Final Clinical Placement Research Articles

Factors associated with newly graduated nurses' work readiness during a pandemic: A cross-sectional study

BackgroundNewly graduated nurses may experience reality shock and leave the career early, if not adequately prepared. The pandemic has significantly impacted nursing education, clinical placements, working conditions and employment opportunities, leaving newly graduated nurses' work readiness unknown. AimTo investigate the work readiness and its associated factors of newly graduated nurses who studied and graduated during a pandemic. DesignA descriptive, cross-sectional correlational study design was employed. SettingsThe study was conducted at a large public health service in Victoria, Australia. ParticipantsNewly graduated registered nurses who studied during the pandemic and graduated between January 2022 and June 2023 (N = 206). MethodsParticipants were recruited between November 2022 and June 2023. Participants' self-perceived work readiness was measured using the Work Readiness Scale for Graduate Nurses, covering personal work characteristics, work competence, social intelligence and organisational acumen. Pearson correlation, multiple regression and hierarchical logistic regression analysis were applied to test the relationship between explanatory variables and participants' work readiness. ResultsMean (SD) values were 50.7 (14.6) for personal work characteristics, 100.5 (18.8) for work competence, and 58.2 (12.4) for social intelligence. Median (IQR) for organisational acumen was 145.5 (18.0). Prior Australian registered nurse or enrolled nurse experience significantly predicted personal work characteristics (β = 0.16, p = 0.037), while previous overseas registered nurse experience significantly predicted work competence (β = 0.14, p = 0.049). Participants who were native-English speakers had a significantly lower work competence (β = −0.15, p = 0.032). Being a female (p = 0.002, 95 % CI = 1.75, 13.21) and the length of a final clinical placement (p = 0.033, 95 % CI = 1.02, 1.59) significantly predicted organisational acumen. ConclusionDespite challenges encountered during the pandemic, participants reported a relatively high self-perceived work readiness. Influencing factors include individual characteristics, clinical placement experiences, and previous healthcare employment.

Implementation of a structured revision program and the impact on final-year undergraduate nursing students’ preparedness for clinical placement: Mixed methods study

ProblemThe effects of a revision program on undergraduate nursing students’ preparedness for their final clinical placement leading to their graduate year are unknown. AimTo explore students’ perceptions of confidence, anxiety, self-doubt, and preparedness for a high-acuity clinical placement following a three-day structured revision program. MethodThis was a mixed methods study conducted in the final year of the undergraduate nursing degree. Data were collected by survey using a self-developed 10-item instrument with three components of confidence, inhibitors (self-doubt/anxiety), and preparedness (n = 75) and by semi-structured individual interviews and focus group (7 students in total). Independent sample t-tests were used to compare data between components’ scores and demographic characteristics. Interview data were analysed using thematic analysis. ResultsStudents who attended the revision program had significantly higher scores for confidence, inhibitors, and preparation. Higher scores in one or more components were associated with enrolment in the Bachelor of Nursing (BN) versus the Bachelor of Nursing/Bachelor of Midwifery, enrolment in the accelerated pathway of the BN, older age, and previous healthcare experience. Four themes emerged from the qualitative data: anticipatory concerns, confidence, preparedness, and striving to belong. ConclusionThe findings have potential implications for adverse learning outcomes and poor student performance because of negative behaviours, lack of preparedness, and belongingness. There is a need to structure curricula, implement instructional support for students with anxiety and self-doubt, and faculty to align pedagogy to best educational practices with student attendance at structured revision sessions before each clinical placement.

