Jennifer Margaret Newton

Exploring a pedagogical approach to integrating research, practice and teaching

Application of evidence is accepted as an important component of clinical practice. Teaching research to undergraduate students has been reported internationally as a challenge, particularly for nurse educators. In this paper, reported is a strategy designed to enhance research learning for undergraduate midwifery students at one university, which formed part of a larger, international investigation into womens responses to caesarean birth. Following theory classes and briefings, students worked with their clinical educators in practice to interview women using existing tools, and were engaged in qualitative data analysis. A number of challenges were encountered throughout the process, both for the educators and students. However, the teaching approach provided benefits for students in learning about midwifery research. Recommended as essential is for continued development of pedagogical approaches that make research tangible for students. Furthermore, provision of support for clinical staff working with students is important for success of such approaches.

Registered nurses' expectations and experiences of first year students' clinical skills and knowledge.

Abstract Background: Clinical education is a fundamental component of nurse education. In theory, this aspect involves integrated input from registered nurses, clinical educators and university lecturers. Registered nurses are important contributors to this process and play a major role in influencing and shaping undergraduate nursing students’ early clinical experiences. Despite this important function, their voice has been somewhat neglected. Little is known about registered nurses’ expectations and experiences of first year undergraduate nursing students undertaking their first clinical placement. Aim: The aim of this study was to explore registered nurses’ expectations and experiences of first year undergraduate students’ levels of knowledge and clinical skills. Method: Three consecutive focus groups were conducted with a purposive sample of 16 registered nurses. Interviews were audiotaped and transcribed and thematic analysis applied to the data to identify themes imbedded in the data sets. Findings: Three main themes emerged: (1) Clinical nursing skills (2) Knowledge requirements and (3) Experiences of reality shock. The findings highlight that registered nurses’ expectations of first year students’ clinical skills and knowledge were not consistently met. Registered nurses placed significant emphasis upon a range of basic skills, but acknowledged that some aspects of nursing knowledge can only be learned through experience. Furthermore, they demonstrated a considerable degree of empathy surrounding the reality shock that students might experience during early clinical placement. Conclusion: Findings from this study suggest that registered nurses and academics differ in their perceptions surrounding the level of clinical skills first year students should have during their first clinical placement. There appears to be a two way theory practice gap between registered nurses in clinical practice and academics in tertiary institutions. Improved communication between registered nurses and providers of nurse education may assist in addressing some of the issues raised by this study and reduce the theory practice gap, which remains ‘alive and well’.

Outcomes of a clinical partnership model for undergraduate nursing students

Abstract Background: Over the last decade several innovative approaches to enhance students’ transition to graduate nurse year have been implemented or piloted. This paper describes a study that investigated how the social practices of clinical partnership placement model underpin workplace learning for undergraduate students as they transitioned to graduate. Methods: A mixed method approach was utilized comprising individual interviews with students, observation of clinical workplaces across six different areas of nursing practice, student surveys of the clinical learning environment and participant workshops. Results: Three themes were identified that influenced participants’ preparedness for work and enhanced the transition into the workplace: ‘organizational familiarity’, ‘continuity’ and ‘social participation’. Conclusion: A clinical partnership model offers a degree of work readiness for novices when commencing their professional practice role. It enables individuals to participate and engage in workplace activities which are a central component of their learning.

A learning partnership: exploring preceptorship through interviews with registered and novice nurses

Novice nurses encounter numerous factors that impact on their learning in the complex healthcare workplace. Registered nurses often work one‐on‐one with novices as preceptors to facilitate the development of novices’ clinical skills and socialisation into the profession. This paper explores the concept of preceptorship from novice nurses’ and preceptors’ perspective, drawing upon data from a project between a large healthcare organisation and a university in Melbourne, Australia. The study, framed in ethnomethodology, included fieldwork observation, interviews and student surveys; this paper focuses on data collected over a series of individual interviews with nursing students (n = 28) and preceptors (n = 25). Thematic analysis yielded six key themes: workplace socialisation, empathy, individuality, willingness to engage, changing support and a realisation [by novices about the preceptor role]. Findings highlight the complexity of workplace learning that is influenced by the idiosyncrasies of the individuals involved and the social milieu in which the learning takes place.

