Clinical Practicum Experiences Research Articles

Defining evidence-based nursing practice: An interpretative phenomenological study

BackgroundEvidence-based nursing practice (EBNP) has been regarded core competencies in nursing practice and education. Defining evidence-based nursing practice and translating evidence into nursing practice by nursing students who are green to clinical practice in their education journey remain unclear. AimTo explore how pre-registered nursing students define and characterize evidence-based nursing practice as they participate in their clinical practicum. DesignThis study used an interpretive phenomenological qualitative study design. Settings and participantsTwenty nursing students were interviewed for their clinical practicum experience from four universities, one nursing college and one hospital-based nursing school in Hong Kong. MethodsData was generated through semi-structured in-depth interview and analyzed following interpretative phenomenological analysis guidelines, using a cyclical coding process. ResultsFour themes emerged regarding nursing students' definition of EBNP, highlighting that EBNP is ‘identifying a reliable learning source’, by which they can ‘rationalize their nursing practice’, and enabling them to ‘establish care standard through critical thinking’, and eventual ‘fostering their professionalism’ to improve health outcomes and reduce potential harms. ConclusionNursing students defined and characterized evidence-based nursing practice as core competencies in accompany their practicum that enables them to learn and grow professionally with a universal desire to be qualified, cope with doubt, and improve patient outcome. They recognized the challenges in identifying evidence and emphasized conservative approach to validate the evidence to avoid patient harm. Students expressed doubt towards their instructors EBNP when observing procedures untaught at school, which requires the curriculum model to foster students' skills in applying and apprising evidence and instructors' capacity to rationalize and role model EBNP.

The early career resilience experience of generation Z newly graduated registered nurses in standardized training in the emergency department: a qualitative study in Shanghai

BackgroundThe period of standardized training is a transitional stage when Generation Z newly graduated registered nurses (Gen Z NGRNs) change their role from student to nurse. Affected by the COVID-19, they lack clinical practice and practicum experience in emergency departments in their university studies. At the beginning of career, they are under great pressure. Resilience is one of the factors that reduce their stress level and increases endurance. It is of interest to understand how this representative group of nurses gained and played the experience of resilience early in their careers.ObjectiveTo explore Gen Z NGRNs’ experience and process of resilience, to provide a new perspective and theoretical basis for psychological rehabilitation or intervention of medical staff who experienced transition shock.MethodsThis study employed a qualitative design based on the phenomenological approach. 18 nurses from a third-level class-A hospital in Shanghai who participated in standardized training in emergency department were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation.ResultsThe investigation uncovered three themes and ten subthemes. Pressure and challenge contained high workload and high risk coexist, death’s stress response, more emergencies and high professional requirements. Coping and adaptation contained team help, psychological restructuring, peer support, transformational leadership. Reflection and planning contained enhance learning, appreciate life.ConclusionsOur study described the embodiment and coping experience of the physical and mental stress faced by Gen Z NGRNs during their standardized training in the emergency department. It is emphasized that nurse educators should pay attention to the character and actual needs of Gen Z NGRNs, explore and formulate strategies, so as to guide NGRNs to quickly adapt and grow in the new role. The ultimate goal is to increase nurse retention and improve the quality of nursing.

Project Building Bridges: A Framework for Preparing Highly Qualified Speech-Language Pathologists to Serve Culturally and Linguistically Diverse Students With Augmentative and Alternative Communication Needs.

Project Building Bridges was funded by the U.S. Department of Education Office of Special Education Programs to address the shortage of speech-language pathologists qualified to serve students with complex communication needs who benefit from augmentative and alternative communication (AAC) and are culturally and linguistically diverse. The purpose was to train future speech-language pathologists in culturally responsive AAC practices through coursework and fieldwork in AAC integrated into the Master of Science degree in Speech, Language and Hearing Sciences. Fifty-seven graduate students completed the project. The scholars' curriculum consisted of two AAC courses, both on-campus and externship AAC clinical practicum experiences to provide services to multicultural and linguistically diverse students, a U.S. or international service-learning opportunity, and cumulative portfolio presentations. Mixed-methods outcome measures consisted of four sets of pre- and postsurveys and qualitative feedback from exit interviews to assess changes in graduate student competencies. Significant differences were demonstrated between scholars' pre- and post-assessments of confidence ratings. Significant differences were also demonstrated in both scholars' and school mentors' pre- and post-assessments of competency ratings. No significant differences were found between evaluations of AAC preparation by Clinical Fellowship (CF) candidates and their CF mentors at 1 year postgraduation. Project Building Bridges provides a framework for preparing highly qualified speech-language pathologists to serve culturally and linguistically diverse students who benefit from AAC as evidenced by pre- and postsurvey results. The project can serve as a model for other university programs in the development of preservice preparation programs focusing on culturally and linguistically diverse students with AAC needs.

