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Background: Despite international consensus advocating a physiological approach to childbirth, there are inconsistent opinions on how to acquire the competencies needed to successfully carry out this approach. While continuity of care experiences (CoCE) within placements is a valued educational strategy, there are limited studies that focus on the learning experiences to support physiological birth., Aim: To describe and understand the learning experiences related to physiological birth, as well as the transformations required to become a midwife who supports physiological birth, during the CoCE placement process in a birth centre., Methods: An interpretive description study design was adopted. Data were collected through audio diaries (n=126) with midwifery students and preceptors (n=14) across four level of placements in birth centres, in Québec, Canada, and discussion groups with students who kept the audio diaries., Results: Three main themes were identified: 1) appropriating culture: relational autonomy; 2) developing competencies: acknowledging attitude, enabling behaviours and narrative skills; 3) constructing identity: coherence and resistance., Discussion: The findings demonstrated the importance of CoCE, along with the continuity of preceptorship and a low-tech environment as optimal educational strategies for the acquisition of a culture and competencies that promote physiological childbirth. Resistance is part of identity transformation and represents an opportunity for critical questioning and safe feedback., Conclusion: This study contributes to the understanding of the nature of the competencies developed and the transformations experienced to support physiological childbirth. It recognises the primacy of CoCE within extended placements, embedded in a workplace culture and environment that support relational autonomy., Competing Interests: Conflict of interest None declared., (Copyright © 2024 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Background: Nursing students are often subjected to bullying during their clinical practices, but few study has examined associations of bullying with psychological status among these groups, and how they cope with the bullying., Objectives: This study aimed to evaluate the experience and psychological status of clinical placement setting bullying among nursing students attending clinical practices, and explore students' coping strategies when bullied., Design: A mixed methods., Settings: Six tertiary hospitals in Northwest China., Participants: A total of 687 nursing students completed the questionnaire survey, of which 18 nursing students participated in the qualitative interview., Methods: A two-phase hybrid study was produced. During first phase, data were collected by using the Bullying Behavior Scale in Nursing Education (BNEQ) and the Depression, Anxiety and Stress Scale (DASS-21). Subsequently, those who have experienced bullying in the workplace were invited to participate in a face-to-face interview (second phase) which focused on exploring students' deeper insights., Results: Of the 687 students involved, 72.19 % had experienced various types of bullying. Of them, 92.11 % experienced implicit violence. Those with higher education levels and from rural were more likely to experience bullying. Students were prone to greater psychological stress when exposed to bullying. "Pretending not to see" (33.16 %), "reporting to superiors" (30.10 %), and "doing nothing" were the most common ways students responded. Four themes were obtained from the qualitative interviews: (a) impaired self-esteem; (b) career rejection; (c) psychological stress; and (d) the decline of humanistic care., Conclusion: Our findings suggest that senior nursing students experience multiple types of bullying during the clinical practices, leading to a high level of psychological stress, which further effect students' professional approval and self-esteem. To prevent such incidents, we need to call on university and hospitals' support to help students successfully cope with bullying., Competing Interests: Declaration of competing interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Final year nursing students may experience higher levels of stress owing to the increasing complexity and expectations from their clinical practicums. Enhancing psychological readiness may be a potential strategy to enhance nursing students' transition to the clinical area., Objective: To evaluate the effects of a psychological readiness enhancement for transition to professional practice program and a 10-week clinical practicum on students' psychological wellbeing, resilience, practice readiness and confidence., Design: A sequential mixed-methods approach comprising of a single-group evaluation and descriptive qualitative study., Setting: Final year nursing students enrolled in an undergraduate nursing program from one autonomous university in Singapore was recruited., Participants: 148 final year nursing students participated in the single-group evaluation study. A total of 24 participants who completed the psychological readiness program were recruited in the qualitative study., Methods: This study included two phases. Phase I comprised of an evaluation of a blended psychological readiness program and clinical practicum. Data was collected across three waves to assess nursing students' psychological wellbeing, resilience, practice readiness and confidence. In Phase II, a qualitative study using individual semi-structured online interviews was conducted to examine students' experiences of the psychological readiness program and clinical practicum., Results: The psychological readiness program led to significant changes in students' anxiety and patient centeredness scores. The accumulated effects of the psychological readiness and clinical practicum showed significant improvements in students' practice readiness and confidence. Although there were no significant improvements in depression, stress and resilience scores, there were improvements in the trend across three waves. Students attributed these improvements to the psychological readiness program and sharing by the alumni., Conclusions: The findings of this study laid the foundation for the development of psychological readiness programs. However, larger scale studies using randomized controlled trial designs should be used to confirm the effects of these interventions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Nurses play a crucial role in caring for families of ill individuals in care, requiring high-quality relational and communication skills to care for them. Yet these skills remain underutilized, leading to reported issues of inadequate inclusion and communication. Education is crucial to enhance nurses' competencies in caring for families and informal caregivers., Aim: To explore the learning process of undergraduate nursing students to care for families and informal caregivers., Design: Qualitative study with a grounded theory approach., Settings: Bachelor's degree in nursing from two off-sites of a university and four local health units collaborating with the university in North Italy., Participants: 15 undergraduate nursing students, 10 nurse preceptors, and 10 nurse clinical teachers., Methods: We adopted initial and theoretical sampling and conducted semi-structured interviews from December 2023 to January 2024, lasting 16 to 62 min. The interviews were audio-recorded, transcribed verbatim, and analysed through open, selective, and theoretical coding., Results: We developed a theory of learning for undergraduate nursing students in caring for families and informal caregivers, comprising two themes, "Learning areas" and "Learning antecedents," and nine categories. Learning areas involve five stages of learning to care for families and informal caregivers and the most frequent opportunities to interact with families and informal caregivers. The five stages are "Seeing and considering families and informal caregivers", "Assessing the families' and informal caregivers' needs and resources", "Preparing for and planning intervention with families and informal caregivers", "Acting with families and informal caregivers", "Reflecting on the intervention with families and informal caregivers". Learning antecedents encompass student characteristics, interpersonal relationships, and the clinical training setting., Conclusions: In this study, we delineate a five-stage learning process for undergraduate nursing students to care for families and informal caregivers, influenced by individual, interpersonal, and contextual factors. We emphasised the importance of relational skill development, tailored learning experiences, and supportive mentorship in enhancing students' preparedness to engage with and support families in healthcare settings. The developed theory provides a foundational framework for designing educational interventions to optimise nursing students' capacities in this domain., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Preceptorship is considered an essential component in undergraduate nursing student's clinical placement, especially those in speciality units such as mental health. During the preceptorship relationship students are granted the opportunity to work alongside experienced nurses in the ward observing their interactions with patients and other professionals. In addition, students are able to build clinical confidence and competence. There is currently a gap in the literature around the preceptorship experience in the mental health clinical environment which warrants further exploration. The aim of this study was to explore the experiences of Registered Nurses precepting undergraduate nursing students during mental health clinical placements. A qualitative, exploratory approach was performed. A total of eight registered nurses working in an acute in-patient mental health unit in a large regional hospital, were recruited and interviewed using a semi-structured interview technique. Thematic analysis was utilised to analyse the data resulting in the development of four overarching themes; (1) Time consuming and additional workload, (2) creating a safe environment, (3) providing and receiving feedback and (4) precepting is not a choice, it is an expectation. The results highlighted that preceptoring students was considered to be an extra workload that required significant time and effort. Preceptors also expressed concerns about student safety, emphasised the importance of feedback and acknowledged preceptorship as an expectation of registered nurses working in mental health. These findings underscore the necessity for further research to delve deeper into the experience of preceptors in mental health settings., (© 2024 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Background: Nursing students' learning during clinical practice is largely influenced by the quality of the guidance they receive from their nurse preceptors. Students that have attended placement in nursing home settings have called for more time with nurse preceptors and an opportunity for more help from the nurses for reflection and developing critical thinking skills. To strengthen students' guidance and assessment and enhance students' learning in the practice setting, it has also been recommended to improve the collaboration between faculties and nurse preceptors., Objective: This study explores first-year nursing students' experiences of using the Technology-Optimized Practice Process in Nursing (TOPP-N) application in 4 nursing homes in Norway. TOPP-N was developed to support guidance and assessment in clinical practice in nursing education., Methods: Four focus groups were conducted with 19 nursing students from 2 university campuses in Norway. The data collection and directed content analysis were based on DeLone and McLean's information system success model., Results: Some participants had difficulties learning to use the TOPP-N tool, particularly those who had not attended the 1-hour digital course. Furthermore, participants remarked that the content of the TOPP-N guidance module could be better adjusted to the current clinical placement, level of education, and individual achievements to be more usable. Despite this, most participants liked the TOPP-N application's concept. Using the TOPP-N mobile app for guidance and assessment was found to be very flexible. The frequency and ways of using the application varied among the participants. Most participants perceived that the use of TOPP-N facilitated awareness of learning objectives and enabled continuous reflection and feedback from nurse preceptors. However, the findings indicate that the TOPP-N application's perceived usefulness was highly dependent on the preparedness and use of the app among nurse preceptors (or absence thereof)., Conclusions: This study offers information about critical success factors perceived by nursing students related to the use of the TOPP-N application. To develop similar learning management systems that are usable and efficient, developers should focus on personalizing the content, clarifying procedures for use, and enhancing the training and motivation of users, that is, students, nurse preceptors, and educators., (©Hege Mari Johnsen, Andréa Aparecida Gonçalves Nes, Kristine Haddeland. Originally published in JMIR Nursing (https://nursing.jmir.org), 10.09.2024.)