Clinical support during COVID-19: An opportunity for service and learning? A cross-sectional survey of UK medical students

Purpose Medical students providing support to clinical teams during Covid-19 may have been an opportunity for service and learning. We aimed to understand why the reported educational impact has been mixed to inform future placements. Methods We conducted a cross-sectional survey of medical students at UK medical schools during the first Covid-19 ‘lockdown’ period in the UK (March–July 2020). Analysis was informed by the conceptual framework of service and learning. Results 1245 medical students from 37 UK medical schools responded. 57% of respondents provided clinical support across a variety of roles and reported benefits including increased preparedness for foundation year one compared to those who did not (p < 0.0001). However, not every individual’s experience was equal. For some, roles complemented the curriculum and provided opportunities for clinical skill development, reflection, and meaningful contribution to the health service. For others, the relevance of their role to their education was limited; these roles typically focused on service provision, with few opportunities to develop. Conclusion The conceptual framework of service and learning can help explain why student experiences have been heterogeneous. We highlight how this conceptual framework can be used to inform clinical placements in the future, in particular the risks, benefits, and structures. Practice points There was a benefit for most students who provided clinical support compared to those who did not during Covid-19. Most students found clinical support roles more beneficial than clinical placements and most final years wanted their final year clinical placements replaced by a formal role within a clinical team. Not every student’s experience of clinical support was equal. The conceptual framework of service and learning can help explain this heterogeneity. The most beneficial roles for students complemented the curriculum and provided opportunities for clinical skill development, reflective practice, and meaningful contribution to the health service. There is an added benefit of combining service and learning if done correctly, and we can use this to inform the structure of clinical placements going forwards. However, there are risks, and we discuss principles of good practice and provide our own considerations.

Nursing Student and Faculty Narratives During COVID-19 Pandemic: Challenges and Recommendations From a Canadian Perspective.

Worldwide, COVID-19 affected nursing students' and faculty's mental and physical health. The final clinical placement for fourth-year nursing students during the third wave of COVID-19 in Toronto, Canada, included direct patient care without vaccination eligibility. Students' experiences during the pandemic and faculty exposure to teaching and supporting them provide unique reflective opportunities. To examine the lived experiences of nursing students and faculty during the third wave of the COVID-19 pandemic. The study used a qualitative phenomenological design with thematic analysis. A voluntary response sample of 80 participants shared their narratives of working and teaching during January to May 2021. An optional interview guide offered open-ended questions requiring reflection. The study was conducted in a nursing school in Toronto, Canada during fourth-year baccalaureate students final clinical placement settings. A total of 77 fourth-year baccalaureate nursing students and three faculty members participated. Thematic analysis of nursing student narratives identified four main themes: (i) fear and anxiety of COVID-19 during clinical practice; (ii) impact on students' learning environments; (iii) intrinsic and extrinsic factors that enabled students to persevere; and (iv) how to deal with future pandemics. Thematic analysis of faculty narratives identified three main themes: (i) the importance of preparatory work; (ii) psychological and physical manifestations of supporting students; and (iii) the resilience of students and faculty. Future disease outbreaks and other large-scale health events will require nurse educators to understand and plan strategies for both themselves and students practicing in high-risk clinical settings. Nursing schools should rethink all fourth-year students' experiences, perceptions, and feelings to minimize their susceptibility to physical and psychological distress.

A teaching role practicum during the COVID-19 for final year nursing students in Spain: A qualitative study.

BackgroundDue to the COVID-19 pandemic, suspension of face-to-face learning and clinical placements for nursing students in Spain led us to expand and adapt clinical training to a teaching role. Final-year nursing students conducted an online clinical training focused on developing their health education competence.PurposeThe aim of this study was to explore the experiences of final-year nursing students who completed their clinical training in a teaching role practicum during the pandemic outbreak (March–June 2020).MethodA qualitative content analysis of reflective journals from eighteen final-year nursing students was conducted.FindingsThree themes were revealed: 1) An array of emotions due to not being able to complete their final clinical placement and deciding not to join the nursing workforce; 2) Perceived benefits of a teaching role such as being able to help, contributing to knowledge, acquiring competence, and learning support and companionship; and 3) Recognizing the teaching role as fundamental to the nursing profession and becoming aware of the importance of scientific evidence in clinical practice.DiscussionNursing students appreciated how teaching and health education are an integral part of the nurse's role. A teaching role allowed final-year students to acquire competence in a key nursing role during the pandemic outbreak providing a good practice for nursing education.

