Clinical evaluation--difficulties experienced by sessional clinical teachers of nursing: a qualitative study

Evaluation of nursing students in the clinical field requires the clinical teacher to make judgements regarding student progress in a number of areas. In this study concepts of role theory, oppressed group behaviour and the ethics of caring emerged and were used as conceptual frameworks to interpret the data relating to the evaluation of undergraduate students. The number of experienced faculty available for clinical teaching and evaluation has become inadequate and a large number of casual or sessional clinical teachers are employed to teach students in the clinical field. Despite the well documented problems associated with clinical teaching and the use of inexperienced clinical teachers, sessional clinical teachers are nevertheless expected to evaluate student success in meeting the clinical requirements of the nursing course, often resulting in disparate decisions for students. A phenomenological study was carried out using unstructured interviews and written clinical scenarios, to explore the evaluation process from the perspective of the sessional clinical teachers. Research findings indicate that although the sessional clinical teachers were skilled at identifying student problems, they were reluctant to make difficult evaluation decisions, due to low self-esteem, role conflict and their ethic of caring. It seems that gender socialization, patriarchal dominance and apprenticeship training had effected their confidence in their own decision making. The implications of such findings are of concern for the ongoing credibility and integrity of nursing courses, as clinical teachers have an influence on the nursing profession through the preparation of its practitioners.     

Bridge to the future: nontraditional clinical settings, concepts and issues

Healthcare restructuring in the wake of healthcare reform places greater emphasis on primary healthcare. Clinical education in acute care settings and existing community health agencies are not compatible with teaching basic concepts, principles and skills fundamental to nursing. Problems of clients in acute care settings are too complex and clients in the community are often too dispersed for necessary faculty support and supervision of beginning nursing students. Nontraditional learning settings offer the baccalaureate student the opportunity to practice fundamental skills of care and address professional skills of negotiation, assertiveness, organization, collaboration and leadership. An overview of faculty designed clinical learning experiences in nontraditional sites such as McDonald's restaurants, inner city churches, YWCA's, the campus community and homes are presented. The legal, ethical and academic issues associated with nontraditional learning settings are discussed in relation to individual empowerment, decision making and evaluation. Implications for the future address the role of the students and faculty as they interact with the community in which they live and practice.     

The apparent desensitization of student nurses during their professional socialization: a cognitive perspective

It is argued that the structures and processes of traditional patterns of pre-registration nurse education in the United Kingdom led to an apparent and relative desensitization of student nurses to human need. The processes underpinning this apparent desensitization were those which promoted both a 'compartmentalization' of concepts for theory and concepts for practice in the cognitions of student nurses and their habituation to examples of poor nursing practice. These processes are described and their nursing pedagogical implications are discussed. It is suggested that unless clinical learning environments are deliberately manipulated to foster the construction and utilization of 'appropriate' action schemata, the considerable opportunities offered by the implementation of Project 2000 to improve both nursing education and nursing practice could be wasted. It is further suggested that this deliberate manipulation should include nurse tutors teaching theory and practice in clinical areas if they are seriously concerned to render nursing care more intelligently responsive to human need.     

Perceptions of clinical role modelling: an exploration of nursing students'' experiential learning

The purpose of this study was to reveal the essence of role modelling in relation to learning in the clinical field from the nursing student's perspective. Twenty-one final year nursing undergraduates voluntarily and purposefully participated as informants in the study. Each participated in a face-to-face interview with a nurse researcher. In addition, a focus group interview session was conducted with seven of the participating students. Using the phenomenological method, the essence of role modelling emerged as a core theme which was linked to the students' clinical learning experiences. Multi-dimensional elements of learning that were contingent upon role modelling were categorised into five major themes: Expectations of self and others; Situational conditional factors; Situational anxiety--reality of fear/nervousness; Application of theoretical knowledge to practice; and, Experiential knowledge--an active learning process. The students' experiences of how role modelling impacted on their learning has implications for nursing education. It is necessary to acknowledge the variety of health carers, and in particular, the clinical nurse educator, who have consequential influences on student learning in the clinical field.     

Teaching metaphors of student nurses

This research focused on exploring the metaphors nursing students use to express their experience of university teachers' practice. A social constructivist approach to meaning underlies the process of interpreting student language in this study. The following evolved as major research questions: What are the metaphors students use to describe teaching? How do these metaphors operate? The research concluded that: students readily use metaphors to describe their experiences of teaching within the nursing degree programme; there is a pattern to the choice of metaphors; some of these images function as incremental or constructive metaphors, extending understanding of what it means to teach; others support current understandings and reflect taken-for-granted notions of teaching. Specific metaphors used by students to describe teaching were contextually analysed. A number of them may offer teachers of nursing insight, into their craft. Metaphors such as teacher as umpire, teacher as student, teaching with distance and teaching the big picture may be useful images for teachers to think about to guide their practice.     

