Nursing student–nurse teacher cooperation using mobile technology during the clinical practicum

The purpose of this three-phase study was to describe the use of mobile devices in nursing student–nurse teacher cooperation during the clinical practicum, to develop a novel alternative called mobile cooperation intervention (MCI) for this cooperation and to evaluate its effectiveness on the students’ clinical learning outcomes and acceptability from the perspective of nursing students. The ultimate goal is to improve the quality of nursing education and thus the outcomes of patient care. In Phase I, an integrative review of use of the mobile devices in nursing student–nurse teacher cooperation during the clinical practicum was conducted. In Phase II, the CLES+T scale was further developed. Additionally, a mobile application called Study@CampusPro (App) and a mobile cooperation intervention (MCI) were developed. In Phase III, a randomised controlled trial design was used to evaluate the effectiveness of the MCI on nursing students’ clinical learning outcomes, i.e. the individual outcomes (competence and self-efficacy) and contextual outcomes (quality of the clinical learning environment). Data were collected using three instruments (1) the Nurse Competence Scale (NCS), (2) the Self-efficacy in Clinical Performance instrument (SECP) and (3) the Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T2). Eligible nursing students (n=102) were randomly allocated to an intervention group (n=52) with mobile cooperation and a control group (n=50) with standard cooperation. The congruence between the nursing students’ self-assessed competence and the mentors’ assessments of the students’ competence was examined by comparing the nursing students’ self-assessments and their mentors’ (n=95) assessments. Moreover, a process evaluation was conducted by examining the students’ acceptability of the MCI by using a process evaluation questionnaire (Peq) developed for this study and the System Usability Scale (SUS) and student essays. The methods of analysis used in this study were critical appraisal, thematic and content analysis as well as descriptive statistics and statistical modelling. There have been only a few studies (n=17) on nursing student–nurse teacher mobile cooperation and their methodological weaknesses are evident. The MCI was found to be significantly effective in facilitating nursing student–nurse teacher cooperation and as effective as standard cooperation in improving the clinical learning outcomes of nursing students. The older age was shown to be significantly associated with improvements in the competence in the whole study population. Students’ self-assessed theoretical knowledge and practical skills prior to the clinical practicum were also shown to be significantly associated with the quality experienced of the clinical learning environment. In the control group, the students’ self-assessed competence showed a weak but significant congruence with their mentors’ assessments. The MCI was given a high degree of acceptance among students and the App’s usability was rated as rather good. The items developed for the T -subscale of the CLES+T scale, on which the CLES+T2 scale were based, demonstrated an appropriate level of content validity and good internal consistency. This study suggests there is potential in the MCI to improve the quality of the nurse teacher’s pedagogical cooperation with students and for being used as an alternative cooperation method in supporting students’ clinical learning outcomes.Hoitotyön opiskelijan ja opettajan välinen mobiiliteknologia-avusteinen ohjaus harjoittelun aikana Tämän kolmivaiheisen tutkimuksen tarkoituksena oli kuvata mobiililaitteiden käyttöä opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa, kehittää mobiiliohjausinterventio (MCI) tähän ohjaukseen ja arvioida intervention vaikuttavuutta opiskelijan kliinisiin oppimistuloksiin ja intervention hyväksyttävyyttä opiskelijoiden näkökulmasta. Tutkimuksen tavoitteena on edistää hoitotyön koulutuksen laatua ja siten hoitotyön tuloksia. Vaiheessa I tehtiin integratiivinen katsaus mobiililaitteiden käytöstä hoitotyön opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa. Vaiheessa II jatkokehitettiin kliininen oppimisympäristö, ohjaus ja opettaja (CLES+T) -mittaria sekä kehitettiin mobiiliapplikaatio Study@CampusPro (App) ja mobiiliohjausinterventio (MCI). Vaiheessa III toteutettiin satunnaistettu kontrolloitu tutkimus, jossa mitattiin mobiiliohjausintervention vaikuttavuutta hoitotyön opiskelijoiden kliinisiin oppimistuloksiin, yksilösidonnaisiin (kompetenssi ja minäpystyvyys) ja kontekstisidonnaisiin (kliinisen oppimisympäristön laatu) seuraavilla mittareilla: (1) Sairaanhoitajien ammattipätevyysmittari (NCS), (2) Self-efficacy in Clinical Performance (SECP) -mittari ja (3) CLES+T2 -mittari. Tutkimukseen soveltuvat hoitotyön opiskelijat (n=102) satunnaistettiin mobiiliohjausta saavaan interventioryhmään (n=52) ja standardiohjausta saavaan kontrolliryhmään (n=50). Opiskelijoiden kompetenssin itsearviointien vastaavuutta ohjaajien arvioimaan opiskelijoiden kompetenssiin tarkasteltiin vertaamalla opiskelijoiden itsearviointeja ohjaajien (n=95) arviointeihin. Lisäksi toteutettiin prosessievaluaatio, jossa selvitettiin opiskelijoiden mobiiliohjausintervention hyväksyttävyyttä tätä tutkimusta varten kehitetyllä prosessievaluaatiokyselyllä (Peq), SUS -mittarilla ja opiskelijoiden esseillä. Analyysimenetelminä olivat kriittinen arviointi, temaattinen ja sisällön analyysi sekä kuvailevat tilastolliset menetelmät ja tilastollinen mallintaminen. Mobiililaitteiden käytöstä hoitotyön opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa on rajoitetusti aikaisempia tutkimuksia (n=17) ja niissä on havaittavissa menetelmällisiä heikkouksia. Mobiiliohjausinterventio osoittautui tehokkaaksi menetelmäksi hoitotyön opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa sekä yhtä tehokkaaksi edistämään opiskelijoiden kliinisiä oppimistuloksia kuin standardiohjaus. Opiskelijan korkeammalla iällä ja kompetenssin kasvulla oli merkitsevä yhteys koko tutkimuspopulaatiossa. Opiskelijoiden itsearvioimilla teoreettisilla tiedoilla ja käytännön taidoilla ennen harjoittelua sekä koetulla kliinisen oppimisympäristön laadulla oli merkitsevä yhteys. Kontrolliryhmässä oli heikko vastaavuus opiskelijoiden ja ohjaajien arvioiman opiskelijoiden kompetenssin välillä. Mobiiliohjausinterventio oli erittäin hyväksyttävä ja mobiiliapplikaation käytettävyys oli melko hyvä opiskelijoiden arvioimana. CLES+T -mittariin kehitetyt uudet T2 -osion väittämät, jotka olivat perustana CLES+T2 -mittarille, olivat sisällöllisesti valideja ja johdonmukaisia. Tämä tutkimus osoittaa mobiiliohjausinterventiolla olevan potentiaalia edistää hoitotyön opettajan pedagogisen ohjauksen laatua ja se soveltuu vaihtoehtoiseksi ohjausmenetelmäksi tukemaan opiskelijan kliinisiä oppimistuloksia

