PERCEPTION OF CLINICAL PLACEMENTS

Student nurses perception of clinical placements as learning environment

Student nurses perception of clinical placements as learning environment

Discussion

Clinical placements make up 50% of nursing students' education, yet the evaluation of these experiences is variable, and clinical staff can remain uncertain about the effectiveness of promoting an environment conducive to learning. By implementing an evaluation tool, feedback can be given directly to the ward, good practice acknowledged and areas for development identified. This article describes the introduction of an evaluation tool and the consequences of its implementation.

Clinical placements are an essential aspect of nurse education. However, despite 50% of nursing students' time being spent in clinical environments (NMC, 2004, pp. 174) the feedback offered to these areas can vary. This may be because evaluation of placements is undertaken within higher education institutions and feedback is not being appropriately disseminated, or because it lacks any relation to a specific placement (for example a group of students in a directorate) and so becomes generalised.

The provision of clinical practice placements remains a high priority in the educational quality agenda and. while annual placement profiles (educational audit) are an annual statutory requirement, not all practice staff are involved. Feedback often comes in the form of 'thank you' letters and chocolates from students who have enjoyed a particular placement, while sometimes none is offered at all. This leaves clinical staff unsure of how effective a placement they provided and can arguably contribute towards poor staff morale.

This was highlighted in the annual educational audit/profile of a placement ward and was a frustration to the university link lecturer for the clinical practice placement at De Montford University. It was decided that an individualized end-of-placement evaluation would be useful to:

* Acknowledge and strengthen existing good practice;

* Identify and troubleshoot aspects that could be improved;

* Motivate and develop staff;

* Enhance the relationship between the university link lecturer and clinical practice staff;

* Facilitate an improved learning environment and therefore ultimately improve students' experience of the placement.

Clinical placement is a phenomenon of importance to nursing students and to those involved in their education. For the majority of the participants in this study, the duration and structure of clinical placements was a key influence on their experience of Clinical placement. Students from three universities (two in Australia and one in the United Kingdom) emphasised the importance of having adequate time to settle in, so they could familiarise themselves with the personnel, culture and practices of each unit or ward they were assigned to. They described the uncertainly that surrounded their clinical placement experiences during this settling in phase and how they often felt lost and unsure of themselves, not knowing staff, patients or ward routines. Once settled, students often progressed from feeling like an outsider to feeling like an accepted member of the nursing team. Importantly, students felt that until they were settled and comfortable in the clinical environment they were unable to confidently engage with learning opportunities.

The paper uses a mixed method design to present a compelling view of students' ...