Practice tutors' readiness to support nursing students who require reasonable adjustments for clinical placement.

BACKGROUND: Preregistration nursing students (trainee nursing associates and student nurses) may have a disability or impairment that requires reasonable adjustments while they are on clinical placement. At The Open University, practice tutors support nursing students on clinical placement, which includes overseeing the facilitation of any such reasonable adjustments. However, they may not feel prepared to provide this support. METHOD: A qualitative approach with a broad interpretivist paradigm was adopted. Data were collected from three focus groups that included a total of 10 nursing practice tutors. Audio data were transcribed and analysed using complete coding followed by thematic analysis. FINDINGS: Three main themes were identified - it's complex; impact of engagement; and a cohesive approach - along with associated subthemes. CONCLUSION: Despite their clear interest in helping nursing students who require reasonable adjustments for practice-based learning, practice tutors can be hindered by barriers resulting from a lack of both training and guidelines. The complexity of the practice tutor role and student issues can compound this. Consistency in practice tutor training is recommended, as well as regular access to peer support to address these difficulties and develop the skills and knowledge.

Exploring student nurses' and their link lecturers' experiences of reasonable adjustments in clinical placement.

BACKGROUND: student nurses who attend preregistration nursing programmes in the UK are assessed on their academic work and their performance in clinical placement. Some of them require reasonable adjustments to be made in order to support their learning. Although there is national guidance on making reasonable adjustments for academic work, information on this associated with clinical placement is limited. The nursing literature reports varying levels of success in facilitating reasonable adjustments in clinical placement. AIM: to explore the experiences of student nurses who require reasonable adjustments and their link lecturers associated with the facilitation of this support in clinical placement. METHOD: a descriptive phenomenological methodology was adopted. Data were collected using semistructured interviews with seven student nurses and three link lecturers from three fields of nursing (adult, child and mental health). Audiorecorded interview data were transcribed, coded and thematically analysed. Phenomena were identified and discussed, viewed through relevant educational theoretical lenses and in conjunction with nursing research literature. FINDINGS: three main themes emerged: defining reasonable adjustments, supporting students, and being professional. CONCLUSION: all study participants could define reasonable adjustments and described a variety of experiences of these being facilitated in clinical placement. The process could be complex and depended on many factors that could promote or hinder the provision of support.

Applying interprofessional education to the practice setting.

Interprofessional education is a key requirement identified in various professional and regulatory body education standards in the UK. However, recent high-profile investigatory reports into adverse incidents in NHS organisations have demonstrated failures of translating interprofessional education into practice. This paper explores how a university in the south of England uses service improvement projects to address this. Working with key senior clinicians, small groups of students from a variety of professional backgrounds collaborate to address an identified problem in practice to bring about better, safer practice to benefit patients. This style of learning enables students to acquire essential attributes in preparation for employment, such as critical thinking, teamworking, ethical practice and leadership.

Using seminars as a teaching method in undergraduate nurse education.

This article explores the use of seminars as a teaching method in undergraduate nurse education. Using the backdrop of a year 1 learning unit, grounded in the 6Cs, entitled person-centred practice, the format of the seminars is described in detail. It argues that engaging in a variety of student-centred activities helps students to become informed, self-motivated and curious learners. It identifies that using seminars as a teaching method helps to ensure that students understand and learn what they need to know by using a variety of learning approaches to support them in their personal and academic growth. These include discussion, groupwork, independent learning, the use of technology and building self-confidence, problem-solving approaches and reflection techniques. While being mindful of the higher order skills required to develop and manage seminars, the author uses the concept of constructive alignment to demonstrate development of the seminar approach from curriculum design, teaching, learning, assessment and evaluation.

Non-technical skills required to recognise and escalate patient deterioration in acute hospital settings.

Recognising patient deterioration is a vital nursing role. Observation based on vital signs and early warning scores are mandatory for all adult patients in acute hospital care and are the first steps in identifying deterioration. However, they rely on users' understanding of the significance of the results they find and their ability to escalate to senior colleagues if necessary. This article examines the non-technical skills nurses require to recognise and escalate patient deterioration. Itexplores and analyses the literature on this topic and suggests there is a need for greater focus on situational awareness in nurse training and in healthcare in general, as this is linked to improved patient safety.

"I was yelled at, intimidated and treated unfairly": Nursing students' experiences of being bullied in clinical and academic settings.

AIMS AND OBJECTIVES: To present findings from a study that explored nursing students' experiences of bullying in clinical and academic settings, the strategies used to negotiate bullying and recommendations for empowering future students. BACKGROUND: Nursing students are identified as a group who are at particular risk of bullying. Numerous studies have examined students' experiences of bullying in clinical contexts by qualified nurses; however, there has been far less attention to the bullying that occurs in academic settings where the perpetrators are university staff and other students. DESIGN: The qualitative findings presented in this paper form one component of a mixed-methods, multisite study that examined the nature and extent of bullying in one cohort of nursing students. METHODS: A convenience sample of 29 first-, second- and third-year undergraduate nursing students from one semimetropolitan Australian university was recruited for semistructured interviews in 2014. Interview data were analysed using NVivo. FINDINGS: Participants described multiple examples of bullying occurring in both clinical and academic settings. Perpetrators included clinicians, facilitators, academics and fellow students. Bullying ranged from incivility to physical attacks. The impact of the bullying was profound; it caused many of the participants to feel anxious and distressed, it undermined their confidence and perception of competence, and it often led them to question their career choice. Strategies described by participants to cope with or manage the bullying included avoidance, trying to "just survive" and seeking support from trusted academic staff, family and friends. No episodes of bullying were formally reported. CONCLUSION: Bullying remains a pervasive phenomenon occurring in both clinical and academic settings. Students are, in many respects, a vulnerable and disempowered population who often fear the consequences of making a formal complaint. Thus, reporting structures and support strategies need to be re-examined, and resilience training is imperative. RELEVANCE TO CLINICAL PRACTICE: Bullying remains a continuing concern in undergraduate nursing degrees. Efforts must be made in clinical and academic settings to heed the advice of undergraduates using broader strategies to address the issues.

Baccalaureate nursing students' perceptions of learning and supervision in the clinical environment.

This study is an exploration of nursing students' experiences within the clinical learning environment (CLE) and supervision provided in hospital settings. A total of 357 second-year nurse students from all universities in Cyprus participated in the study. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher instrument. The dimension "supervisory relationship (mentor)", as well as the frequency of individualized supervision meetings, were found to be important variables in the students' clinical learning. However, no statistically-significant connection was established between successful mentor relationship and team supervision. The majority of students valued their mentor's supervision more highly than a nurse teacher's supervision toward the fulfillment of learning outcomes. The dimensions "premises of nursing care" and "premises of learning" were highly correlated, indicating that a key component of a quality clinical learning environment is the quality of care delivered. The results suggest the need to modify educational strategies that foster desirable learning for students in response to workplace demands.