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Aim: To report a methodological, co‐creative approach for developing an interactive digital educational resource to enhance the quality of student nurses' clinical education in nursing homes and to elucidate the lessons learned from this approach. Design: This study applied a co‐design methodology that builds on participatory design principles. Methods: Co‐creating the digital educational resource included multiple sequential and interactive phases inspired by the design thinking framework. Workshops were employed as the primary co‐creative activity. Results: Seven separate homogenous or joint heterogeneous workshops were conducted with student nurses, nurse educators, registered nurse mentors and e‐learning designers (n = 36) during the active stakeholder engagement phases to inform the educational content, design and functionality of the digital educational resource. These were informed by, and grounded in, learning theory and principles. Conclusion: Co‐creative approaches in nursing education are an essential avenue for further research. We still lack systematic knowledge about the impact and benefits of co‐created initiatives, stakeholders' motivations, barriers, facilitators to participation and the role of context in supporting effective co‐creative processes to increase the quality of nursing education. Impact: This paper demonstrates how digital educational initiatives to enhance quality in clinical nursing education can be co‐created with key stakeholders through a novel methodological approach inspired by design thinking. To date, the methodological development process of co‐created educational interventions has received limited attention and compared with the content and theoretical underpinnings of such interventions, has rarely been addressed. Therefore, this paper facilitates knowledge exchange and documents vital aspects to consider when co‐creating digital educational initiatives incorporating multistakeholder perspectives. This promotes a stronger academic–practice partnership to impact and enhance the quality of clinical nursing education in nursing homes. Public Contributions: Student nurses, nurse educators, and registered nurse mentors worked alongside researchers and e‐learning designers in the co‐creative process. [ABSTRACT FROM AUTHOR]

Introduction: The bachelor's thesis (BT) in undergraduate education is often an autonomous and individual assignment. It aims to demonstrate knowledge gained through education, to be an assessment tool, and to give new learning outcomes through working on the thesis. The process of working with the BT most often includes individual supervision. There is an absence of support for teachers supervising undergraduate nursing theses, which includes a lack of national or institutional guidelines, role definitions and research material. Objective: Given the lack of helpful guidelines, this study aims to explore what the teachers emphasize as important regarding their supervision of nursing students writing their BT. Methods: The study has a qualitative approach, featuring individual semi-structured interviews with nursing teachers supervising nursing students on the BT. Reflexive thematic analysis is used as the method of analysis. Results: The analyses resulted in two generated themes, each with two subthemes, describing the patterns the teachers emphasize as important aspects of their supervision of nursing students writing their BT. The themes were "The pedagogical approach to the supervision" and "The advantages of the bachelor's thesis to the nursing profession." Conclusions: The teachers balanced different roles in the supervision of the students. They wanted the students to grow through challenging them, grounded in a relationship of trust and confidence. They were role models for how to be critical thinkers and incorporated critical thinking as a pedagogical implement in supervision, wanting to raise the students to become nurses who think critically. The teachers sought to combine clinical relevance with academic literacy to secure a new generation of nurses able to be a part of the future development of the profession. They wanted to equip the students with knowledge, skills, and confidence to speak up and communicate nursing. Last, the teachers combined their clinical and academic identities in the supervision of the BT. [ABSTRACT FROM AUTHOR]

Background: Despite the increased use of technology for teaching and learning in clinical nursing education, relatively little attention seems to be directed toward the usefulness of digital educational resources (DERs) to support nurse educators' educational role in clinical nursing education. Methods: An interpretive descriptive qualitative study design was conducted to evaluate the usefulness of a DER to support nurse educators in clinical nursing education. Data were collected through two focus group interviews with part-time and novice educators (n = 5) and full-time, more experienced educators (n = 5), after they had overseen student nurses in nursing home placements. Data were analyzed using thematic analysis and Standards for Reporting Qualitative Research guidelines were used for this study. Findings: The analysis identified three themes related to nurse educators' experiences of the usefulness of a DER to support their educational role while overseeing first-year students on clinical placements in nursing homes: (1) Provides academic support and a sense of security (2) promotes pedagogical efficacy, and (3) represents a flexible resource for educational planning. Conclusion: This study shows that a digital educational resource can be an efficient and useful supplementary strategy to support the nurse educator's role in clinical nursing education. Future research is required to systematize knowledge about the impact of DERs on orientation and training, as well as motivation and facilitators for, and barriers to, their use to enhance quality and strengthen the nurse educator's role in clinical nursing education. [ABSTRACT FROM AUTHOR]