Effectiveness of Clinical Practicum Experience in Drug Addiction Treatment Facilities in Nursing Students' Attitudes Toward Alcohol, Alcohol Use Disorders, and Alcoholics: Systematic Review and Meta-Analysis.

The aim of this study was to identify, analyze, and synthesize the best evidence on the effectiveness of clinical practicum experience in drug addiction treatment facilities on nursing students' attitudes toward alcohol, alcohol use disorder (AUD), and persons with AUD. This systematic review followed the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and used the System for the Unified Management of the Assessment and Review of Information to assess methodological quality and extract data for meta-analysis. A comprehensive literature search of the EBSCO databases, Embase, PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde, PsycINFO, Scopus, Web of Science, Mednar, Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior, and ProQuest Dissertations & Theses catalog was conducted. The System for the Unified Management of the Assessment and Review of Information tool was used for the extraction and critical evaluation of the selected articles followed by a meta-analysis. After removing duplicates, 2,831 publications were identified, and eight met the inclusion criteria. More positive attitudes were observed after performing practicum experience in specialized services (-1.27, 95% confidence interval [-2.85, -0.30]), and an increase in the motivation and satisfaction among the students to care for patients with AUD was also noted. In conclusion, the review suggests that clinical practicum experience in a drug addiction treatment facility has the potential to change the attitudes of nursing students toward AUD and persons with AUD.

The process and indicators of resilience among nursing students in clinical practicum in Taiwan: A qualitative study

Resilience is essential for managing stress and maintaining equilibrium. During the clinical practicum, nursing students may experience tremendous physical and mental stress, and these negative experiences are considered a source of resilience for students. However, no universal definition of resilience among nursing students exists in the literature, occasioning the need to define the processes and indicators of resilience. This study aims to explore the resilience process and indicators among nursing students in clinical practicum in Taiwan. Participants: Fifteen fifth-year junior college nursing students in Northeastern Taiwan who had completed the clinical practicum were interviewed, including 12 females and three males. All participants were aged 20.3±0.61 years and all participants had clinical practicum experiences over four months. A qualitative descriptive study, using purposive and snowball sampling methods, was conducted to collect the experience of the nursing students in their internship. Data were collected using a semi-structured guide and deep interviews, and analyzed through the content analysis method by Waltz, Strickland, & Lenz (2010). Based on the participants' practical experiences during their clinical practicum, three main themes and nine indicators were identified. The resilience of nursing students is considered a process. The main themes are (1) uncontrolled clinical practical stress, (2) Maintain learning-life balance, (3) Positive attitude toward nursing. Resilience is a critical factor to stabilize nursing students and enable them to recover from adversity. Both positive and negative experiences significantly impacted the students' attitudes and confidence levels during the clinical practicum. The findings will provide faculty to adapt their teaching method to various situations of nursing students.

Is the Clinical Practicum in Addiction Treatment Facilities an Effective Educational Intervention to Improve Nursing Students' Attitudes Toward Alcohol Use Disorders?

The paucity of education and training on alcohol use disorders (AUDs) in nursing curricula is the main predictor of negative attitudes and results in limited knowledge access and delivery of health care for persons experiencing these problems. Although experts advocate increasing the time devoted to alcohol-related content in a crowded curriculum, didactic strategies for teaching about addiction in prequalifying nursing education have been discussed. This study aimed to verify the effectiveness of an educational experience that integrated clinical practicum experience in addiction treatment facilities for nursing students' attitudes. A quasi-experimental one-group study with pre-and-post 3-month follow-ups was carried out with 108 nursing students who answered the Attitudes Scale toward Alcohol, Alcohol Use Disorder, and Patients with Alcohol Use Disorders. The effect of the clinical practicum was apparent, with statistically significant changes to more positive global attitude scores in all measures. Previous educational intervention for AUDs during nursing education was a predictor of positive attitudes (OR = 7.21, p < .04). Students' self-perceived skills and professional preparation to deliver and direct care for patients with AUDs improved after the intervention, suggesting that clinical practice influenced students' skills for AUD identification across nursing practice. Previous contact with this population with lack of training in substance use disorder seems to favor negative attitude development. Clinical practicum experience in addiction treatment facilities improved nursing students' attitudes toward AUDs and patients with AUDs, and its effects were sustained 3 months later.