The role of library and information services in the modular curriculum

Radical changes in nurse education, accompanied by advances in library and information services (LIS), set against a background of ever-expanding nursing literature and information, have favoured the development of good practices in curriculum development and student-centred learning. This paper discusses the experience at Keele University of enhanced collaborative effort between curriculum planners and LIS staff, and aims to show how LIS can facilitate student learning and contribute to curriculum planning and delivery, quality resource provision, evaluation processes and life-long learning.     

Update--noise induced hearing loss and the military environment

Quality clinical experiences are a critical component of advanced practice nursing (APN) curricula. Historically, nursing instructors coordinated both the didactic and clinical components of a course. Increasingly, course coordinators organize the didactic component, and external preceptors working in the clinical setting function as practicum teachers. Both scenarios involve labor-intensive processes, and neither facilitate the scheduling of clinical experiences that build on progressive learning across the student's curriculum. A centralized, computerized, relational data base for efficient management of APN preceptors and students across the curriculum was designed. One master's-prepared clinical coordinator maintains the data base and performs all related functions. This system offers numerous benefits to students, preceptors, ] faculty, and nursing school, including balanced and progressively complex clinical learning experiences for students from competent preceptors: consistent interface with students and preceptors; faculty relief from time-consuming tasks; rapid generation of a variety of tables, rosters, and reports; consistent tracking of preceptor evaluations; timely acknowledgment of preceptor assistance; and efficient communication among students, preceptors, faculty, and school administration.     

The new paradigm: concepts and application in community health nursing

The central role of community health nursing in future health care delivery systems is undisputed. The abilities and characteristics of nurses who will practice in those systems depends to a large extent on their learning experiences in basic nursing programs. Educators are being asked to prepare skilled, compassionate scholar-clinicians to provide care for the complex needs of clients, despite already packed curricula. The curricular changes cannot be additive; learning must be designed to empower students to become nurses who are both skilled and compassionate. Certain faculty attitudes and behaviors are essential to this new educational paradigm and student activities and assignments must foster confident effective practice.     

Current educational reforms in nursing in the United Kingdom and their impact on the role of nursing lecturers in practice: a case study approach

This paper explores major developments in nurse education in the UK in the last 5 years and examines their impact on the role of nursing lecturers in practice. It builds upon the findings of an earlier study that described significant changes in the UK in the role and work of nurse teachers resulting from Project 2000 initiatives. Empirical data were collected over a 2.5-year period, through observations of student-teacher interaction and in-depth interviews with experienced nurse teachers and senior health professionals (n = 41). A case study approach using qualitative techniques was adapted for the study. The results of the study showed that, in the light of current educational reforms, nursing lecturers were expected to maintain closer links with the service sector and spend more time on clinical teaching and learner contact. Also considered important was the need for nursing lecturers to support clinical staff in creating an effective learning environment. Using the findings of the study, the author has mapped what was perceived to be the development of an effective model for the role of nursing lecturers in practice: a model that reflects the expected changes to a higher educational environment.     

Cultivating a moral sense of nursing through model emulation

This paper reports part of a longitudinal research project, which sought to capture students' conceptualization of caring practice as they progressed to different levels of study in a nursing diploma programme in Hong Kong. Model emulation was found to be an effective means of focusing students' learning processes on the moral aspects of nursing practice. The theory of model emulation from a Chinese perspective and how it is applied to create a learning context to allow students to acquire a moral sense of nursing are discussed. The participating students are invited to be sincere enquirers in the pursuit of the good embedded in practice through introspective self-examination and dialogue. They are asked to describe and share their experience of positive and negative examples of nursing in written accounts. Van Kaam's phenomenological method was adopted to explicate the good and bad constituents of nursing from these examples, with the students assuming an active role in the explication process. The explication reveals that the students were able to articulate the good and bad practices in a variety of patient care situations.     

Multilevel school consultation training: Preliminary program evaluation.

Recommends the acquisition of consultation skills for school psychologists but notes that this is a neglected area in the majority of training programs. To meet the need for training prototypes, a multilevel consultation training sequence with matched field experiences graduated by learning goals and previous skill development is proposed. Specifically, Level 1 of the consultation program and its matched field experience, consultation with student teachers, is evaluated as a viable means within a university setting by which novice consultants can practice diverse consultation skills. Evaluation data from 12 consultation students (doctoral candidates), student teachers, and student teaching supervisors support the effectiveness of the program for both consultants and consultees. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Villous and tubulovillous adenomas of the colon and rectum. Results in 30 patients

Health care is increasingly driven by information, and consequently, patient care will demand effective management of information. The report of the Priority Expert Panel E: Nursing Informatics and Enhancing Clinical Care Through Nursing Informatics challenges faculty to produce baccalaureate graduates who use information technologies to improve the patient care process and change health care. The challenge is to construct an evolving nursing informatics curriculum to provide nursing professionals with the foundation for affecting health care delivery. This article discusses the design, implementation, and evaluation of an innovative nursing informatics curriculum incorporated into a baccalaureate nursing program. The basic components of the curriculum framework are information, technology, and clinical care process. The presented integrated curriculum is effective in familiarizing students with informatics and encouraging them to think critically about using informatics in practice. The two groups of students who completed the four-course sequence will be discussed.     

