Post-registration Programmes Research Articles

Role and Function of the Clinical Tutor in Mental Health Nursing in Ireland

The clinical tutor (CT) in mental health nursing is a role aimed at supporting the learning needs of mental health nursing students undertaking a 12-month post-registration programme. This paper aims to examine the role of the clinical tutor in mental health nursing in Ireland by describing the experience of nursing students and key service stakeholders. A qualitative descriptive design was employed using focus group discussions and semi-structured interviews. Two focus groups were conducted with 14 nursing students in the final week of their one-year programme. Semi-structured interviews were undertaken with seven service stakeholders and service leaders. Participants reported positive experiences of working with the clinical tutor and valued the role in terms of educational and pastoral support. Participants suggested the role strengthened the link between theory and practice and enhanced the relationship between the higher education institute and clinical sites. However, a lack of clarity existed in terms of role description. Participants suggested the CT role enhanced the link between the university and clinical areas providing benefits to both student and service stakeholders. Implementing similar roles may benefit post-registration mental health nursing students in other jurisdictions. Further investigation on how the role operates from the perspective of those in the post may provide more clarity and enhance the development of such roles in the future.

Interprofessional Learning in an Online Programme: A SWOT Analysis

The unprecedented COVID-19 pandemic has forced educators individually, and educational institutions collectively, to rethink their teaching and assessment modes. Several universities have seen a sudden shift from traditional face to face teaching and learning to online approaches. The aim of this case study is to share the authors’ experience in the design, coordination, delivery and evaluation of a fully online post-registration programme. Now in its twelfth year, this is an interdisciplinary course and caters for qualified health professionals from various sectors and with various levels of experience seeking a baccalaureate qualification. The paper uses the SWOT analysis technique to highlight the programme’s strengths and weaknesses, and to reflect on its opportunities for, and threats to, further development. In so doing, it discusses some considerations underpinning the shift from a face to face to an online, mainly asynchronous, mode of delivery for this post-registration academic top-up programme. The paper explains the challenges encountered and the lessons learnt through feedback from the students, stakeholders, and external examiners. The good practices that were developed as a result, including strategies to foster a community of learners, may be of interest to, and applied by, educators in other settings.

From registered nurse to nursing student - Exploring registered nurses' transition to nursing student during a post-registration children's nurse programme: A qualitative descriptive research study

BackgroundRegistration as a children's nurse in Ireland occurs via two routes, an undergraduate degree in children's and general nursing and a twelve-month post-registration children's nurse programme. Candidates undertaking the latter are experienced nurses on the register for either general, intellectual disability or mental health nursing yet they are required to become a nursing student for the duration of the programme. Although anecdotal evidence indicates that this presents unique challenges for these students the experiences of transitioning from registered nurse to nursing student has not been explored since inception of the programme in 2006. ObjectivesThe study aimed to explore the experiences of the registered nurse that transitioned to nursing student during the Post-registration Children's Nurse Programme, to identify the previous experience of the registered nurse and to identify what challenged and supported successful transition. DesignA qualitative descriptive research design was used. SettingThe study was carried out in a large teaching children's hospital in Dublin, Ireland. ParticipantsA purposeful sample of six registered nurses that completed the programme within the last 12 months was interviewed about their experiences of being a post-registration nursing student. MethodsFace-to-face, semi-structured, conversation-style interviews were conducted. ResultsFour main themes were identified from the data: ‘Feelings related to returning to student status’, ‘Supports throughout the transition’, ‘Differences between disciplines’ and ‘Knowing your place’. Registered General Nurses (RGN) had different learning needs in comparison to registered nurses in intellectual disability (RNID) and expressed difficulty adapting to the role of nursing student as they felt that their previous knowledge and experience was being overlooked. In contrast, RNIDs were more challenged on clinical placement by unfamiliarity with clinical equipment and terminology.Both RNIDs and RGNs found that the nursing staff on their placements were a source of support despite reporting that they rarely worked with their designated preceptor. ConclusionsThe challenges experienced by nursing students from different nursing disciplines sharing the same post-registration programme needs to be considered in the planning and implementation of all aspects of the programme. Healthcare staff should become more aware of the challenges experienced by the postgraduate nursing student when educating and supporting their learning within the preceptor-student relationship.

Consumer participation in nurse education: a national survey of Australian universities.

