The influence of clinical placement and experiential learning on student nurse development: an exploratory case study.

Abstract

The role of clinical placement and experiential learning in the education and preparation of nurses is complex and difficult to research. The outcomes of nursing education, particularly in relation to the care of patients in acute care settings, are equally challenging. This study was conducted to address the question, ‘How does the teaching model and duration of clinical placement, within an undergraduate nursing program, affect clinical skill acquisition and nursing practice? The study describes the application of case study methodology to the experiences of sixteen graduate nurses within a large South Australian metropolitan hospital. Each participant (case) described through interview, their university and clinical placement experiences. A survey conducted at the same time as the interview focused on the participant’s skills and knowledge of interventions for pressure area care, falls and pneumonia. This emphasis was to examine if the nature of the clinical placement experience was influential in developing the capabilities of graduate nurses. A range of analysis techniques including thematic analysis, parametric and non-parametric analysis and a unique approach using qualitative comparative analysis (QCA) enabled the formation of a case report. As the participants had attended various universities, a cross-case comparison was performed using a pattern matching technique. The findings of the study suggest there are a range of conditions, which in combination may contribute to a higher level of skill, knowledge and confidence. Of these conditions, the duration of placement has an important influence on the student’s ability to form effective relationships with clinical education staff and to have an opportunity to provide nursing care through a range of nursing interventions. Of itself however the duration of placement may not be the most important influence in the development of graduate skills, knowledge and capacity to provide nursing care. Rather a combination of certain conditions including, effective feedback, a consistent mentoring relationship with a clinical educator and exposure to a range of nursing care interventions may be more significant in the preparation of a graduate nurse. On the basis of the study findings, an argument is made for Complexity Theory to inform new ways of conceptualising the role of experiential learning and clinical placement in the education of future nurses.