Development and Validation of a Clinical Practicum Assessment Tool for the NAACLS-Accredited Biomedical Science Program.

Student perspectives on their final year clinical placements in biomedical sciences at Qatar University are assessed using the clinical practicum assessment tool (CPAT), which was developed in-house following accreditation body requirements. The tool, which we call the CPAT-Qatar University (CPAT-QU), covers the three clinical practicum domains: practicum content, preceptors, and competencies. Here, we validate this tool. The CPAT-QU has 27 Likert-scale questions and free-text open questions. CPAT-QU readability was calculated using the Flesch–Kincaid Reading Ease (FKRE) instrument. Content validity was assessed using the average and universal average scale-level content validity indices (S-CVI/Average and S-CVI/UA). For construct validity, 50 employed graduates who had completed the practicum were consented for study participation, and the validity was calculated by a principal component analysis (PCA). Reliability was analyzed by Cronbach’s alpha. The S-CVI/Average and S-CVI/UA were 0.90 and 0.59, respectively, indicating that an adequate proportion of the content was relevant. The PCA extracted two core components, which explained 63% of the variance in the CPAT-QU. Cronbach’s alpha values for the items were within the acceptable range of 0.60–1.00, showing that internal consistency has a good level. CPAT-QU appears to be a useful tool for assessing student perspectives on their clinical placements; however, construct validity needs continuous improvement.

A vulnerable journey towards professional empathy and moral courage.

Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements.

The experiences of adult nursing students completing a placement during the COVID-19 pandemic.

The emergency measures implemented by the Nursing and Midwifery Council in response to the COVID-19 pandemic provided nursing students in their final 6 months of study with the opportunity to complete a paid consolidation clinical placement and thus increase their personal responsibility for the care they delivered under supervision. To explore the experiences of third-year nursing students who completed their final clinical placement during the COVID-19 pandemic. Semi-structured interviews were conducted via a virtual platform. Three themes were identified: the importance of support mechanisms, the development of confidence, and innovative learning opportunities. Students reported improved confidence in the transition period to registered practitioner and felt well supported, which enabled them to take greater responsibility. This study provided insight into the experience of nursing students during the COVID-19 pandemic, and found that support mechanisms, and a sense of belonging, helped to increase their confidence in clinical practice.

Exploring the use of knobology for image optimisation in final year sonography students.

Image optimisation is essential for acquisition of quality images in ultrasound and critical to the diagnostic ability of the examination. These skills are taught to sonography students early in their education, but research has found that retention of non-rehearsed knowledge decreases significantly after a year. The aim of this study was to determine which optimisation tools (knobology) final year sonography students use, how often and why they chose to adjust parameters and assess barriers to optimisation of knobology tools. A prospective study using data from an anonymous online survey of 34 final year sonography students. Survey results showed that 19/34 (55%) of students "frequently" optimise all Doppler settings and 23/34 (67%) of students "frequently" optimise basic parameter settings (depth, focus, time gain compensation). Time constraints (24/34 (70%)) and loss of gained knowledge of sonography principles and instrumentation (17/34 (50%)) were the major barriers to the use of knobology. The majority 28/34 (82%) believed they would benefit from further training. This study demonstrates that although most students are optimising settings to improve image quality, sonography principles and instrumentation knowledge loss and time constraints prevent students from maximising machine capabilities. This study supports the need for further training prior to final year clinical placement.

Did university fail to accommodate student's pregnancy?

The plaintiff enrolled in Fox College's physical therapy program in 2015. A year later, the plaintiff informed the administration she was pregnant and her due date conflicted with her scheduled final clinical placement in February 2017. She also expressed her intent to begin her clinical work in January 2017 and complete the remaining hours after childbirth and recovery.

Nursing students' perceptions of a collaborative clinical placement model: A qualitative descriptive study.