Consumers of mental health services have an important role to play in the higher education of nursing students, by facilitating understanding of the experience of mental illness and instilling a culture of consumer participation. Yet the level of consumer participation in mental health nursing programmes in Australia is not known. The aim of the present study was to scope the level and nature of involvement of consumers in mental health nursing higher education in Australia. A cross-sectional study was undertaken involving an internet survey of nurse academics who coordinate mental health nursing programmes in universities across Australia, representing 32 universities. Seventy-eight percent of preregistration and 75% of post-registration programmes report involving consumers. Programmes most commonly had one consumer (25%) and up to five. Face-to-face teaching, curriculum development, and membership-to-programme committees were the most regular types of involvement. The content was generally codeveloped by consumers and nurse academics (67.5%). The frequency of consumer involvement in the education of nursing students in Australia is surprisingly high. However, involvement is noticeably variable across types of activity (e.g. curriculum development, assessment), and tends to be minimal and ad hoc. Future research is required into the drivers of increased consumer involvement.

Problematic but Possible

This artifact identifies the main challenges experienced by the authors, both nurse educators, in the delivery of a module on evidence based practice exclusively through the use of an e-learning platform. The module has been running for the past four years as part of an entirely online post registration programme for qualified health professionals seeking a baccalaureate qualification, and makes use of asynchronous online discussions coupled with traditional written assignments as assessment methods. The authors' efforts to address the identified challenges are discussed, in view of flagging the measures which may need to be put in place by educators embarking on similar teaching initiatives.

The need to address poor numeracy skills in the emergency department environment

Substantial evidence exists for lack of numerical skills among many health professionals. Although poor numeracy has long been recognised as a contributor to medication error, other activities for which numerical literacy are required, such as interpretation of diagnostic results, have been largely ignored. Poor self-awareness of lack of numerical literacy increases the risk, especially in the busy and hurried emergency environment. System changes, such as standardising units and improving number presentation, reduce the potential for misinterpretation; however system changes do not address the underlying deficiencies in mathematical skills. The training of doctors in numeracy has been largely ignored. In contrast, education for nurses frequently occurs during both pre- and post-registration programmes. Interventions have had mixed success, although additional emphasis in increasing conceptual understanding of numbers is encouraging. The consequences of poor numerical literacy should be addressed in all clinical staff, not only by practice change to remove the potential for errors to be made, but also complemented by self-awareness and education.

Nurses’ competence in genetics: a mixed method systematic review

To ascertain the extent to which nurses are achieving the core competences in genetics appropriate for nursing practice. There is an increasing focus on genetics in nursing, and relevant core competences have been developed. However, it is unclear whether nurses are achieving these competences. Four databases (CINAHL, Medline, The Allied and Complementary Medicine Database, and British Nursing Index) were searched. Hand searching of relevant reference lists and author names was also conducted. Systematic review. The systematic review was undertaken using methods described by the Centre for Reviews and Dissemination (University of York, 2008). Research studies published in English between January 2000-January 2011 reporting data focussing on nurse competence in genetics were eligible for inclusion. Data were abstracted for inclusion in a table and subjected to thematic analysis: due to diversity of studies, a meta-analysis was not performed. Of 269 papers retrieved, 13 were eligible for inclusion. There were five main themes: knowledge, experience in using skills, ethical practice, perceived relevance, and confidence. Although the majority of participants believed genetics was relevant to their role, their knowledge of genetic concepts was generally poor; however, most studies measured self-reported knowledge rather than assessing actual knowledge. There is little evidence on this topic, but it does appear from the available evidence that nurses are not demonstrating the competences needed to offer holistic health care to people with genetic conditions. Pre- and post-registration programmes must be enhanced to include genetic health care.

Nursing students’ knowledge, attitude and readiness to work for clients with sexual health concerns

To investigate nursing students' knowledge, attitude and readiness to work for clients with sexual health concerns and to identify strategies to help students develop as they take up their role in sexual health-related care. There is an increasing global demand for improving sexual health. A better understanding of nursing students' attitude and readiness to work for clients with sexual health concerns is the beginning of this endeavour. The need to explore strategies for developing competent health care practitioners is timely. A cross-sectional survey. Nursing students (n = 377) studying in pre- and post-registration programmes were surveyed at a university in Hong Kong using a questionnaire with open- and closed-ended questions about their knowledge, attitude and self-perception on readiness to work for clients with sexual health concerns. Students' knowledge of sexual health was satisfactory. They were positive in acknowledging the nursing role in sexual health care, but hesitant in taking up an active role in practice. Students' readiness to participate in related activities was below satisfactory. Their perception of inadequate knowledge, feelings of anxiety, worries about colleagues' and clients' possible adverse responses and inadequate exemplars were major factors affecting their readiness. This paper also highlighted some important learning areas and strategies that could help in enhancing students' knowledge and confidence in sexual health care practices. Improving the educational programme and clinical practice for nursing students is necessary but may not be adequate. Valuing the affective aspect of education, formal recognition of this extended role and advancing related education to a post-experience level would also benefit the development of sexual health care. Preparing more mentors as exemplars, inviting clinicians and managers as partners in sexual health-related care would help nursing students to work efficiently for clients with sexual health concerns.

