Clinical Placement Research Articles

Implementation of research, education and leadership placements into Operating Department Practitioner training: A 4-pillar practice-based learning approach.

Practice-based learning has traditionally focused on clinical practice in pre-registration courses. However, recent national strategies emphasise the importance of incorporation of all four pillars, clinical, education, leadership and research, into practice-based learning (placements). This article details the introduction of practice-based learning in research, education and leadership alongside clinical placements for BSc Operating Department Practice students at Sheffield Hallam University. It provides insights into the benefits of this approach, outlines the components of each placement with examples of completed projects, shares feedback from students and practice partners and addresses challenges. The authors advocate for adoption of this approach across all pre-registration Operating Department Practice courses, to ensure a workforce capable of meeting evolving health care needs and driving the Operating Department Practice profession forwards.

'Clinical Is the Pinnacle': Nurse Academics' Perspectives and Opinions of Their Students Undertaking Mental Health Clinical Placements.

Clinical placements form an integral and important part of preregistration nursing student learning. The theory-practice gap has been identified as problematic, with clinical experience being a key strategy to address this. Despite this, the perceptions of nurse academics teaching preregistration mental health nursing regarding clinical placements have not been widely explored. To garner perspectives and experiences of mental health clinical placements from nurse academics teaching mental health nursing to preregistration nursing students. A descriptive qualitative study involving 19 nurse academics from 13 metropolitan and regional Australian universities, who were involved in the design and delivery of preregistration mental health nursing content. Data were analysed thematically. The study adhered to the Standards for Reporting Qualitative Research (SRQR). Participants reported that inappropriate clinical placements generate negative student experiences. Furthermore, mental health placements in nonspecialist settings such as medical-surgical or aged care compromised student learning and posed a barrier to linking theory to practice. Increasing meaningful and appropriate mental health clinical placements in nurse education requires investment and support from multiple stakeholders. Nurse academics are crucial stakeholders in terms of understanding the impact of mental health clinical placements. Appropriate mental health clinical placements are central to effective comprehensive nurse education. Academics teaching mental health in preregistration curricula are significant stakeholders, and their informed perceptions are central to compel change.

Evaluation of a Faculty-Led Clinical Model to Meet Pediatric Preventive Care Competencies Through a Pediatric Mobile Clinic.

Limited pediatric primary care clinical placement sites and preceptors have made it difficult for family nurse practitioner (FNP) students to meet pediatric preventive clinical competencies. The purpose of this project was to evaluate a faculty-led clinical model to meet pediatric preventive care competencies through a pediatric mobile clinic. A pre-post evaluation design was used to evaluate student perceptions of their achievement of competencies. Students demonstrated improvement in all seven competencies. A faculty-led clinical model through a pediatric mobile clinic may be an effective way to improve pediatric clinical competencies for FNP students.

Clinical experiences of final-year RN and BSc nursing students during the first wave of the COVID-19 pandemic in Guyana: A mixed-methods study

Objective: The study aimed to explore the clinical experiences of final-year RN and BSc nursing students from four selected nursing schools in Guyana during the first wave of the COVID-19 pandemic.Methods: The study utilized a mixed-methods approach. The sampling involved final-year RN and BSc nursing students. The quantitative design included a survey with a convenient sample of 157 students, and the qualitative approach included seven focus group interviews. The survey data were analyzed using inferential statistics and thematic analysis.Results: The findings revealed the psychological and structural challenges experienced by final-year RN and BSc nursing students during the early months of the pandemic in Guyana. Of the respondents, 82.8% indicated fear of contracting coronavirus, 58% felt depressed, and 56.7% were insecure about daily nursing duties. Structural challenges experienced were that 58% needed PPE readily available, 80.9% felt unsafe in the clinical areas, 71.3% did not receive COVID-19 training, and 70.7% experienced financial burden. Positive responses included 91.7% did not take leave intentionally, and 74.5% felt confident. Thematic analysis yielded categories on stigmatization, fear of contracting, mental stress, shortage of staff and PPE, absence of risk allowance, and disaster planning. Coping strategies indicated were supporting one another, sharing information and resources, and praying, which enabled one to navigate the challenges and highlighted the strength of resilience and teamwork.Conclusions: Final-year nursing students encountered psychological, social, and structural challenges during their clinical placements in the early months of the pandemic outbreak. The findings underscored the need to strengthen material, academic resources, and mental health support services. Future research should focus on the experiences of registered nurses and male nurses during the pandemic. Cultivating an empowered and resilient nursing workforce is imperative to combat future healthcare challenges in Guyana.