Predictors for Augmentative and Alternative Communication Clinical Service Provision: Closing the Gap.

At the core of the clinical services provided by a speech-language pathologist (SLP) is upholding the human right to communicate. Augmentative and alternative communication (AAC) modalities support communication across environments by offering temporary or permanent solutions. Barriers to AAC service provision include translation of knowledge into clinical practice, which remains problematic despite changes to AAC preservice training addressing the knowledge barrier. This study aims to understand the importance of factors impacting the provision of AAC clinical services. From the survey data of SLPs (N = 530) regarding current AAC service delivery practices, barriers, and professional development preferences in the United States, a hierarchical multiple regression identified the importance between individual and clinical practice variables of knowledge and current use of AAC modalities. A binomial logistic regression predicted the probability of one or more independent variables for barriers to AAC service delivery and learning preferences for AAC-related professional development. The factors impacting SLPs' knowledge and barriers to practice are related to clinical practicum experiences. Engagement in AAC-related continuing education (CE) is the primary contributor to the use of AAC service provision. Predictors for barriers to AAC clinical provision are associated with clinical practicum experiences, the average number of patients seen weekly, and geographic region. Preference for CE topics and frequency depend on the work setting. Hands-on clinical practicum experience addresses opportunity barriers in AAC service provision, contributing explicitly to the value of collaboration in AAC service delivery and highlights the importance of evidence-based professional development content. The findings from this study are reassuring in that clinicians are using AAC and suggest that high-quality professional development is an effective means to address the gap between knowledge generation and translation in the field. https://doi.org/10.23641/asha.23202170.

A Scaffolded Simulation Curriculum: Translating Simulation with Standardized Patient Encounters into Clinical Practice for Nurse Practitioner Students

BackgroundMore high-quality research is needed to connect learning in simulation to clinical practice experiences of advanced practice registered nurse (APRN) students. The purpose of this study was to evaluate students’ perceptions of simulation and explore qualitative reflections about the role of simulation in preparing them for clinical practicum experiences. MethodsIn this longitudinal, mixed methods study, a series of six, scaffolded simulation experiences were implemented in an APRN curriculum. Focus groups were conducted with a convenience sample of 23 nurse practitioner students. ResultsThree key, interconnected themes emerged from the focus groups: authenticity, confidence, and harmonization. Quantitative data demonstrated that simulation was effective in promoting clinical decision-making skills. ConclusionsThe findings of this study support the use of scaffolded simulation experiences in nurse practitioner education. The participants valued the knowledge, skills, and confidence gained through the simulation experiences that included a standardized patient, multi-modal feedback, and a debriefing process. Students’ knowledge and behaviors learned through simulation experiences were transferred into their clinical practice.

S2 - Taking Midwifery to the Top and Beyond: PNG Midwifery Rural Care Practicum Experience

Papua New Guinea (PNG) is Australia’ nearest neighbour, about 150 km from the top of the mainland and only a few kilometres from some of the Torres Strait Islands. Despite its proximity to Australia, PNG has one of the highest rates of Maternal Mortality. A woman in PNG is 80 times more likely to die in childbirth than a woman in Australia. There are multiple intersecting reasons for this, including lack of, or difficult access to midwifery services due to remoteness and geographical challenges. The midwifery education program at Pacific Adventist University (PAU) is addressing some of the access issues through taking midwifery to women in remote villages. The midwifery students in the PAU Bachelor of Midwifery program undertake a 280-hour, 8-week Rural Health Care Practicum experience towards the end of their studies. This year, the experience involved taking midwifery care up and over mountainous terrain and over open seas to deliver care to isolated women and families, or as the students describe – reaching out to the unreached. The midwifery students were accompanied by their Course Coordinator and Lecturer. The clinical practicum experience involves the students providing sexual, reproductive, maternal, and newborn care to remote communities and also undertaking community assessment projects like improving sanitation facilities, so their practicum has a lasting impact. The five-hour walk to the village up mountains and over rivers contributes to students’ understanding of the difficulties these communities face in accessing Universal Health Care and allows them to ‘walk a mile’ in others’ footsteps, thus developing empathy and understanding of the significant issues faced. This presentation provides a voice for the Bachelor of Midwifery students and staff to describe their experiences and discuss significant learning resulting from being together at the top (of the mountain) with women and communities in remote PNG.

