The sum of all parts: an Australian experience in improving clinical partnerships.

AIM: To create a collaborative partnership between the education provider (University) and the placement provider (Hospital) to facilitate the identification and development of strategies to improve capacity and capability for nursing clinical placements. This partnership was labelled (TULIP) to identify the two partners and it purpose as a learning investment project. BACKGROUND: The quality of clinical learning is interdependent on the collaborative clinical health partnerships between Hospital, University, preceptors/facilitators and students. Success is dependent on communication between all key stakeholders within the partnership, to meet capacity and capability demand. DESIGN: Collaborative quality assurance project in combination with two research projects. METHOD: Quantitative and qualitative measurements of student perceptions, preceptor understanding and organisation partnership capacity and capability over a three year period in an acute care hospital. RESULTS: Qualitative and quantitative data from students and preceptors, and hospital quality assurance data linked to become the TULIP framework for a clinical placement development model that addresses the key components of strategic communication, resourcing and staff acknowledgement between stakeholders. CONCLUSIONS: The outcomes achieved demonstrated student engagement, clinical leadership from registered nursing staff, and the establishment of a collaborative partnership between hospital executives and staff, and the university resulting in an increased capacity. The TULIP project has provided both partners with a sustainable plan for growth in student placements, improved strategies to develop clinical leadership practice in individual nurses and a better clinical learning environment for staff that uses a framework that is transferrable to other health settings.

RN as gatekeeper: gatekeeping as monitoring and supervision.

AIMS AND OBJECTIVES: To understand the variation of ways that students understand the informal or buddy registered nurse role during facilitated clinical experience, and to identify the relationship between student learning and student understanding and experience of the registered nurse role during clinical experience. BACKGROUND: Student clinical experience is an essential aspect of all undergraduate nursing programs. Students expect registered nurses to supervise and support them and to provide learning experiences during clinical placement. Both positive and negative experiences have been reported in the research literature. The quality of the relationship between the registered nurse and the student directly affects the learning outcome for students. DESIGN: Qualitative research using a phenomenographic approach. METHODS: Semi-structured individual interviews with 24 students from all three years of an undergraduate nursing program at a metropolitan university in Brisbane, Queensland, Australia, who voluntarily participated in this study. Interviews were conducted at the completion of a recent clinical experience. RESULTS: While adequate monitoring and supervision is an expectation of students, there is a wide variation in the way registered nurses appear to understand this aspect of student learning. In the category of description, 'registered nurse as gatekeeper: gatekeeping as monitoring and supervision', student conceptions were identified as: registered nurse awareness, registered nurse vigilance, promoting learning/developing learning and growing (as) students. Students identified their experiences and the strategies they used when monitoring and supervision were lacking or limited. CONCLUSIONS: The findings of this study illuminate the need for recognition of the complexity of the informal registered nurse role with students and highlight the areas that should be addressed to promote quality student learning experiences. RELEVANCE TO CLINICAL PRACTICE: Registered nurses need adequate preparation for their informal role to support and supervise undergraduate students in clinical placement to ensure the safe development of student competence and confidence for their graduate registered nurse role.

RN as gatekeeper: student understanding of the RN buddy role in clinical practice experience.

Students may be informally buddied with registered nurses (RNs), during their clinical experience. This paper describes one component of a larger phenomenographic study that explored the qualitatively different ways students understand the RN buddy role during clinical experience and the implications of this understanding for student learning. The perception of the RN as gatekeeper was an unexpected finding and is the focus of this report. Phenomenography is a field of descriptive research concerned with the variation in ways people experience and understand similar phenomena. This approach was used to identify the variation in experience and understanding of students with buddy RNs. Individual semi-structured interviews were conducted with a purposive sample of 24 students from one university in Queensland, Australia. The two variations in understanding of the role discussed in this paper are: understanding as an expectation, and RN as gatekeeper: gatekeeping as access. The research highlights that the various ways RNs promote or block access for students influence the quality of the learning experience. Formal recognition of the complexity of the RN role is essential to ensure RNs have adequate preparation for their role with students.

RN as gatekeeper: Student understanding of the RN buddy role in clinical practice experience.

Students may be informally buddied with registered nurses (RNs), during their clinical experience. This paper describes one component of a larger phenomenographic study that explored the qualitatively different ways students understand the RN buddy role during clinical experience and the implications of this understanding for student learning. The perception of the RN as gatekeeper was an unexpected finding and is the focus of this report. Phenomenography is a field of descriptive research concerned with the variation in ways people experience and understand similar phenomena. This approach was used to identify the variation in experience and understanding of students with buddy RNs. Individual semi-structured interviews were conducted with a purposive sample of 24 students from one university in Queensland, Australia. The two variations in understanding of the role discussed in this paper are: understanding as an expectation, and RN as gatekeeper: gatekeeping as access. The research highlights that the various ways RNs promote or block access for students influence the quality of the learning experience. Formal recognition of the complexity of the RN role is essential to ensure RNs have adequate preparation for their role with students.