Towards unpredictable - The anticipations of nursing students of the transition to a registered nurse

The aim of this study was to describe anticipations of graduating nursing students of the unpredictable transition to a registered nurse. The graduation can be stressful and challenging and nursing students feel insecure about their competence and ability to start the working life. A descriptive design was used with a modulated narrative method. 16 nursing students wrote narrative essays about their anticipations of the transition. The essays were analyzed using inductive content analysis. The anticipations of the transition can be divided into three main categories: fear and stress of competence, opportunity to learn new skills and orientation to the future. The results can be utilized both in the curriculum development of nursing degree programs and in mentor training programs. The study findings support the development of transition facilitating methods to the final clinical practicum.</p

The relationship between clinical placement duration and students' satisfaction with the quality of supervision and learning environment: A mediation analysis

European Regional Development Fund (ERDF)/Fondo Europeo de Desarrollo Regional (FEDER), Grant/Award Number: DOCM 19/02/2020; Grant for Stays in Other Universities and Research Centers co-financed by the European Regional Development 2014-2020, Grant/Award Number: 2014ES16RFOP010; Nurse Education Foundations (Sairaanhoitajien koulutussaatio) fundWe thank Mikko Saarikoski, Tony Warne, Unn-Britt Johansson, Evridiki Papastavrou, Erna Tichelaar, Marco Tomietto, Koen van den Bossche, and María Flores Vizcaya-Moreno for the permission of using the data. We thank the schools and students their enthusiastic participation in the study.Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified, such as the clinical learning environment, the supervision provided by supervisors, and the level of cooperation with the nurse teacher. The objective was to examine whether the relationship between the clinical placement duration and overall satisfaction with clinical training is mediated by the supervisory relationship and learning environment. A secondary analysis was conducted using the data from a cross-sectional study conducted in 17 higher educational institutions in nine European countries with the Clinical Learning Environment, Supervision and Nurse Teacher scale (n = 1903 pre-registration nursing students). Satisfaction with the supervisor and a good learning environment mediated the relationship between clinical placement duration and overall satisfaction as perceived by the students. Nursing students with longer clinical placement durations were more satisfied with clinical training as a result of both their satisfaction with their supervisor and their perceptions of good learning environment. The optimal duration a nursing student should remain in the different practice settings is approximately 7 weeks.European Regional Development Fund (ERDF)/Fondo Europeo de Desarrollo Regional (FEDER) DOCM 19/02/2020European Commission 2014ES16RFOP010Nurse Education Foundations (Sairaanhoitajien koulutussaatio) fun