12 tips for integrating the 12 Practitioner Values to improve clinical supervision for neurodiverse learners

With the NHS Long Term Workforce Plan requiring clinical placements to accommodate up to 50% more learners, the pressure on clinical educators to maintain high-quality learning environments is becoming increasingly intense. Neurodiverse learners face significant barriers in busy, fast-paced environments, making the cultivation of supportive and adaptive learning spaces essential to ensure all learners have the opportunity to thrive in a healthcare system under immense demand. This article is aimed at empowering clinical educators to lead inclusive placements through implementation of advanced supervision skills to support neurodiverse learners. These are presented as 12 practical strategies, each aligned with the 12 Practitioner Values, for fostering inclusive professional relationships. By offering actionable ‘tips’, this article addresses both the moral imperative to meet diverse learning needs and the systemic necessity of building a more inclusive workforce.

Satisfaction of medical and health science students with their clinical learning environment and its determinant factors at Debre Markos University, northwest Ethiopia

BackgroundUnderstanding the student’s perspective of their clinical learning environment (CLE) might assist to discover solutions to improve the learning process and increase engagement. However, there is a lack of information on this issue, particularly in Ethiopia. The purpose of this study was to assess the satisfaction of undergraduate medical and health science students with their clinical learning environment, as well as to identify the factors that affect it.MethodsInstitutional-based cross-sectional study was conducted using a self-administered questionnaire among 412 medical and health science students from Debre Markos University in 2023 through a simple random sampling technique. Mean, median, frequencies, and percentages were used to describe the data. A multivariate logistic regression model was fitted to test the association of dependent and independent variables. The Hosmer-Lemeshow goodness-of-fit test was used to check the fitness of the model. Variables with a p-value < 0.05 with a 95% confidence interval were considered statistically significant.ResultsThe questionnaire was completed by 394 individuals in total, generating a response rate of 95.63%. Approximately half (49.7%) of the participants were satisfied with their CLE. Age (AOR = 1.12; 95%CI = 1.02, 1.22), university positive perceptions (AOR = 1.60; 95%CI = 1.04, 2.43) and curriculum positive perception (AOR = 2.70; 95%CI = 1.73, 4.10) were all positively associated with CLE satisfaction.ConclusionIn this study, approximately half of the respondents were satisfied with their CLE. Age, positive perceptions of the university and positive perceptions of the curriculum were all positively associated with CLE satisfaction. The university and clinical facilitators should work together to improve infrastructure, and the facilities at the university, build dormitories at the clinical placement sites, as well as the curriculum review should involve students to increase their academic performance, self-esteem, and satisfaction with CLE.

The impact of resilience on academic performance with a focus on mature learners

BackgroundResilience is an essential psychological trait that empowers individuals to adapt and thrive in the face of challenges. Although it is acknowledged that health professionals need to possess high levels of resilience, there has been limited research comparing how different groups of health students, particularly school leaver undergraduates and mature age graduate entry students, develop resilience in their coursework.MethodsThis study combines both objective (academic grades with validated survey results) and subjective data (interviews) to compare how resilience is related to academic coursework performance for two groups of pharmacy students: the mature age graduate entry (GE, N = 64) learners and school leaver undergraduate (UG, N = 208) learners. We employed a sequential explanatory mixed methods design using surveys, academic performance data and semi-structured interviews. The survey tapped constructs related to resilience (burnout, stressors and coping methods) while the interviews elicited a more nuanced understanding of individual and environmental factors.ResultsAlthough there was no statistical difference in burnout experience between the two groups, GE students exhibited more positive resilience attitudes than UG when selecting resilience statements on the survey. Both cohorts indicated in the survey that engaging in distraction activities (physical exercise, sleeping, listening to music, anything other than the stressor) was their most preferred method of relieving stress. Within UG student survey responses, those who indicated support from partners, friends and family had better academic performance, while those who did not report coping methods did worse academically. The three key environmental factors we identified that contributed to both undergraduate and graduate entry resilience were workload, feedback provision and psychosocial support.ConclusionsCurrently, there is still a need for resilience programs geared at academic success to be implemented in higher education. This study provides objective evidence of academic success coupled with exploration into the nuances of resilience amongst different student groups. It not only highlights the differing resilience development strategies and burnout coping mechanisms in emerging health professionals, but showcases the juxtaposition of two different learner groups (UG and GE students) within a discipline. The cross-cohort facilitation of learning as in the discipline-specific strategies identified can help both groups develop resilience and inform future innovations. By comparing mature-age graduate students and younger-in-age undergraduate students, we identified a wider range of strategies and more positive attitudes to burnout in mature-age students. Health and clinical educators in university health degrees, clinical placements and clinical workplaces can develop effective training materials based on findings from this study to 1) assist undergraduate younger-age health students with developing resilience and 2) further refine mature-age health students’ and practicing health professionals’ resilience in today’s fast-paced clinical workplaces.

