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Background Clinical facilitators have an essential role in the development of safe and committed nurses worldwide, but the approach to provision of professional development to help clinical facilitators reach potential is informal, inconsistent and not always relevant to their learning needs. It is important to examine the reported role tensions to generate solutions to the problems and include these teachings in professional development opportunities for clinical facilitators. Method An integrative literature review was undertaken intending to understand and collate the tensions, constraints, as well as supports, and best practice in the role. Results The review identified 40 relevant studies. Conclusion The identified studies highlighted challenges such as lack of role clarity and lack of evaluation of professional development approaches, which hamper best practice; as well as exemplary practices, such as peer-to-peer learning; which has potential to advance the sub-specialty of clinical facilitation.

Background The quality of nursing clinical placements has been found to vary. Placement evaluation tools for nursing students are available but lack contemporary reviews of clinical settings. Therefore, the aim of this study was to develop a feasible, valid and reliable clinical placement evaluation tool applicable to nursing student placements in Australia. Methods An exploratory mixed methods co-design project. Phase 1 included a literature review; expert rating of potential question items and Nominal Group Technique meetings with a range of stakeholders for item development. Phase 2 included on-line pilot testing of the Placement Evaluation Tool (PET) with 1263 nursing students, across all year levels at six Australian Universities and one further education college in 2019–20, to confirm validity, reliability and feasibility. Results The PET included 19-items (rated on a 5-point agreement scale) and one global satisfaction rating (a 10-point scale). Placements were generally positively rated. The total scale score (19 items) revealed a median student rating of 81 points from a maximum of 95 and a median global satisfaction rating of 9/10. Criterion validity was confirmed by item correlation: Intra-class Correlation Co-efficient ICC = .709; scale total to global score r = .722; and items to total score ranging from .609 to .832. Strong concurrent validity was demonstrated with the Clinical Learning Environment and Supervision Scale (r = .834). Internal reliability was identified and confirmed in two subscale factors: Clinical Environment (Cronbach’s alpha = .94) and Learning Support (alpha = .96). Based on the short time taken to complete the survey (median 3.5 min) and students’ comments, the tool was deemed applicable and feasible. Conclusions The PET was found to be valid, reliable and feasible. Use of the tool as a quality assurance measure is likely to improve education and practice in clinical environments. Further international evaluation of the instrument is required to fully determine its psychometric properties.

A multicampus nursing school supported faculty simulation usage by creating a digital repository of simulation resources targeted to faculty needs. This qualitative exploratory study on faculty first impressions and repository usage identified five themes: (a) a welcomed resource;(b) easy to access and use; (c) facilitates multi-campus consistency; (d) supports novice simulation educators; (e) grows simulation pedagogy usage. A digital repository of simulation resources is an innovative tool for supporting simulation usage amongst nursing faculty

Objectives Simulation debriefing skills are inadequate. Barriers to effective debriefing include a lack of understanding of the meaning of debriefing and time to learn necessary skills. In nursing, students have reported simulation debriefs are used for assessment purposes, with little opportunity or time for reflection, affecting their learning. This study reports on an intervention to support nursing simulation facilitators to develop and learn self-reflective learning skills to use when facilitating simulation debriefs. Design The authors designed and developed a six-hour workshop. The published simulation literature and Open Dialogue techniques informed the skill set included in the workshop. Open Dialogue is a therapeutic approach used in mental health care. Participants Twelve (N = 16, n = 12) female nurses who regularly facilitate simulations for nursing students were purposively recruited to the study. Methods This evaluation study utilised a modified version of a previously validated self-reported reflective learning questionnaire for participants to rate their experiences of the workshop. The modified questionnaire comprised 17 items across four subsets and utilised a five point Likert scale. Open-ended questions were also included. Results Eight questionnaires were returned. High scores indicated the participant's positive evaluation of the workshop in developing a skill set to promote self-reflective learning, together with analysing emotions in everyday professional situations and in communication skills. Conclusions Participants reported the intervention was beneficial to their professional development and in helping them to develop their own self-reflective learning skills. The skill set included in the workshop was helpful to nursing simulation facilitators and could be one way to enhance nursing simulation facilitators debriefing skill set.

