Practice education facilitators perceptions and experiences of their role in the clinical learning environment for nursing students: a qualitative study.

BACKGROUND: Clinical placement is recognised as essential for nursing students' development of clinical competence. However, difficulties in providing supportive clinical learning environments are a well-known challenge in nursing education. In Norway, the use of nurse educators in joint university and clinical roles has been recommended as an initiative to strengthen the clinical learning environment and enhance the educational quality. In this study we use the term practice education facilitator in a generic sense for these roles. The aim of this study was to explore how practice education facilitators can contribute to strengthen the clinical learning environments for nursing students. METHODS: This study has a qualitative explorative design with a purposive sample of practice education facilitators affiliated to three different universities located in southeast, mid-, and northern Norway. Individual in-depth interviews with 12 participants were conducted during spring 2021. RESULTS: A thematic analysis resulted in four themes: "coherence between theory and practice"; "student support and guidance during placement"; "supporting the supervisors to support the students" and "factors influencing the practice education facilitators' performance in their role". The participants experienced that the practice education facilitator role contributed to strengthened clinical learning environments. However, their performance in the role was found to be contingent upon factors such as time allocated for the role, personal and professional attributes of the post holder, and a common understanding within the organisations regarding practice learning and role remits for the practice education facilitator. CONCLUSIONS: Findings indicate that the practice education facilitator role can be a valuable resource for clinical supervisors and nursing students in clinical placement. Moreover, nurse educators who are familiar with the clinical area, and who are insiders in both settings, are ideally placed to contribute to bridge the theory-practice gap. The benefits of using these roles, however, were influenced by personal attributes of the post holder, time allocated for the role and the number of practice education facilitators positions, and management anchorage. Thus, to achieve the full potential of these roles, efforts to reduce these barriers should be considered.

The use of practice education facilitators to strengthen the clinical learning environment for nursing students: A realist review.

BACKGROUND: Research suggests that the interventions of practice education facilitators, who liaise between the higher education institution and the clinical placement sites, may strengthen the clinical learning environment for nursing students. However, there is a lack of evidence concerning the value of these roles in nursing education. OBJECTIVE: The objective of this study was to explore how, under what circumstances and why the practice education facilitator role can strengthen the clinical learning environment for nursing students. DESIGN: A realist review was conducted to understand the contextual factors and mechanisms that support or hinder the capacity of the practice education facilitator to strengthen the clinical learning environment for nursing students. SETTING: The settings are clinical areas where nursing students are directly involved with patient care. PARTICIPANTS: The participants comprised academic and clinical staff involved in clinical nursing education. METHODS: This realist review was conducted in three overlapping and iterative phases: (1) the development of an initial programme theory explaining how the practice education facilitator role is thought to strengthen the clinical learning environment; (2) structured searches, screening and data extraction; and (3) analysis and synthesis to develop and refine the programme theory. RESULTS: The review included 27 research papers. Evidence from these studies led to the development of five context-mechanism-outcome configurations that explain how, under what circumstances and why practice education facilitators can (or can fail to) strengthen the clinical learning environment. Factors such as practice education facilitators' visibility and accessibility in the clinical area and their clinical credibility were found to influence whether clinical supervisors took the opportunity to seek support and guidance from them. Moreover, ward culture regarding student learning and opportunities to prepare for the role were found to influence clinical supervisors' motivation to carry out the functions of the role and develop professionally; this in turn further influenced whether they used the resources provided by the practice education facilitator. CONCLUSIONS: Theory-based explanations of how, under what circumstances and why the practice education facilitator role may strengthen the clinical learning environment of nursing students may support further development of this role in the future.

Student nurses' experiences participating in a peer mentoring program in clinical placement studies: A metasynthesis.

AIM: The aim of this metasynthesis was to identify, analyze and synthesize the qualitative findings from original research studies addressing student nurses' experiences with a peer mentoring program in their clinical placements. BACKGROUND: Students' positive experiences from clinical placement studies, are often associated with quality of clinical mentoring and learning environments. However, nurse mentors struggle to find sufficient time for mentoring student nurses. Establishing a peer mentoring program, may provide additional mentoring and strengthen clinical placement as learning environment. A peer mentoring program entails, that senior student nurses at one level act as a supportive mentor and serve as role models for fellow novice student nurses at a lower level. DESIGN: A flexible descriptive design was applied for this metasynthesis. METHODS: By using the same search strategy, systematic searches were made in the following electronic databases: CINAHL, MEDLINE OVID, Embase, ERIC, Scopus, Oria and SveMed+ . Ten articles met the eligibility criteria, reporting findings from altogether 203 student mentors and 446 student mentees. Extracted information (data) from the articles were analyzed in lines with Graneheim & Lundmans' five phases of thematic analysis of data. RESULTS: The analysis resulted in two overarching themes characterizing students' experiences. Student mentors experienced that participating in peer mentoring had been Strengthening the road to becoming a professional nurse. Student mentees experienced that participating in peer mentoring had been Strengthening the studying and learner role in clinical placement. The themes covering student mentors experience were: Understanding and integrating nursing competence; Realizing the need to be mentored and supported as mentors; Understanding the content and complexity of clinical mentoring. The themes covering student mentees experience were: Reaching further for clinical competence and self-confidence; Taking advantage of mentoring and learning situations; Understanding the importance of learning conditions and their own learning responsibility. All themes were further characterized with sub-themes. CONCLUSIONS: The findings from this metasynthesis are in general positive for both student mentors and mentees and both student groups experienced to benefit from participating in the peer mentoring program.