Purpose statement: The two research projects illustrate the students learning gained from community placements in two different settings and the applications of the psychosocial knowledge gained to future nursing and midwifery practice.
Abstract Description: The oral presentation will report on two completed research projects which compare the levels of staff and student learning across two community based placements, one in the Vietnam highlands and one in a homelessness service in South Australia. Both community based placements provided health care to vulnerable and disadvantaged population groups. Community placements with vulnerable population groups provide nursing and midwifery students with the confidence needed to care for people with complex health and social issues in acute care settings. These placements enhanced the student’s clinical skills and linkages to psychosocial theories of human development. The Australian research project mixed methods research design allowed for in-depth interviews and correlational analysis to explore the levels of knowledge gained and application to future practice. The findings outline the impact of these community based placements on the student’s future clinical practice. The Vietnam community placement used in-depth, pre and post interviews, with the staff and students providing health clinic services in the rural Vietnam highlands. Both research projects found that the use of community based placements provides important experiences and learning outcomes for students that enhance their future nursing and midwifery practice.
Abstract summary:
This research and community placement provide nursing and midwifery students with a broader understanding and practical application of psychosocial theories and the social determinants of health through innovative placement experiences. The Australian and Vietnam community placements are compared to determine the benefits or otherwise, of local or international experiences.
The Australian homelessness and student nurse community placement research.
In Australia at least one in 30 children under the age of 5 years are homeless. Further 26% of attendees at homelessness services are children under 10 years accompanied by an adult, with 44% of these children under 5 years. Homelessness is a time of great risk for children. Homeless children and their families have poorer health and educational outcomes. The purpose of this community based participatory research project aimed to provide services to match the identified gaps in service delivery for homeless children and their families. The placement of second year nursing students in a community based setting with vulnerable families had two main aims. Firstly, previous research by Parry and Grant (2015) found a lack of access to health services amongst homeless families leading to poor health in their children. Secondly, the homelessness service staff had limited knowledge and skills about child development, assessment, psychological and mental health issues. Consequently, they were unable to identify homeless families’ health needs and potential issues requiring intervention. The addition of nursing students on placement in the service was recognised as adding value while also contributing significantly to the students learning. The research project of Parry and Hill (2106) demonstrated that the use of community placements provide expanded knowledge on the application of psychosocial theories and advanced skills in working with vulnerable populations groups.
Method
This mixed methods community based participatory research project used qualitative interviews and surveys with the managers, staff and nursing students regarding the inclusion of nursing students in home visiting service to families in emergency and short term housing. The interviews were thematically analysed and the quantitative data provided before and after views of the students and staff regarding the student’s knowledge of factors leading to homelessness and the impact of the nursing students on the care, health information and referral services provided.
Results
Previous research found themes from the staff and parent’s interviews identified the need for greater links with health services. A lack of engagement with health services often resulted in no immunization and children missing developmental milestones. This result for children often occurred due to the homelessness service staff's lack of health knowledge and the parents coping with the homelessness crisis were unable to connect their child with the appropriate health service. There is a need for expanded community health nursing, and collaborative health/homelessness practice to provide support for homelessness children and their families, in order to decrease children's exposure to poorer health outcomes. Community health nursing is ideally placed to address this dire need.
This research investigated student nurses and homelessness staff regarding their knowledge, skills and perceptions of the value of community based placements. This oral presentation reports on these findings and compares the results indicating student’s recognition of the skills to be learned in a non-acute setting “are relevant and useful in traditional nursing roles”. The staff in the homelessness service espouse the enhancement provided by the expertise of the nursing students working with vulnerable populations. This research highlights the benefits as perceived by students on often undervalued community based placements. The Australian research findings are compared to the knowledge and skills learned for an international community placement in Vietnam.
Conclusions
Teaching students of nursing about the broader population through community based placements with disadvantaged groups increases the student’s confidence in dealing with the variety of people they will encounter in the acute care setting. The psychosocial assessment of a patient is an extremely important part of nursing care but often under prioritised in preference to immediate physical care requirements.
The Vietnam highlands student nurse/midwife community placement research.
As above community placements are important to student learning and future professional practice. This research project explored the students' experiences of this 3 week community health placement. The research provided an insight into how this placement will inform their future practice as health professionals. The results have assisted administrators and academics on the needs of students on overseas placements, cultural safety, interprofessional learning.
The research promoted students and staff understanding of the relationship between different social phenomena and the process of OS community health placement. Additionally, the OS community placement provided an understanding the needs of interdisciplinary health students, their education and the nature of work integrated education.
Methods
A thematic analysis of student interviews and journal entries revealed the environment, communication, culture, resources, education, group dynamics, politics and personal development were important key experiences. This paper provides insight into student learning outcomes from an overseas community health placement and extends our knowledge about WIL with an international partner.
A qualitative study design was used to describe the student experiences and reflections relating to an inter-professional community health placement in Vietnam. Ethics approval was received from the Flinders University Social and Behavioural Research Ethics Committee.
A semi-structured face to face interview with 14 students was facilitated prior to the placement to enable the researchers to ascertain the expectations of the students and their previous travel experience. After the placement seven participants were interviewed face to face or by phone and asked to compare and contrast their reflections having completed their trip. An additional source of in-depth data was obtained from reflective journals kept by seven of the participants. The journals afforded an insight into their experiences providing a significant component of the research data. The interview transcripts and reflective journals were read and analysed for emergent themes, words or ideas which described the community placement experience.
Results
This study is important as it provides insight into the student perspectives about their learning experiences when undertaking an international, inter-professional work integrated placement. A review of the literature has identified that, while there has been research on work integrated learning, inter-professional education and study abroad programs, there appears to be limited research on bringing these concepts together. By investigating the synergistic effect of combining these three concepts in one experience, universities will be better positioned to provide more high quality international learning opportunities to supplement local placements.
Overall conclusion
The application of developmental psychosocial theories to clinical practice, and assessment techniques, can be difficult to achieve in traditional acute care placements. In the current BN/BM curriculum community based experiences are provided in each year level to develop student’s understandings about the psychosocial aspects of people in their care. While there are differences between the two community placements overall there is an intrinsic value in community based placement in enhancing students learning of, psychosocial theories, and the social determinants of health, and these impacts on health care for vulnerable population groups. Additionally, these research projects support previous findings that the nursing and midwifery students gain confidence in dealing with vulnerable population groups for their future practice.