Regulation of rat neuronal voltage-dependent calcium channels by endogenous p21-ras

Clinical teaching behaviour is a critical determinant for quality clinical learning experiences of student nurses. It is believed that a better understanding of the perceptions of clinical teaching behaviours between student nurses and nurse educators will enhance clinical teaching. This study examined the perceptions of effective clinical teaching behaviours of nurse educators by student nurses (n = 81) and nurse educators (n = 10) in a hospital-based 3-year general nurse training programme in Hong Kong. Knox & Mogan's Nursing Clinical Teacher Effectiveness Inventory (NCTEI) (1985) was adopted. The respondents were asked to rate the importance of each discrete behaviour on a seven-point scale. It was found that there was greater agreement in the 10 most important behaviours than the 10 least important behaviours among the four groups: students, junior students, senior students and nurse educators. No statistically significant difference could be identified in the perceptions between the nurse educators and students as well as between the junior and senior students regarding the five behavioural categories. The nature and the student status of the nursing programme was accountable for most of the discrepancies between the findings of this study and those of past studies.     

The teaching/learning preferences of student nurses in the Republic of Ireland; background issues and a study

Teaching and learning in all forms of education is being increasingly reviewed in a climate of educational accountability. The literature generally displays a certain irrationality about nurse education; on the one hand teachers are espousing student-centred ideologies while on the other hand, students are expressing preferences for teacher-structured approaches. The research on nurse education generally concludes that the roles of teacher and student operate around a mechanistic view of man with the teacher being viewed as the front of all knowledge and the students the passive recipients of that which was given. This paper reports on related background issues, and a study of the teaching/learning preferences of student nurses from general, psychiatric, sick children's and mental handicap nursing. Whilst students reflected preferences for more teacher-structured strategies, significant differences were identified between the preferences of the four groups of student nurses. It is concluded that any insistence on a doctrinaire approach to teaching and learning would be unnecessarily restrictive to the whole process of nurse education. Nurse tutors therefore need to reflect on what they do, particularly that which influences the relationship between the students and what they learn. It is then the responsibility of nurse tutors to act on what they have learned about that relationship and their part in it.     

Catharsis: an investigation of its meaning and nature

Nurses commonly use catharsis and cathartic techniques as part of their clinical practice to enable clients and themselves to release emotion, to feel better and to facilitate coping. However, the literature does not provide clinical nursing evidence for its use. The main purpose of the investigation is to examine the beliefs about and understanding of catharsis which two groups of nurses hold: one group of nurse teachers and one group of nursing students. One hundred and forty-two respondents completed self-administered questionnaires asking about their understanding of and beliefs about catharsis as being beneficial, social, negative or psychotherapeutic in nature. The possible relationship of their answers to age, sex, philosophical orientation and qualifications was deemed to be important. The results suggest nurses understand that catharsis is related to emotion and has a psychotherapeutic purpose. However, there appear to be gaps in their understanding. Nurses also seem to believe that the release and expression of emotions is more acceptable for women than for men. There is also evidence that the more experienced nurses think differently from less experienced nurses, placing more emphasis on behaviour rather than emotion as they grow older. The problems associated with catharsis are discussed along with the implications for research and practice.     

Cooperative learning: a model for teaching

Cooperative learning provides a socially and intellectually stimulating model for the instruction of nursing students. It is one method of encouraging students to take responsibility for their own learning. Students are often able to explain a concept to another student in a unique way not used by faculty. This model harnesses and directs that student input in a constructive manner to increase achievement and accountability for all involved. Faculty must continue to examine how nursing is taught. The world is changing far too rapidly to do "business as usual." Cooperative learning is one strategy that can be used to motivate students to take active and responsible roles in their learning.     

Psychological reevaluation of handicapped children: A survey of practitioners and policymakers.

To assess the practice and perceived importance of school psychological reevaluations of handicapped children, questionnaires were sent to 100 school psychologists (mean age 38 yrs), 53 state consultants for school psychological services (mean age 42 yrs), and 16 state directors of special education (mean age 43 yrs). Findings indicate that reevaluation practices were nearly identical to initial evaluation practices although there was a reduction in total activity during the reevaluation. Changes in either diagnosis or placement of a reevaluated student were rare, yet the reevaluation process was perceived as very important. Two alternative processes to the current reevaluation procedure are presented that involved rereferring students as needed, and increased participation in the annual review of the individual educational program. Data are also presented concerning the frequency with which different measures were used with learning disabled, emotionally disturbed, and mentally handicapped children. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Connecting the research and nursing processes: making a difference in baccalaureate students' attitudes and abilities

Student nurses are often intimidated by the research process. They also frequently have negative attitudes about working with the elderly, especially in long-term care settings. This article describes a clinical project designed to help students improve their attitudes, knowledge, and skills toward research and care of the elderly by connecting the research process and the nursing process. Students implement research-based clinical practice in a long-term care setting. Student evaluations indicate that project goals are achieved. Nursing staff evaluation data indicate that they find student projects interesting and useful in updating resident care plans.