Professional Experience Placement

Elliott (2002) explored the literature to establish common sources of stress for student nurses while undertaking work integrated learning (WIL) or professional experience.  The author  discussed methods for minimising the anxiety for students. He also reviewed strategies for improving the quality for improving the learning strategies. Elliott (2002) discussed student disillusionment being created by the ‘reality shock’ of the complexities of the professional experience environment. He also acknowledged the experiential setting is less controlled than the classroom and can be a source of stress for them.  Elliott (2002)discusses  6 sources of stress that  emerged in the themes of one study that included students having feelings of anxiety; abandonment; incompetence; confusion; ignorance and lack of value. Another study he reviewed found that feelings of inadequacy due to lack of knowledge was a source of stress for students. On further exploration respondents indicated they feared: making mistakes; the unknown; the clinical facilitator; being scared and failing.

Elliott (2002) discussed attitudes of the ward staff or lack of understanding about the undergraduate curriculum as adding to the stress of students during WIL. Additionally, the author cited exploitation of students as a source of stress when budgetary issues compromised patient safety. Students also indicated they feared harming the patient or client. The concern related to care for their fellow humans as well as the potential repercussions for their career. It was also noted that students feared the social component of the professional experience setting as they were constantly watched or judged in their performance.  The anxiety surrounding undertaking procedures correctly was a constraint on confidence and learning.

Elliott (2002) discussed the value of quality clinical placements rather than the length of time students were exposed to the clinical setting. Adequate preparation was credited with ‘making the difference’.  Preparation could include being familiar with assessment tasks; knowing or meeting the clinical supervisor prior to placement and gaining information about the health care setting. Encouraging students to seek out information and work proactively to create a learning environment that meets their needs is suggested.

This paper discussed the implications for clinical supervisors. Elliott (2002) suggested that clinical supervisors need adequate preparation and are supported in their role. This included a reduced student workload to enable them to spend time with students. Belongingness of students and feelings of being part of the team were also important for reducing stress of students. The author also mentioned that students appreciated recognition for their contribution to patient care and were disappointed when it was not acknowledged. The paper goes on to discuss the need to ensure that clinical supervisors have empathy for the student experience; education in learning and teaching in the professional experience setting and are role models for students.

Elliott (2002) also discusses assessment and the need to guide students from the side rather than criticise performance. There is a need to enable students to reflect on their performance and verbalise their feelings about their professional experience. This author discussed the importance of preceptorship and collaboration between the higher education institution and the health care organisation for maximising the potential of professional experience. Elliott included that much of the stress students experience can be minimised by implementing strategies to support and guide students and clinical supervisors.

Since this paper was written much has changed to support quality clinical placements for students. I have previously blogged about belongingness, orientation, feedback and  educational preparation of clinicial supervisors. I have also provided information about the resources to support students at risk, assessment of clinical supervisors and the organisation that can be found on the SNM PEP webpages for professional experience facilitators and preceptors.  There is also the virtual community of practice using the social media platform known as Twitter . Clinical supervisors can join this group for sharing information, asking questions, seeking feedback or colleagial support. This University is also trialling new models of clinical facilitation that have also previously been reported here.

If you would like further information regarding resources please go to the SNM PEP web pages; if you would like to join the community of practice click on the @PEPCommunity button; or if you have any comments about clinical supervision, please post them here or contact Carey.Mather@utas.edu.au