Nursing students' motivational and self-regulated learning during the COVID-19 pandemic: A cross-sectional study.

On‐site clinical training, which has been greatly hindered during the COVID‐19 pandemic, is essential in nursing practicum. This study aimed to identify the predictors of nursing students' motivational and self‐regulated learning in clinical nursing practicum during the pandemic. This cross‐sectional study aimed to identify the predictors of motivational and self‐regulated learning among nursing students in clinical nursing practicum during the COVID‐19 pandemic. An online survey was completed by 195 nursing students in Korea in 2021. Students' moral sensitivity and motivational and self‐regulated learning were assessed using the Moral Sensitivity Questionnaire and the Motivated Strategies for Learning Questionnaire. Multiple regression analysis revealed that moral sensitivity was the most potent predictor of motivational and self‐regulated learning, followed by online clinical practicum experience, determination to become a nurse, and online practicum type; these factors explained 21.0% of the variance. Practicum courses using a tailored hybrid model, combining online and in‐person approaches for imparting nursing practices and inspiring moral sensitivity, can enhance nursing students' motivational and self‐regulated learning. Modules to enhance nursing students' moral sensitivity should be included in online practicum curricula.

Race, gender, and ethnicity differences of nursing students' experiences during the COVID-19 pandemic.

BackgroundThe coronavirosus disease caused physical, mental, and social stress to humans; however, the human impact was not balanced and proportionately distributed to all people; especially nurses. This study explored nursing students' lives affected by the pandemic.PurposeThe purpose of this study was to investigate the effects of COVID-19 and the pandemic on students' experiences across different races, genders, and ethnicities.MethodThis cross-sectional study sought to investigate significant differences in reported experiences of nursing students during the COVID-19 pandemic based upon race, gender, and ethnicity classifications. A survey was developed to collect the data.ResultsA national sample of 616 student responses was analyzed. Significant differences were found in the pairwise comparisons. The differences found among the diverse student classifications revealed variations in survey responses to classes moved to on-line, interactions with peers, COVID-19 testing, fear/anxiety, and test performance.ConclusionThe research adds knowledge about nursing students' experiences during the pandemic; especially unrepresented students from diverse backgrounds. The findings from this study suggested nursing students reacted differently based on race, ethnicity, and gender.

COVID-19 상황의 간호대학생 비대면 임상실습교육 경험

Objectives: This study aims to in-depth explore the non-face-to-face clinical practicum experience of nursing students in the COVID-19 situation, and to present the actual situation, problems, learning strategies, and effective measures of non-face-to-face clinical practicum education. Methods: Data were collected through in-depth interviews with 12 nursing college students who had experience in non-face-to-face clinical practicum using an open-ended questionnaire. The collected data were analyzed through qualitative content analysis. Results: From the results of this study, 4 general categories and 8 subcategories were derived. The general categories included: “Non-face-to-face clinical practicum is safe and comfortable without stress”, “Feeling distance between non-face-to-face and on-site clinical practicum”, “Feeling desperate for on-site clinical practicum education”, and “Facing limitations in preparing for employment due to lack of clinical practicum experience”. Conclusions: It is necessary to continuously review ways to reduce the difference between alternative practicum, such as simulation-based practicum with increased field reproduction, and on-site practicum. In addition, it is necessary to develop standardized alternative practicum programs containing various contents, immediate feedback, and face-to-face practicum.

The nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in clinical practicum: a European cross-sectional study of graduating nursing students

BackgroundA supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students’ clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher’s cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries.MethodsA cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher’s pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018–2019. The data were analyzed using a Chi-Square test, Pearson’s correlation coefficients, and linear models.ResultsA total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher’s pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher’s pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country.ConclusionsThis study reveals that nurse teachers play an essential role in supporting and guiding nursing students’ final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers’ pedagogical cooperation role within the clinical learning environment.

