Shadowing in Early Baccalaureate Nursing Education and Its Influence on Professional Role Perspectives

Nursing students experience a great discrepancy between their ideal views of nursing obtained while in school and the realities of practice (Chappy, Jambunathan, & Marnocha, 2010).   Many students come into nursing with an “idyllic” view of nursing believing it involves minimal academic study and is more vocational in design (O’Donnell, 2011). A key issue is role discrepancy which has been shown to result in difficult transitions into nursing and reality shock for the newly licensed nurse (Duchscher, 2009; Emeghebo, 2012; Hickey, 2010).  Clinical learning experiences provide opportunities for understanding the nursing role but may not begin until halfway through a nursing program.

     Using the Reflection, Feedback, and Restructuring model (Schuler, 2015)  as a conceptual framework, the aim of this study was to examine whether a shadow the nurse experience (STN) for novice baccalaureate nursing  students led to a transformation in professional nursing role perceptions and goal development. A phenomenological research design was used in which 12 sophomore level nursing students without previous clinical experiences shadowed a professional nurse for 16 hours on a medical surgical unit then responded to guided reflective questions. 

     Reflections were analyzed and synthesized through an interpretative phenomenological lens resulting in three themes related to role development before and three themes related to role development after the shadowing experience.  Additionally students linked practice to classroom learning and developed academic goals to address anticipated learning needs.  While one student questioned if nursing was the appropriate career choice after the shadowing, overall respondent’s perspectives changed from a focus of the nurse as a primary caregiver in a hierarchal structure to a broader perspective recognizing the complexity of nursing and what it means to care. 

       A shadow the nurse experience early in nursing education led to a change in student perspectives of the role of the professional nurse.  Findings from this study support bridging the theory to practice gap in terms of offering the students an opportunity to experience the authentic role of the professional nurse including interactions with other healthcare members, advocacy, and authentic caring earlier in nursing education which may contribute to a student's decision to stay or leave nursing.  Shadowing may be utilized as an innovative educational pedagogy for facilitating role development in novice nursing students.