Examination of student learning about dimensions of health and illness using Stewart's conceptual framework for primary health care

Learning pathways in contemporary primary care settings - student nurses's views

Workforce planning to address nursing supply along with curriculum change affecting practice placements has acted as key drivers shaping learning resources for student nurses within Aberdeen Community Health Partnership. As part of their learning, students are afforded the opportunity to visit a range of contemporary primary care settings such as public health, specialist nurses and NHS 24 on what are known as 'pathway experiences'. This research adopted a qualitative approach using focus group interviews to discover students' learning as a result of this initiative. Two main themes emerged, these being 'Healthcare contexts' and 'Nursing know-how'. Students developed a greater awareness and understanding about the delivery of healthcare in primary care settings and they expanded their nursing knowledge and skills. While students valued the experience, they also thought pathways fragmented their time at the base placement and detracted from gaining the practical nursing skills they considered of prime importance in their transit towards qualifying and working within a clinical setting. Implications for the future development of the pathway initiative are discussed.

Transforming students’ views of gerontological nursing: Realising the potential of ‘enriched’ environments of learning and care: A multi-method longitudinal study

BACKGROUND

Gerontological nursing is often viewed as unchallenging and is rarely a positive career choice for student nurses. Issues of recruitment and retention in gerontological nursing are a global phenomenon and strategies are needed to encourage more students to opt for this area of work.

AIMS AND OBJECTIVES

To identify the role and influence of students' learning experiences on shaping their predispositions to work with older people and to identify the characteristics of a positive learning environment that might promote a more favourable view of gerontological nursing.

METHODS

The study was a 312-year longitudinal investigation using multiple methods of data collection and analysis, including an extensive review of the literature, large-scale postal surveys, focus groups and case studies of clinical placements. The design of the study was emergent and essentially constructivist, and participants, especially student nurses, were actively engaged in the on-going process of data analysis.

FINDINGS

The results suggest that students do not necessarily enter nurse training with negative predispositions towards work with older adults, but that such negative views develop during their training largely as a result of clinical placements and extra-curricula paid work. Student nurses are often exposed to 'impoverished' environments of care in which they witness poor standards of care and negative attitudes towards older people. However, if they experienced 'enriched' environments they are far more likely to view gerontological nursing in a favourable light. The characteristics of an enriched environment can be understood using the Senses Framework as an analytic lens to interpret students' learning experiences.

RELEVANCE TO PRACTICE

The study reinforces the vital role that the placement experience plays in helping students to identify with a particular area of practice. The promotion of an 'enriched' environment of learning and care can be used to help ensure that students have a positive experience of learning to care for older people.

The adrenaline rush: nursing students' experiences with the Northern Ireland Ambulance Service

AIM

The aim of this project was to explore nursing students' experiences whilst on placement with the Northern Ireland Ambulance Service.

BACKGROUND

The literature suggests that experiential learning can enhance understanding, knowledge and skills and has the potential for reducing the theory-practice gap.

DESIGN

A qualitative approach was utilized, employing diaries and focus group interviews to gather data. One hundred and fifty-four nursing students submitted diaries, producing a response rate of 69%, while 190 students partook in interviews (86%).

FINDINGS

Content analysis indicated that the students gained a new appreciation of the concept of holistic care, and that increased interprofessional understanding provides the foundation for improved quality of patient care.

Entry into community-based nursing practice: perceptions of prospective employers

To better prepare new graduates for entry-level positions in community settings, faculty of one college of nursing gathered information using focus groups of prospective employers. The groups were to identify the skills and qualities nurses need to practice in the community and ways to redesign nursing curricula to better prepare undergraduates for community-based practice. Data for this qualitative study were collected in five separate focus groups conducted with prospective employers (N = 18) from four major areas of Kentucky. By collaborating with prospective employers in the community, a partnership was established between nurse educators and community health leaders to improve the marketability of baccalaureate graduates. Assessment was the most frequently named skill essential to nursing practice in the community. Independence, critical thinking, collaboration, and confidence consistently emerged as important skills and qualities. Prospective employers were positive about developing partnerships to improve under-graduate nursing curricula. Recommendations for curricula to better prepare undergraduates for community-based practice are suggested.

Primary Health Care and Partnerships: Collaboration of a Community Agency, Health Department, and University Nursing Program

Health care reform proposals emphasize health care that is essential, practical, scientifically sound, coordinated, accessible, appropriately delivered, and affordable. One route to achievement of improved health outcomes within these parameters is the formation of partnerships. Partnerships adopting the philosophy and five principles of Primary Health Care (PHC) focus on health promotion and prevention of illness and disability, maximum community participation, accessibility to health and health services, interdisciplinary and intersectoral collaboration, and use of appropriate technologies such as resources and strategies. A community service agency serving a multicultural population initiated a partnership with a health department and a university undergraduate nursing program. The result was a preschool health fair and there were benefits for each partner-benefits which could not have been realized without the collaboration. The health fair partnership planning, implementation, and evaluation process was guided by a framework shaped by the philosophy and five principles of PHC. The educational process described can be applied to other learning experiences where the goal is to help students understand and apply the concepts of PHC, develop myriad nursing competencies, and form collaborative relationships with the community and health agencies. Community health care dilemmas and nursing education challenges can be successfully addressed when various disciplines and sectors form effective partnerships.

Analysis of the concept of mutuality

PURPOSE

Mutuality is explored as an interaction style for providers and clients that encourages accountability.

SIGNIFICANCE

Accountability by both providers and clients is necessary to manage health care costs and outcomes.

ORGANIZING FRAMEWORK

Walker and Avant's method of concept analysis.

SCOPE

Literature from 1930 to 1996. Mutuality is compared to autonomy, reciprocity, consumerism, negotiation, participation, collaboration, and paternalism.

CONCLUSIONS

Mutuality is shown to balance power and respect, and to promote productive provider-client communication. This interaction style for partnership relationships fosters positive and lasting health care outcomes.

IMPLICATIONS

Nurses are challenged to develop the skill of eliciting give and take, and creative, mutual exchanges.