A systematic review evaluating the impact of post-registration nursing and midwifery education on practice

Given the current focus on evidence-based practice, it is surprising that there is a dearth of systematic evidence of the impact on practice of post-registration nursing and midwifery education. The systematic review presented here formed part of a national review of post-registration nursing and midwifery education in Ireland [Health Service Executive, 2008. Report of the Post-registration Nursing and Midwifery Education Review Group: Changing practice to support service delivery. Health Service Executive, Dublin]. The review focuses specifically on the impact on practice from the perspective of nurses, midwives, patients, carers, education and health service providers. Sixty-one (61) studies met the criteria set. These studies were mainly of a retrospective and descriptive nature, often with small cohorts, set within one educational setting. The findings indicate that students benefit from post-registration programmes in relation to changes in attitudes, perceptions, knowledge and in skill acquisition. There is also some evidence that students apply their newly acquired attitudes, knowledge and skills. There is however limited evidence of the direct impact on organisational and service delivery changes, and on benefits to patients and carers. It can be concluded that the impact of post-registration nursing and midwifery education on practice has yet to be fully explored through a more systematic and coherent programme evaluation approach.

Providing feedback on clinical performance to student nurses in children’s nursing: challenges facing preceptors

While the importance of providing feedback to student nurses on clinical practice is widely acknowledged, there appears to be inconsistency in the amount, type and timing of feedback they receive (Cahill, 1996; Pertab, 1999; Glover, 2000; Gray and Smith, 2000; Raftery, 2001). However, little is known of preceptors/mentors’ experiences of providing feedback and the challenges they face in this area. This study explores preceptors’ experiences of giving feedback to student nurses undertaking a post-registration programme in children’s nursing. Data were collected from ten preceptors using semi-structured interviews. Thematic content analysis was carried out. The main themes that emerged from the data related to the provision of negative feedback and the factors that may inhibit the provision of feedback. Preceptors described challenges in terms of providing negative feedback, both oral and written and maintaining student relationships. A number of factors such as insufficient student contact time, busy wards and inadequate preparation for the role were viewed as inhibiting the feedback process.

Learning resource for professionals offering antenatal and newborn care

Learning resource for professionals offering antenatal and newborn care

Development of a new multi-professional clinical simulation centre at the University of Hertfordshire.

Simulation training at the University of Hertfordshire has developed through our experience with the “Hertfordshire Intensive Care & Emergency Simulation Centre” (HICESC) that opened in 1998. Recently we have emphasised Inter-professional education as it is expected to help trainees from different disciplines gain more insight into each other’s roles, abilities and enable their working together in clinical practice. Following on from the very positive feedback from students and external participants regarding realistic inter-professional scenario-based learning, the University team have designed a new facility that is currently being built. This will provide a central and modern training facility for our wide range of professional student groups (over 5000 students on pre and post registration programmes) as well as local hospital staff. This major development is due to be completed in September 2006 and will be one of the largest multi-professional clinical simulation centres in Europe with a flexible environment and conference facilities. In its first developmental phase, it will include a fully integrated audio and visual system with 24 cameras, 3 observation rooms, 2 control rooms, a modern pharmacy linked to the different wards, a Paediatric ITU/Theatre, an Adult ITU/Theatre, an Accident and Emergency room, a community area, and a clinical skills/screen-based simulation room. This 500m2 simulated clinical environment will open new training opportunities for our students and make a positive contribution to improved patient care.

The clinical learning portfolio: a practice development experience in gerontological nursing

Assessment of clinical practice in post registration programmes can require a different focus to capture the essence of learning at a higher level. There are differences of opinion in the literature on the potential use of the portfolio as an assessment method. The aims of this paper are to describe the use of a portfolio of evidence-based practice and reflection to assess clinical learning in a Higher Diploma in Gerontological Nursing Programme and to present the findings of a pilot evaluation of this assessment. The evaluation was conducted by postal questionnaire distributed to the first cohort of students following graduation from the programme in 2002. Arising from this exploration of the student experience, it appears that the use of a portfolio in addition to formative assessment, can promote a link between theory and the advancement of gerontological nursing practice.

