Evaluation of an Orthopedic Clinical Orientation Program for Student Nurses Practicing on a Specialty Surgical Unit

Tuesday, 13 July 2010: 8:50 AM

Lori D. Buckland, BSN, RN, ONC1
Teresa L. Payne, BSN, RN, ONC1
Linda A. Sinclair, BSN, RN, ONC2
Melissa A. Hardin, BSN, RN, ONC1
Mary Ziemba-Davis, BA1
1Orthopedics, St. Vincent Hospital, Indianapolis, IN
2Orthopedics, St Vincent Hospital, Indianapolis, IN

Learning Objective 1: Describe the importance of education for nursing students practicing their clinical experiences on a specialty surgical unit.

Learning Objective 2: Assess the value of a tailored orientation to an Orthopedic unit to set expectations for nursing instructors and students while practicing in the clinical setting.

Purpose: Our purpose was to assess the value of a clinical orientation program for student nurses scheduled for rotation on a specialty surgical unit.
Methods: 45 student nurses from three universities completed clinical rotations on a specialty orthopedic unit between October 12, 2007 and April 15, 2008.  Students attended the clinical orientation program and completed an orthopedic knowledge pretest and posttest.  At the end of their first day on the orthopedic unit, students completed nine yes/no questions assessing how prepared they felt to provide patient care; Patients, supervising staff nurses, and university instructors completed 13 questions  on student preparedness.  Five yes/no questions were completed by students and university instructors at the end of the semester (when rotations in other medical/surgical areas were completed) to assess the value of the orthopedic training program.
Results: On average, student nurses correctly answered 36.1% of orthopedic knowledge questions prior to the training program.  After the program, students correctly answered 77.2% of all questions, representing a 140% increase in accuracy.  81.4% of students reported that the program helped them prepare for their first day of patient care.  Mean ratings assessing preparedness to provide patient care were 4.9 (patients), 4.4 (supervising staff nurses), and 4.6 (university instructors).  Mean ratings among staff nurses and university instructors were positively correlated (r = .707, p= .000).  At the end of the semester, 92.7% of students and 96.1% of university instructors indicated that orientation to a specialty unit was valuable for student confidence, competence, and patient care

Conclusion: We demonstrate the potential for specialty-specific programs to enhance knowledge, clinical competence, and confidence prior to the provision of orthopedic patient care by nursing students.  Further research using a controlled study design is recommended to demonstrate the importance of targeted training prior to clinical rotations in a hospital setting.