Background: Nursing students often face challenges reconciling theoretical concepts with clinical realities. This study examines a novel concept 'Communities of Reflection' designed and tested to enhance coherency between theory and practice. The concept involves reflection groups comprising students, preceptors, and faculty during clinical placements., Aim: To examine the meaning of 'Communities of Reflection' regarding the coherency between theory and practice as perceived by the involved participants., Method: A qualitative multi-methods approach involved nursing students, preceptors, and faculty members who participated in 'Communities of Reflection.' Data collection methods included interviews, focus groups, written reflections, and observations., Findings: The content analysis revealed that 'Communities of Reflection' facilitate a shared engagement in nursing, fostering a deeper level of reflection. Creating a safe space and embracing vulnerability are key aspects of this shared engagement., Conclusion: 'Communities of Reflection' offer a valuable framework for promoting coherency between theory and practice. It appears to be crucial to students' outcomes that a well-established, equitable theory-practice partnership is the solid foundation, acknowledging that emotions can serve as a catalyst for the development of professional expertise., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

Background: In Canada, the British Columbia College of Nurses and Midwives requires baccalaureate registered nurse education programs to deliver a generalist curriculum meeting entry-level competencies. To fulfill this requirement, nursing programs ensure the provision of practice opportunities for hands-on experience with patients of all ages through practicum. Current literature suggests the limited availability of clinical placement opportunities in pediatric settings. This may reduce the opportunity for nursing students to become acquainted with the unique needs of infants, children, and adolescents as part of their nursing education., Aim: This study aimed to explore students' and new graduates' experiences of acute and community pediatric clinical practicum as part of their British Columbia nursing education program., Settings, Participants, and Methods: This study utilized a qualitative descriptive approach. Fifteen online semi-structured interviews were conducted with thirteen undergraduate nursing students and two recent graduates. Participants in this study were distributed across the province of British Columbia, representing the North, the Interior, and the Lower Mainland. Data were analyzed using thematic analysis., Results: The key themes of relational practice and exposure to lived experiences (and their related subthemes) are explored in detail. Both themes encapsulate the importance that nursing students ascribe to the pediatric practicum experience as part of their nursing education., Conclusion: The result of this study deduced that the pediatric practicum experience provided nursing students with learning opportunities they may not get elsewhere such as: building relationships with children, adolescents, and their families within the context of care and developing awareness of the lived experiences of health and illness with each patient encounters. This unique perspective of nursing students may prove valuable for the planning and delivery of clinical learning in nursing education programs., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The clinical placement environment plays a pivotal role in shaping the learning experiences and outcomes of nursing students. In this article, the challenges and dynamics within the clinical placement environment are examined, with a particular focus on the role of registered nurse preceptors. The multifaceted nature of the clinical landscape is highlighted with consideration given to the impact on both students and preceptors. Key to the success of any placement is the relationship between nursing students and their preceptors. The quality of this relationship directly influences the learning journey of students, with positive interactions contributing to enhanced learning outcomes and professional growth. However, within the literature, a range of challenges faced by nurse preceptors are captured, including limited support, recognition, and formal training. This lack of preparation and support not only impacts the well-being of preceptors but also compromises the quality of education provided to nursing students. In this article, the complexities of the clinical environment, including high patient acuity, demanding workloads and limited teaching time, are highlighted. If we are serious about preparing quality nurses, then we need to get serious about supporting those who are key to their learning and transition into practice., Competing Interests: Declaration of competing interest The author had no conflict of interest affecting this work., (Copyright © 2024 University of Wollongong. Published by Elsevier Ltd.. All rights reserved.)

The clinical externship program for nursing students was developed and implemented during the COVID-19 pandemic at a multi-site healthcare organization. The program aimed to address the critical shortage of health human resources by hiring qualifying undergraduate nursing and diploma program practical nursing students as unregulated care providers to meet staffing needs. The program incorporated a structured orientation, providing a mix of e-learning modules, in-person learning and shifts with an assigned preceptor. The program also included guidelines to define roles and responsibilities, ensuring safe integration of externs into the healthcare setting. A qualitative study design was employed using semi-structured interviews to explore the perceptions and experiences of the clinical externs (CEs), the extern mentor coordinators and the unit managers involved in the program. Five major themes emerged from the study, including the importance of orientation and the need for increased role clarity. The findings underscore the value of this opportunity both for nursing students as CEs and the broader healthcare system. This study provides valuable insights for nurse leaders aiming to develop or expand clinical externship programs, highlighting their potential to address health human resource challenges and enhance the preparedness and integration of nursing students into the healthcare workforce., (Copyright © 2024 Longwoods Publishing.)

