Creating supportive clinical learning environments: an intervention study.

AIM: To assess the impact of an intervention aimed to build capacity of registered nurses to enhance the clinical learning environment for undergraduate nursing students. Workplace learning is vital for the development of skills, attributes and knowledge of student nurses. Registered nurses need to be appropriately prepared to maximise student learning during clinical placement. BACKGROUND: The quality of student learning during clinical practicum is largely dependent on interactions with ward staff. DESIGN: A quasi-experimental design. METHOD: Measurement of students' perceptions of the psycho social learning environment during and outside of the intervention period was used to evaluate the capacity building intervention. The capacity building intervention consisted of interactive education in clinical areas over a six-week period for registered nurses in two acute surgical wards. RESULTS: First, second and third year students (n = 62) who undertook their clinical practicum in the two surgical wards, before, during and six months after the capacity building intervention assessed the psycho-social learning environment at the time of their clinical practicum. Findings showed that students who undertook their clinical practicum during the intervention period rated the psycho-social clinical learning environment significantly higher than students who undertook their practicum at times outside of the intervention period. CONCLUSIONS: An experienced researcher/educator conducting capacity building sessions can effectively assist and support registered nurses to engage with students. RELEVANCE TO CLINICAL PRACTICE: Capacity building sessions can improve practice, however, structures and processes that ensure continuation of practice change need to be embedded for improvements to be sustained.

Enabling student placement through strategic partnerships between a health-care organization and tertiary institutions.

Nursing management needs to demonstrate its commitment to clinical education for undergraduate nursing students. The vision for the nursing leadership and management team at Princess Alexandra Hospital is to guide and support the development of hospital clinicians, at all levels in the organization, to effectively facilitate undergraduate students' learning during their clinical practical experiences. This paper examines the evolution of the meaning, commitment and practices that have been intrinsic to the development of strategic partnerships between the health-care organization and tertiary institutions to ensure that hospital staff who consistently facilitate student learning in the clinical context are well supported. The partnerships are based on open channels of communication between the health-care organization and the tertiary institutions whereby each party identifies its needs and priorities. This has resulted in increased hospital staff satisfaction through greater involvement by them in the placements of students, and enhanced understanding of clinicians of the student placement process that has contributed to improved satisfaction and outcomes for the students.

Pre-test and post-test evaluation of students' perceptions of a collaborative clinical education model on the learning environment.

OBJECTIVE: This study investigated the impact of a collaborative clinical education model on students' perception of the psycho-social learning environment. DESIGN: A pre-test and post-test quasi experimental design. SETTING: A tertiary referral centre. SUBJECTS: Second and third year undergraduate nursing students were asked to rate their perceptions of the psycho-social learning environment at the completion of the clinical practicum. TOOL: The tool used to measure psycho-social perceptions of the clinical learning environment was the Clinical Learning Environment Inventory previously validated in Australian health care contexts. INTERVENTION: A collaborative arrangement with the university and ward staff where eight students are placed on a ward and a ward staff member is paid by the university to be 'off-line' from a clinical workload to supervise the students. This is in contrast to the standard facilitation model where students are placed with registered nurses in different localities under the supervision of a 'roving' registered nurse paid by the university. RESULTS: No significant differences were found in pre-test mean scores when comparing wards. Significant differences in post-test scores for the intervention group were identified in the sub scales of Student Involvement, Satisfaction, Personalisation and Task Orientation. CONCLUSIONS: The adoption of a collaborative clinical education model where students are integrated into the ward team and the team is responsible for student learning can positively enhance capacity for student learning during their clinical practicum.

Students' perception of the psycho-social clinical learning environment: an evaluation of placement models.

Nursing is a practice based discipline. A supportive environment has been identified as important for the transfer of learning in the clinical context. The aim of the paper was to assess undergraduate nurses' perceptions of the psychosocial characteristics of clinical learning environments within three different clinical placement models. Three hundred and eight-nine undergraduate nursing students rated their perceptions of the psycho-social learning environment using a Clinical Learning Environment Inventory. There were 16 respondents in the Preceptor model category, 269 respondents in the Facilitation model category and 114 respondents in the clinical education unit model across 25 different clinical areas in one tertiary facility. The most positive social climate was associated with the preceptor model. On all subscales the median score was rated higher than the two other models. When clinical education units were compared with the standard facilitation model the median score was rated higher in all of the subscales in the Clinical Learning Environment Inventory. These results suggest that while preceptoring is an effective clinical placement strategy that provides psycho-social support for students, clinical education units that are more sustainable through their placement of greater numbers of students, can provide greater psycho-social support for students than traditional models.

Enhancing support for nursing students in the clinical setting.

Quality clinical placement experiences are essential for effective student learning. Key factors that can influence this experience are students not feeling welcome in the clinical setting and limited opportunities for them to engage in learning. From a review of the literature and of personal experiences, this paper presents some guidelines that can be introduced at local level without requiring additional resources in order to improve students' experiences.