Clinical placements are specifically designed to facilitate authentic learning opportunities and are an integral component of undergraduate nursing programs. However, as academics and clinicians frequently point out, clinical placements are fraught with problems that are long-standing and multidimensional in nature. Collaborative placement models, grounded in a tripartite relationship between students, university staff and clinical partners, and designed to foster students' sense of belonging, have recently been implemented to address many of the challenges associated with clinical placements. In this study a qualitative descriptive design was undertaken with the aim of exploring 14 third year third year nursing students' perceptions of a collaborative clinical placement model undertaken in an Australian university. Students participated in audio recorded focus groups following their final clinical placement. Thematic analysis of the interview data resulted in identification of six main themes: Convenience and Camaraderie, Familiarity and Confidence, Welcomed and Wanted, Belongingness and Support, Employment, and The Need for Broader Clinical Experiences. The clinical collaborative model fostered a sense of familiarity for many of the participants and this led to belongingness, acceptance, confidence and meaningful learning experiences.

Analysis of Drug-Related Problems Identified by Future Pharmacists in Medical Wards of Tertiary Hospitals in the State of Pahang, Malaysia

: Objective: Clinical attachments undertaken by pharmacy students in Malaysia are one of the important platforms in order to prepare future candidates for patient-centred pharmacy practice. The lack of data regarding the identification of drug-related problems (DRPs) and the suggestion of relevant interventions by final year pharmacy students has directed the current research to describe pharmacy students’ abilities in identifying DRPs in their final year clinical placements. Methods: As a descriptive cross-sectional study, it involved the analysis of the clinical case reports of final year pharmacy students during their six-week clinical attachments between February and April 2017 across three different tertiary hospitals in the state of Pahang, Malaysia. A six-member team, who had received the required training by the study’s principal researcher, performed the data extraction from the clinical attachment reports. Results: A total of 385 clinical case reports, identified 880 DRPs. The two most common types of identified DRPs were the untreated condition (17.4 %), followed by inappropriate drug selection (16.3 %). Nearly 47.7 % of total detected DRPs were related to the indication and efficacy domains of therapy assessment. Additionally, there was a positive correlation found between the number of underlying diseases and the number of identified DRP, rs(372) = .14, p = .007. Conclusion: During the final year clinical attachments, the majority of the students were able to identify a considerable number of DRPs in the hospital setting under the supervision of their preceptors. The characterisation of the identified DRPs could be instrumental in refining the experiential clinical learning among future pharmacy practitioners.Key words: Drug-related problem, Experiential learning, Pharmacy students, Clinical attachment.

The impact of curricular changes on BSCN students' clinical learning outcomes.

Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology. Twenty five faculty members who supervised BScN students in clinical placements before and after curriculum renewal shared perceptions of changes in students' overall performance. The chosen clinical learning outcomes were: changes in students' performance related to person-centred care, clinical reasoning and judgment, pathophysiology, and evidence-informed decision-making. Faculty described three major themes in students' performance 1) pulling it all together, 2) seeing the whole person, and 3) finding their nursing voices. This reflected a shift to person-centred care, increasing professional confidence, and improved clinical reasoning and judgment and no changes to integrating pathophysiology or evidence-informed decision-making. In this study curriculum renewal provided an excellent starting point for the scholarship of teaching and learning within nursing education.

Insights into Registered Nurses' professional values through the eyes of graduating students

Professional values are integrated into undergraduate nursing curricula and taught in various ways. A significant influence on students' developing values and their definition of a ‘good nurse’ are the nurses they interact with in practice.The aim of this paper is to present the findings from a study that explored the professional values that graduating students viewed as important and how these values were illustrated in the behaviours of the nurses whose clinical practice they admired and wished to emulate.Fourteen students from one Australian university were interviewed on the last day of their final clinical placement. An interpretive qualitative design employing semi-structured interviews framed the study. Data were audio recorded, transcribed and thematically analysed.The participants' descriptions illustrated a range of professional values and behaviours. Four main professional values were identified, these included: being person-centred; kindness and caring; being in control; and commitment to learning.Findings demonstrated that the participants understood the meaning and relevance of professional nursing values, from a theoretical, moral and practical stance. Their responses also illustrated an appreciation of how these values influence patient care and the organisational culture as a whole.