Aims: To review the contemporary international literature on nurse preceptor competencies and map the components and their descriptors., Review Methods: A mapping review., Data Sources: Articles reporting evidence-based and validated Registered Nurse (RN) preceptor competencies published between 2013 and 2022 were identified. Open access databases such as PubMed and Google Scholar and the library healthcare databases Scopus and CINAHL were searched. The authors collaborated at each review stage that included screening, article selection, tabulation, mapping and preparation of findings., Results: Seven quantitative studies were included. Three were based on existing nurse preceptor competency data sets and four were purposely developed using collaborative research methods. Each study validated findings through a survey of nurse stakeholders. Three key competencies shared across all studies were 'facilitating teaching', 'being a role model' and 'evaluating student's performance'. The number of competency categories ranged from three to 10 and the accompanying item descriptors from 9 to 83. Although terminology describing data sets was inconsistent, similarity was seen across competency domains., Conclusion: The contemporary nursing preceptor role is considered an emerging specialist education role. The results offer a set of validated preceptor competency descriptors, applicable to practice, that provide insight into ways employers may recruit, support and retain nurse preceptors., Implications for the Profession: The mapped results provide a concise summary of nurse preceptor competency research internationally that can inform further development of RN preceptors., Impact: This review addresses the lack of consensus around nursing preceptor competencies for clinical supervision of undergraduate nursing students. Seven competency domains were identified describing key preceptor role capabilities. The domains Facilitator', 'Role model' and 'Evaluator' featured across the included studies: 'More than 300 competency descriptors were reported'. Our review results could better prepare RN preceptors for their important role. Employers of RN preceptors could use the results to design performance competencies that may enhance nursing preceptorship., Reporting Method: This review adheres to the PRISMA-ScR EQUATOR guidelines as the recommended reporting method for mapping reviews., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background: The clinical education environment presents a valuable opportunity for students to learn, acquire and develop the clinical skills essential for professional midwifery practice. The presence of competent and relevant preceptors plays a pivotal role in ensuring the success of midwifery students and fostering positive clinical experiences., Aim: This study was conducted to evaluate the clinical practice experiences of midwifery students and their perceptions of midwifery preceptors., Design: A descriptive and cross-sectional study., Methods: This study was conducted with 205 students enrolled in the midwifery department of the Faculty of Health Sciences of a state university in Turkey. Data collection used a participant information form and the Clinical Learning Environment and Midwifery Preceptor Scales designed to assess factors affecting midwifery students' clinical learning. Data analysis was performed using the SPSS 22.0 program, employing methods such as the Independent Sample T-Test, One-Way Analysis of Variance and Tukey test., Results: The average total score on the Clinical Learning Environment scale was 31.08±2.16 out of a possible 32, while the average total score on the Midwifery Preceptors scale was 17.60 (SD 1.27) out of a possible 18. The mean total score of the Midwifery Preceptor Scale and the mean scores of the sub-dimensions of Skill Development and Midwifery Practice Philosophy were found to be statistically significantly higher in those aged 21 years and older than aged 20 years and younger (P < 0.05). The Midwifery Preceptor Scale total score, the Clinical Learning Environment Scale total score and Skill Development sub-dimensions mean scores of the second-year students were found to be statistically significantly higher than the first and third-year students (P <0.05). Furthermore, students who received education in larger groups and willingly chose and had a passion for the midwifery profession demonstrated significant positive perceptions regarding their clinical learning environment experiences and the impact of their preceptors on their professional growth., Conclusions: Understanding the perspectives of midwifery students regarding the clinical education environment, preceptors and the teaching and learning process holds great importance for enhancing the quality of the clinical education environment and fostering the development of clinical competencies among midwifery preceptors., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Preceptorship in nursing has been a valued concept in nursing. Speciality area such as mental health nursing has a massive gap in research study. To develop sturdy mental health nursing workforce, it is necessary to conduct more studies., Aim: This literature review aims to explore preceptor's experience in precepting undergraduate nursing students in mental health., Design: Systematic review of literature., Methods: The systematic review was conducted from January 2021 to August 2021. Population of the studies included Registered Nurses supervising nursing students in the clinical area. Only studies conducted in English were included. A systematic search using EBSCO Host databases, CINAHL Complete, MEDLINE APA Psycinfo & APA PsycArticles, has been used in this review paper. Papers were also selected from the citation reference of included papers. The new version of the PRISMA 2020 guidelines used to represent the process of selection of papers has been incorporated as part of this review. The final set of data included 14 original papers meeting the eligibility criteria which involved quantitative (n = 5), qualitative (n = 4) and mixed-method studies (n = 5)., Result: Results were presented under three major themes: time-consuming, lack of recognition and need extra support. Further research is required in the mental health clinical setting to effectively explore the impact of relationships between preceptors and the preceptees., Conclusion: Preceptors reported supervising students in the clinical area has many benefits. However, some challenges they raised were increase in workload, requiring some guidance and acknowledgement from the organization., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: To describe and compare the clinical learning environment in community-based home care and primary health care in postgraduate district nursing students' education., Design: Cross-sectional study design., Methods: A convenience sample of postgraduate district nursing students was derived from five Swedish universities in 2016 and 2017., Results: The postgraduate district nursing students were generally satisfied with the clinical learning environment in their clinical placement. In clinical placement, several factors affected the students' opportunities to learn, such as sufficiently meaningful learning situations with multidimensional content. A working environment that imposed psychosocial strain and high levels of stress among the staff negatively affected the students' learning. To further improve their learning from clinical practices, the students need preceptors who have the skills and competence required to support more advanced reflections and critical thinking on caring situations., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: The aim of this systematic scoping review is to examine and synthesise the available literature on developing interpersonal and communication skills in general nursing preceptorship education programmes., Background: Highly developed interpersonal and communication skills are an essential component of nursing preceptorship. Preceptors are integral in facilitating, guiding, and developing positive interpersonal relationships between the nursing student (the preceptee), the qualified nurse (the preceptor), and patients. They also have a responsibility to foster and develop preceptees' interpersonal and communication skills and assess and deem preceptees as competent in such skills. Furthermore, preceptors require effective interpersonal and communication skills to carry out key responsibilities of their role, including creating a safe clinical learning environment, teaching, and providing effective feedback., Design: A scoping review was conducted using the methodological framework of Arksey and O'Malley. The PRISMA Extension for Scoping Reviews guided the reporting., Methods: Five electronic databases were searched for relevant articles in consultation with a librarian, supplemented by hand-searching and internet searches for grey literature. A total of 19,431 potentially relevant articles published between Jan 2000 and August 2021 were retrieved from the initial search, and an additional six articles were obtained from the supplemental search. A total of 146 articles were independently reviewed by two researchers, resulting in 24 articles eligible for inclusion in the review., Results: Several themes were identified in the literature that influenced the development of interpersonal and communication skills in preceptorship education and training programmes, including design and development of programmes, key learning outcomes, pedagogical approaches of preceptorship education and training programmes and interpersonal & communication skills development in preceptorship education and training programmes. Conclusions This review highlighted that research on developing interpersonal and communication skills amongst preceptors is mainly absent from the literature. Further research to address these knowledge gaps is warranted. The results from this review can be used to inform future curriculum design and development of nursing preceptorship education and training programmes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: Preceptors support nursing students when transitioning to the professional nursing role. This study explored student perceptions of preceptor characteristics that promoted or hindered learning., Methods: A Likert-scale survey including two open-ended questions was sent to 571 nursing students completing a preceptorship experience. Descriptive statistics were used to analyze responses to the Likert-scale items. Qualitative analysis was completed on the two exploratory questions to extract themes., Results: Students rated the preceptor between 4=Very Good and 5=Outstanding for all items. No significant differences in scores were found when comparing results between programs. Themes assisting in learning included: increasing independence gradually and pushing out of comfort zone. Themes identified that hindered learning included: doubting self and being pushed aside., Conclusions: Future implications include communicating preceptorship objectives and providing ways to apply research to practice. These findings can guide collaboration between academic and practice partners to assist with transition to practice., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Aim: To examine (1) what role preceptors play in students' learning; (2) how student-preceptor relationships can impact students' views of the profession and their decision to leave the program; and (3) what strategies can be used to improve the preceptor-student relationship to facilitate student retention., Research Design and Participants: We used a qualitative methodological approach utilising semi-structure interviews with 31 midwifery students across Canada. Participants were recruited from all midwifery education programs and were in various stages of their educational journey. The interviews were conducted in English and French. Inductive analysis followed Charmaz's guidelines moving from line-by-line to focused coding and development of analytical categories., Findings: The results show that positive relationships with preceptors boosted students' confidence and contributed to the constructive learning experiences among trainees. Students pointed out that their best learning experiences were facilitated by preceptors who created a safe space to make mistakes and were knowledgeable and invested in students' learning. Students also suggested that power imbalance is embedded in student-preceptor relationships and can negatively impact students' learning experiences and their decision to stay in the program., Key Conclusions and Implications for Practice: It is important to consider how to mitigate the power imbalance embedded in preceptor-student relationship. Offering more training to preceptors, oversight of preceptors' mentorship skills by midwifery educators, and creation of ombudsperson's position might mitigate some of the power differential and facilitate students' ability to complete midwifery training., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest., (Copyright © 2022. Published by Elsevier Ltd.)