Background: Clinical placement is recognised as essential for nursing students' development of clinical competence. However, difficulties in providing supportive clinical learning environments are a well-known challenge in nursing education. In Norway, the use of nurse educators in joint university and clinical roles has been recommended as an initiative to strengthen the clinical learning environment and enhance the educational quality. In this study we use the term practice education facilitator in a generic sense for these roles. The aim of this study was to explore how practice education facilitators can contribute to strengthen the clinical learning environments for nursing students. Methods: This study has a qualitative explorative design with a purposive sample of practice education facilitators affiliated to three different universities located in southeast, mid-, and northern Norway. Individual in-depth interviews with 12 participants were conducted during spring 2021. Results: A thematic analysis resulted in four themes: "coherence between theory and practice"; "student support and guidance during placement"; "supporting the supervisors to support the students" and "factors influencing the practice education facilitators' performance in their role". The participants experienced that the practice education facilitator role contributed to strengthened clinical learning environments. However, their performance in the role was found to be contingent upon factors such as time allocated for the role, personal and professional attributes of the post holder, and a common understanding within the organisations regarding practice learning and role remits for the practice education facilitator. Conclusions: Findings indicate that the practice education facilitator role can be a valuable resource for clinical supervisors and nursing students in clinical placement. Moreover, nurse educators who are familiar with the clinical area, and who are insiders in both settings, are ideally placed to contribute to bridge the theory-practice gap. The benefits of using these roles, however, were influenced by personal attributes of the post holder, time allocated for the role and the number of practice education facilitators positions, and management anchorage. Thus, to achieve the full potential of these roles, efforts to reduce these barriers should be considered. [ABSTRACT FROM AUTHOR]

Introduction: The pre-round meeting is an interprofessional gathering conducted in conjunction with the ward round in many hospitals. Here, nurses, doctors and eventually allied health clinicians discuss clinical issues before attending to the patients. This study focused on the learning aspects of the pre-round meeting, and it is, to our knowledge, the first study to explore the impact of pre-round meetings on learning in a clinical setting. Objectives: To improve our understanding of the impact pre-round meetings has on clinical learning among the nurses and doctors who attend them. Method: A qualitative study. Focus group interviews were conducted. Participants comprised of 9 doctors and 13 nurses from two different hospitals in Norway. The participants represented both surgical and non-surgical departments Results: This study showed that the pre-round meeting is an arena with a high learning potential. Learning takes place in the discussion that arises when different professions meet. Both nurses and doctors emphasized that the pre-round meeting is both a conscious learning arena and an arena where learning is a by-product. Several factors interfered with the utilization of its learning potential. Conclusion: The pre-round meeting is an arena with high learning potential. However various factors can influence this potential. The study highlights the importance of being aware of the learning potential in the pre-round meeting, to achieve higher-level learning objectives. A collaborative environment, continuity, competence, and availability of the staff and structured pre-round meetings are essential elements for achieving higher-level learning objectives. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore registered nurses' mentorship practices of first‐year nursing students in nursing home placements. Background: Enabling nursing students to develop professional competence through clinical placements relies heavily on registered nurses' mentorship practices. Despite renewed interest in nursing homes as an important clinical placement setting, studies are scarce on registered nurses' mentorship practices in this context. Design: An exploratory, qualitative mixed‐methods design. Methods: The data consisted of 126 h' observation of two registered nurse mentor–student dyads, supplemented by in‐depth interviews (n = 12) with registered nurse mentors. The data were collected in three Norwegian nursing homes and analysed using content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used to report the findings. Results: The registered nurses' mentorship practices of first‐year nursing students in nursing home clinical placement were characterised by (1) variability and uncertainty in pedagogical supervisory approaches, (2) lack of management support and engagement of staff members in supervision, (3) lack of supervisory continuity and (4) a peripheral role in formal assessment discussions. Conclusions: A marginal nursing home context, alongside a mismatch between registered nurses' roles and first‐year students' learning objectives, introduces considerable vulnerability that impedes effective mentorship practices. Targeted efforts to enhance mentorship practices in nursing homes are warranted to promote full use of the learning potential in this context. Developing and testing educational interventions is necessary to effectively enhance registered nurses' pedagogical competence, alongside engagement and support from nurse managers and nurse educators. Relevance to clinical practice: This study provides insight into barriers to effective mentorship practices of first‐year nursing students in nursing home placements. These barriers warrant attention from nursing home managers and nurse education institutions towards improvements that enhance effective mentorship practices vital for students' learning, professional growth and future recruitment to care for older people. [ABSTRACT FROM AUTHOR]

