The influence of supervisory support on clinical learning as experienced by Czech Nursing and health professional students in the context of patient safety events: A qualitative study.

AIM: To explore the influence of supervisory and mentoring relationships on the clinical learning experiences of Czech Nursing and health professional students in the context of patient safety events BACKGROUND: Clinical experience is integral to healthcare education, shaping skills, behaviours, values and professional identity. During clinical placements, students may encounter memorable patient safety events and experience varied reactions from mentors/supervisors/others. Some research has highlighted challenges faced by students on clinical placement. Few studies involve multiple professions, most emanating from Western Europe, the UK, the USA and Australia with little relating to central European countries such as the Czech Republic. DESIGN: Two stage interpretivist qualitative study based in social constructionism METHODS: Convenience sample across 13 undergraduate and 18 postgraduate health professions courses. Stage 1 (2022): using SLIPPS Learning Event Recording Tool translated into Czech. 20 students' (Midwifery=11, Nursing=1, Paramedic=1, Occupational therapy =7) submitted 21 patient safety learning event narratives. Stage 2 (2022): Focus group with 2 nursing and nine midwifery students. Phased thematic analysis involving multiple researchers. RESULTS: Three themes illustrate the circumstances and impact of placement mentoring/supervision experiences, conceptualised as: 'Clinical and Emotional Companionship', 'Clinical and Emotional Abandonment' and 'Sense of agency - Professional and personal growth'. 'Companionship' reflected the students' feelings of being welcomed, respected, heard, trusted and supported. Conversely 'abandonment' emerged from feelings of being unheard, vulnerable, humiliated, afraid, leaving students feeling abandoned, lonely and 'useless'. Notwithstanding these conditions, students showed the ability to identify patient safety issues with agency evident in reactions such as stepping-in to try to ameliorate a situation, rather than speaking-up. Professional and personal growth was also apparent in their narratives and a conceptual diagram illustrates the students' learning journeys in a patient safety context. CONCLUSION: The findings and new conceptualisations around abandonment and companionship emerging from this study expand the evidence base regarding the profound impact of clinical experience and mentorship/supervision on learning and students' emotional wellbeing. A sense of companionship appears to play a buffering role even in challenging circumstances of involvement in or witnessing compromised patients' safety. Allowing students a sense of belonging, to vent, grow, feel supported and safe to ask/learn - contributing to 'emotional safety for learning', promotes students' behaviour that may prevent/minimize hazards or ameliorate the aftermath. However, we must not simply blame mentors/supervisors, staff, or the students themselves- they are simply part of a much larger complex environment of professional education encompassing hidden curriculums, power dynamics and professional socialisation.

Czech Version of the Patient Dignity Inventory: Translation and Validation in Incurable Patients.

CONTEXT: The Patient Dignity Inventory (PDI) is a valid, reliable screening tool to assess a range of issues that have been reported to affect the sense of dignity in patients with life-limiting conditions. OBJECTIVES: We investigated the item characteristics, factor structure, and reliability of the Czech version of the PDI (PDI-CZ) among cancer and noncancer patients. METHODS: The PDI was translated into the Czech language following state-of-the-art criteria (a five-stage proceeding method for the translation). Two hundred thirty-nine participants completed the study (136 cancer and 103 noncancer patients). Internal consistency, test-retest reliability, and factor analysis were used for validation of the PDI-CZ. RESULTS: A Czech version of the PDI was obtained. The Cronbach's α for PDI-CZ was 0.92. Item 22 (not feeling supported by my health care providers) did not correlate with any other items, and it was skipped for factor analysis processing for this reason. Factor analysis resulted in a four-factor solution, accounting for 56.34% of the overall variance (factor loadings range, 0.37-0.92). The factor labels were as follows: loss of purpose of life; loss of autonomy; loss of confidence; and loss of social support (internal consistencies range, Cronbach's α 0.58-0.90). Test-retest reliability was assessed with 25 patients after two weeks. The resulting range of the Gwet's coefficient, AC1, was between 0.58 and 1.00. CONCLUSION: The results from the study support the reliability of the PDI-CZ and its future use in patients with incurable cancer and noncancer patients.