Twelve tips for authoring on-line distance learning medical post-registration programmes

With innovation and creativity, almost anything can be delivered and assessed on-line. Successful on-line distance learning puts the needs of the learner first, and is characterized by the quality and clarity of learning and support materials, together with good tutorial and support networks. This in turn depends upon trained authors and implementation of relevant quality assured systems and processes. These pragmatic tips outline the main points, which should help prospective on-line developers and authors.

Sexuality as an aspect of nursing care for women receiving chemotherapy for breast cancer in an Irish context

In this article, findings are presented from a study that aimed to explore the perceptions and experiences of a sample of nurses in addressing sexuality as an aspect of care for women receiving chemotherapy for breast cancer. A sample of 10 oncology nurses was selected from oncology units at three hospitals in Ireland, and each participant was interviewed in depth. A qualitative strategy was employed to analyse data. Findings indicated that participants tended to construct sexuality in broad terms, and were well aware of the effects of chemotherapy on a person's sexuality. In addition, they considered sexuality education to be a legitimate and important aspect of their role. However, they also revealed that they avoided addressing sexuality with patients, or encountered structural obstacles in doing so. Some participants expressed anger and frustration when discussing barriers to incorporating sexuality into their practice. A strong theme in data was participants' perceptions that they were not adequately prepared in either pre- or post-registration programmes to incorporate sexuality as a dimension of patient care, although post-registration programmes were more likely to furnish them with knowledge about sexuality. Finally, participants' views on sexuality care are considered in the context of Irish culture which until recently was dominated by Catholic Church teachings.

Extravasation

This article considers the problem of extravasation within nursing practice. It explores a collaborative approach between nurse educationalists and clinical nurses offering the potential to inform and change practice. The conclusion was the development of pre- and post-registration programmes designed to meet the needs of a specialist area. Extravasation within chemotherapy is a specialist problem requiring urgent treatment. A critical incident concerning extravasation has been utilised to highlight the need for this specialist information within pre- and post-registration programmes.

Health informatics education for clinicians and managers—What’s holding up progress?

This paper reports outcomes of a national survey of health informatics (HI) education and training carried out in the UK. A questionnaire to elicit details of HI and IT skills teaching was derived from a national consensus document (Learning to Manage Health Information, LtMHI). Forms were sent to all pre-qualification medical and nursing schools and to a stratified sample of postgraduate and post-registration programmes. Three case studies were carried out in acute hospital trusts to gain insight into opportunities for continuing professional development in health informatics and IT. Our evidence suggests that in the UK, health informatics is not yet integrated into the clinical curriculum. Nearly all the pre-qualification courses made some provision for teaching IT skills. Nonetheless, many respondents felt that students did not receive sufficient training. There was considerable variation in the amount of HI teaching provided in the different educational sectors. The case studies suggested very little HI training was provided for clinical staff and take-up of provision was not monitored. A number of factors are holding up progress, the most important being a lack of staff with the knowledge and skills to provide academic leadership. The paper outlines some steps that need to be taken to ensure health informatics is embedded in all clinical curricula.

The biosciences and Fitness for Practice: a time for review?

The learning of biosciences by preregistration students has been recognized as being problematic, and the need for better resourcing of education has been identified. The Project 2000 initiative (UKCC, 1988) expanded the breadth and dept of the curriculum content in order to support the delivery of holistic care, and so the resources for bioscience education seemed likely to remain limited. However, the UKCC has concluded that there has been a shortfall in the acquisition of practice skills by preregistration students (UKCC, 2001). To address this, new directives indicate that curricula should move to competency-based outcomes and use student-focused learning. However, there is a lack of clarity as to what the basic expectation is for bioscience learning at registration, and how this might be continued in postregistration programmes. The authors argue that if resources for bioscience teaching in preregistration curricula cannot be improved then it is time to review the situation to ensure that expectations are realistic and attainable. Criteria are required to establish exactly what life-long learning means in relation to the biosciences, from registration through to specialist practice.

The what and how of teaching research

Within the last decade nurse educators have been required to introduce research into the curriculum of every pre- and post-registration programme. This has lead to a debate concerning what practitioners need to know about research and about the best way to teach the research component of any educational programme. Two main approaches may be identified: facilitating research awareness and learning research by ‘doing’. Both approaches raise a number of logistical and ethical problems. Certain of these problems are compounded by the large numbers of nurses who may be required to undertake a research project as a course component. Moreover, the absence of research evidence about the most effective means of educating nurses to become discerning consumers of research leaves the teacher without a sound framework to guide educational practice. In the light of recent educational reforms, this paper considers the unprecedented opportunities for nurse and midwife teachers to explore the role of research in the curriculum and in teaching.