Defining Quality Clinical Education for Pre-licensure Nursing Education

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Defining Quality Clinical Education for Pre-licensure Nursing Education Elizabeth Speakman, EdD, RN, CDE, ANEF, Cecilia Borden, EdD, RN, Frances Amorim, MSN, RN, Mary Hanson-Zalot, MSN, RN, AOCN, Karen Papastrat MSN, RN, Christine Muldoon, BSN, RN, Susan Egger, MSN, RN Oct 13, 2010

PURPOSE The purpose of this research activity is to seek those characteristics that define what constitutes a quality clinical learning experience from the perspectives of nursing faculty, staff, and pre-licensure nursing students.

Background The interest in this topic stems from the collective years experience of the researchers of this study who have been responsible for creating quality clinical experiences for prelicensure nursing students. The premise of this study is based on the fact that the clinical experience is the largest dimension of nursing students education.

Significance to Nursing Education Development of the knowledge, attitudes, and skills a graduate nurse needs to function in an increasingly complex health care environment is supported by strong relationships between nursing faculty, staff, and students. Student satisfaction and transition to practice outcomes are associated with the quality of clinical education. (MacIntyre, Murray, Teel, & Karshmaer, 2009)

Plan Faculty from the Jefferson School of Nursing and nursing staff from the Thomas Jefferson University Hospital met with the goal to investigate: What makes a quality clinical experience for pre-licensure nursing students?

Theoretical Frameworks van Manen Phenomenology is the study of the life-world, the world of experience as it is actually lived. Mezirow Transformative Theory is used to describe a process which leads the learner to re-evaluate past beliefs previously derived from others.

Research Design Descriptive Phenomenology Phenomenology as a science describes the lived experience and gives meaning to the individual perception of that experience. It permits the individual having the experience to be authors of their own reality. The researcher acts as the conduit, by describing the phenomenon within the context of the literature.

Research Plan This qualitative study used self-contained focus group discussions as a method of generating data from the purposeful sample of nursing faculty, nursing staff, and pre-licensure nursing students from Jefferson School of Nursing, and the Thomas Jefferson University Hospital.

Assumptions Individuals who participate in the focus groups will recall and report information accurately. All participants will be truthful and forthcoming in their responses to the focus group questions. Quality in clinical education can be universally defined by the participants in this study. Participants in this study are interested in the study of quality clinical education. All constituents share a common goal at the conclusion of the educational experience.

Implementation Nursing faculty, staff, and students were invited to participate by personal request, through clinical course boards, the JSN Clinical Faculty Resource and Orientation Course Board, and the TJUH Intranet.

Methodology Each focus group moderator and recorder is a member of the proposed research project and facilitated the discussion ensuring that there were no conflicts of interest or impact on the evaluative process of the participants. IRB and individual consent were obtained and individuals were guaranteed that all information would be kept confidential.

Focus Group Questions 1. Describe what you believe is a quality clinical learning experience? 2. What components are essential for a quality clinical learning experience? 3. Identify some examples when you were involved in a quality clinical experience? 4. What is the ideal role of the clinical instructor in providing a quality clinical experience? 5. What is the ideal role of the staff nurse in providing a quality clinical experience? 6. What is the ideal role of the student nurse in a quality clinical experience?

Data Obtained through recorded focus group interview sessions and in the moderator s diary. Moderators reiterated their diary notes to ensure accuracy of the diary entry. All responses are in the process of being transcribed and will be coded and compared to the transcription document from each focus group interaction.

Next Steps Phenomenological Reflection-Conducting a thematic analysis, in order to identify themes from the focus group sessions. Phenomenological themes may be understood as the structures of the experience (van Manen, 1990, 79).

Next Steps Continued Phenomenological Writing, the descriptive writing of themes, by turning to the literature. Descriptive writing in qualitative research, uses literature to illuminate the findings and place them in context of the experience. The investigation is the process of collecting the perception of the lived experience and consulting the literature to give accurate and meaningful interpretation of the data.

References MacIntyre, R., Murray, T., Teel, C. & Karshmaer, J. (2009). The lived experience of nurses working with student nurses in the clinical environment. The Qualitative Report, 14, 227-244. van Manen, M. (1990). Researching lived experience: Human science for an action sensitive pedagogy. Albany: State University of New York Press