Background Australian nursing students have said they learn more from their clinical facilitator than from any other educator or learning experience. Thus, there is need for more studies that focus on the actions of clinical facilitators so that expertise within this subspecialty can be developed and shared. Method In 2017, a qualitative study was undertaken using Interpretive Description. Eleven clinical facilitators working in diverse locations across Australia participated in individual semi-structured telephone interviews. Aim The study aimed to explore the lived experience of Australian clinical facilitators' interactions with nursing students. Findings Four themes revealing participants' different mindsets, actions and skills from their daily work were produced from the study and provide insights into the complexity of the role. These four themes included preparing to work with students; facilitating successful clinical experiences; facing unique challenges; and encountering rewards along the way. Discussion Clinical facilitators are a legitimate sub specialisation within nursing and as such require regular professional development, particularly in relation to the four aspects of work identified in this study. Conclusion Professional development for clinical facilitators should be developed on these four aspects of work and its impact evaluated and reported.

Objectives To review undergraduate nursing students' perceptions of the quality of their clinical placement experiences by means of surveys conducted using the Clinical Learning Environment Supervision and Nurse Teacher questionnaire. Design Systematic review of English language studies published between 2014 and 2020, in any clinical setting, utilising data collected in the decade 2010 to 2020. Data sources Structured searches were conducted in CinahlPlus, Ovid Medline, Scopus, PubMed and Google Scholar. Review methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses framed the review. Results A total of 111 records were screened, after which 21 studies met criteria for inclusion. Studies were centred on students in Sweden and in 15 other countries. Students' ratings of ‘Experience’ were positive across five scale subdimensions with means 3.0–3.95 of a possible 5 (overall mean 75.4%). ‘Satisfaction’ across seven studies was rated highly (mean 4.16 of 5) 83.2% agreement. The highest rated subdimension was Supervisory relationship, with the Role of the Nurse Teacher rated lower and inconsistently. The underlying elements are discussed. Conclusion Although students' Experience and Satisfaction were rated highly averaging over 75%, there is still room for improvement. Further research is needed to examine how students perceive various components of ‘satisfaction’ within clinical learning environments because this can be seen as the primary measure of program quality. Research using experimental and observational study designs is needed to compare ways of preparing clinical teachers and reporting measurable learning outcomes for models of supervision that are applicable in varied clinical learning environments.

Background: A career in nursing academia offers clinicians a new challenge. Academic nursing and clinical nursing are two separate worlds with different social and cultural borders, foci and ways of working. It is possible to imagine this space as a kind of borderland, a new frontier that is simultaneously exciting and perilous. Aim: A concept analysis explored the borders as a site of meaning for professional development. Method: This study employed a four step concept analysis. Results: The analysis revealed four attributes of borders that are useful for clinical teachers to understand; liminality, border crossing, border work, and inhabiting a new world. Conclusion: As a liminal space, clinical teaching can be a site where uncertainty and ambiguity arises. This can create anxiety but also opportunities to think about both worlds differently, so that clinical teachers may discover new insights and applications for their work.

Working the night shift can be fraught and experienced as demanding and, yet, is often dismissed as babysitting. Few researchers have explored the social and cultural meanings of night nursing, including storytelling rituals. In 2019, a narrative study was undertaken. The aim was to explore the stories recalled by nurses about working night shifts. Thirteen Australian nurses participated. Data were gathered using the Biographical Narrative Interview Method, and narrative analysis produced forty stories and three themes: strange and challenging experiences; colleagues can be mentors (or not); and textbook knowledge is only part of what is needed on night shift. Nursing students who engage with these stories may come to understand the challenges of the night shift, and the valuable work that nurses engage in throughout a 24-hr period, work that involves adept psychosocial and interpersonal skills alongside technical and physical competence.

Background Registered Nurses are recruited from clinical positions to work as clinical facilitators, supervising nursing students' clinical learning. Few studies have reported on the capabilities of the group, nor offered clinical facilitators validated tools to support their professional development. Objective To test the validated Capabilities of Nurse Educator (CONE) questionnaire with expert clinical facilitators. To use the modified CONE to investigate the Australian clinical facilitator capability for the role. Design Cross-sectional survey design. Participants A purposive sample of 235 Australian clinical facilitators. Method Face validity testing was completed with five members of the target group. The modified CONE was emailed to the 235 Australian nurses with a link for the CONE to complete online. Appropriate statistical analysis was applied to the aggregate data. Results All 93 items and six subscales remained in the modified CONE following minor rewording, of some items. Eight-one (n = 81) participants responded. Clinical facilitators are committed to supporting students to learn, and to their own life-long learning, however the survey results identified gaps in leadership and research capabilities. Conclusion The modified CONE is suitable for use with clinical facilitators as both a self-assessment tool and for understanding group professional development needs. The results of this study will be beneficial in the design of future professional development for clinicians working with students in clinical settings.

