Ah Marlow

Quality clinical placements for undergraduate nursing students: a cross-sectional survey of undergraduates and supervising nurses.

AIM   This article is a report of a mixed method study of the quality of clinical placements for second year undergraduate nursing students in an acute care hospital. BACKGROUND   In response to the current and predicted workforce shortages, greater numbers of nursing undergraduate places are being offered at tertiary institutions. This means that requests for clinical places in hospitals to support undergraduate students has risen. Little is known about the impact of increased numbers on the quality of clinical placement as a learning experience and this is of concern as demand grows and the means of assessing capacity is still unknown. METHODS   A 5-point Likert Scale questionnaire, including free text fields, was administered to undergraduates (n = 178), clinical facilitators (n = 22) and supervising ward nurses (n = 163) at two time points in 2009. The survey targeted the quality of the clinical placement in four domains: welcoming and belongingness; teaching and learning; feedback; confidence and competence. Findings.  The findings demonstrated consistently high scoring of the clinical placement experience by both undergraduates and registered nurses. There were higher ratings of levels of support from clinical facilitators compared to supervising ward nurses evident in data associated with the items on the questionnaire relating to teaching and learning. CONCLUSION   The results are indicative of the professional commitment of nursing staff to support the next generation of nurses. The findings also give a mechanism to communicate outcomes of undergraduate support to nurses in practice, and highlight steps which can be taken to ensure high quality clinical placement continues.

Learning opportunities in a residential aged care facility: the role of supported placements for first-year nursing students.

The residential aged care sector is reportedly a less attractive career choice for nursing students than other sectors. Research shows that students are often fearful of working with residents with dementia when they are inadequately supported on clinical placements by aged care staff. Thirty first-year nursing students attended a 2-week placement in one of two Tasmanian aged care facilities as part of the Wicking Dementia Research and Education Centre Teaching Aged Care Facilities Program, which aims to provide students with a quality aged care placement focusing on dementia palliation. Placement experience and dementia knowledge were evaluated through preplacement and postplacement questionnaires and weekly feedback meetings with mentors and students. Students had more positive attitudes related to aged care and higher dementia knowledge at the end of placement. Students described their interactions with residents with dementia and thought that the placement had increased their capacity to provide quality care to these residents. The findings indicate that residential aged care placements can be productive learning environments for novice nursing students.

Audio teleconferencing: creative use of a forgotten innovation.

As part of a regional School of Nursing and Midwifery’s commitment to addressing recruitment and retention issues, approximately 90% of second year undergraduate student nurses undertake clinical placements at: multipurpose centres; regional or district hospitals; aged care; or community centres based in rural and remote regions within the State. The remaining 10% undertake professional experience placement in urban areas only. This placement of a large cohort of students, in low numbers in a variety of clinical settings, initiated the need to provide consistent support to both students and staff at these facilities. Subsequently the development of an audio teleconferencing model of clinical facilitation to guide student teaching and learning and to provide support to registered nurse preceptors in clinical practice was developed. This paper draws on Weimer’s ‘Personal Accounts of Change’ approach to describe, discuss and evaluate the modifications that have occurred since the inception of this audio teleconferencing model (Weimer, 2006).

Wicking teaching aged care facilities program: Innovative Practice:

This paper reports on the design of a program that aims to prototype teaching aged care facilities in Australia. Beginning in two Tasmanian residential aged care facilities, the intent of the program is to support large-scale inter-professional student clinical placements, positively influence students’ attitudes toward working in aged care and drive development of a high-performance culture capable of supporting evidence-based aged care practice. This is important in the context of aged care being perceived as an unattractive career choice for health professionals, reinforced by negative clinical placement experiences. The Teaching Aged Care Facilities Program features six stages configured around an action research/action learning method, with dementia being a key clinical focus.

Nursing students’ preferences for clinical placements in the residential aged care setting

AIMS AND OBJECTIVES To examine nursing student placement preferences submitted as online comments to a universitys placement management system, to inform strategies for positive residential aged care experiences. BACKGROUND There are predicted shortages of nurses to service an ageing population. Clinical placements undertaken by undergraduate nursing students help shape their attitudes and are a key determinant of career decision-making, yet there is little research about why students prefer particular placement areas. DESIGN Analysis of qualitative data from a placement management system. METHODS Of 6,610 comments received between 2007-2014, 607 related to aged care and were coded according to preferences for being placed in a residential aged care facility, with reasons for this preference thematically coded and quantified. RESULTS Four hundred and one comments (66.1%) related to students requesting not to be allocated residential aged care for the upcoming placement, primarily due to previous experience in the sector; 104 (17.1%) referred to aged care in a neutral manner, focusing on conflict of interest; 102 (16.8%) related to a request for an aged care placement. CONCLUSIONS The student nurse comments characterise students as being focused on maximising their learning, while considering prior experience. In some cases, increased exposure to aged care is considered to offer limited learning opportunities, which is concerning and suggests that both the tertiary and aged care sectors have a joint responsibility to pursue recognition of aged care nursing as a specialised, highly skilled role. RELEVANCE TO CLINICAL PRACTICE Nursing programme providers should ensure curriculum content and exposure to aged care placement clearly identify the complexities of care and provide genuine opportunities for knowledge acquisition and skill development based on multifaceted resident care needs. This will support both those interested in a future aged care career and those undecided.

Case Studies Exploring the Applicability of the STEPS Interpretive Framework in Other Professions

In this chapter, we consider two case studies where the Interpretive Framework was applied to contexts other than education. The first case study was concerned with improving the professional experience programme for nursing and medical students who undertook placement at a healthcare organisation (HCO). In the second case study, the Interpretive Framework was applied to a project to establish two medical-legal partnerships (MLPs) to better support people with mental health issues to deal with legal problems. The adaptability of the Interpretive Framework becomes evident when, in the first case, it was used to evaluate and improve an existing learning partnership between the university and a HCO, while in the second, it was used to support the establishment of a new partnership between lawyers and mental health clinics. The stakeholders reported that the Interpretive Framework was, with minor adjustments to language, readily adapted to their contexts.