Aim: The aim of this research is to describe and interpret the experiences of preceptors' in supporting nursing students in a one-to-one model across all semesters of the nursing program., Background: The one-to-one preceptorship model is widely used in Canada during the consolidation phase of a Bachelor of Science in Nursing program. The launch of an innovative two-year second-degree entry accelerated nursing program in partnership with several leading academically based health care delivery institutions in Ontario created a one-to-one preceptorship model that is offered within each semester of a two year nursing program. The literature on preceptorship models within baccalaureate programs suggest that the one-to-one preceptorship model can pose major challenges to nursing preceptors. Balancing the competing demands of providing excellent nursing care for complex patients in today's health care environment with the responsibilities of teaching nursing students were highlighted as major factors of the preceptor experience. Balancing the demands of care provision with the responsibilities of teaching nursing students is shown to be a shared experience among preceptors working with consolidating nursing students. However, a gap exists in understanding how these preceptor experiences unfold with nursing students who attend clinical practicum for nine weeks each semester of the program., Design: This study employs an interpretive descriptive design., Methods: Using a purposeful sampling technique, nine Registered Nurses from one affiliate organization, were invited to 30 - 60 min semi-structured, face to face interviews. Thematic and pattern analysis supported the data analysis., Results: Four major themes emerged: acknowledging expectations to teach, recognizing preceptor needs, balancing the act of nursing and teaching and discovering self through the preceptorship experience. To make the new meaning more accessible, a conceptual interpretation of the themes were transformed into a metaphor that depicts the relationship across the meaning units. The image of a bamboo tree represents both the descriptive and interpretive insights., Conclusion: This study illuminates the role competency of preceptors involved in a one-to-one preceptored model in a second-degree accelerated nursing program. A continued use of a one to one preceptor model within each semester of a two-year program serves as a platform to foster cognitive companionship, clinical teaching and experiential learning opportunities., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Introduction: Clinical teaching is essential for undergraduate nursing and midwifery students. Registered nurses/midwives trained as preceptors (an experienced nursing/midwifery professional who teaches, supervises and serves as a role model for a student) , guide the students during clinical practices. Literature is scanty on the roles and experiences of the preceptors in Malawi. This study explored the roles and experiences of preceptors during clinical teaching of the students., Methods: A cross-sectional study utilising quantitative research design was conducted at four tertiary level hospitals; a mental hospital; one mission hospital and five district hospitals. A total of 87 preceptors completed a Clinical Preceptor Experience Evaluation Tool. Data were analysed using SPSS version 20 and descriptive statistics were computed. Analysis of variance (ANOVA) and post hoc analysis were used to determine and test significant differences., Results: The study revealed that respondents were confident in performing their preceptor role; with good level of experience and education qualification of BSc in Nursing. ANOVA and post hoc comparisons using the Tukey HSD test indicated that the role domain mean scores for the respondents with 4-5 years of post-registration experience (M = 6.61, SD = 0.36) was significantly different (p=0.02) with those with >9 years (M = 6.13, SD = 0.60). The results showed that respondents with 4 -5 years experience were more confident in their preceptorship role than those with >9 years., Conclusion: This study indicates the roles of preceptors in Malawi to involve facilitating students' clinical teaching and learning. It suggests that registered nurses/midwives with a BSc in Nursing are suitable preceptors to facilitate students' clinical teaching and learning. There is revelation that preceptors with more years of post-registration experience are less confident in their preceptorship role performance., (© 2021 The College of Medicine and the Medical Association of Malawi.)

Background: Despite the wide use of preceptorship, there is evidence that preceptorship and the role of preceptor in clinical nursing education are not clearly understood or supported., Objectives: To develop a preceptorship model to facilitate clinical nursing education in Botswana., Method: The model development in this study followed the steps of theory generation as described by Chinn and Kramer. These four steps are concept analysis, relationship statements, description and critical reflection of the model., Results: Four main themes emerged from the empirical study that formed the basis for key concepts and model development. The model has six components, namely, agent, recipient, context, procedure, dynamics and terminus. The description of the model is based on Chinn and Kramer., Conclusion: The need for a preceptorship model to facilitate preceptorship cannot be overemphasised in this regard. This model will guide the planning and implementation of preceptorship procedures by different stakeholders to improve its effectiveness in clinical nursing education.

Objectives: To explore and describe the preferred model of practice and first job decisions of final stage midwifery students from three Western Australian universities., Design: Qualitative descriptive., Setting: Three Western Australian (WA) universities offering courses leading to registration as a midwife., Participants: Twenty-seven midwifery students from undergraduate and postgraduate (pre-registration) courses., Methods: Data were collected from recorded interviews and focus groups. Thematic analysis of interview transcripts was used to identify commonalities. Data saturation guided when recruitment ceased and final sample size was achieved., Findings: Participants' preferred model of maternity care was influenced by learning about and witnessing both autonomous midwifery practice and collaborative care during their studies. The greatest influence was clinical experience, with most preferring a continuity of midwifery model (CoM) but first consolidating their practice in a public hospital. Most students reported that they would not choose a private hospital as their first option. Work/life balance was also considered, with some accepting that family commitments and a need to work close to home may prevent them from choosing a CoM model., Conclusion and Implications: Although many Australian midwifery students start their midwifery course with preconceived ideology of their eventual workplace, the influences of their educators, clinical placement environment, preceptors and continuity of care experience relationships with women helped determine their final direction. To provide students with the experiences to become woman-centred autonomous practitioners it is important for universities and all maternity care providers to carefully consider their responsibility in how they influence midwifery students in education and practice., (Copyright © 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Abstract: A significant increase in nurse practitioner program enrollment has resulted in a critical need for committed preceptors willing to offer clinical learning opportunities for students. Academic practice partnerships have been proposed as a strategy to address the preceptorship crisis. This project evaluated the impact of a longitudinal immersive clinical experience designed for nurse practitioner students in collaboration with two federally qualified health centers and an underserved clinic within an academic health center. The study used a pre- and postsurvey method to determine the impact of an immersive clinical experience on preceptor perceptions of benefits and rewards, support, and commitment to the role. A statistically significant increase in preceptor perception of support was noted in three areas. Participants reported increased opportunity to share information with other preceptors, improved support from nursing faculty to help identify students' performance problems, and greater clarity in faculty responsibilities related to the preceptor role. Increases in perceptions of benefits and rewards and commitment to the preceptor role did not reach statistical significance. Immersive clinical experiences have the potential to improve the levels of preceptor support, commitment, and perceived opportunities for benefits and rewards, which may facilitate the development of high-quality, sustainable clinical learning opportunities for nurse practitioner students., Competing Interests: Competing interests: The authors report no conflicts of interest., (Copyright © 2019 American Association of Nurse Practitioners.)