Summary Background Preceptors are crucial to the provision of effective clinical learning experiences for nursing students however many are insufficiently trained and lack support in the role. Within Australia, preceptors may work with students preparing to become Registered Nurses or Enrolled Nurses. An intervention was designed specifically to engage Enrolled Nurse preceptors because they are particularly overlooked. Methodology A qualitative evaluation of the educational experience was undertaken using semi-structured group interviews. Findings Four themes were identified: (a) feelings of disempowerment hinder a desire to do the job, (b) open to embracing opportunities to learn about clinical teaching, (c) barriers to engagement and (d) preceptoring across nursing divisions. Conclusion The study identified that the learning experience was valuable. In particular participants enjoyed the challenge of engaging with digital stories where other experienced educators shared the way they responded to learning problems and developed solutions, and the facilitated discussions. Recommendations to further improve the online resource included development of stories that are relevant to the unique challenges Enrolled Nurse preceptors face.

Background: Enrolled nurses (ENs) across Australia precept nursing students in the clinical field. Yet learning about the preceptoring role is not widely available to ENs.Educational innovation: EN’s in this study participated in a professional development project that utilised the material of an online learning resource, originally designed to inspire clinical registered nurses (RNs), and RN teachers, to develop teaching innovations in their role.Aim: The aim of this paper is to report the results of a pre–post-test questionnaire designed to evaluate the impact of the professional development intervention.Results: The analysis showed high scoring means with many items in the questionnaire statistically significant (p

Background The exponential rise in people living longer but requiring residential care is adding pressure to already overstretched aged care nurses. Consequently, a person-centred care culture in residential care remains aspirational, rather than a reality. For nursing students in Australia and elsewhere, clinical placements in aged care facilities are under-utilised due to negative perceptions about the likelihood for learning. Creative strategies to engage students to safely challenge ageist thinking and to inspire enthusiasm for learning in this context are needed. Objectives The purpose of this thematic review of the literature is to better understand challenges related to learning in aged care settings and identify innovative strategies to enhance nursing student learning experiences in residential aged care placements. Review methods A literature review was undertaken in 2019 using CINAHL, PUBMED, Elsevier, Medline, ProQuest and Google Scholar. The search was limited to papers that were peer reviewed, in English, and published between 2001 and the date of review (mid-2019) in order to situate the review in the new millennium. Results 47 articles and books were included in the review that introduce solutions and innovative strategies that could be used to improve students' attitudes to learning in aged care and from older people. The literature review was categorized into three main themes, including: barriers to working with older people; the need for pedagogical change to foster empathy; and innovative strategies to address barriers. Conclusion These themes are useful to consider in designing engaging learning and teaching for nursing students to be effective in working in aged care.

Objective Clinical supervisors, who support and assess health students' clinical learning, encounter many challenges. Professional development opportunities for clinical supervisors to overcome the challenges are available but are often designed to meet organisational and tertiary provider administrative needs, rather than the needs of intended target groups. Design A qualitative action research study was designed to include a group of Australian nursing clinical supervisors in the design and implementation of meaningful professional development activities. Participants Ten clinical supervisors, from one organisation, participated in three meetings to explore shared challenges and create solutions to resolve these challenges. Results Over a seven-month period in 2018–2019 data revealed clinical supervisors in this study experienced a variety of tensions. Participants prioritised three opposing tensions that were of shared concern; Doing and Thinking; Educator and Clinician and Negotiating and Challenging. Being able to visualise and articulate these tensions helps to empathise with the role complexity that clinical supervisors experience, and this led to the production of solutions which validate and advocate for the role and the values. Conclusion The group created innovative solutions such as podcasts, posters, banners and flyers to assist them to harmonise the tensions and work more effectively in their role.