Through the looking glass; midwifery students' experience of ethical issues: A feminist explanatory case study

BackgroundThe ethical component in midwifery education is governed by international professional values, codes, and ethical principles. The aim of midwifery education is to encourage students to develop a lifelong commitment to ethical practice within their midwifery role and scope. However, little evidence is available on the experiences of midwifery students and how they navigate ethical issues in maternity systems. AimTo present a case study from a midwifery students' perspective that demonstrates observed ethical issues and to provide analysis of the ethical issues identified. DesignA Single explanatory case study design with a feminist lens applied. Explanatory case studies present the ‘how and why’ of a phenomenon and contributes to understanding phenomena in a holistic and real-life context. SettingThis project was set at a West Australian university from which pre-registration midwifery courses are delivered. ParticipantsA solitary case study is presented from a midwifery students' clinical placement. MethodsEthics were approved 2023-04805. Edith Cowan University HREC. The source of data for this case study was direct observation by the primary author (Priya, 2021) and the Joanna Briggs Methods for Case study reporting guide followed. Thematic analysis with a feminist lens was applied to the data. ResultsThree themes were generated ‘Through the looking glass; observing ethical issues’; ‘Whose body Is It? The Erosion of Maternal Consent’ and ‘Relational care versus defensive practice’. These themes explain the antecedents and consequences of the ethical issues identified by the midwifery student, the findings are supported by ethical theory and midwifery philosophy to highlight some of the underlying causes that contribute to ethical issues. ConclusionMidwifery students experience ethical distress when they observe ethical issues and are powerless to support birth people in a way that aligns with midwifery philosophy of relational, woman-centred care. Further research is required to better understand how midwifery students may be better supported to foster ethical care.

Student radiographers’ confidence of adapting practice for autistic patients: A qualitative survey on the role of placement experiences

IntroductionHealthcare services can be inaccessible to autistic people without adaptions to clinical practice and the care provided. Therefore, understanding how radiographer education develops students' confidence in adapting care for autistic patients is crucial. This study aimed to explore how placement experience impacts student radiographer confidence in adapting care for autistic patients. MethodsUK final-year student diagnostic and therapeutic radiographers were invited to complete a qualitative online survey. The survey asked for a description of placement experiences; of observing and/or performing the care of autistic patients and how this impacted confidence in caring for autistic patients. The data was thematically analysed. Results43 responses (of 44 received) were included, from which 5 themes emerged. Those who felt placement experiences developed confidence described opportunities to apply theory learnt at university (theme 1) or drew attention to the benefit of prior (external) experience with autistic people (theme 3). However, the balance of power with the supervising radiographer (theme 2), witnessing autistic patients in distress (theme 4), and the heterogeneous nature of autism (theme 5) disrupted students’ development of confidence. ConclusionSeveral participants in this study found clinical placement developed confidence with autistic patients through applying knowledge and providing an opportunity for reflexive learning. However, various obstacles hindered this development, such as witnessing distressed patients, limited experiences with autistic patients and difficulty navigating relationships with radiographers. Implications for practiceTo improve student radiographers’ confidence of providing care for autistic patients, educators should consider methods, e.g., co-produced simulation, to fill potential gaps in their experience. There is also a pressing need for all radiographers to understand their responsibility in educating students and their impact on student wellbeing.

How do clinical placements influence the career decisions of new-graduate physiotherapists in Australia? A qualitative exploration.

