Quality Of Clinical Placements Research Articles

Nursing students' satisfaction with the quality of clinical placement and their perceptions of preceptors competence: A prospective longitudinal study

BackgroundPrevious studies have demonstrated that preceptor training programs enhance preceptor competence and effectiveness. However, there is little research that has investigated the link between preceptor training and the quality of clinical placement. AimThis study sought to determine if preceptor training influences nursing students' satisfaction with the quality of their clinical placement and their perceptions of preceptor competence. DesignProspective longitudinal survey. MethodsA total of 189 nursing students from two Nursing Training Colleges in the north of Ghana were surveyed before and after a preceptor training program using two validated questionnaires. Data were analyzed using descriptive statistics and paired samples t-test. ResultsThere was a statistically significant increase in student satisfaction with the quality of their clinical placement following preceptors' participation in a preceptor training workshop (t(149) = 4.567, p < 0.001). Student perception of preceptor competence also had a statistically significant improvement following preceptor training, increasing from an average of 136.96 ± 21.45 at baseline to 156.49 ± 25.403 in the follow-up survey (t(142) = 6.731, p < 0.001). Furthermore, the percentage of students who perceived preceptors to be highly competent increased from 23.3 % at baseline to 53.8 % following the preceptor training. ConclusionThe findings from this study indicate that when supported by preceptors who themselves have had training in effective preceptorship, students are more likely to report higher quality clinical placement and perceive preceptors to be more competent.

Assessing the quality of nursing clinical placement: Aquantitative cross-sectional study.

To evaluate the quality of nursing clinical placement among nursing students. This is a descriptive cross-sectional study. Two hundred eighty two nursing student completed self-administered, online questionnaires. The questionnaire assessed participants' socio-demographic data, and the quality of their clinical placement. The students had a high mean score for the overall satisfaction of their clinical training placement with high mean score for the item of "patient safety was fundamental to the work of the units" and the item of "I anticipate being able to apply my learning from this placement," while the lowest mean score was related to "This placement was a good learning environment" and "Staff were willing to work with students." Patient or Public Contribution: Quality of clinical placement is critical for improving the everyday quality of care for patients who are in desperate need of caregivers with professional knowledge and skills.

P32 - An Interprofessional approach to clinical facilitation of midwifery and medical students in the Birth Suite

Quality clinical placement experiences are vital to prepare undergraduate students for their future professional role. Traditionally clinical placements are facilitated in professional silos, a model that when reviewed in the birth suite of a large regional hospital in Victoria, revealed a highly competitive culture of midwifery and medical students who often struggled to meet learning objectives. To address this, an Interprofessional Clinical Facilitator (IPCF) model was introduced that was underpinned by interprofessional education theory and collaborative practice. Facilitators actively supported students to immerse themselves in interprofessional learning experiences in the birth suite, whilst learning how, as a team, they could best support women in the labour and birth setting. The aim of this research was to evaluate the ICPF model in the birth suite. Between 2017 and 2021 midwifery and medical students on clinical placement in birth suite at a large regional Victorian hospital were invited to evaluate their placement by completing an anonymous online survey consisting of statements about placement experience with a 7-point Likert scale and open-ended questions. Ethics approval was obtained. Quantitative data was collected utilising routinely collected data from the Birthing Outcome System to identify student presence and clinical activity in the birthing environment. Results of the student’s evaluation of their placement experiences following implementation of the interprofessional clinical facilitation model will be presented with students describing a more supportive and collaborative learning environment. Data demonstrating learning requirements are being met and an increase in students accoucheuring births despite a decrease in vaginal birth numbers will also be presented. The success of the interprofessional facilitation placement model in Birth Suite has resulted in a significant improvement to the quality of the student learning environment. These outcomes support consideration of wider adoption of this model in other clinical teaching settings.

Nursing Student Perceptions of Home Visit Simulation Scenarios.

