergraduate nursing students is recommended.AimsThe aim of the study was to describe and compare the nature of the nursing clinical practice education models adopted in different countries.MethodsA qualitative approach involving an expert panel of nurses was adopted. The Nominal Group Technique was employed to develop the initial research instrument for data collection. Eleven members of the UDINE-C network, representing institutions engaged in the process of professional nursing education and research (universities, high schools and clinical institutes), participated. Three data collection rounds were implemented. An analysis of the findings was performed, assuring rigour.ResultsDifferences and homogeneity are reported and discussed regarding: (a) the clinical learning requirements across countries; (b) the prerequisites and clinical learning process patterns; and (c) the progress and final evaluation of the competencies achieved.ConclusionsA wider discussion is needed regarding nursing student exchange and internalization of clinical education in placements across European and non-European countries. A clear strategy for nursing education accreditation and harmonization of patterns of organization of clinical training at placements, as well as strategies of student assessment during this training, are recommended. There is also a need to develop international ethical guidelines for undergraduate nursing students gaining international experience.
Aim:
The study compared students' perceptions of their clinical learning experiences in a dedicated education unit (DEU) with their experiences in traditional clinical education.
Background:
Unlike traditional academic-instructor models, expert nurses in the DEU provide clinical education to students with faculty support.
Method:
This repeated measures design used student surveys, supplemented by focus group data.
Results:
Students were more likely to agree that their clinical learning experience was high quality and they had a consistent mentoring relationship during DEU rotations. Students also reported the quality of the unit's learning environment, the leadership style of the nurse manager, and the nursing care on the unit was more favorable in DEUs than traditional units. Consistent with their changed role in DEUs, faculty members were less active in helping students integrate theory and practice.
Conclusion:
These findings provide additional evidence of the value that the DEU model contributes to high-quality clinical education.
Although nursing care has changed significantly over the past 30 years, methods to clinically train nursing students have not. The traditional model of clinical nursing education, where a faculty member oversees a group of six to eight students on an acute care unit for a 4- to 8-hour shift, provides a haphazard approach to learning. A need exists to find innovative ways to effectively train more nursing students to better prepare them for today's health care environment. Using a change framework, seven approaches to clinical nursing education were created through academic-practice partnerships. These approaches may increase the effectiveness and efficiency of the clinical nursing education system.
Objectives:
It has been argued that mixed methods research can be useful in nursing and health science because of the complexity of the phenomena studied. However, the integration of qualitative and quantitative approaches continues to be one of much debate and there is a need for a rigorous framework for designing and interpreting mixed methods research. This paper explores the analytical approaches (i.e. parallel, concurrent or sequential) used in mixed methods studies within healthcare and exemplifies the use of triangulation as a methodological metaphor for drawing inferences from qualitative and quantitative findings originating from such analyses.
Design:
This review of the literature used systematic principles in searching CINAHL, Medline and PsycINFO for healthcare research studies which employed a mixed methods approach and were published in the English language between January 1999 and September 2009.
Results:
In total, 168 studies were included in the results. Most studies originated in the United States of America (USA), the United Kingdom (UK) and Canada. The analytic approach most widely used was parallel data analysis. A number of studies used sequential data analysis; far fewer studies employed concurrent data analysis. Very few of these studies clearly articulated the purpose for using a mixed methods design. The use of the methodological metaphor of triangulation on convergent, complementary, and divergent results from mixed methods studies is exemplified and an example of developing theory from such data is provided.
Conclusion:
A trend for conducting parallel data analysis on quantitative and qualitative data in mixed methods healthcare research has been identified in the studies included in this review. Using triangulation as a methodological metaphor can facilitate the integration of qualitative and quantitative findings, help researchers to clarify their theoretical propositions and the basis of their results. This can offer a better understanding of the links between theory and empirical findings, challenge theoretical assumptions and develop new theory.
This paper aims to discuss the implementation of a 'community of practice' model of clinical teaching into four residential aged care facilities.
There is increasing international evidence that aged care is a burgeoning health issue, particularly in developed countries. Recruitment and retention of nurses is problematic in residential aged care. Nursing students maintain negative perceptions of aged care and dislike clinical placements in that area. Additionally, supporting students in residential aged care is difficult considering the staffing mix of skilled/unskilled staff. Innovative educational strategies are needed to manage the increasing shortages of clinical placements for nursing students in all clinical areas.
Staff experiences were elicited through four focus groups onsite at the residential aged care facility where students had been placed, one year after implementation of a 'communities of practice' clinical model. Data analysis used a qualitative, thematic approach.
The staff in the residential aged care facilities expressed that work was involved in supporting students in the workplace, but that the additional workload was a valuable investment.
Staff in residential aged care see working with students as a local investment, where students' fresh eyes, recent knowledge and questioning behaviours are a worthy investment of staff time and effort. Staff also valued the investment in the future, where working with students now creates future nurses sensitive to aged care issues.