The variables that contribute to positive and negative experiences of clinical education amongst student physiotherapists are well established. Multiple stakeholders are invested in the ongoing success of physiotherapy clinical placements given workforce challenges within the profession and the emerging relationship between clinical placements and new-graduate recruitment. However, little is known about the relationship between clinical placement experiences and the career decisions of new-graduate physiotherapists. To explore the influence of clinical placement experiences on new-graduate physiotherapists' career intentions and decision making. A qualitative study which used a general inductive approach. New-graduate physiotherapists (n = 18) were recruited through a snowball sampling approach and participated in semi-structured interviews. Ethical approval was obtained from The University of Queensland. Four overarching themes were generated; (1) clinical placements impact career decisions, (2) placements as a trial for future employment to identify professional preferences, (3) feeling valued as a team member, and (4) clinical educators' shape placement experiences. Clinical placements play a significant role in directing new-graduate physiotherapists' careers, with clinical placement viewed as an opportunity to explore one's career options. A complex interplay of clinical and nonclinical variables was acknowledged by new-graduates, with positive experiences during clinical placements considered to increase new-graduate physiotherapist intentions to work in similar settings or contexts. Factors that contributed to positive experiences included accessible mentorship from clinical educators with regular feedback, and opportunities for the students' contribution and clinical capacity to be acknowledged and valued. Recommendations are made for creating supportive workplace environments for clinical education and include prioritizing supportive mentorship. Clinical placement providers intending to recruit new-graduates who have attended their workplace as students may benefit from implementing strategies that assist students to feel supported as valued members of the team. Additionally, the findings of this study may guide education providers when considering the training delivered to new and existing clinical placement sites with the aim of providing supported student learning environments.

Factors affecting clinical experience of nursing students in Malaysia: A cross-sectional study

BACKGROUND: Nursing education covers pathophysiology, nursing procedures, and compassionate care. Nursing students can apply theory and develop skills in the real world by participating in a supportive learning environment. For nursing students to effectively apply what they have learned in the classroom, they need a supportive clinical learning environment. However, some difficulties and impediments may prevent them from learning and having excellent clinical placement experiences. This study aims to identify factors affecting nursing students’ clinical experience during clinical placement. MATERIALS AND METHODS: The respondents in this descriptive cross-sectional study were at Universiti Kuala Lumpur (RCMP) Diploma in Nursing students in Ipoh, Perak, who had more than two clinical placements at a public hospital. The time frame of the study was 6 months. Sociodemographic information and elements affecting clinical practice, such as perceptions of clinical experience, hospital settings, and clinical instructor aspects, were obtained by a self-administered questionnaire. A descriptive analysis and the Kruskal–Wallis test were used to obtain the study’s outcome. RESULTS: Although the clinical placement demonstrated possibilities for learning, research has shown that the absence of instructors, equipment, and nursing staff has a negative impact on students’ experiences. The study also discovered a substantial correlation between a student’s semester and their clinical experience and between the clinical environment and the contributions of clinical instructors with P &lt; 0.05. CONCLUSION: In conclusion, the study semester, clinical experience, clinical ambient characteristics, and instructors’ contributions are strongly correlated. It suggests boosting academic-clinical collaboration, interprofessional collaboration, and student clinical experiences.

Expanding clinical placement opportunities: Exploring night shift experiences for nursing students

Academic programs grapple with the daunting task of managing a growing influx of nursing students while ensuring the quality and accessibility of clinical placements, and simultaneously engaging in competition among themselves to secure diverse clinical sites. This article delves into the innovative approach of integrating night shift clinical placements for nursing students to address the challenges posed by growing competition for day shift opportunities in acute care hospital settings. With pressure mounting on academic programs to accommodate a rising number of qualified nursing students while ensuring sufficient clinical placements, this initiative aims to alleviate strain on day shift nursing staff, mitigate teaching fatigue, and provide students with diverse learning experiences. Drawing upon a comprehensive review of literature and practical considerations, this article presents a detailed exploration of the benefits, planning processes, implementation strategies, and evaluation methods associated with night shift clinical placements in prelicensure nursing programs.

Clinical Facilitators' Perceptions of Factors Contributing to Nursing Students' Experience of Workplace Violence.