Speech-Language Pathology Graduate Student Clinicians’ Self-Perceived Competency in Dysphagia Management

Speech-language pathologists (SLPs) are the preferred healthcare providers for managing the direct clinical care of patients with dysphagia. By assessing self-perceived competency during academic training, SLP graduate student clinicians may increase their understanding of their skills in dysphagia management. We modified the Dysphagia Competency Verification Tool (DCVT) to use a 5-point ordinal scale to explore how SLP graduate student clinicians’ self-perception of competency in dysphagia management changes over time and to determine the impact of clinical practicum experiences. Seventy-two SLP graduate student clinicians rated their self-perceived competency for four DCVT domains. We used Generalized Estimating Equations (GEE) models to analyze the statistical significance of self-perception of competency ratings for each of the DCVT domains across semesters while accounting for clinical practicum experiences. Overall, the SLP graduate student clinicians indicated an increase in DCVT scores from the beginning of their graduate training program to the time of graduation, but did not perceive themselves as Adequate on most items of the DCVT until their last semester. These results suggest that both SLP graduate student clinicians and SLP graduate training programs would benefit from using a standardized metric to assess self-perceived competence in dysphagia management. DCVT self-perceived competency ratings could inform SLP graduate student clinicians about areas of dysphagia management practice and skills that need further development, allowing them to target these specific areas and gain actual competence.

Perceptions and Effects of Online Clinical Preparation Modules for First-Semester Speech-Language Pathology Graduate Students

Students begin graduate school with varying backgrounds and experiences from their undergraduate program, which can result in different degrees of competence as they begin clinical work. This study investigated the effects of a series of seven online modules designed to review foundational clinical skills and enhance students’ clinical success. A cohort of 39 incoming graduate students at a midwestern university participated in the study and completed the modules during program orientation. Mixed methods were used to evaluate the effects and perceptions of the modules, including surveying students and the clinical faculty, comparing students’ clinical evaluations to those of previous students who did not use the modules, and facilitating a focus group with the clinical faculty. The findings indicated that students perceived the modules to be helpful, but there were not significant changes in faculty ratings of students’ clinical performance. Both faculty and students responded positively to the use of online modules, but they were challenged in integrating them into the clinical practicum experience, resulting in minimal use of the modules beyond program orientation. Faculty and students made notable suggestions for improvement. Implications for how graduate programs prepare and support students in their clinical experiences are discussed.

Speech-Language Pathology Graduate Student Experiences of Incivility, Bullying, and Intimidation in the Clinical Practicum Setting: An Exploratory Study

Purpose: The purpose of this phenomenological study was to describe and interpret the experiences of graduate students in communication sciences and disorders who experienced forms of incivility in the clinical practicum setting. There is precedent for identifying and handling incivility, such as bullying, harassment, and intimidation, in the nursing education, psychology education, medical education, and physical therapy literature. A literature search for incivilities such as bullying, harassment, and intimidation in graduate student education in communication sciences and disorders did not yield any systematic studies. Method: Nineteen participants who were interested in participating contacted the researcher; of those, nine participants were ultimately interviewed. A thematic analysis of videotaped semistructured interviews was used to measure outcomes based on the five questions posed to the participants. The participants responded to the five questions designed to understand the lived experience of incivility for graduate students in speech-language pathology practicum settings. Conclusions: This study fills a gap in the clinical education literature in speech-language pathology. It was a qualitative study using a phenomenological approach that described and interpreted speech-language pathology graduate students' experiences of bullying, harassment, and/or intimidation during clinical practicums across practice settings. Data analysis yielded five themes based on the participants' responses during the interview. The themes were communication, physical and/or psychological effects, interpersonal dynamics, clinical instruction, and lingering physical and psychological effects of the experience. The authors make recommendations to reduce the probability that incivility, bullying, and/or intimidation will occur during a student's clinical practicum experience.

Quality Improvement: Undergraduate contribution to identify barriers to patient discharge timeliness

The undergraduate quality improvement project goal was to determine the primary barriers to timely discharges through a clinical leadership practicum experience at an advanced tertiary care teaching hospital. Delays in discharges are associated in the literature with adverse health outcomes and diminished efficiency within organizations. The authors retrieved deidentified data in real-time from the health information system and interactions with patient care staff. The study’s metrics included 1) discharge orders placed before 10 a.m, and 2) patients discharged before noon. The primary barriers found were ambulance transport delays and scheduled treatments after target discharge times. Early identification of patients planned to discharge aided in readiness and increased numbers of patients discharged before noon. The information collected by undergraduate students will help address the primary barriers and assist further quality improvement initiatives within the affinity group.

