Two deficits and a solution? Explicating and evaluating clinical facilitation using consultative methods and multiple stakeholder perspectives

Abstract

This paper describes an evaluation of an 18 month pilot scheme for clinical facilitators (CFs) in the acute medical and surgical wards of a consortium's hospital trusts. The CFs were appointed to address two perceived deficits: the deficit in nursing skills showed by newly qualified Project 2000 nurses, and the deficit in supervision for clinical placement following the move of schools of nursing into higher education, the abolition of the clinical tutor and the increased workload on ward staff. The CFs were intended to enhance the competence of pre‐registration nursing students on clinical placement. The evaluation used a three‐pronged approach covering outcomes, process and multiple stakeholder perspectives. Outcome measures proved the most intractable, reflecting widespread problems in nurse education of specification and assessment. The process of clinical facilitation was investigated using consultative methods with the CFs themselves. On the basis of in‐depth interviews with the CFs, a four‐level model of clinical facilitation was developed that included, at its first level, the direct supervision of students in the ward. This supervisory role was characterized by six main teaching methods described by the CFs. These methods and the work of the CFs were evaluated through interviews, focus groups and questionnaires with key stakeholders: students; clinical staff, and university staff. Differences were found in the ranking by students, ward staff and university staff of the teaching methods and of the staff involved in practice learning. Within a generally positive evaluation of the work of the CFs, concerns were expressed regarding communication. University staff tended to evaluate the CFs less positively than did students and ward staff. Further research is recommended regarding those involved in the supervision of practice and the outcomes of their activities.

Clinical education facilitators: a literature review

“…An identifiable gap remains with a degree of ambiguity existing over whom has prime responsibility for clinical teaching and learning. A recent role appearing that may devote prime responsibility to clinical teaching and attempt to narrow the theory–practice gap is that of the clinical education facilitator (Rowan & Barber 2000, Ellis & Hogard 2001, 2003, Salvoni 2001).…”

“…The aim was to support and enhance clinical practice and to teach student nurses’ practical skills within the academic setting in recognition of the theory–practice relationship (Salvoni 2001). Similarly, with the intention of improving the quality of clinical placements ‘Cheshire and Wirral Education and Training Consortium’ launched a pilot scheme in 1999, introducing clinical facilitators into medical and surgical clinical settings of six general hospitals (Rowan & Barber 2000, Ellis & Hogard 2001, 2003). The aim was to provide additional support for preregistration students and to interlink theory and practice.…”

“…The aim was to provide additional support for preregistration students and to interlink theory and practice. Ellis and Hogard (2001, 2003) used questionnaires, semi‐structured and focus groups interviews to ascertain the views of the multiple stakeholders (students, staff, university staff and managers) on the employment and work of clinical facilitators in the evaluation of this 18‐month pilot project. Similar to Irish CPCs, the clinical facilitator had supernumerary status although, contrastingly, spent the majority of their time within clinical areas working alongside student nurses teaching direct patient care, enabling students to link theory with practice (Rowan & Barber 2000).…”

“…It is argued that, while the past two decades have borne witness to various clinical support roles to facilitate the fusion of theory and practice, an identifiable gap exists over who has prime responsibility for clinical teaching. A new post emerging in practice settings is that of the clinical education facilitator who is meant to be the key linchpin in clinical areas for reducing the theory–practice gap (Rowan & Barber 2000, Salvoni 2001, Ellis & Hogard 2003). The aim of this literature review, set within an Irish context, is to present a broad overview of former and existing clinical support personnel, explore the concept of facilitation and examine what is known about the role of the clinical education facilitator.…”

The impact of teacher and peer communication on adolescents' learning outcomes — Positive perception makes better performance

“…Girls' performance are significantly better than boys'; the debating style and relaxing style have notable effects on standardized academic performance; the amiable style, dramatic style and relaxing style have notable effects on emotional outcomes, with dramatic style's impact being negative. All these results do not go beyond the conclusions of Ellis & Hogard (2003), and are supported by some scholars' studies.…”