Introduction: Clinical nursing experiences have been always an integral part of nursing education. Clinical practice is a vital component of B.Sc. Nursing curriculum. Nursing is a performance-based profession. Through clinical training, nursing faculties facilitate student nurses’ application of theoretical classroom knowledge into the clinical practice settings. Clinical training settings include in patient department, out patient department, operation theatre and other health care settings utilized for teaching student nurses. According to Reilly and Oermann (1992), it is through experience in the clinical settings that student nurses acquire the knowledge, skills and values essential to professional practice and become socialized into the nursing profession. This is where students encounter the human side of nursing. Clinical nursing experiences prepare student nurses to be able of doing as well as knowing the clinical practice. The clinical nursing experiences stimulates students to use their critical thinking skills for problem solving.1Clinical nursing experiences plays an important role in the acquisition of professional abilities and trains nursing students to enter nursing profession and become registered nurse. Clinical teaching is a complex process that involves integration of affective and psychomotor skills. Therefore, researchers decided to assess nursing students’ opinion on clinical nursing experiences.
Aim: To assess the nursing students’ opinion on clinical nursing experiences.
Need of the study: There is lack of literature related to opinion of nursing students regarding the clinical experiences. Furthermore, as the setting of this study is a budding institute with the initial batch to still pass out, hence, identifying the lacunae between theory and practice and also the opinion regarding positive and negative clinical nursing experiences of students may aid in providing a feedback to the faculty and administrators and hence help in laying foundations for quality clinical nursing experiences in future.
Hence, the investigators decided to assess the nursing students’ opinion on clinical nursing experiences. This study will provide opportunity to nursing students for open discussion about their problems which are faced by them in the clinical area. All in all, this study will not only help in improving the quality of clinical nursing experiences and learning of nursing students, but also help to prepare confident nurses who will provide quality nursing care.
Methods:
Research Approach and Design : Qualitative , exploratory, phenomenological design.
Research Setting: College of Nursing, All India Institute of Medical Sciences (AIIMS) Rishikesh, India.
Target Population : The target population comprised of all nursing students studying at College of Nursing, AIIMS Rishikesh.
Sample and sampling technique: Sample comprised of B.Sc. (Hons.) nursing 2nd, 3rd and 4th year students selected by systematic purposive sampling technique. Total 6 students from each batch 2nd, 3rd and 4th year were selected on the basis of previous academic year performance, after going through their cumulative records. The participants were selected based on their particular knowledge of phenomenon, for the purpose of sharing their knowledge and experiences with the researchers. Sample size was determined at the end of data collection as per data saturation i.e.18.
Inclusion Criteria:
- B.Sc. (Hons.) Nursing students studying in 2nd year, 3rd year and 4th year.
- B.Sc. (Hons.) Nursing students who gave written consent (willing) to participate in the study.
Exclusion criteria:
- B.Sc. (Hons.) Nursing 1st year students (not exposed sufficiently to clinical area).
Selection and development of tool(s):
Tool consisted of two parts:
Part A: Socio Demographic profile of nursing students: It included age, gender, educational status, religion, habitat, monthly family income, duration of clinical exposure and any family member in the nursing profession.
Part B: Semi-structured, focused group interview to assess the nursing students’ opinion on clinical nursing experiences. It included total 8 semi-structured questions. The first 2 questions were general questions which were used as ice-breakers or to make the students comfortable. The remaining questions focused on assessing their opinion about clinical nursing experiences.
Trustworthiness of data
In order to validate the data, manuscripts were reviewed and data coding process was reconducted by peer reviewer and a faculty member. To obtain generalizability, results were presented to students who had not participated in study and they were asked to judge the similarity between results of research and their own experience. Credibility, dependability, confirmability and transferability of data was ensured by different methods.
Data collection procedure:
B.Sc. (Hons.) Nursing students studying in 2nd, 3rd and 4th year were selected by systematic purposive sampling technique based on inclusion and exclusion criteria of the study. Total 6 students were selected from each batch for each focused group interview.
Two students who had scored highest marks, two with average marks and two with lowest marks in the previous academic year were selected after going through the cumulative record register and previous year academic results.
Details of the study were explained and written consent was obtained from the participants. Socio-demographic profile was filled by the participants, followed by focused group interview session lasting for about 40-50 minutes.
The researchers made use of bracketing to enter in the interview without any bias. The interviews were video recorded and verbatim transcriptions were made. The interviews were conducted in a classroom where privacy could be ensured. The researchers used communication skills such as reflection, nodding, questioning, clarification and maintaining eye contact, to facilitate and encourage participants to talk, until there were no new themes or issues emerging from the participants. Field notes were taken during the interviews. A follow up interview was done with three of the participants, after listening and watching video recording. This was done to verify and allow the participants to expand on inadequate descriptions to the phenomenon.
Ethical considerations
A written permission was taken from Principal of College of Nursing, AIIMS Rishikesh for conducting the study. Also, ethical approval was obtained from the institutional ethics committee. The purpose of study was explained to all the participants and a written informed consent was obtained for each interview and video recording. The participants were assured of the confidentiality of the data.
Results:
Theme 1: A supportive clinical environment facilitates effective learning.
As described by a student: “Staff nurses, teachers and clinical instructors motivate us for improving our clinical skills that we perform in clinical setting then we feel good, that everyone is encouraging us for improving our skills. So it is a good experience that we are learning”.
Yet another student expressed :“The faculty, staff and our teachers are very cooperative; they are very helpful and motivate us to do good in clinical, so that our skills get better.”
Theme 2: Reality is very different from what is expected
One of the student stated: “Earlier in first year we used to have assessments on mannequins only, they should give demo on the patient also, so that we can know or we can differentiate patient who is having particular disease condition and these type of sounds are heard in these type of disease condition only.”
Theme 3: Too much written assignments hinder learning in clinical area.
One of the participants explained: “We have so many written assignment that hinder our practical knowledge gain. As sometimes doctors tell us to study something and when we go back, we become busy in writing assignments and come next day blank.”
Theme 4: Bed side clinical teaching enhances better learning.
As stated by one of the student, “We are not taught on the patients. Clinical instructors with a group of students should go to the patient, take history and discuss the case there itself.”
Conclusion:
Supportive clinical environment is most influential in development of nursing skills, knowledge, and professional socialization. It provides student nurses with unique learning opportunities in which theory and skills are implemented in real life situations. This is imperative for translating theory effectively into practice.