Transition to practice programs: What Australian and New Zealand nursing and midwifery graduates said. A Graduate eCohort Sub-Study

Summary Aim To describe what Australian and New Zealand graduates said about the Nurse Entry to Practice program. Background The Nurse Entry to Practice is a structured programme that offers professional and educational support for graduate nurses in their first year of practice. Method The qualitative research described and reported herein constitutes a sub-study of the Graduate e-Cohort Study. This qualitative sub-study describes the responses to one on-line survey question offered in 2013 which asked about issues around gaining employment. Only those responses related to the Nurse Entry to Practice program by 197 recently graduated Australian and New Zealand nursing and midwifery students as they transitioned into professional practice are presented. Results Graduates looking for jobs in the year 2009 and 2010 were positive about their uptake of a Nurse Entry to Practice program. At the time the programs were a viable and plentiful option in which the graduate could take a program associated with a final undergraduate clinical placement. This resulted in these graduates remaining in the ward or organisation where the program was undertaken. This consequence was reported more widely by 2008 graduates, 2009 graduates from New Zealand but was not reported at all by 2010 graduates. Nurses or midwives looking for a job in 2011 reported less on a Nurse Entry to Practice program and when they did they indicated that the program was hard to get into. Conclusion This research offers educators, employers and administrators insights into improving the transition experience for recently graduated nurses and midwives.

Preregistration student nurses' self-reported preparedness for practice before and after the introduction of a capstone subject.

To assess changes in perceptions of confidence and preparedness for practice of preregistration nursing students before and after the introduction of a capstone subject, and factors associated with perceptions of preparedness. Preregistration nursing student 'readiness' or 'preparedness' for practice has been highlighted in the literature in recent years, along with employer concerns that university graduate nurses are not work ready. Few studies have examined Australian preregistration nursing students' perceptions of preparedness for clinical practice following their final clinical placement or assessed whether preregistration student nurses' perceptions of preparedness change as the result of undertaking a capstone subject. A capstone subject was introduced at a regional northern Australian university in 2013. Perceptions of preparedness were assessed in two different cohorts of final year nursing students; one of which undertook a capstone subject. Two separate cohorts of third year nursing students were surveyed regarding their perceptions of preparedness for practice at the conclusion of their final 240hour clinical placement. The 2012 cohort did not experience a capstone subject, whereas the 2013 cohort were the first nursing students to experience the new capstone subject. Both cohorts were uncomfortable performing invasive procedures and reported low levels of confidence in the area of professional identity. An overall trend of decreasing confidence as patient assignment size increased was observed for both cohorts, and higher confidence was associated with previous health care experience. Perceptions of preparedness for practice did not increase significantly following the introduction of a capstone subject. Although Australian undergraduate nursing student report feeling prepared for practice there are areas of knowledge, skills and patient care in which confidence is low. The results of this study highlight the importance of experience in building confidence and competence. This study highlights that while final year nursing students report feeling prepared for practice there are areas where additional support can be provided. It is recommended that nurse educators and health care facilities tailor their programs to provide support focused on the areas highlighted by this study.

Congruence between graduating nursing students’ self-assessments and mentors’ assessments of students’ nurse competence

Summary Self-assessment is widely used to assess competence in health care, although there is evidence of the weaknesses of self-assessment in the literature. In general, the process of self-assessment has been found to stimulate students' deep-level learning and problem-solving skills. Nursing students need to develop their self-assessment skills in order to identify their learning and ensure up-to-date outcomes and safe practice. This study aims to assess the congruence between graduating nursing students' self-assessment and their mentors' assessments concerning nurse competence with particular focus on nursing skills. The data were collected in November–December 2011 in the last week of final clinical placement of nurse education. Completed questionnaires were received from 60 students and 50 mentors. From these, 42 student–mentor pairs were matched for the sample of this study. Descriptive and inferential statistics were used in the data analysis. Comparisons between the assessments showed that students assessed their nurse competence as higher than their mentors (VAS 64.5±12.2 vs. 56.7±19.0). In nursing skills, the assessments were closer to each other (VAS 75.4±12.8 vs. 72.2±16.7); however, students' assessments still remained higher than those of mentors'. No congruent assessments were found between students and mentors. Compared to mentors' assessments, students overestimated their nurse competence. However, the results may be due to different understanding of nurse competence, and more research is needed on students' self-assessment by comparing students' assessments with those of peers, mentors and/or educators or knowledge tests. Nursing students should practise self-assessment during their nurse education. Mentors would also benefit practising in assessing students' nurse competence.