Aim: This study aimed to evaluate Australian nursing students’ views of placements at seven tertiary education institutions with the use of the Placement Evaluation Tool (PET). Background: Clinical placements are a core element of healthcare education programs around the world (Chuan and Barnett, 2012) with undergraduate nursing students required to complete a prescribed number of hours as part of their degree. The quality of nursing clinical placements varies with a range of positive and negative learning experiences. Design: A survey design was used with a contemporary survey tool– the Placement Evaluation Tool (PET). Using Qualtrics software (Qualtrics, 2005) the on-line survey was distributed to approximately 6265 undergraduate nursing students at six Australian universities and one Technical and Further Education (TAFE) college where Bachelor of Nursing degree students were enrolled. Three Australian States were covered. Sites were selected where a project team member was employed. Methods: A total of 1263 nursing students completed the Placement Evaluation Tool (PET) − 19 items (rated 1–5), one global rating (rated 1–10) − following placement in three Australian States (July 2019−February 2020). Most - 618 (48.9%) completed a placement in acute care with placements positively rated overall. Results: The total PET mean score was 78.3% with 29.8% being ‘extremely satisfied’ (10 out of 10 – Item 20). However, 11.0% were dissatisfied with global ratings of four or less, whilst ratings between States differed significantly (p =

© 2017 International Nursing Association for Clinical Simulation and Learning Background Innovations in simulation in nursing and health care continue to be developed as creative and committed educators respond to challenges of providing pedagogically sound, engaging and effective learning experiences for large student cohorts. Time-pressed educators may find it difficult to network with others working in simulation-based learning, and thus, it is useful to provide summaries or snapshots to provide a brief overview of activities in various countries using simulation in a variety of ways. Method The purpose of this paper is to profile a diverse range of innovative, cost-effective, and tested simulation approaches that have been implemented in healthcare programs by nursing educators from a range of countries to spark creativity. Each strategy was designed to address contemporary and critical practice issues. Results They facilitate immersion in authentic clinical scenarios, increase students' awareness of cues in the environment that may compromise health and safety. Conclusion These snapshots of simulation prepare students for cultural or clinical realities that they may not routinely encounter because of the inherent restrictions associated with clinical placements.

Current international research suggests universities providing nursing education should focus on shifting students' attitudes towards valuing clinical learning derived from aged care settings, offering support and education for aged care facility staff supervising nursing students' learning in the aged care setting, and encouraging nursing graduates to consider pursuing careers in gerontology nursing. Against this international backdrop, one Australian School of Nursing designed a structured clinical learning experience to offer final year nursing students an opportunity to further their knowledge and understanding of the complexities of the role of the gerontology registered nurse. Additionally, this clinical learning experience included provision for nursing academics to offer support and expertise to the aged care facility staff around the role of supervising and assessing final year nursing students' clinical learning. The aim of this paper is to present fifteen final year nursing students' and nine registered nurse supervisors' evaluations of the gerontology clinical learning experience and the success of the learning experience towards meeting the project aims. Mostly participants reported positive experiences and agreed the experience illuminated the role of the gerontology registered nurse. Participants in this study also provided suggestions about the benefits and barriers of the clinical learning experience.

Expensive simulation equipment continues to sit idle in nursing learning and teaching environments. To identify factors that influence nursing educator comfort in the use of simulation at an Australian university an explorative qualitative research project was undertaken using an interpretative constructivist methodology. The Goodwin et al. (2007) adapted Comfort Theory for nursing education has been used. The aim of the study was to identify factors that influence nurse educator's comfort in the use of simulation. Research question asked was: What are the barriers and enhancers to using simulation as a learning and teaching modality. Thematic analysis of data from focus groups on four different campus sites was undertaken. Four themes identified that affected participants' comfort in this study were: 1) Personal barriers; 2) Human resource barriers; 3) Structural barriers and 4) Suggestions to address barriers. Further understanding of the themes and how they relate to educator comfort with simulation are shared with the reader. The paper also outlines emerging recommendations to improve educator comfort.

Background The aim of this study was to evaluate peer-to-peer facilitated student led mid-level fidelity simulation experiences. Methods Second and third year nursing students (N = 637) were invited to complete a 16-item 6-point Likert scale questionnaire after the simulation experience. Results Students reported high self-confidence in their nursing skills (M = 4.14, SD = 0.92) and a high level of satisfaction in the learning they received during the peer-to-peer facilitated student led simulation experience (M = 4.42, SD = 0.93). Conclusion Using peer-to-peer teaching strategies during student led simulation experience is an effective approach for ensuring active engagement of all learners during midlevel fidelity group-based simulations and has the potential for broad applicability.