Ensuring quality clinical placement in community health nursing courses is challenging as faculty cannot observe all nursing students and little consistency is found in student experiences. Simulation can supplement traditional clinical experiences. Two home visit scenarios with learning objectives were developed. Students conducted the scenarios in the role of nurse or nursing student and completed evaluations of the experience. The findings suggest students perceived they were able to meet the learning objectives in each scenario regardless of which role was played. Home visit simulations were beneficial to student learning in the community health nursing course.

Developing Measures of Placement Quality in Allied Health, Dentistry, Medicine, and Pharmacy

As placement numbers expand, there is a concern that the quality of student experience and learning may diminish. Furthermore, there is a paucity of evidence for evaluation and quality improvement in clinical health placements and there have been few studies undertaken to assess quality. Valid and reliable measures of placement quality are needed to provide an evidence-base to guide decisions about the most efficient and effective placement models in health. A two-phase mixed methods design, using a modified Delphi process, focus groups, and surveys, developed and tested items to measure placement quality. Thematic analysis, descriptive statistics, and exploratory factor analysis (EFA) were used to analyse the data. Twenty-three participants took part in the Phase 1 stakeholder focus groups, and 150 useable surveys were returned by 161 who took part in Phase 2 to test validity and reliability of the student survey items. Results show broad agreement on the features of a quality clinical placement across allied health dentistry, medicine, and pharmacy professions. The student survey was found to be a valid and reliable measure of placement quality, with the EFA showing one component accounting for 58.5% of the variance in the survey data. The findings offer a framework and approach that others can adopt to measure placement quality in their setting. The measures may be adaptable to contexts outside health.

Building workplace social capital: A longitudinal study of student nurses' clinical placement experiences.

Quality clinical placement experiences have been associated with nurses' workplace social capital. Social capital is broadly understood as the social organisation of trust, norms and networks that benefit society. Building social capital in the workplace may benefit experiences of staff and students. The aim of this study was to assess the impact of building workplace social capital on student nurse perceptions of clinical learning experiences. A quality improvement process was measured through repeated student surveys. First, second, third year students (n=1176) from three universities completed a validated Student Clinical Learning Culture Survey (SCLCS) following their placement, at the commencement of quality improvement initiatives and five years later. The SCLCS measured students' perceptions of social affiliation, their motivation, satisfaction and dissatisfaction with clinical contexts. The first year of systematic changes focused on increasing student numbers along with improving communication, trust and knowledge sharing, antecedents to workplace social capital. No change was evident after the first year. Six years after commencement of building workplace social capital differences across all subscales, except dissatisfaction, were significant (p<0.001). Leadership that promotes open communication and connections across staff and students to achieve common goals can build workplace social capital that enhances student placement experiences.

A Research Brief: The Current State of Quality Clinical Placement in Nursing Practicums

&lt;p&gt;Purpose: The study was conducted to investigate students’ perceptions on their clinical experience and the quality clinical placement.&lt;br /&gt;Methods: This was a cross-sectional descriptive study. One hundred and thirteen junior or senior nursing students participated in this study. Descriptive statistics were used to analyze the data. &lt;br /&gt;Results: Majority nursing students expressed un-satisfaction (57.52%) with the required hours of practicums. They experienced different quality of clinical placement between the cities. Direct nursing skills they practice were limited to doing chores (67.1%), charting (14.47%), providing education to patients and families (10.53%), giving medication (7.89%). 49.56% of the students did not satisfy with what they have received shift schedule which was given from hospitals. &lt;br /&gt;Conclusion: Simulation and scenario-centered education should be considered in Asian countries as one of replacement of clinical hours on-site. Future research warrants testing and clarifying the most appropriate clinical hours to the nursing undergraduates for their quality clinical placement.&lt;/p&gt;

Perceptions of fieldwork in occupational therapy.

