The purpose of this collaborative qualitative research was to examine and explore first year student nurses’ view of the influence Link Lecturers at a university in England and clinical professors at a university in the United States have on their theory-practice link. The study also investigated the Link Lecturers’ and clinical professors’ perspectives of their influence on the theory-practice link with their students.
According to Honkavuo & Lindstrom (2014), clinical teaching is important as it develops students’ knowledge and skills in the provision of patient care. Whilst Jackson (2015) and Abbaszade, Borhani and Sabzevari (2013) agree, they also believe it is important to identify the factors that develop student nurses’ personal, professional and clinical skills. This collaborative research was instigated when the differences between the role of Link Lecturers in the UK and Clinical Professors in the US and their impact on first year student nurses experiences in practice settings was recognize when the key researcher was on sabbatical leave in the United States.
Methods:
The methodology for this study included convenience sampling of 12 nursing students and 12 faculty members, with the same number included from each of the two universities. Semi-structured interviews using the ZMET or Zaltman Metaphor Elicitation Technique (Zaltman, 1997) were conducted with study participants. This is an eleven step in-depth laddering interview technique that elicits both conscious and unconscious thoughts by exploring metaphoric expressions It enables participants to define, describe, and evaluate their experiences. It was originally developed as a market research tool, but is easily adaptable to diverse experiences, and yields a wealth of information about participants’ thoughts about a subject/topic. With this process, guiding question/s are given to participants and they are required to bring images or pictures in relation to their viewpoint. The researcher uses the images or pictures participants bring and utilizes the eleven sequential steps in the ZMET interview protocol to conduct the semi-structured interviews. The steps are designed to elicit participants’ hidden and unspoken thoughts and non-rational factors and act as a validation tool against the previous step.
The interpretive paradigm (Denzin & Lincoln, 2011) and the hermeneutic phenomenology design informed by Van Manen (2014) was used as the methodological framework for this qualitative nursing research study. Interpretative phenomenological analysis (IPA) was chosen because the researchers were interested in the quality of the experiences of nursing students and nursing faculty in making the practice-theory link. They were also interested in discovering similarities and differences between the responses of students and clinical professors in the United States and the students and Link Lecturers in the United Kingdom. IPA uses reflection and evaluation of participants' and researchers' experiences to comprehend the mindset of participants and to make meaning of events or people (Pietkiewicz & Smith, 2014).
Research questions were formulated, instead of hypotheses, in order to facilitate an open and inductive approach to the data collection and to the data analysis of this study. There was one research question for the nursing students and one for the clinical professors and link lecturers. These guiding research questions were: (a) How do you see your role as a Link Lecturer/ Clinical Professor with your 1st year student nurses in the practice settings? (b) As a student nurse, what do you feel your Link Lecturer/Clinical Professor does with you in the practice setting? These questions are open-ended and intended to facilitate the individual participants’ perspectives and to allow the research process to flow individually with each participant.
Results:
Data analysis revealed numerous themes emerging from all four groups of participants. Among the common themes from the Link Lecturers and clinical faculty were 1) promote professional conduct, 2) encourage critical thinking, 3) offer constructive feedback, and 4) help students connect the dots or bridge the gap. Themes common to students in the United States and the United Kingdom were 1) feeling overwhelmed, 2) uncertainty, fear, or anxiety, 3) not enough time, and 4) finally being able to put the puzzle together. Major differences in the themes between students in the two countries were that many students in the UK did not know who their Link Lecturers were, and students in the US felt a lot of encouragement and building of confidence. Some of the differences in themes among the faculty included those in the UK feeling they had no influence on students and faculty in the US feeling they had to wear many hats.
Conclusion:
Conclusions from this study include several implications for educators. Faculty need to be aware of students’ anxiety and take opportunities to introduce them to nursing in a supporting, appropriately challenging, and positive way. Face-to-face support, encouragement, and role modeling appear to be as important as the actual teaching of theory and demonstration of skills to help students make the theory-practice link.