Self-centeredness or patient-centeredness–final year nursing students’ experiences of learning at a clinical education ward

Abstract

Background: Different types of clinical education wards with the aim of facilitating transition from student to professional have been established giving students more autonomy and responsibility. Studies report positive effects but deeper understanding concerning how clinical education wards can contribute to learning for students nearing graduation is needed. Aim:To explore final year nursing students' experiences of learning when they are supported to take care of patients independently. Methods:The context for this study was a clinical education ward for nursing students at a university hospital in Sweden. Individual and group interviews with 18 students of 29 eligible students were conducted after their clinical practice. The data was analyzed using qualitative content analysis with a focus on students' experiences of their encounters with patients, supervisors, students and other professionals. Results:The two main themes appeared as important aspects influencing final year students' learning, uncertainty as a threshold and experiencing engagement. Sub-themes characterizing uncertainty as a threshold were self-centeredness and ambivalence describing the patient from the perspective of performing nursing tasks. Sub-themes characterizing experiencing engagement were creating mutual relationship and professional development. Caring for patients with extensive need for nursing care helped the students to become patient-centered and overcome the threshold, experience engagement and authenticity in learning the profession. Conclusions:A clinical education ward may enhance the students' experience of both external and internal authenticity enabling meaningful learning and professional development. It is important to acknowledge final year nursing students' need for both challenges and support in the stressful transition from student to professional. Therefore, an explicit pedagogical framework based on patient-centered care and encouraging students to take responsibility should be used to help the students to overcome self-centeredness and to focus on the patients' needs and nursing care.

Supervisors’ pedagogical role at a clinical education ward – an ethnographic study

“…Supervisors’ role as facilitators has been emphasized as important by Brammer [ 11 ]. Having a team of supervisors is appreciated by the students as it enhances the students’ thinking and reflecting on patient care and on their own learning, as well as further developing their existing knowledge and skills [ 8 , 9 , 28 ]. However, it has also been shown by Manninen et al [ 9 ] that students have concerns about the team of supervisors and that they experience feelings of ambivalence.…”

“…They are units with a pedagogical framework focusing on training students in real clinical settings with the support from supervisors [ 4 , 5 ]. While previous research [ 6 – 9 ] has focused on students’ perspectives on learning at clinical education wards, the present study investigates the supervisors’ perspective.…”

“…These wards provide clinical practice for one profession or inter-professionally and train students on different levels [ 5 , 16 , 17 ]. Previous studies [ 7 – 9 ] have shown that clinical education wards have the potential to enhance clinical practice and students’ learning. However, these studies focused on students’ perspectives.…”

Nursing students' perception of patient‐centred care: A qualitative study

“…Students' understanding of patient‐centred care and the role of nursing education programmes are important in the teaching–learning process. Manninen, Scheja, Welin Henriksson, and Silén () in regard to the students' self‐centred and patient‐centred experiences stated that self‐centred care for students is considered to be a tool for learning and a routine nursing practice. Therefore, it is vitally important to consider the concept of patient‐centred care in nursing education programmes (Manninen et al, ).…”

How video cases in preparatory teaching influence students’ approaches to patients in psychiatric clerkship. A qualitative study.

“…Students in our study demonstrated a variety of reflections in their use of mimicry drawn from the video cases, centred on their ability of how to handle the situation. Correspondingly, mimicry in students has previously been identified as a method to cope with stressful transitions (62)(63)(64)(65).…”