In a 'communities of practice' model of clinical experience for students, there are benefits for staff as well as students. The implementation of this clinical model in residential aged care was relatively low in cost, a benefit in this sector and has the potential to address the critical issues of recruitment and retention.
Background
Dedicated Education Units are innovative teaching models that involve collaboration between nurse educators and clinical institutions to provide effective clinical learning. An essential requisite for Dedication Education Units is an effective academic-practice partnership. Following the initiation of a Dedicated Education Unit, partnerships can fade and lines of communication can deteriorate, resulting in dissatisfaction or termination of the partnership.
Problem
The ongoing sustainability of a Dedicated Education Unit was questioned due to personnel turnover, communication challenges, and infrequent provision of training for nurses.
Approach
A redesign project was implemented with the goal to improve academic-practice collaboration, confirm mutual benefit, and envision long-term sustainability. Focus groups were conducted with key stakeholders to identify and evaluate program revisions following three semesters of student rotations on the redesigned Dedicated Education Unit.
Outcomes
The redesigned Dedicated Education Unit elements received overwhelmingly positive feedback from nurses, students, and faculty. Participants reported increased collaboration between the academic and practice partners, improved communication between faculty and nurses, increased student satisfaction, and improved role preparation for nurses.
Conclusion
This project demonstrated that Dedicated Education Units can provide mutual benefits to academic and practice partners; however, ongoing collaboration from all members of the partnership is essential for ongoing sustainability.
Clinically-based interprofessional education offers students an opportunity to witness and experience how interprofessional competencies are translated into practice. In 2011, Massachusetts General Hospital (MGH) and the MGH Institute of Health Professions (IHP) established the first interprofessional dedicated education unit (IPDEU) in the United States, adapting the dedicated education unit model used in nurse education. On the IPDEU, interprofessional groups of IHP students spent a half-day per week across a semester working on both clinical and interprofessional competencies under the guidance of IPDEU staff nurses and therapists who served as clinical instructors. Though student evaluations were consistently favorable, the program strained resources while being able to accommodate only a limited number of students. After three years, MGH and IHP charged a steering committee with re-envisioning a cost-effective instructional model of IPE in acute care, capable of supporting more students. This redesigned experience, introduced in 2015 and continuing today, provides students with a facilitated observational experience focused exclusively on competencies for interprofessional collaborative practice. Scheduled in interprofessional dyads, students spend one half-day on an IPDEU with a nurse interprofessional practice instructor (IPI) and a second half-day with an IPI from speech-language pathology, physical therapy, or occupational therapy. Instructors use active observation techniques to help students recognize interprofessional collaboration and its underlying competencies as they encounter it during their typical care-delivery day, with each session ending in a group debriefing. In evaluations, students indicate that the experience reinforces interprofessional competencies, highlighting the importance of the IPI role and debriefings. In this article, we describe the IPDEU's evolution, share results, offer evidence of the model's scalability and sustainability, and discuss factors contributing to its success in overcoming barriers to clinically-based IPE.
This nursing research text features state-of-the-art research undertaken by Canadian nurse researchers, as well as additional Canadian content relating to the history of nursing research, ethical considerations, models of nursing, and models of research utilization. This thoroughly updated Third Edition has a greater focus on evidence-based practice and assists the reader in evaluating the adequacy of research findings. The text includes four new research reports, two with full written critiques. © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. All rights reserved.
Background and objective: Nursing programs in Australia, New Zealand, and the United States are implementing Dedicated Education Units (DEU) as an innovative approach to provide clinical experiences for undergraduate nursing students. In August 2014 a university in Texas received a state grant to institute a pilot implementation of a DEU as a means of increasing the number of pre-licensure nursing students in the BSN program. The following objectives were designed to provide structure to implement and evaluate the DEU project: (1) Develop and implement a DEU model for pre-licensure nursing clinical education in four medical-surgical courses, using two nursing units at a local regional hospital; (2) Test the effectiveness of the DEU model of clinical education for pre-licensure nursing students; and (3) Increase the number of BSN-prepared nurses serving as DEU Clinical Instructors who enroll in a MSN-Nurse Educator program by six in the first semester of the grant.
Methods: A variety of methods were used to evaluate effectiveness of this project, including focus groups of participants; qualitative assessment of the project orientation process for students, faculty and staff; quantitative analysis of examination scores, course scores, competency evaluations, and enrollment data.
Results: Project evaluation revealed some positive results; however, problems related to orientation and ongoing support were seen as a barrier to successful implementation. Work overload for the Clinical Instructors also negatively impacted the effectiveness of the project. The number of students involved in this project was dictated by the space available in the designated DEUs. Even though the small sample size was insufficient for a research study, the results of this project may be of interest to others implementing a DEU.
Conclusions: This paper focuses on lessons learned from the implementation a DEU pilot project and provides a number of suggestions for addressing challenges. The analysis of the results of this pilot project and related recommendations to avoid or ameliorate the challenges may be instructive for other schools planning to initiate a DEU.