Healthcare student-patient relationship and the quality of the clinical learning environment - a cross-sectional study

Background Relationships with patients are seen as the core component of establishing the quality of patient-centred care and promoting patients' autonomy and relevant use of services. A clinical learning environment that emphasizes relationship-based healthcare is essential for encouraging future healthcare professionals to work in partnership with patients. There is also broad agreement that the insight of patients should be used actively in healthcare students' clinical learning. The aim of this study was to describe healthcare students' perceptions of their relationship with patients and the quality of the clinical learning environment and to identify factors associated with both of these. Methods A cross-sectional survey using an electronic questionnaire was applied to collect data from 1644 Finnish healthcare students, mostly nursing students, between January 2018 and May 2018. The data were analysed statistically using descriptive statistics, Spearman's correlation coefficients, and multifactor analysis of variance. Results Students perceived the level of the student-patient relationship and the role of the teacher as good while pedagogical atmosphere, premises of care, premises of learning, and supervisory relationship were perceived to be at very good level. The correlations between the student-patient relationship and all clinical learning environment dimensions were perceived as moderate. Furthermore, a number of student-related factors associated with the student-patient relationship and the quality of the clinical learning environment were detected. Conclusions In this study, the rarely explored perspective of the student-patient relationship within the context of the clinical learning environment was included. The student-patient relationship and the quality of the clinical learning environment were perceived as good by the students, with a number of determining factors affecting these perceptions. Giving the student-patient relationship a role in clinical education may be conducive to students' learning with the patient in focus, and may thus promote the competence needed in the rapidly evolving healthcare environment and the changing scope of clinical practice.</div

Nurse managers’ perceptions of the competence of newly graduated nurses: A scoping review

AimTo summarise nurse managers’ perceptions of newly graduated nurses’ (NGNs) competence and connected factors.BackgroundNurse managers recruiting staff are responsible for employing competent nurses to ensure quality care and professional standards. Knowledge of managers’ perceptions about the competence of NGNs is needed to understand the expectations of the health care system towards future professionals.EvaluationA scoping review was conducted. A total of 12 research publications met the inclusion criteria and were analysed using inductive content analysis.Key issuesManagers’ perceptions can be divided into three perspectives: NGNs’ competence descriptions, assessment of competences, and connected factors. The NGNs’ level of competence was assessed to be at least satisfactory, and dependent on prior exposure to the work setting, change in the degree of responsibility, and lack of confidence.ConclusionExisting knowledge about nurse managers’ perceptions of NGNs’ competence is limited and rather fragmented. There is a clear need for rigorous empirical studies with comprehensive views of managers, emphasising the key role of managers in the evaluation of nurse competence.</p

Effectiveness of mobile cooperation intervention on students' clinical learning outcomes: A randomized controlled trial

AimsThe aim of this study was to evaluate the effectiveness of the mobile cooperation intervention in improving the competence and self‐efficacy of students and the quality of the clinical learning environment.BackgroundFor students, the clinical practicum is challenging as such and moreover the student — teacher cooperation, which supports the clinical learning of the students, has become complicated. Mobile applications have potential but their role in facilitating this cooperation remains unknown.DesignA parallel‐group randomized controlled trial.MethodsData were collected between January–March 2015 in Finland. The nursing students were randomly allocated to an intervention group (N = 52) or control group (N = 50). The intervention group used a mobile application to cooperate with the teacher during the clinical practicum. The control group engaged in standard cooperation. The primary outcome was competence. The secondary outcomes comprised self‐efficacy and the quality of the clinical learning environment. Nurse Competence Scale, Self‐efficacy in Clinical Performance instrument and the Clinical Learning Environment, Supervision and Nurse Teacher scale were used for student self‐assessments. For the main analysis, hierarchical linear mixed models were used with the intention‐to‐treat principle.ResultsCompetence and self‐efficacy showed no significant between‐group differences in mean improvements, but significant improvements in both groups were detected over the 5 weeks. Satisfaction with the clinical learning environment showed no significant between‐group differences, however, the role of the nurse teacher subscale, especially regarding cooperation, showed significant group differences.ConclusionThe mobile cooperation intervention was not significantly effective in improving individual outcomes, but did seem to improve significantly some aspects of the contextual outcomes.</div

Effectiveness of a mobile cooperation intervention during the clinical practicum of nursing students: a parallel group randomized controlled trial protocol

