The changing role of the nurse teacher

Exploring how nurse lecturers maintain clinical credibility

The role of the nurse lecturer is changing. There is growing pressure from the government and professionals alike to recruit nurse teachers who posses both practical and recent experience of nursing [Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Health Care. DOH, London; UKCC, 2000. Standards for the Preparation of Teachers of Nursing, Midwifery and Health Visiting. UKCC, London]. Whilst much of the literature available suggests a growing concern amongst practitioners, students and nurse educationalists themselves about the importance of being ;clinically credible', what is not clear is how tangible it is to maintain currency and clinical credibility. In addition, the term ;clinical credibility' is in itself ill-defined. An exploratory study was undertaken within one higher education institution which sought to seek the views of nurse lecturers. The principles of ethnography were applied to this research. The sample included six of the most recently appointed nurse lecturers within one academic faculty who taught predominantly on pre-registration programmes. Data from individual and focus group interviews was analysed using a thematic content analysis approach. The findings are discussed which embrace the concepts of: working ;hands on' in the clinical area, clinical currency, transferability of skills, clinical visibility and role development. Recommendations for the development of professional practice are offered.

The clinical role of lecturers in nursing in Ireland: perceptions from key stakeholder groups in nurse education on the role

The clinical role of lecturers in nursing has been a focus of debate since the integration of nurse education into higher education institutions. The purpose of this paper is to report the findings from the preliminary phase of a study, undertaken to investigate the perceptions of key stakeholder groups in nurse education, regarding the current clinical role of nurse lecturers in Ireland. A descriptive exploratory design was used involving focus group and individual interviews, soliciting views of purposefully selected educationalists, clinicians, policy formulators and students. The issue was examined from a policy perspective, aiming to collectively represent views of all participant groups. This approach facilitated a more complete picture of perceptions of the role to emerge, to better inform future decision making. Twenty two focus group interviews and twenty one individual interviews were conducted. Content analysis was used to identify themes. All groups were in agreement that role definition was urgently required to dispel ambiguities surrounding what the clinical role should involve. Conflicting views were evident among groups regarding lecturers' clinical credibility, visibility and teaching effectiveness. Findings highlight the essential nature of nurse lecturers engaging with clinical areas to maintain their skills, demonstrate a value for the practice component of the role and provide a link between education and practice.

The role of the nurse teacher in clinical practice: an empirical study of Finnish student nurse experiences

This paper focuses on the role of the nurse teacher (NT) in supporting student nurse education in clinical practice. The paper draws on the outcomes of a study aimed at exploring student nurse experiences of the pedagogical relationship with NTs during their clinical placements. The participants (N=549) were student nurses studying on pre-registration nursing programmes in Finland. Data were analysed using descriptive statistics, cross-tabulation and ANOVA. The study showed that the core aspect of NTs work in clinical practice revolved around the relationship between student, mentor and NT. Higher levels of satisfaction were experienced in direct proportion to the number of meetings held between the student and NT. However, whilst the importance of this relationship has been reported elsewhere, an additional aspect of this relationship emerged in the data analysis. Those NT who facilitated good face to face contact also used other methods to enhance the relationship, particularly e-mail, virtual learning environment and texting. This outcome suggests that NT's interpersonal and communicative skills are as important as their clinical knowledge and skills in promoting effective learning in the clinical practice area. The paper argues for such approaches to be utilised within the emergent opportunities afforded by new communication and educational technologies.

Negotiating multiple roles: link teachers in clinical nursing practice

BACKGROUND

The background to this study was a concern about the teacher's role in clinical practice. Experience suggested that teachers believed that their role in practice was important but that there were significant forces which impeded their ability to move with ease between education and practice. A discrepancy between previous research findings and theoretical discussions, and the reality experienced by teachers, led to the adoption of grounded theory as a way of exploring uncertainties in the situation.

METHOD

Data were gathered over a period of 7 years and involved 28 in-depth interviews with nurses with a range of educational roles, employed in educational institutions and practice settings in inner city and provincial areas in the South of England.

FINDINGS

The data revealed four categories, 'gaining access', 'negotiating credibility', 'being effective' and the core category 'negotiating multiple roles'. The core category is addressed in this article. Experiences of moving from a position of clinical practitioner to link teacher involved: 'disassembling the self' through leaving behind old identities; 'reconstructing the self' through clarifying new ways of being; and, finally, 'realizing the self' through reciprocal interpersonal activity with students, educational and nursing colleagues.

