Juggling the Needs of Two Communities of Practice Nursing Clinical Mentors Teaching Baccalaureate Students

Thursday, 25 July 2013: 3:35 PM

Cheryl Zlotnick, RN, MS, MPH, DrPH
Dalit Wilhelm, RN, MA
Cheryl Spencer Department of Nursing, University of Haifa, Mt Carmel, Haifa, Israel

Learning Objective 1: 1. Describe the clinical instructors' role in balancing the needs between the educational and clinical environments using Wenger's Community of Practice (CoP).

Learning Objective 2: 2. Identify at least three elements that facilitate teaching clinical practice while balancing the demands of the two CoPs.

Purpose: Clinical instructors balance the needs and perspectives of two environments (Communities of Practice or CoP), the educational facility and the clinical setting.  The clinical instructor is pivotal in negotiating and bridging the demands of both.  Yet, surprisingly few studies have focused on the importance of the role of the clinical instructor.  Guided by Wenger's Community of Practice and Social Learning Model, we sought to fill this gap by using a logic model to identify the clinical instructors' strategies; environments' structures and needs; and the nursing program's outcomes. 

Methods: A cross-sectional, qualitative study was used.  A convenience sample of clinical instructors (n=53) working at four different hospitals participated in facilitator-lead focus groups discussing the role of teaching clinical practice to undergraduate nursing students.  The five-question instrument that was used employed the organizing principle of the logic model's five domains (i.e., environment, structures, processes, and short- and long-term outcomes).  Data analysis used Strauss and Corbin's Grounded Theory to identify patterns and the constellation of themes found in the narratives.  Reiterative reviews were used to promote internal validity.  Focus groups were held at several institutions to increase reliability.   

Results: Although clinical Instructors expressed a strong connection to both CoPs and their very different perspectives, they described their role of juggling the CoP's competing demands while providing meaningful and educational experiences for their undergraduate students. They stressed the importance of creative teaching strategies to facilitate learning and to develop students' professional nursing identity. 

Conclusion: Clinical instructors were pleased to acknowledge their role in creating a new generation of nurses.  While juggling the competing realities of the two CoPs, they learned to see the "big picture" of each setting and the role of the nursing profession.  As a result, they developed skills that enable them to become leaders at their own health organizations.