There are few studies in occupational therapy that compare the perceptions of supervisors and students regarding quality clinical placement programmes, and those that exist indicate substantial differences in the perceptions held by each group. This pilot study was conducted using a cross-sectional descriptive design, with a single questionnaire distributed to occupational therapy students and clinical supervisors. A total of 40 questionnaires were returned: 17 from students and 23 from clinical supervisors. Differences were found between the perceptions of occupational therapy students and clinical supervisors in response to four topics: preparation from the university for their placements; consistency across placement sites; instances of supervisors seeking feedback from students; and the burden associated with the placement-related workload for clinicians. Differences were found between the perceptions ofoccupational therapy students andclinical supervisors in response to four topics DISCUSSION: Different perceptions around preparation from universities and consistency across placement sites relate to the existing roles of each group: students are more aware of university preparation and clinical supervisors are more aware of organisational inconsistencies in their respective usual work environments. The discrepancy in the perceived seeking of feedback from students has also been reported in student debriefing sessions. The burdens perceived by clinical supervisors appear to be influenced by a belief that clinical education is an additional duty rather than a core role.

Factors associated to clinical learning in nursing students in primary health care: an analytical cross-sectional study.

ABSTRACTObjective: to identify the students' perception about the quality of clinical placements and asses the influence of the different tutoring processes in clinical learning. Methods: analytical cross-sectional study on second and third year nursing students (n=122) about clinical learning in primary health care. The Clinical Placement Evaluation Tool and a synthetic index of attitudes and skills were computed to give scores to the clinical learning (scale 0-10). Univariate, bivariate and multivariate (multiple linear regression) analyses were performed. Results: the response rate was 91.8%. The most commonly identified tutoring process was "preceptor-professor" (45.2%). The clinical placement was assessed as "optimal" by 55.1%, relationship with team-preceptor was considered good by 80.4% of the cases and the average grade for clinical learning was 7.89. The multiple linear regression model with more explanatory capacity included the variables "Academic year" (beta coefficient = 1.042 for third-year students), "Primary Health Care Area (PHC)" (beta coefficient = 0.308 for Area B) and "Clinical placement perception" (beta coefficient = - 0.204 for a suboptimal perception). Conclusions: timeframe within the academic program, location and clinical placement perception were associated with students' clinical learning. Students' perceptions of setting quality were positive and a good team-preceptor relationship is a matter of relevance.

Evaluating, understanding and improving the quality of clinical placements for undergraduate nurses: A practice development approach

Supervision and support is central to sustainability of clinical placement experiences of undergraduate nurses, but open to influences that impact nurses' capacity to undertake the role. Whilst supervision of learners is integral to the role of health care professionals, the primary responsibility is to deliver safe and effective care. Supervision of learners in practice is impacted by low levels of organisational support, variable individual preparedness, and lack of feedback and recognition for the role from education and industry partners.Over a period of five years the Quality Clinical Placement Evaluation research team, consisting of a partnership between health care and tertiary sectors have developed, and utilised a practice development approach to understand and support the quality of clinical placement for undergraduates and supervising ward nurses involved in Tasmanian clinical placement programs. Importantly, the approach evolved over time to be a flexible three step program supporting the translation of findings to practice, comprised of an education session related to supervision support; survey distribution to undergraduates and supervising ward nurses following clinical placement; and workshops where stakeholders come together to consider findings of the survey, their experience and the local context, with resultant actions for change. This paper reports on findings from the program after successful implementation in urban tertiary hospitals as it was implemented in non-traditional clinical placement settings, including community, aged care and rural settings.Feedback from clinicians identifies the utility of the three step program across these settings. The unique partnerships and approach to evaluating, understanding and improving quality of clinical placements has potential for transferability to other areas, with the value of findings established for all stakeholders.

Increasing quality and quantity of student placements in smaller rural health services: It can be done.