Background: The dynamics of maternal and newborn care challenge midwifery education programs to keep up-to-date. To prepare for their professional role in a changing world, role models are important agents for student learning., Objective: To explore the ways in which Dutch and Icelandic midwifery students identify role models in contemporary midwifery education., Methods: We conducted a descriptive, qualitative study between August 2017 and October 2018. In the Netherlands, 27 students participated in four focus groups and a further eight in individual interviews. In Iceland, five students participated in one focus group and a further four in individual interviews. All students had clinical experience in primary care and hospital. Data were analyzed using inductive content analysis., Results: During their education, midwifery students identify people with attitudes and behaviors they appreciate. Students assimilate these attitudes and behaviors into a role model that represents their 'ideal midwife', who they can aspire to during their education. Positive role models portrayed woman-centered care, while students identified that negative role models displayed behaviors not fitting with good care. Students emphasized that they learnt not only by doing, they found storytelling and observing important aspects of role modelling. Students acknowledged the impact of positive midwifery role models on their trust in physiological childbirth and future style of practice., Conclusion: Role models contribute to the development of students' skills, attitudes, behaviors, identity as midwife and trust in physiological childbirth. More explicit and critical attention to how and what students learn from role models can enrich the education program., (Copyright © 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Background: Obesity is considered a growing epidemic in the United States. Nurse practitioners (NPs) have the opportunity to serve as leaders in addressing concerns related to disease management, particularly obesity. Currently, we lack an awareness of how NP students are learning obesity management from their preceptors., Purpose: Thus, the current study sought to explore how NP students perceive preceptors' behaviors when managing patients with obesity., Methodological Orientation: This study used a mixed-methods design. Participants were asked to report how often they observed their preceptors engage in different strategies when interacting with patients with obesity (e.g., calculate body mass index, identify goals). Students were then asked to respond to the statement: "share observations you made of how patients with obesity were treated in this environment." Students completed 2 clinical rotations during this period and, thus, were asked to answer the questions twice to capture experiences at both clinical sites., Sample: Researchers surveyed 225 NP students completing clinical rotations in 3 settings (Family Practice, Pediatrics, and Obstetrics/Gynecology)., Conclusions: Quantitative results revealed significant differences in the frequency of observed obesity management behaviors by all preceptors. Qualitative results revealed that NP students most often observed preceptors displaying interpersonal warmth without weight bias when working with patients with obesity. Contrary to current literature, this sample of NP students observed their preceptors engaging in positive interactions with individuals with obesity., Implications for Practice: Educators must continue to teach students to engage in unbiased behavior toward patients. It is critical to continue to improve obesity management content offered in NP programs.

Objective: To explore the teaching and learning experience of midwifery mentors and student midwives in a midwifery led unit. The aim of this paper is to discuss how a conceptual framework emerged from the findings of the study., Design and Method: Ethnography. Non-participant observation of the daily work of an alongside midwifery led unit (AMU) over 14 months, and direct observation of episodes of care involving ten dyads of midwifery mentors and student midwife dyads. These observations were followed by individual semi structured interviews with participants., Setting: An alongside midwifery led unit in a Health Board in Wales, UK. This is an option for place of birth in the National Health Service in the UK., Sample: Ten dyads of midwifery mentors and student midwives., Findings: A conceptual framework emerged from the data in relation to the powerfully shared goals and ethos of the midwives working in this AMU. The framework gave shape and form to the particular nature of the teaching and learning experience in the midwifery led setting. The concept of a community of practice, firmly rooted in the authoritative knowledge and understanding of physiological birth, resulted in positive working practices and happy, motivated midwives who enhanced the birth experience for women. This supported the clinical and socially situated learning of student midwives and new colleagues through legitimate peripheral participation., Implications for Practice, Policy, Education and Research: Positive, committed and autonomous midwives make for a nurturing working environment and may therefore enhance the experience of birthing women. Midwives need to be able to work in an environment and community of practice which mirrors their own philosophy of care to promote professional wellbeing, and to develop the expert knowledge and skill in that area of practice over time., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2020. Published by Elsevier Ltd.)

Clinical placements in correctional settings offer nursing students unique opportunities for learning mental health and community health concepts, including social justice, restorative justice and the impact of poverty and marginalization on health and life choices. Although there is some evidence to suggest that a small number of nursing programs use clinical placements in correctional settings, relatively little scholarly literature addresses nursing education in such settings, or the implications for nursing leadership when students do have an opportunity to learn in correctional settings. In this paper, we examine the literature that is available on this topic and present the findings of a secondary analysis of interviews with undergraduate nursing students at our nursing program in relation to their clinical placements in correctional settings. Drawing on the students' perspectives, we have found that these placements, in particular, have fostered learning about caring for marginalized populations; themes of hope and restorative justice featured prominently in their descriptions of their learning. Students also emphasized that they learned a great deal about the expanded role of nurses and about caring for marginalized populations. With strong administrative and faculty support, these settings offer students exposure to expert registered nurse mentors who work with clients in an expanded role to facilitate their achievement and stabilization of a broad range of health challenges. They are also role models for students, by showing students that nurses can be agents of hope when working with a diverse client population and their families. We offer recommendations on how to maximize student learning in correctional settings, including a reflection on how to support students' integration of their learning experiences in their nursing practice, with the long-term view that these transformative student experiences have the potential to shape our future nurse leaders., (Copyright © 2020 Longwoods Publishing.)