The clinical learning environment and supervisor-student relationship play vital roles in the learning outcomes of nursing students. The aim of this study is to evaluate nursing students' experiences with the clinical learning environment and supervision in a hospital placement organised with a dual preceptor team – preceptors holding dual positions both in the clinic and the nursing faculty in addition to the standard one-to-one supervision by a clinical preceptor. The study is a paper-based survey based on a validated questionnaire developed and tested in hospital settings in various European countries, including Norway. The Norwegian version of the CLES+T Evaluation Scale, was distributed to all second-year students in three different years (2015–2017) at a nursing faculty. A total of 61% students (n = 261) returned the questionnaire. Overall, the students considered that their hospital placement provided a good clinical learning environment. The results suggest that the dual preceptor team on top of one-to-one supervision did not interfere negatively with the clinical learning environment Nevertheless, the dual preceptor model did not compensate for a poor relationship with the clinical preceptor. Thus, the association between a reported 'strained relationship' with the clinical preceptor and low scores on the CLES+T, reported on by other studies, remained in our data. To better grasp the complexity in this area, various methods are needed, such as in-depth interviews with students, nurse teachers and clinical preceptors. Further studies need to elaborate on students' experiences of clinical learning environment according to how supervision is organised. • Nurse students evaluated the clinical learning environment with dual preceptor team as positively. • Stable one-to-one supervisory relationships were highly valued. • Future studies about organising of supervision and clinical learning environment is recommended. [ABSTRACT FROM AUTHOR]

Background: Ageing populations are increasing the demand for geriatric care services. As nursing schools respond to this demand, more high-quality clinical placements are required, and aged care homes offer suitable placement sites. Although an aged care experience for students is beneficial, the basis for effective implementation of these placements is yet to be fully established. The aim of this study was to explore faculty staff perspectives on the challenges associated with providing effective clinical education in aged care homes for first-year student nurses. Methods: An exploratory qualitative study was performed. Fifteen in-depth interviews were conducted with program leaders of nursing degree programs (n = 4), course leaders (n = 6) and practice coordinators (n = 5) in three Norwegian universities. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR). Results: Five themes were identified regarding the perceived challenges to implementing effective clinical education in aged care homes: (1) low staffing levels of registered nurses limit the capacity to effectively host students; (2) prevalence of part-time teachers can compromise the quality of students' learning experiences; (3) tensions about the required qualifications and competencies of nurse teachers; (4) variation in learning assessments; and (5) lack of quality assurance. Conclusions: These challenges signal key areas to be addressed in quality assurance for effective aged care placements. Further research into the minimum staffing levels required to support student learning in the aged care setting is required. Methods for developing shared practices to facilitate learning in aged care homes need to address the prevalence of part-time teaching appointments. Further research into the levels of qualification and competence required to support student learning in aged care facilities can assist with setting standards for this sector. Finally, academic-practice institutions must engage with government officials and national nursing bodies to develop national standards for clinical education in aged care homes. [ABSTRACT FROM AUTHOR]

Aim: To translate The Clinical Learning Environment Comparison Survey (CLECS) into Norwegian and to evaluate the psychometric properties of the Norwegian version. Design: A cross‐sectional survey including a longitudinal component. Methods: The CLECS was translated into Norwegian following the World Health Organization guidelines, including forward translation, expert panel, back‐translation, pre‐testing and cognitive interviewing. Nursing students at a Norwegian university college were invited to participate in the study (psychometrical testing) based on informed consent. Reliability and validity of the translated version of CLECS were investigated using a confirmatory factor analysis (CFA), Cronbach's alpha and test–retest analysis. Results: A total of 122 nursing students completed the questionnaire and Cronbach alphas for the CLECS subscales ranged from 0.69 to 0.89. CFA goodness‐of‐fit indices (χ2/df = 1.409, CFI = 0.915, RMSEA = 0.058) showed acceptable model fit. Test–retest ICC ranged from 0.55 to 0.75, except for two subscales with values below 0.5 [ABSTRACT FROM AUTHOR]

Background: The preparedness of newly graduated registered nurses for a demanding work environment and care practices takes form during nursing education. Norwegian nursing education at one university has implemented a selection of basic physical assessment skills (B-PAS) in the nursing curriculum in order to prepare nursing students for a demanding work environment post-graduation. Methods: A mixed-method cohort design. We evaluated nursing students' self-reported use of B-PAS during their clinical rotation using the "Survey of Examination Techniques Performed by Nurses" questionnaire (30 items). In addition, two focus group interviews elicited factors that hinder or facilitate the actual use of B-PAS during clinical rotation. We recruited students from a bachelor's degree programme for nursing at a Norwegian university. Three hundred and sixty-three of 453 eligible nursing students in the first, second, and third year of the bachelor's degree programme participated in the study (80%). Results: ANOVA showed a significant progression (p < 0.016) in students' self-reported use of B-PAS. Auscultation and percussion skills were graded below the median score of 3, which indicates that these skills were less used throughout the programme. The nursing students highlighted contextual factors for their use of B-PAS when in clinical rotation. Preceptors are important gatekeepers for successful implementation, and there is a need for close collaboration between the university and clinical practice. Conclusion: Despite the reduced PAS taught in the curricula, there is still a lack of application of such skills in clinical rotations. This study highlights that research should explore how different work environments influence the utilisation of learned skills, and which learning strategies are appropriate or most successful for stimulating clinical reasoning and the extensive use of physical assessment. [ABSTRACT FROM AUTHOR]