Student nurses as a future general practice nursing workforce. Implementing collaborative learning in practice: implications for placement learning and patient access. A mixed methods study.

BACKGROUND: There is a global shortage of nurses, with particularly acute shortfall in General Practice Nursing in the United Kingdom estimated at as high as 50% vacancy rate by 2031 by some sources. There has previously been reluctance for General Practices to host student nurses on placement, but it has become imperative to increase placement capacity if practices are to be able to recruit a future workforce. Collaborative Learning in Practice is a means of organising placement learning for student nurses using a coaching model, that allows for leadership development, peer support and earlier engagement in patient care, and increases placement capacity. METHODS: This was a mixed methods study using qualitative data from focus groups to evaluate the implementation of Collaborative Learning in Practice, and routinely collected audit data on numbers of clinic appointments to investigate the potential impact an increased capacity of student nurses might have on patient access to services. The aims of this study were: to implement and evaluate Collaborative Learning in Practice in General Practice Nursing settings; to explore issues of interprofessional learning; to explore patient access to services related to increased student nurse capacity. RESULTS: Our qualitative data indicated the following themes as important to students and staff: Peer Support; Interprofessional Learning; and the Importance of 'own clinics' for students to see patients. The audit data indicated that having students leading their own clinics increased the clinic numbers available by approximately 20% compared to when students were not in placement. CONCLUSIONS: This study shows that student nurses increased clinic capacity and improved access for patients. Students valued their placement, felt that they were more 'part of the team' than in other placements and consequently had a greater sense of belonging. This was multifaceted, coming in part from the welcoming practice staff, in part from the opportunities for peer support engendered by the collaborative learning in practice model, and in part from the interprofessional learning opportunities available. General Practice Nursing placements for students are important for future workforce recruitment and can help meet Quality and Outcomes Framework targets for General Practices.

'Thinking like a nurse'. Changing the culture of nursing students' clinical learning: Implementing collaborative learning in practice.

This article reports a study evaluating the implementation of Collaborative Learning in Practice models at a university School of Nursing and Midwifery with practice partners across the South West of England. We conducted four focus group interviews with 40 students with experience of Collaborative Learning in Practice placements, and two focus groups with eight clinical practice staff with responsibility for implementing and supporting such models in their areas. Data were transcribed and analysed using the Framework Method. Key themes were 'Real time' Practice of Collaborative Learning Implementation, Collaborative Learning as Preparation for Registrant Practice, and the Student/Mentor Relationship. We conclude that Collaborative Learning in Practice utilising models of coaching and peer support, offers benefits to students who are exposed to the reality of nursing practice from the beginning of their placement experiences, enabling them greater responsibility and peer support than under normal mentoring arrangements. Furthermore, there are benefits to the registrants because the burdens of supervising students are spread more widely. This is timely given the review of Nursing and Midwifery Council standards for programmes and student support and the need to increase placement capacity as a response to global nursing shortages.

Collaborative learning in practice: A systematic review and narrative synthesis of the research evidence in nurse education.

Collaborative Learning in Practice is a model of placement learning for student nurses that is currently being implemented in the United Kingdom, apparently originating in Amsterdam. Potential benefits are reported to be increased placement capacity, reduced burdens on mentors as practice assessors, improvements in qualified nurses' job satisfaction, recruitment and retention, and better-developed preparedness for registrant practice amongst student nurses. We conducted a thorough, rigorous systematic review between October and December 2018 of the literature on Collaborative Learning in Practice to discover whether there was a research evidence base for these claims. We found nothing published in English in peer reviewed journals. We found 14 related papers, although these were about the Dedicated Education Unit concept, and we have conducted a narrative synthesis of them. Key findings support the assertions related to Collaborative Learning in Practice, albeit in different models of placement learning. Further research is necessary with Collaborative Learning in Practice stakeholders including staff and students, and regarding patient care metrics, to demonstrate benefits or otherwise and until that research takes place potential gains remain unproven.