Nursing Student Preference for Block Versus Nonblock Clinical Models

Abstract

Integration of both clinical models is recommended within undergraduate nursing curricula, as each model can facilitate student learning. [J Nurs Educ. 2017;56(3):152-157.].

“Yes, the type of student supervision matters, but what about the placement structure?” - A critical realist review of block and integrated practice learning models within pre-registration nursing programmes

“…The integrated model is also variously known as the 'distributed', [37,38] 'non-block', [3,10] 'part-time', [31,39] 'protracted placement' [40] or 'weekly' practicum. [18,32] It involves PRN nursing students experiencing both academic and clinical learning during almost every week of an identified period during their programme; normally spending one or two days in clinical placement per week and the rest of their time in academic study.…”

“…Donnelly and Wiechula [86] claim that the diverse range of practice learning models identified, described, and evaluated within nursing publications suggests that 'curriculum designers and clinical venues are yet to find an optimum model of education'. Phillips [87] argues that 'there is very little in the literature about the optimal length of practice placements for pre-registration nursing students'; whilst Rohatinsky et al [3] similarly maintain that 'little evidence is available to guide curricular planners in determining the appropriate and effective use of different clinical models in nursing education'. Indeed, it is claimed that many placement models have simply evolved through 'custom and practice and in response to industry/professional expectation' [88] and have largely been based on traditional wisdom [89] and 'practical and financial factors rather than pedagogical needs'.…”

“…Third and fourth-year learners, however, showed a preference for a block model; regarding it as an approach which offered better theoretical preparation prior to placement, allowed the student to exclusively concentrate on clinical learning during the experience, promoted continuity of care, strengthened working relationships with nurses in the practicum and more effectively consolidated and enhanced their clinical skills and decision-making. [3] In Australia, a descriptive, exploratory study by Birks et al [37] involving focus groups and individual interviews with 22 third-year PRN students to explore the impact of a block versus distributed (integrated) placement model on the student learning experience found both placement modes had 'inherent advantages and disadvantages that might be magnified depending on the individual student's circumstances'. Participants reported that they were more likely to be accepted as a member of the clinical team during a distributed placement and that this model better facilitated an awareness of ward routines, enhanced communication skills acquisition, offered a better work/life balance and facilitated the integration of theory and practice.…”

“…Although 'learning in clinical practice is of considerable importance for competence development in nursing education' [1] and direct workplace experiences have been by far the most frequently adopted approach to the clinical education of pre-registration nursing (PRN) students, there continues to be no identified placement model on which to structure such learning that is demonstrably superior to any other; [2][3][4] hence practicum experiences for nursing students vary widely in both their duration and intensity. [5] Although increased attention is now being given to alternative practice learning models, [6] more than 150 years since the first formal nurse education programmes were established [7] there is still only limited evidence available regarding exactly what creates a good placement.…”

The use of block and integrated practicum structures within employer-sponsored pre-registration nursing programmes: A Critical Realist study

“…Moreover, no single practicum design has yet been demonstrated to best facilitate such learning. [11][12][13] A range of terminology is used to identify specific practicum models, but this diversity of language masks a reality that placements are commonly based on just one of two frameworks, namely a block or integrated design. Student activity in the block model alternates between dedicated placement periods lasting weeks or months and separate episodes of academic study.…”