Workplace violence (WPV) is experienced by Bachelor of Nursing (BN) students during clinical placements. Students in this vulnerable group are supervised in the practice environment by clinical facilitators. This study examined clinical facilitators' views on WPV. Eleven clinical facilitators were recruited for this study and participated in interviews. Transcribed data were probed, and thematic analysis was conducted. Six major themes emerged that identified factors contributing to BN students' experience of WPV during clinical placements: (1) setting; (2) university; (3) nursing students; (4) site staff; (5) patients; and (6) other factors. Clinical facilitators perceived WPV toward students as being a common yet complex issue due to multiple contributing factors. This study adds detailed knowledge regarding the factors that influence WPV directed toward BN students to inform the development of policies and procedures for reducing the incidence of WPV in the clinical setting. [J Nurs Educ. 2024;63(10):671-678.].

Collaborative Teaching and Curricular Integration in Pre-Intern Clinical Placements: Insights from the Greater Bay Area.

The rising demand for knowledge updates and technological innovations in China has made clinical placement teaching challenging. Reforms for innovative teaching models through pilot classes have shown to improve students' academic performance. This novel integration led to the announcement of healthcare collaboration in the Guangdong-Hong-Kong-Macao Greater Bay Area for projects within China's "Global-Innovation-Hub" zones. First Affiliated Hospital (FAH) of Sun Yat-sen University (SYSU) in Guangzhou and the Faculty of Medicine (FMD) of Macau University of Science & Technology (MUST) in Macau have developed an inaugural project for FMD/MUST medical students to perform pre-internships at FAH-SYSU. This study aimed to reflect on students' experiences with collaborative teaching and learning through medical curricular integration in the "Global-Innovation-Hub" zones designed by both institutions for developing integrated curriculum. FMD/MUST students attended medical clerkships at FAH-SYSU using a system-integrated curriculum in China's "Global-Innovation-Hub" zones, allowing different education systems at different locations. Post-clerkship surveys ranked teaching models in conjunction with written reflections in response to post-clerkship questionnaires for all participating students. The teaching models were defined by the way supervisors' interaction with students, and written reflections in response to the post-clerkship questionnaire were descriptively and semantically analysed. The top-ranked teaching models include first "Student-led consultation under supervision in observers' chair with discussion", second "Observe consultation and discuss with the teacher in-between patients in observers' chair" and third "Student-led consultation under supervision in consultants' chair with discussion". The post-clerkship questionnaires showed positive outcomes. This study demonstrates the successful delivery of collaborative teaching and learning through medical curricular integration in China's "Global-Innovation-Hub" zones. This integration enables the development of a consistent and student-preferred teaching model being introduced into clinical placement curriculum. The unique location of China's "Global-Innovation-Hub" zones in the Guangdong-Hong-Kong-Macao Greater Bay Area allows this integration to significantly improve students' clinical reasoning learning.

The Role of Virtual Simulation in De-Escalating a Patient Demonstrating Escalating Behavior.

Undergraduate nursing students are unprepared to manage patients demonstrating escalating aggressive behavior encountered during their clinical placements. Confidence and competence surrounding de-escalation skills can be achieved through virtual simulated learning opportunities. This study evaluated undergraduate nursing students' perceptions of confidence and success in their de-escalation skills following a virtual simulation intervention. A quantitative, one-group pretestposttest design was used to complete this study. Students (n = 33) completed a 10-question demographic questionnaire with four additional questions on participants' psychosocial well-being considering the pandemic, and a nine-question pre- and postvirtual simulation de-escalation confidence and knowledge survey. Virtual simulation had positive effects on participants' feelings of confidence and success. Male students and students who reported Caucasian as their ethnicity were the most comfortable with de-escalating behaviors. These findings emphasize the effectiveness of de-escalation education. [J Nurs Educ. 2024;63(10):698-702.].

