Professional Experience Placement

I recently read two articles from the Journal of Advanced Nursing that approached the issue of student learning from differencing perspectives. Both papers have added information that is critical to progress learning in the workplace.  The first paper by Bagnasco et al (2014) outlines a systematic view protocol they intend to use to measure meaningful learning in undergraduate healthcare students. They discuss the issues around terminology used to describe learning. These currently include meaningful learning or significant learning and deep learning. They trace the development of the constructivist approach where students create meaning and the progression to student centred learning. These authors outline the responsibility of students to adopt an active and collaborative approach to their own learning. These authors also view clinical supervisors or educators as learners and researchers to tune their own actions and follow students in their learning process. These authors anticipate their systematic review will produce a synthesis of the data related to the instruments that measure learning outcomes. They plan the review will support educators to develop meaningful learning programmes and design new curricula for healthcare students.

The second paper discussed the findings of a systematic review of using online or blended learning for teaching clinical skills. This paper by McCutcheon et al (2014) reviewed 19 published papers that studied online and blended learning approaches used to support students in the development of clinical skills. These authors indicated the rise of these methods due to diminishing opportunities for students to learn in the workplace due to staff turnover, shortages and increased severity of patient co-morbidities. The authors stated that nurse educators have developed innovative methods that are efficient and efficacious in educational outcomes in the development of undergraduate clinical nursing skills.

The measurement of learning outcomes in this  review focused on performance/clinical skill, knowledge, self-efficacy/clinical confidence and user experience/satisfaction. These authors found the majority of the studies had weaknesses in design, methodology or participant numbers. Of those that satisfied the criteria for inclusion found that online learning was useful as students could repeat or  review content at their own pace. The main benefit of online learning was the flexibility in educational delivery. The authors concluded that online delivery was no less effective than traditional methods in teaching clinical skills. It was inconclusive  about blended learning due to the lack of studies found.

The implications of both these articles for clinical supervisors include being aware that learning outcomes are difficult to measure. Curriculum outcomes may be different to the student perception of developing meaning or significant learning.  I have recently blogged about student understanding of their learning and what they actually did learn. Perceptions are sometimes different to reality! Similarly access and use of other learning resources such as using YouTube clips as an adjunct to learning in the clinical environment can enhance understanding of clinical skills and learning by students. Access to online learning can reinforce concepts observed or undertaken during clinical experience.=

The issues raised by both articles demonstrate that competing elements will continue to place pressure on learning in the workplace and clinical supervisors are at the forefront of guiding and supporting the next generation of registered nurses. Further research into the phenomenon of learning in healthcare settings could improve learning and teaching of students in clinical environments. These educators and clinicians are responsible for ensuring undergraduate health professionals have access and gain understanding of the complexities of communicating and undertaking clinical skills with ‘real’ patients or clients. Using a variety of educational methods will ensure students are better prepared to be work-ready at graduation.

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