Designing implementing and evaluating the settlement of the senior undergraduate nursing students at the Educational and Treatment Center of Zanjan University of Medical Sciences

Abstract

Background and Objective: Nursing students experiences in the field of internship require intelligent attention and management. The plan was designed and implemented in order to settle the senior undergraduate nursing students at the Educational and Treatment Center. Materials and Methods: In order to implement this single-group interventional study, undergraduate nursing students were attending full-time work in medical and surgical wards of Educational and Treatment Center under the supervision of a teaching assistant (TA) and a senior instructor in their last year of the course. The program started from the first semester of the 2016-2017 academic year and continued until the second semester of the 2017-2018. The planning and implementation team of the program at the faculty and its corresponding team at the educational and treatment center was responsible for planning, implementing, monitoring, and evaluating the program. Students satisfaction with the program and their feedback was reviewed by the planning and implementation team. In this study, the first level of a Kirkpatrick model was used to evaluate the program. Results: Most of the participating students acknowledged that the program had a positive impact on professional preparation, accountability, self-esteem, and job independence in comparison to the conventional program. They also had criticisms of the program, that the most important of them was mentioned in the article. Also, the head nurses and TAs believed that the program, in addition to reaching the educational goals, was able to moderate the care burden of the nursing staff of the departments. Conclusion: Appraisal of the program illustrates the success of the program in achieving educational goals. It seems that the implementation of similar programs at this stage of the student s curriculum will not only facilitate the transition of the student s professional role but if implemented effectively, it can also help to mitigate the shortage of nursing. It is recommended to study the possibility of implementing such programs in the final year of the midwifery and other paramedical courses. D ow nl oa de d fr om z um s. ac .ir a t 5 :2 6 IR S T o n S at ur da y N ov em be r 2n d 20 19 Residency of senior nursing students in teaching hospitals 2 Journal of Medical Education Development, Vol 12, No 33 Spring, 2019 Introduction The mission of nursing education programs in Iran should be conducted to aim at educating the students who are not only don t align themselves, during the course of studying and after entering the real field of work, with the organization and with its demand but also seeking to provide a positive change in the professional environment and challenge the organization for the desired changes. The purpose of nursing education is to educate nurses who have the ability and knowledge of caring for patients in clinical settings. Clinical learning is an essential part of nursing education (1-4). Clinical learning occurs in a complex social context that aims to develop clinical students skills, apply the theory in practice, apply problem-solving skills, develop interpersonal skills, and learn formal and informal norms, protocols and expectations of the nursing profession and the health care system. The success of nursing programs greatly depends on the effectiveness of these clinical experiences (2, 5-7). Students get acquainted with nursing primary values at nursing faculties and apply them to internships (8). Considering that about half of the nursing programs are devoted to clinical practice, this part of education plays an important role in shaping the professional identity of nursing students (9, 10). Currently, the nursing undergraduate curriculum in Iran consists of three years of theoretical education and one year of clinical practice in health care settings (11). The clinical practice, the internship, is the main part of the professional nursing course, which includes 40 weeks of clinical internship under the supervision of faculty instructors, in which students are set to carry out controlled care of patients (5). Revision of the philosophy, mission, and objectives of the internship program and modification it in practice can have positive and constructive effects and consequences in the student s socialization experience and their transitional role. Responsibilities of nursing educational planners, practitioners, professors, and instructors in educating, educating, supporting and guiding students have a determinative effect in educational and clinical settings. Close collaboration between nursing faculties and hospitals has many benefits to each other. The use of qualified hospital nurses as guides, role models, and clinical instructors in creating an acceptable and stress-free atmosphere is one of the other necessary measures. Modifying the curriculum and patterns should be in a D ow nl oa de d fr om z um s. ac .ir a t 5 :2 6 IR S T o n S at ur da y N ov em be r 2n d 20 19 3 Dinmohammadi & Avazeh Journal of Medical Education Development, Vol 12, No 33 Spring, 2019 direction that educates students, to be selfesteemed and aware nurses (12). The experiences of senior nursing students that coincide with the internship program is a pleasant part of their professional experience and require intelligent care and consolidation. In this program, students gained the necessary conditions and competencies for a professional role after transiting through a rugged path. At this stage, students are actively involved in the process of learning and managing their educational and professional activities, due to the inevitable need to prepare for the real world of work. Their motivation at this stage is to learn, to become more independent and more responsible. Also, communication skills have also grown dramatically with patients and care teams, especially nurses. Acceptance and attention to students abilities during this period reinforces their sense of self-esteem. Providing opportunities for learning, eliminating existing restrictions, admitting them to professional groups, giving full care to patients, providing timely and constructive feedback, and evaluating their fairness, can be effective to restore and maintain their individual and professional integrity (13). Reviewing literature abroad and inside the country highlights the many challenges faced by undergraduate nursing students in the course of study and young nurses at the onset of professional work. Evidence suggests that the common methods of nursing education (the presence of students with close supervision and control of relevant educators) has not been successful in acquiring the professional readiness necessary to transit the student role to a professional independent role. Designing and implementing diverse educational programs for this purpose in the world, including in the interior, also indicate the concern of managers and nursing education leaders in this regard (6-7, 9 and 12). In several countries around the world, similar programs are being developed under different titles, such as internship, preceptorship, mentorship, and externship in faculties and sometimes in hospitals, in order to prepare nursing students or novice nurses to enter work settings. These programs have been designed and implemented for various purposes such as increasing self-esteem, consolidating critical thinking, developing knowledge, skills and clinical competencies, as well as reducing the stress and anxiety of these individuals. For professional organizations, the most important consequence of such programs is to improve the quality of patient care and maintain staff retention and reduce the cost of treatment and care (16-14). D ow nl oa de d fr om z um s. ac .ir a t 5 :2 6 IR S T o n S at ur da y N ov em be r 2n d 20 19 Residency of senior nursing students in teaching hospitals 4 Journal of Medical Education Development, Vol 12, No 33 Spring, 2019 Nursing students’ experiences in the field of internship require intelligent care and management. The experience of the authors during his career in management, educational and research positions in the field of nursing education represents a great challenge in the management of clinical education of undergraduate nursing students. This worries more about the planning and implementation of the nursing senior students educational program. It seems that the implementation of this program is aimed at achieving important goals such as: facilitating the transition of the professional role of students, improving their independencies and self-esteem, improving the quality of care, coherence and continuity of nursing care, improving interaction and communication skills of students with patients and care team, reducing the care burden, and helping students become social nurses (13). This program was designed and implemented with the aim of settling the senior nursing students in educational centers. Materials and Method In order to implement this single-group interventional study, senior undergraduate nursing students were attending full-time work in an medical and surgical ward of Vali-e-Asr hospital under the supervision of teaching assistants (TAs) and a senior instructor in their last year of the course. In order to settle senior nursing students in educational hospitals for four semesters, the program was implemented from the first semester of the 2016-2017 and continued until the second semester of the 2017-2018 academic year. In order to design a settlement program, the program s planning and implementation team at the faculty, consisting of an educational assistant and clinical education manager, heads of nursing educational groups, including medical and surgical nursing, critical care nursing and senior instructors of faculty at the hospital and the corresponding team at the hospital included nursing matron, educational supervisor, head nurses and TAs. The target students included senior