Background: Mentoring in clinical settings is an important factor in the development of nursing students' professional knowledge and competences, but more knowledge of mentors' current and required competences is needed to improve nursing students' clinical learning., Objectives: This study aimed to develop and test an evidence-based model of mentoring nursing students in clinical practice., Design: An international cross-sectional survey coordinated in five European countries: Finland, Italy, Lithuania, Slovenia and Spain., Methods: Mentors, 4980 registered nurses working in both primary and specialist healthcare organizations, were invited to participate in the study during 2016-2019. The final sample consisted of 1360 mentors (mean age 41.9 ± 11). Data were collected with background questions and the Mentor Competence Instrument. The instrument was psychometrically validated then the data were used to construct a Structural Equation Model (SEM) with Full Imputation Maximum Likelihood (FIML) estimation., Results: All of six hypotheses were verified. In summary: mentors' characteristics related to their motivation and reflection are positively related to mentoring practices in the workplace, which (together with constructive feedback) are positively related to and foster goal-orientation in students' clinical learning and student-centered evaluation. All parameters in the SEM model were significant and the model's fit indexes were verified (RMSEA = 0.055; SRMR = 0.083; CFI = 0.914, TLI = 0.909)., Conclusion: Our evidence-based modeling confirms the research hypotheses about mentorship, and identifies focal competences for designing mentors' education to improve students' clinical learning and establish a common European mentoring model. Mentorship is important for both healthcare organizations and educational systems to enhance students' clinical competences, professional growth and commitment to the nursing profession and organizational environments., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: There are challenges in creating positive clinical learning environments. A new model of practice learning for pre-registration nurse education was pilot-tested in the East of England. The Collaborative Learning in Practice model (CLIP) was developed from a similar model of practice learning used in the Netherlands., Objectives: We undertook an evaluation of a new approach to clinical learning. The aims of the project were to consider the challenges of implementation; consider the perception of gains and losses of students and stakeholders experiencing the new model of practice learning; and consider the sustainability of the new model in the context of service delivery., Methods: Mixed methods were used. Data were collected in three forms: (1) a survey of students undertaking the CLIP model and those learning within the existing mentorship model to assess the supervisory relationships and pedagogical atmosphere experienced; (2) student focus groups; and (3) qualitative one-to-one interviews with key stakeholders in the provision of practice learning environments., Results: A total of 607 questionnaires were returned out of the 738 distributed, five focus groups of a total of 30 students were undertaken, and 13 stakeholders were interviewed. Students who had experienced CLIP reported lower supervisory relationship scores compared with those without experience (mean difference = -0.24 points, 95% CI -0.21 to -0.094, p = 0.001). There was no difference in pedagogical atmosphere scores (mean difference -0.085 points, 95% CI -0.21 to 0.040, p = 0.19). Analysis of qualitative data produced two themes: 'Adapting the environment' illustrated the importance of learning context and 'learning to fly' highlighted the process of students gaining greater autonomy., Conclusion: Our findings suggest that collaborative learning in practice offers many benefits as an approach to clinical learning but with important caveats. Attention needs to be paid to particular aspects of the model such as sufficient numbers of students, and an acknowledgement of perceived losses as well as gains., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Theory and clinical practicum in mental health are an important component for students in most nursing curriculum. Some studies have shown that knowledge and confidence in caring for people with mental illness improve after mental health clinical placements while others had contrasting results. Our study examined the relationship between clinical placement, confidence and stigma surrounding mental illness. We undertook a cross-sectional, descriptive correlational study in a sample of 144 undergraduate nursing students in Singapore who had completed their theoretical and clinical practicum in mental health using the Clinical Placement Survey Clinical Confidence Scale and Social Distance Scale. Descriptive, correlations and multiple regression were used to analyse the data. The results showed the mean scores for the social distance scale, clinical confidence scale and clinical placement survey were 19.92 out of 35, 49.29 out of 80 and 103.43 out of 154 respectively. Attitudes toward clinical placement experiences were significantly correlated with both stigmatising attitudes and clinical confidence of which, intentions of working in mental health settings were specifically significantly associated with stigmatising attitudes and attitudes toward clinical placement experiences, with emphasis on greater sense of preparedness, lesser perceived anxiety and greater preference for a future career in mental health nursing. This study highlighted the need to improve current mental health clinical placements to better build nursing students' confidence in caring for mentally ill patients. The interest toward specialising in mental health nursing is still lacking in nursing undergraduate students despite mental health clinical placements., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The aim of this study was to explore the stressors and coping of nursing students with differing levels of resilience and burnout during clinical placement. A qualitative descriptive study was conducted with twenty-four final-year baccalaureate nursing students, who were identified in the quantitative phase of the study as having scores indicating either: a) low resilience and high burnout; or b) high resilience and low burnout. Ten focus group interviews were conducted using a semi-structured interview guide. A thematic analysis of the data identified two main themes: a) stressors arising from the students aligning their expectations with the demands of the clinical placement (i.e., practice demands in busy wards, striving for learning opportunities, and discovering the social rules), and b) coping as a process of fitting into the ward culture. Those students with high resilience and low burnout scores had self-directed goals and coped by using self-regulation strategies. Those with low resilience and high burnout adopted external orientation and self-blame strategies. As suggested by the findings, the following approaches are recommended: offering interventions to enable students to fit actively into the clinical environment; encouraging engagement in reflection to facilitate self-awareness; and encouraging flexible use of personal and external resources., Competing Interests: Declaration of competing interest (1) There is no conflict of interest. (2) This study was funded by the Sigma Theta Tau International Honor Society of Nursing through Sigma Theta Tau International Small Grants. (3) Ethical approval to conduct this study was obtained from Human Subjects Ethics Application Review System of The Hong Kong Polytechnic University (Reference number HSEARS20140719001)., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The National Organization of Nurse Practitioner Faculties and the American Association of Nurse Practitioners collaborated to develop a document outlining expectations when establishing clinical experiences for nurse practitioner (NP) students. A literature review explored the beliefs of clinical preceptors and NP faculty in relation to the process of the establishment and completion of successful clinical experiences. From the literature, the development of two guidance checklists addressed the expectations and responsibilities of the NP faculty and clinical preceptor during the clinical placement process. In light of challenges to secure clinical sites for NP students, it is imperative that the clinical placement process is standardized and the communicative pathway between the NP faculty and clinical preceptor improved.

: This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students and new graduates to apply knowledge in clinical settings. Instructors often seek to link theory with practice during the postclinical conference, but little is known about the most effective methods of doing so. Debriefing, which is an approach primarily associated with simulation-based learning, encourages students to reflect on and improve performance. This article examines various debriefing methods and describes scenarios in which clinical instructors can utilize this approach to improve the effectiveness of the postclinical conference.

Background: Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered., Research Aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors., Research Design: An Italian national cross-sectional study design was performed in 2015-2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 - 'never' to 3 - 'very much')., Participants and Research Context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions., Ethical Considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee., Findings: Overall, 4707 (49%) perceived to have discussed ethical issues 'much' or 'very much'; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, 'enough' or 'never' ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues., Conclusion: Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice.

Background: Student nurse attendance during training is mandatory, and the South African Nursing Council (SANC) stipulates that students must attend 80% of hours for both theory and practice during their training. Unauthorised student nurse absenteeism, especially in the clinical areas, has become an increasing problem in nursing education institutions and in the universities. This study explored student absenteeism with the aim of generating solutions that are specifically relevant to the context of the Free State College of Nursing., Objectives: The objectives of the study were to describe perceived personal reasons and reasons related to clinical areas that contribute to student nurses' absenteeism from the clinical areas and to explore the relationship between demographic data and reasons for absenteeism., Method: A quantitative research design with descriptive and exploratory strategies was used. Data were collected by means of a self-administered questionnaire. Data analysis was performed using SPSS version 23.0. One hundred and fifty-two student nurses were sampled after permission to conduct the study was requested and obtained., Results: The results showed that 72.4% of respondents agreed that students are absent because of physical illness. The majority of students (97.3%) at the selected campus are absent from clinical areas because they are covering staff shortages. The findings showed no particular relationship between gender and absenteeism as absenteeism was present throughout., Conclusion: Student nurses at a selected campus are generally absent at the clinical areas because they are physically ill and are funded for studying but not paid for working. It was recommended that accurate records of attendance should be kept and absenteeism rates be calculated at frequent intervals.