AimThe aim of this study was to describe a study protocol for a study evaluating the effectiveness of a mobile cooperation intervention to improve students’ competence level, self-efficacy in clinical performance and satisfaction with the clinical learning environment.BackgroundNursing student–nurse teacher cooperation during the clinical practicum has a vital role in promoting the learning of students. Despite an increasing interest in using mobile technologies to improve the clinical practicum of students, there is limited robust evidence regarding their effectiveness.DesignA multicentre, parallel group, randomized, controlled, pragmatic, superiority trial.MethodsSecond-year pre-registration nursing students who are beginning a clinical practicum will be recruited from one university of applied sciences. Eligible students will be randomly allocated to either a control group (engaging in standard cooperation) or an intervention group (engaging in mobile cooperation) for the 5-week the clinical practicum. The complex mobile cooperation intervention comprises of a mobile application-assisted, nursing student–nurse teacher cooperation and a training in the functions of the mobile application. The primary outcome is competence. The secondary outcomes include self-efficacy in clinical performance and satisfaction with the clinical learning environment. Moreover, a process evaluation will be undertaken. The ethical approval for this study was obtained in December 2014 and the study received funding in 2015.DiscussionThe results of this study will provide robust evidence on mobile cooperation during the clinical practicum, a research topic that has not been consistently studied to date.</p

The Relationship between Clinical Placement Duration and Students’ Satisfaction with the Quality of Supervision and Learning Environment: A Mediation Analysis

Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified, such as the clinical learning environment, the supervision provided by supervisors, and the level of cooperation with the nurse teacher. The objective was to examine whether the relationship between the clinical placement duration and overall satisfaction with clinical training is mediated by the supervisory relationship and learning environment. A secondary analysis was conducted using the data from a cross-sectional study conducted in 17 higher educational institutions in nine European countries with the Clinical Learning Environment, Supervision and Nurse Teacher scale (n = 1903 pre-registration nursing students). Satisfaction with the supervisor and a good learning environment mediated the relationship between clinical placement duration and overall satisfaction as perceived by the students. Nursing students with longer clinical placement durations were more satisfied with clinical training as a result of both their satisfaction with their supervisor and their perceptions of good learning environment. The optimal duration a nursing student should remain in the different practice settings is approximately 7 weeks.</p

Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Mixed Methods Systematic Review

publishedVersio

The nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in clinical practicum : a European cross-sectional study of graduating nursing students

Funding Information: This study deepened the knowledge base of European NT cooperation, which has been rarely investigated []. As the results show, NT cooperation varies both between European countries and on the national level. NT cooperation appeared to influence the GNSs’ final clinical practicum experiences positively; those GNSs who had an NT cooperating with them reported more positive experiences than GNSs without this cooperation. This finding is supported by earlier studies [, ] and may indicate the importance of the student-centric [, ] and supportive CLE []. However, NT cooperation has been a priority, especially in Iceland and Spain, where the NT has been assigned with a clear clinical role: In Iceland, a nurse NT (called Clinical Instructors, CIs) consistently meets students on a weekly basis during the clinical practicum, i.e. provides feedback on clinical work, engages in clinical reasoning, encourages independence, and fosters critical thinking based on evidence []. In Spain, NTs (called Academic Mentors) act as a “bridge” between the university and the clinical institution, helping students to integrate concepts and guide their reflection during mentoring sessions. Academic Mentors meet both students and nurses in clinical settings and take part in the students’ learning and assessing process. Conversely, Ireland is in a unique position with both a Clinical Placement Coordinator (CPC) and an NT involved in the supervision of nursing students, albeit the NT is without any clear clinical role. According to the Nursing and Midwifery Board of Ireland, [] the CPC is a registered nurse who promotes the CLE by supporting, facilitating and monitoring the clinical learning of students. The CPC’s role is highly valued as a form of Practice-Based Teachers who support both the mentors and students in clinical practice. Moreover, the clinical role of the NT is diverse in Ireland; some HEIs have a clear NT role while other HEI teachers attend the clinical placements when there is a need to offer support in relation to the assessment of a clinical practicum or when a student fails a clinical practicum. Publisher Copyright: © 2022, The Author(s).Background: A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students’ clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher’s cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries. Methods: A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher’s pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018–2019. The data were analyzed using a Chi-Square test, Pearson’s correlation coefficients, and linear models. Results: A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher’s pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher’s pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country. Conclusions: This study reveals that nurse teachers play an essential role in supporting and guiding nursing students’ final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers’ pedagogical cooperation role within the clinical learning environment.Peer reviewe