Future rural nursing and midwifery workforce shortage and current shortage of placements for undergraduate nursing and midwifery students. Developmental evaluation. Five small hospitals and a regional community health service. Increased number of placements available for students; sustainable, quality clinical placement system in place for the future. Clinical facilitators developed a clinical facilitation model and resources that increased quality and quantity of student placements, assisted clinicians to provide higher quality teaching to students, enabled students to develop skills in rural health care service provision and enhanced knowledge around future career options. Placement targets were met and all health services involved chose to continue the model of clinical facilitation developed after project funding ceased. The clinical education skills developed by staff under the project remain in the region to support future students. It is possible to create a sustainable, high-quality, rural placement experience for larger numbers of nursing and midwifery students. Funding sources are available to continue the clinical facilitation model in to the future, but for it to work optimally, a steady supply of students across the year is required.

Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: A qualitative study

Despite the fact that high quality clinical placement is an integral component of pre-registration nursing education for the development of the future nursing workforce, the literature identifies an ongoing struggle to 'get it right'. To examine qualitative data gathered through the Quality Clinical Placements Evaluation project to identify what pre-registration nursing students deemed helpful and not helpful influences on their first year Professional Experience Placement. A total of 553 first year undergraduate nursing students from 2010 to 2012 were enrolled in the programme and all were invited to complete a validated survey to measure the quality of their first clinical placement. A total of 361 completed surveys were returned. This paper examines the data provided through open-ended questions within the survey related to most helpful and least helpful aspects of their clinical experience. An inductive analysis approach using NVIVO allowed inherent areas to emerge from the raw data forming three key themes that influenced the experience of students. Feeling welcomed, individual versus team attitudes, and student expectations of supervising ward nurses were the themes identified that were perceived by the student as important to the success of learning and the quality of the experience overall. The findings echo previous research into the student experience of clinical placement; however the focus regarding the need for students to have a quality relationship with the supervising nurse is an area that warrants further exploration. Furthermore, we argue that students should be purposely engaged in the tertiary sector and provided guidance and strategies related to forming and maintaining relationships with those that supervise their clinical placement, in order to ensure consistent positive experiences. The outcomes from this study suggest that a missing component is teaching undergraduates how to manage relationships in clinical settings.

Hub and spoke model for nursing student placements in the UK.

The quality of clinical placements is an important factor in nurse education and depends, partly, on the quality of the mentoring. In a hub and spoke model of practice learning, pre-qualifying nursing students are allocated to their placement (hub) in the traditional way and, in addition, are formally supported by their mentor to work in other settings and with different clinicians (spoke experiences) for one week in eight. In a first pilot in three children's wards, participants reported the wide-ranging benefits of this model, which included: a richer learning experience; a heightened sense of belonging; enhanced understanding of the patient journey; greater insight into the roles and responsibilities of the multiprofessional team; and increased awareness of possible career choices. The project's students were able to work more confidently with different clinicians and teams, which should help them become nurses who deliver high quality, modern health care.

Preparing students for clinical placements: The student's perspective

Educating undergraduate nurses in the 21st century provides some very realistic challenges. Decreased government health budgets, increased student numbers and higher patient acuities have resulted in a reduction in the availability and quality of clinical placements. Simulated nursing practice is an innovative strategy designed to address these concerns. A simulation programme was designed for first year undergraduate nursing students to help prepare them for clinical placement.The aim of this research is to assess student perspectives and learning from the newly introduced simulation programme.This study is a descriptive design with Kolb's experiential theory providing a theoretical framework. 158 first year students taking part in a four day simulation programme chose to complete a questionnaire on programme completion. Students responded to five statements using a likert scale and categories developed and refined for the remaining four questions.Students reported significant learning in the areas of basic clinical skills and clinical documentation and collaborative care. 100% of students recommended the programme continue.

E.07.04 The new classification of medications exerting antidepressant action

Quality clinical placement experiences have been associated with nurses' workplace social capital. Social capital is broadly understood as the social organisation of trust, norms and networks that benefit society. Building social capital in the workplace may benefit experiences of staff and students. The aim of this study was to assess the impact of building workplace social capital on student nurse perceptions of clinical learning experiences. A quality improvement process was measured through repeated student surveys. First, second, third year students (n = 1176) from three universities completed a validated Student Clinical Learning Culture Survey (SCLCS) following their placement, at the commencement of quality improvement initiatives and five years later. The SCLCS measured students' perceptions of social affiliation, their motivation, satisfaction and dissatisfaction with clinical contexts. The first year of systematic changes focused on increasing student numbers along with improving communication, trust and knowledge sharing, antecedents to workplace social capital. No change was evident after the first year. Six years after commencement of building workplace social capital differences across all subscales, except dissatisfaction, were significant (p < 0.001). Leadership that promotes open communication and connections across staff and students to achieve common goals can build workplace social capital that enhances student placement experiences.