Reflective Learning Groups for Student Nurses

An often-reported difficulty undergraduate student nurses confront in participating effectively in healthcare workplaces is the perceived mismatch between the experiences provided in the university setting and the practice setting. In particular, the pedagogical approaches currently employed in university settings are held to inadequately prepare graduates for the transition to their professional role. As part of a larger project exploring preparation for practice with healthcare professional students, a reflective learning group was piloted with a group of six 3rd-year undergraduate student nurses to redress this issue. This pedagogical approach was undertaken to assist in the facilitation of student nurses’ development of their professional role through the process of supported reflection. It has been suggested that reflection needs to be relocated in the context of practice, as in its current usage it often does not take into consideration the complexity of the workplace. Hence, the reflective learning group was conceived to be an approach for clearing a pathway through the often impenetrable complexity of engaging in a healthcare workplace and contextualising and understanding the practice of nursing. How the reflective learning group supports the development of students as agentic learners will be illustrated through appraisals of the students’ learning and growth that emerged from their participation in this group. The processes of establishing a reflective learning group, and the commitment required for a reflective learning group to be effective, are discussed. The opportunity that the reflective learning group provided in terms of a space in which the students could explore and challenge their values and assumptions about professional practice and organisational cultures and expectations is presented. Evaluation of the reflective learning group is offered which illustrates that the reflective learning group had given the students ‘a voice’ and that they felt more prepared for professional practice as a new graduate.

Preparing nurses and engaging preceptors

The healthcare workforce is a complex entity that provides ongoing challenges for the preparation of professionals. This chapter examines the preparation of undergraduate student nurses to become functioning registered nurses through their experiences in practice settings. The concept of preceptorship is explored as a premise to examining workplace learning for nursing. The worth and qualities of preceptorship are discussed in the context of a 3-year Australian study that followed the journeys of novice and experienced nurses in their preparation to either become a nurse or engage in being a preceptor. The intricacies of workplace learning in relation to individuals’ dispositions, the level of engagement with available learning opportunities, and the receptiveness of the workplace to the novice are posited as the bases for a learning practice supported through a partnership model of learning. Pedagogical strategies are considered that can enhance the contributions of both the academic institution and healthcare organisation in realising the potential of both novice and practitioner in professional learning.

Using creativity to encourage reflection in undergraduate education

Preparing undergraduate nurses to meet the challenges of clinical reality and develop their reflective skills requires innovative and creative pedagogical approaches. It has been suggested that the use of creative arts media enables one to surface well‐springs of knowledge and critique it artistically, cognitively and meta‐cognitively. Recent research highlights the sense of graduate nurses being unprepared at the completion of their undergraduate studies to face the responsibilities and challenges of being a registered nurse. Confronted as an educator with the challenge to address this sense of un‐preparedness, Jenny sought to introduce an element of creative reflectivity into a final year clinical practice unit of the Bachelor of Nursing. This was done in anticipation that it might encourage students to draw upon their multiple intelligences, embrace their artistic intelligence and realise their knowledge and learning. This paper presents through a reflective dialogue, the approach taken by the authors sharing their experiences of the introduction of reflective creativity into the course. Examples of creative works produced by students are celebrated, as are the responses to those works. Students expressed their learning, in many differing media and in doing so gained a sense of realisation that during their course of study they had actually acquired a knowledge base to engage as novice practitioners. As educators it raised a significant issue of being caught up in the creativity of the student and the need to see beyond the creation into the meaning and reflection of what it offered.

Uncovering knowing in practice during the graduate year: an exploratory study.

Becoming a graduate nurse is both a complex and stressful transition. Graduates must socialise into the context of nursing practice while developing their own clinical expertise and knowledge as novice registered nurses.This paper describes a study that explored graduate nurses’ development of knowing and reflectivity during their graduate programs. This study used a series of audio-taped focus groups and anecdotes collected from participants during the first eighteen months of being a nurse. Anecdotes were submitted as word files, electronically to the chief researcher and thematically analysed using Carper’s (1978) ways of knowing as a framework. Four ways of knowing were identified through the anecdotes: knowing self, empirical, personal, and ethical. Substantiation of these was further enhanced from focus group data. Development of practical knowledge as a novice is influenced by the degree of engagement afforded to the graduate nurse and their skills of critical reflectivity.

Women’s Perceptions of Caesarean Birth A Roy International Study

The purpose of this Roy adaptation model-based multi-site international mixed method study was to examine the relations of type of caesarean birth (unplanned/planned), number of caesarean births (primary/repeat), and preparation for caesarean birth to women’s perceptions of and responses to caesarean birth. The sample included 488 women from the United States (n = 253), Finland (n = 213), and Australia (n = 22). Path analysis revealed direct effects for type of and preparation for caesarean birth on responses to caesarean birth, and an indirect effect for preparation on responses to caesarean birth through perception of birth the experience.

Single radial haemolysis compared to haemagglutinin inhibition and microneutralization as a correlate of protection against influenza A H3N2 in children and adolescents

Serum antibodies are often used as correlates of protection for influenza. Three commonly used serological assays for detecting influenza‐specific serum antibodies are single radial haemolysis (SRH), haemagglutinin inhibition (HAI) and microneutralization (MN). However, here are limited data on SRH as well as HAI and MN as correlates of protection against influenza in children and adolescents. There are also limited data that compare SRH to HAI and MN.