Background: Providing adequate and quality clinical training to student nurses is a major issue in nursing education. In the Middle East, this issue is more prominent because providing intimate healthcare to women in maternity nursing, especially by male nursing students, remains a challenge., Purpose: This study compared the effects of a combination of traditional clinical training with high-fidelity simulation (TCT+HFS) activities vs TCT alone on the clinical competency and knowledge among students enrolled in a maternity nursing course in a Middle Eastern public university., Method: A quasi-experimental research design was adopted in the study. The sample consisted of 74 students (40 in the TCT group and 34 in the TCT+HFS group) from a cohort of nursing students in a Middle Eastern university. The Creighton Competency Evaluation Instrument and a 29-item, researcher-designed knowledge scale was used to measure the relevant outcomes., Results: No significant difference was observed in the knowledge (F = 1.064, P = 0.306) or clinical competency scores (F = 0.168, P = 0.683) between the TCT+HFS group and the TCT group., Conclusion: Substituting 25% of the clinical hours with HFS may yield similar learning outcomes (knowledge and clinical competency) as TCT., (© 2019 Wiley Periodicals, Inc.)

Background: Assessment of clinical practice is a core component of midwifery education. Clinical assessment is challenging and affected by a number of factors. Preceptor midwives are reported to be reluctant to fail students in clinical assessments. This is worrying as preceptor midwives are gatekeepers to the profession of midwifery and need to ensure midwifery students are safe and competent practitioners of midwifery on completion of their programmes., Methods: This qualitative descriptive study explores preceptor midwives experiences of clinical assessment of midwifery students in four maternity units in the Republic of Ireland. Following ethical approval, twenty-nine preceptor midwives were interviewed. Content analysis was used to analyse the data and two themes with associated subthemes identified., Findings: Competency assessment in practice was supported by a robust, clearly delineated process, considered vital to ensure effective and fair assessment of midwifery students. The process in place had many advantages but attracted some criticism too, most notably language, documentation and lack of continuity of the preceptor. The challenges of clinical assessment were multifaceted but the most pressing concern was dealing with students who were struggling in practice where the outcome of an assessment was potentially a fail. Preceptor midwives expressed reluctance to fail students but balanced this with ensuring safety for women and their babies. A number of other challenges hampered decisions in clinical assessments. These included the confidence of the preceptor, juggling the competing demands of clinical practice with effective assessment in an increasingly complex and fiscally challenging environment, operationalising the competency assessment process and the emotional toll associated with failing a student., Conclusion: Preceptors' primary focus is on ensuring that graduate midwives are safe and competent practitioners and it is this which guides their decision making on the outcome of clinical assessments. However, more support is required for the onerous responsibility of clinical assessment, particularly for less experienced midwives but also when failure of clinical assessment is a potential outcome. Preceptorship needs to be valued more at a strategic level., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Research concerning this issue demonstrates that nursing students initially feared interacting with and caring for patients with suicidal tendencies. However, there is a lack of research, which examines the care that is provided to patients that are suicidal, by nursing students. The aim of this study was to develop a theory to guide nursing students when caring for patients with suicidal tendencies on their psychiatric clinical practicum. A qualitative approach using Grounded Theory was used. A total of 22 nursing students who had provided care for suicidal patients were interviewed. The core category that emerged from the data was the 'changing of mindsets towards caring for suicidal patients and promotion of suicidal care competencies'. Other key categories linked to and enfolded within this core category were: suicidal risk assessment; protecting patients' safety; and, developing therapeutic communication competencies to advance suicidal care. This study could help fill a theory-practice gap for both psychiatric nursing teachers and students. Nurse teachers could use this theory as a map to help guide students caring for patients with suicidal tendencies and develop nursing students' suicidal care competencies., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Bullying in nursing is not a new phenomenon and nursing students are not exempt from its effects, however there is limited literature that deals directly with bullying of nursing students within the clinical environment in New Zealand. Quality clinical placements are vital to facilitate the link between theory and practice whilst working in complex healthcare settings., Aim: The purpose of this article is to present the experiences described by nursing students regarding the nature and extent of bullying during clinical placements., Design: This study employed a cross-sectional survey design using an electronic survey in which this paper focuses on the textual data provided by nursing students from across New Zealand. Data was analysed by coding and grouping into themes., Results: There were numerous uncivil behaviours students were subject to during clinical placements. The consequences of these behaviours had physical, psychological and financial implications for students, with some suggestions that they choose to leave the nursing profession., Conclusions: Predominantly the practice setting is clearly not nurturing enough for nursing students; a situation unlikely to change in the near future. Hence academic institutions must be proactive in developing students' ability to address incivility in these environments and to educate their own staff on how to recognise and respond to bullying in the clinical arena., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Effective performance of clinical handovers should be one of the priorities of nursing education to promote efficient communication skills and ensure patient safety. However, to date, no studies have explored to what extent nursing students are involved in handovers., Objective: To explore nursing students' handover involvement during their clinical rotations and associated factors., Method: This was a secondary analysis of a large national cross-sectional study that involved 9607 undergraduate nursing students in 27 universities across 95 three-year Italian baccalaureate nursing programs. The involvement in the clinical handovers was the end point (from 0, never, to 3, always). A path analysis was performed to identify variables directly and indirectly affecting students' handover involvement., Results: Handover involvement was reported as 'only a little', 'to some extent', and 'always' by 1739 (18.1%), 2939 (30.6%), and 4180 (43.5%) students, respectively; only 749 (7.8%) of students reported never being involved. At the path analysis explaining the 19.1% of variance of nursing students' involvement, some variables emerged that directly increased the likelihood of being involved in handovers. These were being female (β = 0.115, p < 0.001); having children (β = 0.107, p = 0.011); being a 3rd-year student (β = 0.142, p < 0.001) and being a 2nd-year student as compared to a 1st-year student (β = 0.050, p = 0.036); and having a longer clinical rotation (β = 0.015, p < 0.001) in units with high 'quality of the learning environment' (β = 0.279, p < 0.001). Moreover, students who were supervised by the nurse teacher (β = -0.279, p < 0.001), or by a nurse on a daily basis (β = -0.253, p = 0.004), or by the staff (β = -0.190, p < 0.001) reported being less involved in handovers as compared to those students supervised by a clinical nurse. Variables with indirect effects also emerged (model of student's supervision adopted at the unit level, and number of previous clinical rotations attended by students). Moreover, handover involvement explained 11.5% of students self-reported degree of competences learned during the clinical experience., Conclusions: Limiting students' opportunity to be involved in handover can prevent the development of communication skills and the professional socialization processes. Strategies at different levels are needed to promote handover among undergraduate nursing students., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The nursing profession struggles with providing a bridge to close the theory to practice gap for students. Students are expected to graduate with competencies that promote their safe and comprehensive nursing care provision in accordance with professional standards. This paper reports on students' a simulated clinical educational intervention embedded into a second-year nursing student clinical topic offering experiential learning opportunities for a large cohort. Feedback was analysed using Braun and Clarke's (2006) thematic qualitative process to investigate student-learning experiences and present student perceptions of this experience. Three key themes were identified: support promoted learning, focus on the bigger picture and practice clarifies puzzle pieces. Students perceived the simulated clinical experience as beneficial to their confidence, learning and ability to develop their professional practice. Promotion of learning outcomes facilitated by the structured, supportive and educational approach was important for students. Nurse educators have a responsibility to develop learning experiences that enable student's ability to link theory to practice in context. Ongoing exploration and evaluation of this intervention is required however, such an approach appears to support student's knowledge development for transference across situations and within large student cohorts., (Copyright © 2019. Published by Elsevier Ltd.)