CONCLUSIONS

It is inevitable that an individual with a remit for change entering an established social group will experience difficulties in establishing their role. It is also clear that an individual who changes their role within a group to reflect behaviours not congruent with the primary activity in that setting will experience dimensions of social exclusion. Further work needs to address how educational roles can make a significant impact on the everyday lives of students and nurses working in practice. The findings of this study are as relevant for the new roles of practice educator, clinical facilitator and practice placement co-ordinator as they are for link teachers and lecturer practitioners. Several suggestions are made to improve links with practice.

A transcultural study of Jordanian nursing students' care encounters within the context of clinical education

Clinical education is an integral part of nursing education. Clinical teachers are the vital link in this teaching-learning process. The quality and quantity of student-teacher interactions in the clinical area can either facilitate or hinder students' learning. This paper presents a part of a larger study that discovered, described, explained and compared Australian and Jordanian nursing students' caring and non-caring encounters with their clinical teachers within the context of clinical education. The study was guided by Leininger's theory of culture care universality and diversity and Leininger's ethnonursing research method was utilised. The informants consisted of 12 key informants and 35 general informants. Three major themes emerged from the analysis of the data: (1) clinical teacher's caring behaviours; (2) student-teacher caring encounters; and (3) caring encounter consequences. Under these themes, care constructs emerged which gave light to the Jordanian nursing students' care meanings, expressions and values within their cultural environment, social structures and world view. The overall findings revealed that Jordanian nursing students found their clinical experiences as beneficial when their encounters with the clinical teacher were conducted through mothering, translating, sustaining, negotiating and transforming processes.

Delphi technique: one cycle of an action research project to improve the pre-registration midwifery curriculum

Facilitating a unified interpretation of new or re-designed curricula can be problematic in multi-sited universities. This paper discusses the use of the Delphi technique when implementing an innovative pre-registration midwifery curriculum. It formed one of the action research cycles of the author's doctoral study and was used in an attempt to seek the views of all midwife teachers and achieve a critical mass consensus. The most important issues that emerged from the Delphi process were grouped into four categories. These four categories (the teacher's base site, communications, staff development and administration issues) formed the agenda for a staff away day. The outcome of the process was the generation of a list of priorities and actions for curriculum implementation and the identification of ways in which staff development needs might be met more effectively. An unexpected, but equally important, outcome was the way it helped with team building and agreement on positive actions for its further development.

The nurse teacher's clinical role now and in the future

The role of the nurse teacher in relation to the clinical setting has been debated for 20 years, yet it has been the subject of relatively few large studies. Recent studies led to inconclusive results, hence the nurse lecturer's clinical role remains an area of long-standing dispute. Changes in nurse education United Kingdom Central Council (UKCC) and the amalgamation of nurse education into higher education as part of the Strategy for Nursing, as well as the expansion of supernumerary status for student nurses, gave impetus to the search for a new clinical role for nurse lecturers. Research suggests that nurse teachers wish to maintain clinical contact, but the nature of this contact is vigorously debated at present. Lee, in reviewing the literature, concluded that this topic is highly contentious in terms of its nature, extent and purpose. She goes as far as to suggest that there is a need for empirical research to address the question as to whether there is a role for nurse lecturers in the clinical area. This paper examines some of the factors which influence the development of the clinical aspect of the role of nurse lecturers, explains how the author performed this role and the perceived benefits to students, mentors and the lecturer. It proposes a clinical role model based on the literature and the author's own personal experience as a 'clinical liaison lecturer' since the integration of nursing education into higher education. Key points The clinical role of the nurse teacher remains an area of long standing dispute Nurse lecturers wish to maintain clinical contact and maintain clinical competence, but in reality no consensus exists as to its meaning The mentor's role can be complemented by a clinically competent nurse lecturer who arguably should be able to teach in the classroom and the practice settings Using a triangular approach to reviewing student's experience, lecturers can update their clinical knowledge, demonstrate credibility, promote education-practice relations and ensure classroom teaching is relevant to current practice The establishment of guiding principles (recognized and agreed upon by service and educational managers) serves as a framework which nurse teachers can use to establish their own clinical role for each of their 'link' areas The nurse lecturer is in a good position to influence and maintain standards in nursing practice.