Finding measures of clinical placements quality for pre-service health services training: challenges of definition and search strategy construction

Background Health services provide clinical training to medical, allied health and nursing staff. Ensuring the quality and quantity of this training is critical to workforce supply. Health Workforce Australia (HWA) has funded initiatives to enhance clinical training quality and the availability of clinical training placements. The quantity and quality of clinical placements must be increased. While there are many strategies to improve quantity and many strategies claim to enhance quality, there is an absence of agreed measures to evaluate placement quality. A standardised, comprehensive and widely applicable measure of clinical education placement quality is required. This study describes the challenges involved in constructing a systematic review search strategy.

Starting the Conversation: What are the Issues for Paramedic Student Clinical Education?

Objectives This paper examines the issues that affect the quality of paramedic student clinical placements. Participants included paramedics, paramedic educators, paramedic students and ambulance service managers who had gathered for an Australian conference in Bendigo in central Victoria. The aim of this paper is to highlight issues identified by the participants and to start a conversation about the importance of clinical placement for paramedic students. Methods This was a qualitative study utilising ‘Community conversations’ as a research methodology. ‘Community conversations’ is an action research approach. This study had 53 participants, who spent around 5 hours in conversation throughout a 3-day conference. The conversation initiated was to discuss and raise issues that related to paramedic student clinical placements, and identify creative and innovative solutions. Results In this paper, we focus on three themes that emerged from the conversations: planning and preparation of the placement; continuity of placement experience; and diversity of placements. We argue that better communication is required between the university, the ambulance service, the paramedic educator/clinical instructor and the student. Conclusions Clinical education is an essential element of student learning and skill development, yet in Australia there are no mandatory requirements in relation to duration, content or measurement of quality in student clinical placements. We strongly recommend that continuity is an essential element of a quality clinical placement and argue that students should be allocated to work in one location for 1–2 week blocks.

Development and reliability testing of the quality clinical placement evaluation tool

To develop and test the content and face validity, and reliability of the quality clinical placement evaluation tool. The importance of clinical experience during undergraduate nursing degrees is undisputed. To date, tools available to measure quality of clinical placements have focused on single perspectives, that of the undergraduate or that of the supervising nurse. The quality clinical placement evaluation tool was proposed to provide an assessment of clinical placement experiences informed by supervising ward nurses and undergraduate stakeholders. The study employed a cross-sectional design. The internal validity of an existing instrument was evaluated by an expert panel and modified for use in the acute care sector. Surveys were completed by undergraduate students (n = 48) and supervising ward nurses (n = 47). Factor analysis was used to identify themes drawn from the literature and explore redundancy of items. Reliability was assessed using Cronbach's alpha for internal consistency and test-retest (five to seven days apart). Reliability testing showed good internal consistency for the tool; test-retest reliability testing results were moderate to good for students and fair to moderate for nurses. Factor analysis identified three core themes related to supervising ward nurse responses that could also be applied to undergraduate nurses. The domains identified were the following: welcome and belonging; support to meet learning needs; and confidence and competence: reflections on learning. The quality clinical placement evaluation has shown statistically acceptable levels of reliability and validity for measuring the quality of clinical placement from perspectives of undergraduates and supervising ward nurses. The tool provides tertiary institutions, acute care facilities, wards and individuals with the means to capture views of the quality of clinical placement which can also be used to undertake comparisons over time and between sites.