Despite efforts to increase patient safety, medical incidents and near misses occur daily. Much is still unknown about this phenomenon, especially due to underreporting. This study examined why nursing students and clinical instructors underreport medical events, and whether they believe that changes within their institutions could increase reporting. 103 third- and fourth-year nursing students and 55 clinical instructors completed a validated questionnaire. The results showed that about one-third of the instructors and one-half of the nursing students believed that circumstances and lack of awareness, and fear of consequences, lead to underreporting. Both nursing students and clinical instructors ranked "fear of consequences" as the main reason for not reporting, yet students ranked this higher than their instructors. Moreover, both groups believed that incident reporting could be increased following changes in the clinical field, mainly by increasing awareness and knowledge. A large percentage of participants also wrote that they do not report errors that are the result of circumstances and lack of awareness, mainly fear of consequences. Therefore, hospitals and academic institutions may need to create a more accepting organizational climate. Moreover, institutions that allow incident reports to be submitted anonymously and that take educational (not disciplinary) action, may increase incident reporting., (Copyright © 2019. Published by Elsevier Ltd.)

Assessment of students' learning and achievement requires active involvement of participating students, preceptors and lecturers. The lecturers have overall responsibility for both the content of the assessment and students' learning. The aim of the present study was to investigate lecturers' reflections on the mid-course discussion and final assessment that are part of nursing students' clinical practice education. The design was descriptive and had a qualitative approach. Repeated group discussions were undertaken with 14 lecturers at two university campuses in Norway. Five categories were identified: preparing for the three-part discussion, creating a collaborative atmosphere, facilitating student learning, verifying student learning, using the assessment tool to create the assessment discussion; one theme emerged: 'being able to see and justify students' learning processes'. Lecturers' reflections on both assessment discussions and students' learning proceeded from a clear pedagogical viewpoint., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background and Purpose: Clinical preceptors are vital partners in the education of nurse practitioner (NP) students. This article describes NP student learning stages and proposes strategies preceptors can use to facilitate precepting NP students who enter clinical rotations at varied learner levels., Methods: Searches were conducted in the Cumulative Index to Nursing and Allied Health Literature and PubMed and EBSCOhost interfaces to MEDLINE using terms related to NPs, students, higher education, and preceptorship. Because only 10 publications met the inclusion criteria focusing on precepting NP students at different levels, literature from related health fields are included in the discussion., Conclusions: Benner's Novice to Expert Model is applied to NP education in primary care settings to describe the clinical levels of learning. Clinical teaching methods that focus on either preceptor- or student-led communication are described, followed by a discussion of the association between methods and levels of learners., Implications for Practice: Nurse practitioners who precept NP students at various levels of their clinical learning can apply specific teaching methods that are delineated in this article. By recognizing the unique needs of NP students at different levels, preceptors can help facilitate their experiential learning.

Research demonstrates that basic nursing care receives less attention in clinical settings and has become visually less prominent in nursing education curriculums. While much is known about the importance of preceptorship in clinical settings, little is known about how preceptors teach basic nursing care to students in a school simulation lab. This study explores the preceptors' perceptions of teaching basic nursing care to nursing students in the school simulation lab compared to clinical settings. Data were collected through focus group interviews and participant observation and analyzed by using qualitative content analysis. Three main categories emerged: (i) Perceived advantages and disadvantages, (ii) Positive attitudes - remembering being a student, and (iii) Knowing what to do and showing how to do it. Awareness of the importance of having knowledge about basic nursing care may contribute to counterbalancing the devaluation of basic nursing care among nursing students.

Objective: to analyze factors associated with nursing students' errors during clinical learning, and their perceptions regarding these events and the opportunity for learning and development provided by them., Method: Convergent Mixed Method design according Creswell and Clark. Qualitative dimension included face to face and internet interviews. Data analysis followed Miles and Huberman method., Results: Nursing student's errors were revealed according to their perceptions. They occurred in all phases of the nursing process and in transversal skills. Errors were acknowledged as learning and developmental opportunities., Final Considerations: Students acknowledged their errors and ascribe to themselves reasons and what could have prevented what happened. Mixed Method was a very adequate design to study phenomena. Qualitative dimension was essential to reveal and achieve the objectives. Suggestions founded on the findings are presented.

The aim of this study was to describe the perceptions of nurse preceptors of nursing students and new graduate nurses with learning disabilities in clinical settings. Learning disabilities pose potential challenges in nursing education, especially in clinical settings when working with preceptors. Preceptors (N = 166) who attended a state-wide preceptor workshop responded to an electronic survey that assessed their perceptions. Four concepts were explored: preceptor perceived level of preparedness; preceptor perceived confidence in implementation of their role; preceptor beliefs regarding the potential of learners with learning disabilities; and preceptor agreement with provision of accommodations for learners with learning disabilities. Preceptors felt unprepared and lacked confidence in their ability to implement their role as preceptor for those with learning disabilities. Those who had exposure to learning disabilities reported feeling more prepared, however they had expectations for the learner to work hard, have strategies and accommodations in place, ask for help when needed, and take responsibility for their learning. Preceptors reported they are willing to precept nurses with learning disabilities, and they expect support for those with learning disabilities. Educational modules and support to increase preceptor preparedness and confidence should be incorporated into preceptor training., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Student nurses maintain unfavorable views of people with mental health issues. Many continue to perpetuate common stereotypes, are fearful and believe people with mental health problems are in some way dangerous. The impact of placements greatly affects these views. A pre-post survey of 85 student nurses was conducted to establish the opinions and attitudes of student nurses regarding mental health. Groups were allocated to either community or hospital placements. Each group received the same educational preparation prior to placement. Both community and hospital placed students had improved clinical confidence when working with people experiencing mental health problems. Community placed students demonstrated greater positive attitudes towards people experiencing mental health issues across a number of domains. Students in hospital settings demonstrated more confidence when working with people with mental health issues yet had less attitudinal change about mental health. The approach taken by clinical facilitators also influenced student attitudes. It is suggested that offering community opportunities along with exposure to positive instructor beliefs about mental illness will both improve student attitudes prior to the completion of their nursing studies and may encourage entry into mental health as a nursing option post-education., (Copyright © 2018. Published by Elsevier Ltd.)

Schools of Nursing have witnessed an increase in the number of nursing students who struggle with learning difficulties. Support and accommodations are available in academic settings. Because nursing is a practice profession students also learn in clinical settings, which may not have similar support and accommodations. The compatibility of the clinical setting for the education of students with learning difficulties has not been studied. Staff nurses responsible for the clinical education of students and new nurses receive little preparation for their role as educator, and may not feel supported to meet the needs of those with learning difficulties. This is part one in a series of articles about the clinical education of nursing students with learning difficulties. This paper provides a framework and literature review for the development of a study (part 2) exploring the issue from the perspective of the nurse preceptors who educate students and new graduates with learning difficulties., (Copyright © 2018. Published by Elsevier Ltd.)