Clinical coaching--an innovative role to improve marginal nursing students' clinical practice.

In order for undergraduate nursing students to demonstrate their ability to achieve the required level of competency with practice they must be able to integrate both the clinical skills and knowledge that are pivotal to safe and competent nursing practice. In response to ongoing concerns about students' level of competency expressed by the supervising clinical staff, one School of Nursing and Midwifery created a Clinical Coach (CC) role. The purpose of this paper is to present the data collected including outcomes achieved and the coaching strategies used when a CC role was implemented to support and develop nursing practice for the marginal performer or 'at risk' student. A literature review of the application of coaching to nursing, a detailed analysis and discussion of the outcomes identified from auditing of collected data and the specific coaching strategies that resulted in successful outcomes for students is presented. This model of Clinical Coaching for nursing students could readily be adopted by other Schools of Nursing and Midwifery. This account of the regime of coaching practices may also offer a transferable, adaptable and flexible approach for other health professions who require their undergraduate students to complete clinical placements in preparation for professional practice.

Living and learning in a rural environment: a nursing student perspective.

This study investigates the influences on nursing student learning who live and learn in the same rural environment. BACKGROUND: A declining health workforce has been identified both globally and in Australia, the effects of which have become significantly apparent in the rural nursing sector. In support of rural educational programs the literature portrays rural clinical practice experiences as significant to student learning. However, there is little available research on what influences learning for the nursing student who studies in their own rural community. RESEARCH AIMS AND DESIGN: The aim of this study was to understand what influences student learning in the rural clinical environment. Through a multiple case study design five nursing students and two clinical preceptors from a rural clinical venue were interviewed. The interviews were transcribed and thematically analysed to identify factors that influenced student learning outcomes. RESEARCH FINDINGS: The most significant influence on nursing student learning in the rural clinical environment was found to include the environment itself, the complex relationships unique to living and studying in a rural community along with the capacity to link theory to practice. The rural environment influences those in it, the demands placed on them, the relationships they form, the ability to promote learning and the time to teach and learn.

Critical action research applied in clinical placement development in aged care facilities.

The aim of this study was to develop quality clinical placements in residential aged care facilities for undergraduate nursing students undertaking their nursing practicum topics. The proportion of people aged over 65 years is expected to increase steadily from 13% in 2006 to 26% of the total population in Australia in 2051. However, when demand is increasing for a nursing workforce competent in the care of older people, studies have shown that nursing students generally lack interest in working with older people. The lack of exposure of nursing students to quality clinical placements is one of the key factors contributing to this situation. Critical action research built on a partnership between an Australian university and five aged care organisations was utilised. A theoretical framework informed by Habermas' communicative action theory was utilised to guide the action research. Multiple research activities were used to support collaborative critical reflection and inform actions throughout the action research. Clinical placements in eight residential aged care facilities were developed to support 179 nursing students across three year-levels to complete their practicum topics. Findings were presented in three categories described as structures developed to govern clinical placement, learning and teaching in residential aged care facilities.

Faculty perceptions of interprofessional education.

Nurses and other health professionals are required to demonstrate broad levels of expertise and service to ensure quality patient-centred health care. Interprofessional practice aligned with interprofessional education (IPE) has been promoted as a vehicle to promote broad levels of expertise. However, challenges remain for universities and other higher education institutions to successfully provide IPE opportunities for students. This paper presents perceptions of academic staff towards IPE from one Australian multi-campus health faculty. Perceptions were collected using interviews and two workshops. Findings are themed under the categories of faculty barriers, industry challenges and future opportunities. The perceptions of one health faculty regarding the fundamental factors required for IPE success were executive leadership of IPE, a supportive funding framework and an IPE based curricula. Nursing education can play a key role in embracing and leading future IPE approaches given that nurses are the numerically dominant health professional group and work collaboratively with other professionals to deliver patient-centred care.

Third-year undergraduate nursing students' perceptions of high-fidelity simulation.

High-fidelity simulation, with the potential to enhance cognitive, associative, and autonomous skills, can help students develop clinical reasoning. This study examined third-year students' (N = 300) perceptions about the implementation of high-fidelity simulation into an existing clinical course. Data were collected using an evaluation form completed by students after the simulation. Students perceived high-fidelity simulation as enjoyable, with an appropriate degree of challenge yet possessing congruency with concepts studied in the course. Students' transient feelings of confusion were interpreted as a natural component of the problem solving process as they analyzed, clustered, and interpreted cues to respond to rapid changes in the simulated patient's clinical condition. Debriefing was viewed as an important component and assisted in clarifying students' knowledge and rationale for practice. Further research is required on the relationship between the degree of confusion and its impact on learning and whether high-fidelity simulation increases the ability to reason in the clinical setting.

'Older people have lived their lives': first year nursing students' attitudes towards older people.

A survey was conducted with 262 commencing nursing students at a South Australian university, during a compulsory orientation week lecture prior to the first week of their nursing degree, to determine their attitudes towards older people and to working with older people. The survey provides baseline data to evaluate the efficacy of the Partnerships in Aged Care (PACE) Action Research project, the focus of which is developing aged care curriculum and placements with aged care industry partners. The survey will be replicated when this cohort completes their nursing degree. The results of this initial survey show that while commencing students generally have positive attitudes towards older people they do not aspire to work with them. The reasons cited for a lack of interest in working with older people include: poor experiences of providing care for older people; an inability to relate to or communicate with older people and a perception that the work is depressing and boring. Underpinning a negative perception of working with older people is the association of ageing with disability. Ageing for this cohort, is associated with loss of mental and physical function; loss of independence and increasing reliance on others to meet self care needs. This is viewed as evidence of a biomedical view of ageing. Contrary to previous research, many students studied in this project, who have had experience of working with older people, demonstrate more positive attitudes to older people and are less likely to express stereotypical attitudes towards ageing suggesting that positive exposure to older people can challenge ageist views. The PACE project seeks to demonstrate that strategies which may promote a positive attitude to ageing such as development of educational content which promotes a quality of life rather than a biomedical approach to ageing and supported clinical placements can impact positively on nursing students perception of ageing and of working with older people.