The Nursing Home as a Learning Environment

Molema, Frederique; Koopmans, Raymond T.C.M.; Helmich, Esther

doi:10.1097/acm.0000000000000143

Cited by 13 publications

(5 citation statements)

References 35 publications

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“…This emphasises the importance of giving aged care staff, particularly those engaged in mentoring nursing students, the opportunity to meet and critically reflect on the challenges and opportunities within this educational framework. This supports evidence from international studies, which indicates that Teaching Nursing Homes provide effective nurse training in the context of a collaborative, inter-disciplinary learning environment, where students can experience and contribute to team-based care [ 6 , 7 ].…”

Section: Discussionsupporting

confidence: 76%

“…To redress a widening gap between workforce quality and demand for care, the Wicking Dementia Research and Education Centre (University of Tasmania) has instituted a program to develop a network of Teaching Aged Care Facilities (TACF). This program draws on evidence from the development of Teaching Nursing Homes in the United States of America and Scandinavia, which have been shown to provide effective healthcare student training when they deliver a collaborative, inter-disciplinary learning environment where students can experience team-based care and opportunities for independent assessment [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Are care workers appropriate mentors for nursing students in residential aged care?

2014

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BackgroundThe aged care sector is increasingly dominated by a less-qualified workforce at a time of increasing prevalence of complex health concerns, such as dementia. An Australian program to develop teaching aged care facilities is being undertaken to build the sector’s capacity and provide nursing students with positive experiences of engaging with vulnerable clients. This research aimed to examine care staff potential to facilitate nursing student engagement with clinically relevant knowledge in the performance of hygiene care in a residential aged care facility.MethodsThis study was designed as an action research study. A cycle of reflection, planning, action, and evaluation is described to illustrate the carer mentor capacity to engage with and contribute to the learning of nursing students. Participants were second year student nurses (n = 10) on a four-week placement in a Tasmanian aged care facility in 2013 and their nurse/carer mentors (n = 17). Mentors participated in six action research meetings, and nursing students engaged in a parallel series of four feedback meetings during the placement.ResultsAt the beginning of the placement, nursing students exhibited a disregard for the clinical value of care provision. Students considered provision of hygiene care, in particular, the preserve of care workers and an inappropriate training exercise in the context of an undergraduate nursing qualification. To assist students to make links between core nursing competencies and hygiene care as well as to engender respect for their role within the aged care facility, carer mentors developed the Carer Assessment and Reporting Guide. Once implemented during the final weeks of the placement, the Guide improved student perceptions of resident hygiene care (reframed as assessment) and the role of facility care workers, as well as reinforcing carer self-esteem.ConclusionHygiene care is replete with nursing competencies that are valuable for undergraduate learners, including assessments of skin integrity, mobility, cognitive function, bowels and urine, and basic hygiene. Nurse education programs should strive to address student misconceptions about care work in facilities to account for population level increases in care needs.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Are care workers appropriate mentors for nursing students in residential aged care?

2014

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“…Previous studies have shown how nursing homes can offer medical students and newly qualified doctors a broad range of specific geriatric and long term care learning outcomes [ 12 , 29 , 30 ]. In this study we focused on EOL care and dialogues about death, emphasizing the impact of situated learning on development of doctors’ professional role.…”

Section: Discussionmentioning

confidence: 99%

Doctors’ learning experiences in end-of-life care – a focus group study from nursing homes

et al. 2017

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BackgroundDoctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors’ learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death.MethodsHouse officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger’s theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home’s community of practice.ResultsNewly qualified doctors explained how nursing home staff’s attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members’ hope and trust, they learnt how to adjust words and decisions according to family and patient’s life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance.ConclusionsThere is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.

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“…Residential aged care facilities (RACF) have been identified as non-traditional environments in which to conduct clinical placements for health professional education (Molema, et al, 2014), particularly for many allied health disciplines (Liebig, 2008, Mezey, et al, 2008. The RACF is not a commonly sought after placement opportunity by students due to the perceived unattractive and sometimes confronting nature of ageing (Stevens, 2011).…”

Section: Introductionmentioning

confidence: 99%

Interprofessional education in practice: Evaluation of a work integrated aged care program

Lawlis

Wicks

Jamieson

et al. 2016

Nurse Education in Practice

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Health professional clinical education is commonly conducted in single discipline modes, thus limiting student collaboration skills. Aged care residential facilities, due to the chronic and complex health care needs of residents, provide an ideal placement to provide a collaborative experience. Interprofessional education is widely acknowledged as the pedagogical framework through which to facilitate collaboration. The aim of the evaluation was to assess student attitudes towards collaboration after active involvement in an interprofessional education program. Students studying nursing, occupational therapy, and aged care were invited to complete a version of the Readiness for Interprofessional Learning Scale before and after participating in a three-week pilot interprofessional program. A positive change in student attitudes towards other health professionals and the importance of working in interprofessional teams was reported with significant differences between two statements indicated: Learning with health-care students before qualifications would improve relationships after qualifications; and I learned a lot from the students from the other disciplines. The innovative pilot project was found to enhance student learning in interprofessional teams and the aged care environment. Further development of this and similar interprofessional programs is required to develop sustainable student projects that have health benefits for residents in aged care residential facilities.

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The Nursing Home as a Learning Environment

Cited by 13 publications

References 35 publications

Are care workers appropriate mentors for nursing students in residential aged care?

Are care workers appropriate mentors for nursing students in residential aged care?

Doctors’ learning experiences in end-of-life care – a focus group study from nursing homes

Interprofessional education in practice: Evaluation of a work integrated aged care program

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