The contribution of clinical placement to nutrition and dietetics competency development: A student‐centred approach

AbstractAimThe aim of the present study was to explore the student perception of competency development in nutrition and dietetics and the perceived impact of pre‐placement preparation, the clinical placement learning environment, learning exposures and supervision on this.MethodsA qualitative investigation using semistructured interviews with 26 graduate students who had recently completed their final clinical placement, recruited purposively from three Australian universities was employed. Thematic analysis of the interview transcripts and triangular analysis of data was undertaken by the research team, with a mix of descriptive and interpretive analysis.ResultsStudents across all three universities generally described the placement experience as intense, personally challenging and a steep learning curve. Students felt they had adequate theoretical knowledge prior to placement but were less prepared for the practical application of their skills in a clinical setting. The learning environment varied across placement sites, with physical, organisation and social environmental factors all contributing to the students reported pathway to confidence and competence in practice. The style of supervision and supervisory practices varied considerably and emerged as a significant factor impacting on competency development.ConclusionsNutrition and dietetic students appear to have a hierarchy of psychosocial and educational needs that need to be met in the placement environment in order to achieve competency. The present study provides a framework for enhancing the student experience and the effectiveness of clinical placements as a component of dietetic workforce preparation.

Self-assessed level of graduating nursing students’ nursing skills

Objective: To evaluate the level of nursing skills at the point of graduation based on students’ self-assessments and to identify possible related factors. Background: Nursing skills have been identified as one of the key factors in enhancing patient safety. Maintaining patient safety is a major concern for nurses, which is why the level of graduating nurses’ skills needs to be evaluated. Also, little is known about factors related to students’ nursing skills. Methods: Evaluation is based on graduating nursing students’ (n = 154, response rate 51%) self-assessments during final clinical placements in Finnish university hospitals in 2011. Descriptive statistics and inferential statistics such as paired T -test, Multifactor Analysis of Covariance and Pearson/Spearman correlation coefficients were used to analyse the data. Results: The overall level of nursing skills was self-assessed as good (75.4; VAS 0-100). Nursing skills related to the care of a dying patient was the only category assessed to be on moderate level (63.1; VAS>57-66.8). The more positively the students self-assessed their readiness for practice based on nurse education and the supervisory relationship in clinical placement, the higher was the self-assessed level of nursing skills. Conclusions: Students’ assessments of their level of nursing skills should be taken into account when planning orientation and mentorship programmes for practical work to ensure safe and qualified patient care. Nurse educators should ensure that students can practice nursing skills related to care of a dying person during nurse education. A knowledge test, observation, or comparing the students’ evaluations to assessments by mentors could provide a more comprehensive picture of the level of students’ nursing skills.

The role of the sign-off mentor in the community setting.

In an move to identify nursing as an all-graduate profession, the Nursi Midwifery Council standards identified that future nurses need to be equipped with the skills and knowledge to lead and deliver high-quality care. Inorder to have these skills within the changing context of health care, students need to experience care delivery across a range of community, hospital and other settings. Students have to undertake a final clinical placement of 12 weeks at the end of their programme, commonly called a consolidation placement, and are allocated a sign-off mentor to confirm they meet the requirements for entry to the register. Placement capacity within primary care settings continues to be a challenge alongside the need for providing a sign-off mentor. This article discusses some of the challenges and opportunities of the role of the sign-off mentor and the potential impact for encouraging newly qualified recruitment in this area.