Preparing nursing students for clinical placement using synchronous role-play telesimulation: A descriptive survey study

BACKGROUND

Contemporary teaching modalities in nurse education include teaching clinical skills via telesimulation. The effectiveness of this modality has not been evaluated.

OBJECTIVE

To evaluate undergraduate nursing students' and clinical facilitators' perceptions of student preparedness for placement when clinical skills are taught via role-play telesimulation using home equipment packs.

DESIGN

A descriptive survey study was employed to measure and explore perceptions using Likert scales and open-structured questions delivered via an anonymous online survey.

SETTING

Clinical placement after undertaking preparation via role-play telesimulation for students at an Australian university.

PARTICIPANTS

Data were collected from 180 undergraduate nursing students and 22 clinical facilitators.

METHODS

Quantitative data were analysed using statistical analysis software, SPPS. Open ended responses to survey questions were analysed through the application of Elo and Kyngas (2008) three phases of content analysis.

RESULTS

Seventy-eight percent of students felt prepared for placement, and 86 % of clinical facilitators believed that students were adequately prepared. Three major categories were identified from students' responses: sense of community, learning logistics, and sense of comfort. Three categories emerged from clinical facilitators' responses: nervous and anxious, confidence and preparedness.

CONCLUSIONS

Findings from this study suggest that role-play telesimulation with home equipment packs is a viable, achievable, sustainable and effective modality for teaching hands-on practical skills to prepare undergraduate nursing students for industry placement.

Pre-assessment judgement framework for judging nursing students' performance in clinical placements: A qualitative case study

AIM

This study aims to better understand and articulate the pre-assessment judgement processes commonly used by experienced clinical facilitators when assessing nursing students undertaking clinical placement.

BACKGROUND

In the Australian context, clinical facilitators are registered nurses who primarily educate, monitor, support and assess groups of nursing students on clinical placements without carrying a patient load. The duties and scope of clinical facilitators may differ across international and institutional contexts. However, the core concepts of this paper will be relevant despite these differences as the importance of facilitators' confidence in making pre-assessment judgements of individual nursing student performance while on placement is universally acknowledged. Nursing students are often assessed on their provision of safe practice, patient task-orientated outcomes and professional behaviour. Clearly articulating performance judgements prior to formal assessment is vital to ensure progressive learning of students. Literature reports that many clinical facilitators lack confidence in the art of making performance judgements and call for targeted professional training and support in the clinical assessment of nursing students. To better understand and address this problem, clinical facilitators need a shared understanding of how individual nursing students' pre-assessment performance judgements are reached during placement experiences.

DESIGN

A qualitative case study was used, with data collected via semi-structured interviews. Fifteen Australian clinical facilitators participated, each with over six months of experience.

METHODS

Interview transcripts were analysed through an interpretive-constructivist paradigm. Thematic analysis revealed themes that were then deductively described through the application of the Cognitive Continuum Theory.

RESULTS

Six modes of pre-assessment judgement emerged from the data synthesis process: 1) Recognising patterns, 2) Acknowledging uncertainty, 3) Understanding key players, 4) Verifying or refuting the information, 5) Benchmarking performance and 6) Contextualising information. Each mode is validated through the deductive application of the Cognitive Continuum theory.

CONCLUSIONS

Understanding how experienced clinical facilitators make pre-assessment performance judgements has the potential to increase confidence in performance judgement decisions. In turn, confidence in judgements will increase clinical facilitator's capacity to give nursing students feedback that can be explained and justified. The pre-assessment judgement framework also provides a preliminary model for teaching the art of reaching accurate performance judgements to clinical educators in disciplines beyond nursing.

Rituals, ghosts and glorified babysitters: A narrative analysis of stories nurses shared about working the night shift

Working the night shift can be fraught and experienced as demanding and, yet, is often dismissed as babysitting. Few researchers have explored the social and cultural meanings of night nursing, including storytelling rituals. In 2019, a narrative study was undertaken. The aim was to explore the stories recalled by nurses about working night shifts. Thirteen Australian nurses participated. Data were gathered using the Biographical Narrative Interview Method, and narrative analysis produced forty stories and three themes: strange and challenging experiences; colleagues can be mentors (or not); and textbook knowledge is only part of what is needed on night shift. Nursing students who engage with these stories may come to understand the challenges of the night shift, and the valuable work that nurses engage in throughout a 24-hr period, work that involves adept psychosocial and interpersonal skills alongside technical and physical competence.

Moving nurse educators towards transcendence in simulation comfort

Expensive simulation equipment continues to sit idle in nursing learning and teaching environments. To identify factors that influence nursing educator comfort in the use of simulation at an Australian university an explorative qualitative research project was undertaken using an interpretative constructivist methodology. The Goodwin et al. (2007) adapted Comfort Theory for nursing education has been used. The aim of the study was to identify factors that influence nurse educator's comfort in the use of simulation. Research question asked was: What are the barriers and enhancers to using simulation as a learning and teaching modality. Thematic analysis of data from focus groups on four different campus sites was undertaken. Four themes identified that affected participants' comfort in this study were: 1) Personal barriers; 2) Human resource barriers; 3) Structural barriers and 4) Suggestions to address barriers. Further understanding of the themes and how they relate to educator comfort with simulation are shared with the reader. The paper also outlines emerging recommendations to improve educator comfort.

Advanced life support: retention of registered nurses' knowledge 18 months after initial training

In 1996, The Wesley Hospital introduced a 2 day Advanced Life Support (ALS) course, targeted at all critical care registered nurses and medical officers. The purpose of this study was to explore the retention of theoretical knowledge and clinical skills of registered nurses who had successfully completed the 2 day ALS course 18 months previously and to establish effective retesting timeframes. The study utilised a repeated post-test measure design. Forty registered nurses participated in the study. Data were collected during ALS retesting using scores from a theoretical examination and from the results of four practical skill assessments (basic life support, airway management, defibrillation and code management). Using Wilcoxon test, data were analysed with and compared to the participant's original scores from the training program 18 months previously. The findings demonstrate that the participant's theoretical knowledge remained at an equivalent level over the 18 month timeframe. However, 18 months after successfully completing an ALS course, only 75 per cent (n = 30) of participants passed the practical skill assessment components, with the 25 per cent (n = 10) requiring a second attempt to pass. The implications from this study focus on the model of assessment utilised and the dichotomy between theoretical and practical skill assessment results. Additional study is required to determine the optimal timeframe for ALS retesting and educational strategies to help retain skills over time.