Clinical supervision for nurse teachers: the pertinent issues

The emergence of clinical supervision in nursing is viewed with both enthusiasm and reservation. Professional growth of the nurse practitioner is envisaged through adopting this support framework, although concerns exist particularly in relation to the role of management in monitoring performance and standards. Most authors have attempted to reassure nurses by stressing the positive elements. Potential benefits include the development of self-learning and clinical skills through reflection using a supervisor. It is anticipated that the supervisee will retain ultimate control of the process. Implementation of clinical supervision in nurse education is being considered. The need for a formal method of support has not been identified by teachers. It is debatable whether a format similar to that for clinical practice would be appropriate when the role of the nurse teacher focuses mainly on academic rather than clinical issues. Supervision in nurse education may be accepted or rejected, but a decision cannot be reached until role and cost issues have been adequately addressed.

Managing change in nurse education: the introduction of Project 2000 in the community

The United Kingdom Central Council's proposals for nurse education (Project 2000: A New Preparation for Practice) were implemented in 13 demonstration districts in England in 1989. In 1991, as part of an English National Board-funded research study, the author conducted 15 interviews with first line managers from three of these demonstration districts. The data were reinterpreted in 1995; the experience of implementing educational change in the community setting was discovered to be a complex and difficult process for the managers involved. They found themselves confronted with sometimes conflicting responsibilities; their perception of their role encompassed the meeting of a range of needs, which are presented in this paper within three categories. Firstly, the managers felt they had an obligation to meet the needs of students and of education in general in order both to provide an adequate experience for each individual student and to safeguard standards in community nursing in the long-term. Secondly, they were confronted with the need to mitigate the pressures of Project 2000 placed on 'their' staff. The new educational programme meant that community nurses spent much more time with students than formerly, and the difficulties they encountered were exacerbated by uncertainty about their role with these elements. Finally, and most importantly, managers were responsible for ensuring that clients' needs were met. In particular, they saw it as their role to ensure that the presence of large numbers of students in the community for long periods of time did not compromise standards in the delivery of community nursing services.

Nursing lecturer/practitioners: can lecturer/practitioners be music to our ears?

The value of the recently emerging role of the lecturer/practitioner (LP) in nursing is examined by reflecting on the experience of the authors. Within the evolutionary development of nursing education there appears to be separate branchings into theory and practice. Much effort has been spent on trying to lessen this so called theory-practice gap. Examination and reflection with reference to the LP led to the conclusion that there is a paradoxical nature to nursing. The whole which is nursing comprises of seemingly incongruent aspects, theory and practice which can be integrated. This paper argues that nursing knowledge is complementary in nature. It consists of 'knowing how' and 'knowing that'. These two aspects cannot exist independently but are integrated through practice. It is experience and reflection that integrate these through the embodiment of the LP. It is within this context that the evolution of the role of the LP is reviewed from a theoretical and historical perspective.

How can nurse teachers be more effective in practice settings?

This paper reports on selected aspects of a research project commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the relationship between teaching, support, supervision and role modelling in clinical areas, within the context of Project 2000 diploma courses. The paper will focus upon findings which related to the role of the nurse teacher in practice settings. These were derived from interviews with students, practitioners and nurse teachers in three Project 2000 centres in England, and from a series of case studies in practice settings providing learning experiences for students undertaking the adult and mental health branches of Project 2000 diploma courses. Findings are discussed in relation to four broad areas: establishing a role for nurse teachers within the practice team; preparation of practitioners for their role in student learning; helping students to link theory and practice; and the nurse teacher's role in developing practice.

The development of module evaluation: a Delphi approach

This paper outlines an innovatory approach to curriculum evaluation in one of the six colleges of nursing that developed an English National Board (ENB) pilot scheme in nurse education (ENB 1987a). The method of evaluation is promoted as a means of facilitating a working partnership between student and teacher in which they can share in the dynamic process of systematic monitoring and reviewing of learning programmes to ensure changing needs are met. It is envisaged the strategy would interest planners or implementers of health care courses who seek a deeper insight into the perceptions and values their learners hold.