Nurses guide and support learning of students and new graduates in the workplace. A plethora of literature exists about learners needs in the workplace however nursing leadership teams also need to support experienced nurses who facilitate others' learning.
This study sought to develop a tool for Registered Nurses' to report on the support they receive when they facilitate the learning of others. SCALE DEVELOPMENT: An extensive literature review identified 28 papers about support RNs need to facilitate learning. Five re-occuring themes pertaining to workload, communication, acknowledgement, teamwork and preparation for role emerged from analysis of these papers. These were verified independently through focus groups. A 30-item instrument was generated based on the themes; further RN focus groups were conducted to ensure clarity of items. TESTING OF INSTRUMENT: Data were collected from RNs working in medical and surgical areas across three acute care hospitals (ranging from 300 to 750 beds). A total of 372 registered nurses responded. Principle component analysis identified 5 distinct sub scales represented by 17 items with good reliability: workload 0.953; communication 0.847; acknowledgement 0.858; teamwork 0.852; preparation 0.942.
This newly developed tool measures Registered Nurses perceptions of support they receive to fulfil their role in supporting the learning of others. The data generated from use of this tool can inform nursing leadership about the effectiveness of existing infrastructure and resources to support RNs.
Preparing new nurses to practice independently and provide safe and effective care has always been a priority for nurse leaders in academe and service but is becoming more of a challenge as patient acuity intensifies and care systems become more complex. Recent reports by the Carnegie Foundation and by the Institute of Medicine and RWJF call for nurse leaders to improve how nurses are prepared and educated by reducing the gap between classroom and clinical teaching and making better use of resources and partnerships available in the community. The development of a dedicated education unit is one strategy to address this gap.
The need to attend to quality and safety competency development, increase capacity in nursing education programs, address the faculty and nursing shortages, and find new ways to keep step with an ever-changing health care environment has brought forth numerous creative curricular responses and collaborative efforts. To tackle these multiple needs and challenges simultaneously, a new academic-service partnership was created to collaboratively develop an innovative clinical education delivery model. The designed dedicated education unit model not only promoted student learning about quality and safety competencies via unit-based projects but also supported quality improvements in nursing care delivery. Following the initial semester of the model's implementation, a pilot study was conducted. The findings generated the evidence required to take this innovation to the next level. Moreover, the education-practice partnership, which was created to implement the clinical education delivery model, was strengthened as a result of this preliminary evaluation.
Many undergraduate baccalaureate nursing programs incorporate clinical emersion courses at the end of the program. Nursing capstone courses have become increasingly important in facilitating student transition into practice. However, little is known regarding the overall effectiveness of this teaching model for students, nursing programs, and clinical agencies. Previous studies revealed conflicting results about the benefits of a senior level precepted clinical experience. In this multi-method study, the authors examined student learning outcomes, perceptions, employment choice and retention following implementation of a new capstone nursing course. Results of this study indicated that a capstone course does not necessarily significantly improve scores on achievement exams or NCLEX RN first time pass rates. Nevertheless, qualitative content analysis revealed the following themes: integration, autonomy, confidence, authority, and advocacy consistent with a perceived enhanced competence in the nursing role. Data indicated that graduates often seek employment and remain at their capstone site or within their capstone specialty.
Dedicated Education Units (DEU) are, existing health care units collaboratively developed by clinicians and academics as clinical teaching and learning environments dedicated to students from Flinders University, Adelaide, Australia. Throughout each semester students from all year levels work together as peer teachers and learners supported by academics and clinicians. The School of Nursing and Midwifery first introduced the Dedication Education Units in 1997 with the aim of providing optimal and flexible clinical learning environments for undergraduate nursing students. In this evaluative study students (n=121) and clinicians (n=127) perceived the DEU clinical placement configuration to: maintain quality of patient care, foster student relationships, provide an environment where students and academics were accepted as members of the clinical team and increase the collaborative relationship between clinicians, students and academics.
This article describes the implementation and evaluation of the Dedicated Education Unit (DEU) as an innovative model of clinical nursing education. A partnership of nurse executives, staff nurses and faculty transformed patient care units into environments of support for nursing students and staff nurses while continuing the critical work of providing quality care to acutely ill adults. Various methods were used to obtain formative data during the implementation of this model in which staff nurses assumed the role of nursing instructors. Results showed high student and nurse satisfaction and a marked increase in clinical capacity that allowed for increased enrollment. This article reports on a 3-year project to operationalize the DEU concept with 6 nursing units in 3 hospitals. The development of staff nurses as clinical instructors, best practices to teach and evaluate critical thinking in students, and the mix of student learners continue as focus areas.
Essentials of nursing research
- D Polit
- C Beck
Polit, D., & Beck, C. (2012). Essentials of nursing research. Ethics, 23(2), 145-160.