An Innovative Strategy for Promoting Student Experiences in Nursing Practice and Professional Growth

Friday, 22 February 2019: 3:50 PM

Carrie Edgerly MacLeod, PhD, RN
Lynne Susan Sheppard, DNP, RN
Department of Nursing, Saint Anselm College, Manchester, NH, USA

Many baccalaureate nursing programs are challenged by increasing enrollment, larger class sizes and the national shortage of clinical sites for students (American Association of Colleges of Nursing, 2016). Nursing faculty recognize the demand to create innovative and effective strategies in order to meet the needs of these students while simultaneously adhering to state board requirements. Faced with an above average junior nursing class size and concerned with ability to place all students for a senior preceptorship experience, an optional summer preceptorship for rising seniors was developed at this baccalaureate program. This summer preceptorship, initiated in 2017, was presented as an option to the traditional senior-year second semester preceptorship. The State Board of Nursing voiced concern regarding the lack of student participation in the clinical setting during the last semester of their baccalaureate education. Faculty and college administration collaborated to create a solution to address this concern. The result was the development of a four-credit course entitled, “Promoting Nursing Practice and Professional Growth” designed to enhance the summer preceptorship experience.

This semester-long course, taken during the last semester of this four-year program, consisted of a didactic classroom experience and a clinical learning component. The clinical learning portion was individually developed by the student and faculty with a focus on mentorship, education in nursing practice, and an improved understanding of healthy work environments. The course, emphasizing personal and professional development, incorporated the concepts of advanced communication, emotional intelligence (Goleman, 2005; Lynn, 2005; Woods, 2014), change theory (Kotter & Rathbeger, 2005), and Covey’s “The 7 Habits of Highly Effective People” (Covey, 2013). These concepts were introduced and expounded upon through hours of guided clinical experiences, class discussion, and journaling. Seven second-semester senior students enrolled during the first year of this course.

The didactic portion of this course was developed utilizing learner-centered teaching and authentic learning principles (Doyle, 2011). Each week the course facilitator required students to read assigned material and then apply what they learned to associated homework assignments. Class time was spent reviewing the highlights of the weekly reading and then discussing and applying the material to their life experiences. Throughout the semester, at various intervals after class discussion had taken place, reflective journals were assigned to further optimize student learning. Reflection techniques were used to promote both new connections with prior knowledge and greater understanding and recall of material (Doyle, 2011).

The clinical component of this course focused on simultaneously fostering autonomy and building professional relationships, rather than on direct patient care. Students were placed in a variety of clinical settings including nursing homes; labor and delivery; public schools and intensive care units with nursing students and a faculty member who attended informational sessions about the course. Clinical experiences included mentoring second or third year nursing students in the clinical setting; serving as a liaison to the clinical instructor; shadowing nursing administrators, nurse educators and advanced practice nurses; participating in interdisciplinary rounds; and, coordinating a health fair for school-aged children. The students enrolled in this course were also responsible for performing a clinical issue needs-based assessment for their assigned clinical group. Each student was responsible for creating a presentation to educate the clinical group on this need. Clinical group students and faculty completed constructive evaluations of the student and presentation which were shared with the student. In addition, the students also assisted in simulation and skills labs for sophomore student nurses. The students who worked in the intensive care unit, with the assistance of a faculty member, also created a short simulation experience presented to junior students enrolled in critical care courses.

Thematic analysis of student course evaluations and journal reflections was performed by an experienced qualitative researcher. This analysis produced the following emergent themes regarded as essential for the development of mentorship, leadership and professional growth: Being Part of the Change; Fostering Communication; Respecting Team Interdependence; and, Caring for Myself to Care for Others. Students voiced that the experience produced an increased sense of personal and professional growth. In addition, the students shared that they felt more prepared to interview and join a healthcare institution after the didactic and clinical experiences provided by this course.

Faculty feedback was also collected. In general, faculty noted the students to be a great source of support and reassurance to the younger students. Faculty also felt they were able to see their own clinical students through a different lens as the course participants would share, at times, how nervous the students were. In addition, faculty found the course participants were helpful to the younger students by assisting them to prepare for patient assessments, review of medications, and documentation with faculty.

In conclusion, thematic analysis demonstrated that this innovative academic and clinical experience enhanced student awareness of self within the workplace, the change process, and effective communication. In addition, participants’ positive role modeling and support of younger students may have a significant effect toward enhancing nursing students’ level of confidence in the clinical setting and would be a topic to explore with future course cohorts. These qualitative research results provided a strong foundation for the continuation and expansion of this course. Enhancing student professional growth within the academic experience may contribute to increased student recognition of nurses’ responsibility and role in the promotion of a healthy work environment.

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