P Stands for Pivot: Pivoting Face-to-Face Practicum to Virtual Simulation during the Pandemic

Virtual simulation has been widely used to temporarily replace face-to-face clinical practicum experiences in nursing education in response to the global COVID-19 pandemic. While more traditional clinical settings were prioritized and made available only to senior students, the use of virtual simulation provided an opportunity to safely pivot from the usual placement to a comparable practical learning modality to maintain clinical competence during unprecedented public health restrictions and mitigation strategies. Like many others across the globe, nursing students in a Canadian university continued their nursing education predominantly using virtual simulation for an entire academic year to avoid catastrophic delays in entering the workforce and to ultimately protect the health service delivery needs throughout the oncoming waves of the pandemic. The purpose of the paper is to describe guiding principles established in a School of Nursing as a means to responsibly and ethically adopt a replacement of traditional clinical practicum experiences with virtual simulation. The principles for incorporating virtual simulation included the need to achieve and maintain a high level of quality of learning experiences, a fluid delivery articulated in phases, and a financial commitment by the learning institution. As the global pandemic may see a fourth wave, the use of virtual simulation will continue to present a major change for clinical practicum and establishing principles for the use of virtual simulation has demonstrated to be an integral part of safe pandemic response and post-pandemic recovery.

Experiences of Ghanaian Student Nurses’ and Midwives’ during Clinical Practice in the Kumasi Metropolis: An Ethnographic Study

Background: The clinical practice component in nursing and midwifery education is a neglected area of research. There is far ranging evidence that clinical exposure and skills acquisition is not equitable in Ghana. Researchers have focused mostly on clinical supervision with students’ needs still not prioritized. Therefore, this research sought to explore students’ views and stories about their clinical practicum experiences and to help gain a deeper understanding into their knowledge, competency acquisition, clinical learning, and transition to practice.&#x0D; Methods: We utilized focused ethnography design with Roper &amp; Shapira’s methods on 12 students during their intra-practicum period in a tertiary hospital situated in the Kumasi Metropolis of the Ashanti-Region of Ghana. Within the period of 4 weeks intra practicum, participants were conveniently and purposively sampled and with an interview guide with a grand tour question participants’ were involved in conversation to elicit information through focus group discussions (FGD) in their natural setting. The FGDs were conducted on weekly basis during debrief sessions for 3 weeks until participants repeated what they have already said in the previous weeks indicating data saturation.&#x0D; Results: Nursing and midwifery students’ face diverse realities in the clinical sites, and are least supported in their skills and competency acquisitions, leading to theory practice confusion and inconsistencies, as students face challenges with the clinical component of their training. It was found that there were lack of preceptors and limited ward nurses’ preparedness to support students during clinical sessions hence students were subjected to excessive unproductive errands during the periods of practicum. It was also found that there is lack of collaboration between tutors and practicing nurses in the students training further exacerbating the theory-practice confusion. Conclusion and Recommendations: The identified gap is calling for a collaboration between clinicians and tutors to strengthen the clinical practice component of student nurse training. This will address the challenge of “theory-practice confusion and inconsistencies” among others.

Preparing Culturally and Linguistically Diverse Students to Work with Culturally and Linguistically Diverse Populations: A Program Design and Student Outcomes Study

Adequate service provision for culturally and linguistically diverse (CLD) clients has been an issue the field of speech-language pathology (SLP) has been grappling with. At the root of this issue is a lack of professional CLD training in SLP programs and a lack of diversity among the students enrolled in these programs. The current study described the MS-SLP bilingual emphasis curriculum and recruitment practices at Florida International University (FIU). Outcomes for the MS-SLP graduates were also explored. The FIU MS-SLP program entails three dedicated courses on bilingual clientele with communication disorders across the lifespan, infusion of CLD concepts across all required courses, clinical practicum experiences with CLD clients, and taking a non-traditional approach in the admissions process by not making GRE scores compulsory. Through statistical analyses, FIU MS-SLP graduate Praxis test scores were compared to those of SLP graduates, nationally. White non-Hispanic/Latinx, Asian, and Black graduates of FIU’s MS-SLP program attained comparable Praxis scores while Hispanic/Latinx FIU MS-SLP graduates scored significantly higher than their counterparts, nationally. Implications include the need for graduate SLP programs to reconsider traditional admissions requirements which historically prevent many CLD students from being accepted into graduate school. Only by recruiting CLD students and pragmatically implementing cultural competence objectives into the SLP graduate program curricula will the field of SLP be able to address the critical shortage of bilingual and CLD speech-language pathologists.