Clinical placements in general practice: Relationships between practice nurses and tertiary institutions

As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and models of clinical placement. This paper uses qualitative research methods to explore the perspectives of 12 Australian general practice nurses who have experience in facilitating undergraduate clinical placements about the relationships between HEIs and nurses. Findings are presented in the following three themes: (1) Appropriate preparation for placement: They don't know what primary health really means, (2) Seeking greater consultation in the organisation of clinical placements: they’ve got to do it one way for everyone, and (3) Uncertainty and lack of support: I had no contact with the university. Clinical placements in general practice can be an innovative strategy providing non-traditional, yet high quality, teaching and learning experiences for undergraduate nursing students. To optimise the quality of these placements, however, it is essential that HEIs provide appropriate support to the practice nurses mentoring these students.

Life Review:Connecting Undergraduate Nursing Students with Older Adults

MOST HEALTH CARE PROFESSIONALS PRACTICING TODAY, INCLUDING NURSES, RECEIVED MINIMAL GERIATRIC CONTENT OR CLINICAL EXPERIENCES IN THEIR FORMAL EDUCATION PROGRAMS. Moreover, the negative perceptions or stereotypes of aging held by many practicing nurses and nursing students are barriers to choosing gerontological nursing as a career choice or specialty. Brown, nolan, davies, nolan, and Keady (2008) found that the quality of clinical placements during an educational program influenced the career choices of nursing students. When clinical placements were in environments where nurses practiced high standards of care and positive attitudes toward older adults, students voiced a more positive view of gerontological nursing (2008). in 1997, visionary nursing faculty at our university included gerontological nursing courses as part of the curricular revisions in the generic baccalaureate and rn to BSn programs. However, only the BSn course had a clinical component. Faculty teaching the rn to BSn gerontological nursing course wanted an assignment that would connect their students with community-based older adults. pairing students with an older adult mentor has been an effective strategy for providing medical students with positive learning experiences in geriatrics (Stewart & alford, 2006). this article describes the Life review assignment, which brings together undergraduate nursing students and older adults within the context of a nonclinical nursing course. this assignment has been used successfully for more than 10 years and has evolved so that it can now be included in an online, intense, five-week modular gerontological nursing course. The Life Review Assignment the original idea for using a Life review assignment in a gerontological nursing course was shared with the first author by Marion rowe, phd, rn, a member of the faculty of a sister school of nursing. dr. rowe's students interviewed older adults in long-term care facilities. the assignment was based on Butler's (1963) pioneering work in life review therapy, Erickson's (1963) psychosocial theory of human development over the lifespan, and Haight and Haight's (2007) structured review process. the purposes of the assignment are to provide students with an opportunity to: develop one-to-one interactions with an older adult who resides in the community, develop and refine students' communication skills, and examine successful aging through the lived experiences of an older adult. there are two components to the assignment: a single visit consisting of the life review interview and a written paper based on the interview. the interview should not exceed two hours, but if more time is needed, students may schedule another meeting. the older adult is asked to give consent and sign a permission form, electronically or in hard copy. one copy of the consent is given to the older adult and the original is given to the instructor for filing at the university. Interviews take place at a mutually convenient time and place. the student prepares for the visit, schedules the interview, and documents the date, time, and place of the interview with the older adult's signature on the consent form. after the interview, the student writes and submits a paper. Course faculty may randomly call some of the older adults to verify that the interviews took place. it has been the experience of the instructor that, occasionally, an interviewee will contact the instructor to discuss the interview. the permission form provides assurance that information shared during the interview is seen only by course faculty; where appropriate, it may be seen by peers in the class. initials are used in all written work to protect the privacy of the participants. Life Review Assignment Guidelines the student's objectives for the Life review assignment are as follows: Completing this assignment will enable the student to: a) conduct a life review with an older adult, b) understand the significance of the life story of an older adult, c) discuss the process of conducting a life review, d) identify possible legacies and their importance to elders, and e) describe the degree of ego integrity (Erickson's theory) reached by the older adult (on a scale of 0-10). …