The Chinese version of the Nursing Student Academic Resilience Inventory: A validity and reliability study

AimTo translate and adapt the Nursing Student Academic Resilience Inventory (NSARI) into Chinese and assess its validity and reliability among Chinese nursing students. BackgroundNursing students frequently encounter stress during their clinical education and academic resilience is an important skill to help students withstand stress. The NSARI is a valid and reliable tool for assessing the level of academic resilience of nursing students during clinical practice. Currently, there is no valid and reliable measurement tool to assess academic resilience for nursing students in China. DesignA descriptive, methodological and cross-sectional design was used. MethodThis study was conducted on 600 nursing students in Northeast China. A socio-demographic form, the Chinese version of the NSARI and the nurse resilience scale were used for data collection between May to November 2023. The exploratory factor analysis and confirmatory factor analysis samples comprised 300 students, respectively, to test the structural validity of the inventory. In addition, internal consistency and invariance analyses were conducted to assess the reliability of the inventory. ResultsThe Chinese version of NSARI comprises 24 items separated into six dimensions. Exploratory factor analysis extracted six factors, with a cumulative variance contribution rate of 71.908%. Confirmatory factor analysis showed a satisfactory fit. Cronbach’s alpha coefficient for the internal consistency of the total inventory was 0.939 with a test-retest stability reliability value of 0.957. ConclusionThe Chinese version of NSARI is a valid and reliable measurement tool for assessing the level of academic resilience of nursing students during clinical placement.

An Innovative Student Interview to Assess Clinical Placement Readiness – Could This Be the End of the OSCE?

An Innovative Student Interview to Assess Clinical Placement Readiness – Could This Be the End of the OSCE?

Lessons in Sexual Assault and Violence: A Scoping Review of Undergraduate Nursing Education.

More than half of women and one third of men have experienced sexual violence in their lifetime. Nurses must be able to screen and treat patients who have experienced sexual assault, yet they may lack the knowledge and identification skills based on their exposure to content in their undergraduate nursing programs. This study examined the current state of the science regarding sexual assault and violence education in undergraduate nursing curricula. This scoping review was guided by Levac's five-step framework. Databases were searched using the key terms "nursing education" and "sexual assault education." A total of 501 articles were identified; eight articles were included in the review. Themes of knowledge, confidence, and educational preparedness emerged. Despite the importance and prevalence of sexual assault, limited educational content is provided in undergraduate nursing schools. Results urge implementing educational didactic, simulation, and clinical placement opportunities to improve nursing students' knowledge. [J Nurs Educ. 2024;63(10):665-670.].

Exposure to and awareness of oral and maxillofacial surgery for first degree dental undergraduates in the United Kingdom

Evidence shows that the majority of OMFS trainees undertook dentistry as their first degree, however, an increasing number of undergraduates undertaking OMFS training have completed medicine first. It is vital that all undergraduates wanting to commit to another degree have adequate exposure to, and understanding of, the specialty. The aim of our study was to evaluate the perspectives of final-year dental students concerning their exposure to, and perceptions of, OMFS during their undergraduate teaching. This is a cross-sectional cohort study that used an online survey to collect data. All final-year dental students at a UK dental school who will graduate in 2024 were included. Regarding the exposure to OMFS, 122 (71.8%) respondents reported that they had been offered OMFS-related clinical placements from their respective dental schools, while 48 (28.2%) had not. Of the 122 who reported receiving placements, the placement lasted a mean of 3.78 days. Participants were then asked if they thought they had adequate experience and information to make an informed choice regarding OMFS as a career, to which 70 (41.2%) responded that they did have that knowledge and experience whilst 100 (58.8%) responded that they did not. Our study overall shows a better understanding of the scope of oral and maxillofacial surgery amongst final-year dental students in the UK compared with their medical student counterparts from previous literature. However, our results reflect areas in which knowledge, exposure to, and perception of, OMFS can be improved amongst dental undergraduates.

A comparison of approaches to teaching clinical skills

Background: The most appropriate timing and mode for teaching clinical skills as preparation for medical students’ clinical rotations or clerkships is not widely agreed upon. Increasing pressure on placement opportunities has led to a shift towards simulation-based teaching in the early years of medical training. Approach: A major curriculum renewal provided an opportunity for comparison of the effectiveness of a largely ward-based (early patient exposure) curriculum with a largely simulation-based one in preparing students for clinical rotations. Evaluation: We surveyed students from two different programs and invited them to take part in voluntary objective structured clinical examinations (OSCEs) to compare their skills and self-reported preparedness. Qualitative data was also collected from focus groups with a small number of students. Implications: The findings suggest that the more structured, simulation-based curriculum is at least equivalent to the ward-based approach in teaching clinical skills and preparing students for clinical rotations. Students’ clinical reasoning skills could be enhanced in a simulation-based curriculum through more explicit training to prepare them for being asked questions on clinical placement.